Enhanced liver fibrosis (ELF) score: Reference ranges, biological variation in healthy subjects, and analytical considerations.

•The reference range of the ELF score (7.14–9.55) overlap with the common range of moderate fibrosis.•In contrast to hyaluronic acid, the ELF score revealed low within-subject and between-subject biological variation.•During monitoring, a change of 10% in the ELF score was recognized as significant.•The analytical performance of components of the ELF score was excellent.