A new easy-to-use risk model was developed for predicting severe liver disease

Liver cirrhosis and other serious liver diseases are an increasing health risk in Finland and globally. Chronic liver diseases, in particular liver cirrhosis and liver cancer, are increasing globally. The most common liver disease is metabolic fatty liver disease, but most liver deaths are caused by alcohol-related liver disease.

“The problem is that liver diseases often develop unnoticed until they are already advanced,” says specialist in gastroenterology and Associate Professor Fredrik Åberg, who is chief physician at HUS Abdominal Center.

Current screening methods are not sufficiently effective to predict future severe liver damage at population level.

Scoring model based on basic laboratory tests

Fredrik Åberg participated in a study that sought new ways of predicting liver cirrosis and other serious liver diseases. The study was led by the Swedish Karolinska University Hospital and the Karolinska Institutet, and researchers from THL and the Minerva Foundation Institute for Medical Research also participated in it.

“In the study, we wanted to find out whether a risk score model can be built from the normal liver values taken in primary health care for predicting future serious liver diseases,” says Åberg.

The Cirrhosis Outcome Risk Estimator (CORE) model developed by Swedish and Finnish researchers predicts an individual’s risk of developing severe liver disease over the following ten years by utilising the patient’s age, sex and three common laboratory tests: ALT, AST and gamma-GT values.

Widely tested CORE risk score proved to be an effective predictor of liver diseases

In the study, the model was tested with almost one million people in Sweden, Finland and the United Kingdom. The results showed that the CORE risk score predicts a severe liver disease clearly better than the FIB-4 risk score currently used to estimate the existence of significant liver fibrosis and cirrhosis. CORE has been developed in the population where it is intended to be used and it predicts clinically significant endpoints. CORE is also freely available and gives a concrete risk percentage, not only a rough classification for a low and high risk.

The study showed that the CORE risk score can significantly improve the risk estimation of liver diseases at population level and in primary health care. The model has been validated in Western European populations, but its suitability in other countries and, for instance, in patients with type 2 diabetes requires further studies.

“The CORE model could be introduced in primary health care without costly further studies,” says Åberg.

Link to research article: Use of new CORE risk score to predict 10 year risk of liver cirrhosis in general population: population-based cohort study

Link to CORE model

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