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    Fibroscan diagnostics consultation document [noACIC].docx

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    1 Recommendations

    1.1 FibroScan is recommended for use in primary or community care to assess liver fibrosis or cirrhosis if:

    • it is used in accordance with national guidelines (see sections 2.3 to 2.5)

    • a clear care pathway with advice for healthcare professionals on what to do based on a FibroScan result is established locally in collaboration between primary or community care and secondary or specialist care providers

    • there is training for healthcare professionals on how to do the test

    • the company provides supporting materials to make sure people using the test continue to use it correctly, and

    • each FibroScan device is expected to be used for at least 500 scans per year.

    Why the committee made these recommendations

    Using FibroScan in primary and community care for assessing liver disease has the potential to detect liver disease earlier. Moving tests closer to people may improve access and so attendance at appointments. This may also reduce health inequalities for people from disadvantaged or high-risk communities.

    This assessment did not assess wider use of FibroScan than what is currently recommended in national guidelines (see sections 2.3 to 2.5). It only considered changing the location of testing and therefore FibroScan is only recommended for use in primary or community care in line with national guidelines. For the test performance to be maintained in primary or community care, testing should be done as part of a clear care pathway. Also, training on doing the test should be provided and the expertise of trained operators should be maintained by frequent use of the device.

    There is some uncertainty about the overall long-term costs of using the test in primary or community care. But, it is likely that if each device is used frequently, the immediate costs of doing a test in the community will be lower than the cost of referring a person for testing in secondary or specialist care. So, using FibroScan for assessing liver fibrosis and cirrhosis in primary or community care is recommended for routine use.