Reducing the burden of liver disease in Europe requires a paradigm shift in how diagnosis, treatment and prevention are enacted. The LiverScreen project's overarching goal is to sustain this shift by enabling early diagnosis of chronic liver diseases, to allow for timely, personalised treatment efforts and prevention of disease progression into debilitating morbidity and mortality.
The LiverScreen project will set-up a targeted population-based screening intervention that will screen people at risk for liver disease to identify people with hidden liver disease an allow the application of effective personalized interventions. The LiverScreen project allows for early diagnosis of a disease that would otherwise continue to progress due to absence of symptoms until a very late disease stage. The need for the LiverScreen project is enormous, because over 60% of the European adult population is at risk and 3% is expected to already have hidden advanced liver disease.
We will accomplish our goal by setting up a targeted, easy-to-use, cost-beneficial screening program for detection of liver fibrosis in high-risk populations, using transient elastography (TE) as screening tool.
LiverScreen will screen over 21000 people in this project and combine the data with their current running cohort of 9.000. By analysing 30000 patients, the LiverScreen consortium can validate the diagnostic accuracy, cost-effectiveness and acceptability of using the TE technology to case-find advanced liver fibrosis in the general population. Moreover, LiverScreen will assess the prevalence of liver fibrosis within certain subpopulations based on health risk factors and will use this knowledge to fine-tune the case-finding. At project completion, we aim to have a targeted, population-based screening intervention program for chronic liver diseases in Europe, ready for implementation.
The LiverScreen project will achieve its goal by the following specific sub-objectives:
1. Validate the diagnostic accuracy of TE to screen for liver fibrosis in the general population and primary care, using liver biopsy as gold standard
2. Assess the prevalence of significant fibrosis as evidenced by increased liver stiffness in the general population and stratified according to subjects at risk for liver fibrosis
3. Identify optimal screening intervals and define population subgroups at highest risk of progressive liver fibrosis with the aim to design the ideal screening strategy
4. Create a medical-decision support prognostic model (in form of a digital tool) of liver fibrosis and estimate the long-term effects of screening for chronic liver disease
5. Estimate the incremental cost-effectiveness ratios of the screening program for different populations or groups and the budget impact for healthcare systems
6. Develop and evaluate a tailored screening program for four pilot EU countries, representative of the different European healthcare systems
