Table 1.
Tests capable of satisfactorily excluding/diagnosing significant fibrosis (negative and positive likelihood ratios <0.25 and >5.0, respectively)
| Excluding significant fibrosis
| ||||
|---|---|---|---|---|
| Biomarkers | Cut-off | Sensitivity | Specificity | Negative likelihood |
| APRI39 | ≤0.36 | 95% | 27% | 0.18 |
| Forn’s Index42 | <4.2 | 94% | 51% | 0.12 |
| Fibroindex43 | <1.25 | 94% | 40% | 0.14 |
| Fibrotest44 | <0.22 | 89% | 53% | 0.21 |
| Fibrometer45 | <0.44 | 81% | 74% | 0.25 |
| ELF46 | <9.39 | 90% | 55% | 0.19 |
|
| ||||
| Elastography | ||||
|
| ||||
| Fibroscan47 | <5.2 kPa | 97% | 35% | 0.09 |
| 2D-SWE48 | <7.1 kPa | 90% | 89% | 0.11 |
| pSWE (ARFI)49 | <1.21 m/s | 86% | 70% | 0.17 |
|
| ||||
| Combination | ||||
|
| ||||
| APRI+Fibrotest44 | <0.5 and <0.22 | 88% | 96% | 0.12 |
| Fibrotest+Fibroscan50 | <0.48 and <7.1 kPa | 88% | 89% | 0.14 |
| APRI+MP344 | <1.0 and <0.30 | 88% | 86 | 0.20 |
|
| ||||
| Diagnosing significant fibrosis | ||||
|
| ||||
| Biomarkers | Cut-off | Sensitivity | Specificity | Positive likelihood |
|
| ||||
| APRI43 | >0.85 | 37% | 95% | 7.4 |
| FPI51 | >0.8 | 43% | 94% | 7.2 |
| Fibrotest52 | >0.48 | 75% | 85% | 5.0 |
| Fibroindex43 | >2.25 | 30% | 97% | 10.0 |
| Forn’s Index42 | >6.9 | 36% | 94% | 6.5 |
| Hepascore53 | >0.5 | 63% | 89% | 5.7 |
| MP354 | >0.40 | 35% | 96% | 8.75 |
|
| ||||
| Elastography | ||||
|
| ||||
| Fibroscan55 | >7.1 kPa | 67% | 89% | 6.1 |
| 2D-SWE48 | >7.1 kPa | 90% | 89% | 7.2 |
| pSWE (ARFI)56 | >1.34 m/s | 68% | 93% | 9.7 |
|
| ||||
| Combination | ||||
|
| ||||
| Fibrotest+Fibroscan50 | >0.48 and >7.1 kPa | 85% | 97% | 7.8 |
| APRI+Fibroscan57 | >1.5 and >7.1 kPa | 67% | 89% | 6.3 |
Note: Information was based on individual studies compiled; no head-to-head comparisons were made. Tests and components: APRI: AST, platelets; Forn’s index: Platelets, age, GGT, Total Cholesterol; Fibroindex: Platelets, AST, gamma globulin; Fibrotest®: Age, Total Bilirubin, GGT, Alfa2-macroglobulin, Haptoglobin, Apolipoprotein A1; Fibrometer®: Gender, Prothrombin time, GGT, Urea, Alfa2-macroglobulin, hyaluronate; ELF (Enhanced Liver Fibrosis score®): PIIMP, TIMP-1 and Hyaluronate; Hepascore®: Gender, GGT, Total Bilirubin, Hyaluronate, Alfa2-macroglobulin; MP3: PIIIMP and MMP-1; FPI: Age, AST, Total Cholesterol, insulin resistance, alcohol intake.
Abbreviations: 2D-SWE, two-dimensional shear-wave elastography; APRI, AST to platelet ratio index; AST, aspartate aminotransferase; ELF, enhanced liver fibrosis; FPI, fibrosis probability index; GGT, gamma glutamyl transferase; MMP-1, metalloproteinase 1; PIIMP, N-terminal propeptide from type II collagen; pSWE (ARFI), point shear-wave elastography (acoustic radiation force impulse); TIMP-1, tissue inhibitor of metalloproteinase I.