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

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 ¹.

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 ¹.

Patients with suspected or confirmed cirrhosis should be referred to a specialist in hepatology ¹.