Table 4. Screening for advanced liver fibrosis (LSM ≥8.0 kPa) using non-invasive fibrosis tests in the “at risk” subgroup of NAFLD with a valid fibroscan.
| Tests | N‡ | Cut-off | Se % (IC 95%) | Spe % (IC 95%) | PPV % (IC 95%) | NPV % (IC 95%) | Accuracy % | AUROC (IC 95%) | Patients with suspected AdLF on NITs&, n (%) | LSM ≥ 8 kPa among H-I NITs&, n (%) |
|---|---|---|---|---|---|---|---|---|---|---|
| NFS | 147 | ≥-1.455/0.12† | 70.0 (39.7–89.2) | 59.8 (51.5–67.7) | 11.3 (6.2–16.4) | 96.5 (93.5–99.5) | 60.5 (56.5–64.5) | 0.662 (0.446–0.805) | 62 (42.2) | 7 (11.3) |
| Forns | 149 | ≥4.2 | 100 (72.2–100) | 17.3 (11.9–24.4) | 8.0 (3.6–12.4) | 100 (1–1) | 22.8 (19.4–26.2) | 0.738 (0.555–0.853) | 125 (83.9) | 10 (8.0) |
| APRI | 148 | ≥0.5 | 30.0 (10.8–60.3) | 91.3 (85.4–94.9) | 20.0 (13.5–26.4) | 94.7 (91.1–98.3) | 87.2 (84.5–89.9) | 0.707 (0.451–0.855) | 15 (10.1) | 3 (20.0) |
| FIB-4 | 148 | ≥1.30/2.0† | 20.0 (5.7–51.0) | 77.5 (69.9–83.7) | 6.0 (2.2–9.8) | 93.0 (88.9–97.1) | 73.6 (70.0–77.2) | 0.687 (0.518–0.804) | 33 (22.3) | 2 (6.1) |
| eLIFT | 149 | ≥8 | 60.0 (31.2–83.2) | 70.5 (62.5–77.4) | 12.7 (7.3–18.0) | 96.1 (93.0–99.2) | 69.8 (66.0–73.6) | 0.743 (0.550–0.860) | 47 (31.5) | 6 (12.8) |
&: High and intermediate zones (H-I zones) of NFS, APRI, Forns and FIB-4 were grouped; patients in the H-I zones and those with eLIFT ≥ 8 had a suspected advanced liver fibrosis and were referred for liver stiffness measurement (LSM).
‡: Patients with at least one of the following conditions: elevated ALAT (n = 16, 10.7%), diabetes (n = 54, 36.2%), triglycerides ≥ 1.7 mmol/L (n = 55, 36.9%), BMI ≥ 25 kg/m2 (n = 135, 90.6%).
†: First cut-off for patients aged < 65 years, second cut-off for patients aged ≥65 years.
NITs, non-invasive fibrosis tests.