Evidence map›Paper›PMID 28352941›Full record

Observational studyDiabetologia2017

EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral?

Emilie Blond, Emmanuel Disse, Charlotte Cuerq, Jocelyne Drai, Pierre-Jean Valette, Martine Laville, Charles Thivolet, Chantal Simon, Cyrielle Caussy

Registry-linked trialOpen access · bronzeAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Diabetologia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06132477 (Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric), which is not on this map. Cited by 58 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 1 pooled it
8.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06132477 phase4recruitingstarted 2024, after this paper: background citation

Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric

Ran2024Enrolled150Registered outcomes5Posted comparisons0ConditionsDiabetes Mellitus, Hypertension, Metabolic Syndrome, Morbid ObesityArmsGLP-1 receptor agonist
Open the trial in the graph
3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 1 synthesis or guideline pooled it, 123 citations in OpenAlex.

  1. Pooled it
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  7. Elevated LECT2 and PEDF in Pediatric MAFLD: Diagnostic Performance and Metabolic Correlations.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Emilie BlondBiochemistry Department, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre Bénite, France.
Emmanuel DisseDepartment of Endocrinologie, Diabète, Nutrition, Centre Intégré de l'Obésité Rhône-Alpes, Fédération Hospitalo-Universitaire DO-iT, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
Charlotte CuerqBiochemistry Department, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre Bénite, France.
Jocelyne DraiBiochemistry Department, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre Bénite, France.
Pierre-Jean ValetteDepartment of Radiology, E. Herriot University Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Lyon, France.
Martine LavilleDepartment of Endocrinologie, Diabète, Nutrition, Centre Intégré de l'Obésité Rhône-Alpes, Fédération Hospitalo-Universitaire DO-iT, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
Charles ThivoletDepartment of Endocrinologie, Diabète, Nutrition, Centre Intégré de l'Obésité Rhône-Alpes, Fédération Hospitalo-Universitaire DO-iT, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
Chantal SimonDepartment of Endocrinologie, Diabète, Nutrition, Centre Intégré de l'Obésité Rhône-Alpes, Fédération Hospitalo-Universitaire DO-iT, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
Cyrielle CaussyDepartment of Endocrinologie, Diabète, Nutrition, Centre Intégré de l'Obésité Rhône-Alpes, Fédération Hospitalo-Universitaire DO-iT, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France. cyrielle.caussy@chu-lyon.fr.
Hospices Civils de Lyon · FRLaboratoire CarMeN · FRUniversité Claude Bernard Lyon 1 · FRHôpital Lyon Sud · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisWe aimed to assess the application of the recent European Association for the Study of the Liver (EASL)-European Association for the Study of Diabetes (EASD)-European Association for the Study of Obesity (EASO) clinical practice guidelines for the management of non-alcoholic fatty liver disease (NAFLD) in severely obese individuals in routine clinical practice.

methodsWe performed a single-centre retrospective observational study of 385 patients referred for severe obesity (BMI ≥ 35 kg/m

resultsWe identified 313 (81.3%) individuals with NAFLD in the cohort. The application of the EASL-EASD-EASO guidelines using NFS would lead to referral to a specialist for up to 289 individuals (75.1%) in the cohort. The combination of NFS and TE measurement reclassified 28 (25%) individuals from the medium/high risk group to low risk and would lead to the referral of 261 (67.7%) individuals to a specialist. These proportions appear to be excessive given the expected prevalence of advanced fibrosis and non-alcoholic steatohepatitis (NASH) of around 10% and 30%, respectively, in the severely obese population. CONCLUSIONS/

interpretationThis is the first study to assess the strategy proposed by the EASL-EASD-EASO clinical practice guidelines for the management of NAFLD in severely obese individuals. The retrospective application of the guidelines in a cohort representing the routine clinical practice in our department would lead to an excessive number of specialist referrals and would also lead to an unjustified increase in health costs. Biomarkers and specific strategy for the screening of NASH and advanced fibrosis in morbidly obese individuals are thus crucially needed and would help to improve the actual guidelines.

Indexed as

Practice Guidelines as TopicReferral and ConsultationAdultBiomarkersBiopsyBody Mass IndexCohort StudiesElasticity Imaging TechniquesEuropeFemaleFibrosisHumansLiver CirrhosisMaleMedical OveruseMiddle AgedBiomarkersFibrosisNAFLD fibrosis scoreNon-alcoholic fatty liver diseaseNon-alcoholic steatohepatitisObesityTransient elastography

Identifiers

PMID28352941
OpenAlexW2598782894

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.