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Assessment of PRevalence, Diagnostic and TrEatment Approaches of Cholestasis & Fibrosis in Metabolic Dysfunction-Associated SteatOtic Liver Disease by HEalthcare ProfessionaLs in India (REMODEL)

Survey Questionnaire Form
Doctor's details
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Prevalence, Diagnosis, and Treatment Approaches

  1. In how many patients do you observe cases of MASLD in your practice in a month? *

  2. In your practice, how many MASLD patients with cholestasis and fibrosis do you see in a month? *

  3. In your clinical experience, which age group is most commonly affected by cholestasis and fibrosis in MASLD patients? *

  4. Based on your clinical observations, do you notice any gender-related predominance in the prevalence of cholestasis and fibrosis among your patients with MASLD? *

  5. In your opinion, what are the common risk factors for cholestasis and fibrosis in MASLD among patients that you see? (Select all that apply) *

  6. Describe the typical dietary habits that you observe in your patients diagnosed with cholestasis and fibrosis in MASLD. (Please elaborate in brief) *
  7. To what extent do you think genetic factors play a role in the progression of MASLD to cholestasis and fibrosis in Indian patients? *

  8. How often do you encounter cholestasis and fibrosis in non-obese or lean individuals? *

  9. Which comorbidities are most frequently associated with MASLD patients who progress to cholestasis and fibrosis? (Select all that apply) *

  10. What are the most common presenting symptoms of MASLD -related cholestasis and fibrosis in your patients? (Please elaborate) *
  11. In your experience, how often do patients with MASLD show clinical signs suggestive of cholestasis and fibrosis? *

  12. What is your approach for the preliminary diagnosis of cholestasis and fibrosis in your patients? (Select all that apply) *

  13. Which laboratory tests do you primarily rely on for evaluating MASLD patients? (Select all that apply) *

  14. How frequently do you observe elevated Alkaline Phosphatase (ALP) or Gamma-Glutamyl Transferase (GGT) in your patients with cholestasis and fibrosis? *

  15. Which common imaging modalities do you use to assess cholestasis and fibrosis in your MASLD patients? (Select all that apply) *

  16. Do you routinely use transient elastography to assess liver cholestasis and fibrosis in MASLD patients? *

  17. How often do you suggest imaging to check cholestasis and fibrosis in MASLD patients during follow-up? *

  18. Do you use a scoring system [e.g., NAFLD Fibrosis Score (NFS), Fibrosis Index Based on 4 Factors (FIB-4)] for screening advanced fibrosis in patients with MASLD? If yes, which scoring system do you use and why? (Please elaborate) *

  19. How often do you use biopsy to confirm the diagnosis of MASLD? *

  20. When assessing liver cholestasis or fibrosis, how do you incorporate non-invasive techniques (e.g., transient elastography, serum biomarkers) versus liver biopsy in your practice? Please explain. *
  21. What are the targets of different non-invasive techniques and suggested thresholds for ruling out/ruling in certain features of MASLD in your clinical practice? *
  22. What is the diagnostic work-up you do in your clinical practice to identify relevant comorbidities of MASLD? *
  23. How do you monitor the progression of cholestasis or fibrosis in your MASLD patients over time? What parameters or tests do you regularly use to track disease progression? *
  24. Do you routinely screen for other causes of chronic liver disease (e.g. viral hepatitis, autoimmune hepatitis) in patients with suspected cholestasis and fibrosis? *

  25. What are the most common misdiagnoses or delays in diagnosing cholestasis and fibrosis in MASLD patients, and how do you address these challenges? (Please elaborate) *
  26. Please describe any diagnostic or therapeutic challenges you have encountered in managing MASLD patients in your surgical practice. *
  27. What is your first-line management advice for patients with MASLD? (Select all that apply) *

  28. How often do you recommend dietary changes specifically targeting cholestasis in MASLD patients? *

  29. Which medications do you commonly prescribe for fibrosis in your patients? (Select all that apply) *

  30. Which medications do you commonly prescribe for cholestasis in your patients? (Select all that apply) *

  31. What is the average duration for treatment of cholestasis and fibrosis in your MASLD patients? *

  32. How often do you monitor liver enzyme levels in MASLD patients with cholestasis and fibrosis during treatment? *

  33. Based on your clinical experience, how frequently do you encounter patients with treatment-resistant MASLD? What is your approach for diagnosis and management for these patients? *
  34. In your opinion, what are the most promising advancements or therapies in the management of cholestasis and fibrosis that may benefit Indian patients? *
  35. Do you consider surgical interventions (such as bariatric surgery) as part of the therapeutic approach in patients with progressive MASLD (cholestasis and fibrosis)? *

  36. Based on your clinical experience, how have weight loss interventions influenced the progression or resolution of cholestasis and hepatic fibrosis in MASLD patients? *
  37. In your clinical practice, how do you monitor treatment adherence among MASLD patients? *

  38. In your experience, how compliant are cholestasis and fibrosis patients with lifestyle modifications? *

  39. Are you aware of any India-specific guidelines for the management of cholestasis and fibrosis in MASLD? *

  40. In your clinical experience, what are the most significant unmet needs in the diagnosis and management of cholestasis and fibrosis in MASLD patients in India? (Please elaborate) *