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Predicting Alcohol-Related Liver Disease Across Populations: Model Development and Validation

Award Number: R01AA033259
ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/05/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2030

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Predicting Alcohol-Related Liver Disease Across Populations: Model Development and Validation - ABSTRACT Alcohol-associated liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease with unhealthy alcohol intake (MetALD) are serious and growing chronic health problems and major causes of mortality and morbidity. Patients with alcohol use disorder (AUD) are at especially high risk yet are rarely screened for liver-related problems. Currently, many cases go undetected as patients usually do not experience symptoms until serious problems emerge. Accurate and early identification of patients at elevated risk for ALD or MetALD based on clinical and sociodemographic factors could facilitate targeted delivery of interventions, including pharmacotherapy or referral to addiction medicine if needed before severe symptoms develop. Patients with AUD already in specialty care could especially benefit from integrated interventions to mitigate liver disease development or progression. Our objective is to develop risk-prediction models incorporating key clinician and patient perspectives and using clinical and sociodemographic characteristics commonly available in electronic health records (EHRs) to identify patients at high risk of developing ALD and MetALD. In this multi-method study based in Kaiser Permanente Northern California (KPNC), we will conduct qualitative interviews with clinicians and patients in Primary Care, Addiction Medicine, and Gastroenterology/Hepatology, to: i) identify challenges in ALD and MetALD identification across a range of severity, such as barriers/facilitators of the model’s implementation into routine clinical care and risk-based intervention strategies and treatment option communication with patients, ii) estimate a range of tolerance for false positive/negative alerts from a prediction model, and iii) inform the selection of predictors for models predicting ALD and MetALD. Next, we will use KPNC’s comprehensive EHR data, including systematic alcohol screening data on the vast majority of adult KPNC members (~4.5 million), to identify predictor variables and develop algorithms to predict ALD and MetALD. Analyses will use advanced machine learning techniques to develop models predicting ALD and MetALD in two retrospective cohorts of adult (≥ 18 years) KPNC members: 1) primary care patients screening positive for unhealthy drinking (n~417,300), and 2) patients with AUD seen in addiction medicine (n~17,100). We will evaluate all final models for potential differences in performance and accuracy, validating the final models in the entire sample and among distinct population groups (e.g., sex and age). Findings will be generalizable across a range of patient populations and health systems, to support broad implementation. If determined to be accurate and reliable, these decision support tools could facilitate early detection of liver disease risk and tailored interventions in primary care and addiction medicine settings with the potential to profoundly improve how we treat patients at risk of serious liver disease.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $2,591,645 )
2026	2026	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Alcohol Research Programs	000	1	8/4/2026	NEW	$2,591,645
														Subtotal = $2,591,645

Grand Total All Awards = $2,591,645

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Predicting Alcohol-Related Liver Disease Across Populations: Model Development and Validation

Award Number: R01AA033259

ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/05/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2030

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