---
title: >-
  A Pragmatic Clinical Prognostic Classification Suitable for Universal
  Application Stratifies Patients with NAFLD by Risk of Mortality and Both
  Hepatic and Extrahepatic Outcomes.
description: >-
  Explore this publication on real-world evidence: A Pragmatic Clinical
  Prognostic Classification Suitable for Universal Application Stratifies
  Patients with…
date: '2020-01-01'
category: Publications
tags:
  - AASLD
  - Poster Presentation
  - R&D
  - Care
  - Hepatology
  - MASH/MASLD
  - Health System Partner
canonical_url: >-
  https://www.pedestalhealth.com/resources/publications/aasld/a-pragmatic-clinical-prognostic-classification-suitable-for/
source: Pedestal Health
license: © 2026 Pedestal Health. All rights reserved.
slug: a-pragmatic-clinical-prognostic-classification-suitable-for
id: 2j4HDAkBNFXlNePA9TtAfa
contentType: article
---

## Challenge

Existing NAFLD prognostic classification systems required liver biopsy for accurate staging, limiting their applicability in community practice and clinical trial screening where biopsy is impractical. A pragmatic biopsy-free system validated against hard outcomes was needed for universal application.

## Solution

The TARGET-NASH cohort was used to validate a three-tiered (Class A/B/C) prognostic classification based on FIB-4 and clinical-laboratory criteria against hard outcome incidence rates—mortality, liver events, MACE, and HCC—demonstrating stepwise outcome separation across risk strata.

## Impact

Validating a universally applicable biopsy-free prognostic classification against hard outcomes provides a regulatory-grade risk stratification tool for MASH trial enrollment, clinical decision support, and health economic modeling applicable across both academic and community settings.