{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:11:11Z","timestamp":1778623871665,"version":"3.51.4"},"reference-count":0,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008582","name":"McGill University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008582","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>OBJECTIVE: To determine practices among physicians in Canada for the assessment of liver fibrosis in patients with chronic liver diseases.<\/jats:p><jats:p>METHODS: Hepatologists, gastroenterologists, infectious diseases specialists, members of the Canadian Gastroenterology Association and\/or the Canadian HIV Trials Network who manage patients with liver diseases were invited to participate in a web-based, national survey.<\/jats:p><jats:p>RESULTS: Of the 237 physicians invited, 104 (43.9%) completed the survey. Routine assessment of liver fibrosis was requested by the surveyed physicians mostly for chronic hepatitis C (76.5%), followed by autoimmune\/cholestatic liver disease (59.6%) and chronic hepatitis B (52.9%). Liver biopsy was the main diagnostic tool for 46.2% of the respondents, Fibroscan (Echosens, France) for 39.4% and Fibrotest (LabCorp, USA) for 7.7%. Etiology-specific differences were observed: noninvasive methods were mostly used for hepatitis C (63% versus 37% liver biopsy) and hepatitis B (62.9% versus 37.1% liver biopsy). For 42.7% of respondents, the use of noninvasive methods reduced the need for liver biopsy by &gt;50%. Physicians\u2019 characteristics associated with higher use of noninvasive methods were older age and being based at a university hospital or in private practice versus community hospital. Physicians\u2019 main concerns regarding noninvasive fibrosis assessment methods were access\/availability (42.3%), lack of guidelines for clinical use (26.9%) and cost\/lack of reimbursement (14.4%).<\/jats:p><jats:p>CONCLUSIONS: Physicians who manage patients with chronic liver diseases in Canada require routine assessment of liver fibrosis stage. Although biopsy remains the primary diagnostic tool for almost one-half of respondents, noninvasive methods, particularly Fibroscan, have significantly reduced the need for liver biopsy in Canada. Limitations in access to and availability of the noninvasive methods represent a significant barrier. Finally, there is a need for clinical guidelines and a better reimbursement policy to implement noninvasive tools to assess liver fibrosis.<\/jats:p>","DOI":"10.1155\/2014\/675409","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T04:02:24Z","timestamp":1458014544000},"page":"23-30","source":"Crossref","is-referenced-by-count":26,"title":["Physicians\u2019 Practices for Diagnosing Liver Fibrosis in Chronic Liver Diseases: A Nationwide, Canadian Survey"],"prefix":"10.1155","volume":"28","author":[{"given":"Giada","family":"Sebastiani","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Royal Victoria Hospital, McGill University Health Centre, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Ghali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Royal Victoria Hospital, McGill University Health Centre, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Royal Victoria Hospital, McGill University Health Centre, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina B","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases\/Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Deschenes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Royal Victoria Hospital, McGill University Health Centre, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P","family":"Myers","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","container-title":["Canadian Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2014\/675409.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2014\/675409.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T09:23:21Z","timestamp":1471944201000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cjgh\/2014\/675409\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014]]}},"alternative-id":["675409"],"URL":"https:\/\/doi.org\/10.1155\/2014\/675409","relation":{},"ISSN":["2291-2789","2291-2797"],"issn-type":[{"value":"2291-2789","type":"print"},{"value":"2291-2797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}