What is the CORE model and why it matters
Liver disease is on the rise, and outcomes worsen when it is detected late. A new tool, known as the CORE model, has been developed to help primary care clinicians assess a patient’s risk of severe liver conditions before symptoms appear. By relying on three simple blood tests that are already part of routine checkups, the CORE model aims to estimate a person’s likelihood of developing cirrhosis or liver cancer within the next ten years, and to indicate whether a liver transplant might become necessary.
In a recent statement, Rickard Strandberg, an affiliated researcher at the Karolinska Institutet’s Department of Medicine in Huddinge, explained that this approach is designed for the setting where most people first seek care. He noted that the diseases addressed by CORE — including cirrhosis and liver cancer — have mounting prevalence and poor outcomes if discovered late. The model’s goal is to bring high-risk individuals into closer monitoring sooner, potentially changing the trajectory of their disease.
How the CORE model works
The CORE model does not require new or complex testing. Instead, it uses three standard blood tests whose results are already collected in busy primary care clinics. By combining these data points with demographic and clinical variables, the model generates a risk score that translates into a ten-year outlook for liver-related illness. Clinicians can use this score to decide whether a patient should receive intensified follow-up, liver imaging, lifestyle intervention, or referral to a hepatology or transplant team for further evaluation.
Because the tests are routine, the CORE approach has the potential to be integrated into existing workflows with minimal disruption. The emphasis is on early detection and proactive management, rather than relying on incidental findings or late presentations that limit treatment options.
Why this matters for patients and primary care
Early identification of patients at elevated risk can significantly alter outcomes. Cirrhosis and liver cancer are increasingly common and carry serious prognoses when treatment is delayed. A ten-year risk estimate gives clinicians a practical horizon for discussing lifestyle changes—such as reduced alcohol use, weight management, and vaccination against hepatitis—and for planning surveillance strategies that can catch disease at a more treatable stage.
For patients, a clear, data-driven risk assessment can reduce uncertainty about symptoms that might otherwise prompt urgent visits or hospitalizations. For busy primary care teams, CORE offers a structured method to prioritize care, ensuring that those most at risk receive timely specialist input and monitoring while avoiding unnecessary testing for low-risk individuals.
Implementation in primary care
Adopting the CORE model involves incorporating its risk calculation into routine patient encounters. Clinicians would review the three blood-test results alongside standard clinical data and ask patients about risk-modifying behaviors, alcohol use, metabolic health, and family history. When the score indicates higher risk, clinicians can tailor follow-up intervals, order liver imaging or ultrasound as indicated, and coordinate care with hepatology or transplantation services as needed.
Successful implementation depends on training, clear referral pathways, and collaboration with laboratory services to ensure consistency of test results. Health systems may also need to address data privacy and patient consent when using predictive risk tools in shared decision-making.
Limitations and future directions
While promising, the CORE model is not a stand-alone diagnostic. It is a risk stratification tool intended to guide, not replace, clinical judgement. Further external validation in diverse populations is essential to confirm accuracy across age groups, ethnicities, and comorbidity profiles. Researchers are also exploring calibration to different healthcare settings and the potential integration with imaging or novel biomarkers as part of a stepwise diagnostic pathway.
Public health implications and the road ahead
As liver disease incidence rises, tools like CORE could help shift care from reactive treatment to proactive prevention. If validated and broadly adopted, it may reduce late-stage disease presentation, improve survival odds, and optimize resource use within primary care. The key next step is robust real-world testing, followed by guidelines that define how and when to act on CORE risk scores.
Conclusion
The CORE model embodies a practical approach to identifying people at elevated risk for serious liver disease using information already gathered in primary care. By supporting earlier intervention and targeted follow-up, this three-blood-test tool has the potential to change how liver disease is detected and managed at the point of first contact with the health system.
