Community-based FibroScans: critical analysis, PPIE and direct observation to inform the design of a qualitative study

Objective To undertake a critical analysis of the existing literature, patient and public involvement and engagement (PPIE) work and direct observation of the interaction between FibroScan practitioners and individuals attending for a scan as part of the National Health Service England Plymouth Community Liver Health Checks pilot to inform the design of a qualitative study. Methods A literature search was conducted using Medline, CINAHL and Cochrane databases. PPIE interviews were held with individuals who had undergone a FibroScan test to gain feedback about the design of a qualitative study. Field notes were taken while observing interactions between the FibroScan practitioner and individuals undergoing a FibroScan. Results The critical analysis of the literature found that community-based FibroScans are considered widely acceptable, but little is known about the impact of undergoing a FibroScan on an individual’s beliefs or behaviours among other effects. Observational field notes found variation in FibroScan result delivery. Practitioner factors, such as language, appeared to influence the reaction of the person receiving the result. PPIE interviews highlighted a lack of awareness about FibroScans and that a planned qualitative study to investigate this further would be acceptable to potential participants. Conclusion There is a lack of evidence regarding the benefits and harms of those with risk factors for liver disease undergoing a community-based FibroScan. FibroScan result delivery may alter an individual’s interpretation of their result. A qualitative study is being designed to investigate the individual impact of undergoing a community-based FibroScan and receiving an immediate result.