How do you incorporate routine alcohol biomarkers (e.g., PEth) into hepatology care to support AUD recognition and ongoing monitoring without increasing shame-driven concealment, particularly in liver transplant candidates?

I try to incorporate the test into my general assessment of alcohol use. I ask the AUDIT-C questions. I tell the patient that I have included this test in their panel of tests. However, I often have a patient when I did not see them prior to getting a PEth. Here the key is to treat the result as a result, not a test of moral character. An unexpected positive is often met by an 'ah yes' moment: 'I had a few drinks on...'.

If the patient is adamant that they have not had alcohol, I do not contest t...