In a primary care setting, positive predictive values of liver function tests (LFTs) in patients with hypertension were low, with increased rates of subsequent referrals, consultations, and blood testing, leading to high rates of false positive results, according to a study published in BJGP Open. In a prospective study of 30,000 patients with hypertension who had LFTs, researchers assessed the diagnostic validity of LFT. Following testing, they measured rates of blood tests, consultations, and referrals within 6 months. For eight LFT analytes and an overall LFT panel, the study measured diagnostic precision against the reference standard of liver disease. The study team observed that a 1-year incidence of liver disease in patients with hypertension was 0.5% (95% CI, 0.4%-0.6%). Mean number of referrals, consultations, and tests were higher in the 6 months following false positives at 10.5, 0.7 and 29.8 respectively, compared with true negatives of 8.6, 0.6, and 19.8 among patients who did not develop liver disease. “Avoiding LFT for routine monitoring could potentially reduce patient’s anxiety, [clinician] workload, and healthcare costs,” the study authors wrote.
