Evidence map›Paper›PMID 32293289›Full record

ArticleBMC gastroenterology2020

The Enhanced Liver Fibrosis test is associated with liver-related outcomes in postmenopausal women with risk factors for liver disease.

Paul M Trembling, Sophia Apostolidou, Aleksandra Gentry-Maharaj, Julie Parkes, Andy Ryan, Sudeep Tanwar, Matthew Burnell, Scott Harris, Usha Menon, William M Rosenberg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Paul M TremblingDivision of Medicine, University College London, Institute for Liver and Digestive Health, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. p.trembling@ucl.ac.uk.
Sophia ApostolidouMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, Faculty of Population Health Sciences, University College London, 2nd Floor, 90 High Holborn, London, WC1V 6LJ, UK.
Aleksandra Gentry-MaharajMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, Faculty of Population Health Sciences, University College London, 2nd Floor, 90 High Holborn, London, WC1V 6LJ, UK.
Julie ParkesPrimary Care and Population Sciences Academic Unit, Faculty of Medicine, University of Southampton, Level C, South Academic Block, University Hospital Southampton, Southampton, SO16 6YD, UK.
Andy RyanMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, Faculty of Population Health Sciences, University College London, 2nd Floor, 90 High Holborn, London, WC1V 6LJ, UK.
Sudeep TanwarDivision of Medicine, University College London, Institute for Liver and Digestive Health, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
Matthew BurnellMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, Faculty of Population Health Sciences, University College London, 2nd Floor, 90 High Holborn, London, WC1V 6LJ, UK.
Scott HarrisPrimary Care and Population Sciences Academic Unit, Faculty of Medicine, University of Southampton, Level C, South Academic Block, University Hospital Southampton, Southampton, SO16 6YD, UK.
Usha MenonMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, Faculty of Population Health Sciences, University College London, 2nd Floor, 90 High Holborn, London, WC1V 6LJ, UK.
William M RosenbergDivision of Medicine, University College London, Institute for Liver and Digestive Health, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
MRC Clinical Trials Unit at UCL · GBUniversity College London · GBUniversity of Southampton · GBRoland Hill (United Kingdom) · GBThe Royal Free Hospital · GB

Funding

Medical Research Council G0801228Medical Research Council G9901012Medical Research Council MC_UU_12023/20
6 · The paper itself

Abstract

backgroundChronic liver disease (CLD) is usually asymptomatic but earlier detection is critical to permit life-saving interventions for those at risk due to high alcohol consumption and increased body mass index (BMI). The aim of this study was to estimate the association between the Enhanced Liver Fibrosis (ELF) test and liver-related events (LRE) and its performance in predicting LRE in postmenopausal women with risk factors in a nested case-control study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS).

methodsIn a cohort of 95,126 we performed a case-control study measuring ELF in blinded samples from 173 participants with self-reported high alcohol use and / or BMI ≥25 kg/m

resultsUsing Cox regression at an ELF threshold of 10.51 hazard ratios (HR) for LRE were 4.88 (95% confidence interval (CI) 2.37-10.03) (unadjusted model) and 4.62 (95% CI 2.12-10.08) (adjusted for deprivation and self-reported hypertension, heart disease, hypercholesterolaemia and diabetes). At a threshold of 9.8 HR for LRE were 2.21 (95% CI 1.22-3.97) (unadjusted model) and 2.18 (95% CI 1.19-4.01) (adjusted). ELF was evaluated as a time dependent variable by generating time-dependent Cox models; HRs at an ELF threshold of 10.51 were 1.94 (95% CI 1.10-3.39) (unadjusted) and 2.05 (95% CI 1.16-3.64) (adjusted) and at a threshold of 9.8 HRs were 1.85 (95% CI 1.09-3.15) (unadjusted) and 1.80 (95% CI 1.04-3.13) (adjusted). Area under the receiver operating characteristic curve for recruitment ELF predicting LRE was 0.58 (95% CI 0.49-0.68), and for second subsequent ELF 0.61 (95% CI 0.52-0.71).

conclusionThis study demonstrates the association between ELF and CLD in postmenopausal women with risk factors for liver disease, creating the opportunity to intervene to reduce liver-related mortality and morbidity. Although larger studies are required, these results demonstrate the potential of ELF as a prognostic tool in health checks in primary care.

trial registrationThis study is nested in UKCTOCS. UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Registered 06/04/2000.

Indexed as

Clinical Decision RulesHealth Status IndicatorsAgedCase-Control StudiesFemaleFollow-Up StudiesHumansLiver CirrhosisLiver DiseasesMiddle AgedPostmenopausePrognosisRetrospective StudiesRisk FactorsSelf ReportAlcohol-related liver diseaseLiver fibrosisNon-alcoholic fatty liver diseaseObesity

Identifiers

PMID32293289
PMCPMC7158048
OpenAlexW3016006115

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.