Table 3. Performance of NAFLD screening scores: development and external validation datasets.
Method, by Dataset | High risk(%) | Sensitivity | Specificity | PPV | NPV | Positive | Negative | Youden | AUC* | RequiresClinician’sInput? |
LR | LR | Index | ||||||||
Development dataset (N = 15676) | ||||||||||
Comprehensive score (male) ≥40 | 43 | 69 | 84 | 82 | 72 | 4.46 | 0.36 | 54 | 0.86 | Yes |
Comprehensive score (female) ≥40 | 29 | 72 | 89 | 73 | 88 | 6.50 | 0.31 | 61 | 0.90 | Yes |
Simple score (male) ≥8 | 58 | 80 | 67 | 72 | 76 | 2.41 | 0.29 | 47 | 0.82 | No |
Simple score (female) ≥8 | 36 | 77 | 81 | 63 | 89 | 4.09 | 0.28 | 58 | 0.87 | No |
Park’s index* | 41 | 72 | 81 | 73 | 80 | 3.84 | 0.35 | 53 | 0.83 | Yes |
Hepatic steatosis index* | 20 | 41 | 95 | 85 | 70 | 7.91 | 0.62 | 36 | 0.85 | Yes |
Fatty liver index* | 12 | 26 | 98 | 89 | 65 | 11.09 | 0.76 | 23 | 0.86 | Yes |
NAFLD liver fat score* , ‡ | 19 | 37 | 94 | 81 | 68 | 6.26 | 0.67 | 31 | 0.77 | Yes |
External validation dataset (N = 66868) | ||||||||||
Comprehensive score (male)† ≥40 | 37 | 67 | 85 | 76 | 77 | 4.32 | 0.39 | 52 | 0.85 | Yes |
Comprehensive score (female)† ≥40 | 20 | 71 | 88 | 49 | 95 | 6.13 | 0.33 | 59 | 0.89 | Yes |
Simple score (male)† ≥8 | 49 | 75 | 71 | 66 | 79 | 2.53 | 0.36 | 45 | 0.80 | No |
Simple score (female)† ≥8 | 22 | 68 | 85 | 42 | 94 | 4.57 | 0.38 | 54 | 0.85 | No |
Park’s index* | 38 | 76 | 78 | 59 | 89 | 3.44 | 0.30 | 54 | 0.84 | Yes |
Hepatic steatosis index* | 21 | 52 | 92 | 74 | 82 | 6.56 | 0.52 | 44 | 0.86 | Yes |
Fatty liver index* | 11 | 30 | 97 | 82 | 76 | 10.77 | 0.72 | 27 | 0.87 | Yes |
NAFLD liver fat score* , ‡ | 16 | 40 | 94 | 75 | 79 | 6.96 | 0.63 | 35 | 0.82 | Yes |
*The definition of the above risk models for NAFLD.
Park’s index for NAFLD: index ≥3, in which Park’s index = (ALT/AST ratio >1.5)×1+(γ-glutamyl-transferase >50)×1+(triglycerides >150)×1+(23≤ BMI <25)×2+(25≤ BMI)×3.
Hepatic steatosis index (HSI): HSI >36 for high-risk and <30 for no NAFLD, in which HSI = 8×ALT/AST ratio+BMI (+2, if diabetes;+2, if female).
Fatty liver index (FLI): FLI ≥60 for high-risk and <30 for no NAFLD, in which FLI = 1/(1+exp(−x))×100, where x = 0.953×loge (triglycerides)+0.139×BMI+0.718×loge (γ-glutamyl-transferase)+0.053×WC −15.745.
NAFLD liver fat score: score ≥−0.640, in which NAFLD liver fat score = −2.89+1.18×metabolic syndrome+0.45×diabetes+0.15×fasting insulin+0.04×AST+0.94×AST/ALT ratio.
After imputing the missing data for alcohol consumption and menopausal status.
After imputing the missing data of fasting insulin levels.