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CPE-005 · Fibrosis risk
LV-FIB-03: FIB-4 and elastography disagree
FIB-4 and elastography disagree. Evaluates FIB-4 low and liver stiffness 12 kPa or above, OR FIB-4 high and liver stiffness below 8 kPa.
Condition
- FIB-4 low and liver stiffness 12 kPa or above, OR FIB-4 high and liver stiffness below 8 kPa
What it reports
- Discordant non-invasive tests: the result is not reassuring
Recommended next steps (for physician review)
- Consider repeating or adding another test (ELF, or elastography at a specialist center)
Diagnostic boundary
- Does not choose which test is right.
Evidence
- EV-AASLD-2023Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.Supports: FIB-4 first for risk stratification; thresholds <1.3 and >2.67; elastography 8 and 12 kPa; ELF 7.7 and 9.8 ALT upper limits near 29–33 U/L (men) and 19–25 U/L (women) Cardiovascular risk is the leading cause of death in MASLD
- EV-EASL-NIT-2021European Association for the Study of the Liver. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis, 2021 update. J Hepatol. 2021;75(3):659-689.Supports: Use of elastography and serum tests in sequence, and handling of discordant results
Cases where this rule fires
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