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Liver function tests: what is the risk?

Clifton P Titcomb1

  • 1ING-Re, 901 Chestnut Hills Parkway, Fort Wayne, IN 46814, USA.

Journal of Insurance Medicine (New York, N.Y.)
|December 26, 2003
PubMed
Summary
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Liver function tests (LFTs) like ALT and AST are not specific to liver function, posing challenges for clinicians and underwriters. This paper reviews LFTs, mortality data, and underwriting strategies for abnormal results.

Area of Science:

  • Clinical Biochemistry
  • Medical Diagnostics
  • Underwriting Science

Background:

  • Commonly termed liver function tests (LFTs) include alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), and bilirubin.
  • These assays lack specificity for liver function, creating challenges for accurate clinical assessment and risk evaluation.
  • Underwriters and insurance medical directors face difficulties in interpreting LFTs due to limited data correlating elevated results with mortality outcomes.

Purpose of the Study:

  • To review fundamental information regarding liver function tests (LFTs).
  • To examine available mortality data associated with LFT results.
  • To provide a strategy for evaluating abnormal LFTs in the underwriting process for accurate risk assessment and pricing.

Related Experiment Videos

Main Methods:

  • Literature review of basic information on LFTs.
  • Analysis of existing mortality data related to LFT elevations.
  • Development of an application strategy for underwriting abnormal LFT results.

Main Results:

  • LFTs are frequently used but are not definitive measures of liver function.
  • Elevated LFTs present interpretation challenges for clinicians and risk assessors.
  • A strategic approach is necessary for evaluating abnormal LFTs to ensure fair insurance pricing.

Conclusions:

  • A clear understanding of LFTs, their limitations, and associated mortality data is crucial.
  • Implementing a standardized strategy for abnormal LFT evaluation improves underwriting accuracy.
  • Effective interpretation of LFTs aids in fair risk selection and pricing within the insurance industry.