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1. Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease.

Author

Goldberg, David, Mathur, Amit, Wilder, Julius, Vittorio, Jennifer, Yeoman, Andrew, Rich, Nicole, Lazo, Mariana, Kardashian, Ani, Asrani, Sumeet, Spann, Ashley, Ufere, Nneka, Verma, Manisha, Verna, Elizabeth, Simpson, Dinee, Schold, Jesse, Rosenblatt, Russell, McElroy, Lisa, Wadwhani, Sharad, Lee, Tzu-Hao, Strauss, Alexandra, Chung, Raymond, Aiza, Ignacio, Carr, Rotonya, Yang, Jin, Brady, Carla, Fortune, Brett, Brahmania, Mayur, Rogal, Shari, Serper, Marina, and Patel, Arpan

Subjects
Humans, Healthcare Disparities, Continuity of Patient Care, Liver Diseases, Chronic Disease, Liver Transplantation, Health Equity, Health Services Accessibility, Liver Cirrhosis
Abstract

Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The current review outlines the disparities along the chronic liver disease health care continuum from screening and diagnosis to the management of cirrhosis and considerations of pre-liver and post-liver transplantation. Using a health equity research and implementation science framework, we offer pragmatic strategies to address barriers to implementing high-quality equitable care for patients with chronic liver disease.

Published
2024

2. Predictive Algorithm for Hepatic Steatosis Detection Using Elastography Data in the Veterans Affairs Electronic Health Records

Author

Bangaru, Saroja, Sundaresh, Ram, Lee, Anna, Prause, Nicole, Hao, Frank, Dong, Tien S, Tincopa, Monica, Cholankeril, George, Rich, Nicole E, Kawamoto, Jenna, Bhattacharya, Debika, Han, Steven B, Patel, Arpan A, Shaheen, Magda, and Benhammou, Jihane N

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Liver Disease, Chronic Liver Disease and Cirrhosis, 4.1 Discovery and preclinical testing of markers and technologies, Oral and gastrointestinal, Good Health and Well Being, Humans, Non-alcoholic Fatty Liver Disease, Elasticity Imaging Techniques, Liver, Veterans, Electronic Health Records, Prospective Studies, ROC Curve, Liver Diseases, Alcoholic, Biopsy, Liver Cirrhosis, Nonalcoholic fatty liver disease, Prediction, Model, Elastography, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background and aimsNonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Early detection can identify at-risk patients who can be linked to hepatology care. The vibration-controlled transient elastography (VCTE) controlled attenuation parameter (CAP) is biopsy validated to diagnose hepatic steatosis (HS). We aimed to develop a novel clinical predictive algorithm for HS using the CAP score at a Veterans' Affairs hospital.MethodsWe identified 403 patients in the Greater Los Angeles VA Healthcare System with valid VCTEs during 1/2018-6/2020. Patients with alcohol-associated liver disease, genotype 3 hepatitis C, any malignancies, or liver transplantation were excluded. Linear regression was used to identify predictors of NAFLD. To identify a CAP threshold for HS detection, receiver operating characteristic analysis was applied using liver biopsy, MRI, and ultrasound as the gold standards.ResultsThe cohort was racially/ethnically diverse (26% Black/African American; 20% Hispanic). Significant positive predictors of elevated CAP score included diabetes, cholesterol, triglycerides, BMI, and self-identifying as Hispanic. Our predictions of CAP scores using this model strongly correlated (r = 0.61, p

Published
2023

3. Clinical Characteristics and Outcomes of Nonalcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma in the United States.

Author

Karim, Mohammad, Singal, Amit, Kum, Hye, Lee, Yi-Te, Park, Sulki, Rich, Nicole, Noureddin, Mazen, and Yang, Ju Dong

Subjects
Liver Cancer, NAFLD, NASH, Surveillance, Humans, Aged, United States, Carcinoma, Hepatocellular, Non-alcoholic Fatty Liver Disease, Liver Neoplasms, Medicare
Abstract

BACKGROUND & AIMS: The extent to which nonalcoholic fatty liver disease (NAFLD) contributes to hepatocellular carcinoma (HCC) prevalence in contemporary practices and whether there are any etiologic differences in surveillance receipt, tumor stage, and overall survival (OS) remain unclear. We aimed to estimate the burden of NAFLD-related HCC and magnitude of associations with surveillance receipt, clinical presentation, and outcomes in a contemporary HCC cohort. METHODS: In a cohort of HCC patients from the Surveillance, Epidemiology and End Results-Medicare database between 2011 and 2015, we used multivariable logistic regression to identify factors associated with surveillance receipt, early-stage tumor detection, and curative treatment. Cox regression was used to identify factors associated with OS. RESULTS: Among 5098 HCC patients, NAFLD was the leading etiology, accounting for 1813 cases (35.6%). Compared with those with hepatitis C-related HCC, NAFLD was associated with lower HCC surveillance receipt (adjusted odds ratio, 0.22; 95% confidence interval [CI], 0.17-0.28), lower early-stage HCC detection (adjusted odds ratio, 0.49; 95% CI, 0.40-0.60), and modestly worse OS (adjusted hazard ratio, 1.20; 95% CI, 1.09-1.32). NAFLD subgroup analysis showed that early-stage HCC, absence of ascites/hepatic encephalopathy, surveillance, and curative treatment receipt were associated with improved OS. NAFLD patients with coexisting liver disease were more likely to have surveillance, early-stage detection, curative treatment, and improved OS than NAFLD patients without coexisting liver diseases. CONCLUSIONS: NAFLD is the leading etiology of HCC among Medicare beneficiaries. Compared with other etiologies, NAFLD was associated with lower HCC surveillance receipt, early-stage detection, and modestly poorer survival. Multifaceted interventions for improving surveillance uptake are needed to improve prognosis of patients with NAFLD-related HCC.

Published
2023

4. Recall patterns and risk of primary liver cancer for subcentimeter ultrasound liver observations: a multicenter study.

Author

Singal, Amit G, Ghaziani, T Tara, Mehta, Neil, Zhou, Kali, Grinspan, Lauren T, Benhammou, Jihane N, Moon, Andrew M, Yang, Ju Dong, Salgia, Reena, Pillai, Anjana, Zheng, Elizabeth, Rich, Nicole E, Gopal, Purva, Jalal, Prasun, Verna, Elizabeth, Yekkaluri, Sruthi, Phen, Samuel, Melendez-Torres, Jonathan, Alshuwaykh, Omar, Choi, Hailey, Junus, Kevin, Grady, John, Song, Michael, Leven, Emily A, Yum, Jung, Gowda, Vrushab, Alsudaney, Manaf, Hernandez, Perla, Desai, Nirmal, and Parikh, Neehar D

Subjects
Bile Ducts, Intrahepatic, Humans, Carcinoma, Hepatocellular, Bile Duct Neoplasms, Liver Neoplasms, Liver Cirrhosis, alpha-Fetoproteins, Retrospective Studies, Digestive Diseases, Biomedical Imaging, Cancer, Clinical Research, Liver Disease, Prevention, Hepatitis, Liver Cancer, Chronic Liver Disease and Cirrhosis, Rare Diseases, Good Health and Well Being
Abstract

BackgroundPatients with cirrhosis and subcentimeter lesions on liver ultrasound are recommended to undergo short-interval follow-up ultrasound because of the presumed low risk of primary liver cancer (PLC).AimsThe aim of this study is to characterize recall patterns and risk of PLC in patients with subcentimeter liver lesions on ultrasound.MethodsWe conducted a multicenter retrospective cohort study among patients with cirrhosis or chronic hepatitis B infection who had subcentimeter ultrasound lesions between January 2017 and December 2019. We excluded patients with a history of PLC or concomitant lesions ≥1 cm in diameter. We used Kaplan Meier and multivariable Cox regression analyses to characterize time-to-PLC and factors associated with PLC, respectively.ResultsOf 746 eligible patients, most (66.0%) had a single observation, and the median diameter was 0.7 cm (interquartile range: 0.5-0.8 cm). Recall strategies varied, with only 27.8% of patients undergoing guideline-concordant ultrasound within 3-6 months. Over a median follow-up of 26 months, 42 patients developed PLC (39 HCC and 3 cholangiocarcinoma), yielding an incidence of 25.7 cases (95% CI, 6.2-47.0) per 1000 person-years, with 3.9% and 6.7% developing PLC at 2 and 3 years, respectively. Factors associated with time-to-PLC were baseline alpha-fetoprotein >10 ng/mL (HR: 4.01, 95% CI, 1.85-8.71), platelet count ≤150 (HR: 4.90, 95% CI, 1.95-12.28), and Child-Pugh B cirrhosis (vs. Child-Pugh A: HR: 2.54, 95% CI, 1.27-5.08).ConclusionsRecall patterns for patients with subcentimeter liver lesions on ultrasound varied widely. The low risk of PLC in these patients supports short-interval ultrasound in 3-6 months, although diagnostic CT/MRI may be warranted for high-risk subgroups such as those with elevated alpha-fetoprotein levels.

Published
2023

6. Provider Attitudes Toward Risk-Based Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis in the United States.

Author

Kim, Nicole, Rozenberg-Ben-Dror, Karine, Jacob, David, Rich, Nicole, Singal, Amit, Aby, Elizabeth, Yang, Ju, Nguyen, Veronica, Pillai, Anjana, Fuchs, Michael, Moon, Andrew, Shroff, Hersh, Agarwal, Parul, Perumalswami, Ponni, Chandna, Shaun, Zhou, Kali, Patel, Yuval, Latt, Nyan, Wong, Robert, Duarte-Rojo, Andres, Lindenmeyer, Christina, Frenette, Catherine, Ge, Jin, Mehta, Neil, Yao, Francis, Benhammou, Jihane, Bloom, Patricia, Leise, Michael, Kim, Hyun-Seok, Levy, Cynthia, Barnard, Abbey, Khalili, Mandana, and Ioannou, George

Subjects
Computed Tomography, Liver Cancer, Magnetic Resonance Imaging, Screening, Ultrasound, Attitude of Health Personnel, Carcinoma, Hepatocellular, Diagnostic Tests, Routine, Early Detection of Cancer, Humans, Liver Cirrhosis, Liver Neoplasms, Ultrasonography, United States, alpha-Fetoproteins
Abstract

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) surveillance rates are suboptimal in clinical practice. We aimed to elicit providers opinions on the following aspects of HCC surveillance: preferred strategies, barriers and facilitators, and the impact of a patients HCC risk on the choice of surveillance modality. METHODS: We conducted a web-based survey among gastroenterology and hepatology providers (40% faculty physicians, 21% advanced practice providers, 39% fellow-trainees) from 26 US medical centers in 17 states. RESULTS: Of 654 eligible providers, 305 (47%) completed the survey. Nearly all (98.4%) of the providers endorsed semi-annual HCC surveillance in patients with cirrhosis, with 84.2% recommending ultrasound ± alpha fetoprotein (AFP) and 15.4% recommending computed tomography (CT) or magnetic resonance imaging (MRI). Barriers to surveillance included limited HCC treatment options, screening test effectiveness to reduce mortality, access to transportation, and high out-of-pocket costs. Facilitators of surveillance included professional society guidelines. Most providers (72.1%) would perform surveillance even if HCC risk was low (≤0.5% per year), while 98.7% would perform surveillance if HCC risk was ≥1% per year. As a patients HCC risk increased from 1% to 3% to 5% per year, providers reported they would be less likely to order ultrasound ± AFP (83.6% to 68.9% to 57.4%; P < .001) and more likely to order CT or MRI ± AFP (3.9% to 26.2% to 36.1%; P < .001). CONCLUSIONS: Providers recommend HCC surveillance even when HCC risk is much lower than the threshold suggested by professional societies. Many appear receptive to risk-based HCC surveillance strategies that depend on patients estimated HCC risk, instead of our current one-size-fits all strategy.

Published
2022

10. The Mortality and Overall Survival Trends of Primary Liver Cancer in the United States

Author

Lee, Yi-Te, Wang, Jasmine J, Luu, Michael, Noureddin, Mazen, Kosari, Kambiz, Agopian, Vatche G, Rich, Nicole E, Lu, Shelly C, Tseng, Hsian-Rong, Nissen, Nicholas N, Singal, Amit G, and Yang, Ju Dong

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Liver Cancer, Rare Diseases, Cancer, Liver Disease, Aging, Digestive Diseases, Good Health and Well Being, Aged, Bile Duct Neoplasms, Bile Ducts, Intrahepatic, Carcinoma, Hepatocellular, Cholangiocarcinoma, Humans, Liver Neoplasms, United States, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

BackgroundRecent trends of hepatocellular carcinoma (HCC) mortality and outcome remain unknown in the United States. We investigated the recent trends of primary liver cancer (excluding intrahepatic cholangiocarcinoma) mortality and HCC stage, treatment, and overall survival (OS) in the United States.MethodsThe National Center for Health Statistics Database was analyzed to investigate the trend of primary liver cancer mortality. We analyzed the Surveillance, Epidemiology, and End Results 18 Database to assess the temporal trend of tumor size, stage, treatment, and OS of HCC. We investigated the association between HCC diagnosis year and OS using Cox regression analysis. All statistical tests were 2-sided.ResultsDuring 2000-2018, liver cancer mortality rates increased until 2013, plateaued during 2013-2016 (annual percent change = 0.1%/y, 95% confidence interval [CI] = -2.1%/y to 2.4%/y, P = .92), and started to decline during 2016-2018 (annual percent change = -1.5%/y, 95% CI = -3.2%/y to 0.2%/y, P = .08). However, mortality continues to increase in American Indian and Alaska Native, individuals aged 65 years or older, and in 33 states. There was a 0.61% (95% CI = 0.53% to 0.69%, P

Published
2021

11. Racial and Ethnic Disparities in Liver Transplantation for Alcohol-associated Liver Diseases in the United States

Author

Cotter, Thomas G., Mitchell, Mack C., Patel, Mausam J., Anouti, Ahmad, Lieber, Sarah R., Rich, Nicole E., Arab, Juan Pablo, Díaz, Luis Antonio, Louissaint, Jeremy, Kerr, Thomas, Mufti, Arjmand R., Hanish, Steven I., Vagefi, Parsia A., Patel, Madhukar S., VanWagner, Lisa B., Lee, William M., O’Leary, Jacqueline G., and Singal, Amit G.

Published
2024
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22. Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection Is Associated With Increased Survival in Patients With a History of Hepatocellular Carcinoma

Author

Singal, Amit G, Rich, Nicole E, Mehta, Neil, Branch, Andrea D, Pillai, Anjana, Hoteit, Maarouf, Volk, Michael, Odewole, Mobolaji, Scaglione, Steven, Guy, Jennifer, Said, Adnan, Feld, Jordan J, John, Binu V, Frenette, Catherine, Mantry, Parvez, Rangnekar, Amol S, Oloruntoba, Omobonike, Leise, Michael, Jou, Janice H, Bhamidimarri, Kalyan Ram, Kulik, Laura, Ioannou, George N, Huang, Annsa, Tran, Tram, Samant, Hrishikesh, Dhanasekaran, Renumathy, Duarte-Rojo, Andres, Salgia, Reena, Eswaran, Sheila, Jalal, Prasun, Flores, Avegail, Satapathy, Sanjaya K, Kagan, Sofia, Gopal, Purva, Wong, Robert, Parikh, Neehar D, and Murphy, Caitlin C

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Chronic Liver Disease and Cirrhosis, Digestive Diseases, Cancer, Emerging Infectious Diseases, Clinical Research, Hepatitis, Rare Diseases, Prevention, Infectious Diseases, Liver Cancer, Hepatitis - C, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Infection, Good Health and Well Being, Aged, Antiviral Agents, Carcinoma, Hepatocellular, Female, Hepatitis C, Humans, Liver Neoplasms, Male, Middle Aged, North America, Protective Factors, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, HCC, Survival, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsThere is controversy regarding the benefits of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection for patients with a history of hepatocellular carcinoma (HCC). We performed a multicenter cohort study to compare overall survival between patients with HCV infection treated with DAAs and patients who did not receive DAA treatment for their HCV infection after complete response to prior HCC therapy.MethodsWe conducted a retrospective cohort study of patients with HCV-related HCC who achieved a complete response to resection, local ablation, transarterial chemo- or radioembolization, or radiation therapy, from January 2013 through December 2017 at 31 health care systems throughout the United States and Canada. We used Cox proportional hazards regression to determine the association between receipt of DAA therapy, modeled as a time-varying covariate, and all-cause mortality, accounting for informative censoring and confounding using inverse probability weighting.ResultsOf 797 patients with HCV-related HCC, 383 (48.1%) received DAA therapy and 414 (51.9%) did not receive treatment for their HCV infection after complete response to prior HCC therapy. Among DAA-treated patients, 43 deaths occurred during 941 person-years of follow-up, compared with 103 deaths during 526.6 person-years of follow-up among patients who did not receive DAA therapy (crude rate ratio, 0.23; 95% confidence interval [CI], 0.16-0.33). In inverse probability-weighted analyses, DAA therapy was associated with a significant reduction in risk of death (hazard ratio, 0.54; 95% CI, 0.33-0.90). This association differed by sustained virologic response to DAA therapy; risk of death was reduced in patients with sustained virologic response to DAA therapy (hazard ratio, 0.29; 95% CI, 0.18-0.47), but not in patients without a sustained virologic response (hazard ratio, 1.13; 95% CI, 0.55-2.33).ConclusionsIn an analysis of nearly 800 patients with complete response to HCC treatment, DAA therapy was associated with a significant reduction in risk of death.

Published
2019

23. Racial and Ethnic Disparities in Liver Transplantation for Alcohol-associated Liver Diseases in the United States

Author

Cotter, Thomas G., Mitchell, Mack C., Patel, Mausam J., Anouti, Ahmad, Lieber, Sarah R., Rich, Nicole E., Arab, Juan Pablo, Díaz, Luis Antonio, Louissaint, Jeremy, Kerr, Thomas, Mufti, Arjmand R., Hanish, Steven I., Vagefi, Parsia A., Patel, Madhukar S., VanWagner, Lisa B., Lee, William M., O’Leary, Jacqueline G., and Singal, Amit G.

Published
2023
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24. Psychiatric disorders in patients with hepatocellular carcinoma: A large US cohort of commercially insured individuals

Author

Patel, Mausam J., primary, Jones, Alex, additional, Jiang, Yue, additional, Gowda, Prajwal, additional, VanWagner, Lisa B., additional, Cotter, Thomas G., additional, Seif El Dahan, Karim, additional, Louissaint, Jeremy, additional, Patel, Madhukar, additional, Rich, Nicole E., additional, Singal, Amit G., additional, and Lieber, Sarah R., additional

Published
2024
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25. TOP-063 The efficacy of Glucagon-like Peptide-1 receptor agonists in patients with compensated cirrhosis and obesity

Author

Han Ng, Wee, primary, Hui Yeo, Yee, additional, Singal, Amit, additional, Parikh, Neehar D., additional, Kuo, Alexander, additional, Kim, Hyunseok, additional, Wang, Yun, additional, Trivedi, Hirsch, additional, Rich, Nicole, additional, Samaan, Jamil, additional, S Ayoub, Walid, additional, Ma, Kevin, additional, and Yang, Ju Dong, additional

Published
2024
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26. High Neutrophil–Lymphocyte Ratio and Delta Neutrophil–Lymphocyte Ratio Are Associated with Increased Mortality in Patients with Hepatocellular Cancer

Author

Rich, Nicole E., Parvathaneni, Aarthi, Sen, Ahana, Odewole, Mobolaji, Arroyo, Ana, Mufti, Arjmand R., Kerr, Thomas A., Grant, Lafaine, Tujios, Shannan R., Mayo, Marlyn J., Lee, William M., Yang, Ju Dong, Yokoo, Takeshi, Gopal, Purva, Hoshida, Yujin, Zhu, Hao, Yopp, Adam C., Marrero, Jorge A., and Singal, Amit G.

Published
2022
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28. Direct-Acting Antiviral Therapy Not Associated With Recurrence of Hepatocellular Carcinoma in a Multicenter North American Cohort Study

Author

Singal, Amit G, Rich, Nicole E, Mehta, Neil, Branch, Andrea, Pillai, Anjana, Hoteit, Maarouf, Volk, Michael, Odewole, Mobolaji, Scaglione, Steven, Guy, Jennifer, Said, Adnan, Feld, Jordan J, John, Binu V, Frenette, Catherine, Mantry, Parvez, Rangnekar, Amol S, Oloruntoba, Omobonike, Leise, Michael, Jou, Janice H, Bhamidimarri, Kalyan Ram, Kulik, Laura, Tran, Tram, Samant, Hrishikesh, Dhanasekaran, Renumathy, Duarte-Rojo, Andres, Salgia, Reena, Eswaran, Sheila, Jalal, Prasun, Flores, Avegail, Satapathy, Sanjaya K, Wong, Robert, Huang, Annsa, Misra, Suresh, Schwartz, Myron, Mitrani, Robert, Nakka, Sasank, Noureddine, Wassim, Ho, Chanda, Konjeti, Venkata R, Dao, Alexander, Nelson, Kevin, Delarosa, Kelly, Rahim, Usman, Mavuram, Meher, Xie, Jesse J, Murphy, Caitlin C, and Parikh, Neehar D

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Emerging Infectious Diseases, Digestive Diseases, Rare Diseases, Hepatitis - C, Hepatitis, Chronic Liver Disease and Cirrhosis, Clinical Research, Liver Cancer, Cancer, Infectious Diseases, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Aged, Antiviral Agents, Canada, Carcinoma, Hepatocellular, Female, Hepatitis C, Chronic, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Sustained Virologic Response, Time Factors, United States, Hepatitis C Virus, Recurrence, Direct-Acting Antiviral, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsThere is controversy over the effects of direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection on hepatocellular carcinoma (HCC) recurrence and tumor aggressiveness. We compared HCC recurrence patterns between DAA-treated and untreated HCV-infected patients who had achieved a complete response to HCC treatment in a North American cohort.MethodsWe conducted a retrospective cohort study of patients with HCV-related HCC with a complete response to resection, local ablation, transarterial chemo- or radioembolization, or radiation therapy from January 2013 through December 2017 at 31 health systems throughout the United States and Canada. Cox regression was used to examine the association between DAA therapy and time to recurrence after a complete response, with DAA therapy analyzed as a time-varying exposure. We also estimated the association between DAA therapy and risk of early HCC recurrence (defined as 365 days after complete response).ResultsOf 793 patients with HCV-associated HCC, 304 (38.3%) received DAA therapy and 489 (61.7%) were untreated. HCC recurred in 128 DAA-treated patients (42.1%; early recurrence in 52 patients) and 288 untreated patients (58.9%; early recurrence in 227 patients). DAA therapy was not associated with HCC recurrence (hazard ratio 0.90, 95% confidence interval 0.70-1.16) or early HCC recurrence (hazard ratio 0.96, 95% confidence interval 0.70-1.34) after we adjusted for study site, age, sex, Child-Pugh score, α-fetoprotein level, tumor burden, and HCC treatment modality. In DAA-treated and untreated patients, most recurrences were within the Milan criteria (74.2% vs 78.8%; P = .23). A larger proportion of DAA-treated than untreated patients received potentially curative HCC therapy for recurrent HCC (32.0% vs 24.6%) and achieved a complete or partial response (45.3% vs 41.0%) but this did not achieve statistical significance.ConclusionIn a large cohort of North American patients with complete response to HCC treatment, DAA therapy was not associated with increased overall or early HCC recurrence. HCC recurrence patterns, including treatment response, were similar in DAA-treated and untreated patients.

Published
2019

32. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Al Maadany, Faraj, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M., Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH., Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A., Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Campos Jácome, Ana Filipa, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Ocke Reis, Paulo Eduardo, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H., Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, Corless, Kevin, Ioannidis, Orestis, Friedrich, Oliver, Van Herzeele, Isabelle, Vijaynagar, Badri, Cohnert, Tina, Bell, Rachel, Moore, Hayley, Saha, Prakash, Gifford, Edward, Laine, Matti, Barkat, Adel, Karkos, Christos, Binti Safri, Lenny Suryani, Buitron, Gabriel, Del Castillo, Javier, Carrera, Paul, Salinas, Nilson, Biagioni, Rodrigo Bruno, Benites, Sergio, Mafla, César Andrés, Pian, Putera Mas, Albino, Pereira, Serrano, Ernesto, Marin, Andres, González, Marco, Foreroga, Marsha, Russo, Alejandro, Reyes, Andrés, Guglielmone, Daniel, Grillo, Lorena, Flumignan, Ronald, Palones, Francisco Gomez, Silveira, Pierre Galvagni, Ramely, Rosnelifaizur Bin, Edeiken, Sara, Chetter, Ian, Green, Lucy, Sudarsanam, Abhilash, Lyons, Oliver, Lemmon, Gary, Neville, Richard, Castelli, Mariano, Hinojosa, Carlos A., Carvajal, Rubén Rodríguez, Rivera, Aksim, Wong, Peng, Drudi, Laura, Perkins, Jeremy, Sieunarine, Kishore, Attia, Doaa, Atef, Mahmoud, Eftychios, Lostoridis, Weaver, Fred, Ren, Leong Chuo, Alomari, Mohannad, Jamjoom, Reda, Aljarrah, Qusai, Abbas, Ayman, Alomran, Faris, Kumar, Ambrish, Altoijri, Abdulmajeed, ElSanhoury, Kareem T., Alhumaid, Ahmed, Fekry, Tamer, Sekhar, Raghuram, Theodoridis, Panagiotis, Panagiotis, Theodoridis, Roditis, Konstantinos, Tsiantoula, Paraskevi, Antoniou, Afroditi, Soler, Raphael, Hasemaki, Natasha, Baili, Efstratia, Mpaili, Eustratia, Huasen, Bella, Wallace, Tom, Duncan, Andrew, Metcalfe, Matthew, Mannoia, Kristyn, Bechara, Carlos F., Tsilimparis, Nikolaos, Aranson, Nathan, Riding, David, Palena, Mariano, McDonnell, Ciarán, Mouawad, Nicolas J., Banegas, Shonda, Rossi, Peter, Oshodi, Taohid, Diaz, Rodney, Afifi, Rana, Dindyal, Shiva, Thapar, Ankur, Kordzadeh, Ali, Pullas, Gonzalo, Lin, Stephanie, Davies, Chris, Darvall, Katy, Kodama, Akio, Gooneratne, Thushan, Gunawansa, Nalaka, Munoz, Alberto, Jie, Ng Jun, Bradley, Nicholas, Al-Jundi, Wissam, Meyer, Felicity, Lee, Cheong, Malina, Martin, Renton, Sophie, Lui, Dennis, Batchelder, Andrew, Oszkinis, Grzegorz, Freyrie, Antonio, Giordano, Jacopo, Saratzis, Nikolaos, Tigkiropoulos, Konstantinos, Kyriakos, Stavridis, Popov, Guriy, Cheema, Muhammad Usman, Lapolla, Pierfrancesco, Ling Patricia, Yih Chun, Ennab, Raed, Ullery, Brant W., Pasenidou, Ketino, Tam, Jacky, Sidel, Gabriel, Jayaprakash, Vivek Vardhan, Bennett, Lisa, Hardy, Simon, Davies, Emma, Baker, Sara, Wijesinghe, Lasantha, Tam, Adam, McCune, Ken, Chana, Manik, Lowe, Chris, Goh, Aaron, Powezka, Katarzyna, Kyrou, Ioanna, Altaf, Nishath, Harkin, Denis, Travers, Hannah, Cragg, James, sharif, Atif, Akhtar, Tasleem, Chávez, José Antonio, Ordonez, Claudia, Mazzurco, Martin, Choke, Edward, Asghar, Imran, Summerour, Virginia, Dunlop, Paul, Morley, Rachel, Hardy, Thomas, Bevis, Paul, Cuff, Robert, Stavroulakis, Konstantinos, Beropoulis, Efthymios, Argyriou, Angeliki, Loftus, Ian, Azhar, Bilal, Sheth, Sharvil, Usai, Marco Virgilio, Choudhry, Asad, Nicole, Kira, Boyle, Emily, Joyce, Doireann, Abdelaty Hassan, Mohammed Hassan, Saltiel, Alberto, Frahm-Jensen, Gert, Antoniou, George, Elhadi, Muhammed, Kimyaghalam, Ali, Malgor, Rafael, O'Banion, Leigh Ann, Telve, Diego, Isaak, Andrej, Schmidli, Jürg, McKevitt, Kevin, Siddiqui, Tam, Asciutto, Giuseppe, Floros, Nikolaos, Papadopoulos, George, Kafetzakis, Alexandros, Koutsias, Stylianos G., Nana, Petroula, Giannoukas, Athanasios, Kakkos, Stavros, Moulakakis, Konstantinos G., Shafique, Natasha, Jawien, Arkadiusz, Popplewell, Matthew, Imray, Chris, Abayasekara, Kumar, Rowlands, Timothy, Kuhan, Ganesh, Rajagopalan, Sriram, Jaipersad, Anthony, Sadia, Uzma, Kobe, Isaac, Mittapalli, Devender, Enemosah, Ibrahim, Behrendt, Christian-Alexander, Beck, Adam, Almudhafer, Muayyad, Ancetti, Stefano, Jacobs, Donald, Jayakumar, Priya, Malekpour, Fatemeh, Shalhub, Sherene, Keldiyorov, Boboyor, Simon, Meryl, Khashram, Manar, Rich, Nicole, Shepherd, Amanda, Meecham, Lewis, Doherty, Daniel, and Benson, Ruth A.

Published
2022
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33. A mixed-methods investigation of incident Hemodialysis access in a safety-net population

Author

Rich, Nicole C, Vartanian, Shant M, Sharief, Shimi, Freitas, Daniel J, and Tuot, Delphine S

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Behavioral and Social Science, Patient Safety, Kidney Disease, Assistive Technology, Bioengineering, Basic Behavioral and Social Science, Clinical Research, Adult, Aged, Aged, 80 and over, Catheters, Indwelling, Cohort Studies, Female, Hospitals, Urban, Humans, Insurance, Health, Male, Medically Uninsured, Middle Aged, Renal Dialysis, Retrospective Studies, Safety-net Providers, Young Adult, Arteriovenous fistula, Disparities, Hemodialysis access, Safety-net, Vascular access, Vascular surgery, Clinical Sciences, Urology & Nephrology, Clinical sciences, Health services and systems, Nursing
Abstract

BackgroundDespite improved health outcomes associated with arteriovenous fistulas, 80% of Americans initiate hemodialysis using a catheter, influenced by low socioeconomic status among other factors. Risk factors for incident catheter use in safety-net populations are unknown. Our objective was to identify factors associated with incident catheter use among hemodialysis patients at one safety-net hospital, with a goal of informing fistula placement initiatives targeted at safety-net populations more generally.MethodsWe performed a retrospective review of all incident hemodialysis patients at a single urban safety-net hospital from January 1, 2010 - December 31, 2015 (n = 241), as well as semi-structured interviews with a multi-lingual convenience sample of patients (n = 10) from this cohort. The primary outcome was incident vascular access modality. Multivariable logistic regression was used to identify factors associated with incident catheter use. Interview transcripts were coded using a directed content analysis framework based on a model describing barriers to healthcare access.ResultsSubjects were 61.8% male, racially/ethnically diverse (19.5% white, 29.5% black, 28.6% Hispanic, 17.4% Asian), with a mean age of 52.4 years. Eighty-eight percent initiated hemodialysis using a catheter. In multivariable analysis, longer duration of nephrology care was associated with decreased catheter use (>12 months vs. 0-6 months: adjusted Odds Ratio [aOR] 0.07, 95% CI 0.02-0.23, p

Published
2017

34. Racial and ethnic disparities in alcohol-associated liver disease in the United States: A systematic review and meta-analysis

Author

Anouti, Ahmad, primary, Seif El Dahan, Karim, additional, Rich, Nicole E., additional, Louissaint, Jeremy, additional, Lee, William M., additional, Lieber, Sarah R., additional, Arab, Juan Pablo, additional, Zhang, Bill Y., additional, Patel, Mausam J., additional, Thimphittaya, Chanattha, additional, Díaz, Luis Antonio, additional, Gregory, Dyanna L., additional, Kozlitina, Julia, additional, VanWagner, Lisa B., additional, King, Andrea C., additional, Mitchell, Mack C., additional, Singal, Amit G., additional, and Cotter, Thomas G., additional

Published
2024
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35. Association of Hepatic Triglyceride Content With Cardiac Structure and Function Among Community-Dwelling Adults

Author

Saha, Srishti, primary, Keshvani, Neil, additional, Segar, Matthew W., additional, Patel, Kershaw V., additional, Fudim, Marat, additional, Rohatgi, Anand, additional, Ayers, Colby, additional, VanWagner, Lisa B., additional, Rao, Vishal N., additional, Drazner, Mark H., additional, Garg, Sonia, additional, Singal, Amit G., additional, Rich, Nicole E., additional, Browning, Jeffrey D., additional, Neeland, Ian J., additional, and Pandey, Ambarish, additional

Published
2024
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41. Provider Attitudes and Practice Patterns for Direct-Acting Antiviral Therapy for Patients With Hepatocellular Carcinoma

Author

Rich, Nicole E., Yang, Ju Dong, Perumalswami, Ponni V., Alkhouri, Naim, Jackson, Whitney, Parikh, Neehar D., Mehta, Neil, Salgia, Reena, Duarte-Rojo, Andres, Kulik, Laura, Rakoski, Mina, Said, Adnan, Oloruntoba, Omobonike, Ioannou, George N., Hoteit, Maarouf A., Moon, Andrew M., Rangnekar, Amol S., Eswaran, Sheila L., Zheng, Elizabeth, Jou, Janice H., Hanje, James, Pillai, Anjana, Hernaez, Ruben, Wong, Robert, Scaglione, Steven, Samant, Hrishikesh, Kapuria, Devika, Chandna, Shaun, Rosenblatt, Russell, Ajmera, Veeral, Frenette, Catherine T., Satapathy, Sanjaya K., Mantry, Parvez, Jalal, Prasun, John, Binu V., Fix, Oren K., Leise, Michael, Lindenmeyer, Christina C., Flores, Avegail, Patel, Nayan, Jiang, Z. Gordon, Latt, Nyan, Dhanasekaran, Renumathy, Odewole, Mobolaji, Kagan, Sofia, Marrero, Jorge A., and Singal, Amit G.

Published
2020
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46. S1326 Caregivers of Waitlisted Liver Transplant Candidates Experience Significant Financial Burden and Psychological Symptoms

Author

Tadros, Meena M., primary, Ramirez, Alvaro Noriega, additional, Gregory, Dyanna, additional, Ufere, Nneka, additional, Louissaint, Jeremy, additional, Cotter, Thomas G., additional, Rich, Nicole E., additional, Mufti, Arjmand R., additional, VanWagner, Lisa B., additional, Singal, Amit G., additional, and Lieber, Sarah R., additional

Published
2023
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