FIB-4 Index

When it activates

Scribeable activates a calculator from the encounter. The FIB-4 Index can activate when the transcript or pasted chart context documents any of these:

• Chronic liver disease evaluation
• NAFLD/NASH assessment
• Hepatitis fibrosis staging
• Elevated liver enzymes workup

Note-type scope: it activates on notes whose subject resolves to hepatology, gi, hospital medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.

Inputs the note needs

4 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

FIB-4 = (Age x AST) / (Platelets x sqrt(ALT))

Interpretation

<1.45: Low risk (F0-F1), continue monitoring. 1.45-3.25: Intermediate (F2-F3). >3.25: Advanced fibrosis/cirrhosis, consider biopsy.

Evidence

Sources carried in Scribeable's citation registry for this calculator.

• Sterling RK et al. Development of a simple noninvasive index to predict significant fibrosis (FIB-4)Sterling et al. (FIB-4) 2006 · 2006 · link last verified 2026-03-23

How Scribeable handles it in the note

When an encounter activates the FIB-4 Index (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a FIB-4 Index value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.

Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.

Related calculators

• Child-Pugh ScoreClassifies cirrhosis severity and prognosis
• MELD-Na ScoreQuantifies end-stage liver disease severity for transplant prioritization
• Maddrey's Discriminant FunctionQuantifies severity of alcoholic hepatitis and identifies patients who may benefit from corticosteroid therapy
• Glasgow Alcoholic Hepatitis ScoreAlternative severity score for alcoholic hepatitis that identifies patients likely to benefit from corticosteroid therapy
• Lille ModelPredicts response to corticosteroid therapy at day 7 in severe alcoholic hepatitis; identifies non-responders who should stop steroids
• BISAP ScorePredicts mortality in acute pancreatitis within 24 hours of presentation using readily available parameters

Can activate in: Internal Medicine, Primary Care, Gastroenterology, Hospital Medicine.