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Background:

In conjunction with other laboratory findings and clinical assessments, an ELF Score can aid the diagnosis and assessment of the severity of liver fibrosis in patients with chronic liver disease. It has recently been recommended by NICE in the assessment and monitoring of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) (see NICE NG49: https://www.nice.org.uk/guidance/ng49).

As per the locally agreed primary care pathway, the ELF test should be considered for the assessment of liver fibrosis in adult patients with NAFLD.

An ELF Score ≥10.51 suggests advanced liver fibrosis and is an indication for referral to a specialist in hepatology. If the ELF Score is <10.51, then advanced liver fibrosis is unlikely.

Assuming no other indications for referral, patients should be managed in primary care, offered lifestyle advice and retested using ELF in 3 years (please note: repeat requests made within this time frame will be rejected by the laboratory).