Table 1.
UK key performance indicator (KPI) results.
| Management of people with, or at risk of, NAFLD before the gastroenterology or liver clinic | N | Overall (%) |
|---|---|---|
| 1. Services should have an agreed local clinical pathway for the investigation of suspected liver disease that includes an assessment for liver fibrosis using available non-invasive liver fibrosis tests | 34 | 85.3 |
| 2. Individuals referred to secondary care with suspected NAFLD should have their non-invasive fibrosis staging (e.g. FIB-4 score or NAFLD fibrosis score) documented in the referral letter. |
776 |
27.9 |
| Investigations and management in secondary care | ||
|---|---|---|
| 3. People with NAFLD should have their weight and BMI documented | 776 | 73.2 |
| 4. People with NAFLD should have an alcohol history documented and advice given, where appropriate | ||
| (a) Documented | 776 | 77.6 |
| (b) Advice given where appropriate | 474 | 39.2 |
| 5. People with NAFLD should have a smoking history documented and advice given, where appropriate | ||
| (a) Documented | 776 | 54.9 |
| (b) Advice given where appropriate | 256 | 13.7 |
| 6. People with NAFLD should undergo liver fibrosis staging using available non- invasive tests or liver biopsy | 776 | 79.1 |
| Transient elastography/Fibroscan requested/performed | 776 | 74.0 |
| ELF requested | 776 | 5.9 |
| Ultrasound Acoustic Radiation Force Impulse (ARFI) requested | 776 | 0.5 |
| NFS score calculated | 776 | 2.2 |
| FIB-4 score calculated | 776 | 17.7 |
| Liver biopsy | 776 | 6.4 |
| 7. Patients with NAFLD should be screened for type 2 diabetes | 776 | 33.0 |
| Diabetic patients advised on optimising diabetes control | 334 | 38.3 |
| 8. People with NAFLD should be screened for hypertension | 776 | 19.3 |
| Patients with hypertension advised on optimising BP control | 385 | 17.4 |
| 9. Patients with NAFLD should have weight loss advice documented including objective goals for weight change and physical activity. | ||
| (a) Assessment of physical activity | 776 | 38.1 |
| (b) Assessment of dietary habits | 776 | 37.6 |
| (c) Exercise advice given | 733 | 55.1 |
| (d) Weight loss target given | 728 | 32.1 |
| (e) Tailored dietary advice | 737 | 35.7 |
| 10. Patients who are at increased cardiovascular risk (T2DM and/or QRISK-3 >10%) should be offered statin treatment in accordance with NICE guidelines | 339 | 9.1 |
| 11. Patients should be provided with written information about NAFLD and weight management and/or signposted to credible information sources | 717 | 18.3 |
ELF, Enhanced Liver Fibrosis; FIB-4, Fibrosis 4; N, total number of recorded responses for each KPI; NAFLD, non-alcoholic fatty liver disease; NFS, NAFLD fibrosis score; NICE, National Institute for Health and Care Excellence, Overall, percentage of positive responses for each KPI; T2DM, type 2 diabetes mellitus.