Chronic hepatitis B: a critical appraisal of current approaches to therapy
| Autor: | Chloe L. Thio, Robert G. Gish, Eugene R. Schiff, Maria Buti, Emmet B. Keeffe, W. Graham E. Cooksley, Robert P. Perrillo, Naoky Tsai, Yun Fan Liaw, Marion G. Peters, Michael W. Fried, Nikolai V. Naoumov, Alfredo Alberti, Solko W. Schalm, Stephanos J. Hadziyannis |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Hepatitis B virus Endpoint Determination Biopsy MEDLINE Organophosphonates Interferon alpha-2 Hepatitis b surface antigen Virus Replication Antiviral Agents Polyethylene Glycols Strength of evidence Hepatitis B Chronic Chronic hepatitis medicine Humans Hepatitis B e Antigens Societies Medical Hepatology business.industry Adenine Patient Selection Gastroenterology Treatment options Interferon-alpha Alanine Transaminase Recombinant Proteins Critical appraisal Liver Lamivudine Family medicine Expert opinion Immunology DNA Viral Disease Progression Drug Therapy Combination Clinical Competence Interferons Working group business |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 4(2) |
| ISSN: | 1542-3565 |
| Popis: | Background & Aims: Treatment of chronic hepatitis B (CHB) involves a number of complex and controversial issues. Expert opinions may differ from those of practicing hepatologists and gastroenterologists. We aimed to explore this issue further after a critical review of the literature. Methods: A panel of 14 international experts graded the strength of evidence for 16 statements addressing 3 content areas: patient selection, therapeutic end points, and treatment options. Available data relating to the statements were reviewed critically in 3 small work groups. After discussion of each statement with the entire panel, the experts voted anonymously to accept or reject statements based on the strength of evidence and their experience. A total of 241 members of the American Association for the Study of Liver Diseases (AASLD) responded to the same statements and their responses were compared with those of the experts. A discordant response was defined as a difference of more than 20% in any of the 5 graded levels of response (accept or reject) between the 2 groups. Results: With the exception of 2 statements, the experts’ responses were relatively uniform. However, the responses of the AASLD members were discordant from the experts in 12 statements, spanning all 3 content areas. Conclusions: Several areas of disagreement on the management of CHB exist between experts and AASLD members. Our results indicate a potential knowledge gap among practicing hepatologists. Better educational efforts are needed to meet the challenge of managing this complex disorder in which even expert opinion occasionally may disagree. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|