The detection of fibrosis within nonalcoholic fatty liver disease is important for ascertaining prognosis and the stratification of patients for emerging therapeutic intervention.
Dr Indra Neil Guha and colleagues from the United Kingdom validated the Original European Liver Fibrosis panel and a simplified algorithm not containing age.
The Enhanced Liver fibrosis panel is an independent cohort of patients with nonalcoholic fatty liver disease.
|88% of liver biopsies could be avoided for diagnosis of severe fibrosis using the combined panel|
The team explored whether the addition of simple markers to the existing panel test could improve diagnostic performance.
The team included 196 consecutively recruited patients from 2 centers in the validation study.
The diagnostic accuracy of the discriminant scores of the Enhanced Liver fibrosis panel, simple markers, and a combined panel were compared using receiver operator curves, predictive values, and a clinical utility model.
The team found the Enhanced Liver fibrosis panel had an area under the curve of 0.90 for distinguishing severe fibrosis, 0.82 for moderate fibrosis, and 0.76 for no fibrosis.
Simplification of the algorithm by removing age did not alter diagnostic performance.
The team found that the addition of simple markers to the panel improved diagnostic performance with an area under the curve of 0.98 for the detection of fibrosis.
The research team noted that adding these markers improved diagnosis of moderate fibrosis and no fibrosis with area under the curves of 0.93 and 0.84, respectively.
The clinical utility model showed that 82% and 88% of liver biopsies could be potentially avoided for the diagnosis of severe fibrosis using Enhanced Liver fibrosis and the combined panel, respectively.
Dr Guha's team concluded, "The Enhanced Liver fibrosis panel has good diagnostic accuracy in an independent validation cohort of patients with nonalcoholic fatty liver disease."
"The addition of established simple markers augments the diagnostic performance across different stages of fibrosis."
"This will potentially allow superior stratification of patients with nonalcoholic fatty liver disease for emerging therapeutic strategies."