Mozes, Ferenc E. and Lee, Jenny A. and Vali, Yasaman and Selvaraj, Emmanuel A. and Jayaswal, Arjun N. A. and Boursier, Jerome and de Ledinghen, Victor and Lupsor-Platon, Monica and Yilmaz, Yusuf and Chan, Wah-Kheong and Mahadeva, Sanjiv and Karlas, Thomas and Wiegand, Johannes and Tsochatzis, Emmanouil and Liguori, Antonio and Wong, Vincent Wai-Sun and Lee, Dae Ho and Holleboom, Adriaan G. and van Dijk, Anne-Marieke and Mak, Anne Linde and Hagstroem, Hannes and Akbari, Camilla and Hirooka, Masashi and Lee, Dong Hyeon and Kim, Won and Okanoue, Takeshi and Shima, Toshihide and Nakajima, Atsushi and Yoneda, Masato and Thuluvath, Paul J. and Li, Feng and Berzigotti, Annalisa and Mendoza, Yuly P. and Noureddin, Mazen and Truong, Emily and Fournier-Poizat, Celine and Geier, Andreas and Tuthill, Theresa and Yunis, Carla and Anstee, Quentin M. and Harrison, Stephen A. and Bossuyt, Patrick M. and Pavlides, Michael (2024) Diagnostic accuracy of non-invasive tests to screen for at-risk MASH-An individual participant data meta-analysis. Liver International, 44 (8). pp. 1872-1885. ISSN 1478-3223, DOI https://doi.org/10.1111/liv.15914.
Full text not available from this repository.Abstract
Background & Aims: There is a need to reduce the screen failure rate (SFR) in metabolic dysfunction-associated steatohepatitis (MASH) clinical trials (MASH+F2-3; MASH+F4) and identify people with high-risk MASH (MASH+F2-4) in clinical practice. We aimed to evaluate non-invasive tests (NITs) screening approaches for these target conditions. Methods: This was an individual participant data meta-analysis for the performance of NITs against liver biopsy for MASH+F2-4, MASH+F2-3 and MASH+F4. Index tests were the FibroScan-AST (FAST) score, liver stiffness measured using vibration-controlled transient elastography (LSM-VCTE), the fibrosis-4 score (FIB-4) and the NAFLD fibrosis score (NFS). Area under the receiver operating characteristics curve (AUROC) and thresholds including those that achieved 34% SFR were reported. Results: We included 2281 unique cases. The prevalence of MASH+F2-4, MASH+F2-3 and MASH+F4 was 31%, 24% and 7%, respectively. Area under the receiver operating characteristics curves for MASH+F2-4 were .78, .75, .68 and .57 for FAST, LSM-VCTE, FIB-4 and NFS. Area under the receiver operating characteristics curves for MASH+F2-3 were .73, .67, .60, .58 for FAST, LSM-VCTE, FIB-4 and NFS. Area under the receiver operating characteristics curves for MASH+F4 were .79, .84, .81, .76 for FAST, LSM-VCTE, FIB-4 and NFS. The sequential combination of FIB-4 and LSM-VCTE for the detection of MASH+F2-3 with threshold of .7 and 3.48, and 5.9 and 20 kPa achieved SFR of 67% and sensitivity of 60%, detecting 15 true positive cases from a theoretical group of 100 participants at the prevalence of 24%. Conclusions: Sequential combinations of NITs do not compromise diagnostic performance and may reduce resource utilisation through the need of fewer LSM-VCTE examinations.
| Item Type: | Article |
|---|---|
| Funders: | Innovative Medicines Initiative 2 |
| Uncontrolled Keywords: | at-risk MASH; FAST; FIB-4; LSM-VCTE; MASH; NFS; non-invasive tests |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 09 Jan 2025 01:42 |
| Last Modified: | 09 Jan 2025 01:42 |
| URI: | http://eprints.um.edu.my/id/eprint/46998 |
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