Steatosis-Associated Fibrosis Estimator (SAFE) Score
Estimates the risk of moderate to advanced liver fibrosis (stages 2 or higher) among patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
Advice
This tool should be used in conjunction with a thorough evaluation and clinical judgment.
Management
- Low risk (score <0):
- Reinforce lifestyle and metabolic risk mitigation measures.
- Repeat score or alternative noninvasive testing routinely (typically every 1–3 years) or if clinical status worsens.
- Indeterminate risk (score 0–99):
- Consider additional noninvasive testing (e.g., VCTE, ELF).
- Refer to hepatology if imaging suggests fibrosis or other high-risk features are present (e.g., thrombocytopenia, advanced age).
- Otherwise, repeat score or alternative noninvasive testing routinely or if clinical status worsens.
- High risk (score ≥100):
- Refer to hepatology.
- May require biopsy.