ArticleEndocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists2024
Safety-Net Primary Care and Endocrinology Clinicians' Knowledge and Perspectives on Screening for Nonalcoholic Fatty Liver Disease: A Mixed-Methods Evaluation.
Article in Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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Who cites it
5 citing papers in PubMed.
- Low Rates of MASLD Screening in Young Adults With Type 2 Diabetes: A Retrospective Cohort Study.Journal of the Endocrine Society · 2026Article
- Failing to succeed: advancing mechanistic understanding of implementation strategies through retrospective and prospective use of causal pathway diagrams.Implementation science communications · 2025Article
- Failing to Succeed: Advancing Mechanistic Understanding of Implementation Strategies Through Retrospective and Prospective Use of Causal Pathway Diagrams.Research square · 2025Article
- Assessing Clinician Engagement With a Passive Clinical Decision Support System for Liver Fibrosis Risk Stratification in a Weight Management Clinic.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025Article
- Increasing engagement with liver disease management across the UK: a follow-up cross-sectional survey.BJGP open · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveClinical guidelines have expanded the indications for nonalcoholic fatty liver disease (NAFLD) screening to type 2 diabetes mellitus and obesity, which are conditions common in populations who receive care in urban safety-net settings. This study aimed to evaluate safety-net primary care and endocrinology clinicians' knowledge of NAFLD, determine barriers and facilitators to screening, and examine perspectives on the use of electronic health record tools for risk assessment.
methodsSequential explanatory mixed methods using survey and qualitative interviews with primary care, primary care subspecialty, and endocrinology clinicians in an urban safety-net health care system.
resultsA total of 109 participants completed the survey (36.5% response rate), and 13 participated in interviews. Most respondents underestimated or did not know the prevalence of NAFLD (68%), did not use the recommended noninvasive tests for risk stratification (65%), and few were comfortable with screening for (27%) or managing (17%) NAFLD. Endocrinologists had greater knowledge of risk factors but lower rates of comfort and more often felt that screening was not their responsibility. The qualitative themes included the following: (1) lack of knowledge about screening, (2) concern for underdiagnosing NAFLD, (3) perception of severity impacts beliefs about screening, (4) screening should occur in primary care but is not normative practice, (5) concerns exist about benefit, (6) competing demands with a complex population hinder screening, and (7) a need for easier ways to integrate screening into practice.
conclusionKnowledge gaps may hamper uptake of new guidelines for NAFLD screening in primary care and endocrinology clinics in an urban safety-net health care system. Implementation strategies focused on training and educating clinicians and informed by behavioral economics may increase screening.
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Registered trials
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