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August 2025
In this educational video, HoChong Gilles, NP—Clinical Program Director at the Central Virginia VA Healthcare System—breaks down practical, non-invasive strategies for evaluating liver fibrosis in community GI and primary care settings. With over 25 years of hepatology experience, she walks through the importance of calculating the FIB-4 score using just four parameters: age, ALT, AST, and platelet count. Learn how to interpret FIB-4 score cutoffs to determine low, indeterminate, or high risk of advanced fibrosis and explore alternative tools like the ELF (Enhanced Liver Fibrosis) test when imaging options are limited. Whether you're a hepatology specialist or a frontline provider, this video offers actionable insights to help bridge the gap in liver care access using guideline-supported lab-based methods.
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Misconceptions About Liver Health
September 2025
Elizabeth Goacher, PA-C at Duke University in Durham, North Carolina, addresses a common misconception about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—that it’s a “death sentence.” While early screening and awareness are critical, Elizabeth emphasizes the importance of balanced messaging: most patients with MASLD, especially those without advanced fibrosis, will not experience liver failure or require a transplant. Instead, their greatest health risks are often from cardiovascular disease and all-cause malignancy, making lifestyle changes, metabolic health management, and cardiovascular risk reduction key priorities. This discussion encourages both patients and referring providers to focus on evidence-based care, clear communication, and realistic risk assessment, ensuring that awareness doesn’t translate into unnecessary fear.
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Common Questions From Community GI About MASH
November 2025
In this educational discussion from the GHAPP MASLD Community Network, Allysa Saggese, NP, from Weill Cornell Medicine in New York City, addresses two of the most frequently asked questions in metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH) management. Allysa breaks down the clinical reasoning behind initiating therapy, emphasizing shared decision-making with patients, reviewing medication mechanisms, side effects, and the role of accessibility in treatment sequencing. She explains that while both Resmetirom and GLP-1s offer benefits, the order of initiation often depends on tolerability, dosing complexity, and availability. The session also explores how to interpret FIB-4, ELF, FibroScan, and MR elastography results, when discrepancies occur, and when a liver biopsy remains necessary for diagnostic confirmation. This video provides clear, practical guidance for APPs and hepatology providers navigating modern MASLD and MASH management decisions through a personalized and evidence-based lens.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD and MASH Community Network, Tessa Janovsky, PA-C at Arizona Liver Health, answers common questions from primary care providers about Metabolic Dysfunction–Associated Steatohepatitis (MASH) and its updated terminology. She explains why MASH has replaced the term NASH, highlighting the shift to reflect underlying metabolic drivers such as obesity and type 2 diabetes while removing stigmatizing language. Tessa discusses how normal or mildly elevated liver enzymes do not rule out MASH, the importance of screening high-risk groups—including patients with diabetes, obesity, metabolic syndrome, or incidental fatty liver on imaging—and why the FIB-4 score is the preferred first-line test for fibrosis risk assessment. She also reviews the first FDA-approved medication for MASH, resmetirom, as well as the role of GLP-1 therapies and upcoming treatment options. Whether you’re a clinician seeking updated screening guidelines or a patient wanting clarity on diagnosis and management, this session provides clear, evidence-based guidance on identifying and treating MASH.
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Common Questions from Primary Care Providers About MASH
July 2025
In this educational video, Erin Parkinson, APRN at the Transplant Institute at Tampa General Medical Group, addresses two of the most frequently asked questions from primary care providers about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). First, she explains when it’s appropriate to refer a patient to GI or hepatology, emphasizing the use of FIB-4 for risk stratification and recommending referral when scores are indeterminate or high, especially if a FibroScan® result shows ≥8 kPa. Erin also discusses lifestyle interventions, reinforcing the importance of weight loss and dietary modification, with strong endorsement of the Mediterranean diet—a recommendation supported by major liver societies. She also notes that intermittent fasting may be a helpful adjunct for patients seeking to improve liver health through sustainable weight reduction. This video provides practical tools for frontline providers to improve early detection and management of fatty liver disease.
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How is MASH severity staged? What would an ideal MASH NIT algorithm look like?
January 2025
Thank you to Madrigal for sponsoring this FAQ Video Module. In this GHAPP FAQ Video Module, Jonathan Yeh, a physician assistant at the Center for Liver Disease and Transplantation at Columbia University Irving Medical Center, discusses advancements in diagnosing and staging metabolic dysfunction-associated steatohepatitis (MASH). He explains the transition from traditional liver biopsy to non-invasive testing methods such as FibroScan and the Enhanced Liver Fibrosis (ELF) test for assessing fibrosis stages. Jonathan highlights the use of these methods, in combination with blood tests, to provide reliable staging of fibrosis in patients with MASH. For more information, visit the GHAPP website or ACE app.
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Misconceptions About Liver Health
September 2025
Join Jill Olmstead, DNP from Providence Health in Southern California for an eye-opening GHAPP MASLD Community Network Insight on the biggest misconceptions about liver health. In this session, Jill explains why fatty liver disease is not “normal” or harmless, but a serious metabolic disorder linked to obesity, prediabetes, diabetes, and high cholesterol. She highlights how fat in the liver causes cellular injury, leading to fibrosis and even cirrhosis if untreated. Jill also addresses the common myth that alcohol is safe in moderation—reminding patients that alcohol is a liver toxin and no amount is risk-free, despite outdated beliefs about red wine being heart-protective. This educational talk empowers providers and patients alike to recognize fatty liver disease early, manage risk factors, and adopt lifestyle changes that protect long-term liver health. Watch more from the MASLD & MASH Community Network to stay informed on advances in fatty liver disease education and care.
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Common Questions From Community GI About MASH
June 2025
In this video, Lindsay Yoder, PA-C, a hepatology expert at Indiana University in Indianapolis, addresses some of the most common questions general GI providers have about diagnosing and managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). She explains the nuance of interpreting positive autoantibodies like ANA or ASMA, emphasizing that up to 30% of patients with MASLD/MASH may have non-specific reactive antibodies that are not clinically significant for autoimmune hepatitis. Lindsay walks viewers through how to evaluate serologic workups in context—considering IGG levels, ALT trends, and symptoms like fatigue or pruritus—and when to consider liver biopsy. She also shares expert guidance on when to refer patients to hepatology, particularly those with advancing fibrosis (F2-F4) or cirrhosis. Finally, she clarifies how to distinguish between MASLD and alcohol-associated liver disease (ALD), using daily alcohol consumption levels alongside cardiometabolic risk factors to help determine whether a patient falls into a MASLD, ALD, or mixed-etiology category like MetALD. This informative session is essential viewing for clinicians navigating the evolving landscape of metabolic liver disease.
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Common Questions From Community GI About MASH
October 2025
In this APP Insight, Tina Gregg, NP-C, from GI Associates, addresses two of the most common questions about MASLD and MASH that clinicians encounter in practice. First, she clarifies that normal liver enzymes do not rule out MASH or advanced fibrosis—up to half of biopsy-proven cases can present with normal ALT and AST levels. Tina explains why liver enzymes fluctuate, why traditional reference ranges may be misleading, and how clinicians can better interpret lab results in context. She also answers another frequent question: Are statins safe in patients with MASLD or MASH? Drawing on evidence from multiple large studies, Tina emphasizes that statins are both safe and beneficial for most patients with fatty liver disease and play a key role in managing cardiovascular risk. This session, part of the GHAPP MASLD & MASH Community Network, helps APPs dispel common misconceptions and make evidence-based decisions in liver and metabolic care.
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APP Insight: Common Questions from Patients About MASH
July 2025
In this impactful episode, Sherona Bau, NP from UCLA, addresses the most frequent and pressing questions patients ask after being diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease) or MASH (Metabolic-associated steatohepatitis)—including concerns about life expectancy, risk of liver failure, liver cancer, and genetic impact on family members. She emphasizes the importance of risk stratification using non-invasive testing, particularly FibroScan®, to determine the extent of fat accumulation and liver fibrosis. Sherona explains that early identification of stage 2 or 3 fibrosis is critical, as treatment options are now available for these stages, offering hope for patients. She also stresses that MASLD is not just a liver disease—it's a systemic, metabolic condition—and encourages coordinated care with endocrinologists, cardiologists, and dietitians. Additionally, she discusses the hereditary nature of fatty liver and the importance of family screening, especially for children of affected individuals. This video offers clear, compassionate guidance for patients and providers navigating the complexities of fatty liver disease.
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Misconceptions About Liver Health
July 2025
In this short and informative video, Milly Ng, a nurse practitioner at Tufts Medical Center, debunks two of the most common myths about liver health. First, she sets the record straight on liver cleanses and detox teas—explaining that your liver already detoxifies your body daily and doesn’t need fad diets or trendy supplements. Instead, what your liver needs is support through sustainable habits like reducing alcohol intake, cutting back on processed sugars, and maintaining a healthy weight. She also highlights a critical point: liver disease is often silent, and many people with significant liver damage have no symptoms until it’s advanced. If you're at risk due to metabolic syndrome, alcohol use, or other factors, Miu Lai urges you to talk to your healthcare provider about screening options like FIB-4 or FibroScan®. Your liver works hard for you—this video is a reminder to return the favor with real, lasting care.
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