The study proposes replacing "NAFLD" with "MASLD" (metabolic dysfunction-associated steatotic liver disease), reflecting the central role of metabolic dysfunction. It also proposes diagnostic criteria based on the presence of at least one cardiometabolic risk factor and creates a separate category ("MetALD") for patients with MASLD and increased alcohol consumption.

Many authors disclosed consulting relationships with or receiving grants from pharmaceutical companies involved in NAFLD research and treatment.

This study used a robust, multi-stage Delphi process with a diverse panel of experts and patient advocates to reach consensus on new nomenclature for fatty liver disease. The thorough methodology, global representation, and inclusion of patient perspectives are strengths. However, potential bias in the Delphi method and the declared COIs of some authors slightly lower the rating.