Intelligent Liver Function Testing (iLFT): An Intelligent Laboratory Approach to Identifying Chronic Liver Disease

Abstract

The intelligent Liver Function Testing (iLFT) pathway is a novel, algorithm-based system which provides automated laboratory investigations and clinical feedback on abnormal liver function test (LFT) results from primary care. iLFT was introduced to NHS Tayside, Scotland, in August 2018 in response to vast numbers of abnormal LFTs, many of which were not appropriately investigated, coupled with rising mortality from chronic liver disease. Here, we outline the development and implementation of the iLFT pathway, considering the implications for the diagnostic laboratories, primary care services and specialist hepatology clinics. Additionally, we describe the utility, outcomes and evolution of iLFT, which was used over 11,000 times in its first three years alone. Finally, we will consider the future of iLFT and propose areas where similar ‘intelligent’ approaches could be used to add value to laboratory investigations.

Impact of dietary selenium and blood concentration on liver function: a population-based study

“…In the laboratory, serum liver function biomarkers were quantitatively assessed using the advanced Beckman Coulter DxC800 Synchron clinical system. ALT, primarily found in liver cells, is an enzyme involved in amino acid metabolism ( 26 , 27 ). When liver cells are damaged or die, ALT is released into the blood.…”

“…Elevated serum ALT levels are often seen as a sign of liver damage. AST, found in liver cells, cardiomyocytes, muscle cells, and other tissues, is not as liver-specific as ALT ( 26 , 27 ). However, AST levels increase in response to liver injury.…”

“…The ALT to AST ratio is used to differentiate between various types of liver disease. GGT and ALP are indicators of cholestasis ( 26 , 27 ). Specifically, in this cross-sectional study, ALT, AST, ALT/AST ratio, GGT, and ALP were used to assess liver function impairment.…”