To assess the liver appropriately in order to determine treatment and or prognosis, the gold standard has always been to obtain a tissue of the liver by what is medically termed, biopsy.
Liver biopsy is invasive, time consuming and potentially dangerous.
Even when the liver tissue is obtained, there is need of expert staff to process, produce the slides and read the results accurately in order to assist the liver specialist to determine the next line of action.
In many low income and middle income countries, liver specific pathologists are not at post and hence the overall management of liver diseases in these centres have suffered setbacks. The overall outcome has been higher than expected morbidities and mortality from liver diseases.
Non-invasive means of estimating liver stiffness have emerged, among which is fibroscan.
Fibroscan is expensive and requires a highly trained expert to interpret the results and guide treatment. Many centres in developing countries do not have access to fibroscan.
Clinician scientists have emerged with mathematical models, such as APRI and FIB-4 scores that have compared favorably well with liver fibrosis stages and which have been validated for use in clinical practice. APRI stands for AST to Platelet Ratio Index, while FIB-4 stands for Fibrosis -4 Index.
There remains a need for the liver stiffness assessment tools to be available offline in order to enable people living in areas that do not have stable internet services to provide quick results to the patients that require good care for their patients.
APRI or FIB-4 can be used independent of each other to estimate liver fibrosis.
A combination of the 2 models have been shown to provide better results than either alone.
Whilst these calculators are already available online, there remains a need for the liver stiffness assessment tools to be available offline in order to enable people living in areas that do not have stable internet services to provide quick results to the patients that require good care for their patients.
I am introducing LIVSA - Liver stiffness App in this write up; which you can download on the highlighted link.
Here, you can view how it can be used:
For those that do not have access to good date to view above, a gallery is also available; thus:
Here is how to use this app in practical decision-making:
Carry out Liver Function Test and Full blood Count
Input the values as indicated in the app
Get your results with accompanying explanations
If you are a patient, discuss your results with your doctor
If you are a healthcare professional, decide on which appropriate treatment to offer to patient. This may involve referring the patient to a liver specialist.
Click on the image icon below to install the app - available on your android device: