What is the study about?

Mortality rates from liver disease have increased 400% in the UK since 1970. Most deaths due to liver disease occur in people aged between 18 to 65 years, making it the third biggest cause of premature death in working age with 62,000 years of working life lost every year. Liver disease is commonly caused by alcohol and/or associated with obesity and type 2 diabetes. 

In early stages, liver disease is usually asymptomatic and undiagnosed even among persons with cirrhosis. In 70% of cases, liver disease with cirrhosis is first identified when complications develop and hospital admission is required. Such hospital admissions are associated with a very high mortality rate. 

While 90% of liver disease is preventable, there are currently no programs for early detection, and it is often diagnosed late, presenting with a major complication and hence high mortality. 

Who can take part in the study?

Patients aged between 18 and 40 with risk factors associated with liver disease (excess alcohol consumption, abnormal liver test results, obesity or type 2 diabetes) who receive a letter from their GP practice inviting them to participate in a liver testing visit. 

What is being tested in the study?

Invitation of at-risk patients for a non-invasive liver health check, including a blood test and an ultrasound scan. 

What is this being compared to?

The usual standard of care, whereby patients are referred for testing when their GP deems it clinically necessary to do so. 

What are we trying to find out?

Previous studies have shown that early testing increases cirrhosis detection and reduces unnecessary referrals to hospital. The DIALS study will test the most effective approach for early detection of liver disease in the community by comparing non-invasive testing with current practice. 

How many patients do we need?

300 participants per practice for a total of 42,000 participants.