Suggested Title for Your Retrospective Cohort Study on MASLD
"Natural History, Risk Factors, and Clinical Outcomes in Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Retrospective Cohort Study"
Alternative Title Options
Based on the comprehensive EASL-EASD-EASO 2024 guidelines 1 and recent research on MASLD outcomes 2, 3, 4, here are additional title suggestions that align with current nomenclature and research priorities:
Option 1 (Emphasizing Disease Progression):
"Disease Progression and Liver-Related Outcomes in Adults with MASLD: A Retrospective Analysis of Risk Factors and Natural History"
This title emphasizes the key outcomes that matter most—progression to cirrhosis, hepatocellular carcinoma, and hepatic decompensation—which are the primary liver-related outcomes of clinical significance 1.
Option 2 (Emphasizing Metabolic Risk Stratification):
"Metabolic Risk Factors and Clinical Outcomes in MASLD: A Retrospective Cohort Study of Disease Progression and Mortality"
This focuses on the metabolic dysfunction aspect, which is central to the 2023 Delphi Consensus definition 1 and aligns with recent research showing that metabolic factors (obesity, type 2 diabetes, hypertension, hyperlipidemia) are the strongest independent risk factors 4.
Option 3 (Emphasizing Fibrosis and Clinical Events):
"Fibrosis Progression and Liver-Related Events in Adults with MASLD: A Retrospective Cohort Analysis"
This title prioritizes fibrosis, which is the most critical histological feature associated with adverse outcomes 1. The guidelines clearly state that fibrosis regression is associated with reduced risk of liver-related outcomes, and fibrosis stage is the strongest predictor of mortality, HCC, and decompensation 1.
Key Elements to Consider Including
Based on the 2024 guidelines 1, your study should ideally address:
- Primary outcomes: All-cause mortality, liver-related mortality, cirrhosis development, HCC incidence, and hepatic decompensation 1
- Risk stratification factors: Age, sex, BMI, type 2 diabetes, fibrosis stage (assessed by non-invasive tests like FIB-4, NFS, or elastography) 5
- Natural history endpoints: Progression from simple steatosis to MASH, fibrosis progression, and development of cirrhosis 1
Rationale for Title Selection
The first title option is recommended because it:
- Uses the current accepted terminology (MASLD rather than NAFLD)
- Encompasses all three key components you mentioned: natural history, risk factors, and clinical outcomes
- Aligns with the heterogeneous, fluctuating natural history of the disease that requires long-term observation 1
- Reflects the current research priorities identified in recent large cohort studies 2, 3, 4
The guidelines emphasize that liver-related outcomes (cirrhosis decompensation, decline in liver function, HCC, and liver transplantation) are the most clinically meaningful endpoints 1. Recent real-world data shows that only 4% of MASLD patients undergo liver biopsy, and those who do represent a selected high-risk group with 9-fold higher HCC risk and 3-fold higher cirrhosis risk 2. This underscores the importance of studying natural history in unselected cohorts.
Your title should reflect that you're examining real-world disease progression rather than surrogate endpoints, as the guidelines note that surrogate histological endpoints "have not been unambiguously linked to true clinical benefits" 1.