ArticleHepatology communications2026
A liver function test pathway significantly increases the early detection of chronic liver disease and cirrhosis.
Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Comparative analysis of Methamphetamine and Alcohol-Induced Liver Damage using Ultrasound Shear Wave Elastography.Pakistan journal of medical sciences · 2026Article
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6 authors.
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Abstract
backgroundTo enhance early liver disease detection, a clinical pathway integrating reflex AST testing and automated AAR reporting was implemented. We aim to evaluate the long-term effectiveness of introducing reflex AST testing by assessing its impact after implementation in 2 regions of Wales.
methodsWe applied a quasi-experimental, Difference-in-Difference approach to evaluate the introduction of the reflex AST:ALT pathway in Wales (January 2010 to December 2023). Outcomes were the monthly incidence rate of (1) chronic liver disease (including cirrhosis) and (2) cirrhosis in the 2 intervention regions versus the control regions.
resultsIn total, 78,917 individuals with liver disease were included in the study. A significant increase in cirrhosis diagnoses was observed in both regions (first region: incidence rate ratio=1.24, 95% CI: 1.15-1.34, p<0.001; second region: incidence rate ratio=1.16, 95% CI: 1.02-1.33, p=0.028). The incidence of composite chronic liver disease (including cirrhosis) increased transiently in the second region only (incidence rate ratio=1.35, 95% CI: 1.16-1.56, p<0.001).
conclusionsIn this long-term, population-level evaluation, reflex AST:ALT testing increased cirrhosis detection in both regions and produced a short-term rise in chronic liver disease (including cirrhosis) diagnoses one region, strengthening the evidence of the pathway's effect on cirrhosis detection. Further study is warranted to understand regional variation.
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