| Audit Standard | Pre-defined minimum (%) | Actual % (overall) | % in individual centres (median(range) | Centres meeting pre-defined minimum No. (%) |
|---|---|---|---|---|
|
Diagnosis
Tested for HBV and HCV Had diagnostic liver biopsy+ Met 1999 IAIHG diagnostic criteria Time from 1st abnormal LFTs to diagnosis is <4 months | 100 80 90 90 | 96 96 94 54 | 98 (50–100) 97 (71–100) 94 (65–100) 55 (12–82) | 22 (79) 27 (96) 22 (79) 0 (0) |
|
Treatment
Attain normal serum ALT by 1 year after start of treatment* Steroids continued for ≥1 year** Appropriate blood monitoring++ | 90 90 80 | 87 75 74 | 89 (33–98) 78 (33–92) 79 (3–100) | 10 (34) 3 (10) 14 (50) |
|
Follow-up
Follow-up biopsy Ishak Necroinflammatory Score (NIS) ≤3 Decompensation during follow up¥ (incl MELD > 15/Alb < 30 for 6 wks) Died from liver disease or had liver transplantation | NA 60 <21 <21 | NA 38 14 3.3 | 18 (0–73) 35 (0–70) 9 (0–72) - | NA 2 (7) 24 (86) - |
↵+performed >90 days after the start of treatment in 42 patients
↵*In those with ≥12 months follow up after treatment started & date of first normal ALT is known
↵**In those followed up ≥ 1 year
↵++Bloods documented as checked at 3 months, 6 months & 12 months
↵¥Decompensation: clinical decompensation (ascites, encephalopathy, variceal bleed), portal vein thrombosis or hepatocellular carcinoma.