{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:59:19Z","timestamp":1789624759307,"version":"build-2803163510"},"reference-count":48,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,2,2]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Effective oral therapies for hepatitis B and C have recently been developed, while there are no approved pharmacological therapies for alcoholic and non-alcoholic fatty liver diseases (ALD and NAFLD). We hypothesise that fewer advances in fatty liver diseases could be related to disparities in research attention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed the Attention-to-Burden Index (ABI) that compares the research activities during 2010\u20132014, and an estimate of disease burden of these 4 major liver diseases. The resulting ratio reflects either overattention (positive value) or inadequate attention (negative value) compared with disease burden. The mean research attention and disease burden were calculated from 5 and 6 different parameters, respectively. The efficacy rate of current pharmacological therapies was assessed from published clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The mean research attention for hepatitis B and C was 31% and 47%, respectively, while NAFLD and ALD received 17% and 5%. The overall burden was 5% and 28% for hepatitis B and C, and 17% and 50% for NAFLD and ALD. The calculated ABI for hepatitis B and C revealed a +6.7-fold and +1.7-fold overattention, respectively. NAFLD received an appropriate attention compared with its burden, while ALD received marked inadequate attention of \u22129.7-fold. The efficacy rate of current pharmacological agents was 72% for hepatitis B, 89% for hepatitis C, 25% for non-alcoholic steatohepatitis and 13% for alcoholic hepatitis. Importantly, we found a positive correlation between the mean attention and the efficacy rate of current therapies in these 4 major liver diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>There are important disparities between research attention and disease burden among the major liver diseases. While viral hepatitis has received considerable attention, there is a marked inadequate attention to ALD. There is a critical need to increase awareness of ALD in the liver research community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013620","type":"journal-article","created":{"date-parts":[[2017,3,23]],"date-time":"2017-03-23T20:12:54Z","timestamp":1490299974000},"page":"e013620","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Disparities between research attention and burden in liver diseases: implications on uneven advances in pharmacological therapies in Europe and the USA"],"prefix":"10.1136","volume":"7","author":[{"given":"Nambi","family":"Ndugga","sequence":"first","affiliation":[{"name":"Divisions of Gastroenterology and Hepatology, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teisha G","family":"Lightbourne","sequence":"additional","affiliation":[{"name":"Biochemistry, Departments of Medicine and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavon","family":"Javaherian","sequence":"additional","affiliation":[{"name":"Biochemistry, Departments of Medicine and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-484X","authenticated-orcid":false,"given":"Joaquin","family":"Cabezas","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology and Hepatology, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Verma","sequence":"additional","affiliation":[{"name":"Biochemistry, Departments of Medicine and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"IV","given":"A Sidney","family":"Barritt","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology and Hepatology, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Bataller","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology and Hepatology, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"2025120520023604000_7.3.e013620.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0145-y"},{"key":"2025120520023604000_7.3.e013620.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010017"},{"key":"2025120520023604000_7.3.e013620.3","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27406"},{"key":"2025120520023604000_7.3.e013620.4","unstructured":"Poznyak V , Rekve D . 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