Multi-modal non-invasive biomarker screening for high-risk undiagnosed liver disease

非酒精性脂肪性肝病(NAFLD)和非酒精性脂肪性肝炎(NASH)在英国正变得越来越普遍，估计有20%的成年人受到影响。这些情况与肥胖和2型糖尿病有关，并可能导致严重的肝脏损伤，包括肝硬变和肝癌。据估计，英国每年治疗肝病的成本约为65亿GB，因为它出现的时间较晚，这给英国国家医疗服务体系(NHS)的资源带来了巨大的压力。患有NASH和NAFLD的患者预期寿命较短，患心血管疾病、肝癌和肝功能衰竭的风险较高。此外，这些情况通常是无症状的，这意味着患者通常直到疾病发展到更严重的阶段才被诊断出来。这增加了治疗的复杂性和成本，并降低了干预的有效性。除了治疗NASH和NAFLD的直接成本外，这些疾病的更广泛的经济影响也不容忽视。生产力下降和因病缺勤的增加可能会对英国整体经济产生重大影响，估计每年在7到130亿GB之间。解决日益严重的NASH和NAFLD问题的一个有希望的解决方案是使用成本效益高的非侵入性方法来在早期阶段识别高危患者。这项应用建议结合纵向生物标记物分析、非侵入性肝脏扫描和非侵入性基因测试，可以比现有方法更早地识别高危肝病病例，特别关注早期(25-35岁)和快速进展的肝病。由Somerset FT与预测健康情报合作开发的算法已被证明可以从NHS记录(由NIHR i4i计划--200965资助)中已有的普通血液测试中识别高风险肝病病例，从而减少对健康人进行进一步测试的需要。与此同时，Sano Genetics开发了一个平台，用于非侵入性基因测试、远程样本采集和纵向患者报告结果。这项提议将使这两家中小企业之间的合作能够在两个独立的NHS环境中迅速得到验证。

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are becoming increasingly prevalent in the UK, with an estimated 20% of the adult population affected. These conditions are associated with obesity and type 2 diabetes, and can lead to serious liver damage, including cirrhosis and liver cancer. The cost of treating liver disease in the UK is estimated to be around £6.5 billion per year because it presents late, putting a significant strain on the National Health Service (NHS) resources.Patients with NASH and NAFLD have a reduced life expectancy and a higher risk of cardiovascular disease, liver cancer, and liver failure. Furthermore, these conditions are often asymptomatic, meaning that patients are often not diagnosed until the disease has progressed to a more serious stage. This increases the complexity and cost of treatment, as well as reducing the effectiveness of interventions.In addition to the direct cost of treating NASH and NAFLD, the wider economic impact of these conditions cannot be ignored. Reduced productivity and increased absenteeism due to illness can have a significant impact on the UK economy as a whole estimated at between £7 and £13 billion per year.A promising solution to the growing problem of NASH and NAFLD is the use of cost-effective non-invasive approaches to identify at-risk patients at an earlier stage. This application proposes combining longitudinal biomarker analysis, non-invasive liver scanning, and non-invasive genetic testing can identify high-risk liver disease cases far earlier than existing approaches, with a particular focus on early-onset (25-35 years old) and fast-progressing liver disease.Algorithms developed by Somerset FT in collaboration with Predictive Health Intelligence have been shown to identify high-risk liver disease cases from common blood tests already present in NHS records (funded by NIHR i4i Programme -- 200965), thus reducing the need for further testing of healthy people. In parallel, Sano Genetics have developed a platform for non-invasive genetic testing, remote sample collection, and longitudinal patient reported outcomes. This proposal will enable a collaboration between these two SMEs that can be rapidly validated in two independent NHS contexts.