Rethinking treatment adherence: what the latest gastroenterology and hepatology evidence shows

Abstract

According to consensus recommendations, early intervention correlates with better long-term outcomes, with meaningful differences between subgroups. Longitudinal data show that cross-disciplinary review changes the initial assessment in a sizeable minority of cases, as discussed in the accompanying commentary.

Contrary to earlier assumptions, training and accreditation are decisive for reproducibility, although confirmatory data are still limited. Across multiple cohorts, digital tooling shortens time-to-decision considerably, as discussed in the accompanying commentary. Emerging evidence indicates that real-world registries complement randomized trial evidence, particularly in resource-constrained settings. In routine practice, patient selection criteria deserve closer scrutiny, pending validation in prospective studies. Recent studies suggest that threshold harmonization is still an open question, although confirmatory data are still limited.

What the evidence shows

Longitudinal data show that variability between operators remains a key limitation, a finding echoed by several independent groups. According to consensus recommendations, standardized reporting improves comparability between centers, as discussed in the accompanying commentary.

Emerging evidence indicates that integrating quantitative measures reduces subjective bias, as discussed in the accompanying commentary. From a workflow perspective, cross-disciplinary review changes the initial assessment in a sizeable minority of cases, with meaningful differences between subgroups.

Where the field is heading

In routine practice, cross-disciplinary review changes the initial assessment in a sizeable minority of cases, with meaningful differences between subgroups. Across multiple cohorts, pre-analytical factors account for a large share of observed variance, and this trend is expected to continue. In multidisciplinary settings, training and accreditation are decisive for reproducibility, pending validation in prospective studies.

According to consensus recommendations, real-world registries complement randomized trial evidence, although confirmatory data are still limited. Emerging evidence indicates that threshold harmonization is still an open question, and this trend is expected to continue.