Observational studyThe New England journal of medicine2021
Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease.
Observational study in The New England journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 573 papers, 5 of them syntheses that pooled 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.
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.
Nonalcoholic Fatty Liver Disease (NAFLD) Adult Database 2
Epidemiologic Liver Outcomes Retrospective Study to Confirm The Prognostic Value of the FibroNest Digital Pathology Fibrosis Biomarker (Ph-FCS) in Patients With MASLD (DPAILO-1)
Epidemiologic Liver Outcomes Retrospective Study to Confirm The Prognostic Value of the FibroNest Digital Pathology Fibrosis Biomarker (Ph-FCS) in Patients With MASLD (DPAILO-2)
AcceleRating the Translation of Virtual Twins Towards a pErsonalised Management of Steatotic Liver Patients
Who cites it
573 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prognostic value of liver histology in steatotic liver disease: a systematic literature review and meta-analysis.Journal of comparative effectiveness research · 2026Pooled it
- Meta-Analysis: Enhanced Liver Fibrosis (ELF) Test for Identifying Significant Fibrosis, Advanced Fibrosis, and Cirrhosis in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.Alimentary pharmacology & therapeutics · 2026Pooled it
- Efficacy of tirzepatide, lanifibranor, and resmetirom in metabolic dysfunction-associated steatotic liver disease: a meta-analysis of high-quality randomized controlled trials.Internal and emergency medicine · 2026Pooled it
- Progression to Decompensation of Severe Fibrosis Compared to Cirrhosis in MASLD: A Systematic Review and Meta-Analysis.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- Epidemiology of Metabolic Dysfunction-Associated Steatotic Liver Disease in South Asian Ethnicities: A Systematic Review and Meta-Analysis.Journal of gastroenterology and hepatology · 2025Pooled it
- Clinical Trial: Phase 3 Trial of Resmetirom Versus Placebo in Metabolic Dysfunction-Associated Steatohepatitis-Reanalysis of Fibrosis Stage 2-3 Subset.Alimentary pharmacology & therapeutics · 2026Trial
- Detection of undiagnosed liver cirrhosis via AI-enabled electrocardiogram: a pragmatic, cluster-randomized clinical trial.Nature medicine · 2026Trial
- Targeting ROAM1 with UDP-GlcNAc nanosheets selective activates lysosomal AMPK to resolve metabolic dysfunction-associated steatotic liver disease.Bioactive materials · 2026Article
- Age-Specific Associations of Polygenic Risk Scores With Advanced Fibrosis and Histological Activity in Biopsy-Proven MASLD.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Is MASLD an independent risk factor for micro- and macrovascular complications of diabetes? A critical reappraisal and future directions.Diabetologia · 2026Review
- Review Article: Fibrosis Reversal in Metabolic Dysfunction-Associated Steatohepatitis-The Promise of Emerging Therapeutics.Alimentary pharmacology & therapeutics · 2026Review
- Changing epidemiology and etiology of hepatocellular carcinoma in Europe: implications for clinical practice and health policy.The Lancet regional health. Europe · 2026Review
- Metabolic stress-activated endothelial STING rewires the sinusoidal immune niche to promote MASLD progression.The Journal of clinical investigation · 2026Article
- Review
- Selecting Pharmacologic Interventions for MASH.Digestive diseases and sciences · 2026Review
- Embedding metabolic dysfunction-associated steatotic liver disease fibrosis risk stratification within pharmacist-integrated diabetes comanagement in primary care.Journal of managed care & specialty pharmacy · 2026Article
- Review
- Changes in Muscle Mass and the Risk of Liver-Related Events: A Prospective Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Senolytics dasatinib and quercetin in metabolic dysfunction-associated steatohepatitis: a proof-of-principle randomized, controlled trial.Nature metabolism · 2026Article
- OPA1 controls mitochondrial dysfunction-driven liver fibrosis in MASLD.bioRxiv : the preprint server for biology · 2026Article
513 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundThe prognoses with respect to mortality and hepatic and nonhepatic outcomes across the histologic spectrum of nonalcoholic fatty liver disease (NAFLD) are not well defined.
methodsWe prospectively followed a multicenter patient population that included the full histologic spectrum of NAFLD. The incidences of death and other outcomes were compared across baseline histologic characteristics.
resultsA total of 1773 adults with NAFLD were followed for a median of 4 years. All-cause mortality increased with increasing fibrosis stages (0.32 deaths per 100 person-years for stage F0 to F2 [no, mild, or moderate fibrosis], 0.89 deaths per 100 persons-years for stage F3 [bridging fibrosis], and 1.76 deaths per 100 person-years for stage F4 [cirrhosis]). The incidence of liver-related complications per 100 person-years increased with fibrosis stage (F0 to F2 vs. F3 vs. F4) as follows: variceal hemorrhage (0.00 vs. 0.06 vs. 0.70), ascites (0.04 vs. 0.52 vs. 1.20), encephalopathy (0.02 vs. 0.75 vs. 2.39), and hepatocellular cancer (0.04 vs. 0.34 vs. 0.14). As compared with patients with stage F0 to F2 fibrosis, patients with stage F4 fibrosis also had a higher incidence of type 2 diabetes (7.53 vs. 4.45 events per 100 person-years) and a decrease of more than 40% in the estimated glomerular filtration rate (2.98 vs. 0.97 events per 100 person-years). The incidence of cardiac events and nonhepatic cancers were similar across fibrosis stages. After adjustment for age, sex, race, diabetes status, and baseline histologic severity, the incidence of any hepatic decompensation event (variceal hemorrhage, ascites, or encephalopathy) was associated with increased all-cause mortality (adjusted hazard ratio, 6.8; 95% confidence interval, 2.2 to 21.3).
conclusionsIn this prospective study involving patients with NAFLD, fibrosis stages F3 and F4 were associated with increased risks of liver-related complications and death. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; NAFLD DB2 ClinicalTrials.gov number, NCT01030484.).
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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.