Table 2.
Diagnostic accuracy of tests for fibrosis
| Fibrosis test (cutoff) | Number of samples | Sensitivity (median, range) | Specificity (median, range) | Positive likelihood ratio (median, range) | Negative likelihood ratio (median, range) |
|---|---|---|---|---|---|
| Platelets <140 to <163 |
8 |
0.56 (0.28–0.89) |
0.91 (0.69–1.0) |
6.3 (2.3–14) |
0.48 (0.16–0.78) |
| With additional data |
10a |
0.57 (0.28–0.89) |
0.91 (0.58–1.0) |
6.3 (1.64–35) |
0.48 (0.16–0.78) |
| API >3.5 or ≥4.0 |
5 |
0.70 (0.52–0.82) |
0.70 (0.51–0.77) |
2.3 (1.7–2.7) |
0.43 (0.34–0.67) |
| With additional data |
6a |
0.64 (0.52–0.82) |
0.69 (0.51–0.77) |
2.0 (1.7–2.7) |
0.53 (0.34–0.67) |
| API ≥6.0 |
5/3b |
0.51 (0.19–0.75) |
0.90 (0.58–0.96) |
5.1 (1.8
–
7.3) |
0.54 (0.43–0.94) |
| With additional data |
6a |
0.54 (0.19–0.75) |
0.88 (0.58–0.96) |
4.5 (1.4
–
7.3) |
0.52 (0.43–0.94) |
| APRI ≥0.5 to >0.55 |
28 |
0.81 (0.29–0.98) |
0.55 (0.10–0.94) |
1.8 (1.1–4.8) |
0.35 (0.08–0.78) |
| With additional data |
40c |
0.79 (0.29–0.98) |
0.56 (0.10–1.0) |
1.8 (1.0–7.5) |
0.56 (0.07–0.93) |
| AST: ALT ratio >1.0 |
5 |
0.35 (0.08–0.45) |
0.77 (0.62–1.0) |
1.5 (1.1–15) |
0.84 (0.84–0.98) |
| With additional data |
8a,c |
0.36 (0.08–0.59) |
0.80 (0.48–1.0) |
1.7 (1.1–14) |
0.81 (0.65–0.98) |
| ELF >8.75, >9.0, or >9.78 |
3 |
0.85 (0.84–0.86) |
0.70 (0.62–0.80) |
2.8 (2.3–4.2) |
0.21 (0.19–0.23) |
| With additional data |
3a |
0.84 (0.62–0.85) |
0.80 (0.70–0.86) |
4.2 (2.8–4.4) |
0.20 (0.19–0.45) |
| FIB-4 > 1.26 or ≥1.45 |
6 |
0.64 (0.62–0.86) |
0.68 (0.54–0.75) |
2.0 (0.88–2.6) |
0.53 (0.21–1.3) |
| With additional data |
9c |
0.64 (0.57–0.86) |
0.68 (0.28–0.85) |
2.0 (0.88–3.7) |
0.53 (0.21–1.3) |
| FIB-4 > 3.25 |
4 |
0.50 (0.28–0.86) |
0.79 (0.59–0.99) |
2.4 (1.3
–
28) |
0.63 (0.21–0.80) |
| With additional data |
7c |
0.28 (0.11–0.86) |
0.97 (0.59–1.0) |
9.3 (1.3
–
28) |
0.74 (0.21–0.89) |
| FibroIndex >1.25 |
3 |
0.94 (0.62–0.97) |
0.40 (0.40–0.48) |
1.6 (1.2–1.6) |
0.15 (0.08
–
0.79) |
| With additional data |
6c |
0.64 (0.54–0.97) |
0.57 (0.40–1.0) |
1.5 (1.2–2.2) |
0.62 (0.08
–
0.79) |
| FibroIndex >2.25 or ≥2.25 |
3 |
0.30 (0.17–0.36) |
0.97 (0.97–1.0) |
10,12,∞ |
0.72 (0.66–0.83) |
| With additional data |
4c |
0.24 (0.14–0.36) |
0.99 (0.97–1.0) |
10,12,∞ |
0.78 (0.66–0.87) |
| FibroMeter >0.419 to >0.59 |
3 |
0.69 (0.64–0.80) |
0.81 (0.76–0.81) |
3.6 (3.4–3.6) |
0.38 (0.26–0.44) |
| With additional data |
5c |
0.80 (0.64–0.87) |
0.76 (0.64–0.81) |
3.3 (2.4–3.6) |
0.26 (0.21–0.44) |
| FibroTest >0.10 to >0.22 |
6 |
0.92 (0.88–0.97) |
0.38 (0.27–0.56) |
1.5 (1.3–1.9) |
0.21 (0.11
–
0.28) |
| With additional data |
9c |
0.92 (0.64–0.98) |
0.46 (0.21–1.0) |
1.7 (1.2–2.2) |
0.17 (0.11
–
0.39) |
| FibroTest >0.70 or >0.80 |
5 |
0.22 (0.20–0.50) |
0.96 (0.95–0.98) |
5.5 (5.5–13) |
0.81 (0.53–0.82) |
| With additional data |
10a,c |
0.38 (0.20–0.94) |
0.95 (0.36–0.98) |
7.6 (1.4–13) |
0.65 (0.12–0.82) |
| Forns Index >4.2 to >4.57 |
14 |
0.88 (0.57–0.94) |
0.52 (0.20–0.77) |
1.8 (1.2–2.2) |
0.22 (0.12–0.64) |
| With additional data |
16a,c |
0.89 (0.42–0.94) |
0.51 (0.20–0.77) |
1.8 (0.54–2.2) |
0.23 (0.12–2.6) |
| Forns Index >6.9 |
10 |
0.36 (0.18–0.61) |
0.94 (0.66–1.0) |
6.5 (1.6–18) |
0.68 (0.56–0.92) |
| With additional data |
14c |
0.40 (0.18–0.81) |
0.95 (0.33–1.0) |
7.4 (1.2–18) |
0.63 (0.22–0.92) |
| Hepascore >0.46 to ≥0.55 |
5 |
0.66 (0.54–0.82) |
0.79 (0.65–0.86) |
3.1 (2.3–4.5) |
0.43 (0.28–0.55) |
| With additional data |
8c |
0.65 (0.54–0.82) |
0.80 (0.65–0.86) |
3.2 (2.3–4.5) |
0.44 (0.28–0.55) |
| Lok Index >0.17 or >0.20 |
0 |
NA |
NA |
NA |
NA |
| With additional data | 3c | 0.58 (0.48–0.82) | 0.80 (0.58–0.81) | 2.9 (2.0–3.1) | 0.53 (0.31–0.65) |
Values in italics indicate a change to above or below a cutoff of 5.0 for positive likelihood ratio or 0.20 for negative likelihood ratio.
ALT serum alanine aminotransferase, API age platelet index, APRI aspartate aminotransferase to platelet ratio index, AST aspartate aminotransferase, ELF enhanced liver fibrosis, NA not available.
aAdditional data for study(s) with discrepancy in reported data.
bThe first number is the number of samples for sensitivity/the second number is the number of samples for specificity.
cAdditional data for study(s) without 2 × 2 tables.