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116 calculators match

Most used

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
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  3. SAFE Score
Fibrosis & MASLD

SAFE Score

Steatosis-Associated Fibrosis Estimator for MASLD in primary care

Globulin = total serum protein − albumin.

Seven routine values. Globulin is total protein minus albumin; the published coefficients expect it in g/dL, AST/ALT in U/L and platelets in ×10⁹/L.

When to use
Use it as a first-line case-finding tool for significant fibrosis in the primary-care and community setting, where the population is large, unselected and skewed toward the ages at which FIB-4 struggles. Its job is to safely exclude significant fibrosis in the majority so that specialist referral and elastography are reserved for the higher-risk minority. It is well suited to running over an existing metabolic-clinic or general-practice dataset, since every input bar globulin sits on a routine panel. It is not a fibrosis stager, it does not diagnose steatohepatitis, and it is validated in metabolic liver disease rather than in viral or alcohol-related disease.
Why use it
Because FIB-4, the usual first-line score, has a structural weakness that matters most exactly where case-finding happens. FIB-4 puts age in the numerator against fixed cut-offs, so it over-calls fibrosis in older people and under-performs in the young, and it leaves a third of patients indeterminate. SAFE was derived to fix that: it models age continuously, adds BMI, diabetes and globulin, and in validation against the general US population it discriminated significant fibrosis better than FIB-4 and reclassified many of FIB-4's indeterminate results. It also carries prognostic weight — people with a SAFE below 0 had 25-year survival comparable to those without any steatosis, while rising scores tracked with higher mortality.
Formula, evidence and interpretation

About the SAFE Score (Steatosis-Associated Fibrosis Estimator)

The SAFE (Steatosis-Associated Fibrosis Estimator) score combines seven routine values — age, BMI, diabetes status, AST, ALT, globulin and platelet count — to estimate the risk of significant fibrosis (stage F2 or higher) in metabolic (MASLD/NAFLD) liver disease. Below 0 the score rules out significant fibrosis with a negative predictive value of 88–92%; at or above 100 it rules it in; between 0 and 100 is indeterminate. It was designed for primary care and, unlike FIB-4, handles age as a continuous variable rather than through fixed thresholds, which is why it performs better than FIB-4 in the general population and at the extremes of age.

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

SAFE = 2.97·Age + 5.99·BMI + 154.85·ln(AST) − 58.23·ln(ALT) + 195.48·ln(globulin) − 141.61·ln(platelets) + 62.85·(diabetes) − 75
Age
Years, weight 2.97.
BMI
kg/m², weight 5.99.
AST
U/L, natural log, weight 154.85.
ALT
U/L, natural log, weight −58.23.
globulin
g/dL (total protein − albumin), natural log, weight 195.48.
platelets
×10⁹/L, natural log, weight −141.61.
diabetes
1 if present, 0 if absent; weight 62.85.
  • The AST, ALT, globulin and platelet terms are natural logarithms (ln); age and BMI enter linearly.
  • Globulin is total serum protein minus albumin, in g/dL. If reported in g/L, divide by 10 first (or use the unit toggle).
  • The coefficients are large because the score is scaled so that its decision points fall at 0 and 100 — the raw number is not a probability and not a stage.

Interpreting the result

Treat SAFE as a triage tool with a wide safe zone below 0. A negative score excludes significant fibrosis with a negative predictive value near 90% and, in population data, marks a group whose long-term survival matches people without any fatty liver — these patients can usually stay in primary care with metabolic management. A score of 100 or above marks high risk and should route the patient to specialist assessment and elastography. The 0–100 band is indeterminate and must be worked up further rather than treated as normal. The score's advantage over FIB-4 is concentrated in the young and the old and in shrinking that indeterminate group, so it is most useful precisely where FIB-4 is least reliable.

ScoreBandWhat it meansAction
< 0Low riskSignificant fibrosis (≥ F2) ruled out — NPV 88–92%; 25-year survival like people without steatosisManage metabolic risk in primary care; reassess over time
0–100Intermediate riskIndeterminate — neither ruled in nor outProceed to a second-line test (elastography or an imaging/blood fibrosis score)
≥ 100High riskHigh probability of significant fibrosis; correlated with shorter survival (adjusted HR ≈ 1.5)Refer for specialist fibrosis assessment

What the SAFE Score needs (6 inputs)

Age (years)
Enters linearly with a positive weight. Unlike FIB-4, SAFE uses age as a continuous term rather than against fixed thresholds, which is the main reason it behaves better at the extremes of age.
BMI (kg/m²)
Body mass index, positive weight — the metabolic-load term. Along with diabetes it anchors the score in the metabolic phenotype that FIB-4 ignores.
Diabetes (yes/no)
A large positive contribution when present, reflecting how strongly type 2 diabetes raises the probability of significant fibrosis in fatty liver disease.
AST and ALT (U/L)
Both enter as natural logarithms — AST with a large positive weight, ALT with a negative one, so a rising AST:ALT pattern drives the score up, as in FIB-4 and the NAFLD Fibrosis Score.
Globulin (g/dL)
Total serum protein minus albumin, entering as a natural log with a large positive weight. A rising globulin is a marker of chronic liver injury. This is the one input not always on a basic panel.
Platelet count (×10⁹/L)
Enters as a natural log with a negative weight — the portal-hypertension marker, as in FIB-4. A falling platelet count raises the score.

What it returns

SAFE score
A continuous value on a scale where the decision points are 0 and 100. It is a risk estimate for significant fibrosis, not a fibrosis stage.
Risk band
Low (< 0), intermediate (0–100) or high (≥ 100). The intermediate band is an instruction to test further, not a reassuring result.

How it is calculated

SAFE is a regression model fitted against biopsy-defined significant fibrosis and then validated against liver stiffness and long-term mortality. It reuses the markers that make FIB-4 and the NAFLD Fibrosis Score work — the AST:ALT pattern and a falling platelet count — but adds the metabolic drivers (BMI, diabetes) and a marker of chronic injury (globulin), and, critically, keeps age as a continuous variable instead of binning it. Modelling age continuously is what removes FIB-4's age-related bias, because the score no longer flips a patient across a threshold on a birthday. The output is deliberately rescaled so the two operating points sit at round numbers, 0 for rule-out and 100 for rule-in.

Facts & figures

Decision thresholds
SAFEBandMeaning
< 0Low riskRules out ≥ F2 (NPV 88–92%)
0–100IntermediateSecond-line testing required
≥ 100High riskRules in ≥ F2; refer

Target is significant fibrosis (stage F2 or higher).

SAFE vs FIB-4
FeatureSAFEFIB-4
InputsAge, BMI, DM, AST, ALT, globulin, plateletsAge, AST, ALT, platelets
Age handled asContinuous variableFixed thresholds
General-population discriminationHigherLower
Prognostic (long-term mortality)YesYes, but less well in the young

SAFE was built to outperform FIB-4 specifically in primary-care and general populations.

Evidence

Derivation — biopsy-defined fibrosis

2023

Developed against biopsy-confirmed fibrosis stage in metabolic liver disease cohorts, selecting age, BMI, diabetes, AST, ALT, globulin and platelets and scaling the model so its rule-out and rule-in points fell at 0 and 100.

At SAFE < 0, negative predictive values for ruling out ≥ F2 were 88% and 92% in the two testing sets. The score discriminated significant fibrosis better than FIB-4, particularly at the extremes of age.

General US population validation

2023

Applied to the general adult US population using liver stiffness as the fibrosis reference, and to NHANES III with 25-year mortality follow-up.

Outperformed FIB-4 for identifying significant fibrosis and reclassified many FIB-4-indeterminate patients. SAFE < 0 marked survival comparable to people without steatosis; SAFE > 100 carried an adjusted hazard ratio of about 1.5 for mortality.

How it compares

SAFE Score vs FIB-4

SAFE was purpose-built to beat FIB-4 in primary care — it discriminates significant fibrosis better in the general population and at age extremes, and leaves fewer indeterminate results — at the cost of three extra inputs (BMI, diabetes, globulin).

FIB-4 is simpler and guideline-embedded, using only age, AST, ALT and platelets, but its fixed age thresholds cause systematic error in the young and old and it leaves about a third of patients indeterminate. SAFE models age continuously and adds metabolic and chronic-injury markers, which is why it reclassifies many FIB-4-indeterminate patients correctly. Where the two disagree at the extremes of age, SAFE is the more reliable; where simplicity and existing data matter, FIB-4 remains the pragmatic first step.

Open the FIB-4 calculator →

SAFE Score vs NAFLD Fibrosis Score

They share most inputs and both target advanced/significant fibrosis, but SAFE swaps albumin for globulin, keeps age continuous, and was validated for primary-care case-finding with a mortality link, making it the more modern general-population tool.

The NAFLD Fibrosis Score uses age, BMI, glucose/diabetes, AST, ALT, platelets and albumin; SAFE uses the same metabolic backbone but substitutes globulin for albumin and was calibrated and validated specifically for community case-finding, including 25-year survival data. In a specialist clinic either performs well; in unselected primary-care populations SAFE has the stronger validation.

Open the NAFLD Fibrosis Score calculator →

SAFE Score vs Fibrotic NASH Index (FNI)

Different endpoints — SAFE estimates significant fibrosis (≥ F2), FNI estimates at-risk NASH (activity plus fibrosis) — so choose the score whose target matches the decision at hand.

SAFE answers 'is there significant fibrosis' for case-finding and referral; FNI answers 'is there the active, fibrotic NASH phenotype that treatment targets'. A patient can be SAFE-positive for fibrosis while their FNI is aimed at whether that fibrosis is accompanied by treatment-relevant activity. They are complementary rather than competing.

Open the Fibrotic NASH Index (FNI) calculator →

Pearls & pitfalls

  • SAFE estimates the risk of significant fibrosis (≥ F2); it is not a fibrosis stage and does not diagnose steatohepatitis.
  • Globulin is total protein minus albumin, in g/dL — it is the one input not always on a basic panel, and getting its units wrong (g/L versus g/dL) badly distorts a logarithmic term.
  • Its edge over FIB-4 is greatest in the young and the old; in middle age the two agree more often.
  • The 0–100 intermediate band still requires a second-line test — treating it as negative is the same mistake as ignoring FIB-4's indeterminate zone.
  • The coefficients are large and the raw score is not a probability; read the band, not the magnitude.
  • It shares FIB-4's vulnerability to non-hepatic causes of a low platelet count or a raised AST.
  • It was derived and validated in metabolic liver disease and should not be applied to viral or alcohol-related disease without separate evidence.

Critical actions

  • Confirm globulin is entered in g/dL (total protein − albumin); a units error here is the commonest way to get SAFE badly wrong.
  • Act on the intermediate band with a second-line test rather than filing it as normal.
  • At high risk, refer for specialist assessment and elastography rather than repeating bloods.
  • Where FIB-4 and SAFE disagree in a young or old patient, weight SAFE, since that is where it was designed to be more reliable.
  • Treat the metabolic drivers — weight, glycaemic control, cardiovascular risk — at every band; a low SAFE does not make metabolic disease benign.

Why this score exists

SAFE was built as a direct answer to a known failing of FIB-4 in the setting where most fatty liver disease is actually found — primary care. Its authors' central design decision was to stop treating age as a switch and model it continuously, which is what removes the systematic over- and under-calling FIB-4 shows at the ends of the age range. Adding BMI, diabetes and globulin brought in the metabolic and chronic-injury information FIB-4 lacks. The choice to rescale the output so the thresholds land at 0 and 100 is cosmetic but deliberate: it makes a large-coefficient regression easy to communicate as a simple three-band result.

About the creator

  • Pimsiri Sripongpun

    First author, 2022 derivation study

    Derived the steatosis-associated fibrosis estimator to improve on FIB-4 in primary-care populations.

  • Allison J. Kwong

    Senior author

    Also senior author of the MELD 3.0 revision.

Limitations

  • It estimates the risk of significant fibrosis, not a fibrosis stage, and does not diagnose steatohepatitis.
  • It requires BMI, diabetes status and globulin in addition to the routine FIB-4 inputs, and globulin is not on every basic panel.
  • The intermediate 0–100 band still needs second-line testing, so it does not by itself resolve every case.
  • It shares FIB-4's sensitivity to non-hepatic causes of thrombocytopenia and transaminitis.
  • The large-coefficient formula is not mentally computable, so it depends on a calculator and on correct input units.
  • It was derived and validated in metabolic (MASLD/NAFLD) liver disease and should not be transferred to other liver diseases without dedicated evidence.

If you are the patient

The SAFE score is a way of estimating how likely it is that fatty liver disease has caused significant scarring in the liver, using information that is easy to collect: your age, your body mass index, whether you have diabetes, and four blood results (two liver enzymes, a protein called globulin, and your platelet count). It was designed for use in general practice, and it works better than the older FIB-4 score for younger and older people. A score below 0 means significant scarring is unlikely — reassuringly, people with a score this low tend to live just as long as people with no fatty liver at all — and you would usually be managed with lifestyle and metabolic care. A score of 100 or more means scarring is more likely and you would be referred to a specialist. A score in between means the test could not tell, and another test such as a liver scan is needed. The main thing your team checks is that the globulin value is entered in the right units, because that part of the calculation is sensitive to it.

Frequently asked questions

What is the SAFE score?#

The SAFE (Steatosis-Associated Fibrosis Estimator) score is a blood-and-clinical score that estimates the risk of significant liver fibrosis (stage F2 or higher) in metabolic fatty liver disease. It combines age, BMI, diabetes, AST, ALT, globulin and platelets, and was designed for first-line case-finding in primary care.

What SAFE score rules out significant fibrosis?#

A SAFE score below 0 is the rule-out result: significant fibrosis is unlikely, with a negative predictive value of 88–92%. In population data, people with a SAFE below 0 had 25-year survival comparable to people without any steatosis, underlining how reassuring a negative result is.

Is the SAFE score better than FIB-4?#

In primary-care and general populations, yes — SAFE discriminated significant fibrosis better than FIB-4 and reclassified many of FIB-4's indeterminate results, mainly because it models age continuously instead of using fixed thresholds. FIB-4 remains simpler (four inputs) and is embedded in guidelines, so it is still a reasonable first step, but SAFE is the more reliable of the two at the extremes of age.

What does a SAFE score above 100 mean?#

It falls in the high-risk band: significant fibrosis is likely and specialist assessment with elastography is warranted. A score above 100 also carried an adjusted hazard ratio of about 1.5 for long-term mortality in population data, so it flags both fibrosis risk and prognosis.

What units does the SAFE calculator need?#

Age in years, BMI in kg/m², AST and ALT in U/L, platelets in ×10⁹/L, and globulin in g/dL (globulin being total serum protein minus albumin). Because globulin and the enzymes enter as natural logarithms, using the wrong units — particularly g/L instead of g/dL for globulin — will produce a badly wrong score.

Does SAFE replace a FibroScan or biopsy?#

No. SAFE is a triage tool that excludes significant fibrosis cheaply in low-risk patients and flags higher-risk ones for further testing. Those with an intermediate or high score still need a second-line test such as elastography, and occasionally biopsy, to confirm and stage the fibrosis.

Related calculators

  • FIB-4 Index — Liver fibrosis scoring index
  • NAFLD Fibrosis Score — Advanced fibrosis probability in MASLD/NAFLD
  • Fibrotic NASH Index (FNI) — At-risk NASH probability from AST, HbA1c and HDL
  • APRI — AST to platelet ratio — liver fibrosis
  • BARD Score — BMI, AST/ALT ratio, diabetes — MASLD fibrosis
  • MEFIB Index — MRE + FIB-4 rule for significant fibrosis (≥F2) in MASLD

References

Original / primary reference

  1. Sripongpun P, Kim WR, Mannalithara A, et al. The steatosis-associated fibrosis estimator (SAFE) score: a tool to detect low-risk NAFLD in primary care. Hepatology. 2023;77(1):256-267.

Validation

  1. van Kleef LA, et al. The steatosis-associated fibrosis estimator (SAFE) score: validation in the general US population. Hepatol Commun. 2023;7(4):e0075.

Clinical practice guidelines

  1. Berzigotti A, Tsochatzis E, Boursier J, et al. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis – 2021 update. J Hepatol. 2021;75(3):659-689.
  2. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024;81(3):492-542.
  3. Kanwal F, Shubrook JH, Adams LA, et al. Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2021;161(5):1657-1669.

Further reading

  1. Sterling RK, Lissen E, Clumeck N, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection (FIB-4). Hepatology. 2006;43(6):1317-1325.
  2. Tavaglione F, De Vincentis A, Jamialahmadi O, et al. Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis (FNI). Clin Gastroenterol Hepatol. 2023;21(6):1523-1532.e1.

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.