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21
MELD-NaAssesses the severity of chronic liver diseaseChild-Pugh ScoreAssesses the prognosis of chronic liver disease, mainly cirrhosisFIB-4 IndexLiver fibrosis scoring indexAPRIAST to platelet ratio — liver fibrosisMaddrey's DFAlcoholic hepatitis severityGlasgow-BlatchfordUpper GI bleed risk stratificationGAHSGlasgow alcoholic hepatitis scoreMontreal IBDIBD classification — CD & UCMayo ScoreUlcerative colitis activityBISAP ScoreBedside index for severity of pancreatitisCLIF-SOFAOrgan failure scoring in cirrhosisAlcohol ContentStandard drinks & alcohol grams calculatorAARC-ACLFAcute-on-chronic liver failure gradePELD / CR ScorePediatric end-stage liver diseaseHarvey-BradshawCrohn's disease activity indexCTSICT severity index — pancreatitisRockall ScoreGI bleed rebleeding & mortality riskCAGEAlcohol use disorder screening (4 questions)MELD 3.0Updated MELD — sex-inclusive formulaAUDIT ScoreAlcohol use disorders identification testVOCAL-Penn ScorePost-operative mortality risk in cirrhosis surgery

Liver & Cirrhosis

17
ALBI GradeAlbumin-bilirubin liver function grade in HCCUKELD ScoreUK model for end-stage liver diseaseMELD-XIMELD excluding INR — for anticoagulated patientsWest Haven CriteriaHepatic encephalopathy gradingMilan CriteriaLiver transplant eligibility in hepatocellular carcinomaLI-RADS v2018 (CT/MRI)Liver observation category from size, APHE and major featuresBCLC StagingHepatocellular carcinoma stage and treatment allocationSimplified AIH CriteriaSimplified criteria for autoimmune hepatitisRevised Original AIH ScoreIAIHG 1999 comprehensive autoimmune hepatitis scoreSAAGSerum-ascites albumin gradient — cause of ascitesR FactorHepatocellular vs cholestatic pattern in liver injuryCLIF-C ACLFMortality prediction in acute-on-chronic liver failureKing's College CriteriaTransplant criteria in acute liver failureGALAD ScoreHCC detection from gender, age, AFP-L3, AFP and DCPMetroticket 2.0AFP-adjusted up-to-seven for HCC transplant eligibilityRUCAMCausality in drug- and herb-induced liver injuryBaveno VII CriteriacACLD, CSPH and sparing screening endoscopy

Fibrosis & MASLD

8
NAFLD Fibrosis ScoreAdvanced fibrosis probability in MASLD/NAFLDBARD ScoreBMI, AST/ALT ratio, diabetes — MASLD fibrosisFatty Liver IndexPredicts hepatic steatosis from routine labsFibrotic NASH Index (FNI)At-risk NASH probability from AST, HbA1c and HDLNAFLD Activity Score (NAS)Histologic activity grade — steatosis, inflammation, ballooningMEFIB IndexMRE + FIB-4 rule for significant fibrosis (≥F2) in MASLDFAST ScoreFibroScan-AST — at-risk NASH from LSM, CAP and ASTSAFE ScoreSteatosis-Associated Fibrosis Estimator for MASLD in primary care

Pancreas & Biliary

8
Ranson's CriteriaAcute pancreatitis severity at 48 hoursGlasgow-Imrie CriteriaAcute pancreatitis severity — the PANCREAS criteriaHAPSHarmless acute pancreatitis scoreTokyo Guidelines — CholangitisTG18 diagnosis and severity grade for acute cholangitisTokyo Guidelines — CholecystitisTG18 diagnosis and severity grade for acute cholecystitisBiliary Pain (Rome IV)Rome IV — defining biliary-type pain before interventionFunctional Pancreatic SODRome IV — pancreatic sphincter of Oddi disorderRevised Atlanta ClassificationAcute pancreatitis severity — mild, moderately severe, severe

IBD

9
Truelove & Witts CriteriaAcute severe ulcerative colitis — admission decisionUCEISUlcerative colitis endoscopic index of severitySCCAISimple clinical colitis activity index — symptoms onlyCDAICrohn's disease activity index — the trial standardSES-CDEndoscopic severity in Crohn's diseasePUCAIPaediatric ulcerative colitis activity indexTravis (Oxford) CriteriaDay 3 colectomy risk in acute severe ulcerative colitisHo IndexDay 3 steroid failure risk in acute severe ulcerative colitisRutgeerts ScorePostoperative Crohn's recurrence at ileocolonoscopy

GI Bleeding

7
EVendo ScorePredicts oesophageal varices needing treatmentForrest ClassificationPeptic ulcer bleeding — rebleeding risk at endoscopyAIMS65 ScoreUpper GI bleed mortality — five bedside criteriaOakland ScoreSafe-discharge risk for acute lower GI bleedingABC ScoreAge, blood tests, comorbidities — GI bleed mortalitySarin ClassificationEndoscopic classification of gastric varicesEGUS (Gastric Ulcer)Malignancy risk in a gastric ulcer, and who needs repeat endoscopy

Alcohol

2
ABIC ScoreAge, bilirubin, INR, creatinine — alcoholic hepatitisLille ModelSteroid response at day 7 in alcoholic hepatitis

Upper GI

4
Chicago Classification v4.0Oesophageal motility pattern from high-resolution manometryLA Classification (Oesophagitis)Los Angeles grade A–D for erosive oesophagitisPrague C & M CriteriaCircumferential and maximal extent of Barrett's oesophagusEREFS (Eosinophilic Oesophagitis)Endoscopic reference score — oedema, rings, exudates, furrows, stricture

Colorectal

3
Boston Bowel Prep ScaleColonoscopy preparation adequacy by segmentStool Osmotic GapOsmotic vs secretory diarrhoea from stool electrolytesATLAS Score (C. difficile)Predicted response to therapy in Clostridioides difficile infection

Functional GI

37
Bristol Stool ScaleStool form types 1–7 and colonic transitRome IV Criteria for IBSIrritable bowel syndrome diagnosis and subtypeFunctional ConstipationRome IV — two of six items, IBS excludedOpioid-Induced ConstipationRome IV — constipation tied to opioid therapyFunctional DiarrhoeaRome IV — loose stools without predominant painFunctional Bloating / DistensionRome IV — bloating without other bowel disorder criteriaUnspecified Functional Bowel DisorderRome IV — bowel symptoms fitting no other categoryCentrally Mediated Abdominal Pain (CAPS)Rome IV — continuous pain unrelated to gut eventsNarcotic Bowel SyndromeRome IV — opioid-induced hyperalgesia of the gutFaecal Incontinence (Rome IV)Rome IV — the criteria, and why nobody is askedFunctional Anorectal PainLevator ani, unspecified pain and proctalgia fugaxFunctional Defecation DisordersRome IV — dyssynergia and inadequate propulsionInfant RegurgitationRome IV — the happy spitter, and the alarm features that rule it outInfant ColicRome IV — recurrent unexplained crying in a well infant under 5 monthsInfant DyscheziaRome IV — straining before a soft stool, and why not to intervenePaediatric Functional ConstipationRome IV — two of six over one month, with overflow soiling as a criterionToddler's DiarrhoeaRome IV functional diarrhoea of childhood — painless, thriving childPaediatric Cyclic Vomiting SyndromeRome IV — both age bands, with different criteria for eachPaediatric Rumination SyndromeRome IV — infant and child/adolescent criteriaFunctional Nausea & Vomiting (Children)Rome IV — two separate disorders that can be met togetherAerophagiaRome IV — distension that increases through the dayPaediatric Functional DyspepsiaRome IV — four times a month, with PDS and EPS subtypingPaediatric Irritable Bowel SyndromeRome IV — plus the constipation clause clinicians missAbdominal MigraineRome IV — stereotypical incapacitating episodes weeks apartFunctional Abdominal Pain — NOSRome IV — the residual category, reached after the other threeNonretentive Faecal IncontinenceRome IV — soiling without retention, where laxatives make it worseFunctional DyspepsiaRome IV — with PDS and EPS subtypingRumination SyndromeRome IV — effortless regurgitation without retchingCyclic Vomiting SyndromeRome IV — stereotypical episodic vomitingCannabinoid HyperemesisRome IV — CVS pattern relieved by cannabis cessationChronic Nausea & VomitingRome IV — chronic nausea and vomiting syndromeBelching DisordersRome IV — supragastric vs gastric belchingFunctional HeartburnRome IV — heartburn with normal acid exposureReflux HypersensitivityRome IV — normal acid exposure, positive symptom associationFunctional Chest PainRome IV — non-cardiac, non-reflux chest painGlobusRome IV — painless lump-in-throat sensationFunctional DysphagiaRome IV — dysphagia with normal endoscopy and manometry
  1. Calculators
  2. /
  3. BARD Score
Fibrosis & MASLD

BARD Score

BMI, AST/ALT ratio, diabetes — MASLD fibrosis

When to use
BARD suits the situation where you want a fibrosis rule-out and do not have a platelet count or albumin to hand — a clinic visit, a telephone review, or a patient whose recent bloods were a limited panel. Because BMI, transaminases and diabetes status are almost always already known, it can often be scored from memory. Treat it as a rule-out screen in metabolic dysfunction-associated steatotic liver disease: a low score is genuinely reassuring, whereas a score of 2 to 4 says only that fibrosis cannot be excluded and something better is needed. The original authors noted it performs particularly well in non-diabetics, which is worth remembering, because in a diabetic patient one of the three points is automatic and the score loses much of its ability to discriminate.
Why use it
Because the simplest possible test that still rules out advanced fibrosis has real value in a disease this common, and BARD was built to find that floor. Harrison and colleagues deliberately restricted themselves to variables any clinician already knows without ordering anything, then used forced-entry logistic regression to weight them. The result requires no calculator, no laboratory beyond a standard liver panel, and no albumin or platelet count — and it still achieves a negative predictive value of 96%. Where BARD earns its place is triage in settings where FIB-4 or the NAFLD Fibrosis Score cannot be computed at all; where they can, they are the better tests.
Formula, evidence and interpretation

About the BARD Score for Advanced Fibrosis in Steatotic Liver Disease

Three items and a maximum of four points make BARD the simplest of the serum fibrosis scores: BMI of 28 or more scores 1, an AST/ALT ratio of 0.8 or more scores 2, and diabetes scores 1. A total of 0 or 1 excludes advanced fibrosis with a 96% negative predictive value, while 2 to 4 carries an odds ratio of 17 (95% CI 9.2–31.9) for advanced fibrosis. The asymmetric weighting is deliberate — the AST/ALT ratio counts double because it was the strongest of the three predictors. Its trade-off is bluntness: with only five possible values it discriminates less well than FIB-4 or the NAFLD Fibrosis Score, and it spared the fewest biopsies of any score in head-to-head comparison.

On this page

  • Formula
  • Interpreting the result
  • Inputs
  • What it returns
  • How it is calculated
  • Facts & figures
  • Evidence
  • How it compares
  • Pearls & pitfalls
  • Critical actions
  • Why it exists
  • About the creator
  • Limitations
  • If you are the patient
  • FAQ
  • Related calculators
  • References

Formula

BARD = (BMI ≥ 28 ? 1 : 0) + (AST/ALT ratio ≥ 0.8 ? 2 : 0) + (diabetes ? 1 : 0)
BMI ≥ 28
1 point. Note the threshold is 28, not the conventional obesity cut-off of 30.
AST/ALT ratio ≥ 0.8
2 points — the only double-weighted item, and the one that most determines the total.
diabetes
1 point if present.
  • Because the AST/ALT ratio alone is worth 2 points, a patient with a ratio of 0.8 or above is already at the high-risk threshold regardless of BMI and diabetes status.
  • Conversely a patient below the ratio threshold cannot exceed 2 even with both other points, so the ratio effectively gates the result.
  • All three items are thresholds rather than continuous terms, so a BMI of 27.9 and 40 differ by a point at one boundary and not at all thereafter.
  • The BMI cut-off is 28 kg/m², which is lower than the standard definition of obesity and is easy to misremember as 30.

Interpreting the result

A score of 0 or 1 excludes advanced fibrosis with a negative predictive value of 96%, and in a patient with no other concerning features that supports metabolic management in primary care without hepatology referral. A score of 2 to 4 carries an odds ratio of 17 for advanced fibrosis, but this must be read for what it is — a strong relative risk in a cohort where a quarter of patients had advanced fibrosis, not a high probability in an individual. Positive predictive value is the weak point across all simple serum scores and BARD is no exception, so a high score is an instruction to test further, typically with FIB-4, the NAFLD Fibrosis Score or elastography. One structural caveat dominates interpretation: in a patient with diabetes and a BMI of 28 or more, two points are already banked before the transaminases are considered, so the score's ability to separate risk in that very common group is limited.

ScoreBandWhat it meansAction
0–1Low risk of advanced fibrosisAdvanced fibrosis excluded with 96% negative predictive valueManage metabolic risk factors; hepatology referral not indicated on this basis alone
2–4High risk of advanced fibrosisOdds ratio 17 (95% CI 9.2–31.9) for advanced fibrosis, but only modest positive predictive valueAdvanced fibrosis cannot be excluded — proceed to FIB-4, the NAFLD Fibrosis Score or transient elastography

What the BARD Score needs (3 inputs)

BMI (kg/m²)
Scores 1 point at 28 or above, 0 below. A single step, not a gradient.
AST and ALT (U/L)
Entered as the AST/ALT ratio, which scores 2 points at 0.8 or above — double-weighted because it was the strongest single predictor.
Diabetes
Scores 1 point when present.

Units. AST and ALT are used only as a ratio, so their units cancel provided both come from the same assay. BMI is in kg/m² with a threshold of 28. No albumin, platelet count or unit conversion is required — which is the score's main practical advantage.

What it returns

BARD score
An integer from 0 to 4. Only five values are possible, which is the source of both its simplicity and its bluntness.
Risk category
Low risk (0–1) or high risk (2–4) of advanced fibrosis.

How it is calculated

The score came out of an analysis of 827 patients with NAFLD across two geographically separate tertiary centres, a cohort that was 51% female with a median BMI of 33, 35% diabetic, 91% insulin-resistant, and 24% with advanced fibrosis. Univariate analysis identified several features each carrying an odds ratio of at least 2.4 for advanced fibrosis, including BMI of 28 or more, age over 50, an AST/ALT ratio of 0.8 or more, insulin resistance and diabetes. Forced-entry logistic regression then reduced these to three that could be combined in a weighted sum, with the AST/ALT ratio receiving double weight. Notably, age did not make the final score despite being a univariate predictor — a difference from FIB-4 and the NAFLD Fibrosis Score, both of which include it, and one that spares BARD their tendency to over-call in older patients.

Facts & figures

The three items and their weights
ItemThresholdPoints
BMI≥ 28 kg/m²1
AST/ALT ratio≥ 0.82
DiabetesPresent1

Maximum 4. The double-weighted AST/ALT ratio effectively gates the result: at or above 0.8 the patient already meets the high-risk threshold; below it, they cannot exceed 2.

Derivation cohort characteristics (Harrison 2008)
FeatureValue
Patients827 across two tertiary centres
Female51%
Median BMI33 kg/m² (only 3% had a normal BMI)
Hypertension60%
Diabetes35%
Insulin resistance91%
Advanced fibrosis24%

The high baseline prevalence of advanced fibrosis is why the odds ratio of 17 does not translate into a high positive predictive value in lower-prevalence community populations.

Evidence

Derivation and validation — Harrison

2008 · n = 827

827 patients with NAFLD analysed at two geographically separate tertiary medical centres. Univariate analysis identified BMI ≥ 28, age over 50, an AST/ALT ratio ≥ 0.8, a low insulin-sensitivity index and diabetes as individually associated with advanced fibrosis (each odds ratio ≥ 2.4); forced-entry logistic regression reduced these to three, combined as a weighted sum.

A BARD score of 2–4 was associated with an odds ratio of 17 for advanced fibrosis (95% CI 9.2–31.9) and a negative predictive value of 96%. The authors concluded the score can reliably exclude advanced fibrosis from readily available clinical data, particularly among non-diabetics.

Comparative validation — McPherson

2010 · n = 145

145 consecutive patients with biopsy-proven NAFLD from the Newcastle Hospitals Fatty Liver Clinic (2003–2009), mean age 51, mean BMI 35, half diabetic, of whom 27 (19%) had advanced fibrosis. BARD was compared directly against the AST/ALT ratio, APRI, FIB-4 and the NAFLD Fibrosis Score on blood taken at the time of biopsy.

BARD achieved an AUROC of 0.77 — fourth of the five scores, ahead only of APRI (0.67) and behind FIB-4 (0.86), the AST/ALT ratio (0.83) and the NAFLD Fibrosis Score (0.81). Its negative predictive value of 95% was among the highest, but it would have avoided biopsy in only 38% of patients, the lowest of the four scores capable of reliable exclusion.

How it compares

BARD Score vs FIB-4

FIB-4 is clearly the stronger test — AUROC 0.86 against BARD's 0.77 in direct comparison, and it spares 62% of biopsies against BARD's 38% — so BARD is justified only when a platelet count is unavailable.

Both are simple serum scores, but FIB-4's continuous output extracts far more information than BARD's five integer values. Head to head in 145 biopsy-proven patients, FIB-4 achieved the best discrimination of any score tested and BARD the second worst. Their negative predictive values were comparable (95% each), so BARD's rule-out claim holds up; what it loses is the proportion of patients it can confidently rule out at all. BARD's only practical advantage is that it needs no platelet count and no albumin.

Open the FIB-4 calculator →McPherson S, Stewart SF, Henderson E, et al. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut. 2010;59(9):1265-1269.

BARD Score vs NAFLD Fibrosis Score

The NAFLD Fibrosis Score discriminates better and rules out advanced fibrosis in more patients, but BARD needs neither albumin nor a platelet count and gives a binary answer rather than a wide indeterminate zone.

In the same 145-patient comparison the NFS reached an AUROC of 0.81 against BARD's 0.77 and would have avoided biopsy in 52% of patients versus 38%. The NFS also uses six variables including albumin and platelets, so it is not always computable. There is a genuine structural trade-off: the NFS leaves roughly a quarter of patients formally indeterminate, whereas BARD always returns a low- or high-risk answer — at the cost of that answer carrying less information.

Open the NAFLD Fibrosis Score calculator →McPherson S, Stewart SF, Henderson E, et al. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut. 2010;59(9):1265-1269.

BARD Score vs APRI

BARD outperformed APRI for advanced fibrosis in steatotic liver disease (AUROC 0.77 versus 0.67) — APRI was derived in hepatitis C and does not transfer well to MASLD.

APRI combines AST with platelet count and was developed for chronic hepatitis C, where the relationship between transaminases and fibrosis differs from that in MASLD. In the head-to-head comparison of five simple scores in biopsy-proven NAFLD, APRI ranked last, and it was the only score whose negative predictive value did not exceed 90%. BARD, though crude, was built on a NAFLD cohort and reflects the metabolic phenotype directly.

Open the APRI calculator →

Pearls & pitfalls

  • The BMI threshold is 28 kg/m², not 30. Using the conventional obesity cut-off will misclassify patients between 28 and 30.
  • The AST/ALT ratio is double-weighted, so it dominates: at 0.8 or above the patient is already high-risk, and below it they cannot reach 3 or 4.
  • In a patient who is both diabetic and has a BMI of 28 or more, two of the four points are automatic — the score has little discriminating power left in that very common group, which is why the authors highlighted its performance in non-diabetics.
  • BARD has no age term, unlike FIB-4 and the NAFLD Fibrosis Score. That spares it their over-calling in the elderly but also discards a genuine risk factor.
  • The odds ratio of 17 is a relative measure from a cohort with 24% advanced fibrosis. It is not a probability, and positive predictive value in community populations is considerably lower.
  • Only five score values exist, so BARD cannot track change over time in any meaningful way — it is a one-off triage tool, not a monitoring instrument.

Critical actions

  • Use the correct BMI threshold of 28 kg/m² when scoring.
  • Treat a score of 2–4 as 'not excluded' and proceed to a better test — FIB-4, the NAFLD Fibrosis Score or elastography — rather than as a positive diagnosis.
  • Prefer FIB-4 or the NAFLD Fibrosis Score whenever a platelet count and albumin are available, since both discriminate better.
  • Interpret the score cautiously in diabetic patients, where two points are frequently automatic.
  • Address the metabolic drivers regardless of score — weight, glycaemic control, cardiovascular risk and alcohol — since these determine progression more than any single measurement.

Why this score exists

The paper's title states the purpose plainly — identifying patients *without* advanced disease — and BARD should be read as a rule-out instrument built to that specification rather than a general-purpose fibrosis estimate. The authors' wider finding was arguably as important as the score: in their 827 patients, insulin resistance was present in 91% and only 3% had a normal BMI, which reframed NAFLD as a metabolic disease with liver consequences rather than a primarily hepatic one. Against that background the choice of BMI, transaminase ratio and diabetes is not an arbitrary convenience selection but a deliberate use of the metabolic phenotype itself as the predictor. Their specific caveat that the score works best in non-diabetics follows directly from the design, since diabetes is one of the three inputs.

About the creator

  • Stephen A. Harrison

    First author, 2008 derivation study

    Derived BARD across two tertiary centres, and later became senior author of the FAST score — the same investigator on both ends of the simple-to-elastography spectrum.

  • Brent A. Neuschwander-Tetri

    Senior author

    Co-authored the derivation and has shaped much of the wider NAFLD/MASLD natural-history literature.

Limitations

  • With only five possible values it is the bluntest of the serum fibrosis scores, and it cannot track change over time.
  • It ruled out advanced fibrosis in the smallest proportion of patients (38%) among the scores capable of reliable exclusion, so most patients still need a further test.
  • Two of the four points are frequently automatic in diabetic, obese patients, precisely the group most at risk, which erodes discrimination where it is most needed.
  • It contains no age term, discarding a well-established fibrosis risk factor.
  • Positive predictive value is modest; the headline odds ratio of 17 comes from a tertiary cohort with 24% advanced fibrosis and does not transfer to community prevalence.
  • It was derived in tertiary-centre NAFLD populations with a median BMI of 33, so its behaviour in lean steatotic liver disease — where only 3% of the derivation cohort sat — is poorly characterised.
  • It does not apply to viral hepatitis or alcohol-related liver disease.

If you are the patient

The BARD score is a quick way to check whether fatty liver disease is likely to have caused significant scarring of the liver. It uses just three things: your body mass index, the ratio between two liver enzymes in a routine blood test (AST and ALT), and whether you have diabetes. The score runs from 0 to 4. A score of 0 or 1 is reassuring — significant scarring is very unlikely, and in the original study this was correct 96% of the time. A score of 2 or more does not mean you definitely have scarring; it means it cannot be ruled out from these three pieces of information alone, so your doctor will arrange a better test, such as a different blood score or a liver scan. Because having diabetes and a raised body mass index each add a point automatically, people with both will often score 2 or more without that necessarily indicating liver scarring.

Frequently asked questions

What does BARD stand for?#

BMI, AST/ALT Ratio, and Diabetes — the three components. BMI of 28 or more scores 1, an AST/ALT ratio of 0.8 or more scores 2, and diabetes scores 1, for a maximum of 4.

What BARD score means low risk?#

0 or 1. That excludes advanced fibrosis with a negative predictive value of 96%. A score of 2 to 4 carries an odds ratio of 17 for advanced fibrosis and means further testing is needed.

Why is the AST/ALT ratio worth two points?#

Because it was the strongest of the three predictors in the derivation analysis. The practical effect is that it gates the result — at 0.8 or above a patient already meets the high-risk threshold, and below it they cannot score more than 2.

Is the BARD BMI threshold 28 or 30?#

28 kg/m². It is deliberately lower than the conventional definition of obesity, and using 30 instead will misclassify patients in that range.

Is BARD better than FIB-4?#

No. In direct comparison FIB-4 achieved an AUROC of 0.86 against BARD's 0.77 and ruled out advanced fibrosis in 62% of patients versus 38%. BARD's advantage is only that it needs no platelet count or albumin.

Does BARD work in patients with diabetes?#

Less well. Diabetes is itself one of the three inputs, so a diabetic patient with a BMI of 28 or more has two points automatically. The original authors specifically noted the score performs best in non-diabetics.

Related calculators

  • FIB-4 Index — Liver fibrosis scoring index
  • NAFLD Fibrosis Score — Advanced fibrosis probability in MASLD/NAFLD
  • APRI — AST to platelet ratio — liver fibrosis
  • Fatty Liver Index — Predicts hepatic steatosis from routine labs
  • SAFE Score — Steatosis-Associated Fibrosis Estimator for MASLD in primary care

References

Original / primary reference

  1. Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwander-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut. 2008;57(10):1441-1447.

Validation and comparison

  1. McPherson S, Stewart SF, Henderson E, et al. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut. 2010;59(9):1265-1269.

Guidelines

  1. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.

Last updated July 30, 2026. Clinical knowledge base written and curated by GastroAGI Team from primary medical literature.

Written from primary literature and not yet independently clinically reviewed.

For use by qualified healthcare professionals. This calculator supports clinical judgement and does not replace it.