News Release

Liver disease may be being missed in primary care

Peer-Reviewed Publication

BMJ

How are abnormal results for liver function tests dealt with in primary care? Audit of yield and impact

Treatable chronic liver disease may be being missed in primary care because abnormal test results for liver function are often not adequately investigated, according to a study in this week's BMJ.

Researchers from the Queen's Medical Centre in Nottingham followed up all adult patients who had an abnormal result for liver function based on a test requested by their doctor between January and June 1995. Of 873 patients followed up, 342 were not under hospital review. 157 of these patients were thought to require further investigation, yet no further tests had been requested for 91. 66 patients had been partially investigated by their doctor and, in seven patients, results suggesting a treatable chronic liver disease had not been followed up and no referral had been made to a gastroenterologist.

Our findings show that many important diagnoses - including communicable, potentially life threatening diseases - are missed, say the authors. Patients with persistently abnormal test results should be referred to a hepatologist or gastroenterologist, they conclude.

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Contact:

Stephen Ryder, Consultant Hepatologist, Division of Gastroenterology, Queen's Medical Centre, Nottingham, UK. Email: stephen.ryder@mail.qmcuh-tr.trent.nhs.uk


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