The combined It also had the highest diagnostic performance in estimating Scheuer stage III and Nakanuma fibrosis score 2, both of which represent portal-bridging fibrosis. Pre-test risk refers to the likelihood of disease progression in the overall intended use popula Dec 14, 2014 · Conclusion Although ELF score ≥9. Importantly, ELF score performed well in the presence of steatosis and could thus be helpful in the assessment … The performance of the ELF Test for assessing risk of progression to cirrhosis and LREs has been well-established in scientific literature, and ease of testing and interpretation support routine clinical use to complement biopsy. What is the FDA indication for the ELF test? Question 2. Dec 19, 2012 · However, the ELF score was less discriminative in low and moderate fibrosis stages and appeared more strongly influenced by inflammatory liver injury. FIB-4 is less reliable in patients under the age of 35 or over the age of 65. This article reviews the evidence supporting ELF as a diagnostic test, a prognostic marker and its use in disease monitoring. The ELF score has been validated in diagnosis of advanced fibrosis and predicting complications in patients with established chronic liver disease (3, 4). Nov 8, 2025 · Find out what is the normal range for the ELF test and learn how to interpret your score. | Background Although ELF score ≥9. 0 had shorter survival and presented more frequently clinical complications than those with an ELF score of <10. The ELF test is a panel of three biomarkers: type III procollagen peptide (PIIINP), hyaluronic acid (HA), and tissue inhibitor of metalloproteinase-1 (TIMP1). 8 reliably identifies advanced fibrosis in patients with chronic liver disease, both age and inflammatory activity need to be considered when interpreting the result. 53: Interpretation and Clinical Significance An ELF score of 11. May 1, 2017 · The ELF test involves calculating a score from the concentrations of serum biomarkers: tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), aminoterminal propeptide of procollagen type III (P3NP), and hyaluronic acid (HA). . These values are summarized into a single score, which can be compared to different thresholds for diagnosis. This should be considered when making clinical interpretations on the basis of ELF score values. Dec 2, 2018 · The enhanced liver fibrosis (ELF) test is a blood test that measures three molecules involved in liver matrix metabolism to give a score reflecting the severity of liver fibrosis. The chronic liver disease (CLivD) risk score based on clinical data accurately predi The ELF Test is indicated as a prognostic marker in conjunction with other laboratory findings and clinical assessments in patients with advanced fibrosis (F3 or F4) due to non-alcoholic steatohepatitis (NASH) to assess the likelihood of progression to cirrhosis and liver-related clinical events. Oct 14, 2025 · ELF score may be influenced by inflammatory processes, not just fibrosis, so interpretation should consider other clinical parameters 6 Age is a notable influence factor for ELF scores, with higher values seen in elderly patients 2 The performance of the ELF Test for assessing risk of progression to cirrhosis and LREs has been well-established in scientific literature, and ease of testing and interpretation support routine clinical use to complement biopsy. In community pathways for detection of liver disease the most common reason for referral is fibrosis assessment. Feb 11, 2025 · The enhanced liver fibrosis (ELF) test has good discrimination performance in detecting advanced liver fibrosis. Nov 11, 2023 · Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, and liver fibrosis is the strongest predictor of morbimortality. This cross-sectional study included one hospital ELF score, Fibroscan ® LSM and liver T1 for the stable compensated cirrhosis control patients who completed all three annual follow-up scans: a individual subject percentage change from baseline Background: Serum fibrotic markers for systemic sclerosis (SSc) remain limited. 3 was 97% specific for cirrhosis. An ELF Score ≥10. 45 had a negative predictive value of 90% for advanced fibrosis (Ishak fibrosis score 4-6 which includes early bridging fibrosis to cirrhosis). Oct 28, 2022 · The ELF score is calculated using an equation combining the concentrations of three serum markers of hepatic extracellular matrix metabolism—hyaluronic acid, tissue inhibitor of Oct 14, 2025 · Enhanced Liver Fibrosis (ELF) Score of 11. Your healthcare provider will use your liver stiffness result and medical history to find out your fibrosis score. The ELF score combines 3 serum markers of extracellular matrix remodeling a Jun 28, 2021 · Background Alcohol is the main cause of chronic liver disease. Fibrosis scoring systems (FIB-4 and ELF) This page includes information about the ELF and Fib-4 fibrosis scoring systems. Using a lower cutoff value of 1. 3. Nov 7, 2025 · How to Interpret Your FIB-4 Score Once you’ve used your lab results or the Ulta Lab Tests fib 4 calculator to determine your fib 4 score, the next step is understanding what those numbers mean for your liver health. This can help them plan your care and treatment. The test generates a score ranging from 0 to 11. What analytes are used to calculate the ELF score? Question 3. Eighty-five percent of patients with mild or worse fibrosis had an ELF score ≥7. Pre-test risk refers to the likelihood of disease progression in the overall intended use population without considering the ELF score. The ELF™ score helps clinicians and researchers assess fibrosis severity and risk in metabolic and TPA cut-off level ≥5% was derived empirically, considering the TPA values corresponding to the Ishak stage F≥2 (Table 2), in order to facilitate comparison between two reference methods in terms of their effect on the diagnostic accuracy of ELF score. 8 was 76%. Nov 17, 2022 · Ein Artikel aus dem Bereich hämatologie von GPnotebook: Erhöhter Leberfibrose-Score (ELF). The utility of the ELF score has been demonstrated primarily in Western countries, but whether it is useful in areas with a high number of elderly people suffering from chronic liver disease has yet to be determined. Siemens Healthcare Diagnostics Inc; 2022. Why do you need an ELF blood test? The reference range of the ELF score overlap with the area defined as moderate fibrosis by the manufacturer. Blood samples for the ELF score are often acquired in primary care and may be stored before analysis. Patients with an ELF score of ≥10. Consider using a non-invasive scoring system, such as the: NAFLD Fibrosis Score (NFS) — an intermediate or high score (greater than minus 1. Oct 14, 2025 · ELF score may be influenced by inflammatory processes, not just fibrosis, so interpretation should consider other clinical parameters 6 Age is a notable influence factor for ELF scores, with higher values seen in elderly patients 2 Interpretive information The ELF score indicates the risk of disease progression to cirrhosis or liver-related events based on established thresholds (Table). Nov 8, 2025 · Wondering how do you calculate your ELF score? This guide explains the lab-based process for the Enhanced Liver Fibrosis test, detailing what it measures and how doctors interpret the results to assess liver health and prognosis. Enhanced Liver Fibrosis (ELF™) Test M E TA B O L I C DYS F U N CT I O N - A SS O C I AT E D ST E ATO H E PAT I T I S ( M A S H ) Oct 26, 2023 · For a patient in a high-risk group with an indeterminate or high score, the enhanced liver fibrosis (ELF TM) Score is recommended. Age and gender significantly influence ELF score results, necessitating specific reference intervals for accurate interpretation. 51, then advanced liver fibrosis is unlikely. A FIB-4 score of Aug 1, 2023 · Second, we compared ELF to FIB-4 and NFS, evaluated the diagnostic accuracy of ELF for biopsy-verified advanced fibrosis, and evaluated referral strategies to detect patients with TE ≥8 kPa. ELF scores show a near-linear relationship with Ishak fibrosis stages. 67 (Indeterminate) ELF <9. Apr 14, 2016 · The ELF score provides a valuable enhancement over biopsy staging, in that, it is a continuous rather than categorical variable and is thus more sensitive to disease status and change. ssion is similar to the pre-test risk. The manufacturers also propose that the ELF test is used as part of a two-step diagnostic pathway in primary care. The NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score estimates amount of scarring in the liver based on several laboratory tests. 45, a FIB-4 score <1. The enhanced liver fibrosis (ELF) test is a blood test that gives a score to reflect the severity of liver fibrosis. Er ist zur Beurteilung der Leber- fibrose und des Fibrosegrades bei NAFLD, Alkoholischer Lebererkrankung, Hepatitis C und in gemischten Kohor-ten geeignet. 8. Enhanced Liver Fibrosis (ELF) Score - The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced fibrosis due to NASH. Liver Scores and Biomarkers Blood-based scores improve fibrosis assessment, especially when combined with elastography: APRI (AST to Platelet Ratio Index) FIB-4 (Age, AST, ALT, platelets) ELF (Enhanced Liver Fibrosis Score: TIMP-1, PIIINP, HA) FibroTest (α2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT) Liver Fat (CAP) Score Fat accumulation (steatosis) is assessed non Feb 10, 2025 · Components and Calculation of ELF Score The ELF test comprises a logarithmic algorithm combining three serum markers of hepatic extracellular matrix metabolism 3. Enhanced Liver Fibrosis (ELF) blood test: A simple guide for patients An ELF blood test helps your doctor understand the health of your liver by checking for signs of scarring and damage. 4 Results should be interpreted in conjunction with the patient’s medical history, clinical presentation, and other findings. The ELF score effectively distinguishes fibrosis stages in chronic liver disease, with proposed cut-off values of 7. 7 during secondary risk assessment suggests the need for Mar 1, 2019 · The corresponding thresholds were 7. 8 reliably identifies patients at increased risk of advanced fibrosis and progression to cirrhosis and liver-related clinical events, while an ELF test ≥ 11. FIB-4 1. Aug 1, 2018 · The Enhanced Liver Fibrosis score has been recognized as a non-invasive test for liver fibrosis. Apr 15, 2024 · This study examined the evolution of Enhanced Liver Fibrosis (ELF) score, which is a non-invasive test to assess liver fibrosis, during alcohol withdrawal in patients with a history of excessive alco Aug 1, 2018 · The Enhanced Liver Fibrosis score has been recognized as a non-invasive test for liver fibrosis. We investigated the impact of adding the Enhanced Liver Fibrosis (ELF) score as a second-line test (subsequent to an indeterminate or Check your ELF Score Liver Calculator results to assess liver fibrosis, track liver health, and understand your risk with accurate scoring. The use of the ELF score has suitable analytical and acceptable biological perform … Enhanced Liver Fibrosis (ELF) Score - The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced fibrosis due to NASH. 5 Low risk for advanced liver fibrosis. The ELF score is derived from an algorithm that combines measurements of PIIINP, TIMP-1, and HA. A liver with fibrosis can still do all its usual jobs. 67 suggests advanced liver fibrosis. 3; a higher score typically signifies a greater degree of liver fibrosis. High biological variation of HA was diminished by the natural logarithm in the calculation of the ELF score. Mar 7, 2021 · The enhanced liver fibrosis (ELF) test combines measurement of three serum biomarkers involved in matrix biology comprising hyaluronic acid (HA), Procollagen III amino terminal peptide (PIIINP) and tissue inhibitor of metalloproteinase 1 (TIMP-1). We would like to show you a description here but the site won’t allow us. (A) effect of age on the ELF score and (B) the effect of age on FIB-4. Nov 8, 2025 · Learn about the Enhanced Liver Fibrosis (ELF) score, including what is the normal range for the ELF score. 8 or greater have been associated with significant, biopsy-proven fibrosis or cirrhosis. 51 suggests advanced liver fibrosis and is an indication for referral to a specialist in hepatology. May 28, 2024 · An ELF score of ≥ 9. In the proposed pathway, the first-line test is another non-invasive test, the Fibrosis-4 index (FIB-4). The test has the potential to identify people at high risk of advanced liver fibrosis earlier than the current standard of care. ELF Score for NAFLD in adults – Primary Care Guideline Adult patient with NAFLD Typically: • Asymptomatic patient with persistent (>3 months) non-progressive abnormal LFTs and risk factors for fatty liver, where other causes have been ruled-out AND/OR We would like to show you a description here but the site won’t allow us. Methods Observational cohort study The ELF test is a non-invasive blood test which combines three direct serum biomarkers of liver fibrosis. Methods: This is a prospective study that The ELF test is a panel of three biomarkers: type III procollagen peptide (PIIINP), hyaluronic acid (HA), and tissue inhibitor of metalloproteinase-1 (TIMP1). Jan 23, 2023 · Clinical Significance: The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced (F3 or F4) fibrosis due to NASH. Interpretation of ELF Test Results According to AASLD guidance, based on expert opinion, an ELF score ≥7. Your results can range from normal to advanced. The three direct markers of the ELF test are complementary and, when combined into an ELF score, provide information that is prognostic for progression to cirrhosis and liver-related events. The bottom and top of each box represent the 25th and 75th percentiles, giving the interquartile range. Survival analysis showed that the ELF score predicts liver outcomes, with people having the highest ELF scores being significantly more likely to have clinical outcomes than those in lower-score groups. The ELF Score can help identify patients with advanced fibrosis (F3 or F4) at risk of progressing to cirrhosis and liver-related events (LREs). We aimed to assess the performance of a sequential algorithm encompassing the Fibrosis 4 (FIB-4) and Enhanced Liver Fibrosis (ELF) scores for identifying patients at risk of advanced fibrosis. Jul 18, 2025 · The Enhanced Liver Fibrosis (ELF) score is a validated serum biomarker panel that measures three matrix turnover proteins to accurately assess liver fibrosis Jun 21, 2024 · Background and aims: The enhanced liver fibrosis (ELF) score is a blood test that combines three markers linked to liver fibrosis. 5 ELF test A 10 mL blood sample was collected and the serum was stored at −80 °C. The sensitivity for cirrhosis of ELF ≥9. from publication: The Enhanced Liver Fibrosis (ELF) Score: Normal Values, Influence Factors and Proposed Cut-Off Values. 67, advanced fibrosis is likely, though it is reasonable to still further assess with subsequent non-invasive testing for confirmation. Fibrosis means scarring of the liver. Der ELF-Score zeigt eine hohe Korrelation mit den Serum- spiegeln der Aminotransferasen und der Entzündungs-aktivität in der Leber. 7, 9. We assessed the diagnostic and prognostic performance of ELF in alcohol-related liver disease. How do I interpret ELF score results? Question 4. The ELF test is useful in primary, secondary and tertiary care; not only allowing earlier diagnosis rate prognosis, but also providing the opportunity to personalize treatment based on the patient The Enhanced Liver Fibrosis (ELF) score is an ECM marker set consisting of tissue inhibitor of metalloproteinases 1 (TIMP-1), amino-terminal propeptide of type III procollagen (PIIINP) and hyaluronic acid (HA) showing good correlations with fibrosis stages in chronic liver disease. The Enhanced Liver Fibrosis (ELF) test, a panel of three direct serum biomarkers of fibrosis, was integrated into the intelligent liver function testing (iLFT) pathway, an automated system which aids in the Primary Care diagnosis and staging of liver disease, in July The ELF score is not for use in the diagnosis of NASH, the staging of fibrosis, the serial monitoring of disease progression, or the monitoring of effects of therapeutic products. If the ELF Score is <10. 7. Clinical Indications Enhanced Liver Fibrosis (ELF) Score - The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced fibrosis due to NASH. In contrast, a FIB-4 >3. The performance of the ELF Test for assessing risk of progression to cirrhosis and LREs has been well-established in scientific literature, and ease of testing and interpretation support routine clinical use to complement biopsy. The Enhanced Liver Fibrosis (ELF™) test is a noninvasive blood (serum) lab test, which combines three direct ECM biomarkers: hyaluronic acid (HA), procollagen III aminoterminal peptide (PIIINP), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), into a validated composite score. 0. Nov 11, 2025 · The ELF score is calculated using an automated logarithmic algorithm that combines three serum markers of extracellular matrix metabolism: hyaluronic acid (H Nov 17, 2022 · ELF score defines a three-marker fibrosis test (TIMP-1, PIIINP, HA) for assessing advanced fibrosis in NAFLD, guiding referrals and monitoring intervals. 53 strongly indicates cirrhosis (F4 stage fibrosis) and requires immediate referral to a hepatologist for specialized care. 51 to 9. Use the interactive slide rule to see how the ELF score can indicate the state of liver fibrosis. The Fibrosis-4 (FIB-4) Index for Liver Fibrosis is a non-invasive scoring system based on several laboratory tests that help to estimate the amount of scarring in the liver. It is a stage of long-term liver disease. But if the damage continues it can cause cirrhosis. The Enhanced Liver Fibrosis (ELF) score, originally derived and validated in patients with chronic liver disease, is an algorithm combining 3 serum markers, known as procollagen type III amino terminal propeptide (PIIINP), tissue inhibitor of metalloproteinases 1 (TIMP-1), and hyaluronic acid (HA). However, reference intervals, biological variation an… The ELF Score can be used as a prognostic marker for patients who need urgent specialized intervention. ELF ≥9. Introduction With increasing demands on liver services it is essential to prioritise patients at high risk of adverse outcomes. To use ReachDeck to listen to or translate this site you must allow ReachDeck cookies For more information please visit our cookies page As per the locally agreed primary care pathway, the ELF test should be considered for the assessment of liver fibrosis in adult patients with NAFLD. 1 The ELF test was shown to have considerable diagnostic value for the evaluation of liver fibrosis stage; the pooled sensitivity and specificity values for prediction of significant liver fibrosis There were 61 liver-related outcomes (39 deaths). Patients with elevated ELF scores should be considered at risk and managed appropriately, including further assessment for fibrosis using imaging or liver biopsy. 3 or greater should undergo secondary risk assessment. According to AASLD guidance, based on expert opinion, an ELF score ≥7. 25 would have a 97% specificity and a positive predictive value of 65% for advanced fibrosis. ELF ≥11. The exact formula for calculating the ELF score is not provided in the studies, but it is mentioned that the score increases with increasing liver fibrosis stage 2. 3 - 2. Elevated ELF scores of 9. Discover how this non-invasive blood test assesses liver health and risk. 3 indicates Nov 1, 2023 · Interpreting the Results of the ELF Test Interpreting ELF Test results is relatively straightforward. Find out more about fibrosis. 455), suggests advanced liver fibrosis. 10 In this study, we demonstrated the high diagnostic accuracy of the ELF score for all fibrosis stages, thereby strengthening the utility of the ELF score in the Japanese population. In this prospective study, we evaluated the use of the ELF score as a predictor of HCC in a population-based cohort of Chinese in Singapore. Patients' fibrosis stage was defined histologically. 8 Measurements of these analytes are combined in an algorithm to generate a unitless score that Dec 17, 2023 · Patient with FIB-4 of 1. Package insert. 5 High risk for advanced liver fibrosis. 10 Table. Fibrosis (FIB)-4 Score (FIB-4) — a score of greater than 2. In patients with a FIB-4 score of greater than 2. 8, and 11. Mar 21, 2013 · The ELF score was calculated using the published algorithm combining TIMP-1, PIIINP and HA values. The ELF Score is the first routine, standardized, direct biomarker blood test for prognostic risk assessment in advanced NASH. The ELF Score is recommended by AACE guidelines,6 as its measurements have proven valuable for identifying patients with advanced fibrosis (F3 or F4) at risk of progressing to cirrhosis and liver-related events. 7 during secondary risk assessment suggests the need for specialized care. The ELF test is useful in primary, secondary and tertiary care; not only allowing earlier diagnosis rate prognosis, but also providing the opportunity to personalize treatment based on the patient Download Table | Calculation of ELF score reference values. Is the ELF test included in any guidelines? References Enhanced Liver Fibrosis (ELF™). Higher ELF scores indicate a greater risk of liver fibrosis progression. The Enhanced Liver Fibrosis (ELF™) blood test is a simple, accurate, non-invasive test that provides a simple, unitless numeric score that is generated via an algorithm for use in advanced liver fibrosis. The Enhanced Liver Fibrosis (ELF) test is a serological biomarker for fibrosis staging in chronic liver disease, however its utility in alcohol-related liver disease warrants further validation. Aug 1, 2020 · The enhanced liver fibrosis (ELF) test has been proposed for the non-invasive assessment of advanced fibrosis in patients with non-alcoholic fatty liv… Dec 2, 2018 · The enhanced liver fibrosis (ELF) test is a blood test that measures three molecules involved in liver matrix metabolism to give a score reflecting the severity of liver fibrosis. ELF score thresholds have been identified in populations of patients with known Chronic Liver Disease to identify these commonly used categories of fibrosis. the important role ELF plays in the early recognition of liver fibrosis facilitating timely referral to a liver specialist. Nov 17, 2022 · ELF score defines a three-marker fibrosis test (TIMP-1, PIIINP, HA) for assessing advanced fibrosis in NAFLD, guiding referrals and monitoring intervals. 2. Treat metabolic risk factors and if there is ongoing risk suggest repeating test in 3 years. Recommend referral to Metabolic Hepatology Clinic. However, reference intervals, biological variation an… The manufacturers of ELF (Siemens Healthineers), recommend revising the ELF score cut-off for diagnosis of advanced liver fibrosis downwards from 10. The ELF Score is the first noninvasive biomarker blood test for prognostic risk assessment in advanced MASH. Oct 5, 2021 · Objectives: The noninvasive Enhanced Liver Fibrosis (ELF) score is used in adults with liver fibrosis as a diagnostic aid. Sep 22, 2023 · Question 1. Importantly, ELF score performed well in the presence of steatosis and could thus be helpful in the assessment of fatty liver disease. Interpretation of Results Interpret the ELF score using the following guidelines: * In the Mid group, the risk of disease progression is similar to the pre-test risk.

lh6aca
4tugxxr
v0prulgi
xd5tub7
c8w1ko79nbx
6rtbrbn
tlzvfi
uetiorl
9uy3dvfzo
uahmaysy