Progress In A Pandemic: The Year In Review

BY RAYMOND CHUNG, MD, FAASLD
AASLD PRESIDENT

As the pandemic entered its second year, 2021 continued to test and challenge us all.  Challenges notwithstanding, I am thrilled to report that as a society, AASLD continued to accomplish great things and has made good on the objectives originally laid out in our strategic plan in 2018. I want to describe several of our most important accomplishments here.

Thanks to prudent and thoughtful financial stewardship, even in the face of the pandemic, we found ourselves in the enviable position of being able to make bold investments to future-proof our society. As an example, the pandemic highlighted for us the opportunities and current limitations that exist in the digital space at aasld.org, so we have invested in a digital transformation that will catalyze the accomplishment of one of our key strategic objectives, to optimize the accessibility and value of AASLD’s content, education, and advocacy resources to the hepatology community. This website transformation will re-envision how we deliver our content and how our users and members engage with the society. We look forward to unveiling that to you in 2022.

We also saw the opportunity to deliver critical leadership in our field by implementing a nationwide network for care quality metrics, the Cirrhosis Quality Collaborative (CQC). This year has seen us make good on accelerating CQC output and take major steps toward creating the leading national clinical data and care quality repository for liver disease. We also know that accomplishing this critical task requires a major financial investment, so this year, the Governing Board committed nearly $2.5 million over the next five years to assure sustainability of this signature enterprise.

We also had an opportunity to invest in our own members. As COVID was wreaking havoc across the world, a major US-based registry was developed to track its impact on liver disease patients. We have provided support for the SECURE-Liver Registry to drive submissions and raise its profile. In turn, the data emerging from the registry will be accessible to and provide real value to our members and their patients.

While the fall surge of the Delta variant forced us to cancel the in-person component of The Liver Meeting, TLMdX version 2.0 was again hugely successful, building on lessons learned and feedback from 2020. We welcomed 7,000 attendees from 85 countries at the meeting this year, and early returns from our post-meeting survey show that once again, we delivered a meeting that more than upheld our standards of excellence. I’ve heard often from so many that they came away from the Meeting educated, uplifted and energized. They particularly enjoyed the opportunity to network through an unprecedented array of small group offerings.

For many years, AASLD has been focused mostly on our annual meeting, a place for so many of us to gather and connect. While we have no intention of diminishing the importance of The Liver Meeting, the pandemic accelerated a reckoning that we could not rely on TLM alone – it gave us the opportunity to diversify our portfolio. We are now committed to offering a series of year-round, smaller in-person meetings, beginning in 2022, combined with even more virtual meetings, to both optimize our member experience and expand our reach and opportunities for both participation and leadership. Indeed, the ability to hold such robust meetings online has opened AASLD up to the farthest corners of the world and to reach those who may never be able to travel here. It’s for that reason that we are committed to a Liver Meeting beginning in 2022 that will continue both in person and virtually in the years to come.

2021 also saw major achievements for our journals. HEPATOLOGY and Liver Transplantation earned their highest ever Impact Factors and Hepatology Communications earned its first and very strong impact factor of 5.073. We extend our deep thanks to our editors and their teams for their tremendous stewardship of our journals. Even with such an impressive performance, we have begun actively exploring ways to improve our journal offerings. We embarked on a request for proposals from publishers this year to be sure we knew all our publishing options and confirm the right partnership so that our journals could continue to thrive in the 2020s and beyond. We're also exploring ways to enhance our portfolio by developing a coherent cascading strategy to strengthen our suite of journals and keep quality submissions in the family.

In 2021, our commitment to increasing equity and undoing racial disparities in the field further deepened. We had several major DE&I accomplishments to be very proud of this year. For one, we dedicated our most extensive programming yet at TLMdX to diversity. This included parallel sessions, workshops, and special networking opportunities that focused entirely on diversity and inclusion themes. We also defined an entire abstract category to research focused on DE&I and awarded research prizes to the top abstracts centered on healthcare disparities. With the AASLD Foundation, we have implemented a Pilot Research Award that gives priority to research addressing disparities in healthcare access or quality. In November, with the Intersociety Group on Diversity (IGD), we published a white paper based on the research of our own members analyzing racial disparities in the specialty and proposing remedies – including creating a pipeline and mentoring those already in the pipeline. We understand that to arrive at true equity in the field, we need to have a workforce that is representative of the patients we care for. So, we’ve begun initiatives to engage diverse groups at a younger age – from high school to college through medical school – to raise awareness and interest in the specialty. We are also engaged in an initiative with the IGD to explore ways of supporting career development awards for URM faculty members in hepatology. We have formed an LGBTQ Task Force to explore issues around discrimination in hepatology due to sexual orientation. And finally, we are practicing what we preach and focusing on diversity within our own leadership. I’m thrilled to be able to tell you that next year’s Governing Board will be majority female for the first time in AASLD’s history!

This year we placed major focus on our Mentorship initiative. We’ve dived deep as an organization to expanding the ways it’s delivered to our members, particularly digitally and beyond the walls of our institutions, as well as by interests and role models. We know there is great benefit to one-on-one longitudinal mentoring, so we’re leveraging digital tools to help us with a matching program and to provide a forum for mentors and mentees to engage. We’re also proud of the incredible inter-committee collaboration around mentorship that’s been fostered by this initiative, with the Membership and Mentorship, Women’s Initiative, Training and Workforce, and Inclusion and Diversity Committees coalescing to develop approaches to support one another in mentorship delivery, including small group sessions that were launched at TLMdX. We launched a new Thought Leaders Series aimed at horizontal mentoring to help our members learn how our esteemed academic leaders built their clinical and research centers of excellence. 

COVID-19 has profoundly impacted the ways in which we as hepatologists network with our colleagues across the nation and around the world. Despite the inability to host in-person joint programming with other societies over the last two years, we have still strengthened our ties with our sister societies through a variety of global digital programs, including our hugely successful CONNECT symposia and Trainee Research Workshops. A major priority of our global work has been Viral Hepatitis Elimination (VHE), a centerpiece of our vision to prevent and cure liver disease. To this end, AASLD has organized the North American Elimination Summit in collaboration with our friends in Canada (CASL) and Mexico (AMH). We have also launched an annual VHE Symposium at TLMdX and are partnering with WHO and CDC to assist those agencies in their elimination efforts. This year, AASLD was proud to co-sponsor and participate for the first time in the annual Conference on Liver Disease in Africa (COLDA). AASLD is committed to working with our partners in Africa on education and training in the quest for VHE. 

Thanks to the hard work of our Training and Workforce Committee, AASLD is poised to take stewardship of the Transplant Hepatology Fellowship process, which has been largely unsynchronized and as a result inequitable to both applicants and programs. Earlier this year, the committee took major steps to create a central repository for available programs and positions available along with a standard application and timeline to create community standards for both institutions and applicants. We look forward to launching this product later in January.  There can be no better example of AASLD taking leadership when it was sorely needed.

When our strategic plan took effect in 2018, AASLD for the first time made a formal commitment to engage our patients and patient organizations as partners in learning, research, and advocacy. Thanks to the work of our Patient Advisory Group, we have made spectacular strides in this regard, having doubled our programming and growing patient attendance by 20% at TLMdX 2021 from the previous year. We have integrated patients into many of our Committees, and we are collectively producing companion patient guides to our Guidelines and Guidances.  With a growing emphasis on patient-reported outcomes and requirements for patients to be involved in research consortia, the integration of patients into our organization positions us to reap important dividends for years to come.

All this to say, the pandemic did little to keep AASLD from making good on its strategic goals. The year spawned remarkable new opportunities for growth, and we leave 2021 in many ways healthier and stronger as an organization than ever before. Of course, we owe huge thanks for this outcome to so many, including the members of our Governing Board, our Committees, SIGs, and Task Forces, our Editors and their teams, our members, our patient volunteers, and the truly amazing AASLD staff, who rose to meet the twin challenge of a pandemic and an ambitious agenda. Your talent, energy, and dedication to AASLD’s mission have consistently left me in awe. I am honored to have had the privilege to work with you and serve as your president. Even though we regrettably could not meet in person in Anaheim, this year has been the highlight of my professional career. Knowing that the greatness of this organization lies in its people, I can only be unreservedly optimistic for the future of AASLD and for hepatology as a whole. As we move into 2022 and the reins are passed to my friend and colleague Dr. Laurie Deleve, I can’t wait to step into that future. Wishing you all a very happy and safe 2022.