Diagnosis and Monitoring of Hepatic Injury. I. Performance Characteristics of Laboratory Tests

To review information on performance characteristics for tests that are commonly used to identify acute and chronic hepatic injury. A MEDLINE search was performed for key words related to hepatic tests, including quality specifications, aminotransferases, alkaline phosphatase, gamma-glutamyltransfer...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 2000-12, Vol.46 (12), p.2027-2049
Main Authors: Dufour, D. Robert, Lott, John A, Nolte, Frederick S, Gretch, David R, Koff, Raymond S, Seeff, Leonard B
Format: Article
Language:English
Subjects:
Acute Disease
Biological and medical sciences
Biomarkers - analysis
Chronic Disease
Clinical Laboratory Techniques - standards
Digestive system
Humans
Investigative techniques, diagnostic techniques (general aspects)
Liver Diseases - diagnosis
Liver Diseases - physiopathology
Liver Function Tests
Medical sciences
MEDLINE
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Practice Guidelines as Topic
Quality Control
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Summary:To review information on performance characteristics for tests that are commonly used to identify acute and chronic hepatic injury. A MEDLINE search was performed for key words related to hepatic tests, including quality specifications, aminotransferases, alkaline phosphatase, gamma-glutamyltransferase, bilirubin, albumin, ammonia, and viral markers. Abstracts were reviewed, and articles discussing performance of laboratory tests were selected for review. Additional articles were selected from the references. Guideline Preparation and Review: Drafts of the guidelines were posted on the Internet, presented at the AACC Annual Meeting in 1999, and reviewed by experts. Areas requiring further amplification or literature review were identified for further analysis. Specific recommendations were made based on analysis of published data and evaluated for strength of evidence and clinical impact. The drafts were also reviewed by the Practice Guidelines Committee of the American Association for the Study of Liver Diseases and approved by the committee and the Association's Council. Although many specific recommendations are made in the guidelines, some summary recommendations are discussed here. Alanine aminotransferase is the most important test for recognition of acute and chronic hepatic injury. Performance goals should aim for total error of
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/46.12.2027