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Diagnostic innovation and models of care to improve fibrosis detection and risk stratification in steatotic liver disease

Lookup NU author(s): Helen JarvisORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).

Abstract

© 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/. Steatotic liver disease (SLD) is the leading cause of chronic liver disease in Europe, with liver fibrosis representing the strongest predictor of liver-related outcomes and an important contributor to cardiometabolic risk. This Series paper examines diagnostic innovation and models of care to improve fibrosis detection and risk stratification across the continuum of care for SLD. A growing range of non-invasive tests for fibrosis assessment is now available, including blood-based biomarkers, imaging modalities, automated laboratory algorithms, and artificial intelligence-enabled tools. However, implementation remains inconsistent because of limited awareness, restricted geographic and financial access to advanced diagnostics, fragmented referral pathways, heterogeneous reimbursement, limited use of automated reflex testing, and poor digital integration across laboratories and electronic health records. Integrated multidisciplinary models of care linking primary care with specialist services may improve early fibrosis detection, referral efficiency, and equitable access to risk-stratified management, particularly among people living with indicator conditions such as type 2 diabetes and obesity.

Publication metadata

Author(s): Pugliese N, White TM, Brennan PN, Pannain S, Hagstrom H, Michel M, Rice-Duek L, Targher G, Caussy C, Dillon JF, Tacke F, Kopka CJ, Sebastiani G, Boursier J, Tsochatzis EA, Brouwer WP, Guaraldi G, Vettor R, Thiele M, Roden M, Stefan N, Jarvis H, Gines P, Schattenberg JM, Pose E, Buttigieg S, Byrne CD, Lazarus JV

Publication type: Review

Publication status: Published

Journal: The Lancet Regional Health - Europe

Year: 2026

Volume: 65

Print publication date: 01/06/2026

Online publication date: 25/06/2026

Acceptance date: 11/05/2026

ISSN (electronic): 2666-7762

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.lanepe.2026.101722

DOI: 10.1016/j.lanepe.2026.101722

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