ArticleNature medicine2023
Diagnostic performance of circulating biomarkers for non-alcoholic steatohepatitis.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 3 of them syntheses that pooled 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.
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
67 citing papers in PubMed, 3 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Meta-Analysis: Enhanced Liver Fibrosis (ELF) Test for Identifying Significant Fibrosis, Advanced Fibrosis, and Cirrhosis in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.Alimentary pharmacology & therapeutics · 2026Pooled it
- Clinical Outcomes and Non-Invasive Testing in Metabolic Dysfunction-Associated Steatohepatitis With Cirrhosis: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- Exploration of Multiple Non-Invasive Tests for Assessing Response to Treatment in a Semaglutide Phase 2b Trial in Patients with MASH.Alimentary pharmacology & therapeutics · 2026Trial
- The liver in diabetes: current state and future perspectives.Diabetologia · 2026Review
- Screening and diagnosis of liver disease in diabetes: a guide and evidence-based assessment.Diabetologia · 2026Review
- Review
- Noninvasive surrogate endpoints in MASH trials: current perspectives and challenges.Hepatology international · 2026Review
- Review
- The Prevalence and Risk Factors for at-Risk MASH and Advanced Liver Fibrosis in People With Metabolic Risk Factors in Primary Care.Alimentary pharmacology & therapeutics · 2026Article
- Sequential FIB-4-based testing limits detection of fibrotic MASLD despite optimized ELF thresholds.Hepatology communications · 2026Article
- Liver Biopsy in Metabolic Dysfunction-Associated Steatohepatitis Clinical Trials: Potential Pitfalls and Solutions.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Prospective validation of imaging and serum diagnostic biomarkers of steatohepatitis and fibrosis in MASLD: the LITMUS Imaging Study.Nature medicine · 2026Article
- A precision-constrained framework for evaluating noninvasive biomarkers in MASLD and beyond.Nature communications · 2026Article
- High Prevalence of Metabolic Dysfunction-Associated Steatohepatitis With Significant Fibrosis in Primary Care and Endocrinology Clinics.Diabetes, obesity & metabolism · 2026Article
- Non-coding RNA networks in metabolic dysfunction-associated steatotic liver disease: Mechanisms and therapeutic perspectives.Liver research (Beijing, China) · 2026Review
- From bench to bedside: Molecular mechanisms, diagnostic tools, and therapeutic strategies in liver fibrosis.Liver research (Beijing, China) · 2026Review
- A reasonably likely surrogate endpoint for metabolic dysfunction-associated steatohepatitis.Nature medicine · 2026Article
- Multi-threshold analysis of the ELF Test versus histology for prognostication of disease progression and regression in MASH.Hepatology communications · 2026Article
- Metabolic liver disease: A summary of major guidelines and identifying opportunities to improve future guidelines.Diabetes, obesity & metabolism · 2026Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Update of
Authors and funding
19 authors at 11 institutions in 1 country.
Funding
Abstract
There are no approved diagnostic biomarkers for at-risk non-alcoholic steatohepatitis (NASH), defined by the presence of NASH, high histological activity and fibrosis stage ≥2, which is associated with higher incidence of liver-related events and mortality. FNIH-NIMBLE is a multi-stakeholder project to support regulatory approval of NASH-related biomarkers. The diagnostic performance of five blood-based panels was evaluated in an observational (NASH CRN DB2) cohort (n = 1,073) with full spectrum of non-alcoholic fatty liver disease (NAFLD). The panels were intended to diagnose at-risk NASH (NIS4), presence of NASH (OWLiver) or fibrosis stages >2, >3 or 4 (enhanced liver fibrosis (ELF) test, PROC3 and FibroMeter VCTE). The prespecified performance metric was an area under the receiver operating characteristic curve (AUROC) ≥0.7 and superiority over alanine aminotransferase for disease activity and the FIB-4 test for fibrosis severity. Multiple biomarkers met these metrics. NIS4 had an AUROC of 0.81 (95% confidence interval: 0.78-0.84) for at-risk NASH. The AUROCs of the ELF test, PROC3 and FibroMeterVCTE for clinically significant fibrosis (≥stage 2), advanced fibrosis (≥stage 3) or cirrhosis (stage 4), respectively, were all ≥0.8. ELF and FibroMeter VCTE outperformed FIB-4 for all fibrosis endpoints. These data represent a milestone toward qualification of several biomarker panels for at-risk NASH and also fibrosis severity in individuals with NAFLD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.