NASHnext is a noninvasive test that uses a proprietary blood-based diagnostic algorithm called NIS4 to identify nonalcoholic steato-hepatitis (NASH). It is recommended for patients with metabolic risk factors and no other causes of chronic liver disease or steatosis. NASHnext is one of many potential biomarkers for NASH. The NIS4 algorithm combines results from four independent NASH-associated biomarkers (miR-34a, a2M, YKL-40/CHI3L1, and A1C) into a score (0 to 1) that identifies those at risk of NASH and progression to advanced fibrosis (Table 1).¹ It is projected that by 2030, NASH will be the leading cause of liver transplantation in the United States.² The American Gastroenterological Association and several other national societies recommend noninvasive tests, such as Fibrosis-4, which also comprise biomarkers, to stratify a patient’s risk before performing imaging or liver biopsies.³