A cross-sectional study on the variability of Pediatric fatty liver disease diagnosis

Abstract

Background: Pediatric fatty liver disease (PFLD), encompassing non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH), has emerged as a significant public health concern. Variability in diagnostic criteria across different clinical settings may lead to inconsistent diagnoses, impacting patient management and epidemiological understanding. Objective: This study aims to evaluate the variability in diagnostic criteria for PFLD and assess its implications on diagnosis rates and patient outcomes. Methods: A cross-sectional study was conducted involving 15 pediatric clinics across diverse geographic regions. Data were collected from medical records of children aged 5-17 years diagnosed with fatty liver disease over the past two years. Diagnostic criteria from various guidelines, including those from the American Academy of Pediatrics (AAP), European Association for the Study of the Liver (EASL), and the Pediatric NAFLD Research Society (PNFRS), were compared. Results: Significant variability was observed in diagnostic criteria application, particularly in the use of imaging modalities and biochemical markers. Clinics adhering strictly to AAP guidelines reported a higher prevalence of NAFLD, whereas those following EASL criteria had a higher diagnosis rate of NASH. Discrepancies in diagnosis led to differences in reported prevalence rates, ranging from 8% to 22% among the studied populations. Conclusion: The variability in diagnostic criteria for PFLD contributes to inconsistent diagnosis rates and may affect clinical management. Standardizing diagnostic protocols is essential to ensure accurate diagnosis, appropriate treatment, and reliable epidemiological data.