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Background Non-alcoholic fatty liver disease (NAFLD) is a growing burden on European healthcare [1], with estimated annual healthcare costs of €19 billion EUR within the EU-5 region (France, Germany, Italy, Spain and the United Kingdom) [2]. In studies with long-term follow-up, excess mortality in people with NAFLD was shown to be dependent on the degree of underlying hepatic fibrosis [3]. Importantly, NAFLD also significantly impairs patients’ quality of life [4]. The histological definition of both the presence of the inflammatory subtype of the disease, which is commonly called non-alcoholic steatohepatitis (NASH), and hepatic fibrosis, causes challenges for all epidemiological studies on the prevalence of the disease in Europe.

Assessing the disease burden of non-alcoholic fatty liver disease in the real world – big data and big numbers