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Calculators

The following calculators have been collected here for general informational purposes. Please feel free to explore these resources and the supporting published evidence.
The liver is a complex organ, and a human even more so, and therefore we do not recommend making clinical decisions on the basis of these scores alone.
However, there is a lot of interest in these scores, so putting them all in one place makes them more accessible and easier to compare.

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FIB-4
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SAFE
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ALERT
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FAST
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cTAG
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MAST

What is MASLD?

MASLD is a liver condition where excess fat accumulates in liver cells. In many people this causes few symptoms, but it puts you at higher risk of both liver and cardiovascular complications. Checking for MASLD is crucial, especially in those with risk factors such as being overweight or having diabetes two.

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A Global Issue

The global prevalence of MASLD is approximately 32% of the population

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Affecting 1 Billion People

MASLD is reaching epidemic levels, affecting an estimated one billion people worldwide

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Costing $100+ Billion

An estimated 30% of adults in the United States have MASLD, costing over 100 billion dollars annually

What is MASH?

MASH refers to a more severe form of MASLD, where inflammation and liver damage occur due to fat accumulation.
It can progress to cirrhosis and increase the risk of liver-related complications.

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MASH is estimated to affect up to 12% of Americans

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Projected as #1 reason for Liver Transplants by 2030

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Per patient cost of MASH is 12x that of MASLD

Resources

FAST

FibroScan-AST (FAST) score for the non-invasive identification of patients with non-alcoholic steatohepatitis with significant activity and fibrosis: a prospective derivation and global validation study.
cTAG

A composite biomarker using multiparametric magnetic resonance imaging and blood analytes accurately identifies patients with non-alcoholic steatohepatitis and significant fibrosis.
SAFE

The steatosis-associated fibrosis estimator (SAFE) score: A tool to detect low-risk NAFLD in primary care.
ALERT

This score aims to alert investigators/clinicians to the potential inclusion of a participant in MASLD clinical trials based on their (likely) liver fat percentage.
FIB-4

Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection.
MAST

MRI-based (MAST) score accurately identifies patients with NASH and significant fibrosis.
The global NAFLD epidemic
Rohit Loomba, Arun J Sanyal
Global incidence and prevalence of nonalcoholic fatty liver disease
Margaret Lp Teng, Cheng Han Ng, Daniel Q Huang, Kai En Chan, Darren Jh Tan, Wen Hui Lim, Ju Dong Yang, Eunice Tan, Mark D Muthiah
Mortality in the United States, 2021
Jiaquan Xu, M.D., Sherry L. Murphy, B.S., Kenneth D. Kochanek, M.A., and Elizabeth Arias, Ph.D.
Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008
Zobair M Younossi, Maria Stepanova, Mariam Afendy, Yun Fang, Youssef Younossi, Hesham Mir, Manirath Srishord
Liver disease is a significant risk factor for cardiovascular outcomes - A UK Biobank study
Adriana Roca-Fernandez, Rajarshi Banerjee, Helena Thomaides-Brears, Alison Telford, Arun Sanyal, Stefan Neubauer, Thomas E Nichols, Betty Raman, Celeste McCracken, Steffen E Petersen, Ntobeko Ab Ntusi, Daniel J Cuthbertson, Michele Lai, Andrea Dennis, Amitava Banerjee
Economic and Clinical Burden of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes in the U.S
Zobair M Younossi, Radhika P Tampi, Andrei Racila, Ying Qiu, Leah Burns, Issah Younossi, Fatema Nader
Non-alcoholic fatty liver disease and type 2 diabetes: An update
Chi-H Lee, David Tw Lui, Karen Sl Lam
The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review
Zobair M Younossi, Pegah Golabi, James M Paik, Austin Henry, Catherine Van Dongen, Linda Henry
Liver transplantation for nonalcoholic fatty liver disease: New challenges and new opportunities
Mina Shaker, Adam Tabbaa, Mazen Albeldawi, Naim Alkhouri
New Year, New Name: NAFLD becomes MASLD
Jennifer Middleton
The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases
Naga Chalasani, Zobair Younossi, Joel E Lavine, Michael Charlton, Kenneth Cusi, Mary Rinella, Stephen A Harrison, Elizabeth M Brunt, Arun J Sanyal
MASLD, MASH Projected to Grow by 23% in the US Through 2050
Neil Osterweil
Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes
Zobair M Younossi, Aaron B Koenig, Dinan Abdelatif, Yousef Fazel, Linda Henry, Mark Wymer