P1156 - Fibrosis-4 Index Use for Early Detection of Hepatic Fibrosis in Patients With Risk Factors for MASLD: A Quality Improvement Project

Hamsika Moparty, MD¹, Camelia Ciobanu, MD², Ali Wakil, MD², Amr Dokmak, MD², Jeeva Jaganathan, MD², Arnold N. Forlemu, MD, MPH³, Praneeth Bandaru, MBBS, MD², Srilaxmi Gujjula, MD¹, Vijay Bhaskar Reddy Gayam, MD⁴, Suut Gokturk, MD¹, Manasa Ginjupalli, MBBS, MD⁵, Saigopal R. Gujjula, MD², Vikash Kumar, MD⁶, Denzil Etienne, MD², Madhavi Reddy, MD, FACG^2
1The Brooklyn Hospital Center, Brooklyn, NY; ²Brooklyn Hospital Center, Brooklyn, NY; ³Brooklyn Hospital Center, Athens, GA; ⁴University of Texas Southwestern, Dallas, TX; ⁵The Brooklyn Hospital Center, New York, NY; ⁶Creighton University School of Medicine, Brooklyn, NY

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined as hepatic fat accumulation in patients with metabolic risk factors, without harmful alcohol consumption. MASLD can progress from inflammation to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Although liver biopsy is the gold standard for detecting fibrosis and cirrhosis, it is invasive and impractical for serial monitoring. The increasing prevalence of MASLD has led to the development of non-invasive diagnostic tests (NITs) such as the Fibrosis-4 index (FIB-4), which serves as an initial screening tool for assessing liver fibrosis. Our initiative aimed to educate internal medicine residents at our institution about the FIB-4 index and the importance of early fibrosis detection in patients with risk factors for MASLD in primary care settings. Additionally, we have implemented a SmartPhrase in our electronic medical record to facilitate automatic FIB-4 index calculation.

Methods: An educational session was conducted for internal medicine residents at our institution, focusing on the latest American Association for the Study of Liver Diseases (AASLD) guidelines for MASLD diagnosis and the FIB-4 index implication in primary care settings. Participants completed pre- and post-session questionnaires to assess their knowledge of MASLD risk factors, the role of FIB-4 index, and their willingness to use it in future practice.

Results: The educational session significantly enhanced participants' knowledge and readiness to use the FIB-4 index. Awareness of biomarkers for FIB-4 testing increased from 45.7% pre-session to 94.3% post-session. Familiarity with using FIB-4 index for advanced fibrosis screening in primary care rose from 68.6% to 100%, and understanding of cut-off values for specialist referral improved from 42.5% to 80%. Additionally, while 43.8% had never calculated the FIB-4 index before, 77.1% intended to use it in future practice.

Discussion: Our quality improvement initiative successfully enhanced internal medicine residents' knowledge of the FIB-4 Index's role in early hepatic fibrosis detection in patients with MASLD risk factors, particularly within primary care settings. This aims to enable early identification and timely specialist referrals for comprehensive management and risk modification, mitigating disease progression. Follow-up plans include retrospective and post-educational session chart reviews to monitor improvements in FIB-4 Index use in primary care settings.



Disclosures:


Hamsika Moparty, MD¹, Camelia Ciobanu, MD², Ali Wakil, MD², Amr Dokmak, MD², Jeeva Jaganathan, MD², Arnold N. Forlemu, MD, MPH³, Praneeth Bandaru, MBBS, MD², Srilaxmi Gujjula, MD¹, Vijay Bhaskar Reddy Gayam, MD⁴, Suut Gokturk, MD¹, Manasa Ginjupalli, MBBS, MD⁵, Saigopal R. Gujjula, MD², Vikash Kumar, MD⁶, Denzil Etienne, MD², Madhavi Reddy, MD, FACG². P1156 - Fibrosis-4 Index Use for Early Detection of Hepatic Fibrosis in Patients With Risk Factors for MASLD: A Quality Improvement Project, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.