Concordance in a World without a Gold Standard: A New Non-Invasive Methodology for Improving Accuracy of Fibrosis Markers
2008

Improving Accuracy of Liver Fibrosis Markers

Sample size: 2004 publication Evidence: high

Author Information

Author(s): Poynard Thierry, Ingiliz Patrick, Elkrief Laure, Munteanu Mona, Lebray Pascal, Morra Rachel, Messous Djamila, Bismut Francoise Imbert, Roulot Dominique, Benhamou Yves, Thabut Dominique, Ratziu Vlad

Primary Institution: APHP Groupe Hospitalier Pitié-Salpêtrière, Université Paris VI, CNRS UMR, Paris, France

Hypothesis

The concordance between liver stiffness measurements (LSM) and FibroTest (FT) would be improved by excluding high-risk patients.

Conclusion

The study validated the use of concordance between non-invasive estimates of liver fibrosis to identify variability factors and precautions for use.

Supporting Evidence

  • Applying manufacturers' recommendations increased the strength of concordance between LSM and FT.
  • Older age and NAFLD were identified as factors associated with lower concordance.
  • Biopsy confirmed the diagnostic value of LSM and FT for predicting advanced fibrosis.

Takeaway

Doctors can use new tests to check for liver damage without needing a painful biopsy, and this study shows how to make those tests more accurate.

Methodology

The study compared liver stiffness measurements and FibroTest results in patients, validating findings with liver biopsy.

Potential Biases

Potential operator effects and variability factors related to patient demographics and conditions could bias results.

Limitations

The study relied on retrospective liver biopsies rather than simultaneous biopsies, which could introduce variability.

Participant Demographics

{"age_mean":50,"male_percentage":61,"ethnic_distribution":{"Caucasian":71.5,"Asian":7.5,"North_African":10.5,"Other_African":10.5}}

Statistical Information

P-Value

p<0.00001

Confidence Interval

95% CI not specified

Statistical Significance

p<0.00001

Digital Object Identifier (DOI)

10.1371/journal.pone.0003857

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