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In a monumental moment for combatting Fatty Liver disease, NICE has published the much anticipated evidence-based recommendations on FibroScan for assessing liver fibrosis and cirrhosis outside secondary and specialist care. Such a positive announcement comes at no better time than the start of the Surfing NASH ongoing coverage of International #NASHDay 2023 . To kick off the occasion, this first episode features hepatology researcher and KOL, William Alazawi, and new guest Vanessa Hebditch who serves as Director of Communications and Policy at the British Liver Trust. The panelists, alongside Louise Campbell and Roger Green, celebrate and comment on the new guidance on FibroScan use in the UK.

This conversation continues focus on the concerns around appropriate data collection and analysis to discover the best path forward. Will describes the need to collect the kinds of data that will assess the value of the process and the right way to execute as processes are built and implemented. Vanessa agrees, but asks that we not let the perfect be the enemy of the good and that we keep in mind how many patients with advanced fibrosis are not getting diagnosed today and need the support of this program. One point that clearly emerges in dialogue with Will is that other countries will look to NICE and the UK experience to inform their own decisions. This only amplifies the need to collect data well and wisely. Louise states that she would also like to see data about the effect of this initiative on related metabolic conditions. She likens FibroScan scoring to dropping a pebble in a pond and seeks to explore the ripples it makes in related diseases and conditions, particularly for endocrinology and cardiology. Roger remarks on how refreshing it is to hear a conversation where multiple stakeholders are aligned to find the best approach to the disease. He goes on to contrast this topic to the role of ICER. Finally, Roger asks questions around Louise's pond metaphor and mentions comments that Stephen Harrison and Mazen Noureddin made last autumn that had suggested that FAST may be a better first line test. Will suggests that many questions need to be answered before determining the accuracy of the tests or what the best way to perform them is.

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