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Adherence to guideline-directed hepatocellular carcinoma screening:A single-center US experience

World Journal of Hepatology 2023年第3期15卷 410-418页

作者： William W King Raymond Richhart Tyler Culpepper Maneola Mota debdeep banerjee Media Ismael Joydeep Chakraborty Michael Ladna Walid Khan Nicole Ruiz Jake Wilson Ellery Altshuler Virginia Clark Roniel Cabrera Department of Medicine University of FloridaGainesvilleFL 32610United States Department of Gastroenterology University of FloridaGainesvilleFL 32610United States Department of Hospital Medicine University of FloridaGainesvilleFL 32610United States

BACKGROUND The American Association for the Study of Liver Disease recommends screening patients with cirrhosis for hepatocellular carcinoma(HCC)using imaging with or without alpha-fetoprotein every six ***,screening rates remain *** To assess root causes of screening failure in a subspecialty hepatology *** The authors identified patients with cirrhosis seen in a subspecialty hepatology clinic and determined whether they underwent appropriate screening,defined as two cross-sectional images between five and seven months *** authors characterized the primary driver of screening ***,other hepatologists were surveyed to determine provider perceptions of screening failure *** 1034 patients were identified with an average age of 61 years and a mean MELD of 8.1±*** C virus was the most common cirrhosis etiology.489(47%)underwent appropriate *** demographic or clinical differences were detected between those who underwent appropriate screening and those who did *** most common etiologies of screening failure,in descending order,were:radiology unable to schedule timely imaging,provider did not order imaging,patient canceled follow up appointment,appointments scheduled too far apart,lost to follow up,no-show to radiology appointment,and provider canceled *** surveyed believed the most common cause of screening failure was no-show to *** Rates of screening were poor even in a subspecialty hepatology *** failure was mostly due to systemic factors such as radiology availability and time between hepatology appointments rather than individual error.

关键词： Hepatocellular carcinoma Cirrhosis Health maintenance Quality improvement Screening Hepatology

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