Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis

Table 3 Comparison of recommendations about non-invasive evaluation of fibrosis and follow up strategies

	EASL	NICE	Asia-Pacific	AISF	AASLD
Non-invasive evaluation	NFS and FIB-4 upon diagnosis. If inconclusive, perform transient elastography	ELF blood test	Combination of serum tests and imaging tools (no specification about the preferred tests)	NFS + FIB-4 upon diagnosis. If inconclusive, perform transient elastography	NFS, FIB-4 and transient elastography (or MRE) upon diagnosis
Follow up	Negative markers > reassess every 2 yr; Fibrosis or abnormal liver enzymes > reassess every year; Cirrhosis-> surveillance every 6 mo	Negative ELF test, > reassess every 3 yr; Positive ELF test > liver biopsy	No information provided	Negative markers > reassess every 2 yr; Fibrosis or abnormal liver enzymes > reassess every year; Cirrhosis > surveillance every 6 mo	No information provided

EASL: European Association for the Study of the Liver; NICE: National Institute for Health and Care Excellence; AISF: Italian Association for the study of the Liver; AASLD: American Association for the Study of Liver Diseases; NFS: NAFLD fibrosis score; FIB-4: Fibrosis-4; ELF: Enhanced Liver Fibrosis; MRE: Magnetic resonance elastography.