S3-E52.1 – FIB-4 and the Way Forward in Primary Care Screening

S3-E52.1 - FIB-4 and the Way Forward in Primary Care Screening
The 2022 AASLD Liver Meeting takes place November 4th-8th in Washington DC in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care. Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green in a second preview of key presentations and posters of interest. In this session, Mazen leads discussion on the way forward in diagnosing fibrotic NASH in patients with Type 2 Diabetes.

In a follow-up preview, Jörn Schattenberg, Louise Campbell, Mazen Noureddin, Ian Rowe and patient advocate Jeff McIntyre join Roger Green to discuss key presentations and posters of interest at the 73rd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). On November 4th-8th in Washington DC, as many as 10,000 attendees will convene in an effort to advance and disseminate the science and practice of hepatology, and to promote liver health and quality patient care.

This conversation focuses on a presentation by Laurent Castera from Parallel Session 33 on Monday afternoon. The abstract looks to validate and compare head-to-head the FASTTM, MAST, and MEFIB scores as well as FIB-4 and NAFLD fibrosis score in a large cohort of T2D patients with NAFLD. Mazen points out that while the paper compares the various tests, the key is to ask which test is best for each specific purpose. In general, these results show that MAST and FAST perform better than the other three tests in terms of area under curve. Results also indicate that MAST has an indeterminate range of around 20%, as compared to 44% for FAST and MEFIB. The latter result suggests to Mazen that the researcher will need fewer biopsies to classify patients using MAST and MAST should score better on true classifications. Roger refers to last week’s discussion around which test to use at different points in the patient screening process. Mazen notes that while he has concerns with FIB-4, it remains as one of the best primary test options today. He repeats Stephen Harrison’s question from last week on whether we should start primary screening with FibroScan instead of FIB-4.

As the session ends, Jörn suggests that the discussion on best clinical use will continue. He notes that the goal of this paper is to contribute to discussion around the value of each test, ‘the true task of academia.’

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