The factors that we identified on univariate analysis as being significantly associated with NILT accuracy (transaminases, BMI, platelet count, albumin and the presence of diabetes) are themselves components of NILT scores and are well known to be associated with an increased risk of advanced fibrosis.29 NILTs were designed and validated to identify patients with advanced fibrosis and it is therefore unsurprising that a NILT is more likely to be accurate if there is a priori evidence of advanced disease. Here, ALB is linked to diabetes mellitus.