proposed survey questionnaire for hepatologists/gastroenterologists/physicians
Assess needs & initiatives that will eliminate barriers and gaps experienced by HCPs in the management of NAFLD & NASH.
a
1Please rate your expertise with NAFLD & NASH. Answer for your speciality only.
Familiarity with NAFLD
Familiarity with NASH
2What is the primary nature of your practice?
aGovt/ Institute based
bPrivate Hospital
cIndividual / Clinic
dOthers
3No of NAFLD Patients seen weekly
a <5
b5-10
c 10-20
d>20
4What is your perception on NAFLD & NASH?
b
5What is your primary source for knowledge on NAFLD & NASH? Select all that apply.
aGuidelines
bLocal CMEs
cNational / International Conferences
dMedical Journals
eInternet
fOwn experiences
gOthers
6To the best of your knowledge which of the following best defines NAFLD. Please select one.
aEvidence of hepatic steatosis on imaging or histology with exclusion of secondary causes of hepatic fat accumulation
bEvidence of hepatic steatosis on imaging or histology
cNot sure, would like to receive more information
7To the best of your knowledge which of the following best defines NAFL (Non Alcoholic Fatty Liver). Please select one.
aPresence of > 5% hepatic steatosis irrespective of degree of hepatocellular injury and/or fibrosis
bPresence of > 5% hepatic steatosis with no or minimal evidence of hepatocellular injury
8To the best of your knowledge which of the following best defines NASH (Non Alcoholic SteatoHepatitis). Please select one.
aPresence of > 5% hepatic steatosis on imaging or histology
bPresence of hepatic steatosis on imaging or histology with elevated serum ALT.
CPresence of > 5% hepatic steatosis with hepatocellular injury evidenced by lobular inflammation, hepatocyte ballooning with or without hepatic fibrosis on liver histology.
DNot sure, would like to receive more information
9What proportion of following subjects is likely to have NAFLD
10All the following statements are true about NAFLD except -
aMost patients with NAFLD have incidental detection.
bPresence of jaundice in NAFLD suggests advanced liver disease
cHepatomegaly may be present in patients with NAFLD
dAlmost all patients have elevated ALT at presentation
c
11What is the reason for not screening NAFLD / NASH regularly (if applicable). Select all that apply
aI don't have time
bPrevalence is low
cI am not familiar with screening procedures
dDiagnostic tools are not readily accessible
eTreatment options are limited
fLack of updated guidelines
gNAFLD & NASH are not life threatening
hNone of the above
12 Which patient groups should be screened regularly for NAFLD & NASH?
13What is your initial Assessment in patients with NAFLD/Suspected NAFLD .
14Which methods are available in your practice for the diagnosis of NAFLD/NASH? Select all that apply
aSerum Tests
bUltrasound
cFibroscan
dMRI PDFF
eLiver Biopsy
15What are your preferred methods to approach non-invasive diagnosis of steatohepatitis and significant/advanced fibrosis in NAFLD? Rate with 6 being most preferred , 1 being least preferred
16Would you recommend routine surveillance for HCC in patients with Non Cirrhotic NASH
aYes
bNo
cWould need more information to decide.
17What are your indications for liver biopsy in NAFLD ?
D
18How do you counsel your patients with NAFLD / NASH regarding a healthy lifestyle?
aNo, I/we do not counsel our patients
bYes, I do it myself
cYes, I do it along with my team
dMy team - assistant, nutritionist, dietitian or others do it
eOther
19Which of the following advice is given to patients with NAFLD & NASH?
20Which of the following diets you usually recommend to NAFLD / NASH patients? Select All That Apply
aHypocaloric Diet
bLow Carb Diet
cLow carb and low fat diet
dHigh Protein Diet
eMediterranean Diet
fOthers
gWould like more info.
21Do you have diet charts to be handed over to patients? Select All That Apply
aYes, calorie specific diet charts are readily available.
bI prepare the diet chart as per the patient's need
cMy team prepares the diet chart as per patient's need
dI use an app to prepare diet charts
eI refer my patients to a dietitian / nutritionist.
fI give only general diet recommendation without diet chart.
22which patient related barriers for NAFLD & NASH management do you face? Select All That Apply
aLack of awareness amongst patients
bCost of evaluation & Treatment
cLack of compliance by patient
dNot comfortable to discuss Obesity and its consequences with patient
eLack of sufficient educational tools to counsel the patient
23Do you feel that awareness through mass media such as Print, Radio, TV is effective and needed in disseminating information about NAFLD & NASH to general population?
24Please rate the following media in order of their effectiveness for spreading NAFLD awareness
e
25In the absence of FDA approved treatments, do you currently use pharmacotherapy for NASH ?
26Which pharmacotherapy options do you prefer? Select all that apply.
aVitamin E in Non- Diabetic Adults
bPioglitazone
cMetformin
dSaroglitazar
eUrsodeoxycholic acid
fObeticholic acid
gStatins
hOthers
f
27On a scale of 1-5 how would you rate the preparedness of our healthcare system pertaining to NAFLD & NASH
28Has the recent inclusion of NAFLD in the NPCDCS guidelines had any impact in your practice?
cEarly to comment
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