33 research outputs found
European 'NAFLD Preparedness Index' - Is Europe ready to meet the challenge of fatty liver disease?
Background & Aims: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome,
and diabetes, is a highly prevalent emerging condition that can be optimally managed through a multidisciplinary patient centred approach. National preparedness to address NAFLD is essential to ensure that health systems can deliver effective
care. We present a NAFLD Preparedness Index for Europe.
Methods: In June 2019, data were extracted by expert groups from 29 countries to complete a 41-item questionnaire about
NAFLD. Questions were classified into 4 categories: policies/civil society (9 questions), guidelines (16 questions), epidemiology
(4 questions), and care management (12 questions). Based on the responses, national preparedness for each indicator was
classified into low, middle, or high-levels. We then applied a multiple correspondence analysis to obtain a standardised
preparedness score for each country ranging from 0 to 100.
Results: The analysis estimated a summary factor that explained 71.3% of the variation in the dataset. No countries were
found to have yet attained a high-level of preparedness. Currently, the UK (75.5) scored best, although falling within the mid level preparedness band, followed by Spain (56.2), and Denmark (43.4), whereas Luxembourg and Ireland were the lowest
scoring countries with a score of 4.9. Only Spain scored highly in the epidemiology indicator category, whereas the UK was the
only country that scored highly for care management.
Conclusions: The NAFLD Preparedness Index indicates substantial variation between countries’ readiness to address NAFLD.
Notably, even those countries that score relatively highly exhibit deficiencies in key domains, suggesting that structural
changes are needed to optimise NAFLD management and ensure effective public health approaches are in place.
Lay summary: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome, and
diabetes, is a highly prevalent condition that can be optimally managed through a multidisciplinary patient-centred approach.
National preparedness to address NAFLD is essential to allow for effective public health measures aimed at preventing disease
while also ensuring that health systems can deliver effective care to affected populations. This study defined preparedness as
having adequate policies and civil society engagement, guidelines, epidemiology, and care management. NAFLD preparedness
was found to be deficient in all 29 countries studied, with great variation among the countries and the 4 categories studied
COVID-SCORE: A global survey to assess public perceptions of government responses to COVID-19 (COVID-SCORE-10)
BACKGROUND content: Understanding public
perceptions of government responses to COVID-19 may foster
improved public cooperation. Trust in government and population
risk of exposure may influence public perception of the
response. Other population-level characteristics, such as
country socio-economic development, COVID-19 morbidity and
mortality, and degree of democratic government, may influence
perception. - Label: METHODS AND FINDINGS content: We developed
a novel ten-item instrument that asks respondents to rate key
aspects of their government's response to the pandemic
(COVID-SCORE). We examined whether the results varied by gender,
age group, education level, and monthly income. We also examined
the internal and external validity of the index using
appropriate predefined variables. To test for dimensionality of
the results, we used a principal component analysis (PCA) for
the ten survey items. We found that Cronbach's alpha was 0.92
and that the first component of the PCA explained 60% of
variance with the remaining factors having eigenvalues below 1,
strongly indicating that the tool is both reliable and
unidimensional. Based on responses from 13,426 people randomly
selected from the general population in 19 countries, the mean
national scores ranged from 35.76 (Ecuador) to 80.48 (China) out
of a maximum of 100 points. Heterogeneity in responses was
observed across age, gender, education and income with the
greatest amount of heterogeneity observed between countries.
National scores correlated with respondents' reported levels of
trust in government and with country-level COVID-19 mortality
rates. - Label: CONCLUSIONS content: The COVID-SCORE survey
instrument demonstrated satisfactory validity. It may help
governments more effectively engage constituents in current and
future efforts to control COVID-19. Additional country-specific
assessment should be undertaken to measure trends over time and
the public perceptions of key aspects of government responses in
other countries
The Hep-CORE policy score: A European hepatitis C national policy implementation ranking based on patient organization data.
BACKGROUND content: New hepatitis C virus (HCV) treatments spurred the World Health Organization (WHO) in 2016 to adopt a strategy to eliminate HCV as a public health threat by 2030. To achieve this, key policies must be implemented. In the absence of monitoring mechanisms, this study aims to assess the extent of policy implementation from the perspective of liver patient groups. - Label: METHODS content: "Thirty liver patient organisations, each representing a country, were surveyed in October 2018 to assess implementation of HCV
policies in practice. Respondents received two sets of questions
based on: 1) WHO recommendations; and 2) validated data sources
verifying an existing policy in their country. Academic experts
selected key variables from each set for inclusion into policy
scores. The similarity scores were calculated for each set with
a multiple joint correspondence analysis. Proxy reference
countries were included as the baseline to contextualize
results. We extracted scores for each country and standardized
them from 0 to 10 (best)." - Label: RESULTS content: Twenty-five
countries responded. For the score based on WHO recommendations,
Bulgaria had the lowest score whereas five countries (Cyprus,
Netherlands, Portugal, Slovenia, and Sweden) had the highest
scores. For the verified policy score, a two-dimensional
solution was identified; first dimension scores pertained to
whether verified policies were in place and second dimension
scores pertained to the proportion of verified policies in-place
that were implemented. Spain, UK, and Sweden had high scores for
both dimensions. - Label: CONCLUSIONS content: Patient groups
reported that the European region is not on track to meet WHO
2030 HCV goals. More action should be taken to implement and
monitor HCV policies
The Hep-CORE policy score: A European hepatitis C national policy implementation ranking based on patient organization data.
BACKGROUND: New hepatitis C virus (HCV) treatments spurred the World Health Organization (WHO) in 2016 to adopt a strategy to eliminate HCV as a public health threat by 2030. To achieve this, key policies must be implemented. In the absence of monitoring mechanisms, this study aims to assess the extent of policy implementation from the perspective of liver patient groups. METHODS: Thirty liver patient organisations, each representing a country, were surveyed in October 2018 to assess implementation of HCV policies in practice. Respondents received two sets of questions based on: 1) WHO recommendations; and 2) validated data sources verifying an existing policy in their country. Academic experts selected key variables from each set for inclusion into policy scores. The similarity scores were calculated for each set with a multiple joint correspondence analysis. Proxy reference countries were included as the baseline to contextualize results. We extracted scores for each country and standardized them from 0 to 10 (best). RESULTS: Twenty-five countries responded. For the score based on WHO recommendations, Bulgaria had the lowest score whereas five countries (Cyprus, Netherlands, Portugal, Slovenia, and Sweden) had the highest scores. For the verified policy score, a two-dimensional solution was identified; first dimension scores pertained to whether verified policies were in place and second dimension scores pertained to the proportion of verified policies in-place that were implemented. Spain, UK, and Sweden had high scores for both dimensions. CONCLUSIONS: Patient groups reported that the European region is not on track to meet WHO 2030 HCV goals. More action should be taken to implement and monitor HCV policies