Evidence map›Paper›PMID 41586394›Full record

ArticleAnnals of gastroenterology

Magnetic resonance elastography combined with fibrosis-4 index for diagnosing at-risk metabolic dysfunction-associated steatohepatitis: a systematic review and meta-analysis of diagnostic test accuracy studies.

Konstantinos Malandris, Anastasia Katsoula, Tarek Nayfeh, Kalliopi Tsapa, Dimitra Tsapa, Georgios Kalopitas, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Emmanouil Sinakos and 2 more

Abstract read
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Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

Konstantinos MalandrisClinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Apostolos Tsapas).
Anastasia KatsoulaSecond Propaedeutic Medical Department, Aristotle University of Thessaloniki, Greece (Anastasia Katsoula).
Tarek NayfehUnion Memorial Hospital, Georgetown University, Baltimore, Maryland, USA (Tarek Nayfeh).
Kalliopi TsapaSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Kalliopi Tsapa, Dimitra Tsapa).
Dimitra TsapaSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Kalliopi Tsapa, Dimitra Tsapa).
Georgios KalopitasFirst Medical Department, Aristotle University of Thessaloniki, Greece (Georgios Kalopitas, Georgios Germanidis).
Aris LiakosClinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Apostolos Tsapas).
Thomas KaragiannisClinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Apostolos Tsapas).
Eleni TheocharidouClinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Apostolos Tsapas).
Emmanouil SinakosFourth Medical Department, Aristotle University of Thessaloniki, Greece (Emmanouil Sinakos).
Georgios GermanidisFirst Medical Department, Aristotle University of Thessaloniki, Greece (Georgios Kalopitas, Georgios Germanidis).
Apostolos TsapasClinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Apostolos Tsapas).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with metabolic dysfunction-associated steatohepatitis (MASH; nonalcoholic fatty liver disease activity score ≥4) and significant fibrosis (≥F2; at-risk MASH) are at increased risk for disease progression. Magnetic resonance elastography (MRE) combined with the fibrosis-4 (MEFIB) index enables the noninvasive diagnosis of at-risk MASH and significant fibrosis. We assessed the performance of the MEFIB index for ruling in/out both target conditions. Methods: We analyzed studies up to February 2025 assessing the performance of MEFIB index for ruling in (MRE≥3.3 kPa plus FIB-4≥1.6) and out (MRE<3.3 kPa plus FIB-4<1.6) at-risk MASH or significant fibrosis, using liver biopsy as the reference standard. We calculated pooled diagnostic accuracy estimates using bivariate random-effects models. Results: We included 7 studies with 3356 participants. For ruling in at-risk MASH, the MEFIB index yielded a pooled specificity of 0.94 (95% confidence interval [CI] 0.74-0.99), and a positive likelihood ratio (LRp) of 5.3 (95%CI 1.8-15.7). For ruling out at-risk MASH, the MEFIB index had a pooled sensitivity of 0.77 (95%CI 0.62-0.88) and a negative likelihood ratio (LRn) of 0.34 (95%CI 0.23-0.52). For ruling in significant fibrosis, the MEFIB index achieved a summary specificity of 0.93 (95%CI 0.85-0.97) with LRp 8.2 (95%CI 4.5-14.9). For excluding significant fibrosis, the pooled sensitivity and LRn of the MEFIB index were 0.88 (95%CI 0.79-0.94) and 0.16 (95%CI 0.08-0.31), respectively. Conclusions: MEFIB index has acceptable accuracy for diagnosing at-risk MASH and significant fibrosis. Proposed thresholds can be used to identify both target conditions in high prevalence settings and facilitate patient recruitment in clinical trials.

Indexed as

fibrosisMEFIB indexmeta-analysismetabolic dysfunction-associated steatohepatitissystematic review

Identifiers

PMID41586394
PMCPMC12829540

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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.