ArticleDigestive diseases and sciences2024
Missed and Delayed Diagnoses of Chronic Liver Disease in Primary Care Patients with Cirrhosis.
Article in Digestive diseases and sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of comparisons of AI and radiologists in the diagnosis of HCC in multiphase CT: implications for practice.Japanese journal of radiology · 2026Pooled it
- An artificial intelligence-augmented electrocardiogram model can detect undiagnosed chronic liver disease, but can this be applied in primary care?Hepatobiliary surgery and nutrition · 2026Article
- Reduced wait times for hepatology referrals in a prospective quality improvement initiative.Hepatology communications · 2026Article
- Implications of Expanded Advanced Fibrosis Screening Strategies for Metabolic Dysfunction-Associated Steatotic Liver Disease in Primary Care.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026Article
- Diagnostic innovation and models of care to improve fibrosis detection and risk stratification in steatotic liver disease.The Lancet regional health. Europe · 2026Review
- Association between triglyceride-glucose-related indices and liver-related events in patients with type 2 diabetes.Frontiers in endocrinology · 2026Article
- Arthritis and High Alcohol Intake at Diagnosis Increase Future Risk of Hepatocellular Carcinoma inGastro hep advances · 2026Article
- Aspirin and hepatocellular carcinoma risk in metabolic dysfunction-associated steatotic liver disease: nationwide cohort study with genetic risk analysis.Clinical and molecular hepatology · 2026Article
- Development of an AI algorithm for early identification of MASLD in the electronic health record.Hepatology communications · 2025Article
- Comparison of Zinc Levels in Liver Cirrhosis and Evaluating the Severity Using Child-Pugh Score.Cureus · 2025Article
- HMGB1: key mediator in digestive system diseases.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025Review
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Authors and funding
6 authors.
Funding
Abstract
backgroundChronic liver diseases (CLD), cirrhosis, and hepatocellular carcinoma (HCC) cause significant morbidity and mortality. Unfortunately, patients with CLD often go undiagnosed until progression to cirrhosis and HCC. We aimed to determine the proportion of primary care patients with severe liver disease outcomes that had missed or delayed CLD diagnoses.
methodsThis retrospective cohort study evaluated primary care patients with a diagnosis of cirrhosis, HCC, or other severe liver disease outcome between 2012 and 2021. The outcomes of interest were missed and delayed diagnoses of CLD, defined as the absence of a CLD diagnosis (missed) or first appearance of CLD on the same day as the cirrhosis diagnosis (delayed). Univariate analyses were performed to describe the cohort. Multivariable logistic regression models analyzed the association of aminotransferase elevations with the outcomes of interest.
resultsOf 667 patients with cirrhosis or HCC, 133 (20%) had a missed CLD diagnosis, and 243 (36%) had a delayed CLD diagnosis. Alcohol-related liver disease was the most common etiology among patients with missed/delayed diagnoses. A lower proportion of patients with missed/delayed diagnoses had an elevation in ALT or AST compared to patients with timely diagnoses (61% vs. 77%, p < 0.001). Elevated aminotransferase values were associated with lower odds of a missed/delayed diagnosis (OR 0.47; 95%CI 0.34-0.66).
conclusionsMost patients with cirrhosis or HCC had missed or delayed diagnoses of CLD in the context of probable overreliance on aminotransferase elevation for CLD detection. Enhanced screening for high prevalence CLD, especially alcohol, in primary care is needed.
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