Dr.PeteFamMed said:

The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value.

This is where I part company with the consensus forming above. I would drop the "get everything" instinct further than this thread does. Every extra test is another chance at a false positive, and incidental findings have their own cost in scans, biopsies and worry.

That is the short version; the long version is somebody else's post.

Adding the numbers, since they settle part of this. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.

Dr.KarenChen said:

I would drop the "get everything" instinct further than this thread does.

There is a second half to this that has not been said yet. The liver data is among the strongest non-weight findings in the class. The semaglutide MASH programme reported a large advantage over placebo on MASH resolution, with a substantial minority also achieving fibrosis improvement — and fibrosis is the endpoint that predicts outcomes. Mechanistically it is reduced hepatic lipogenesis, increased fatty-acid oxidation, less hepatic inflammation, and possibly a direct effect on stellate-cell activation.

One thing that is still open after DeniseRN_TPA’s answer:

How often to repeat it, because quarterly seems to be the convention and I cannot find the reasoning?

Closing the loop on my own question.

Took the whole panel in rather than the one flagged line, and the conversation lasted two minutes instead of generating three more tests.