This conversation between Scott Friedman, Laurent Castera, Louise Campbell and Roger Green covers what the panelists found exciting, important or striking about liver science, VCTE, regulatory approvals using NITs or AI, and other issues at TLM 2023. It starts with Roger sharing his belief that regulators are likely to approve NITs only if a small battery of tests (or ideally, a single test) prove valuable in assessing all agents, or at least all agents, for a stage of disease or segment of the market. Scott notes his frustration that biopsy is an expensive and poorly-graded measure and hopes that FDA will move past semi-qualitative biopsy. 

Roger asks Scott what we learned about basic science in the meeting. Scott discusses advances in single-cell technologies as pivotal in helping us understand underlying disease better, and goes on to mention several presentations on senescent cells that provided insight but, he felt, little for basic drug development. 

Roger then asks Louise what in the meeting she found most interesting. She points to two posters regarding VCTE. The first looks at liver stiffness and controlled attenuation parameter, or CAP in patients after transplantation. Louise describes this as the first time she has seen CAP used as an independent predictor. She mentions a second poster on methotrexate using VCTE as having similar promise to expand VCTE as a research tool.

Louise then goes on to discuss a poster addressing the evolving impact of allied providers in hepatology. In this poster, the authors projected a roughly 1/3 growth in hepatology patients by 2023 requiring treatment, coupled with a roughly 1/3 decline in the number of hepatologists available to treat them. Allied providers in hepatology showed a similar trend. To Louise, this signaled clearly that all countries need to boost the number of allied providers if these patients are to receive the care they will need. As the conversation winds down, Louise and Roger discuss the high level of patient presence and energy suffusing the entire event.

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