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In everyday clinical practice, alcohol histories rely primarily on physician\u2010assisted self\u2010report, with validated questionnaires used variably. Both provider\u2010level inconsistencies in documentation and patient\u2010level factors (e.g., recall and social\u2010desirability biases) can contribute to misclassification of SLD subtypes. Phosphatidylethanol (PEth), a direct alcohol biomarker detectable for ~2\u20134\u2009weeks, has emerged as a promising objective tool that can complement self\u2010report. Across diverse SLD populations, PEth consistently uncovers underreported alcohol use, sharpens subclassification, informs prognosis, and enables longitudinal monitoring to guide care. In liver transplantation, PEth supports documentation of abstinence and detection of relapse to enable timely intervention. This mini\u2010review synthesises current evidence on PEth in SLD, emphasises its value in both clinical and research settings, and outlines priorities for integrating PEth into structured care pathways and clinical trial design to improve outcomes and harmonise endpoints.<\/jats:p>","DOI":"10.1111\/liv.70489","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:59:57Z","timestamp":1766401197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Integrating Phosphatidylethanol to Enhance Alcohol Quantification in Steatotic Liver Disease and Clinical Trials"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5922-7912","authenticated-orcid":false,"given":"Elias D.","family":"Rady","sequence":"first","affiliation":[{"name":"Division of Digestive and Liver Diseases UT Southwestern Medical Center  Dallas Texas 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