Considerations and clinical utility of referral pathways for early detection of liver disease in at-risk populations

Table 4 Recently presented non-invasive tests for liver disease detection

	Components	Target	Derivation population
SAFE	Age, BMI, diabetes, AST, ALT, globulin, platelets	≥ F2 fibrosis	MASLD patients
LRS	Age, sex, fasting glucose, cholesterol, AST, ALT, GGT and platelets	LSM (score correlates with expected LSM)	General population/primary care population
MAF-5	BMI, waist circumference, diabetes AST and platelets	≥ LSM 8 kPa	General population
FIB-9	AST, ALT, GGT, ALP, bilirubin, albumin, platelets, prothrombin index and urea	≥ F2 fibrosis	MASLD patients
LiverPRO	Age, AST, GGT, alkaline phosphatase, total cholesterol, sodium, INR, bilirubin, albumin, platelets	≥ F2 fibrosis	At-risk metALD population
acMASH	AST, creatine	MASH	MASLD patients
CORE	Age, sex, GGT, AST, ALT	Liver related events	General population
CLivD	Age, sex, alcohol use, waist-hip ratio, diabetes, smoking, with or without GGT values	Fatal and non-fatal advanced liver disease	General population

SAFE: Steatosis-associated fibrosis estimator; LRS: Liver risk score; MAF-5: Metabolic dysfunction-associated fibrosis 5; FIB-9: Fibrosis-9; acMASH: Aspartate aminotransferase creatinine metabolic dysfunction-associated steatohepatitis index; CORE: A new risk score measuring gamma-glutamyl transferase, aspartate aminotransferase, and alanine aminotransferase; ClivD: Chronic liver disease; BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Gamma-glutamyl transferase; ALP: Alkaline phosphatase; INR: International normalized ratio; LSM: Liver stiffness measurement; MASH: Metabolic dysfunction-associated steatohepatitis; MASLD: Metabolic dysfunction-associated steatotic liver disease; metALD: Metabolic and alcohol-associated liver disease.