{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T10:46:39Z","timestamp":1787222799067,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020098","name":"Innovative Health Initiative","doi-asserted-by":"publisher","award":["101132946"],"award-info":[{"award-number":["101132946"]}],"id":[{"id":"10.13039\/100020098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Metabolic dysfunction\u2010Associated Steatotic Liver Disease (MASLD) is a growing clinical challenge, necessitating effective diagnostic strategies to identify advanced liver fibrosis while minimising unnecessary referrals of mild cases. Current clinical guidelines recommend care pathways utilising non\u2010invasive tests (NITs) to stratify patients, but the optimal diagnostic algorithm across care settings remains unclear. This state\u2010of\u2010the\u2010art review systematically examines studies describing clinical care pathways for detecting advanced fibrotic MASLD and stratifying patients at risk. A comprehensive literature search of MEDLINE, Embase, Cochrane Library, and Scopus, finalised in January 2026, identified nine relevant studies that met predefined criteria including structured care plans and applicability beyond diagnosis alone. Pathway populations included patients at risk for MASLD (type 2 diabetes (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094) or broad range cardiometabolic risk factors (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091)) or confirmed MASLD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094). The most frequently employed NITs were FIB\u20104 and vibration\u2010controlled transient elastography (VCTE). Numbers needed to screen (NNS) for hepatology referral and advanced fibrosis detection varied considerably across pathways and populations, reflecting heterogeneity in design and fibrosis assessment methods. All studies reported improved patient risk stratification; attendance rates declined at each pathway step. Findings suggest that NIT\u2010based clinical care pathways can effectively align patient management and optimise transmural care for MASLD. Nonetheless, heterogeneity in pathway design and fibrosis determination highlights the need for standardised protocols and validation in larger, at\u2010risk cohorts to strengthen evidence supporting widespread adoption. This review contributes to advancing MASLD management within evolving clinical frameworks.\n                  <\/jats:p>","DOI":"10.1111\/liv.70603","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:47:21Z","timestamp":1773910041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Care Pathways for Metabolic Dysfunction\u2010Associated Steatotic Liver Disease (\n                    <scp>MASLD<\/scp>\n                    ): A State\u2010of\u2010The\u2010Art Review"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0440-2063","authenticated-orcid":false,"given":"Kirsi M. A.","family":"van Eekhout","sequence":"first","affiliation":[{"name":"Department of Vascular and Internal Medicine Amsterdam University Medical Centre, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard D.","family":"Broekman","sequence":"additional","affiliation":[{"name":"Department of Vascular and Internal Medicine Amsterdam University Medical Centre, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian D.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Global Public Health &amp; Bioethics, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Julius Clinical  Zeist the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Saarland University Medical Center, Saarland University  Homburg Germany"},{"name":"Saarland University  Saarbr\u00fccken Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Grobbee","sequence":"additional","affiliation":[{"name":"Department of Global Public Health &amp; Bioethics, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Julius Clinical  Zeist the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Maya\u2010Miles","sequence":"additional","affiliation":[{"name":"SeLiver Group, Instituto de Biomedicina de Sevilla\/CSIC\/Virgen del Roc\u00edo University Hospital University of Seville, Seville, Spain\/Centro De Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD)  Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8494-8947","authenticated-orcid":false,"given":"Manuel","family":"Romero\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"UCM Digestive Diseases. Virgen del Rocio University Hospital, Institute of Biomedicine of Seville, CIBEREHD University of Seville  Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Muris","sequence":"additional","affiliation":[{"name":"Care and Public Health Research Institute (CAPHRI), Department of Family Medicine Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-7707","authenticated-orcid":false,"given":"Juan M.","family":"Mendive","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, La Mina Primary Health Care Academic Centre University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7002-118X","authenticated-orcid":false,"given":"Yasaman","family":"Vali","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar H.","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Global Public Health &amp; Bioethics, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-4703","authenticated-orcid":false,"given":"J\u00f6rn M.","family":"Schattenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Saarland University Medical Center, Saarland University  Homburg Germany"},{"name":"Saarland University  Saarbr\u00fccken Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Fournier\u2010Poizat","sequence":"additional","affiliation":[{"name":"Echosens  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Castro Cabezas","sequence":"additional","affiliation":[{"name":"Julius Clinical  Zeist the Netherlands"},{"name":"Department of Internal Medicine Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"},{"name":"Department of Internal Medicine, Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten E.","family":"Tushuizen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Leiden University Medical Centre, University of Leiden  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan G.","family":"Holleboom","sequence":"additional","affiliation":[{"name":"Department of Vascular and Internal Medicine Amsterdam University Medical Centre, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the GRIPonMASH consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1599"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.03.006"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2412865"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000735"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00193-6"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322786"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1047129"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci24-0094"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2309000"},{"issue":"9","key":"e_1_2_11_12_1","first-page":"802","article-title":"Pipeline of New Drug Treatment for Non\u2010Alcoholic Fatty Liver Disease\/Metabolic Dysfunction\u2010Associated Steatotic Liver Disease","volume":"12","author":"Hu Y.","year":"2024","journal-title":"Journal of Clinical and Translational Hepatology"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2022.100596"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2403308"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.08.026"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_11_18_1","unstructured":"K. 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