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Alina Allen of the Mayo Clinic joins the Surfers to discuss her recent publication demonstrating that kPa scores from MR Elastography can predict the course of disease for non-cirrhotic and cirrhotic patients and consider its implications for clinical trials and every day patient treatment.

This episode has an unusual format. First, Alina Allen discusses her study and its implications with Louise Campbell and Roger Green. Next, Roger interviews Stephen Harrison on what he considers most important about the study and any comments on the transcript. Finally, Roger and Alina explore one remaining issue.

What emerges is an understanding that the importance of shifting from what Alina calls the "box" of looking for a fixed relationship between fibrosis levels and kPa scores to defining a linear relationship. The linear relationship simultaneously creates multiple questions for academic reason and provides a simple way for the clinician to inform the patient about level of risk therapeutic options and next decisions. This is an exciting, vitally important shift both in trials and the clinic.