Evidence map›Paper›PMID 34419953›Full record

ArticleObesity facts2021

Development and Validation of a Novel Scoring System for Noninvasive Nonalcoholic Steatohepatitis Detection in Bariatric Patients.

Adrian T Billeter, Sarah Wloka, Rouven Behnisch, Thomas Albrecht, Stephanie Roessler, Benjamin Goeppert, Sebastian Mueller, Felix Nickel, Beat Müller

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

Article in Obesity facts, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 21% 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

5 citing papers in PubMed, 9 citations in OpenAlex.

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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

9 authors at 2 institutions in 1 country.

Adrian T BilleterDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Sarah WlokaDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Rouven BehnischInstitute of Medical Biometry and Informatics, Heidelberg, Germany.
Thomas AlbrechtDepartment of Pathology, University of Heidelberg, Heidelberg, Germany.
Stephanie RoesslerDepartment of Pathology, University of Heidelberg, Heidelberg, Germany.
Benjamin GoeppertDepartment of Pathology, University of Heidelberg, Heidelberg, Germany.
Sebastian MuellerDepartment of Internal Medicine, Salem Medical Center and Center for Alcohol Research, University of Heidelberg, Heidelberg, Germany.
Felix NickelDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Beat MüllerDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Heidelberg University · DEZimmer Biomet (Germany) · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNonalcoholic fatty liver disease covers a broad spectrum. Simple steatosis has usually a benign course while nonalcoholic steatohepatitis (NASH) can progress into hepatocellular carcinoma, and cirrhosis. Therefore, differentiating patients with benign steatosis and NASH is crucial. Liver biopsy, the usual gold standard for NASH diagnosis, cannot be used as a screening method due to its associated risks. This is especially problematic for obese patients with a prevalence of nonalcoholic fatty liver disease (NAFLD) in >80% of patients. The aim of this study was therefore to develop and validate a noninvasive NASH screening test in a cohort of high-risk, morbidly obese patients.

methodsThis prospective study examined diagnostic accuracy in accordance with STARD guidelines. 112 liver biopsies were consecutively assigned to either a training or validation cohort. Using the Bedossa histological scoring system, the cohorts were subdivided into NASH versus NAFLD/No NAFLD. Predictors of NASH were evaluated with receiver operating characteristic (ROC) curves. A model was then constructed using a backward stepwise logistic regression and evaluated in an independent validation cohort.

results53.5% of the patients had NASH and 4 patients had cirrhosis. Mean body mass index (BMI) was 49.8 ± 7.5 kg/m2. Backward stepwise logistic regression identified 4 parameters associated with the presence of NASH: alanin-aminotransferase, albumin, BMI, and triglycerides. The noninvasive NASH detection score (NI-NASH-DS) had an ROC of 0.851 and 0.727 in the training and validation cohorts, respectively. Sensitivity and specificity were 77.1% and 88% in the training cohort and 88% and 48% in the validation cohort which was much better than the established noninvasive scores. DISCUSSION/

conclusionThe NI-NASH-DS is easy-to-use, inexpensive, and noninvasive and can reliably detect NASH in patients with morbid obesity. Due to its simplicity, it can be used frequently and repeatedly.

Indexed as

BariatricsBariatric SurgeryNon-alcoholic Fatty Liver DiseaseObesity, MorbidHumansLiverProspective StudiesBariatric surgeryFatty liverNonalcoholic fatty liver diseaseNonalcoholic steatohepatitisNoninvasive score

Identifiers

PMID34419953
PMCPMC8546458
OpenAlexW3195917604

What OpenQuestion holds

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Registered trials

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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.