Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease.

A. Srivastava, R. Gailer, S. Tanwar, P. Trembling, J. Parkes, A. Rodger, D. Suri, D. Thorburn, K. Sennett, S. Morgan, E.A. Tsochatzis, W. Rosenberg

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND & AIMS: We aimed to develop and evaluate a pathway for management of patients with non-alcoholic fatty liver disease (NAFLD) using blood tests to stratify patients in primary care to improve detection of cases of advanced fibrosis and cirrhosis, and avoid unnecessary referrals to secondary care. METHODS: This was a prospective longitudinal cohort study with before-and-after analysis and comparison to unexposed controls. We used a two-step algorithm combining the use of FIB-4 followed by the ELF test if required RESULTS: In total, 3,012 patients were analysed. Use of the pathway detected 5 times more cases of advanced fibrosis (Kleiner F3) and cirrhosis (OR=5.18; 95%CI=2.97 to 9.04; p
Original languageEnglish
JournalJournal of Hepatology
Volume71
Issue number2
Early online date6 Apr 2019
DOIs
Publication statusPublished - Aug 2019

Keywords

  • ELF
  • FIB-4
  • cirrhosis
  • non-invasive fibrosis test
  • steatohepatitis

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