Gastroenterology team of the yearBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1639 (Published 01 April 2015) Cite this as: BMJ 2015;350:h1639
- Nigel Hawkes, freelance journalist, London, UK
Scarred liver project
In Nottingham, a team from the university and the hospital trust led by Guruprasad Aithal and Neil Guha has transformed the diagnosis of chronic liver disease by identifying those at risk from GP records and inviting them to clinics held in GP practices where they are scanned to assess any scarring of their liver. The technique identifies twice as many patients with cirrhosis, the vast majority of whom had no symptoms and had normal liver function tests, illustrating, says Guha, the inadequacy of these widely used enzyme tests in flagging up chronic liver injury. The scan also detects early asymptomatic liver disease at a stage when it is still reversible.
“We screened over 20 000 patients in four GP practices, targeting factors such as diabetes and alcohol rather than liver enzymes,” he says. “All these patients were offered appointments for a scan, which is done by a trained nurse. We use a FibroScan, an ultrasound scanner, to measure the stiffness of the liver—it’s well established in secondary care but not in primary care, …