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Detection of steatosis severity in chronic liver disease

The most recent issue of the Journal of Gastroenterology & Hepatology examines controlled attenuation parameter for the detection of steatosis severity in chronic liver disease.

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Controlled attenuation parameter is a novel ultrasound-based elastography method for detection of steatosis severity.

Professor Kai-Fu Tang and colleagues from China performed a meta-analysis to assess the performance of controlled attenuation parameter.

PubMed, the Cochrane Library, and the Web of Knowledge were searched to find studies, published in English, relating to accuracy evaluations of controlled attenuation parameter for detecting stage 1 (S1), stage 2 (S2), or stage 3 (S3) hepatic steatosis which was diagnosed by liver biopsy.

Sensitivities, specificities, and hierarchical summary receiver operating characteristic (HSROC) curves were used to examine controlled attenuation parameter performance.

The clinical utility of controlled attenuation parameter was also evaluated.

The summary sensitivities and specificities values were 0.78 for stage 1
Journal of Gastroenterology & Hepatology

The team identified 9 studies, with 11 cohorts.

The summary sensitivities and specificities values were 0.78 and 0.79 or ≥ S1, 0.85, and 0.79 for ≥ S2, and 0.83 and 0.79 for ≥ S3.

The research team found that the HSROCs were 0.85 for ≥ S1, 0.88 for ≥ S2, and 0.87 for ≥ S3.

Following a 'positive' measurement for ≥ S1, ≥ S2, and ≥ S3, the corresponding post-test probabilities for the presence of steatosis were 78%, 80% and 80%, respectively.

The team noted that if the values were below these thresholds, the post-test probabilities were 22%, 16%, and 17%, respectively.

Professor Tang's team commented, "Controlled attenuation parameter has good sensitivity and specificity for detecting hepatic steatosis."

"However, based on a meta-analysis, controlled attenuation parameter was limited in their accuracy of steatosis, which precluded widespread use in clinical practice."

J Gastroenterol Hepatol 2014: 29(6): 11491158
16 June 2014

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