Intelligent Liver Function Testing (iLFT) for the earlier diagnosis of chronic liver disease (CLD)
Evidence Overview
Background
- iLFT is an automated algorithm-driven diagnostic pathway designed to enhance the earlier diagnosis of liver disease in primary care settings and improve patient outcomes including reducing the need for specialist referrals.
- iLFT has been implemented across NHS Tayside since 2018.2 Evidence from NHS Tayside indicates that:
- Following the introduction of iLFT, CLD detection increased by 43%, compared with usual care, as all abnormal LFTs were investigated automatically.
- In the first year of iLFT implementation, 75% of people with potential CLD were recommended by the algorithm to be safely managed in primary care.
- Adding the Enhanced Liver Fibrosis (ELF) test to the iLFT pathway can support a 34% reduction in referrals to secondary care by enabling the stratification of people with indeterminate fibrosis score estimates, although the calculation for this statistic is unclear.
- GPs reported that they felt that using the iLFT pathway was easy, reduced their workload and would recommend it to colleagues.
- Within trial economic evaluation from NHS Tayside found that while iLFT increased the cost per diagnosis at the outset, iLFT dominated current standard of care in the long term by delivering savings generated from the earlier identification of liver disease.
- Preliminary budget impact analysis estimates that an additional £22,879 would be spent for every 1,000 iLFT tests requested by primary care.
- The impact of the iLFT pathway (with or without ELF) on equality outcomes, as well as longer-term outcomes, such as mortality and morbidity, is not currently clear.
IMTO
Health service organisation and delivery
20 May 2026
The Accelerated National Innovation Adoption (ANIA) collaborative
