Experts' opinions on the role of liver biopsy in HCV infection: A Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.)

Piero Luigi Almasio, Mauro Niero, Donato Angioli, Antonio Ascione, Sergio Gullini, Giorgio Minoli, Nadia C. Oprandi, Giovan Battista Pinzello, Giorgio Verme, Angelo Andriulli

Research output: Contribution to journalArticle

Abstract

Background/Aims: Liver biopsy represents the gold standard to establish a diagnosis in all liver patients, but its current position in chronic viral hepatitis is questioned. We aimed to create a consensus on best practice of use of liver biopsy in the management of chronic HCV infection. Methods: We applied the Delphi method to 12 clinical scenarios of chronic HCV infection, to assess the extent of agreement (consensus measurement) and to resolve disagreement (consensus development) on the appropriateness of liver biopsy. Results: Among 108 chosen hepatologists, 61 (56.5%) accepted to participate to the first-round survey. In four patients the majority of experts (from 61.4 to 86.2%) agreed not to perform liver biopsy; in two cases an equivalent opinion was found, and in the remaining six scenarios the majority of experts would have recommended a biopsy. No expert recommended liver biopsy in all cases, while most agreed for an histological evaluation of 4 to 8 cases. At the second round, 36 experts (59%) submitted ballots. Fifty-four out of 431 (12.6%) original judgments were changed with equal distribution among different scenarios. Conclusions: Our survey showed a great divergence of management of similar patients and should provide a stimulus for an evidence-based evaluation of liver histology in chronic HCV infection.

Original languageEnglish
Pages (from-to)381-387
Number of pages7
JournalJournal of Hepatology
Volume43
Issue number3
DOIs
Publication statusPublished - Sep 2005

Fingerprint

Expert Testimony
Biopsy
Liver
Infection
Consensus
Chronic Hepatitis
Gastroenterologists
Surveys and Questionnaires
Practice Guidelines
Histology

Keywords

  • Delphi method
  • HCV
  • Liver biopsy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Experts' opinions on the role of liver biopsy in HCV infection : A Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.). / Almasio, Piero Luigi; Niero, Mauro; Angioli, Donato; Ascione, Antonio; Gullini, Sergio; Minoli, Giorgio; Oprandi, Nadia C.; Pinzello, Giovan Battista; Verme, Giorgio; Andriulli, Angelo.

In: Journal of Hepatology, Vol. 43, No. 3, 09.2005, p. 381-387.

Research output: Contribution to journalArticle

Almasio, Piero Luigi ; Niero, Mauro ; Angioli, Donato ; Ascione, Antonio ; Gullini, Sergio ; Minoli, Giorgio ; Oprandi, Nadia C. ; Pinzello, Giovan Battista ; Verme, Giorgio ; Andriulli, Angelo. / Experts' opinions on the role of liver biopsy in HCV infection : A Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.). In: Journal of Hepatology. 2005 ; Vol. 43, No. 3. pp. 381-387.
@article{cda4e4f3334246e892ec65bd2484e6df,
title = "Experts' opinions on the role of liver biopsy in HCV infection: A Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.)",
abstract = "Background/Aims: Liver biopsy represents the gold standard to establish a diagnosis in all liver patients, but its current position in chronic viral hepatitis is questioned. We aimed to create a consensus on best practice of use of liver biopsy in the management of chronic HCV infection. Methods: We applied the Delphi method to 12 clinical scenarios of chronic HCV infection, to assess the extent of agreement (consensus measurement) and to resolve disagreement (consensus development) on the appropriateness of liver biopsy. Results: Among 108 chosen hepatologists, 61 (56.5{\%}) accepted to participate to the first-round survey. In four patients the majority of experts (from 61.4 to 86.2{\%}) agreed not to perform liver biopsy; in two cases an equivalent opinion was found, and in the remaining six scenarios the majority of experts would have recommended a biopsy. No expert recommended liver biopsy in all cases, while most agreed for an histological evaluation of 4 to 8 cases. At the second round, 36 experts (59{\%}) submitted ballots. Fifty-four out of 431 (12.6{\%}) original judgments were changed with equal distribution among different scenarios. Conclusions: Our survey showed a great divergence of management of similar patients and should provide a stimulus for an evidence-based evaluation of liver histology in chronic HCV infection.",
keywords = "Delphi method, HCV, Liver biopsy",
author = "Almasio, {Piero Luigi} and Mauro Niero and Donato Angioli and Antonio Ascione and Sergio Gullini and Giorgio Minoli and Oprandi, {Nadia C.} and Pinzello, {Giovan Battista} and Giorgio Verme and Angelo Andriulli",
year = "2005",
month = "9",
doi = "10.1016/j.jhep.2005.02.041",
language = "English",
volume = "43",
pages = "381--387",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier B.V.",
number = "3",

}

TY - JOUR

T1 - Experts' opinions on the role of liver biopsy in HCV infection

T2 - A Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.)

AU - Almasio, Piero Luigi

AU - Niero, Mauro

AU - Angioli, Donato

AU - Ascione, Antonio

AU - Gullini, Sergio

AU - Minoli, Giorgio

AU - Oprandi, Nadia C.

AU - Pinzello, Giovan Battista

AU - Verme, Giorgio

AU - Andriulli, Angelo

PY - 2005/9

Y1 - 2005/9

N2 - Background/Aims: Liver biopsy represents the gold standard to establish a diagnosis in all liver patients, but its current position in chronic viral hepatitis is questioned. We aimed to create a consensus on best practice of use of liver biopsy in the management of chronic HCV infection. Methods: We applied the Delphi method to 12 clinical scenarios of chronic HCV infection, to assess the extent of agreement (consensus measurement) and to resolve disagreement (consensus development) on the appropriateness of liver biopsy. Results: Among 108 chosen hepatologists, 61 (56.5%) accepted to participate to the first-round survey. In four patients the majority of experts (from 61.4 to 86.2%) agreed not to perform liver biopsy; in two cases an equivalent opinion was found, and in the remaining six scenarios the majority of experts would have recommended a biopsy. No expert recommended liver biopsy in all cases, while most agreed for an histological evaluation of 4 to 8 cases. At the second round, 36 experts (59%) submitted ballots. Fifty-four out of 431 (12.6%) original judgments were changed with equal distribution among different scenarios. Conclusions: Our survey showed a great divergence of management of similar patients and should provide a stimulus for an evidence-based evaluation of liver histology in chronic HCV infection.

AB - Background/Aims: Liver biopsy represents the gold standard to establish a diagnosis in all liver patients, but its current position in chronic viral hepatitis is questioned. We aimed to create a consensus on best practice of use of liver biopsy in the management of chronic HCV infection. Methods: We applied the Delphi method to 12 clinical scenarios of chronic HCV infection, to assess the extent of agreement (consensus measurement) and to resolve disagreement (consensus development) on the appropriateness of liver biopsy. Results: Among 108 chosen hepatologists, 61 (56.5%) accepted to participate to the first-round survey. In four patients the majority of experts (from 61.4 to 86.2%) agreed not to perform liver biopsy; in two cases an equivalent opinion was found, and in the remaining six scenarios the majority of experts would have recommended a biopsy. No expert recommended liver biopsy in all cases, while most agreed for an histological evaluation of 4 to 8 cases. At the second round, 36 experts (59%) submitted ballots. Fifty-four out of 431 (12.6%) original judgments were changed with equal distribution among different scenarios. Conclusions: Our survey showed a great divergence of management of similar patients and should provide a stimulus for an evidence-based evaluation of liver histology in chronic HCV infection.

KW - Delphi method

KW - HCV

KW - Liver biopsy

UR - http://www.scopus.com/inward/record.url?scp=23444455619&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23444455619&partnerID=8YFLogxK

U2 - 10.1016/j.jhep.2005.02.041

DO - 10.1016/j.jhep.2005.02.041

M3 - Article

C2 - 16006002

AN - SCOPUS:23444455619

VL - 43

SP - 381

EP - 387

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 3

ER -