ArticleDigestive diseases and sciences2015
Accuracy of ultrasound and noninvasive markers of fibrosis to identify patients with cirrhosis.
Article in Digestive diseases and sciences, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 30 citations in OpenAlex.
- Barriers and facilitators to liver fibrosis screening: Perspectives and practices of Canadian primary care physicians.Canadian liver journal · 2025Article
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- Serum biomarkers for liver fibrosis assessment.Advances in laboratory medicine · 2024Review
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- Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection.Lipids in health and disease · 2022Article
- Estimation of hepatocellular carcinoma mortality using aspartate aminotransferase to platelet ratio index.Journal of gastrointestinal oncology · 2020Article
- Chronic Rifaximin Use in Cirrhotic Patients Is Associated with Decreased Rate of C. difficile Infection.Digestive diseases and sciences · 2020Article
- Liver Cirrhosis, Not Antiviral Therapy, Predicts Clinical Outcome in Cohorts with Heterogeneous Hepatitis B Viral Status.Gut and liver · 2019Article
- Case definitions for inclusion and analysis of endpoints in clinical trials for nonalcoholic steatohepatitis through the lens of regulatory science.Hepatology (Baltimore, Md.) · 2018Article
- Accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C.Clinics (Sao Paulo, Brazil) · 2017Article
- Diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase.World journal of gastroenterology · 2017Article
- Subcirrhotic liver stiffness by FibroScan correlates with lower risk of hepatocellular carcinoma in patients with HBV-related cirrhosis.Hepatology international · 2017Article
- Transient Elastography is Superior to FIB-4 in Assessing the Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B.Medicine · 2016Article
- Noninvasive Measures of Liver Fibrosis and Severity of Liver Disease.Gastroenterology & hepatology · 2016Article
- Non-invasive diagnosis of liver fibrosis and cirrhosis.World journal of gastroenterology · 2015Review
- Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis.Journal of clinical and diagnostic research : JCDR · 2015Article
- Long-term follow-up for incident cirrhosis among pediatric cancer survivors with hepatitis C virus infection.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2015Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAccurate identification of patients with cirrhosis using noninvasive markers of fibrosis is useful for esophageal varices and hepatocellular carcinoma surveillance programs. The aims of our study were to characterize the accuracy of ultrasonography, AST-to-platelet ratio index (APRI), and FIB-4 as noninvasive markers to identify the presence of cirrhosis.
methodsWe conducted a retrospective cohort study of patients who underwent liver biopsy at a large urban safety-net institution between November 2008 and July 2011. The sensitivity, specificity, positive predictive value (PPV), negative predictive value, and overall accuracy using receiver operator characteristic curve analysis for the detection of cirrhosis were calculated for each noninvasive marker.
resultsLiver biopsy was performed in 388 patients, of whom 93 (24.0 %) had cirrhosis. C-statistics for APRI and FIB-4 predicting the presence of cirrhosis were 0.68 (95 % CI 0.63-0.74) and 0.73 (95 % CI 0.68-0.78), respectively. The c-statistic for a nodular appearance on ultrasound was 0.78 (95 % CI 0.72-0.83). The PPV of a shrunken nodular-appearing liver was 64.8 %; however, PPV was significantly higher in the subset with a cirrhotic-appearing liver and signs of portal hypertension (PPV 83.6 %, p = 0.01) as well as in the subset with a noninvasive fibrosis marker also suggesting cirrhosis (PPV 77.8 %, p < 0.001).
conclusionSerum and imaging noninvasive markers of fibrosis may have insufficient accuracy when used in isolation; however, a combination of markers may allow sufficient accuracy to systematically identify patients with cirrhosis.
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