What role is there for use of ELF in patients with active alcohol use disorder for which Fibroscan is not able to give a reliable assessment of fibrosis due to ongoing active alcohol use?  

I generally find that Fibroscans are reliable when patients are actively drinking, unless the patient has acute alcohol associated hepatitis. I currently do not order ELF tests for patients with ALD unless a fibroscan and MR elastography are unable to be completed (habitus, claustrophobia, cost/insu...