Primary care sequential use of FIB-4 and the enhanced liver fibrosis test to stratify patients with non-alcoholic fatty liver disease increases cirrhosis detection and reduces referrals of patients with mild disease – 2 year study analysis

Srivastava, Achal; Gailer, R.; Demma, Shirin; Warner, A.; Morgan, S.; Sennett, Karen; Thorburn, Douglas; Parkes, Julie; Tsochatzis, Emmanuel; Rosenberg, William

doi:10.1016/s0168-8278(17)30397-5

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“…Two stage stratification pathways have been set up in areas of the UK and adopted as routine clinical care. An example of a two stage pathway is in North London where Srivastava et al put in place a "NAFLD pathway" using FIB4 scoring and ELF test for stratification of patients with a clinical diagnosis of NAFLD or an abnormal ALT (22). Patients with a new or established diagnosis of NAFLD are eligible for participation in the program and based on the initial FIB4 result the patients are stratified to be at either low risk, indeterminate risk or high risk of advanced liver fibrosis.…”

Section: Early Detection Of Liver Disease In the Ukmentioning

confidence: 99%

Health Technology Adoption in Liver Disease: Innovative Use of Data Science Solutions for Early Disease Detection

Bennett

Purssell

Street

et al. 2022

Front. Digit. Health

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Chronic liver disease (CLD) is an ignored epidemic. Premature mortality is considerable and in the United Kingdom (UK) liver disease is in the top three for inequitable healthcare alongside heart and respiratory disease. Fifty percentage of patients with CLD are first diagnosed with cirrhosis after an emergency presentation translating to poorer patient outcomes. Traditional models of care have been based in secondary care when the need is at community level. Investigating patients for disease based on their risk factors at a population level in the community will identify its presence early when there is potential reversibility. Innovation is needed in three broad areas to improve clinical care in this area: better access to diagnostics within the community, integrating diagnostics across primary and secondary care and utilizing digital healthcare to enhance patient care. In this article, we describe how the Integrated Diagnostics for Early Detection of Liver Disease (ID-LIVER) project, funded by UK Research and Innovation, is developing solutions in Greater Manchester to approach the issue of diagnosis of liver disease at a population level. The ambition is to build on innovative pathways previously established in Nottingham by bringing together NHS organizations, academic partners and commercial organizations. The motivation is to co-create and implement a commercial solution that integrates multimodal diagnostics via cutting edge data science to drive growth and disrupt the currently inadequate model. The ambitious vision is for this to be widely adopted for early diagnosis and stratification of liver disease at a population level within the NHS.

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Section: Early Detection Of Liver Disease In the Ukmentioning

confidence: 99%