Patterns in Provider Specialties and Adoption of Non-Invasive Tests (NITs) for Diagnosing Metabolic Dysfunction-Associated Steatohepatitis (MASH)
Author(s)
Carmen Ng, PhD1, Semiu O. Gbadamosi, MPH, PhD, MD2, Aidan McGovern, PhD3, Andres Quintero, PhD4.
1Rapid Clinical Analysis, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 2Real-World Evidence, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 3Evidence Strategy and Synthesis, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 4Medical Affairs, Novo Nordisk Inc, Plainsboro, NJ, USA.
1Rapid Clinical Analysis, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 2Real-World Evidence, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 3Evidence Strategy and Synthesis, Clinical Data Science and Evidence, Novo Nordisk Inc, Plainsboro, NJ, USA, 4Medical Affairs, Novo Nordisk Inc, Plainsboro, NJ, USA.
Presentation Documents
OBJECTIVES: MASH poses a burgeoning global health challenge. Timely diagnosis of MASH faces considerable barriers, stemming in part from the multidisciplinary nature of diagnosis, variable disease awareness, and historically limited data validating diagnostic NITs. This study aimed to delineate provider specialties involved in diagnosing MASH and the specific NITs used for diagnosis.
METHODS: We conducted a retrospective analysis of Komodo’s Healthcare Map™ to identify newly-diagnosed cases of MASH from 2018 to 2023, defining the index date as the first instance of an inpatient or outpatient visit for MASH (ICD-10 code K7581). Eligible patients were at least 18 years old at the index date and had at least 24 months of continuous enrollment preceding that date. We tracked the provider specialty at diagnosis and subsequent claims, as well as NITs ordered during the 24 months prior to the index visit.
RESULTS: Among 148,609 patients with MASH, 81.4% had a provider specialty linked to their index claim. The predominant specialties at diagnosis were primary care physicians (PCPs; internal medicine (23.0%) and family medicine (18.5%)) and gastroenterology (22.0%). Although the percentage diagnosed by mid-level practitioners was small, it steadily rose from 3.0% in 2018 to 5.4% in 2023. Following diagnosis, patients remained under the care of the same specialty - only 3.8% went from a PCP in the index claim to a liver specialist in the next visit. In the 24 months prior to diagnosis, 85.5% of patients had a panel test including alanine aminotransferase, aspartate aminotransferase, and platelets that are used to determine Fibrosis-4 index scores; 36.7% had FibroSure; and 12.3% had vibration controlled transient elastography.
CONCLUSIONS: This analysis offers valuable insights regarding the dominant role of PCPs in diagnosing and treating MASH. It also highlights the most frequently used NITs in diagnosis, likely skewing toward PCP preference.
METHODS: We conducted a retrospective analysis of Komodo’s Healthcare Map™ to identify newly-diagnosed cases of MASH from 2018 to 2023, defining the index date as the first instance of an inpatient or outpatient visit for MASH (ICD-10 code K7581). Eligible patients were at least 18 years old at the index date and had at least 24 months of continuous enrollment preceding that date. We tracked the provider specialty at diagnosis and subsequent claims, as well as NITs ordered during the 24 months prior to the index visit.
RESULTS: Among 148,609 patients with MASH, 81.4% had a provider specialty linked to their index claim. The predominant specialties at diagnosis were primary care physicians (PCPs; internal medicine (23.0%) and family medicine (18.5%)) and gastroenterology (22.0%). Although the percentage diagnosed by mid-level practitioners was small, it steadily rose from 3.0% in 2018 to 5.4% in 2023. Following diagnosis, patients remained under the care of the same specialty - only 3.8% went from a PCP in the index claim to a liver specialist in the next visit. In the 24 months prior to diagnosis, 85.5% of patients had a panel test including alanine aminotransferase, aspartate aminotransferase, and platelets that are used to determine Fibrosis-4 index scores; 36.7% had FibroSure; and 12.3% had vibration controlled transient elastography.
CONCLUSIONS: This analysis offers valuable insights regarding the dominant role of PCPs in diagnosing and treating MASH. It also highlights the most frequently used NITs in diagnosis, likely skewing toward PCP preference.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD77
Topic
Real World Data & Information Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)