Managing Abnormal Liver Test Results (ELF Test)

Which patients with fatty liver are at risk of advanced fibrosis? Which should be referred?

The risk stratification is based on a FIB4 score and then uses a new ELF test for selected patients.

An EMIS template has been developed to help with correct coding.

About FIB4

FIB4 is a score for calculating risk of advanced fibrosis, based on age, platelet count, ALT and AST levels.

Fib-4 calculator is here

Note: For UCLH, AST must be separately requested.

About the ELF test

This is a new blood test to allow risk stratification where FIB4 is equivocal, and only needs to be done in this situation.

Samples will be collected by GPs' usual hospital, but will then be taken to North Middlesex Hospital pathology lab, so they will need to be appropriately identified:

  • Stick ELF test request sticker (sticker template attached) to usual pathology form.
  • Do not request other tests on the same form
  • Fill out full GP surgery address and contact details – do not use local codes as these will be unknown to pathology at North Middlesex Hospital
  • Provide clinical details