MD Scope - January 25, 2024: FIB-4 New test in Alberta to risk stratify patients

FIB-4: New test in Alberta to risk stratify patients of developing liver fibrosis

Clinical laboratories across Alberta will introduce a new test called Fibrosis-4 (FIB-4) on February 1, 2024. FIB-4 is a calculated scored based on age and a combination of lab tests (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and platelet count). It is a well-validated score to risk stratify patients with non-alcoholic fatty liver disease (NAFLD) in high, intermediate and low risk of developing cirrhosis over the next 10 years. FIB-4 is a key step in NAFLD Primary Care Pathway, Hepatitis C Virus Primary Care Pathway and Alcohol Use Disorder Pathway.

Prior to FIB-4 introduction, physicians had to separately order AST, ALT, and platelet count and manually calculate FIB-4 score. With this new availability in Alberta, it will be simpler to order the test and receive results in the patient’s health record without the need to order multiple tests and perform a manual calculation.

This new FIB-4 test (LAB5191) is not only available in Connect Care, it can also be found in the most updated Alberta Precision Laboratory (APL) General Laboratory Requisition. It is recommended to use the most updated requisition, as older versions will not list FIB-4. Alternatively, FIB-4 can be written in the Additional Tests section of older requisitions.

There are interpretive comments attached along with FIB-4 results to assist with interpretation. They highlight that a FIB-4 score <1.30 indicates low risk, FIB-4 between 1.30 and 2.67 indicates at risk, and FIB-4 >2.67 indicates high risk for significant liver fibrosis. Interpretation should also follow the related primary care pathways.

Refer to the APL Laboratory Bulletin website for more information.

The opinions expressed in AMA publications are those of the authors and do not necessarily reflect the opinions or positions of the Alberta Medical Association, its Board of Directors or members.

The Alberta Medical Association does not assume responsibility or liability for damages arising from any error or omission or from the use of any information or advice contained in these materials. Advertisements included in our publications are not necessarily endorsed by the Alberta Medical Association.

The Association reserves the right to edit any submissions that are accepted to appear in any of our publications or platforms. Please consult our editorial guidelines for tips on submissions or advertising.

Our mailing address is:
12230 106 Ave NW
Edmonton, AB T5N 3Z1

Canada