RE:RE:RE:Case-finding strategies in non-alcoholic fatty liver diseaseThe negative to it all is that if you can develop a test with high accuracy and predictability that your liver is at the NAFLD or early NASH stage, likey the intervention would be diet, exercise and vitamin E (or whatever it is they tell you to take). That will work for plenty of people and lower the percentage that get in to the NASH or advanced NASH stages. That would be a far better outcome for payors and patients. Try to nip it in the bud, so to say.
scarlet1967 wrote: Quite frankly if the science backs up set of accurate diagnostic sets which are more cost effective and less invasive it's a win win situation for all parties, patients get detected earlier thus less advanced symptoms, less pressure to the healthcare thus more resources to deal with othe conditions and less costs to payors as they don't need to cover lengthy and extensive treatment for more advanced stages of the disease. Of course the clinical trials will be more practical both for patients and docs.
Wino115 wrote: Whenever there's a barrier between a disease and the payors unwillingness to blindly pay for treatment, science steps in and creates innovative tests. This will be the same. Payors/Insurers will want something more failproof than a hunch and large wasteband in order to start treatement. Less expensive testing can be done early to detect it before it gets to the worst case/expensive side. The Genfit NASH test is one (maybe they'll extend it to NAFLD) and I believe Exact Sciences is developing one for at home early liver cancer signs (like their colon cancer screening one). Have to assume that sometime in the next 2-3 years we'll see these relatively less expensive tests added in to the annual checkups if you have some of the conditions, are overweight, diabetic, over 50, etc...
scarlet1967 wrote: Well the summary says it all..
“Among the large population of patients with non-alcoholic fatty liver disease (NAFLD), identifying those with advanced disease remains challenging. Many patients are diagnosed late, following the development of liver-related complications, leading to poor clinical outcomes. Accumulating evidence suggests that using non-invasive tests for liver fibrosis in patients with metabolic risk factors improves the detection of patients in need of specialised management and is cost-effective. Because of the vast number of patients requiring evaluation, the active participation of general practitioners and physicians who manage patients with metabolic disorders, such as diabetologists, is crucial; this calls for the increased awareness of NAFLD beyond liver clinics. Non-invasive case-finding strategies will need to be further validated and generalised for upcoming drug therapies to have the required impact on the worldwide burden of NAFLD.”
https://www.jhep-reports.eu/article/S2589-5559(20)30153-1/fulltext