July 15, 2014
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FibroTest yielded suboptimal accuracy in detecting significant fibrosis, cirrhosis

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FibroTest showed low accuracy in detecting significant fibrosis and cirrhosis among patients with chronic hepatitis B-related cirrhosis, according to results from a meta-analysis.

Nermin N. Salkic, MD, PhD, department of gastroenterology and hepatology, University Clinical Center Tuzla, Bosnia and Herzegovina, and colleagues included 16 studies with 2,494 patients after searching Medline, Embase and Cochrane Library databases. Studies were used in a hierarchical summary receiver operating curve model to determine the presence of liver fibrosis, while 13 of the studies (n=1,754) were included in a different hierarchical summary receiver operating curve model to assess liver cirrhosis.

Nermin N. Salkic

The AUC for significant liver fibrosis was 0.84 (95% CI, 0.78-0.88) and was 0.87 (95% CI, 0.85-0.9) in the studies for significant liver cirrhosis. At a FibroTest threshold of 0.74, the sensitivity, specificity and diagnostic odds ratio (DOR) for cirrhosis were 62 (47-75%), 91 (88-93%) and 15.7% (8.6-28.8), respectively. With a threshold of 0.48, the sensitivity, specificity and DOR of the FibroTest for significant fibrosis were 61 (48-72%), 80 (72-86%) and 6.2% (3.3-11.9), respectively.

In the fibrosis curve, strong heterogeneity among the studies was observed. Heterogeneity also was present among the cirrhosis curve, but in studies that used a FibroTest threshold less than 0.74, reduced heterogeneity occurred.

“FibroTest is of excellent utility for excluding cirrhosis in patients with chronic hepatitis B,” Salkic told Healio.com/Hepatology. “The diagnostic performance of FibroTest in detection of significant fibrosis and cirrhosis and exclusion of significant fibrosis is suboptimal. It is important for clinicians to adhere to the recommended thresholds of FibroTest until better ones are derived.”

Disclosure: The researchers report no relevant financial disclosures.