Review and Recommendations for the Component Tests in the Liver Function Test Profile.

Area of Science:

• Clinical Biochemistry
• Laboratory Medicine
• Diagnostic Testing

Background:

• Pathology labs group biochemistry tests into organ-specific profiles (e.g., liver function tests-LFTs) for high-throughput analyzers.
• Current LFT profile components are historically determined, vary between laboratories, leading to confusion and potential misdiagnosis.
• Some LFT components exhibit low sensitivity and specificity, causing false positives/negatives and unnecessary patient concern, particularly regarding fatty liver.

Purpose of the Study:

• To address the confusion and inconsistencies arising from variable LFT profile compositions in clinical practice.
• To propose a harmonized set of analytes for LFT profiles, aligning with the ongoing harmonization of clinical chemistry reference intervals.
• To enhance the diagnostic utility and reduce misinterpretation of LFTs in both screening and clinical settings.

Main Methods:

• Review of current practices in pathology laboratory test profiling.
• Analysis of the clinical relevance and diagnostic performance of common LFT analytes.
• Development of a proposed list of analytes for a standardized LFT profile.

Main Results:

• Identified significant variability in LFT profile composition across different laboratories.
• Highlighted specific analytes within LFTs that are more indicative of conditions like fatty liver than overall liver function, causing potential alarm.
• A proposed list of analytes for a harmonized LFT profile has been developed.

Conclusions:

• Harmonization of LFT profile components is necessary to improve consistency and reduce diagnostic errors.
• A standardized LFT profile can enhance clinical utility, particularly in community medicine screening.
• The proposed LFT analyte list aims to provide a more accurate and less confusing assessment of liver function.