Screening for nonalcoholic fatty liver disease-when, who and how?

Figure 2 Linking primary care to hepatology. Unselected patients from the general population are most likely in contact with primary care. In primary care, patients at risk for the presence of nonalcoholic fatty liver disease and according to computer-based scores at risk for advanced fibrosis should be transferred into secondary testing facilities at a specialist setting. Critical for the overall efficacy of a screening algorithm are the likelihood of referral of “intermediate or high risk” individuals to secondary care, the proportion of subjects with “indeterminate” test results (“gray zone” of score-based tests) and the availability of advanced testing platforms for referral. NPV: Negative predictive value; PPV: Positive predictive value.