Performance against standards in the overall cohort
| Audit standard | All cases % | Standard met | % in individual centres (median (range)) | Number of centres meeting standard (%) |
| Treatment | ||||
| a) ≥90% of symptomatic patients start prednisolone* within 4 months of diagnosis | 92 | ✓ | 92 (33–100) | 19 (68) |
| b) ≥90% steroids continued ≥1 year† | 75 | ✗ | 76 (33–92) | 3 (11) |
| c) ≥80% adequate blood monitoring‡ | 74 | ✗ | 79 (3–100) | 14 (50) |
| d) ≥90% attain normal serum ALT by 1 year after start of treatment§ | 82 | ✗ | 83 (38–100) | 7 (25) |
| e) ≥80% clinically decompensated patients who did not improve on treatment were discussed with a transplant team | 95 | ✓ | 100 (80–100) | 25 (100)¶ |
| Follow-up | ||||
| f) ≥60% of those re-biopsied attain histological remission | 37 | ✗ | 35 (0–70) | 2 (8)¶ |
| g) ≥75% do not develop de-novo cirrhosis | 93 | ✓ | 95 (71–100) | 27 (96) |
| h) ≤21% new clinical decompensation | 3 | ✓ | 3 (0–10) | 27 (96) |
*Or equivalent (budesonide/methylprednisolone or hydrocortisone).
†In those followed up ≥1 year.
‡Liver blood tests documented in the first year at 3, 6 and 12 months adjusted for length of follow-up.
§In those with ≥12 months follow-up after treatment started and date of first normal ALT is known.
¶25of the 28 centres had decompensated patients or performed follow-up liver biopsies.
ALT, alanine aminotransferase.