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Abstract Details
Accuracy of Noninvasive Diagnostic Tests for the Detection of Significant and Advanced Fibrosis Stages in Nonalcoholic Fatty Liver Disease: A Systematic Literature Review of the US Studies
Diagnostics (Basel). 2022 Oct 27;12(11):2608. doi: 10.3390/diagnostics12112608.
1Department of Commercial Strategy and Operations, Glympse Bio, Cambridge, MA 02140, USA.
2Department of Medicine, Medicine Sorbonne University, 75013 Paris, France.
3Health Economics and Outcomes Research Department, ZRx Outcomes Research Inc., Mississauga, ON L5A 2X7, Canada.
4Department of Hepatology, Impact Research Institute, Waco, TX 76710, USA.
5Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
6Department of Medicine, UCLA Santa Monica Medical Center, Santa Monica, CA 90404, USA.
7Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
Abstract
Background: The purpose of this systematic literature review (SLR) was to evaluate the accuracy of noninvasive diagnostic tools in detecting significant or advanced (F2/F3) fibrosis among patients with nonalcoholic fatty liver (NAFL) in the US healthcare context.
Methods: The SLR was conducted in PubMed and Web of Science, with an additional hand search of public domains and citations, in line with the PRISMA statement. The study included US-based original research on diagnostic test sensitivity, specificity and accuracy.
Results: Twenty studies were included in qualitative evidence synthesis. Imaging techniques with the highest diagnostic accuracy in F2/F3 detection and differentiation were magnetic resonance elastography and vibration-controlled transient elastography. The most promising standard blood biomarkers were NAFLD fibrosis score and FIB-4. The novel diagnostic tools showed good overall accuracy, particularly a score composed of body mass index, GGT, 25-OH-vitamin D, and platelet count. The novel approaches in liver fibrosis detection successfully combine imaging techniques and blood biomarkers.
Conclusions: While noninvasive techniques could overcome some limitations of liver biopsy, a tool that would provide a sufficiently sensitive and reliable estimate of changes in fibrosis development and regression is still missing.