[Evaluating new tests for liver damage: still a long way to go]

Because of its limitations and risks, alternatives are being developed for liver biopsy as the first-line method for evaluating liver injury. Many markers and several imaging methods have been developed as non-invasive alternatives. Although these methods have been evaluated in studies published in peer-reviewed journals, the methodological rigor of the design, execution and analysis of these studies leaves much to be desired. In addition, some of the inventors of these methods, who have become shareholders of the companies that market these tests, can be found frequently in the list of authors. The way in which new medical tests are evaluated can be improved, as well as the level of independence from conflicting interests.