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One critical success factor for putting a dent in Fatty Liver disease – one we do not discuss very often on the podcast – is patient empowerment. In this conversation, Roger Green and Louise Campbell are joined by patient advocates Michael Betel, Wayne Eskridge and Robert Mitchell-Thain to discuss the use of FIB-4 as a front-line tool for primary care triage.

Roger starts by noting FIB-4 as cheap and relies on a small number of widely-used tests. At different levels, FIB-4 is prognostic not only for major adverse liver outcomes and mortality but also at its indeterminate level for cardiovascular and overall mortality. He connects the most recent Rising Tide episode, where it’s mentioned that the US may be the only country to include AST so widely in standard testing. It's asked in that episode whether this is an issue advocates can adopt and use to advance disease awareness and screening. Wayne endorses the idea and Robert expresses some concern about FIB-4. Robert does acknowledge that Fatty Liver Alliance’s new charity status positions it as an excellent organization to make the major change. 

The final question asks each advocate what change they can make in their country in the next 12 months that might extend beyond the country’s borders. Surf on to hear their answers.