Chan WK, et al. - Since only patients with indeterminate or high nonalcoholic fatty liver disease (NAFLD) fibrosis scores (called a 2-step approach) have been reported to measure liver stiffness, reduce indeterminate or discordant outcomes while maintaining accuracy in the identification of patients with advanced fibrosis (histologic fibrosis stage ≥F3), researchers have validated this approach using data collected from the Gut and Obesity in Asia Workgroup. From 2006 through 2018, they conducted a retrospective analysis of data from 759 subjects with biopsy-proven NAFLD (24% with advanced fibrosis), seen at 10 centers in 9 countries in Asia. In populations with a low prevalence of advanced fibrosis, a 2-step approach using fibrosis scores (NAFLD fibrosis score or Fibrosis-4 score) followed by liver stiffness measurement (LSM) most precisely identifies advanced fibrosis. However, in populations with a high prevalence of advanced fibrosis, LSM ≥10 kPa identifies patients with advanced fibrosis with the highest level of accuracy.