27 May 2026, Somerset, UK and Barcelona, Spain: Predictive Health Intelligence today announced results from the LiveWell study at the EASL Congress, demonstrating that hepatoSIGHT CLDI™ is a highly effective method for identifying people with clinically significant liver fibrosis from the general population using routinely collected NHS laboratory data.
The study, sponsored by Sano Genetics and funded by Innovate UK, shows that the Cumulative Liver Damage Index (CLDI) can identify clinically significant fibrosis more accurately than commonly used first-line investigations. This will enable a major shift in how liver disease is identified and managed within NHS pathways.
Chronic liver disease represents a growing challenge for the NHS. Death rates have increased more than fourfold since the 1970s, in contrast to improvements seen in many other chronic conditions. Liver disease is typically progressive and asymptomatic until advanced stages, meaning patients are often identified too late for effective intervention. Despite this, there is no national screening programme, in part because existing approaches have not been sufficiently accurate or cost-effective at scale.
Once there is a suspicion of liver disease, the current NHS pathway typically relies on a two-step approach. A first-line score such as FIB-4 is used to identify patients at risk, followed by more expensive second-line testing with Enhanced Liver Fibrosis (ELF™) or transient elastography. While this is more efficient than unguided referral, the performance of first-line investigations in the general population is limited, impeding effort to improve earlier identification.
The LiveWell study evaluated an alternative approach using CLDI, a longitudinal measure derived from routine blood tests. This captures cumulative liver injury over time, using the hepatoSIGHT case-finding platform. Rather than relying on a single test result, CLDI reflects the total burden of liver damage built up over years.
In this study, CLDI demonstrated strong performance for identifying clinically significant fibrosis amongst the general population, achieving an AUC of 0.884. This compares favourably to published population-level performance for FIB-4 of 0.572.
“These findings are an exciting and important step forward, showing how patients can know more, sooner, and have a better chance to act before serious damage is done,” said Larry R. Holden, President and CEO of the Global Liver Institute. “For patients and families, earlier identification means more opportunity, more informed choices, and more hope. This is exactly the kind of progress we need if we are going to turn the tide on chronic liver disease.”
The study recruited 994 participants prospectively from a single NHS site in less than a year, providing a substantial real-world dataset and supporting the feasibility of this approach within routine clinical pathways.
Furthermore, by using CLDI to identify high-risk individuals directly from historic data, patients can be referred straight to transient elastography, effectively creating a one-step pathway from identification to diagnostic confirmation. This reduces unnecessary sequential testing and minimises burden on both patients and services. A CLDI based pathway would be simpler, and significantly cheaper than one based on sequential blood tests. During the LiveWell study, patients identified using CLDI were invited for a non-invasive liver scan through Tawazun Health’s rapid access FibroScan® pathway, alongside genetic profiling provided by Sano Genetics. This demonstrated a possible real-world delivery model, linking population-level risk stratification to timely non-invasive assessment.
“This study is a meaningful step forward for people living with undiagnosed liver disease. The fact that CLDI can identify clinically significant fibrosis this accurately, using data that already exists in NHS systems, changes what earlier identification can realistically look like at scale,” said Charlotte Guzzo, Chief Operating Officer of Sano Genetics. “We are proud to have supported this work and excited to see where the larger validation study takes it.”
The implications extend beyond clinical care. Patient identification remains a major constraint in liver disease research, particularly in metabolic dysfunction-associated steatotic liver disease (MASLD), where there are currently over 130 active studies ongoing. By enabling more accurate identification of patients at scale, CLDI has the potential to significantly accelerate recruitment, reduce screen failure rates, and improve trial efficiency.
“After more than 20 years as an NHS gastroenterologist, I have seen too many patients whose liver disease was only found once serious damage had already been done. Chronic liver disease develops silently over many years, so it makes sense that we should look at the pattern of liver injury over time, not just single blood tests in isolation. These findings show that using routine NHS data in this way could help us identify people at higher risk much earlier and create a simpler, more targeted pathway for assessment before advanced disease develops.”
hepatoSIGHT has received funding to extend its footprint across the South West of England, with further rollouts planned in 2027. A wider validation study of CLDI involving 8,000 patients is now in progress, with results expected later this summer. This will further assess the performance of CLDI across multiple sites.
This work was supported by Innovate UK Grant Number iUK 10073169.
ENDS.
Notes to editors
About Predictive Health Intelligence
Predictive Health Intelligence is a medical technology company with a mission to end the late diagnosis of liver disease. They have developed a case-finding search engine to help clinicians identify people who might be at risk of developing chronic liver disease using existing, historical data. Identifying liver disease early, whilst more treatment options are available, can improve clinical outcomes and reduce the burden of late-stage disease on healthcare systems and individuals.
Predictive Health Intelligence was initially funded by the National Institute for Health and Care Research, and is a part NHS-owned entity.
About Sano Genetics
Sano Genetics’ mission is to accelerate the world’s transition to precision medicine. Although accessibility to DNA sequencing has surged in the past decade, precision medicine studies have failed to keep up. They are still complex, time-consuming and costly, and many potentially life-changing treatments never see daylight.
Sano simplifies precision medicine studies with a 360° platform that connects every stage: strategy consultation, patient finding, biomarker screening, patient engagement and analytics. The company works with pharmaceutical companies and biotechs to find, screen, and engage participants faster and more cost effectively; with researchers to increase efficiency and impact; and with patient advocacy groups to drive research with and for their communities.
Headquartered in Cambridge, UK, Sano’s diverse team combines years of expertise in medical research, genetics and security-focused software engineering. More information is available at https://www.sanogenetics.com/.
About Somerset NHS Foundation Trust
Somerset NHS Foundation Trust runs acute hospital services, community services, mental health and learning disability services and a quarter of Somerset’s GP practices. It runs services from two acute hospitals – Musgrove Park Hospital in Taunton, Yeovil Hospital in Yeovil – services in the community and services from the 13 community hospitals in the county, a range of mental health and learning disability services and Symphony Healthcare Services runs a quarter of GP practices in the county. The trust is committed to delivering high-quality, compassionate care and improving health outcomes through clinical excellence, research and innovation. It hosts an active portfolio of clinical research and works with NHS, academic and industry partners to develop and deliver studies that benefit patients and communities, supported by dedicated research infrastructure and experienced multidisciplinary teams.
About Tawazun Health
Tawazun Health is a CQC-regulated specialist provider of FibroScan liver assessments, delivering early identification of liver disease risk across healthcare, community, research, and corporate environments. Working with NHS partners, commercial sponsors, and independent organisations, Tawazun expands access to non-invasive liver diagnostics beyond traditional hospital pathways — enabling scalable deployment where services are resource constrained.
Learn more at: https://tawazunhealth.com/
Media contact
James Hounsell,
Co-Founder, Evolene Ltd.