BACKGROUND AND STUDY AIMS: Fibroscan and APRI are promising noninvasive alternatives to liver biopsy for detecting hepatic fibrosis. However, their overall test performance in various settings remains questionable. The aim of our study was to perform a systematic review and meta-analysis of diagnostic accuracy studies comparing fibroscan and APRI with liver biopsy for hepatic fibrosis. PATIENTS AND METHODS: Electronic and manual bibliographic searches to identify potential studies were performed. Selection of studies was based on reported accuracy of fibroscan and APRI compared with liver biopsy. Data extraction was performed independently by two reviewers. Meta-analysis combined the sensitivities, specificities, and likelihood ratios of individual studies. Extent and reasons for heterogeneity were assessed. RESULTS: 23 studies for fibroscan and 20 studies for APRI in full publication were identified. For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of fibroscan were 83.4% (95% confidence interval [CI], 71.7-95.0%) and specificity 92.4% (95% CI, 85.6-99.2%). For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of APRI at cutoff point of 1.5 were 66.5% (95% CI, 25.0-100%) and specificity 71.7% (95% CI, 35.0-100%). Diagnostic threshold bias was identified as an important cause of heterogeneity for pooled results in both patient groups. CONCLUSIONS: Fibroscan and APRI appear to be clinically useful tests for detecting cirrhosis however not useful tools in early stages of fibrosis.
BACKGROUND AND STUDY AIMS: Fibroscan and APRI are promising noninvasive alternatives to liver biopsy for detecting hepatic fibrosis. However, their overall test performance in various settings remains questionable. The aim of our study was to perform a systematic review and meta-analysis of diagnostic accuracy studies comparing fibroscan and APRI with liver biopsy for hepatic fibrosis. PATIENTS AND METHODS: Electronic and manual bibliographic searches to identify potential studies were performed. Selection of studies was based on reported accuracy of fibroscan and APRI compared with liver biopsy. Data extraction was performed independently by two reviewers. Meta-analysis combined the sensitivities, specificities, and likelihood ratios of individual studies. Extent and reasons for heterogeneity were assessed. RESULTS: 23 studies for fibroscan and 20 studies for APRI in full publication were identified. For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of fibroscan were 83.4% (95% confidence interval [CI], 71.7-95.0%) and specificity 92.4% (95% CI, 85.6-99.2%). For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of APRI at cutoff point of 1.5 were 66.5% (95% CI, 25.0-100%) and specificity 71.7% (95% CI, 35.0-100%). Diagnostic threshold bias was identified as an important cause of heterogeneity for pooled results in both patient groups. CONCLUSIONS: Fibroscan and APRI appear to be clinically useful tests for detecting cirrhosis however not useful tools in early stages of fibrosis.
Authors: Amit G Singal; Jasmin A Tiro; Caitlin C Murphy; Jorge A Marrero; Katharine McCallister; Hannah Fullington; Caroline Mejias; Akbar K Waljee; Wendy Pechero Bishop; Noel O Santini; Ethan A Halm Journal: Hepatology Date: 2018-12-14 Impact factor: 17.425
Authors: Amit G Singal; Jasmin A Tiro; Jorge A Marrero; Katharine McCallister; Caroline Mejias; Brian Adamson; Wendy Pechero Bishop; Noel O Santini; Ethan A Halm Journal: Gastroenterology Date: 2016-11-05 Impact factor: 22.682
Authors: Victor G Valcour; Leah H Rubin; Mary U Obasi; Pauline M Maki; Marion G Peters; Susanna Levin; Howard A Crystal; Mary A Young; Wendy J Mack; Mardge H Cohen; Christopher B Pierce; Adaora A Adimora; Phyllis C Tien Journal: J Acquir Immune Defic Syndr Date: 2016-07-01 Impact factor: 3.731
Authors: Geraldine J Ooi; Paul R Burton; Lisa Doyle; John M Wentworth; Prithi S Bhathal; Ken Sikaris; Michael A Cowley; Stuart K Roberts; William Kemp; Paul E O'Brien; Wendy A Brown Journal: Obes Surg Date: 2017-01 Impact factor: 4.129