Guidelines on the management of abnormal liver blood tests

Philip N. G. Newsome; Rob Cramb; Suzanne M. Davison; John F. Dillon; Mark Foulerton; Edmund M. Godfrey; Richard Hall; Ulrike Harrower; Mark Hudson; Andrew Langford; Anne Mackie; Robert Mitchell-Thain; Karen Sennett; Nicholas C. Sheron; Julia Verne; Martine Walmsley; Andrew Yeoman

doi:10.1136/gutjnl-2017-314924

Guidelines on the management of abnormal liver blood tests

Philip N. G. Newsome (Lead / Corresponding author), Rob Cramb, Suzanne M. Davison, John F. Dillon, Mark Foulerton, Edmund M. Godfrey, Richard Hall, Ulrike Harrower, Mark Hudson, Andrew Langford, Anne Mackie, Robert Mitchell-Thain, Karen Sennett, Nicholas C. Sheron, Julia Verne, Martine Walmsley, Andrew Yeoman

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Abstract

These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.

Original language	English
Pages (from-to)	6-19
Number of pages	14
Journal	Gut
Volume	67
Issue number	1
Early online date	9 Nov 2017
DOIs	https://doi.org/10.1136/gutjnl-2017-314924
Publication status	Published - Jan 2018

Keywords

alcoholic liver disease
fibrosis
liver
nonalcoholic steatohepatitis
Humans
Risk Factors
Non-alcoholic Fatty Liver Disease/diagnosis
Liver Function Tests/methods
Chemical and Drug Induced Liver Injury/diagnosis
Liver Diseases/diagnosis
Algorithms
Biomarkers/blood
Disease Management
Evidence-Based Medicine/methods

ASJC Scopus subject areas

Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/gutjnl-2017-314924Licence: CC BY

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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Final published version, 2.31 MBLicence: CC BY

Cite this

@article{6c49e2761824465cb76ec081cc141041,

title = "Guidelines on the management of abnormal liver blood tests",

abstract = "These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.",

keywords = "alcoholic liver disease, fibrosis, liver, nonalcoholic steatohepatitis, Humans, Risk Factors, Non-alcoholic Fatty Liver Disease/diagnosis, Liver Function Tests/methods, Chemical and Drug Induced Liver Injury/diagnosis, Liver Diseases/diagnosis, Algorithms, Biomarkers/blood, Disease Management, Evidence-Based Medicine/methods",

author = "Newsome, {Philip N. G.} and Rob Cramb and Davison, {Suzanne M.} and Dillon, {John F.} and Mark Foulerton and Godfrey, {Edmund M.} and Richard Hall and Ulrike Harrower and Mark Hudson and Andrew Langford and Anne Mackie and Robert Mitchell-Thain and Karen Sennett and Sheron, {Nicholas C.} and Julia Verne and Martine Walmsley and Andrew Yeoman",

note = "This work was funded by support from the British Society of Gastroenterology. PNN is supported by the National Institute of Health Research (NIHR) Birmingham Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health",

year = "2018",

month = jan,

doi = "10.1136/gutjnl-2017-314924",

language = "English",

volume = "67",

pages = "6--19",

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AU - Dillon, John F.

AU - Foulerton, Mark

AU - Godfrey, Edmund M.

AU - Hall, Richard

AU - Harrower, Ulrike

AU - Hudson, Mark

AU - Langford, Andrew

AU - Mackie, Anne

AU - Mitchell-Thain, Robert

AU - Sennett, Karen

AU - Sheron, Nicholas C.

AU - Verne, Julia

AU - Walmsley, Martine

AU - Yeoman, Andrew

N1 - This work was funded by support from the British Society of Gastroenterology. PNN is supported by the National Institute of Health Research (NIHR) Birmingham Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health

PY - 2018/1

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N2 - These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.

AB - These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.

KW - alcoholic liver disease

KW - fibrosis

KW - liver

KW - nonalcoholic steatohepatitis

KW - Humans

KW - Risk Factors

KW - Non-alcoholic Fatty Liver Disease/diagnosis

KW - Liver Function Tests/methods

KW - Chemical and Drug Induced Liver Injury/diagnosis

KW - Liver Diseases/diagnosis

KW - Algorithms

KW - Biomarkers/blood

KW - Disease Management

KW - Evidence-Based Medicine/methods

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DO - 10.1136/gutjnl-2017-314924

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SN - 0017-5749

VL - 67

SP - 6

EP - 19

JO - Gut

JF - Gut

IS - 1

ER -

Guidelines on the management of abnormal liver blood tests

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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