The Enhanced liver fibrosis score is associated with clinical outcomes and disease progression in patients with chronic liver disease

Background and Aims Current tools for risk stratification of chronic liver disease subjects are limited. We aimed to determine whether the serum‐based ELF (Enhanced Liver Fibrosis) test predicted liver‐related clinical outcomes, or progression to advanced liver disease, and to compare the performance of ELF to liver biopsy and non‐invasive algorithms. Methods Three hundred patients with ELF scores assayed at the time of liver biopsy were followed up (median 6.1 years) for liver‐related clinical outcomes (n = 16) and clear evidence of progression to advanced fibrosis (n = 18), by review of medical records and clinical data. Results Fourteen of 73 (19.2%) patients with ELF score indicative of advanced fibrosis (≥9.8, the manufacturer's cut‐off) had a liver‐related clinical outcome, compared to only two of 227 (