Table 5

Diagnostic performance of combinations of NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and liver stiffness measurement (LSM) by vibration controlled transient elastography (VCTE), and Fibrosis-4 Index (FIB-4) and LSM by VCTE tests to diagnose patients with advanced fibrosis

FIB-4 & LSM by VCTE
(n=5159)
NFS & LSM by VCTE
(n=3094)
FIB-4 & LSM by VCTE
(n=5159)
NFS & LSM by VCTE
(n=3094)
FIB-4 & LSM by VCTE (n=5159)NFS & LSM by VCTE (n=3094)
Advanced fibrosis, %302830283028
Thresholds for blood-based NIT<0.88, ≥2.31*<−2.55, ≥0.28*<1.3, ≥2.67†<−1.455, ≥0.676†<1.3, ≥2.67†<−1.455, ≥0.676†
Thresholds for LSM by VCTE, kPa<7.4, ≥12.1*<7.4, ≥12.1*<7.9, ≥9.6†<7.9, ≥9.6†<8.0, ≥10.0†
Sensitivity, %80 (77–83)77 (74–81)67 (64–69)65 (62–68)66 (63–68)64 (62–67)
Specificity, %81 (79–83)83 (81–85)85 (84–87)86 (84–88)86 (84–87)86 (84–88)
PPV, %62 (60–65)61 (58–64)66 (64–68)63 (61–67)66 (64–68)64 (61–67)
NPV, %91 (90–92)91 (89–93)86 (85–87)87 (85–88)86 (85–87)86 (85–88)
Indeterminate, %18 (17–19)20 (18–21)5 (4–5)5 (5–6)5 (4–6)5 (5–6)
Misclassification, %16 (14–17)15 (13–17)19 (18–21)19 (17–21)19 (18–20)19 (17–21)
Patients undergoing LSM by VCTE, %51 (50–53)56 (54–59)34 (32–35)38 (36–40)34 (33–35)38 (37–40)
  • 95% CIs were estimated with 500 bootstrap replicates.

  • *Thresholds were determined from the individual patient data study group as corresponding to 90% sensitivity (lower value) and 90% specificity (upper value)

  • †Threshold were determined from the literature. For LSM by VCTE, a threshold pair yielding the highest sensitivity and specificity while having the smallest proportion of indeterminate cases in diagnosing advanced fibrosis was chosen.

  • NIT, non-invasive test; NPV, negative predictive value; PPV, positive predictive value.