BARD Score for NAFLD Fibrosis

BARD Calculator

BMI ≥28 kg/m²

AST/ALT Ratio ≥0.8

Diabetes Mellitus

BARD Score: –

–

Predicts risk of advanced fibrosis in NAFLD patients.

Why Use

Predicts advanced fibrosis in NAFLD patients with a NPV of 97% (rules out fibrosis), thus potentially avoiding need for liver biopsy. Comparable to NAFLD Fibrosis Score in terms of sensitivity and specificity.

When to Use

Patients with suspected NAFLD.

Formula

Addition of the selected points: Variable Points BMI ≥28 No 0 Yes 1 AST / ALT ratio ≥0.8 No 0 Yes 2 Diabetes No 0 Yes 1

Pearls / Pitfalls

Strong negative predictive value for ruling out fibrosis ( Raszeja-Wyszomirska 2010 ). Original study involved mostly Caucasian patients and therefore score may be less applicable in other populations. Doesn’t predict fibrosis but rules out (high sensitivity). Helps differentiate adult patients with NAFLD from NASH who have not yet developed clinical stigmata of cirrhosis.

Management

Lifestyle modifications include: Tight glycemic control Blood pressure control Balanced diet Regular aerobic exercise

Critical Actions

Patients with advanced fibrosis can be monitored closely on the basis of BARD score for their disease progression and can be referred to liver transplant centers.

Advice

Patients identified at high risk of fibrosis related to NAFLD can get focused interventions to prevent future complications through life style modifications.

More Information

Interpretation: BARD Score Risk of advanced fibrosis 0-1 Low 2-4 High* *Scores 2-4 were associated with odds ratio (OR) 17 (95% CI 9.2-31.9) and 96% NPV ( Harrison 2008 ).