Patients with chronic liver disease are often diagnosed during an index presentation to hospital with decompensated cirrhosis or liver-related events, and these presentations are associated with high mortality. However, there is often a long asymptomatic phase, in which there is an opportunity for earlier diagnosis and interventions to prevent progression to advanced disease. Therefore, strategies for early diagnosis and interventions (including behavioural changes and pharmacological treatments) that prevent patients progressing to cirrhosis and its associated complications probably have substantial benefits for patients and health-care services. Many community pathways have been generated. Some pathways focus on abnormal liver function tests as a starting point to diagnose liver disease. Other pathways target groups at greater risk of chronic liver disease—particularly people with harmful alcohol consumption, type 2 diabetes, and obesity. This systematic review summarises the existing strategies available for the early detection or risk stratification of liver disease, focusing primarily on alcohol-related liver disease and non-alcoholic fatty liver disease. Conducting randomised clinical trials that compare different strategies will be essential to elucidate which pathways are acceptable to patients, feasible, provide high diagnostic accuracy for the detection of liver disease, improve liver-related outcomes, and are most cost-effective at the population level.

慢性肝病患者通常在去医院就诊时被诊断为失代偿性肝硬化或肝脏相关事件，这些就诊与高死亡率相关。然而，通常有一个漫长的无症状阶段，在此期间有机会进行早期诊断和干预以防止进展为晚期疾病。因此，预防患者进展为肝硬化及其相关并发症的早期诊断和干预策略（包括行为改变和药物治疗）可能对患者和医疗保健服务具有重大益处。许多社区途径已经产生。一些途径将异常肝功能测试作为诊断肝病的起点。其他途径针对慢性肝病风险较高的人群，尤其是有害饮酒、2 型糖尿病和肥胖症的人群。本系统综述总结了可用于肝病早期检测或风险分层的现有策略，主要关注酒精相关性肝病和非酒精性脂肪肝。进行比较不同策略的随机临床试验对于阐明哪些途径是患者可以接受的、可行的、为肝病检测提供高诊断准确性、改善肝脏相关结果以及在人群水平上最具成本效益的途径至关重要。本系统综述总结了可用于肝病早期检测或风险分层的现有策略，主要关注酒精相关性肝病和非酒精性脂肪肝。进行比较不同策略的随机临床试验对于阐明哪些途径是患者可以接受的、可行的、为肝病检测提供高诊断准确性、改善肝脏相关结果以及在人群水平上最具成本效益的途径至关重要。本系统综述总结了可用于肝病早期检测或风险分层的现有策略，主要关注酒精相关性肝病和非酒精性脂肪肝。进行比较不同策略的随机临床试验对于阐明哪些途径是患者可以接受的、可行的、为肝病检测提供高诊断准确性、改善肝脏相关结果以及在人群水平上最具成本效益的途径至关重要。