{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T02:01:35Z","timestamp":1772244095303,"version":"3.50.1"},"update-to":[{"DOI":"10.3310\/nihropenres.13663.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000}}],"reference-count":17,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/3\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","award":["This study\/project is funded by the NIHR Health Technology Assessment (HTA) Programme (NIHR 154876)."],"award-info":[{"award-number":["This study\/project is funded by the NIHR Health Technology Assessment (HTA) Programme (NIHR 154876)."]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns3:p>Background The incidence and severity of liver disease in the United Kingdom have increased over the last 20 years. Many patients present with advanced disease with limited treatment options and subsequently high morbidity and mortality. There was also a significant correlation with deprivation. Strategies that support the earlier detection of liver disease are paramount to reverse this trend. Despite significant progress in terms of novel pathways, the optimal strategy for early detection of liver disease remains unknown. Novel ways to tackle the deprivation gradient and reduce health inequalities are urgently required. Methods Clinical research has an enormous role to play both in terms of identifying the true scale of this challenge, where current gaps exist, and to identify the optimal early detection strategies and their implementation. We therefore established Liver Research Cymru (LRC) a multi-disciplinary collaboration that seeks to maximise the benefits from our existing data sources and clinical networks and increase the output of hepatology research in Wales. Results LRC has developed the first Wales wide research collaborative. We have successfully collaborated with the Secure Anonymised Information Linkage (SAIL) data resource to develop a greater understanding of liver disease burdens through comprehensive analysis of primary and secondary care data. We are now using this information to evaluate the effectiveness of local early detection pathways and to identify the scale of delays in diagnosis with a view to addressing this important care gap. Conclusion LRC has successfully brought together patients. Hepatologists and population\/primary care academics to better understand current discrepancies in the early diagnosis of liver disease in Wales. In addition, it has laid a foundation for future research work based both on our preliminary findings and allowed us to collaborate with other more established liver disease research groups.<\/ns3:p>","DOI":"10.3310\/nihropenres.13663.2","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T17:10:10Z","timestamp":1755277810000},"page":"57","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The development of Liver Research Cymru, a new partnership to increase hepatology research activity in 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.14834.r33214, Sofia Hemrage, King's College London, London, England, 15 Nov 2024, version 1, 2 approved with reservations","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-57\/v1#referee-response-33214","order":0,"name":"referee-response-33214","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>andrew yeoman<\/b>; \n<i>Posted: 04 Feb 2025<\/i>; Authors response  We thank the reviewer for their comments   Point 1. We have reviewed and amended the manuscript where typos exist  Point 2. The burden we describe relates to incidence and severity of liver disease. This is based on existing coded data published as cited in this report (reference 1). WE did not expand on that in the interests of keeping the word count down. In terms of severity this is supported within that same publication by significant increase not just in coded liver disease (which might merely represent better awareness) but in Hepatocellular cancer, Cirrhosis and Portal Hypertension and admissions and mortality . I have expanded the introduction to reflect this and made additional references&nbsp;  Point 3. Additional literature has been added in introduction and in later text regarding research priorities and that we have now had work from WP 2 accepted for publication  Point 4. PPI group members. We did not ask the housing status or educational attainment of the PPI members. We did attempt to capture a broad range of to cover different liver diseases and a geographical split across Wales. We did this by working with the British Liver Trust who assisted us in recruiting people. Every member was white \u2013 2021 census data shows that 94% of the Welsh population identifies as such. This remains an important issue however and we remain keen to recruit people of different ethnic backgrounds. Since the development of this collaboration we have developed informal links with Muslim Doctors Cymru who we can use as a conduit to try and recruit other PPI members in the future. WE have added a comment in the discussion addressing the limitations within the recruited PPI group.  Point 5. The research infrastructure with the NHS in Wales is significantly different to England and we do not have dedicated liver research nurses. We do not dispute the impact and importance of their role but as we have none currently it was not possible to bring their expertise to inform our approach. If we are able to develop this critical workforce over time then clearly we would utilise their expertise in any planned future research.  Point 6. We did not involve 3rd sector services in the original collaboration. However one of the early potential collaborations that have come out of LRC is in relation to a project evaluating the utility of Fibroscan to bring about behaviour change in relation to ARLD. This would be delivered within community 3rd sector delivered settings. The preliminary discussions will hopefully allow us to bring this additional expertise into our collaborative.  Point 7. Apologies for this. Higher resolution images have been uploaded.","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-57\/v2#referee-comment-3414","order":1,"name":"referee-comment-3414","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15113.r36821, Jee-Fu Huang, Kaohsiung Medical University, Kaohsiung, 30 Aug 2025, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-57\/v2#referee-response-36821","order":2,"name":"referee-response-36821","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15113.r36855, Michael Ronan Lucey, University of Wisconsin School of Medicine and Public Health, Madison, 09 Sep 2025, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-57\/v2#referee-response-36855","order":3,"name":"referee-response-36855","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute for Health and Care Research (NIHR) under its [Health Technology Assessment (HTA) (Grant Reference Number (NIHR 154876)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This open access work is licensed under the Open Government Licence v3.0.","order":0,"name":"copyright-info","label":"Copyright"}]}}