Diagnostic and therapeutic decisions of general practitioners in patients with suspected or diagnosed non-alcoholic fatty liver disease with reference to current European guidelines
Bibliographic record
Abstract
Objective: The aim of the multicenter study was to assess the compliance of diagnostic and therapeutic decisions of general practitioners in patients with suspected or diagnosed non-alcoholic fatty liver disease (NAFLD) with current guidelines of the European Association for the Study of the Liver, the European Association for the Study of Diabetes and the European Association for the Study of Obesity.Material and methods: The multicenter survey was performed nation-wide by 844 general practitioners among 20,550 outpatients suspected for or already diagnosed with NAFLD (48.2%) during a routine visit.The lack of oral consent to participate and the inability to obtain answers to the survey questions were the only exclusion criteria.Results: In the group suspected for NAFLD, activity of liver enzymes and ultrasound were ordered in 48.3% and 54.7% of patients.Among non-diabetic patients already diagnosed with NAFLD fasting glucose level was measured in 75.7%, an oral glucose tolerability test was performed in 38.7%, fasting insulin level was measured in 15.1%, and HOMA-IR was calculated in 5.5%.In the therapy the following were recommended: reduction of diet energy by 500-1000 kcal corresponding to the patient's needs (in 40.9% and 87.2% suspected and diagnosed with NAFLD, respectively), restriction of the consumption of animal fat (in 45.1% and 93.7%) and alcohol (in 39.2% and 80.7%), increase in the consumption of complex carbohydrates (in 28.6% and 62.9%), avoidance of drinks and foods rich in fructose (in 32.4% and 71.5%), regular aerobic physical activity 150-200 minutes per week (in 39.2% and 82.5%) and regular resistance training (in 14.4% and 31.5%).Pharmacological treatment of concomitant diseases was prescribed in 38.7% and 73.4% of patients, respectively, including pharmaceutical products containing the necessary phospholipids (in 13.6% and 36.0%) and thiazolidine carboxylic acid (in 29.2% and 74.9%).Conclusions: 1. Polish general practitioners too rarely perform a diagnostic test for NAFLD and recommend changes in diet and physical activity, and too rarely perform tests for carbohydrate metabolism disturbances.2. Diagnostic workup and NAFLD therapy are in line with the current guidelines.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".