Complex non-invasive fibrosis models are more accurate than simple models in non-alcoholic fatty liver disease

Background and Aim:  Significant hepatic fibrosis is prognostic of liver morbidity and mortality in non‐alcoholic fatty liver disease (NAFLD); however, it remains unclear whether non‐invasive fibrosis models can determine this end‐point. We therefore compared the accuracy of simple bedside versus co...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2011-10, Vol.26 (10), p.1536-1543
Main Authors: Adams, Leon A, George, Jacob, Bugianesi, Elisabetta, Rossi, Enrico, De Boer, W Bastiaan, van der Poorten, David, Ching, Helena L I, Bulsara, Max, Jeffrey, Gary P
Format: Article
Language:English
Subjects:
accuracy
Adult
Age Factors
Algorithms
Analysis of Variance
Biological and medical sciences
Biomarkers - blood
Biopsy
Body Mass Index
Digestive system
Fatty Liver - complications
Fatty Liver - diagnosis
Fatty Liver - pathology
Female
fibrosis
Gastroenterology. Liver. Pancreas. Abdomen
Health Status Indicators
Humans
Investigative techniques, diagnostic techniques (general aspects)
Italy
Likelihood Functions
Linear Models
Liver - pathology
liver biopsy
Liver Cirrhosis - diagnosis
Liver Cirrhosis - etiology
Liver Cirrhosis - pathology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Models, Biological
New South Wales
Non-alcoholic Fatty Liver Disease
Other diseases. Semiology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Platelet Count
Predictive Value of Tests
Prognosis
ROC Curve
Severity of Illness Index
Sex Factors
Western Australia
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Summary:Background and Aim:  Significant hepatic fibrosis is prognostic of liver morbidity and mortality in non‐alcoholic fatty liver disease (NAFLD); however, it remains unclear whether non‐invasive fibrosis models can determine this end‐point. We therefore compared the accuracy of simple bedside versus complex fibrosis models across a range of fibrosis in a multi‐centre NAFLD cohort. Methods:  Simple (APRI, BARD) and complex (Hepascore, Fibrotest, FIB4) fibrosis models were calculated in 242 NAFLD subjects undergoing liver biopsy. Significant (F2‐4) and advanced fibrosis (F3,4) were defined using Kleiner criteria. Models were compared using area under the receiver operator characteristic curves (AUC). Cut‐offs were determined by Youden Index or 90% predictive values. Results:  For significant fibrosis, non‐invasive fibrosis models had modest accuracy (AUC 0.707–0.743) with BARD being least accurate (AUC 0.609, P 
ISSN:0815-9319
1440-1746
DOI:10.1111/j.1440-1746.2011.06774.x