Maximising Diagnoses of Advanced Fibrosis in Primary Care with Non-Invasive Markers of Liver Fibrosis and Minimising Unnecesary Referals to Secondary Care

Abstract

S73 for positives, 2) serial testing with the Enhanced Liver Fibrosis (ELF) test and liver stiffness measurement (LSM) for ELF positives, 3) serial testing with the Forns index followed by ELF for index positives and referral to LSM for ELF positives, or 4) liver biopsy. RESULTS: At a prevalence of advanced fibrosis of 6% among Danish excessive drinkers the correct-diagnoses-to-unnecessary-referrals ratio per 1000 tested was 0.24 for strategy 1, 10.1 for strategy 2, 65.8 for strategy 3, and 0.063 for strategy 4. CONCLUSIONS: With an objective of maximising the correct number of advanced fibrosis diagnoses, and minimising unnecessary referrals to the secondary care sector, triaging patients first with the non-commercial Forns index, followed by ELF and LSM in serial for positive patients was optimal.