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Should you be concerned about an elevated transaminase level in a patient with no symptoms of hepatic disease? What about an elevated bilirubin level? As Drs Kools and Bloomer explain, abnormal results occur in up to 5% of large populations undergoing liver function testing and can be caused by a variety of nonhepatic factors. They therefore recommend a cost-effective, noninvasive approach to evaluation, as outlined here in three simple algorithms.