A novel 2-step approach combining the NAFLD fibrosis score and liver stiffness measurement for predicting advanced fibrosis

Hepatology International
Wah-Kheong ChanSanjiv Mahadeva

Abstract

The non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS) is indeterminate in a proportion of NAFLD patients. Combining the NFS with liver stiffness measurement (LSM) may improve prediction of advanced fibrosis. We aim to evaluate the NFS and LSM in predicting advanced fibrosis in NAFLD patients. The NFS was calculated and LSM obtained for consecutive adult NAFLD patients scheduled for liver biopsy. The accuracy of predicting advanced fibrosis using either modality and in combination were assessed. An algorithm combining the NFS and LSM was developed from a training cohort and subsequently tested in a validation cohort. There were 101 and 46 patients in the training and validation cohort, respectively. In the training cohort, the percentages of misclassifications using the NFS alone, LSM alone, LSM alone (with grey zone), both tests for all patients and a 2-step approach using LSM only for patients with indeterminate and high NFS were 5.0, 28.7, 2.0, 2.0 and 4.0 %, respectively. The percentages of patients requiring liver biopsy were 30.7, 0, 36.6, 36.6 and 18.8 %, respectively. In the validation cohort, the percentages of misclassifications were 8.7, 28.3, 2.2, 2.2 and 8.7 %, respectively. The percentages of patients ...Continue Reading

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Citations

Mar 20, 2015·Hepatology International·Grace Lai-Hung Wong, Henry Lik-Yuen Chan
Aug 1, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sumeet K Asrani
Jun 1, 2017·The Nurse Practitioner·Jessica Wisocky, Sonali Paul
Feb 22, 2018·Nature Reviews. Gastroenterology & Hepatology·Elliot B Tapper, Rohit Loomba
Mar 8, 2018·Alimentary Pharmacology & Therapeutics·W-K ChanUNKNOWN GO ASIA Initiative
Jul 4, 2017·Journal of Gastroenterology and Hepatology·Vincent Wai-Sun WongGeoff Farrell
Jun 12, 2018·Journal of Gastroenterology and Hepatology·Jeremy Chak-Lun ChowVincent Wai-Sun Wong
Dec 7, 2018·Journal of Gastroenterology and Hepatology·Wataru TomenoAtsushi Nakajima
May 31, 2018·Nature Reviews. Gastroenterology & Hepatology·Vincent Wai-Sun WongSilvia Sookoian
Jun 26, 2018·The American Journal of Gastroenterology·Masato YonedaAtsushi Nakajima
May 8, 2019·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Eugene Choon-Li TanSanjiv Mahadeva
Jun 11, 2020·International Journal of Molecular Sciences·Yasushi HondaAtsushi Nakajima
Feb 15, 2021·Clinical Therapeutics·Shannon Kogachi, Mazen Noureddin
Feb 3, 2021·Clinical Therapeutics·Wei-Kei Wong, Wah-Kheong Chan
Mar 12, 2021·Clinical and Translational Gastroenterology·Feng GaoMing-Hua Zheng
May 16, 2021·Journal of Hepatology·Emmanuel Anandraj SelvarajUNKNOWN LITMUS Investigators
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Aug 18, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Manik AggarwalArthur McCullough

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