Original Title: Utilisation judicieuse des analyses biomédicales – Dosage de l’aspartate aminotransférase (AST) pour l’investigation d’une atteinte hépatique

Authors' objectives: The testing of aspartate aminotransferase (AST) raises several issues concerning its relevance, and the appropriateness of its use in the investigation of liver injury is limited. In Québec, a decreasing trend in the use of AST testing has been observed since the original INESSS report on the topic published in 2014. The objective of this work is to develop a guidance sheet to support appropriate use, in order to reduce the volume of procedures with low added value within Québec’s healthcare system.

Authors' results and conclusions: RESULTS (#1 AST TESTING IS NOT INDICATED:): • for routine screening in the general population; • for the detection of non-alcoholic liver disease; (#2 AST TESTING MAY BE INDICATED): • for calculating fibrosis scores (e.g., FIB-4, NFS, APRI) in the assessment of the risk of liver fibrosis, if the results could modify clinical management; • during the initial investigation of: - alcohol-related liver disease; - abdominal pain in pregnant women (e.g., suspected preeclampsia); - suspected non-accidental trauma in children; • in the case of a drug intoxication (e.g., with acetaminophen); • during certain chemotherapies for the purpose of drug toxicity adjustment. CONCLUSION: The guidance sheet that was developed aims to engage, guide, and support healthcare professionals in promoting the appropriate use of AST testing. It may thus contribute to reduce the number of annual test requests and associated costs and workload, while also generating a positive environmental impact.

Authors' methods: A review of the literature on indications and recommendations related to AST testing was conducted using INESSS’s rapid review methodology. Healthcare professionals provided experiential and contextual knowledge specific to Québec.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/utilisation-judicieuse-des-analyses-biomedicales.html

Year Published: 2025

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Technologies/Analyses_Biomed_AST_GN_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)