Clinical recommendation	Evidence rating	References
Although no laboratory test can diagnose cirrhosis accurately, liver function tests, a complete blood count with platelets, and a prothrombin time test should be performed if a liver abnormality is suspected.	C	14
If clinical, laboratory, and radiographic data are inconclusive, but suspicion of cirrhosis remains, a diagnostic liver biopsy should be performed.	C	15,17
If serum transaminase levels are greater than twice the upper limit of normal or remain elevated for longer than six months, additional serologic studies should be performed to evaluate for various etiologies of cirrhosis. If clinical suspicion for liver disease is high, further serologic work-up is warranted earlier.	C	15
Abdominal ultrasonography is a specific, reliable, noninvasive, fast, and cost-effective test that should be used as a first-line radiographic study for diagnosing cirrhosis.	C	20,21