AGA technical review on the evaluation of liver chemistry tests

Green, Richard M.; Flamm, Steven L.

doi:10.1053/gast.2002.36061

Cited by 516 publications

(394 citation statements)

References 117 publications

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“…Analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States yielded a 7.9% prevalence rate of elevated AST or ALT (1), which is somewhat higher than the 1-4% rate commonly found in other studies (2). The five most common chronic liver diseases, and thus the usual causes of elevated liver chemistry tests, include NAFLD, chronic hepatitis C, ALD, chronic hepatitis B, and hemochromatosis.…”

Section: Elevated Ast or Alt To Nonalcoholic Fatty Liver Disease: Accmentioning

confidence: 91%

Elevated AST or ALT to nonalcoholic fatty liver disease: accurate predictor of disease prevalence?

2003

The American Journal of Gastroenterology

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Section: Elevated Ast or Alt To Nonalcoholic Fatty Liver Disease: Accmentioning

confidence: 91%

Elevated AST or ALT to nonalcoholic fatty liver disease: accurate predictor of disease prevalence?

2003

The American Journal of Gastroenterology

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“…Despite the nearly 6000 papers published on LFTs since 1990 [6] nearly all are based on hospital practice and most are retrospective and concerned with probabilities given a disease state rather than the predictive probability of disease. Until recently there were no prospective studies based in primary care practice where patients were fully investigated following at least one abnormal analyte from a full LFT profile.…”

Section: Liver Function Testsmentioning

confidence: 99%

Review and Recommendations for the Component Tests in the Liver Function Test Profile

Badrick

Turner

2015

Ind J Clin Biochem

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Pathology laboratories group some tests that they perform on their high throughput biochemistry analysers into profiles of tests that are associated with different organs (e.g. liver function tests-LFT). The components of these profiles are historic and often vary between different laboratories. This can lead to confusion and begs the question of what should be in a particular profile. In community medicine profiles may be used as screening tests but some of the components of the profiles may have low sensitivity and specificity and may produce both false positives and negatives. The LFT may include components which are poor liver function tests but are sensitive to fatty liver and hence elevations may cause unnecessary concern. Harmonisation of clinical chemistry reference intervals and units is occurring now so it is time to consider a similar process for components of a profile. A proposed list of analytes to be performed in the LFT profile is given.

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“…Similarly, NSAIDs were not thoroughly studied as risk factors for stress ulcers although their longterm use was associated with GI bleeding problems [37][38][39] ; (5) Current GI bleeding: Patients with active GI bleeding were also excluded from the study since those patients will be receiving AST as a pharmacologic intervention for the management of upper GI bleeding. Moreover, prophylaxis has no role and is not indicated in this population [40][41][42] ; (6) Lab tests including complete blood count, liver function tests and stool exam were documented to monitor for bleeding [43][44][45] ; (7) Stress ulcers risk factors: A stress ulcer risk stratification, adopted from the ASHP guidelines, divided patients into three categories: non-critically ill medical patients, ICU populations and pediatrics. The recommendation for prophylaxis was based on the risk factors for clinically important bleeding.…”

Section: Data Collectionmentioning

confidence: 99%

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

Zeitoun

Zeineddine²,

Dimassi³

2011

WJGPT

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AIM:To evaluate the current practice of stress ulcer prophylaxis (SUP) in Lebanese Health care centers. METHODS:A multi-center prospective chart review study was conducted over 8 mo. A questionnaire was distributed to pharmacy students who collected data on demographics, SUP medications, dose, route, duration and associated risk factors. The appropriateness of SUP use was determined as per American Society of Health-System Pharmacists guidelines. Institutional review board approval was obtained from each hospital center. RESULTS:A total of 1004 patients were included. 67% of the patients who received prophylaxis did not have an indication for SUP. The majority (71.6%) of the patients who were administered parenteral drugs can tolerate oral medications. Overall, the regimen of acid-suppressant drugs was suboptimal in 87.6% of the sample. This misuse was mainly observed in nonteaching hospitals. CONCLUSION:This study highlighted the need, in Lebanese hospitals, to establish clinical practice guidelines for the use of SUP; mainly in non-critical care settings.

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AGA technical review on the evaluation of liver chemistry tests

Cited by 516 publications

References 117 publications

Elevated AST or ALT to nonalcoholic fatty liver disease: accurate predictor of disease prevalence?

Elevated AST or ALT to nonalcoholic fatty liver disease: accurate predictor of disease prevalence?

Review and Recommendations for the Component Tests in the Liver Function Test Profile

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

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