Evidence map›Paper›PMID 40631606›Full record

ArticleJournal of occupational health2025

Comparative evaluation of FIB-3 and FIB-4 indices for liver fibrosis screening in workplace-based health checkups.

Kota Fukai, Shoko Nakazawa, Kosuke Sakai, Yuko Furuya, Yuya Watanabe, Toru Honda, Takeshi Hayashi, Toru Nakagawa, Masaaki Korenaga, Masayuki Tatemichi

Abstract readComparative Study
In one paragraph

Article in Journal of occupational health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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.

Kota FukaiDepartment of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.ORCID 0000-0002-8319-8467
Shoko NakazawaDepartment of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
Kosuke SakaiDepartment of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
Yuko FuruyaDepartment of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
Yuya WatanabeHitachi Health Care Center, Hitachi, Japan.
Toru HondaHitachi Health Care Center, Hitachi, Japan.
Takeshi HayashiOccupational Hygiene and Promotion Center, Hitachi Ltd, Tokyo, Japan.
Toru NakagawaHitachi Health Care Center, Hitachi, Japan.
Masaaki KorenagaHepatitis Information Center, The Research Center for Hepatitis and Immunology, National Institute of Global Health and Medicine, Japan Institute for Health Security, Ichikawa, Japan.
Masayuki TatemichiDepartment of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.

Funding

Health and Labor Sciences Research Grant, Ministry of Health, Labor, and Welfare, Japan
6 · The paper itself

Abstract

objectivesTo examine the utility of the FIB-3 index as a secondary screening tool for liver fibrosis in workplace-based health checkups, by comparing its concordance and negative predictive values (NPVs) with those of the FIB-4 index.

methodsThis cross-sectional study included 12 622 workers from the Hitachi Cohort Study who underwent workplace-based health checkups between April 2021 and March 2022. FIB-4 was calculated using age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count, whereas FIB-3 used the same components except age. To evaluate the utility of FIB-3 in excluding liver fibrosis, NPVs were calculated using FIB-4 thresholds (1.30, 2.01, and 2.67) as references. Concordance between FIB-3 and FIB-4 was examined across different age groups. In addition, multivariate logistic regression analysis was conducted to identify factors associated with false-positive FIB-3 results.

resultsThe FIB-3 index demonstrated high NPVs for excluding liver fibrosis, with values of 99.9% at FIB-4 ≥ 1.30 and 98.2% at FIB-4 ≥ 2.67. Strong concordance between FIB-3 and FIB-4 was observed consistently across different age groups. Among participants with elevated ALT (>30 IU/L), FIB-3 consistently ruled out fibrosis, whereas FIB-4 positivity increased with advancing age. Multivariate analysis indicated that higher AST levels and increased alcohol intake were significantly associated with false-positive FIB-3 results.

conclusionsThe FIB-3 index demonstrated stable performance across age groups while maintaining high concordance and NPV relative to FIB-4. These findings suggest that FIB-3 may serve as a practical screening tool in routine workplace-based health checkups, particularly in mitigating age-related overestimation observed with the FIB-4 index.

Indexed as

Liver CirrhosisMass ScreeningAdultAgedAge FactorsAlanine TransaminaseAspartate AminotransferasesCross-Sectional StudiesFemaleHumansMaleMiddle AgedPlatelet CountPredictive Value of TestsWorkplaceAlanine TransaminaseAspartate AminotransferasesFib-3 indexFib-4 indexliver fibrosisnegative predictive valuenoninvasive screeningsteatotic liver diseaseworkplace health checkups

Identifiers

PMID40631606
PMCPMC12341935

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LicenceCC BY
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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.