ArticleGut and liver2020
Simple Noninvasive Scores Are Clinically Useful to Exclude, Not Predict, Advanced Fibrosis: A Study in Turkish Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease.
Article in Gut and liver, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Accuracy of Noninvasive Scoring Systems in Assessing Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.Gut and liver · 2022Pooled it
- The egyptian clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationGuideline
- Optimal timing of liver stiffness assessment in methotrexate-treated rheumatoid arthritis patients.Zeitschrift fur Rheumatologie · 2026Article
- The Impact of Balloon Pulmonary Angioplasty (BPA) on Changes in the Liver Fibrosis Index (FIB-4 Index) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH).Journal of clinical medicine · 2026Article
- Blood Urea Nitrogen to Serum Albumin Ratio Is Associated with MASH and Significant Fibrosis: Report from a Turkish Biopsy-Proven MASLD Cohort.Journal of clinical medicine · 2026Article
- A precision-constrained framework for evaluating noninvasive biomarkers in MASLD and beyond.Nature communications · 2026Article
- Article
- AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020).BMC gastroenterology · 2025Article
- Adding salt to foods increases the risk of metabolic dysfunction-associated steatotic liver disease.Communications medicine · 2025Article
- Platelet-derived growth factor receptor-β as a non-invasive biomarker for liver fibrosis prediction in Egyptian diabetic patients with metabolic-associated fatty liver disease.BMC gastroenterology · 2025Article
- Comparing FIB-4, VCTE, pSWE, 2D-SWE, and MRE Thresholds and Diagnostic Accuracies for Detecting Hepatic Fibrosis in Patients with MASLD: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2025Review
- Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Non-invasive prediction nomogram for predicting significant fibrosis in patients with metabolic-associated fatty liver disease: a cross-sectional study.Annals of medicine · 2024Article
- Nonalcoholic steatohepatitis: A comprehensive updated review of risk factors, symptoms, and treatment.Heliyon · 2024Review
- Advanced liver fibrosis is associated with decreased gait speed in older patients with chronic liver disease.Scientific reports · 2024Article
- Suboptimal reliability of FIB-4 and NAFLD-fibrosis scores for staging of liver fibrosis in general population.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Community-centered Disease Severity Assessment of Metabolic Dysfunction-associated Fatty Liver Disease.Journal of clinical and translational hepatology · 2023Article
- Change in skeletal muscle mass is associated with hepatic steatosis in nonalcoholic fatty liver disease.Scientific reports · 2023Article
- TASL Practice Guidance on the Clinical Assessment and Management of Patients with Nonalcoholic Fatty Liver Disease.Hepatology forum · 2023Article
- Liver fibrosis scores and atrial fibrillation incidence in heart failure with preserved ejection fraction.ESC heart failure · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/Aims: Advanced fibrosis (F≥3) indicates poor outcomes in nonalcoholic fatty liver disease (NAFLD). Here, we examined the diagnostic performance of the fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) for detecting (or excluding) advanced fibrosis in patients with biopsy-proven NAFLD. Methods: The diagnostic performance of each noninvasive test according to previously identified cutoff points indicating low and high risk for advanced fibrosis was determined in 463 patients with NAFLD. Patients who scored <1.3 and >2.67 on the FIB-4 were considered at low and high risk for advanced fibrosis, respectively. Patients who scored <-1.455 and >0.676 on the NFS were considered at low and high risk for advanced fibrosis, respectively. Results: Eighty-one patients (17.5%) had biopsy-proven advanced fibrosis (F≥3). The published FIB-4 cutoff values for low and high risk were able to exclude advanced fibrosis with negative predictive values (NPVs) of 0.907 and 0.843 and specificities of 74% and 97%, respectively. The published NFS cutoff values for low and high risk were able to exclude advanced fibrosis with NPVs of 0.913 and 0.842 and specificities of 63% and 96%, respectively. If biopsies were performed in only patients with a FIB-4 above the low cutoff point (≥1.3), 67.1% could be avoided. Conversely, if biopsies were performed in only patients with an NFS above the low cutoff point (≥-1.455), 57.0% could be avoided. Conclusions: The main clinical utility of the FIB-4 and NFS in patients with NAFLD lies in the ability to exclude, not identify, advanced fibrosis.
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