BSG Updates Guidelines on Liver Blood Tests

The Clinical Services and Standards Committee (CSCC) of the British Society of Gastroenterology (BSG) has issued updated guidelines on the management of abnormal liver blood tests in children and adults in both primary and secondary care.

The guidelines were first written in 2000 and, since then, have undergone extensive revisions by the Guidelines Development Group (GDG). In this update, the AGREE II tool was used to appraise the quality of evidence and grading of recommendations.

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The new guidelines include the following recommendations:

  • Bilirubin, albumin, alanine aminotransferase (ALT), alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT), in combination with a full blood count, should be included in the initial investigation (level 2b, grade B).
  • After reviewing patients’ previous results, past medical history, and current medical condition, abnormal liver blood test results could then be interpreted (level 5, grade D).
  • Clinical significance should not be determined by the extent of liver blood test abnormality. It should be determined by the specific analyte that is abnormal (outside the reference range) and the clinical context (level 5, grade D).

The full version of the guidelines was published in the journal Gut.

—Christina Vogt


Newsome PN, Cramb R, Davison SM, et al. Guidelines on the management of abnormal liver blood tests. Gut. 2018;67(1).