Evidence map›Paper›PMID 41454644›Full record

ArticleAlimentary pharmacology & therapeutics2026

Barriers to Medical Care Are Frequently Reported by Patients With Cirrhosis.

William Chai, Nicole E Rich, Yan Liu, Juana Campos, Lisa Quirk, Jennifer R Kramer, Jahna Anyanwu, Amanda Gibbons, Aaron Loewy, Dalal Youssef and 5 more

Abstract read
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

William ChaiDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Nicole E RichDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Yan LiuMichael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety and Baylor College of Medicine, Houston, Texas, USA.
Juana CamposMichael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety and Baylor College of Medicine, Houston, Texas, USA.
Lisa QuirkDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Jennifer R KramerMichael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety and Baylor College of Medicine, Houston, Texas, USA.
Jahna AnyanwuSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Amanda GibbonsSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Aaron LoewySection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Dalal YoussefSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Riya MalhortaDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Hadley McGheeDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Meena TadrosDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
Fasiha KanwalMichael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety and Baylor College of Medicine, Houston, Texas, USA.
Amit G SingalDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.ORCID https://orcid.org/0000-0002-1172-3971

Funding

Multilevel factors for racial/ethnic and socioeconomic disparities in prognosis of hepatocellular carcinomaR01MD012565 · NIMHD · UT SOUTHWESTERN MEDICAL CENTER · PI SINGAL, AMIT, YOPP, ADAM · 2018 to 2022
$4.3M
Precision Risk Stratification and Screening for HCC among Patients with Indeterminate Liver NodulesU01CA283935 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI HOSHIDA, YUJIN, SINGAL, AMIT · 2023 to 2025
$3.9M
Multi-level Evaluation of Racial/ethnic Disparities in Liver Disease OutcomesR01CA256977 · NCI · BAYLOR COLLEGE OF MEDICINE · PI KANWAL, FASIHA, SINGAL, AMIT · 2021 to 2025
$3.0M
Determining the influence of sex and gender in hepatocellular carcinoma risk and survivalK08CA259536 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI Nicole Elizabeth Rich · 2022 to 2026
$1.3M
Cancer Prevention and Research Institute of Texas RP200633NCI NIH HHS K08 CA259536NCI NIH HHS R01 CA256977NCI NIH HHS U01 CA283935NIMHD NIH HHS R01 MD012565
6 · The paper itself

Abstract

backgroundPatient-reported barriers to care can delay treatment and increase mortality. Addressing these barriers can improve clinical outcomes and reduce disparities, underscoring the importance to understand their prevalence in patients with cirrhosis.

methodsWe invited adults with cirrhosis at four US health systems (two tertiary care referral centres, one safety-net health system, and one Veterans Affairs medical center) to complete a survey assessing barriers to care. Questions for barriers to care were adapted from prior surveys as available. Responses were summarised using descriptive statistics, and Chi-square analysis was used to examine differences by study site and race/ethnicity.

resultsOf 5197 patients contacted by telephone, 1332 (25.6%) completed the survey and were eligible for analyses. The most frequent barriers to care included time to travel to clinic (22.7%), long wait times for appointments (21.6%), and difficulty scheduling visits (19.2%). Conversely, few patients reported competing demands or difficulty finding time for liver appointments, difficulty discussing concerns with their physicians, or lack of physician engagement with concerns. Several barriers to care significantly differed by study site but were generally consistent across racial and ethnic subgroups.

conclusionPatients with cirrhosis report frequent barriers to medical care including limited access to clinic appointments, although barriers vary by healthcare system. Barriers to care serve as intervention targets to improve outcomes for patients with cirrhosis.

Indexed as

Health Services AccessibilityLiver CirrhosisAdultAgedFemaleHumansMaleMiddle AgedSurveys and QuestionnairesUnited Statesbarriers to carecirrhosisdisparitiessurvey

Identifiers

PMID41454644
PMCPMC13021293

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.