NAFLD Fibrosis Score
Non-invasive score to identify significant fibrosis (F2–F4) or cirrhosis in patients with non-alcoholic fatty liver disease (NAFLD/MASLD), potentially avoiding liver biopsy.
Score interpretation
NFS < −1.455: Advanced fibrosis (F2–F4) unlikely. NPV ~93%.
→ Reassure. Lifestyle modification (diet, exercise, weight loss). Review in 1–2 years. No liver biopsy required.
NFS −1.455 to 0.676: Indeterminate. Cannot reliably exclude or confirm advanced fibrosis.
→ Consider FibroScan (liver elastography) or FIB-4. Hepatology referral. Lifestyle advice. Monitor LFTs annually.
NFS > 0.676: Advanced fibrosis likely. PPV ~90%.
→ Hepatology referral. Liver biopsy or FibroScan to confirm. Cirrhosis surveillance (6-monthly USS + AFP). Endoscopy for varices if cirrhosis confirmed. Address metabolic risk factors (T2DM, dyslipidaemia, hypertension).
Interpretation bands for the NFS. Apply clinical judgement and local guidance.
References
- Angulo P, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846–854.
Related
Curated clinical cross-links plus same-class fallbacks.
- Omega-3-acid ethyl esters · Omega-3 fatty acids
- Ivacaftor · CFTR Potentiator (Cystic Fibrosis — Gating Mutations)
- Elexacaftor / Tezacaftor / Ivacaftor · CFTR Triple Modulator (Cystic Fibrosis — F508del)
- Ivacaftor · CFTR Potentiator — Cystic Fibrosis
- Elexacaftor / Tezacaftor / Ivacaftor · CFTR Triple Modulator — Cystic Fibrosis
- Dornase Alfa (rhDNase) · Mucolytic — Cystic Fibrosis
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.