Evidence map›Paper›PMID 25086193›Full record

ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2015

Significant variations in elastometry measurements made within short-term in patients with chronic liver diseases.

Fabio Nascimbeni, Pascal Lebray, Larysa Fedchuk, Claudia P Oliveira, Mario Reis Alvares-da-Silva, Anne Varault, Patrick Ingiliz, Yen Ngo, Mercedes de Torres, Mona Munteanu and 3 more

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PubMed Publisher
In one paragraph

Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
7.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 80 citations in OpenAlex.

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  18. Nonalcoholic fatty liver disease: Evolving paradigms.World journal of gastroenterology · 2017
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Fabio NascimbeniUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Pascal LebrayUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Larysa FedchukUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Claudia P OliveiraDepartment of Gastroenterology, Clinical Division (LIM-07), University of São Paulo School of Medicine, Sao Paulo, Brazil.
Mario Reis Alvares-da-SilvaSchool of Medicine, Universidade Federal do Rio Grande do Sul, Division of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Anne VaraultUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Patrick IngilizUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Yen NgoBioPredictive, Paris, France.
Mercedes de TorresUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Mona MunteanuBioPredictive, Paris, France.
Thierry PoynardUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France.
Vlad RatziuUniversité Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, INSERM U938, CdR Saint-Antoine, Paris, France. Electronic address: vlad.ratziu@upmc.fr.
LIDO Study Group
Inserm · FRBiopredic (France) · FRUniversidade de São Paulo · BRUniversidade Federal do Rio Grande do Sul · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsTransient elastometry is a noninvasive procedure used to measure fibrosis when patients are diagnosed with liver disease; it might be used to monitor changes over time. We investigated whether there are short-term variations in stiffness measurements that are not attributable to changes in fibrosis by studying patients with stable liver disease.

methodsWe performed a retrospective analysis of 531 paired liver stiffness measurements made by Fibroscan when the study began (LSM1) and at follow-up (LSM2), more than 1 day and less than 1 year apart, from 432 stable (for body mass index, waist circumference, and alcohol consumption), untreated, immunocompetent patients with chronic liver disease (from January 2006 through March 2009). Variations between the first and follow-up measurements were expressed as absolute (LSM2-LSM1, kPa) or relative ([LSM2-LSM1]/LSM1*100) or as changes in fibrosis stage.

resultsThere was >20% variation in 49.7%, >30% in 34.3%, and >50% in 12.2% of paired measurements; this variation was constant across the spectrum of LSM1 values. The variations produced a 1-fibrosis stage difference in 31.5% of pairs and a ≥ 2-stage difference in 9.8% of pairs. Patients with LSM1 >7 kPa had increased probability of having a different stage of fibrosis at LSM2, compared with patients with LSM1 <7 kPa. Factors associated with variation included measurements made by 2 different operators or at least 1 non-senior operator, ratios of interquartile range:median values, significant fibrosis (≥ 7 kPa) at LSM1, baseline body mass index, or a 2-fold difference in level of alanine aminotransferase between measurements. When the analyses were restricted to measurements made by the same operator, the variation was slightly reduced; fibrosis stage differed between measurements for only 34.3% of cases.

conclusionsOperator-related and patient-related factors produce significant variations in liver stiffness measurements made by transient elastometry, limiting its use in monitoring patients. These variations are unrelated to disease progression. The lowest levels of variation occur in measurements made in patients with no or early-stage fibrosis or by a single experienced operator.

Indexed as

AdultAgedChronic DiseaseElasticity Imaging TechniquesFemaleFollow-Up StudiesHumansLiver CirrhosisMaleMiddle AgedReproducibility of ResultsRetrospective StudiesALTBMICirrhosisDisease ProgressionLiver Fibrosis Markers

Identifiers

PMID25086193
OpenAlexW2095851283

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.