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Although liver biopsy as an assessment of fibrosis has become the key biomarker of and target for new therapies, it is invasive and subject to sampling error, and cannot quantify metabolic function or porto\u2010systemic shunting. Measurement of the hepatic venous pressure gradient accommodates some of the deficiencies of biopsy but requires expertise not widely available and misses minor changes in hepatocellular mass and thereby information about metabolic function. Thus, an unmet need in clinical hepatology remains unfulfilled: a noninvasive biomarker which quantitates both the hepatocellular insufficiency and porto\u2010systemic shunting inherent in progressive hepatic fibrosis. Ideally, such a biomarker should correlate with clinical endpoints including liver\u2010related survival and cirrhotic complications, be performed at the point\u2010of\u2010care, and be affordable and easy to use. This review, an expert opinion, summarizes background and recent data suggesting that metabolic breath tests may now meet these requirements and have a valid place in clinical hepatology to supplant the time\u2010honoured assessment of hepatic fibrosis.<\/jats:p>","DOI":"10.1111\/liv.13268","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T06:45:03Z","timestamp":1476341103000},"page":"328-336","source":"Crossref","is-referenced-by-count":15,"title":["Potential use of metabolic breath tests to assess liver disease and prognosis: has the time arrived for routine use in the clinic?"],"prefix":"10.1111","volume":"37","author":[{"given":"R. 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