Identifying the patients with compensated advanced chronic liver disease (cACLD) who are at risk for clinical decompensation is a goal of clinical management [1]. Early detection of those at risk for liver decompensation to target clinical intervention is crucial for reducing mortality, decreasing healthcare costs, and improving quality of life. Staging of liver fibrosis by liver biopsy and measurement of portal pressure by hepatic venous pressure gradient correlate with risk for clinical outcome [2,3], however, both tests are invasive, carry risk for complications, and are not embraced by patients.
