Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2023; 15(3): 419-430
Published online Mar 27, 2023. doi: 10.4254/wjh.v15.i3.419
To scan or not to scan: Use of transient elastography in an integrated health system
Libby Stein, Rasham Mittal, Hubert Song, Joanie Chung, Amandeep Sahota
Libby Stein, Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, United States
Rasham Mittal, Amandeep Sahota, Department of Transplant Hepatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, United States
Hubert Song, Joanie Chung, Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, CA 91101, United States
Author contributions: Stein L, Mittal R and Sahota A designed the study; Song H and Chung J gathered the data and performed the statistical analysis; Stein L wrote the manuscript; all authors read, edited and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Kaiser Permanente Southern California Institutional Review Board (Approval No. #12674).
Informed consent statement: Because of the nature of a retrospective study, signed informed consent form is not needed. However, Kaiser Permanente Los Angeles Medical Center has given permission to conduct this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Libby Stein, MD, Doctor, Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, 4867 Sunset Blvd, Los Angeles, CA 90027, United States. libby.x.stein@kp.org
Received: October 21, 2022
Peer-review started: October 21, 2022
First decision: December 23, 2022
Revised: January 6, 2023
Accepted: March 1, 2023
Article in press: March 1, 2023
Published online: March 27, 2023
Processing time: 152 Days and 11.1 Hours
Core Tip

Core Tip: This was a retrospective study of nearly 1000 patients with non-alcoholic fatty liver disease who underwent FibroScan. The purpose of this study was to compare patients before and after a clinical decision support tool was implemented. This tool was designed to guide primary care providers on the management of non-alcoholic fatty liver disease. After the tool was released, we saw higher rates of early-stage fibrosis diagnosed by FibroScan. We saw appropriate allocation of care, whereby patients with advanced fibrosis had more labs, imaging studies and specialty referrals. These results suggest non-alcoholic fatty liver disease can feasibly be diagnosed and managed in the primary care setting.