Rebecca Harris1, Timothy R Card2, Toby Delahooke3, Guruprasad P Aithal1,4, I Neil Guha1,4. 1. National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, UK. 2. Division of Epidemiology and Public Health, University of Nottingham, UK. 3. Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK. 4. Nottingham Digestive Diseases Centre, University of Nottingham, UK.
Abstract
BACKGROUND: Transient elastography is a non-invasive tool which can stratify patients at risk of chronic liver disease. However, a raised body mass index has been independently associated with a failed or unreliable examination. OBJECTIVE: The purpose of this study was to analyse the performance of two probes (M/XL) on a portable transient elastography device within an obese community population. METHOD: The method involved a prospective study with recruitment from a primary care practice. Patients identified with a risk factor for chronic liver disease were invited to a community-based risk stratification pathway for transient elastography readings with both probes. A threshold of ≥8.0 kPa defined elevated liver stiffness. RESULTS: A total of 477 patients attended the pathway. Of the patients, 21% had no valid measurements with the M probe. There was a significant difference between the probes in the proportion achieving ≥10 valid readings (M versus XL probe: 66.2% versus 90.2%; p ≤ 0.001) and in their reliability (M versus XL probe: 77.4% versus 98.5%; p = 0.028). Unreliable readings with the M probe increased as the body mass index increased. The XL probe re-stratified 5.2% of patients to have a normal reading. CONCLUSION: The XL probe on a portable device significantly improves the applicability of transient elastography within a community-based risk stratification pathway.
BACKGROUND: Transient elastography is a non-invasive tool which can stratify patients at risk of chronic liver disease. However, a raised body mass index has been independently associated with a failed or unreliable examination. OBJECTIVE: The purpose of this study was to analyse the performance of two probes (M/XL) on a portable transient elastography device within an obese community population. METHOD: The method involved a prospective study with recruitment from a primary care practice. Patients identified with a risk factor for chronic liver disease were invited to a community-based risk stratification pathway for transient elastography readings with both probes. A threshold of ≥8.0 kPa defined elevated liver stiffness. RESULTS: A total of 477 patients attended the pathway. Of the patients, 21% had no valid measurements with the M probe. There was a significant difference between the probes in the proportion achieving ≥10 valid readings (M versus XL probe: 66.2% versus 90.2%; p ≤ 0.001) and in their reliability (M versus XL probe: 77.4% versus 98.5%; p = 0.028). Unreliable readings with the M probe increased as the body mass index increased. The XL probe re-stratified 5.2% of patients to have a normal reading. CONCLUSION: The XL probe on a portable device significantly improves the applicability of transient elastography within a community-based risk stratification pathway.
Authors: Belinda K Moessner; Tina R Jørgensen; Merete Skamling; Mogens Vyberg; Peter Junker; Court Pedersen; Peer B Christensen Journal: Addiction Date: 2010-12-23 Impact factor: 6.526
Authors: Seng Chan You; Kwang Joon Kim; Seung Up Kim; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Won Jae Lee; Kwang-Hyub Han Journal: World J Gastroenterol Date: 2015-01-28 Impact factor: 5.742
Authors: Raj Vuppalanchi; Mohammad S Siddiqui; Mark L Van Natta; Erin Hallinan; Danielle Brandman; Kris Kowdley; Brent A Neuschwander-Tetri; Rohit Loomba; Srinivas Dasarathy; Manal Abdelmalek; Edward Doo; James A Tonascia; David E Kleiner; Arun J Sanyal; Naga Chalasani Journal: Hepatology Date: 2017-11-29 Impact factor: 17.425
Authors: David J Harman; Stephen D Ryder; Martin W James; Matthew Jelpke; Dominic S Ottey; Emilie A Wilkes; Timothy R Card; Guruprasad P Aithal; Indra Neil Guha Journal: BMJ Open Date: 2015-05-03 Impact factor: 2.692
Authors: Dina Mansour; Allison Grapes; Marc Herscovitz; Paul Cassidy; Jonathan Vernazza; Andrea Broad; Quentin M Anstee; Stuart McPherson Journal: JHEP Rep Date: 2021-04-22