{
  "abstract": "Objectives: To evaluate the effectiveness, feasibility and acceptability of mobile application-enabled lifestyle interventions in adults with metabolic dysfunction-associated steatotic liver disease (MASLD).\n\nDesign: Systematic review and meta-analysis following Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidance.\n\nData sources: Medline (via PubMed), EMBASE, Scopus and ClinicalTrials.gov, inception to 12 August 2026, with reference-list and citation searching.\n\nEligibility criteria: English-language randomised controlled trials (RCTs) and single-arm prospective studies of interventions delivered primarily by mobile application in adults with, or at risk of, MASLD, reporting a liver-specific outcome (enzymes, steatosis or fibrosis).\n\nData extraction and synthesis: Two reviewers independently extracted data and assessed risk of bias (Cochrane Risk of Bias 2; National Heart, Lung and Blood Institute tool). RCT outcomes were pooled by random-effects meta-analysis and other outcomes synthesised narratively. Certainty was assessed using the Grading of Recommendations Assessment, Development and Evaluation.\n\nResults: 12 studies (6 RCTs, 6 single-arm studies; n=756) were included. There was no significant pooled effect on weight (k (number of studies)=6: mean difference −1.14 kg, 95% CI −2.93 to 0.65; I²=69%), alanine aminotransferase (ALT; k=5: −7.6 U/L, −20.8 to 5.6; I²=79.7%) or aspartate aminotransferase (k=4: −5.7 U/L, −12.5 to 1.0; I²=0%). Prespecified subgroup analysis showed ALT effect differed by intervention type (p=0.011; human-supported, k=4: −10.94 U/L, −26.45 to 4.57; automated, k=1: +2.87 U/L, −1.87 to 7.61), though neither was significant. Median retention was 83% (range 49%–95%).\n\nConclusions: Feasibility and retention signals are encouraging, but controlled evidence does not support consistent efficacy. Larger, longer trials with standardised endpoints, diverse populations and cost-effectiveness analyses are needed and should test whether human support is the active ingredient before recommendation alongside MASLD pharmacotherapies.",
  "abstract_shown": true,
  "affiliations": [
    "St George’s University Hospitals NHS Trust, London, UK",
    "University of London, London, UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Caroline Gosson",
      "orcid": "0009-0007-0751-5639"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria Megapanou",
      "orcid": "0009-0002-1469-8342"
    },
    {
      "affs": [
        1
      ],
      "name": "Sarah White"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Daniel Forton"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/exam18dax12c7.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjgast-2026-002514",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723786/",
  "id": "exam18dax12c7",
  "issns": [
    "2054-4774"
  ],
  "landing_url": "https://doi.org/10.1136/bmjgast-2026-002514",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "Hepatology"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2713|Liver Disease Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223839148",
  "pdf_url": null,
  "pmcid": "PMC13723786",
  "pmid": "42946487",
  "published": "2026-10-27",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/exam18dax12c7.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:21Z",
      "native_id": "PMC13723786",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bmjgast-2026-002514"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Liver Disease Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Mobile application-enabled lifestyle interventions for metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis",
  "title_text": "Mobile application-enabled lifestyle interventions for metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:32Z",
  "url": "https://research.draconitic.com/paper/exam18dax12c7",
  "venue": "BMJ Open Gastroenterology",
  "versions": []
}