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

摘要: Background & Aims The development of non-invasive liver fibrosis tests may enable earlier identification patients with non-alcoholic fatty disease (NAFLD) requiring referral to secondary care. We developed and evaluated a pathway for the management NAFLD, aimed at improving detection cases advanced cirrhosis, avoiding unnecessary referrals. Methods This was prospective longitudinal cohort study, analyses performed before after introduction pathway, comparisons made unexposed controls. used 2-step algorithm combining use Fibrosis-4 score followed by ELF™ test if required. Results In total, 3,012 were analysed. Use detected 5 times more (Kleiner F3) cirrhosis (odds ratio [OR] 5.18; 95% CI 2.97–9.04; p  Conclusions blood improves while reducing referrals in NAFLD. strategy resource benefits patients. Lay summary Non-alcoholic effects up 30% population but only minority develop disease. Our study has shown that established can be primary care stratify disease, leading reduction 80% greatly cirrhosis.