NASH diagnosis is typically based on assessment by a pathologist using scoring systems such as the Steatosis, Activity, and Fibrosis (SAF) score. The SAF score measures the presence and extent of each individual component of steatosis (fattiness), activity (inflammation and ballooning), and fibrosis (scarring).[1] LiverFASt is a blood-based diagnostic test that evaluates the same categories used in classic SAF scoring by using an algorithm to look at 10 different biomarkers. This algorithm is key to LIVERFASt and has been trained and tested on thousands of patient cases around the world.[2] Once a lab draws blood and assess the 10 biomarkers, the results can be inputted into the LIVERFASt online portal, which uses the algorithm to calculate scores. The use of the algorithm helps improve consistency in results, which has proven to be a challenge for human pathologists.[3] Once the algorithm has analyzed the biomarker results, patients will be given a score for each category of analysis, seen in the following graphic.

These data, in combination with demographic information (age, gender), are used to classify patients into different levels of NAFLD or NASH.

  • NAFLD, only: fibrosis stage is 0, activity stage is <2, steatosis stage is 0
  • NAFLD or initial NASH: fibrosis stage is 0, activity stage is 2, steatosis stage is 0
  • Moderate NASH: fibrosis stage is 1 or 2, activity stage is >2, steatosis stage is >0
  • Advanced NASH: fibrosis stage is 3 or 4, activity stage is >2, steatosis stage is >0

The ability of the LIVERFASt test to distinguish between levels of severity of NAFLD and NASH addresses one of the more challenging aspects of diagnosis. With its user-friendly results and graphics (shown in the first image), LIVERFASt allows this information to be obtained simply and affordably enough to encourage regular retesting and restaging. The accessibility of this technology has the potential to improve disease management and understanding of progress in a manner both attainable for and accessible to patients and providers.


[1] Aravind et al., 2-3.

[2] Aravind et al., Tangvoraphonkchai et al.

[3] Bedossa, 565.

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