Later, the Royal Free Hospital (RFH) score was proposed in an observational study including 312 cirrhotic patients in ICU and it proved similar discriminative ability compared with SOFA and CLIF-SOFA and better than MELD score.[22] Another modified score for critically ill cirrhosis (MSCIC) including prothrombin time, bilirubin, vasopressin usage, HE and SIRS, was developed and demonstrated superior to CTP, MELD, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, and CLIF-SOFA.[23] However, the SIRS criteria within MSCIS were modified and it was also too complex to calculate. The gene discussed is F2; the disease is hereditary elliptocytosis.