Date of Conferral

1-1-2011

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Shana Morrell

Abstract

Liver disease causes an estimated 36,000 deaths in the United States each year. Currently, to detect liver disease, an invasive biopsy is required. Other, less invasive diagnostic alternatives are needed. The purpose of this study was to assess the efficacy of a modified form of sonographic screening, including portal, hepatic, and splenic venous pressure, hepatic venous waveform analysis, portal vein diameter, and echogenicity of liver parenchyma in predicting liver disease. The study was based on conversion of a velocity measurement to a pressure gradient, allowing a fluid comparison between known catheterization venous pressures and sonographic Doppler-derived pressure gradients. This study was a secondary data analysis of a data set from 546 patients who received abdominal sonograms at a medical facility in the western United States between March 2010 and December 2010. The dependent variable was liver disease and the independent variables were ECHOGRADE, hepatic venous waveform (HVW), splenic vein pressure gradient (SVPG), modified portal vein pressure gradient (MPVPG), and hepatic vein pressure gradient (HVPG). Logistic regression was used to analyze the data. ECHOGRADE, HVW, and MPVPG in males were found to be statistically significant in detecting liver disease, supporting the theoretical framework and thus documenting a novel use of Doppler for the detection of liver disease. The social change significance of these results is to provide clinicians with an alternative, noninvasive method of diagnosing early liver disease before it progresses into chronic liver disease. With earlier detection, severe adverse health outcomes leading to irreversible liver cirrhosis may be avoided.

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