SynthesisGut2022
Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis.
Open access · hybridAbstract readMeta-Analysis
In one paragraph
Synthesis in Gut, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 267 papers, 11 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
267citing papers in PubMed, 11 pooled it
52.6field-weighted citation impact, top 1% of its field
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.
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.
Who cites it
267 citing papers in PubMed, 11 syntheses or guidelines pooled it, 470 citations in OpenAlex.
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Evidence-based clinical practice guidelines for metabolic dysfunction-associated steatotic liver disease (MASLD) 2026.Journal of gastroenterology · 2026Guideline
- Progression to Decompensation of Severe Fibrosis Compared to Cirrhosis in MASLD: A Systematic Review and Meta-Analysis.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- Traditional Chinese medicine for type 2 diabetes with metabolic-associated steatotic liver disease: unified effects and design thresholds.Frontiers in endocrinology · 2026Pooled it
- The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.Hepatology international · 2025Guideline
- Global prevalence of advanced fibrosis in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.Journal of gastroenterology and hepatology · 2024Pooled it
- KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.Clinical and molecular hepatology · 2024Guideline
- Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: A systematic review and meta-analysis.Clinical and molecular hepatology · 2024Pooled it
- Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis.Clinical and molecular hepatology · 2024Pooled it
- Accuracy of prognostic serological biomarkers in predicting liver fibrosis severity in people with metabolic dysfunction-associated steatotic liver disease: a meta-analysis of over 40,000 participants.Frontiers in nutrition · 2024Pooled it
- MEFIB-Index and MAST-Score in the assessment of hepatic decompensation in metabolic dysfunction-associated steatosis liver disease-Individual participant data meta-analyses.Alimentary pharmacology & therapeutics · 2023Pooled it
- Parallel randomised trial testing community fibrosis assessment for suspected non-alcoholic fatty liver disease: outcomes from LOCATE-NAFLD.BMJ open gastroenterology · 2024Trial
- Trial
- Screening and diagnosis of liver disease in diabetes: a guide and evidence-based assessment.Diabetologia · 2026Review
- Derivation and internal validation of the enhanced liver fibrosis (ELF)-based prediction score for advanced liver fibrosis in obese patients undergoing bariatric surgery.Surgical endoscopy · 2026Article
- Machine Learning-Driven Noninvasive Prediction of Liver Fibrosis in Unclassified Liver Disease.MedComm · 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
- Metabolic Dysfunction-Associated Steatotic Liver Disease and Vascular Complications: Associations with Serum Testosterone Levels in a Korean Multicenter Male Cohort.Gut and liver · 2026Article
- Differential Cancer Risks and Noninvasive Predictors in MASLD, MetALD, and ALD: A Longitudinal Analysis.Gut and liver · 2026Article
- Metabolic Dysfunction-Associated Steatotic Liver Disease in the Aging Population: A Narrative Review of Pathophysiological Synergy, Diagnostic Challenges, and Tailored Management.Current gastroenterology reports · 2026Review
207 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
54 authors at 20 institutions in 18 countries.
Ferenc Emil MózesCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-1361-4349
Jenny A LeeDepartment of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Emmanuel Anandraj SelvarajCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Arjun Narayan Ajmer JayaswalCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Michael TraunerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-1275-6425
Jerome BoursierLaboratoire HIFIH, UPRES EA 3859, SFR ICAT 4208, Universite d'Angers, Angers, Pays de la Loire, France.ORCID 0000-0002-7282-1436
Céline FournierEchosens SA, Paris, Île-de-France, France.
Katharina StauferDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Rudolf E StauberDepartment of Internal Medicine, Medical University of Graz, Graz, Austria.
Elisabetta BugianesiMedical Sciences, University of Turin, Torino, Italy.ORCID 0000-0002-0502-4381
Ramy YounesBoehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany.ORCID 0000-0003-2302-5318
Silvia GaiaMedical Sciences, University of Turin, Torino, Italy.
Monica Lupșor-PlatonDepartment of Ultrasonography, University of Medicine and Pharmacy, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj Napoca, Romania.
Salvatore PettaSection of Gastroenterology and Hepatology, PROMISE, Palermo, Italy.ORCID 0000-0002-0822-9673
Toshihide ShimaHepatology Center, Saiseikai Suita Hospital, Suita, Osaka, Japan.
Takeshi OkanoueHepatology Center, Saiseikai Suita Hospital, Suita, Osaka, Japan.
Sanjiv MahadevaFaculty of Medicine, Department of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia.ORCID 0000-0001-5824-0590
Wah-Kheong ChanFaculty of Medicine, Department of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
Peter J EddowesNIHR Biomedical Research Centre, University of Birmingham, Birmingham, UK.
Gideon M HirschfieldToronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada.
Philip Noel NewsomeNIHR Biomedical Research Centre, University of Birmingham, Birmingham, UK.ORCID 0000-0001-6085-3652
Vincent Wai-Sun WongDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong.ORCID 0000-0003-2215-9410
Victor de LedinghenCentre d'Investigation de la Fibrose Hépatique, Hopital Haut-Leveque, Pessac, France.
Jiangao FanDepartment of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Feng ShenDepartment of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jeremy F CobboldTranslational Gastroenterology Unit, University of Oxford, Oxford, Oxfordshire, UK.
Yoshio SumidaDepartment of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan.
Akira OkajimaDepartment of Gastroenterology, Koseikai Takeda Hospital, Kyoto, Japan.
Jörn M SchattenbergDepartment of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Rhineland-Palatinate, Germany.
Christian LabenzDepartment of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Rhineland-Palatinate, Germany.ORCID 0000-0001-8390-9663
Won KimDepartment of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
Myoung Seok LeeDepartment of Radiology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, The Republic of Korea.
Johannes WiegandDepartment of Medicine II, Leipzig University Medical Center, Leipzig, Sachsen, Germany.ORCID 0000-0001-9233-4064
Thomas KarlasDepartment of Medicine II, Leipzig University Medical Center, Leipzig, Sachsen, Germany.ORCID 0000-0002-8109-8526
Yusuf YılmazDepartment of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.ORCID 0000-0003-4518-5283
Guruprasad Padur AithalNIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, Nottinghamshire, UK.ORCID 0000-0003-3924-4830
Naaventhan PalaniyappanNIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, Nottinghamshire, UK.
Christophe CassinottoDiagnostic and Interventional Radiology, University Hospital Centre Montpellier, Montpellier, Languedoc-Roussillon, France.ORCID 0000-0001-5136-4742
Sandeep AggarwalDepartment of Surgical Disciplines, AIIMS, New Delhi, Delhi, India.
Harshit GargDepartment of Surgical Disciplines, AIIMS, New Delhi, Delhi, India.
Geraldine J OoiDepartment of Surgery, Monash University, Prahran, Victoria, Australia.ORCID 0000-0002-4540-408X
Atsushi NakajimaDepartment of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Kanagawa, Japan.ORCID 0000-0002-6263-1436
Masato YonedaDepartment of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Kanagawa, Japan.
Marianne ZiolService d'Anatomie Pathologique et Centre de Ressources Biologiques, Hopital Jean Verdier, Paris, France.
Nathalie BargetCentre de Ressources Biologiques, Hopitaux Universitaires Paris-Seine-Saint-Denis, Bondy, Île-de-France, France.
Andreas GeierDivision of Hepatology, University Hospital Wurzburg, Wurzburg, Bayern, Germany.ORCID 0000-0002-9626-5083
Theresa TuthillInternal Medicine Research Unit, Pfizer Inc, Cambridge, Massachusetts, USA.
M Julia BrosnanInternal Medicine Research Unit, Pfizer Inc, Cambridge, Massachusetts, USA.
Quentin Mark AnsteeTranslational and Clinical Research Institute, Faculty of Medicine, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK.
Stefan NeubauerCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Stephen A HarrisonCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Patrick M BossuytDepartment of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Michael PavlidesCardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK michael.pavlides@cardiov.ox.ac.uk.ORCID 0000-0001-9882-8874
LITMUS Investigators
University of Oxford · GBUniversity of Nottingham · GBAll India Institute of Medical Sciences Raipur · INAmsterdam University Medical Centers · NLJohannes Gutenberg University Mainz · DELeipzig University · DEPfizer (United States) · USSaiseikai Suita Hospital · JPSeoul National University · KRShanghai Jiao Tong University · CNUniversity of Malaya · MYUniversity of Turin · ITYokohama City University · JPAichi Medical University · JPBoehringer Ingelheim (Germany) · DECentre Hospitalier Universitaire d'Angers · FRChinese University of Hong Kong · HKHôpital Jean-Verdier · FRHôpitaux Universitaires Paris-Ouest · FRIjinkai Takeda General Hospital · JP
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLiver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies.
designIndividual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations.
resultsData were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m
conclusionSequential combinations of markers with a lower cut-off to rule-out advanced fibrosis and a higher cut-off to rule-in cirrhosis can reduce the need for liver biopsies.
Indexed as
Diabetes Mellitus, Type 2Elasticity Imaging TechniquesNon-alcoholic Fatty Liver DiseaseBiomarkersBiopsyFemaleFibrosisHumansLiverLiver CirrhosisMaleMiddle AgedBiomarkersbiostatisticsclinical decision makingfatty liverhepatic fibrosis
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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.