What criteria should I use to determine if a patient with NAFLD requires referral to a specialist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Refer a patient with NAFLD to a hepatology specialist if they are at high risk of advanced liver fibrosis, have signs of advanced liver disease on examination, or if there is uncertainty about the diagnosis .

Specific criteria include: evidence of advanced liver fibrosis, diagnosed by an ELF score of 10.51 or above, or if transient elastography or acoustic radiation force impulse imaging indicates cirrhosis or advanced fibrosis .

Patients with suspected or confirmed cirrhosis should be referred to a specialist in hepatology .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.