In Episode 13, we explored ways that data modeling can inform a deeper understanding of the value of community and primary care VCTE screening for NAFLD and NASH. This week, we ask Chris Estes, lead modeler at the Center for Disease Analysis Foundation, what guidance data modeling can provide about diagnostic and drug development.
The episode is a cross between a discussion and an interview-type program. It starts with Chris explaining how he derives models, which variables he selects as proxy measures, why he chooses those, and where shortcomings exist in the data that is available for him to use in populating models. For much of the rest, the other panelists -- Alina Allen, Louise Campbell, Jörn Schattenberg and Roger Green -- either ask questions about how Chris's models work or what we can learn from them, and Chris answers. Beyond that, panelists share their own observations based on research and patient treatment experiences and Chris responds. The group covers a virtual shopping list of topics, including: underreported and misreported diseases; which proxies are more reliable when modeling disease (and which are less so); gaps in current data; positives, negatives and challenges in using obesity as the proxy variable for NAFLD instead of diabetes; the case for treating F2 agents with drugs when they become available; countries most at risk in the coming global NASH pandemic; the need to forecast pediatric NAFLD and NASH better; impact of alcohol consumption on NAFLD or NASH patients; and the situations where regressing fibrosis is pivotal vs. others where simply stopping progression might be a sufficient goal. In the end, this conversation offers a better understanding of how complex modeling is and how remarkable that people like Chris produce results that bear up so well over time.
After the episode, keep listening for an "extra-sode," originally recorded on January 27, 2022, focusing on the practical value and uses of MRE in day-to-day practice. In addition to Louise Campbell and Roger Green, the panel for this extra-sode includes Stephen Harrison, Mazen Noureddin, Kay Pepin from Mayo Clinic and Resoundant, and Scott Reeder from the University of Wisconsin. This discussion, which appears as stand-alone conversation S3 E16.4, addresses the uses of MRE in community settings and the unique benefits MRE can bring as a standalone test and combined with MRI-PDFF in a test/reporting structure known as an hepatogram.
This episode is sponsored by Resoundant, a Mayo Clinic company and the developers of Magnetic Resonance Elastography. MRE is widely available with over 2000 locations worldwide, and can be done as a low-cost, rapid exam in just 5 minutes. Together with PDFF, this quantitative exam is called an Hepatogram – a powerful non-invasive alternative to liver biopsy in many cases. For more information, visit www.resoundant.com on the web.
