Fibroscan

Can Fibroscans give a false low reading?

[nash2 Partner]

Since there is an operator technique involved it is possible to get a false high or low reading though experienced operators shouldn't have any problem recognizing that there is some issue.

[Hidden in reply to nash2]

It was to get on a clinical trial, she surprised me when she said she didn’t know what ascites was. I don’t think I had any at the time as I had a clear US a couple of weeks before. I know ascites can give unreliable reading but she hadn’t heard of ascites she admitted.

[nash2 Partner in reply to Hidden]

That highlights a key problem we have. Medical people don't know about liver disease so they don't look for it early. The lack of education is a huge barrier for us.

[Hidden in reply to nash2]

I mean how can someone dealing with the liver every day not know about ascites? Very scary, that’s why I don’t trust the Fibroscan results.

[Hidden in reply to nash2]

From a UK perspective, I agree that liver disease isn’t screened for routinely, but I tend to disagree about medical people not knowing about liver disease if they are doing an ultrasound or any form of scanning. That would be a core part of their training. NHS training is rigorous and constantly reviewed

[nash2 Partner in reply to Hidden]

Hi BlueThanks for the note. For a long time fat in the liver was considered to be benign. Medicine has advanced, but we still have practicing physicians who were taught that in med school and minimize any concerns about fatty liver. It is fairly common that the first time a patient learns about NAFLD is when they are diagnosed with advanced NASH. A big difference between the UK and the US is that EASL supports proactive screening for asymptomatic disease but the AASLD does not so US docs don't have an intent to diagnose asymptomatic NAFLD. They may note it but often don't explain it to the patient.

Wayne

[Hidden in reply to nash2]

Thanks for your reply, I see your point and there definitely isn’t sufficient importance placed upon early disease detection and often it is advanced when it’s found.

My point however was pertaining to the example given of a clinical scan, involving liver investigation, being performed by a clinician unaware of what ascites is. My medical and clinical colleagues in the NHS would be rigorously investigated if that’s the case as that would denote a competency issue.

[nash2 Partner in reply to Hidden]

That would be an issue. Something we have seen more of during this covid event is people being drafted into tasks without enough training and we have had reports of knowledge gaps that wide as systems have coped with the emergency. I feel badly for the patients and the staffs who find themselves in choppy waters.

[Hidden]

This was a clinical trial. It had nothing to do with NHS. She weighed me to make sure the correct equipment was used. Sure she was very competent, but it did surprise me.

[Hidden in reply to Hidden]

That’s still very worrying if it’s related to a clinical trial as that would deem the trial void if the pre screening was inaccurate and the clinician inadequately trained. My advice in that case would be to report it to the CQC and ask your GP for further advice on reporting clinical trials.

[Hidden]

When I mentioned that I had learned that a small amount of ascites could stop a test being accurate, she did say that she didn’t know what ascites was, BP was taken, weight measured etc. It is strange, will pay for one next time.

[Hidden]

I apologise for my ignorance but if she wasn’t in the NHS, you didn’t pay privately for it, who was she operating a fibroscan?! You can’t do that and not understand clinical significance of basic pathological processes.

[Hidden]

Even more reason to discuss with your GP as that certainly would make you worry.

[Hidden]

I’ve no idea! She had a nurses uniform on. It was bang on with the cap score. I have mild fatty liver and it was 197. She said I was welcome to take read out to Gastro to look at. Another measurement was 13% so that was good. I believe if under 30% it’s accurate. I’m not sure but I believe that’s correct. I was impressed to be honest, weighed, took my height and BP which was something ridiculous, nervous wreck here but I still can’t believe she hadn’t heard of ascites.

[Hidden]

I know. I hadn’t got any I hope because I had US 2 weeks before and they said it was ok.

[Hidden]

You have asked me to read the clinical trial, where can I find this and what is it’s name?

[Hidden]

After some reflection on this post, I wanted to reiterate a point because I feel that it is of vital importance. Before I do, I wanted to assure the forum that I am extremely mindful and respectful that this being a US based health site that has kindly opened to others in the UK via Health Unlocked, many thanks.

Due to the vulnerability of patients with liver disease and the struggles some may have in overcoming barriers to seeking help, I wanted to reassure the UK NHS forum users that both medical and clinical practitioners DO know about liver disease. I also would not want anyone to think that they would not understand basic pathological processes.

I certainly agree that there needs to be a more proactive approach, starting in the primary care sector by early screening and education becoming routine. Mistakes may rarely occur as an exception, not the rule, but stringent NHS regulations would seek this out and rectify it. NHS clinicians have to constantly prove that they are good enough, up to date enough and competent to be there. They are there also generally because it’s their passion and as we’ve seen recently would risk their own health to help others. (They definitely aren’t doing it for the money!!!)

I would not want the previous discussion to pose a barrier to seeking help. If I were viewing this forum for the first time with worries about my liver, reading this post, my thoughts would be ….. what’s the point of asking for help if medical people don’t know about the liver? The fear of judgement in some liver conditions is already a huge hurdle for many. Please, please see your GP as soon as you can.

Warmest wishes