This morning, Peter Glynn led us on a discussion on high-value care for abnormal LFTs. One study looked at the cost-effectiveness of focused testing (testing that is deliberate, patient-centered) compared with extensive, non-directed testing (testing for all etiologies at once). Some take-aways:
- When accounting for pre-test probabilities and clinical evaluation, focused testing was more cost-effective, with fewer false positive results
- Consider hemochromatosis as part of an initial focused testing approach in somebody who is asymptomatic or with nonspecific symptoms (nausea, fatigue, constipation), especially if they do not have a clear alternative explanation for an otherwise unexplained elevation in AST/ALT
https://www.journal-of-hepatology.eu/article/S0168-8278(16)30544-X/fulltext
