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Validating non-invasive markers of fibrosis: the need for a new histological reference standard - The Authors' response
  1. Julie Parkes on behalf of the authors
  1. Correspondence to Dr Julie Parkes, Public Health Sciences & Medical Statistics, University of Southampton, Level C (805),South Academic Block Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; jules{at}soton.ac.uk

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Tsochatzis and colleagues1 criticise the methodology used in the analysis of our data and make a comment about the utility of measuring collagen proportionate area (CPA).2 In our analysis, we determine the performance of a continuous variable, the enhanced liver fibrosis (ELF) test score, in predicting clinical outcomes. No attempt was made to convert the ELF score into a virtual histological stage or to relate ELF test scores to histology but both ELF test scores and histology were compared with clinical outcomes as the reference standard. The range of ELF results in the cohort was divided into tertiles and the middle tertile was divided into two groups to create four groups of ELF score. We then determined the …

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