Diagnostic performance of non-invasive tests for advanced fibrosis (F3–F4)
| LSM by VCTE (n=5489) | FIB-4 (n=5393) | NFS (n=3248) | APRI (n=5477) | AST/ALT (n=5434) | |||||||||||
| Advanced fibrosis, % | 30 | 30 | 29 | 30 | 30 | ||||||||||
| AUROC | 0.85 (0.84–0.86) | 0.76 (0.74–0.77) | 0.73 (0.71–0.75) | 0.70 (0.69–0.72) | 0.64 (0.62–0.65) | ||||||||||
| YI | 90% Se | 90% Sp | YI | 90% Se | 90% Sp | YI | 90% Se | 90% Sp | YI | 90% Se | 90% Sp | YI | 90% Se | 90% Sp | |
| Threshold | 9.1 | 7.4 | 12.1 | 1.44 | 0.88 | 2.31 | −1.39 | −2.55 | 0.28 | 0.49 | 0.29 | 0.91 | 0.64 | 0.51 | 1.34 |
| Sensitivity, % | 77 (75–79) | 90 (89–91) | 55 (52–57) | 69 (67–72) | 90 (88–91) | 38 (36–41) | 75 (72–78) | 90 (88–92) | 29 (26–32) | 67 (64–69) | 90 (89–92) | 32 (30–34) | 75 (73–77) | 90 (87–91) | 16 (14–18) |
| Specificity, % | 78 (76–79) | 60 (59–61) | 90 (89–91) | 70 (69–72) | 39 (37–40) | 90 (89–91) | 63 (61–65) | 36 (33–37) | 90 (89–91) | 63 (62–65) | 29 (28–30) | 90 (89–91) | 47 (45–48) | 25 (23–26) | 90 (89–91) |
| Misclassified, % | 22 (22–23) | 31 (31–32) | 21 (20–21) | 30 (30–31) | 46 (46–47) | 26 (25–26) | 34 (34–36) | 48 (49–50) | 28 (28–29) | 36 (36–37) | 53 (53–54) | 27 (27–28) | 45 (45–46) | 56 (56–57) | 32 (32–33) |
For each non-invasive test thresholds were selected according to Youden’s index (YI), and fixed at 90% sensitivity (90% Se) and 90% specificity (90% Sp). 95% CIs were estimated with 500 bootstrap replicates.
ALT, alanine aminotransferase; APRI, AST-to-platelet ratio index; AST, aspartate aminotransferase; FIB-4, Fibrosis-4 Index; LSM, liver stiffness measurement; NFS, NAFLD (non-alcoholic fatty liver disease) Fibrosis Score; VCTE, vibration controlled transient elastography.