## 3 Perspectives and Outcomes of the Presented RHMS with a Focus on Diet-Related Approaches
### Nutrition Evaluation Methods from an RHMS (HepatoConect System) Perspective
#### 3.1.3 RHMS Role (HepatoConect System) for Optimising Nutritional Support for Liver Cirrhosis  
As detailed above, the HepatoConect system is designed as a remote health monitoring tool for optimising nutritional status evaluation and intervention and improving outcomes in LC patients at risk for decompensation. Table 1 summarizes the functionalities of the HepatoConect system, with a focus on potential nutritional evaluation, monitoring, and intervention capabilities. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Type of Evaluation and** & & & **Specific Capabilities of the** \\
**Intervention Method** & & & **HepatoConect System** \\ \hline Physical examination & - & Initial physical examination should be & - \\  & performed during a medical visit & & \\  & - & TSF and MAMC are quick methods & - \\  & unaffected by fluid retention but have & & - \\  & interobserver variability; weight and & & \\  & BIA are affected by fluid retention & & \\  & - & Useful for weight loss management in & - \\  & overweight patients & & - \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Characteristics of different nutritional status evaluation and intervention methods and specific actual and future capabilities of the HepatoConect system. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Type of Evaluation and** & **Characteristics and Requirements** & \multicolumn{2}{c}{**Specific Capabilities of the**} \\
**Intervention Method** & & & **HepatoConect System** \\ \hline \multirow{8}{*}{Frailty assessment} & - & Important for identifying those & - & Functional capacity surveys \\  & & at high risk for malnutrition and & & and virtually assessed \\  & & adverse events & performance measures * \\  & - & Classically requires a standard & - & Aids in tailoring \\  & - & in-person assessment method & & nutritional intervention \\  & - & Gold standard for direct assessment of & - \\  & & muscle mass & \\ CT scan and MRI & - & Radiation exposure (CT); high costs & & through AI * \\  & & and low availability (MRI) & \\  & & & - & Use of standard/personalized questionnaires and immediate \\  & & & personalized diet optimisation \\  & & & intervention (either as automated \\  & - & 24 h dietary recall or 3-day food & response or through \\  & & intake diary & medical intervention) \\  & and intervention & - & Implies patient/caregiver compliance & - \\  & and permanent monitoring & & \\  & & & \"late-night snack\" reminders \\  & & & - \\  & & & - \\  & & & - \\  & & & - \\  & - & Important for preventing sarcopenia & - \\  & & and deconditioning in LC patients & - \\  & - & Important intervention for weight loss & - \\  & & support in overweight patients & - \\  & - & Implies patient compliance & - \\  & & & - \\  & & & - \\  & & & - \\  & & & - \\  & - & Implies patient/caregiver compliance & - \\  & & & - \\  & - & & - \\  & - & & - \\  & - & Crucial for patient empowerment and & - \\  & & increased quality of life & - \\  & - & Should be tailored for the stage of liver & - \\  & & impairment and level of literacy & - \\  & - & Not limited to nutrition education & - \\ \hline \hline \end{tabular}  
* Future capabilities of the HepatoConect system: integration of virtual frailty assessment tools; integration of AI and DL algorithms for cross-sectional imaging data interpretation. BMI = body mass index; TSF = tricipital skinfold thickness; MAMC = mid-arm muscle circumference; BIA = bioelectrical impedance analysis; CT = computer tomography; MRI = magnetic resonance imaging; AI = artificial intelligence; LC = liver cirrhosis; ECG = electrocardiography.  
\end{table} 
Table 2: Targeted actual and future functionalities of the HepatoConect system with a focus on LC management.