News from the AGA

As COVID-19 cases rise in the United States due to the Delta variant, there is renewed concern about infection and transmission of SARS-CoV-2 during endoscopy. In May 2021, AGA released updated recommendations on preprocedure testing post vaccination in the setting of ongoing population-wide vaccination programs for the prevention of COVID-19–related morbidity. In vaccinated individuals, breakthrough infections occurred very infrequently. Weighing the evidence demonstrating extremely low rates of rates of infection and transmission with vaccination and PPE, and considering the downsides of routine testing (burden, cost, false test results, increased disparities), AGA made a conditional recommendation against routine preprocedure testing for elective cases. The highly contagious Delta variant has now emerged as the predominant SARS-CoV2 virus in the U.S. and some data suggests that it may cause more severe illness than previous strains.  While more breakthrough infections may develop in fully vaccinated individuals, the greatest risk of infection, transmission and hospitalizations is among those who are unvaccinated.

• AGA suggests against reinstituting routine preprocedure testing prior to elective endoscopy. The downsides (delays in patient care, burden, inaccurate results) outweigh potential benefits. Infection and transmission of SARS-CoV-2 from asymptomatic individuals is rare especially among vaccinated health care workers using personal protective equipment (PPE), even with the emergence of the Delta variant.
• If PPE is available, AGA recommends using N95 for upper endoscopy and suggests using N95 or surgical masks for lower endoscopy (acknowledging that upper endoscopy is more aerosolizing than lower endoscopy) and continuation of elective and nonelective endoscopy.
• Based on local prevalence rates, PPE, and test availability, in intermediate- and high-prevalence settings, preprocedure testing may be used to inform PPE decisions (N95 versus surgical mask). Additional benefits to testing are small and include deferring elective endoscopy in individuals testing positive and reducing anxiety among staff and patients.

As COVID-19 cases rise in the United States due to the Delta variant, there is renewed concern about infection and transmission of SARS-CoV-2 during endoscopy. In May 2021, AGA released updated recommendations on preprocedure testing post vaccination in the setting of ongoing population-wide vaccination programs for the prevention of COVID-19–related morbidity. In vaccinated individuals, breakthrough infections occurred very infrequently. Weighing the evidence demonstrating extremely low rates of rates of infection and transmission with vaccination and PPE, and considering the downsides of routine testing (burden, cost, false test results, increased disparities), AGA made a conditional recommendation against routine preprocedure testing for elective cases. The highly contagious Delta variant has now emerged as the predominant SARS-CoV2 virus in the U.S. and some data suggests that it may cause more severe illness than previous strains.  While more breakthrough infections may develop in fully vaccinated individuals, the greatest risk of infection, transmission and hospitalizations is among those who are unvaccinated.

• AGA suggests against reinstituting routine preprocedure testing prior to elective endoscopy. The downsides (delays in patient care, burden, inaccurate results) outweigh potential benefits. Infection and transmission of SARS-CoV-2 from asymptomatic individuals is rare especially among vaccinated health care workers using personal protective equipment (PPE), even with the emergence of the Delta variant.
• If PPE is available, AGA recommends using N95 for upper endoscopy and suggests using N95 or surgical masks for lower endoscopy (acknowledging that upper endoscopy is more aerosolizing than lower endoscopy) and continuation of elective and nonelective endoscopy.
• Based on local prevalence rates, PPE, and test availability, in intermediate- and high-prevalence settings, preprocedure testing may be used to inform PPE decisions (N95 versus surgical mask). Additional benefits to testing are small and include deferring elective endoscopy in individuals testing positive and reducing anxiety among staff and patients.

As COVID-19 cases rise in the United States due to the Delta variant, there is renewed concern about infection and transmission of SARS-CoV-2 during endoscopy. In May 2021, AGA released updated recommendations on preprocedure testing post vaccination in the setting of ongoing population-wide vaccination programs for the prevention of COVID-19–related morbidity. In vaccinated individuals, breakthrough infections occurred very infrequently. Weighing the evidence demonstrating extremely low rates of rates of infection and transmission with vaccination and PPE, and considering the downsides of routine testing (burden, cost, false test results, increased disparities), AGA made a conditional recommendation against routine preprocedure testing for elective cases. The highly contagious Delta variant has now emerged as the predominant SARS-CoV2 virus in the U.S. and some data suggests that it may cause more severe illness than previous strains.  While more breakthrough infections may develop in fully vaccinated individuals, the greatest risk of infection, transmission and hospitalizations is among those who are unvaccinated.

• AGA suggests against reinstituting routine preprocedure testing prior to elective endoscopy. The downsides (delays in patient care, burden, inaccurate results) outweigh potential benefits. Infection and transmission of SARS-CoV-2 from asymptomatic individuals is rare especially among vaccinated health care workers using personal protective equipment (PPE), even with the emergence of the Delta variant.
• If PPE is available, AGA recommends using N95 for upper endoscopy and suggests using N95 or surgical masks for lower endoscopy (acknowledging that upper endoscopy is more aerosolizing than lower endoscopy) and continuation of elective and nonelective endoscopy.
• Based on local prevalence rates, PPE, and test availability, in intermediate- and high-prevalence settings, preprocedure testing may be used to inform PPE decisions (N95 versus surgical mask). Additional benefits to testing are small and include deferring elective endoscopy in individuals testing positive and reducing anxiety among staff and patients.

AGA President John Inadomi, MD, and former AGA President David Lieberman, MD, along with American Cancer Society Cancer Action Network and Fight CRC, met with Assistant Secretary of Labor, Ali Khawar, and representatives from the U.S. Department of Health & Human Services and U.S. Department of Treasury to request they direct private health plans to cover colonoscopy after a positive noninvasive colorectal cancer (CRC) screening test.

The meeting was in response to an appeal sent to the three agencies, which provided guidance to health plans to ensure that workers have the benefits that have been agreed upon by their employers. As part of the Affordable Care Act, plans are mandated to cover colorectal cancer screening without cost sharing.

In May 2021, when the United States Preventive Services Task Force (USPFTF) lowered the recommended CRC screening age to 45, it also stated that “positive results on stool-based screening tests require follow-up with colonoscopy for the screening benefits to be achieved.”

To ensure that privately insured Americans receive proper CRC screening, AGA, ACS, and Fight CRC are pushing the government to provide written guidance to private plans clarifying that follow-up colonoscopies conducted after a positive noninvasive screening test are part of the colorectal cancer screening process and, therefore, patients should not face out-of-pocket costs when completing colorectal cancer screening.

Colorectal cancer remains the second leading killer in cancer in the United States despite the availability of preventive screening options. In 2018, just 68.8% of those eligible were screened for colorectal cancer. The challenge of getting people screened was exacerbated in 2020 when it is estimated that colorectal cancer screening declined by 86% during the first few months of the COVID-19 pandemic.

AGA President John Inadomi, MD, and former AGA President David Lieberman, MD, along with American Cancer Society Cancer Action Network and Fight CRC, met with Assistant Secretary of Labor, Ali Khawar, and representatives from the U.S. Department of Health & Human Services and U.S. Department of Treasury to request they direct private health plans to cover colonoscopy after a positive noninvasive colorectal cancer (CRC) screening test.

The meeting was in response to an appeal sent to the three agencies, which provided guidance to health plans to ensure that workers have the benefits that have been agreed upon by their employers. As part of the Affordable Care Act, plans are mandated to cover colorectal cancer screening without cost sharing.

In May 2021, when the United States Preventive Services Task Force (USPFTF) lowered the recommended CRC screening age to 45, it also stated that “positive results on stool-based screening tests require follow-up with colonoscopy for the screening benefits to be achieved.”

To ensure that privately insured Americans receive proper CRC screening, AGA, ACS, and Fight CRC are pushing the government to provide written guidance to private plans clarifying that follow-up colonoscopies conducted after a positive noninvasive screening test are part of the colorectal cancer screening process and, therefore, patients should not face out-of-pocket costs when completing colorectal cancer screening.

Colorectal cancer remains the second leading killer in cancer in the United States despite the availability of preventive screening options. In 2018, just 68.8% of those eligible were screened for colorectal cancer. The challenge of getting people screened was exacerbated in 2020 when it is estimated that colorectal cancer screening declined by 86% during the first few months of the COVID-19 pandemic.

AGA President John Inadomi, MD, and former AGA President David Lieberman, MD, along with American Cancer Society Cancer Action Network and Fight CRC, met with Assistant Secretary of Labor, Ali Khawar, and representatives from the U.S. Department of Health & Human Services and U.S. Department of Treasury to request they direct private health plans to cover colonoscopy after a positive noninvasive colorectal cancer (CRC) screening test.

The meeting was in response to an appeal sent to the three agencies, which provided guidance to health plans to ensure that workers have the benefits that have been agreed upon by their employers. As part of the Affordable Care Act, plans are mandated to cover colorectal cancer screening without cost sharing.

In May 2021, when the United States Preventive Services Task Force (USPFTF) lowered the recommended CRC screening age to 45, it also stated that “positive results on stool-based screening tests require follow-up with colonoscopy for the screening benefits to be achieved.”

To ensure that privately insured Americans receive proper CRC screening, AGA, ACS, and Fight CRC are pushing the government to provide written guidance to private plans clarifying that follow-up colonoscopies conducted after a positive noninvasive screening test are part of the colorectal cancer screening process and, therefore, patients should not face out-of-pocket costs when completing colorectal cancer screening.

Colorectal cancer remains the second leading killer in cancer in the United States despite the availability of preventive screening options. In 2018, just 68.8% of those eligible were screened for colorectal cancer. The challenge of getting people screened was exacerbated in 2020 when it is estimated that colorectal cancer screening declined by 86% during the first few months of the COVID-19 pandemic.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion: 

Vikrant Parihar, MD, wrote the following in “COVID-19 and UC”:

A 43-year-old man with an index presentation of distal colitis (Montreal E2) (Mayo endoscopic score 2-3) was discharged home on tapering doses of oral steroids. He was being worked up to commence anti-TNF likely initially as combo therapy. Fully vaccinated against COVID – had both doses of vaccine way back in May. Attended a match and looks to have got mild symptoms and on testing turned out to be COVID+. Rx himself by self-quarantine.

What would be the optimal strategy?

1. Stop steroids completely and immediately given the adverse signal in registry data?

2. When can anti-TNF’s be safely started?

3. How to manage him in the interim?

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25172.
 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion: 

Vikrant Parihar, MD, wrote the following in “COVID-19 and UC”:

A 43-year-old man with an index presentation of distal colitis (Montreal E2) (Mayo endoscopic score 2-3) was discharged home on tapering doses of oral steroids. He was being worked up to commence anti-TNF likely initially as combo therapy. Fully vaccinated against COVID – had both doses of vaccine way back in May. Attended a match and looks to have got mild symptoms and on testing turned out to be COVID+. Rx himself by self-quarantine.

What would be the optimal strategy?

1. Stop steroids completely and immediately given the adverse signal in registry data?

2. When can anti-TNF’s be safely started?

3. How to manage him in the interim?

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25172.
 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion: 

Vikrant Parihar, MD, wrote the following in “COVID-19 and UC”:

A 43-year-old man with an index presentation of distal colitis (Montreal E2) (Mayo endoscopic score 2-3) was discharged home on tapering doses of oral steroids. He was being worked up to commence anti-TNF likely initially as combo therapy. Fully vaccinated against COVID – had both doses of vaccine way back in May. Attended a match and looks to have got mild symptoms and on testing turned out to be COVID+. Rx himself by self-quarantine.

What would be the optimal strategy?

1. Stop steroids completely and immediately given the adverse signal in registry data?

2. When can anti-TNF’s be safely started?

3. How to manage him in the interim?

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25172.
 

New patient care resource: NASH Clinical Care Pathway

The American Gastroenterological Association – in collaboration with seven professional associations – assembled a multidisciplinary taskforce of 15 experts to develop an action plan to develop a nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) Clinical Care Pathway providing practical guidance across multiple disciplines of care. The guidance ranges from screening and diagnosis to management of individuals with NAFLD and NASH, as well as facilitating value-based, efficient, and safe care that is consistent with evidence-based guidelines. 

This clinical care pathway is intended to be applicable in any setting in which care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices. 

Read the special report: Clinical Care Pathway for the Risk Stratification and Management of Patients with Nonalcoholic Fatty Liver Disease. 

To learn more about the development of this publication, visit NASH.gastro.org. 
 

GI societies push CMS for payment rules favorable for practices 

As part of our longstanding collaboration and ongoing efforts on critical policy and payment issues impacting GI clinicians, AGA, the American College of Gastroenterology, and American Society for Gastrointestinal Endoscopy submitted comments on proposed 2022 Medicare payments to physicians, ambulatory surgery centers (ASCs), and hospital outpatient departments to the CMS. We advocated for the following: 

Increased and more accurate valuation for peroral endoscopic myotomy (POEM) and capsule endoscopy services. 

Continued flexibility and payment parity for telehealth and telephone services. 

Elimination of the secondary scalar for ASCs, which contributes to the widening differential in payments to ASCs compared to the hospital outpatient department. 

You can access our letter here. 

New patient care resource: NASH Clinical Care Pathway

The American Gastroenterological Association – in collaboration with seven professional associations – assembled a multidisciplinary taskforce of 15 experts to develop an action plan to develop a nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) Clinical Care Pathway providing practical guidance across multiple disciplines of care. The guidance ranges from screening and diagnosis to management of individuals with NAFLD and NASH, as well as facilitating value-based, efficient, and safe care that is consistent with evidence-based guidelines. 

This clinical care pathway is intended to be applicable in any setting in which care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices. 

Read the special report: Clinical Care Pathway for the Risk Stratification and Management of Patients with Nonalcoholic Fatty Liver Disease. 

To learn more about the development of this publication, visit NASH.gastro.org. 
 

GI societies push CMS for payment rules favorable for practices 

As part of our longstanding collaboration and ongoing efforts on critical policy and payment issues impacting GI clinicians, AGA, the American College of Gastroenterology, and American Society for Gastrointestinal Endoscopy submitted comments on proposed 2022 Medicare payments to physicians, ambulatory surgery centers (ASCs), and hospital outpatient departments to the CMS. We advocated for the following: 

Increased and more accurate valuation for peroral endoscopic myotomy (POEM) and capsule endoscopy services. 

Continued flexibility and payment parity for telehealth and telephone services. 

Elimination of the secondary scalar for ASCs, which contributes to the widening differential in payments to ASCs compared to the hospital outpatient department. 

You can access our letter here. 

New patient care resource: NASH Clinical Care Pathway

The American Gastroenterological Association – in collaboration with seven professional associations – assembled a multidisciplinary taskforce of 15 experts to develop an action plan to develop a nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) Clinical Care Pathway providing practical guidance across multiple disciplines of care. The guidance ranges from screening and diagnosis to management of individuals with NAFLD and NASH, as well as facilitating value-based, efficient, and safe care that is consistent with evidence-based guidelines. 

This clinical care pathway is intended to be applicable in any setting in which care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices. 

Read the special report: Clinical Care Pathway for the Risk Stratification and Management of Patients with Nonalcoholic Fatty Liver Disease. 

To learn more about the development of this publication, visit NASH.gastro.org. 
 

GI societies push CMS for payment rules favorable for practices 

As part of our longstanding collaboration and ongoing efforts on critical policy and payment issues impacting GI clinicians, AGA, the American College of Gastroenterology, and American Society for Gastrointestinal Endoscopy submitted comments on proposed 2022 Medicare payments to physicians, ambulatory surgery centers (ASCs), and hospital outpatient departments to the CMS. We advocated for the following: 

Increased and more accurate valuation for peroral endoscopic myotomy (POEM) and capsule endoscopy services. 

Continued flexibility and payment parity for telehealth and telephone services. 

Elimination of the secondary scalar for ASCs, which contributes to the widening differential in payments to ASCs compared to the hospital outpatient department. 

You can access our letter here. 

We’ve launched a new app designed to help AGA trainees and early career members navigate each step along their GI career path. Once users get started by setting up their professional profile, AGA Career Compass offers curated resources on topics like career planning, clinical education, and leadership skills.

The Connections Corner section hosts experienced mentors and matches them with users based on profile compatibility and shared topics of interest, such as grant writing, setting up a lab, navigating career options in academic medicine, managing burnout, and more. Download the app today to branch out from your institution or practice and receive personalized career guidance.

Now available in Apple and Google Play stores.

We’ve launched a new app designed to help AGA trainees and early career members navigate each step along their GI career path. Once users get started by setting up their professional profile, AGA Career Compass offers curated resources on topics like career planning, clinical education, and leadership skills.

The Connections Corner section hosts experienced mentors and matches them with users based on profile compatibility and shared topics of interest, such as grant writing, setting up a lab, navigating career options in academic medicine, managing burnout, and more. Download the app today to branch out from your institution or practice and receive personalized career guidance.

Now available in Apple and Google Play stores.

We’ve launched a new app designed to help AGA trainees and early career members navigate each step along their GI career path. Once users get started by setting up their professional profile, AGA Career Compass offers curated resources on topics like career planning, clinical education, and leadership skills.

The Connections Corner section hosts experienced mentors and matches them with users based on profile compatibility and shared topics of interest, such as grant writing, setting up a lab, navigating career options in academic medicine, managing burnout, and more. Download the app today to branch out from your institution or practice and receive personalized career guidance.

Now available in Apple and Google Play stores.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion:  

Junaid Beig, MBBS, FRACP wrote the following in “Subtherapeutic Azathioprine metabolites despite being adherent to medication”:

“I have an Ulcerative patient (Pancolitis) on Mesalazine and Azathioprine 150mg since 2018. His levels are subtherapeutic (6TGN 159 and 6MMP 70) despite being adherent to medication. He drinks 2 liters of wine per week.

“Questions: Is there any way we can find if he has high TPMT activity (Level is normal 6.1)? Does alcohol have an impact on TPMT activity? Does he warrant alternative treatment?”

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25109.
 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion:  

Junaid Beig, MBBS, FRACP wrote the following in “Subtherapeutic Azathioprine metabolites despite being adherent to medication”:

“I have an Ulcerative patient (Pancolitis) on Mesalazine and Azathioprine 150mg since 2018. His levels are subtherapeutic (6TGN 159 and 6MMP 70) despite being adherent to medication. He drinks 2 liters of wine per week.

“Questions: Is there any way we can find if he has high TPMT activity (Level is normal 6.1)? Does alcohol have an impact on TPMT activity? Does he warrant alternative treatment?”

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25109.
 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion:  

Junaid Beig, MBBS, FRACP wrote the following in “Subtherapeutic Azathioprine metabolites despite being adherent to medication”:

“I have an Ulcerative patient (Pancolitis) on Mesalazine and Azathioprine 150mg since 2018. His levels are subtherapeutic (6TGN 159 and 6MMP 70) despite being adherent to medication. He drinks 2 liters of wine per week.

“Questions: Is there any way we can find if he has high TPMT activity (Level is normal 6.1)? Does alcohol have an impact on TPMT activity? Does he warrant alternative treatment?”

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25109.
 

When life changes, so should your will. An old will can’t cover every change that may have occurred since it was first drawn. Ensure that this important document matches your current wishes by reviewing it every few years.

Use your will to give back!

Help support young investigators doing research. A flexible and versatile way to support the mission of the AGA Research Foundation is to leave a gift in your will or living trust, known as a charitable bequest.

• Gift us a share of what›s left in your estate after other obligations are met.
• Make a contingent bequest. That is, you give part of your estate to some individual if that person survives you; if not, then it goes to us.
• Create a charitable remainder trust to pay an income to your spouse or other loved one for life and designate the remaining principal for us.
• Create a charitable lead trust to pay income to us for a number of years, or for another person’s lifetime, with the trust assets eventually being distributed to your family.
• Donate a specific amount of cash or securities.

To make sure your will accomplishes all you intend, seek the help of an attorney who specializes in estate planning. If our organization fits into your plans, we can help you choose the method that best satisfies your wishes and our needs.

When life changes, so should your will. An old will can’t cover every change that may have occurred since it was first drawn. Ensure that this important document matches your current wishes by reviewing it every few years.

Use your will to give back!

Help support young investigators doing research. A flexible and versatile way to support the mission of the AGA Research Foundation is to leave a gift in your will or living trust, known as a charitable bequest.

• Gift us a share of what›s left in your estate after other obligations are met.
• Make a contingent bequest. That is, you give part of your estate to some individual if that person survives you; if not, then it goes to us.
• Create a charitable remainder trust to pay an income to your spouse or other loved one for life and designate the remaining principal for us.
• Create a charitable lead trust to pay income to us for a number of years, or for another person’s lifetime, with the trust assets eventually being distributed to your family.
• Donate a specific amount of cash or securities.

To make sure your will accomplishes all you intend, seek the help of an attorney who specializes in estate planning. If our organization fits into your plans, we can help you choose the method that best satisfies your wishes and our needs.

When life changes, so should your will. An old will can’t cover every change that may have occurred since it was first drawn. Ensure that this important document matches your current wishes by reviewing it every few years.

Use your will to give back!

Help support young investigators doing research. A flexible and versatile way to support the mission of the AGA Research Foundation is to leave a gift in your will or living trust, known as a charitable bequest.

• Gift us a share of what›s left in your estate after other obligations are met.
• Make a contingent bequest. That is, you give part of your estate to some individual if that person survives you; if not, then it goes to us.
• Create a charitable remainder trust to pay an income to your spouse or other loved one for life and designate the remaining principal for us.
• Create a charitable lead trust to pay income to us for a number of years, or for another person’s lifetime, with the trust assets eventually being distributed to your family.
• Donate a specific amount of cash or securities.

To make sure your will accomplishes all you intend, seek the help of an attorney who specializes in estate planning. If our organization fits into your plans, we can help you choose the method that best satisfies your wishes and our needs.

According to Endpoints News, Tadataka “Tachi” Yamada, MD, died unexpectedly of natural causes at his home in Seattle on Aug. 4, 2021. Dr. Yamada had a storied career as a GI leader, educator, and mentor before his work as a biotech pharma research chief and a global health advocate with the Bill and Melinda Gates Foundation.

AGA President John Inadomi, MD, tweeted “We lost a mentor, sponsor, role model and true pioneer in gastroenterology – Honor his legacy.” You can share your remembrances on the AGA Community.

Over the years, Tachi made enormous contributions to AGA. He served on multiple committees, too numerous to list. He served on the AGA Governing Board multiple times and as president.

He was awarded the association’s highest honor, the Julius Friedenwald Medal, in 2003. At that time, Chung Owyang, MD, wrote a bio of Tachi and noted his critical role in shaping AGA and Digestive Disease Week® (DDW). He was the founding chair of the AGA Council working hard to reformat DDW into a major international event for our subspecialty. He was also among the group of AGA leaders who proposed the establishment of the AGA Foundation.

In 1996, Tachi assumed the presidency of AGA during a time of great turbulence in health care, where not only the practice but also the education and research missions of gastroenterology were threatened by change. Tachi took on the challenge with exemplary vision, energy, and intelligence.

Dan Podolsky, MD, a former AGA president commented at the time of Tachi’s Friedenwald Medal that “Tachi applied characteristic creativity and energy to all AGA activities. An inspirational leader, he was especially effective in promoting the AGA’s commitment to the career development of young gastroenterologists, promoting digestive diseases research, and as a tireless advocate for the field of gastroenterology.”

“Tachi has not only led our field, but he has been a global leader helping pharma rethink their role in global health, and helping the Gates Foundation save so many lives. He was soft-spoken but his worldwide contributions and vision will carry on. Heartfelt condolences to his family and friends,” said Bishr Omary, MD, PhD, past president of AGA Institute.

According to Endpoints News, Tadataka “Tachi” Yamada, MD, died unexpectedly of natural causes at his home in Seattle on Aug. 4, 2021. Dr. Yamada had a storied career as a GI leader, educator, and mentor before his work as a biotech pharma research chief and a global health advocate with the Bill and Melinda Gates Foundation.

AGA President John Inadomi, MD, tweeted “We lost a mentor, sponsor, role model and true pioneer in gastroenterology – Honor his legacy.” You can share your remembrances on the AGA Community.

Over the years, Tachi made enormous contributions to AGA. He served on multiple committees, too numerous to list. He served on the AGA Governing Board multiple times and as president.

He was awarded the association’s highest honor, the Julius Friedenwald Medal, in 2003. At that time, Chung Owyang, MD, wrote a bio of Tachi and noted his critical role in shaping AGA and Digestive Disease Week® (DDW). He was the founding chair of the AGA Council working hard to reformat DDW into a major international event for our subspecialty. He was also among the group of AGA leaders who proposed the establishment of the AGA Foundation.

In 1996, Tachi assumed the presidency of AGA during a time of great turbulence in health care, where not only the practice but also the education and research missions of gastroenterology were threatened by change. Tachi took on the challenge with exemplary vision, energy, and intelligence.

Dan Podolsky, MD, a former AGA president commented at the time of Tachi’s Friedenwald Medal that “Tachi applied characteristic creativity and energy to all AGA activities. An inspirational leader, he was especially effective in promoting the AGA’s commitment to the career development of young gastroenterologists, promoting digestive diseases research, and as a tireless advocate for the field of gastroenterology.”

“Tachi has not only led our field, but he has been a global leader helping pharma rethink their role in global health, and helping the Gates Foundation save so many lives. He was soft-spoken but his worldwide contributions and vision will carry on. Heartfelt condolences to his family and friends,” said Bishr Omary, MD, PhD, past president of AGA Institute.

According to Endpoints News, Tadataka “Tachi” Yamada, MD, died unexpectedly of natural causes at his home in Seattle on Aug. 4, 2021. Dr. Yamada had a storied career as a GI leader, educator, and mentor before his work as a biotech pharma research chief and a global health advocate with the Bill and Melinda Gates Foundation.

AGA President John Inadomi, MD, tweeted “We lost a mentor, sponsor, role model and true pioneer in gastroenterology – Honor his legacy.” You can share your remembrances on the AGA Community.

Over the years, Tachi made enormous contributions to AGA. He served on multiple committees, too numerous to list. He served on the AGA Governing Board multiple times and as president.

He was awarded the association’s highest honor, the Julius Friedenwald Medal, in 2003. At that time, Chung Owyang, MD, wrote a bio of Tachi and noted his critical role in shaping AGA and Digestive Disease Week® (DDW). He was the founding chair of the AGA Council working hard to reformat DDW into a major international event for our subspecialty. He was also among the group of AGA leaders who proposed the establishment of the AGA Foundation.

In 1996, Tachi assumed the presidency of AGA during a time of great turbulence in health care, where not only the practice but also the education and research missions of gastroenterology were threatened by change. Tachi took on the challenge with exemplary vision, energy, and intelligence.

Dan Podolsky, MD, a former AGA president commented at the time of Tachi’s Friedenwald Medal that “Tachi applied characteristic creativity and energy to all AGA activities. An inspirational leader, he was especially effective in promoting the AGA’s commitment to the career development of young gastroenterologists, promoting digestive diseases research, and as a tireless advocate for the field of gastroenterology.”

“Tachi has not only led our field, but he has been a global leader helping pharma rethink their role in global health, and helping the Gates Foundation save so many lives. He was soft-spoken but his worldwide contributions and vision will carry on. Heartfelt condolences to his family and friends,” said Bishr Omary, MD, PhD, past president of AGA Institute.

Whether you’re a clinician or researcher, your voice is an important part of AGA’s mission to advocate for health care policies that support GI patients and practitioners.

Help us elevate the GI perspective by participating in AGA Advocacy Day on Thursday, Sept. 23, 2021, from 9 a.m. to 4 p.m. EDT. This is a unique opportunity for you to virtually meet with federal legislators to share your experiences and show how supporting the needs of GIs and our patients impacts the community they represent.

No prior advocacy experience needed! AGA staff will supply key talking points on a variety of health care policies and provide plenty of training to help you tell your story in a way that inspires and influences policymakers.

Your participation on this day – no matter how long – is vital to our success. If you can’t attend meetings the entire day, then share your availability during registration and we’ll arrange meetings around your busy schedule.

Save your spot.

Whether you’re a clinician or researcher, your voice is an important part of AGA’s mission to advocate for health care policies that support GI patients and practitioners.

Help us elevate the GI perspective by participating in AGA Advocacy Day on Thursday, Sept. 23, 2021, from 9 a.m. to 4 p.m. EDT. This is a unique opportunity for you to virtually meet with federal legislators to share your experiences and show how supporting the needs of GIs and our patients impacts the community they represent.

No prior advocacy experience needed! AGA staff will supply key talking points on a variety of health care policies and provide plenty of training to help you tell your story in a way that inspires and influences policymakers.

Your participation on this day – no matter how long – is vital to our success. If you can’t attend meetings the entire day, then share your availability during registration and we’ll arrange meetings around your busy schedule.

Save your spot.

Whether you’re a clinician or researcher, your voice is an important part of AGA’s mission to advocate for health care policies that support GI patients and practitioners.

Help us elevate the GI perspective by participating in AGA Advocacy Day on Thursday, Sept. 23, 2021, from 9 a.m. to 4 p.m. EDT. This is a unique opportunity for you to virtually meet with federal legislators to share your experiences and show how supporting the needs of GIs and our patients impacts the community they represent.

No prior advocacy experience needed! AGA staff will supply key talking points on a variety of health care policies and provide plenty of training to help you tell your story in a way that inspires and influences policymakers.

Your participation on this day – no matter how long – is vital to our success. If you can’t attend meetings the entire day, then share your availability during registration and we’ll arrange meetings around your busy schedule.

Save your spot.

AGA, in collaboration with seven professional associations, convened an international conference of 32 experts to develop a multidisciplinary action plan to improve care for the growing population of patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). The recommendations from this meeting have been copublished in Gastroenterology along with three other leading journals: Diabetes Care, Metabolism: Clinical and Experimental, and Obesity: The Journal of the Obesity Society.

Key findings from this special report include the following:

• Patients with obesity or type 2 diabetes are at a higher risk of developing NAFLD/NASH with diabetes being a major risk factor for worse disease severity and progression to cirrhosis (permanent damage to the liver).
• Primary care providers are critical to managing this growing epidemic. They should be the first line for screening patients at risk, stratifying patients based on their risk for advanced fibrosis, and providing effective management and referrals.
• The guiding principle for risk stratification is to rule out advanced fibrosis by simple, noninvasive fibrosis scores (such as NAFLD fibrosis score or Fibrosis-4 Index). Patients at intermediate or high risk may require further assessment with a second-line test – evaluation with elastography or by serum marker test with direct measures of fibrogenesis.
• Because NAFLD is not an isolated disease but a component of cardiometabolic abnormalities typically associated with obesity, insulin resistance, and type 2 diabetes, the cornerstone of therapy is lifestyle-based therapies (altered diet – such as reduced-calorie or Mediterranean diets – and regular, moderate physical activity), as well as replacing obesogenic medications, to decrease body weight and improve cardiometabolic health. Patients with diabetes who also have NASH may benefit from certain antidiabetic medications (such as pioglitazone and semaglutide) that treat not only their diabetes but also reverse steatohepatitis and improve cardiometabolic health.
• Optimal care of patients with NAFLD and NASH requires collaboration among primary care providers, endocrinologists, diabetologists, obesity medicine specialists, gastroenterologists, and hepatologists to tackle both the liver manifestations of the disease and the comorbid metabolic syndrome and cardiovascular risk, as well as screening and treating other comorbid conditions (such as obstructive sleep apnea).

AGA, in collaboration with seven professional associations, convened an international conference of 32 experts to develop a multidisciplinary action plan to improve care for the growing population of patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). The recommendations from this meeting have been copublished in Gastroenterology along with three other leading journals: Diabetes Care, Metabolism: Clinical and Experimental, and Obesity: The Journal of the Obesity Society.

Key findings from this special report include the following:

• Patients with obesity or type 2 diabetes are at a higher risk of developing NAFLD/NASH with diabetes being a major risk factor for worse disease severity and progression to cirrhosis (permanent damage to the liver).
• Primary care providers are critical to managing this growing epidemic. They should be the first line for screening patients at risk, stratifying patients based on their risk for advanced fibrosis, and providing effective management and referrals.
• The guiding principle for risk stratification is to rule out advanced fibrosis by simple, noninvasive fibrosis scores (such as NAFLD fibrosis score or Fibrosis-4 Index). Patients at intermediate or high risk may require further assessment with a second-line test – evaluation with elastography or by serum marker test with direct measures of fibrogenesis.
• Because NAFLD is not an isolated disease but a component of cardiometabolic abnormalities typically associated with obesity, insulin resistance, and type 2 diabetes, the cornerstone of therapy is lifestyle-based therapies (altered diet – such as reduced-calorie or Mediterranean diets – and regular, moderate physical activity), as well as replacing obesogenic medications, to decrease body weight and improve cardiometabolic health. Patients with diabetes who also have NASH may benefit from certain antidiabetic medications (such as pioglitazone and semaglutide) that treat not only their diabetes but also reverse steatohepatitis and improve cardiometabolic health.
• Optimal care of patients with NAFLD and NASH requires collaboration among primary care providers, endocrinologists, diabetologists, obesity medicine specialists, gastroenterologists, and hepatologists to tackle both the liver manifestations of the disease and the comorbid metabolic syndrome and cardiovascular risk, as well as screening and treating other comorbid conditions (such as obstructive sleep apnea).

AGA, in collaboration with seven professional associations, convened an international conference of 32 experts to develop a multidisciplinary action plan to improve care for the growing population of patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). The recommendations from this meeting have been copublished in Gastroenterology along with three other leading journals: Diabetes Care, Metabolism: Clinical and Experimental, and Obesity: The Journal of the Obesity Society.

Key findings from this special report include the following:

• Patients with obesity or type 2 diabetes are at a higher risk of developing NAFLD/NASH with diabetes being a major risk factor for worse disease severity and progression to cirrhosis (permanent damage to the liver).
• Primary care providers are critical to managing this growing epidemic. They should be the first line for screening patients at risk, stratifying patients based on their risk for advanced fibrosis, and providing effective management and referrals.
• The guiding principle for risk stratification is to rule out advanced fibrosis by simple, noninvasive fibrosis scores (such as NAFLD fibrosis score or Fibrosis-4 Index). Patients at intermediate or high risk may require further assessment with a second-line test – evaluation with elastography or by serum marker test with direct measures of fibrogenesis.
• Because NAFLD is not an isolated disease but a component of cardiometabolic abnormalities typically associated with obesity, insulin resistance, and type 2 diabetes, the cornerstone of therapy is lifestyle-based therapies (altered diet – such as reduced-calorie or Mediterranean diets – and regular, moderate physical activity), as well as replacing obesogenic medications, to decrease body weight and improve cardiometabolic health. Patients with diabetes who also have NASH may benefit from certain antidiabetic medications (such as pioglitazone and semaglutide) that treat not only their diabetes but also reverse steatohepatitis and improve cardiometabolic health.
• Optimal care of patients with NAFLD and NASH requires collaboration among primary care providers, endocrinologists, diabetologists, obesity medicine specialists, gastroenterologists, and hepatologists to tackle both the liver manifestations of the disease and the comorbid metabolic syndrome and cardiovascular risk, as well as screening and treating other comorbid conditions (such as obstructive sleep apnea).