부산대학교 도서관

Chronic liver disease is a prevalent and growing cause of death in the UK. Liver disease is often related to lifestyle-associated risk factors, and it is typically characterised by progressive fibrosis, which is often asymptomatic until the advanced stages of cirrhosis. Half of cases are diagnosed on emergency admission for decompensation. Effective public screening is necessary, and it is possible with risk stratification and the right diagnostic modalities. Liver biopsy is excessively invasive and biochemical liver function tests (LFTs) often miss serious asymptomatic liver disease. However, vibration-controlled transient elastography (VCTE) is a non-invasive, low-cost and accurate technology for assessing liver fibrosis through liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). The hepatology team at Nottingham University Hospital developed a community pathway that allows GPs to identify at-risk patients and refer them for VCTE. This pathway is now an established nurse-led service.