S5 - E3 - The New MASLD Nomenclature And How We Got Here

Send us Fan MailThe process of creating a new MASLD nomenclature for the condition formerly known as Fatty Liver Disease was a multi-year process with unique challenges and complications. Three leaders in the process, Maru Rinella, Jeff Lazarus and Meena Bansal, and patient advocate Mike Betel join Louise Campbell and Roger Green to discuss the process, transition and rollout.00:00:00 - Surf's Up: Season 5 Episode 3Co-hosts Louise Campbell and Roger Green sit with Maru Rinella, who co-chaired the New Nomenclature process, Jeff Lazarus, who oversaw the entire Delphi process, Meena Bansal, who played a key role and co-moderated the 2023 AASLD session, and patient advocate Mike Betel to discuss the entire process from inception to today and beyond.00:03:57 - Meet Meena BansalDr. Meena Bansal, Division Chief at Mt. Sinai Hospital in New York, discusses how she became involved in liver disease and her current research interests, and shares one fact about herself that might surprise you. 00:05:47 - GroundbreakerPanelists share one piece of good personal or professional news from the previous week.00:08:22 - Characterizing the Nomenclature ProcessMaru and Jeff discuss the original goals of the process and how focus broadened and shifted throughout.00:16:02 - How the Delphi Process WorkedJeff describes the overall process. Roger asks about people who chose not to participate at the outset, which leads to a discussion about the overall rate of participation. Roger then asks what might have worked better, which leads Maru, Meena and Jeff to discuss groups they wish had been better represented. 00:27:05 - The Role of Allied Health ProvidersLouise asks why Allied Health Providers did not play a larger role throughout the process. Maru and Meena differentiate between providers' roles in the early process and the mechanics of rolling out to the patient community.00:29:38 - Focusing on the RolloutRoger's question about the rollout leads Jeff to focus on some of the key early stage events. Jeff and Maru go on to discuss the high level of participation from key journals.00:33:32 - Early AwarenessMike Betel brings a piece of data on physician awareness from the pre-test of a study he is conducting in Canada, which serves as a conduit into the entire topic of who is aware of the nomenclature today and how knowledge will spread over time. 00:38:56 - The New Message for Patients Louise notes that the upcoming UK effort to bring VCTE screening to primary care will provide an effort to define and characterize the disease for patients. Meena comments that providers have done this informally for years, but while the message used to be that the patient "just has fat on the liver," this nomenclature will formalize the disease, remove "just," and focus the patient on therapy.00:39:15 - MetALD - A New Disease in the SLD FamilyRoger states that in his mind, the newly defined disease MetALD is a major positive outcome of the process. Maru, Meena and Louise each describe ways this new definition will aid diagnosis and treatment, Mike notes that the message still must be tailored for each patient. 00:43:55 - Implication for Diagnostics The group discusses the idea that while the nomenclature will not lead to new diagnostic tests, it might lead to increased and more appropriate use of the tests that exist.00:48:25 - The Future of the NomenclatureRoger asks the group where this process will be in a year and five years. Answers vary.00:51:58 - Grading the Process So FarRoger asks panelists how they grade the process to date. Grades are high although, as Jeff notes, they are grading their own work.00:55:27 - Business ReportNews on audience metrics, the upcoming Question of the Week, next week's epidemiology discussion and this week's Vault conversation