To Professor Rowe, the ELF approval was the most important story of summer because it promises a brighter future for non-invasive tests and, eventually, decreased reliance on biopsy. Dr. Rowe points out that transitioning from the ordinal results that biopsy generates (fibrosis score level) provide limited, unrealistic guidance in determining the probability of a downstream negative event (transplant, cancer, death). He contrasts this to continuous test results, including blood-based and device-driven tests, which provide clearer guidance about downstream risks. Louise Campbell adds her own reflections about the importance of inexpensive, blood-based tests to address the emerging NASH pandemic in poorer Third World Countries. This is not a long conversation, but it looks at the issue from some unusual, enlightening angles.