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MASLD AI 10:26 PM
September 2025
In this interactive case discussion, Valerie Shin, NP, from UCLA Health’s hepatology team, walks through how to compare F3 and F4 fibrosis in patients with metabolic dysfunction–associated steatohepatitis (MASH). Presented as part of the GHAPP MASLD Community Network series sponsored by Madrigal, this session uses real-world patient data to explore how non-invasive testing (NITs) like FibroScan, FIB-4, and ELF testing help stage liver fibrosis and guide treatment decisions. Valerie highlights the importance of accurate staging for prognosis, monitoring, and management—whether identifying patients with advanced fibrosis (F3) who may benefit from resmetirom (Rezdiffra), or recognizing progression to cirrhosis (F4) that requires enhanced surveillance and multidisciplinary care. This video also emphasizes practical strategies for lifestyle modification, metabolic risk factor control, and liver cancer screening. Whether you are a hepatology specialist, primary care provider, or advanced practice provider (APP), this case comparison offers valuable clinical insights into diagnosing and managing MASLD/MASH.
Related Podcast
MASLD Pharmacotherapy With Jill Olmstead
September 2025
Join Jill Olmstead, DNP from Providence Health for a practical, clinician-focused overview of MASLD pharmacotherapy and new treatment horizons for hepatic steatosis. This session in the GHAPP MASLD & MASH Community Network covers the shift in nomenclature, why care must be multidisciplinary (obesity, type 2 diabetes, dyslipidemia, hypertension, cardiovascular risk), and how to stage disease with FIB-4, noninvasive tests, and FibroScan before initiating therapy. Jill reviews lifestyle and weight-loss strategies, GLP-1 receptor agonists—their mechanisms, common GI side effects, and peri-procedure considerations due to delayed gastric emptying—plus where vitamin E and pioglitazone do and don’t fit today. She also walks through practical use of resmetirom for non-cirrhotic MASH with F2–F3 fibrosis (labs to order, monitoring, drug–drug interactions, and setting expectations alongside diet and exercise). If you’re a GI/hepatology clinician, APP, or primary-care partner looking to streamline risk reduction, staging, and evidence-based therapy for MASLD/MASH, this talk delivers step-by-step guidance you can use in clinic today.
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Non-Invasive Testing With April Morris
July 2025
In this educational presentation, April Morris, FNP—an experienced provider in both liver disease and endocrinology—guides viewers through the evolving landscape of non-invasive testing (NITs) for diagnosing and managing patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. Using the case of a 65-year-old male with metabolic co-morbidities and suspected liver disease, Morris reviews how to effectively apply tools like the FIB-4 score, ELF test, and FibroScan (VCTE) to assess fibrosis risk and stratify patients. She compares imaging modalities including transient elastography, MR elastography (MRE), and shear wave elastography, offering practical considerations such as patient eligibility, test accuracy, and insurance barriers. The discussion emphasizes the importance of interpreting NITs within clinical context—highlighting how to determine risk, guide patient counseling, and establish a follow-up plan for low-risk patients. This session also reinforces the role of primary care in longitudinal liver health management and directs providers to resources available through the GHAPP MASLD & MASH Community Network.
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Common Questions From Community GI About MASH
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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Lifestyle Management With Allysa Saggese
August 2025
Join Allysa Saggese, NP, from Weill Cornell Medicine in New York City, for an insightful and practical discussion on lifestyle management for MASLD and MASH, presented through the GHAPP MASLD/MASH Community Network, sponsored by Madrigal Pharmaceuticals. In this case-based presentation, Allysa walks viewers through the non-pharmacologic strategies used to manage Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), highlighting the role of nutrition, physical activity, and patient-centered counseling. Using a real-world example of a 65-year-old patient with obesity, diabetes, and steatosis, Allysa demonstrates how to assess fibrosis risk through non-invasive testing like FIB-4 and FibroScan, and explains how lifestyle modifications remain central to slowing disease progression—even in the era of advanced therapeutics. The session explores the importance of motivational interviewing, cultural dietary preferences, and how to structure effective, individualized conversations around reducing sugar intake, increasing movement at home, and achieving sustainable 5–10% weight loss to improve liver histology. Allysa also breaks down the metabolic interplay between central adiposity, insulin resistance, and liver inflammation, and shares counseling tips to build patient trust and long-term engagement. Whether you're a GI or hepatology provider, this session delivers real-world guidance to help empower patients to reverse early liver damage through everyday lifestyle changes.
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NITs: A Practical Overview: Navigating the Basics
October 2025
In this educational session, Stacie Egan, NP, from Ogden Clinic Gastroenterology, explores the critical role of non-invasive testing (NITs) in diagnosing and managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Stacy explains the key differences between MASLD—fat accumulation without active damage—and MASH, where inflammation and cellular injury drive fibrosis, cirrhosis, and hepatocellular carcinoma. Understanding this distinction is vital for early detection and intervention. This session also highlights how ALT levels, metabolic comorbidities, and alcohol use should influence decision-making, and why combining test results with clinical context ensures accurate risk stratification. Clinicians will learn how to use NITs not as standalone diagnostics, but as integrated puzzle pieces that drive earlier treatment with lifestyle modification and emerging pharmacotherapies for F2–F3 fibrosis. Perfect for APPs, NPs, and GIs managing patients with fatty liver disease, this video offers a clear roadmap to detect, monitor, and manage MASH with fibrosis—improving outcomes while minimizing invasive procedures.
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LFTs Demystified: A practical guide for APPs
July 2025
In this GHAPP MASLD Community Network podcast, Jessica Crimaldi, NP, from the Cleveland Clinic, provides practical, real-world insights into interpreting liver function tests (LFTs) in the context of MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (steatohepatitis). Drawing on over a decade of experience in GI and hepatology, Jessica explains common ALT and AST elevation patterns that should prompt a diagnostic workup, even in asymptomatic patients. She reviews the hepatocellular vs. cholestatic patterns of injury, the value of the R-factor calculator in identifying the likely etiology of liver enzyme abnormalities, and how to differentiate MASH from other liver diseases such as PBC, viral hepatitis, or bile duct obstruction. The episode also addresses key non-liver labs like triglycerides, A1C, and cholesterol, and how they contribute to assessing metabolic risk. Finally, Jessica discusses the role of serial LFT monitoring in evaluating treatment response—highlighting what it means when liver enzyme levels fall and why "normal" LFTs don’t always indicate disease resolution. Whether you're a primary care provider or hepatology specialist, this podcast offers valuable guidance for early detection, risk stratification, and longitudinal monitoring of patients with MASH.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
August 2025
Join Tessa Janovsky, PA-C from Arizona Liver Health, for a practical and guideline-based discussion on screening for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH) in primary care. This session outlines which patient populations Advanced Practice Providers (APPs) should routinely screen—such as individuals with type 2 diabetes, medically complicated obesity, metabolic risk factors with fatty liver on imaging, moderate alcohol use (MetALD), or a family history of MASH cirrhosis. Learn how to apply first-line non-invasive screening tools like FIB-4 and the NAFLD Fibrosis Score, understand their limitations, and incorporate them into busy clinic workflows. Tessa shares strategies for communicating positive results to patients, next steps for further evaluation (ELF test, FibroScan, MRI elastography), and criteria for timely referral to gastroenterology or hepatology. With practical tips for integrating MASLD/MASH screening into electronic medical records, building clinical pathways, and standardizing protocols, this episode equips PCPs and specialists to detect high-risk patients earlier, intervene effectively, and ultimately improve liver health outcomes.
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Diet and Nutrition: Tailoring Plans for Diverse Populations
July 2025
In this quick and practical video, Miu Lai Ng, a nurse practitioner at the hepatology clinic at Tufts Medical Center in Boston, shares simple, culturally sensitive, and cost-effective dietary tips to help patients manage fatty liver disease—also known as MASH (metabolic dysfunction–associated steatohepatitis). From avoiding white-colored refined carbs like sugar, white rice, and potatoes to smart swaps like oatmeal—rich in soluble fiber and low on the glycemic index—this video emphasizes realistic changes tailored to diverse backgrounds. Miu Lai Ng also covers powerful tools for sticking with a liver-friendly diet, including food tracking apps, photo logging, meal planning tools, and the importance of social support. Plus, she highlights the hidden dangers of liquid calories found in sodas, juices, and bubble tea, which spike liver fat and cost more than you think. Whether you're supporting a patient or managing MASH yourself, this video offers actionable advice that respects both culture and budget—because small changes can lead to big results for your liver and your life.
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Non-Invasive Testing With Elizabeth Alqueza
August 2025
In this session, Elizabeth Alqueza, PA-C at Beth Israel Deaconess Medical Center, provides a comprehensive overview of non-invasive testing in patients with Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and MASH. Using a real clinical case, she explains how to evaluate patients with abnormal liver enzymes and steatosis on imaging, and how to apply widely used tools such as the FIB-4 score, ELF test, FibroScan (VCTE), CAP score, shear wave elastography, and MR elastography. Elizabeth highlights the strengths, limitations, and interpretation of each test, along with practical considerations like cost, accessibility, patient factors, and operator experience. She also reviews the MASLD care pathway, emphasizing how accurate staging with non-invasive tests helps identify at-risk patients with advanced fibrosis who need closer monitoring, lifestyle interventions, and specialty referral. This talk underscores the critical role of non-invasive assessment in preventing progression to cirrhosis, liver failure, and hepatocellular carcinoma.
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Non-Invasive Testing With Maly Tiev
September 2025
Maly Tiev, NP, NYU Langone Health, shares a practical, case-based walkthrough of non-invasive testing (NITs) for MASLD/MASH—showing how to move from initial risk identification to confident staging and follow-up without a biopsy in most patients. Using Albert’s case, a 65-year-old with steatosis and mild ALT elevation, she explains how to apply FIB-4 first, then layer in FibroScan/VCTE with Liver Stiffness (kPa) and CAP for fat quantification, plus when to order ELF or MRI elastography. You’ll learn reliability checks for FibroScan, common confounders, insurance/operational tips for MRE, and an easy algorithm for primary care/endocrine clinics: start with FIB-4 → triage by cutoffs → use VCTE/ELF → refer when intermediate or high risk. She closes with clear next steps for low-risk patients—lifestyle modification, cardiometabolic optimization, and repeating NITs in 2–3 years—and when to escalate to hepatology for advanced disease.
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