An innovative Nottingham research project to improve diagnosis of liver disease has won a prestigious national award this week after benefitting over 4,500 patients.
The Scarred Liver project was developed by clinicians and academics in Nottingham, supported by the Research and Innovation team at Nottingham University Hospitals NHS Trust (NUH) and the NIHR Nottingham Biomedical Research Centre (BRC). In addition, the team worked closely with the East Midlands Academic Health Science Network and GP practices for the pilot studies, as well as clinical commissioners.
Last night the initiative was awarded the ‘Improving the Value of Diagnostic Services Award’ at the HSJ Value Awards. These prestigious Awards recognise excellent use of resources, as well as acknowledging excellent examples of demonstrable improvement in outcomes, both within back office functions and clinical initiatives.
The initiative was selected from hundreds of entries for its work in helping to develop a new and simple pathway to diagnose chronic liver disease at a critical early stage, often when there are no apparent symptoms.
Liver disease is the third largest cause of premature death in the UK, with an average mortality rate of 59. It usually has no symptoms and therefore is often not diagnosed until a late stage, when treatment options are limited.
The Scarred Liver Project focuses on assessing patients who are at risk of liver disease, rather than those who already have symptoms – when the disease is often advanced. It is the first pathway in the UK that allows the severity of liver disease to be directly assessed by GPs dependent on underlying risk factors.
Patients with risk factors of liver disease undergo a non-invasive test called Fibroscan® to determine whether they have any liver scarring. Only those with abnormal scans are referred for a specialist opinion.
Risk factors of liver disease include: excess alcohol intake, diabetes and obesity. Every patient is also offered information into maintaining good liver health as part of the Fibroscan® appointment.
The mobile scanner provides a more accurate indication of scarring than a liver function test (LFT) and is painless and non-invasive for the patient, as it removes the need for a biopsy. Results are immediate, allowing clinicians to agree treatment with the patient during the same appointment.
This innovative approach has proved to more effectively detect chronic liver disease at an earlier stage, when it can often be halted or reversed. The project has seen more patients referred for a scan per month increase and a total of 4,612 referrals over a two-year period.
Dr Neil Guha, clinical academic based at the University of Nottingham and NUH, said: “On behalf of the team it’s an honour to win this national award. This represents a combined effort form the clinical at NUH, the research team at the University of Nottingham and our wider partners including the East Midlands academic health science network, GP colleagues and clinical commissioners. It is important to improve the way we detect significant liver disease; presently this occurs with imprecise tools or very late in the natural history.”
“The Scarred Liver project has developed a pathway that enables GPs to directly access tools for the assessment of liver disease. This is an important step in trying to tackle the problem of premature deaths that currently result from liver disease in the UK.”
Some of the research team behind the project, including Rebecca Harris, Tracey Wildsmith, Angela Dames and Mary Holmes, were at last night’s Awards held at Manchester Central.