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This conversation on NAFLD Care Delivery and NASH practices comes from Episode 20, our introductory conversation with newly designated full-time co-host Jörn Schattenberg. Most of the conversation focused on Jörn's background and research interests, but this section explores ways we can provide better diagnosis, coaching and care for Fatty Liver patients in Germany, the UK and the US.

The conversation stems from an observation Louise makes about how much she appreciates Jörn's focus on integrating primary care into screening and diagnosis. Jörn picks up on this to mention his work with LiverScreen, an EU-funded consortium that screens for Fatty Liver in primary care offices. This has brought him in contact with a significant number of primary care physicians and opened discussions about primary care's role in NAFLD and NASH. Jörn notes how the phenomenon Stephen Harrison has described as "greet 'em and street 'em" leaves primary care physicians short of the time to screen and support patients.

Roger Green asks if the improvising liquid biopsies will help address this problem, which leads Jörn to note that in general, German physicians do not draw blood, which makes liquid biopsies less valuable. This will be particularly true if the blood test is the one shot at diagnosis and the test is FIB-4 or something else with low cost but also low overall predictive ability.

Roger asks about the role of AI in this process, which leads Jörn and, after him, Louise to discuss the value of AI in risk identification, although not diagnosis. This brings the discussion back to the question of pathways, testing and the idea that in the German system, physicians have the latitude to ignore an abnormal liver test and many do so...all of which highlights the importance of physician education, which, as Jörn notes, is a focus of NASH Tsunami and becoming increasing important to the new company, SurfingNASH.com.