Evidence map›Paper›PMID 32352687›Full record

ArticleClinical and translational gastroenterology2020

Accuracy of Noninvasive Fibrosis Scoring Systems in African American and White Patients With Nonalcoholic Fatty Liver Disease.

Hemnishil K Marella, Yala Kirthi Reddy, Yu Jiang, Surosree Ganguli, Pradeep S B Podila, Peter D Snell, Alexander J Kovalic, George Cholankeril, Ashwani K Singal, Satheesh Nair and 2 more

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

Article in Clinical and translational gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Review
  6. 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

12 authors at 8 institutions in 1 country.

Hemnishil K MarellaDepartment of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Yala Kirthi ReddyDepartment of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Yu JiangDivision of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, Tennessee, USA.
Surosree GanguliDepartment of Medicine, University of Louisville, Louisville, Kentucky, USA.
Pradeep S B PodilaDivision of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Peter D SnellDivision of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Alexander J KovalicDepartment of Internal Medicine, Novant Forsyth Medical Center, Winston Salem, North Carolina, USA.
George CholankerilDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
Ashwani K SingalDepartment of Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA.
Satheesh NairDivision of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Benedict MaliakkalDivision of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Sanjaya K SatapathyDivision of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
University of Tennessee Health Science Center · USMethodist University Hospital · USUniversity of Tennessee at Knoxville · USAvera McKennan Hospital & University Health Center · USNovant Health Forsyth Medical Center · USStanford University · USUniversity of Louisville · USUniversity of Memphis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesNonalcoholic fatty liver disease fibrosis score (NFS), fibrosis-4 (FIB-4) score, aspartate aminotransferase (AST)-to-platelet ratio index (APRI) score, and AST-alanine aminotransferase (ALT) ratio are noninvasive fibrosis scoring systems for the staging of liver fibrosis in patients with chronic liver disease.

methodsIn a large cohort of patients with nonalcoholic fatty liver disease, we compared AST-ALT ratio, NFS, FIB-4 score, and APRI score in predicting advanced fibrosis (defined as fibrosis stage ≥ 3) in histologically confirmed African American (AA) and white patients. We identified 907 patients: 677 (74.6%) white and 230 (25.3%) AA patients with nonalcoholic fatty liver disease.

resultsOf the 907 patients, 115 (12.8%) patients had advanced fibrosis (stages 3 and 4) in the total cohort: 6 (2.6%) AAs, and 109 (16.2%) whites. In AAs, the area under the receiver operating characteristic (area under the curve) for predicting advanced fibrosis was 0.58 by NFS, 0.86 by APRI score, 0.77 by FIB-4 score, and 0.65 by AST-ALT ratio. In whites, the area under the receiver operating characteristic for predicting advanced fibrosis was 0.82 by NFS, 0.82 by APRI score, 0.88 by FIB-4 score, and 0.76 by AST-ALT ratio. In the AA population, NFS > 0.675, FIB-4 score > 2.67, and APRI score > 1.5 each has a negative predictive value of 98%, whereas the negative predictive values in whites are 91%, 88%, and 85%, respectively. DISCUSSION: Noninvasive fibrosis scoring systems can reliably exclude advanced fibrosis in both AAs and whites and have acceptable discriminatory ability to predict advanced fibrosis in whites. The utility of noninvasive fibrosis scoring systems in predicting advanced fibrosis in AAs needs further validation in a larger multicenter cohort.

Indexed as

Severity of Illness IndexAdultAlanine TransaminaseAspartate AminotransferasesBiopsyBlack or African AmericanFemaleHumansLiverLiver CirrhosisMaleMiddle AgedNon-alcoholic Fatty Liver DiseasePlatelet CountPredictive Value of TestsRetrospective StudiesAlanine TransaminaseAspartate Aminotransferases

Identifiers

PMID32352687
PMCPMC7263664
OpenAlexW3022025221

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.