The DIAgnosis of Liver Disease in Primary Care (DIALS) trial, the largest liver study in NHS history, will see 42,000 adults across the UK screened for early signs of liver disease through GP‑led community testing. The study is funded by the National Institute for Health and Care Research (NIHR)
The trial is led by Prof Emmanouil Tsochatzis, consultant hepatologist at the Royal Free Hospital and Professor of Hepatology at UCL (Division of Medicine), together with Dr Ian Rowe of the University of Leeds. The trial team brings together hepatologists, primary care physicians, clinical trialists, health economists and implementation scientists from across the UK.
Earlier diagnosis
Late‑stage liver disease is frequently diagnosed only once patients reach hospital, with around 70% having had no prior diagnosis. Approximately 25% of these patients die within two months, leaving very little opportunity for early intervention. Alcohol is the leading cause of liver cirrhosis. According to Professor Tsochatzis, earlier diagnosis would allow clinicians to support patients to reduce or stop alcohol consumption, while those with fatty liver disease could be helped to improve their diet. In many cases, dietary changes combined with medication can even help reverse the condition.
Non-invasive liver scans
People at higher risk - including those with excessive alcohol intake, obesity or Type 2 diabetes - will be invited for a suite of three non-invasive liver scans shown to be effective at detecting early liver damage. Where signs of cirrhosis or fibrosis are found, patients will be referred to specialist hospital teams for further investigation and potential treatment.
Professor Anthony Gordon, Programme Director for the NIHR Health Technology Assessment (HTA) Programme, which funded the trial, said: “Liver disease claims the lives of thousands of people each year. But evaluating screening interventions through high-quality research studies can hopefully lead to diagnosing this serious condition much earlier and prevent further deterioration.”
NIHR funding and awards: DIALS DIAgnosis of Liver diseaSe in primary care
This study has the potential to be ground-breaking. Diagnosing preventable liver disease earlier would have a profound effect in healthcare, the NHS and society by reducing hospitalisations and costs.
It aligns with the NHS long term plan of moving the focus away from hospital care to being cared for in the community – and the NHSE priority to reduce cancer risk as people with liver disease are at much higher risk of developing liver cancer. So our aim is for this to become national policy.
