1. Liver Function Testing (LFT) in Primary Care:
Retrospective Case Note Review of 100 Patients
with Abnormal LFTs in 2 Tayside General Practices
University of Dundee
Medical Research Institute
Dr Chris Weatherburn, Academic Clinical Fellow
Prof Bruce Guthrie, Professor of Primary Care Medicine, University of Dundee

2. University of Dundee
Medical Research Institute
Objectives
In order to inform design of new laboratory reporting and care pathway, to examine:
• Indications for LFT testing in primary care in Tayside
• Prevalence and management of abnormal results
• Feasibility of implementing validated algorithms for calculating risk of death within 1 year
and chance of a liver disease diagnosis in the next 24 months(1) (2)
Abdominal Pain, Tired all the time, Unwell 28
Abnormal LFTs being repeated, Alcohol abuse 6
Diabetes review, Health check, Other monitoring 60
Secondary care request, no reason documented 6
Reason LFT Taken
References
1. McLernon DJ, Dillon JF, Sullivan FM, Roderick P, Rosenberg WM, Ryder SD, Donnan PT. The Utility of Liver FunctionTests for Mortality Prediction within One Year in Primary Care Using the Algorithm for Liver Function Investigations (ALFI). PLoS One:2012;7(12):e50965.
2. McLernon DJ, Donnan PT, Sullivan FM, Roderick P, Rosenberg WM, Ryder SD, Dillon JF. Prediction of liver disease in patients whose liver function tests have been checked in primary care: model development and validation using population-based observational cohorts. BMJ Open 2014;4:e004837.

3. University of Dundee
Medical Research Institute
Results
Conclusion
• 7 patients had Hepatitis B and C tested 7
patients had Immunology checked
• 13 patients appeared to have new LFT
abnormalities
• Majority of LFTs checked are for planned
monitoring
• Feasible to implement risk prediction tools
based on information in GP record but utility
unclear
• 17 documented suspected diagnosis
accounting for LFT abnormalities:
• 6 Alcohol induced fatty liver
• 4 Gilbert’s syndrome
• 3 Fatty liver (non alcohol related)
• 2 Drug Reactions *
• 1 Gallstones
• 1 Malignancy *
0
1
2
3
4
5
16 17 19 23 25 28 33 35 44 49 50 51 52 54 55 56 57 58 59 61 62 63 64 65 66 67 68 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 94 102
%
Predicted % Chance of Liver Diagnosis within 2 Years based on LFTs Values against Age