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. Author manuscript; available in PMC: 2022 Nov 23.
Published in final edited form as: Hepatology. 2021 Dec 15;75(3):661–672. doi: 10.1002/hep.32145

FIGURE 3.

FIGURE 3

A two-step screening strategy for significant fibrosis by MEFIB and the summary of the diagnostic ability of MEFIB. As a first screening step in a primary care center, FIB-4 could be applied for the first screening as a readily available blood-based test. Patients with FIB-4 < 1.6 need no further examination, and patients with FIB-4 ≥ 1.6 need a further examination at a referral care center. As a second step, MRE could be applied. Patients with the MEFIB rule-in criteria (MRE ≥ 3.3 kPa and FIB-4 ≥ 1.6) have a high PPV for significant fibrosis (95%) and are good candidates for clinical trials. Furthermore, patients with the MEFIB rule-out criteria (MRE < 3.3 kPa and FIB-4 < 1.6) have a high NPV (90%) for significant fibrosis (PPV for nonsignificant fibrosis), and these patients could be followed up by a repeat blood-based test (FIB-4)