Bayesian Evidence Synthesis And Decision Modeling For...

Bayesian Evidence Synthesis and Decision Modeling for Non-Alcoholic Fatty Liver Disease Summary The World Gastroenterology Organization (WGO) has recently declared NALFD as most common cause of liver disease. Obesity is an increasing problem not only in the UK but worldwide. An estimated 26% of the adults in the UK are considered to be obese 1, 2. Obesity induced metabolic syndrome may lead to NAFLD, which can progress to Nonalcoholic Steatohepatitis (NASH), and in turn to advanced fibrosis and an increased risk of Hepatocellular Carcinoma (HCC) 2, 3. Background Recent increases in the prevalence of obesity induced metabolic syndrome (MetS) resulted in an upsurge in the global incidences of both Nonalcoholic fatty liver disease (NAFLD)†¦show more content†¦Apart from their clinical implications, the current economic burden of NAFLD/NASH on the health care system is substantial. A recent study analyzed outpatient resource utilization in the United States (US) observed an increase in annual inflation adjusted total NAFLD/NASH outpatient charges from $2,624 in 2005 to $5,132 in 2010 7. A simulation study estimated $103 billion ($1,613 per patient) annual direct medical cost attributed to NAFLD, which further increased to $189 billion upon including societal cost 8. In the UK, the total annual cost of NAFLD is estimated to be  £31.26 billion, of which,  £5.24 billion is in direct cost 8. With the manifold health consequences of metabolic syndrome are projected to considerably increase in the next decade, the clinical and economi c burdens of NAFLD/NASH are bound to surge in upcoming years. Research Problem NAFLD is the hepatic manifestation of the metabolic syndrome (MetS). However, little is known about the natural history of NAFLD. Furthermore, the pathophysiological relationships between MetS and hepatic steatosis is not fully understood. The diagnosis of the MetS involves the presence of three of the following five risk factors: 1) hyperglycemia (fasting glucose ≠¥ 100 mg/dL), 2) low concentrations of high-density lipoprotein (HDL) cholesterol ( (-- removed HTML --) than 150 mg/dL), 4) increased waist circumference (102 cm for men and 89