Diagnostic accuracy of pairs of cut-offs from the literature for liver stiffness measurement (LSM) by vibration controlled transient elastography (VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) for diagnosing advanced fibrosis
| LSM by VCTE (n=5489) | FIB-4 (n=5393) | NFS (n=3248) | ||||||||
| Advanced fibrosis, % | 30 | 30 | 29 | |||||||
| AUROC | 0.85 (0.84–0.86) | 0.76 (0.74–0.77) | 0.73 (0.71–0.75) | |||||||
| Source | Anstee et al 29 | Eddowes et al 31 | Wong et al 76 | Wong et al 20 | This study | Shah et al 83 | McPherson et al 84 | This study | Angulo et al 16 | This study |
| Thresholds | <9.9, ≥11.4 | <7.1, ≥14.1 | <10, ≥15 | <7.9, ≥9.6 | <7.4, ≥12.1* | <1.3, ≥2.67 | <1.3, ≥3.25 | <0.88, ≥2.31* | <−1.455, ≥0.676 | <−2.55, ≥0.28* |
| Sensitivity, % | 69 (67–71) | 83 (80–86) | 59 (57–61) | 84 (82–87) | 84 (81–87) | 54 (52–56) | 44 (42–46) | 80 (76–83) | 47 (44–50) | 74 (70–79) |
| Specificity, % | 86 (85–88) | 90 (88–92) | 94 (93–96) | 78 (76–80) | 87 (85–88) | 91 (89–92) | 95 (93–96) | 79 (77–81) | 91 (89–93) | 78 (76–81) |
| Misclassified, % | 17 (16–19) | 7 (6–8) | 12 (11–13) | 17 (16–19) | 10 (9–11) | 12 (11–13) | 10 (9–11) | 10 (9–11) | 11 (10–13) | 10 (8–11) |
| Indeterminate, % | 7 (6–8) | 39 (37–40) | 18 (17–19) | 13 (12–14) | 31 30–33) | 34 (33–35) | 39 (37–40) | 52 (50–53) | 39 (37–41) | 56 (54–59) |
*Cut-offs determined from the individual patient data study group. Lower cut-offs correspond to a lower limit of 90% sensitivity, upper cut-offs correspond to a lower limit of 90% specificity. 95% CIs were determined with 500 bootstrap replicates.
AUROC, area under the receiver operating characteristic.