S2434 Primary Care Physician Comfort With MASLD Screening in a Higher-Risk, Resource-Limited Setting: A Proposed Cost-Conscious Algorithm to Screening

Introduction: MASLD is the most common cause of chronic liver disease and the leading cause of liver-related morbidity and mortality. Hispanic adults are disproportionately affected and have a higher prevalence of MASLD than non-Hispanic adults. The Puentes de Salud community clinic serves a primarily Hispanic and underinsured community in South Philadelphia and is uniquely positioned to address disparities within this population. However, there remain significant out of pocket financial burdens on patients for costs of bloodwork and imaging. We aimed to assess primary care providers comfort with MASLD screening and perceived cost burden, and propose a cost-conscious algorithm to screening. Methods: This cross-sectional study utilized a REDCap-based survey administered April-May 2025 to primary care providers at the Puentes de Salud community clinic. One survey response was allowed per person. The survey was composed of 11 multiple choice, likert-scale questions about current practices related to MASLD screening and diagnostics. Participants had the option of a short response to provide additional comments. Results: Twenty primary care physicians completed the survey; 95% reported general comfort in identifying risk factors for MASLD, while 80% reported comfort with screening patients for MASLD. Seventy percent reported they were comfortable with counseling patients on management of MASLD. However, 75% reported uncertainty with ordering imaging such as ultrasound at the clinic and 95% reported they would benefit from further teaching of MASLD screening practices at the clinic. To help address barriers to MASLD screening at the clinic, we proposed a cost-conscious algorithm to identify and screen higher-risk individuals. Conclusion: Primary Care providers at this higher risk, resource-limited setting reported general comfort with MASLD screening. However, there remained significant areas of uncertainty including how to order diagnostic testing and when to refer to specialists. Through proposal of an algorithm for MASLD screening, we aim to address barriers and improve screening in this community. Future research will assess the implementation of this algorithm and impact on provider comfort.