Dataset Information

Tailored algorithms for hepatocellular carcinoma surveillance: Is one-size-fits-all strategy outdated?

ABSTRACT:

Purpose of review

Current clinical practice guidelines recommend regular hepatocellular carcinoma (HCC) surveillance with biannual ultrasound with or without serum alpha-fetoprotein uniformly applied to all patients with cirrhosis. However, clinical implementation of this one-size-fits-all strategy has been challenging as evidenced by very low application rate below 20% due to various reasons, including suboptimal performance of the surveillance modalities.

Recent findings

Newly emerging imaging techniques such as abbreviated MRI (AMRI) and molecular HCC risk biomarkers have increasingly become available for clinical evaluation and implementation. These technologies may have a potential to reshape HCC surveillance by enabling tailored strategies. This would involve performing optimized surveillance tests according to individual HCC risk, and allocating limited medical resources for HCC surveillance based on cost-effectiveness.

Summary

Tailored HCC surveillance could lead to achievement of precision HCC care and substantial improvement of the current dismal patient prognosis.

SUBMITTER: Goossens N

PROVIDER: S-EPMC5358664 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Publications

Tailored algorithms for hepatocellular carcinoma surveillance: Is one-size-fits-all strategy outdated?

Goossens Nicolas N Bian C Billie CB Hoshida Yujin Y

Current hepatology reports 20170201 1

<h4>Purpose of review</h4>Current clinical practice guidelines recommend regular hepatocellular carcinoma (HCC) surveillance with biannual ultrasound with or without serum alpha-fetoprotein uniformly applied to all patients with cirrhosis. However, clinical implementation of this one-size-fits-all strategy has been challenging as evidenced by very low application rate below 20% due to various reasons, including suboptimal performance of the surveillance modalities.<h4>Recent findings</h4>Newly e ...[more]

PMID: 28337405

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Project description:BackgroundAs precision medicine gains momentum, the traditional - One Size Fits All - approach to disease prevention and treatment is becoming less reliable. Medical education must prioritize equipping physicians with the knowledge to apply precision medicine effectively. The present study aimed to investigate the knowledge, attitudes, and perceived barriers to precision medicine among medical students, interns, and physicians in Jordan.Materials and methodsAn analytical cross-sectional study, using an online validated and reliable questionnaire to collect data, was conducted. The knowledge, attitudes, and perceptions related to precision medicine were assessed and explored for statistical associations. The strength of each association was further presented by calculating the Cramér's phi (φc).ResultsParticipants in the present study were 607 individuals, 55.5% were males. 29.6% of participants had low knowledge scores (marks between - 12 and 0). The strongest association was reported between knowledge score and primary care setting followed by age (φc = 0.27 and 0.29, respectively). Physicians at the Ministry of Health had the highest odds of a high knowledge score (OR = 5.3, 95% CI 2.7-10.2, P < 0.001). Most respondents (79.1%) would consider using genome-guided prescribing tools developed by researchers, with only (15.8%) deeming these tools clinically useless. Nevertheless, almost 78% of participants expressed concern regarding patient anxiety with test results. Students showed better perception than physicians (p = < 0.001), but Physicians were more confident to implement precision medicine (P = < 0.0001). Most participants (87.1%) considered expanding their knowledge in precision medicine. Physicians cited limited accessibility as the main barrier to adopt precision medicine (92.9%), while high cost was the primary obstacle reported by students (80.2%).ConclusionMedical students and Physicians share a positive attitude toward implementing Precision Medicine, but barriers must be overcome for successful implementation. Integrating precision medicine and genome-based technologies into medical education is necessary for its successful application in clinical practice.

Dataset Information

Tailored algorithms for hepatocellular carcinoma surveillance: Is one-size-fits-all strategy outdated?

Purpose of review

Recent findings

Summary

Publications

Tailored algorithms for hepatocellular carcinoma surveillance: Is one-size-fits-all strategy outdated?

Similar Datasets

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