---
title: >-
  Liver Biopsy in the Real World—Reporting, Expert Concordance and Correlation
  with a Pragmatic Clinical Diagnosis.
description: >-
  Explore this publication on real-world evidence: Liver Biopsy in the Real
  World—Reporting, Expert Concordance and Correlation with a Pragmatic Clinical…
date: '2021-01-01'
category: Publications
tags:
  - Alimentary Pharmacology & Therapeutics
  - Abstract / Manuscript
  - Approval / Commercialization
  - Care
  - Hepatology
  - MASH/MASLD
  - Pharma Partner
  - Health System Partner
canonical_url: >-
  https://www.pedestalhealth.com/resources/publications/alimentary-pharmacology-therapeutics/liver-biopsy-in-the-real-world-reporting-expert-concordance/
source: Pedestal Health
license: © 2026 Pedestal Health. All rights reserved.
slug: liver-biopsy-in-the-real-world-reporting-expert-concordance
id: 3GuvBv1pL8Y100BZN88Opt
contentType: article
---

## Challenge

Liver biopsy is the reference standard for NASH diagnosis, but the accuracy and completeness of pathology reporting in real-world clinical practice—and the concordance between site and central pathologists—had not been quantified, raising questions about the reliability of histological data from community and academic sites alike.

## Solution

The TARGET-NASH cohort was used to audit 153 real-world pathology reports from 14 sites and compare local pathologist reads against a central expert pathologist using weighted kappa statistics, providing the first large-scale real-world concordance analysis of NASH histology.

## Impact

Documenting poor to moderate concordance for key NASH histological features across real-world sites establishes the evidence base for standardizing pathology reporting in NASH clinical trials, directly informing data quality requirements for regulatory submissions.

### [Andrea R. Mospan](/people/andrea-mospan/)

![Andrea R. Mospan, PhD, RAC — Profile Photo](https://images.ctfassets.net/h4s3ip99qawo/4w6bkwPHPqrXKYs4tHZPkK/1d21763b54ecc3466764986693b7072f/andrea-mospan.jpg)