Once we accept the idea that cirrhosis can make an excellent target for drug development driven using non-invasive testing, the question is take the lead in bringing the appropriate initiative forward. Stephen Harrison points out that principal investigator KOLs are the group with the most knowledge and perspective but later notes that work-life balanced for these exceptionally busy people might limit their involvement. The group considers other stakeholders until Louise Campbell asks a question toward the end of this conversation that shifts panelists’ focus from traditionally, static guidance documents to a continuously updated living document similar to what exists for Hepatitis C.