Diagnostic accuracy of non-invasive tests to screen for at-risk MASH-An individual participant data meta-analysis.

Autor: Mózes FE; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, OCMR, University of Oxford, Oxford, UK., Lee JA; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Vali Y; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Selvaraj EA; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, OCMR, University of Oxford, Oxford, UK.; Translational Gastroenterology Unit, University of Oxford, Oxford, UK.; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK., Jayaswal ANA; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, OCMR, University of Oxford, Oxford, UK., Boursier J; Laboratoire HIFIH, UPRES EA 3859, SFR ICAT 4208, Université d'Angers, Angers, France.; Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, Angers, France., de Lédinghen V; Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, France.; INSERM1312, Bordeaux University, Bordeaux, France., Lupșor-Platon M; Department of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Regional Institute of Gastroenterology and Hepatology 'Prof.Dr. Octavian Fodor', Cluj-Napoca, Romania., Yilmaz Y; Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey.; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey., Chan WK; Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Mahadeva S; Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Karlas T; Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany., Wiegand J; Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany., Shalimar; Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India., Tsochatzis E; Sheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital and University College London, London, UK., Liguori A; Sheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital and University College London, London, UK.; Department of Translational Medicine and Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy., Wong VW; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong., Lee DH; Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea., Holleboom AG; Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., van Dijk AM; Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Mak AL; Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Hagström H; Division of Liver and Pancreatic diseases, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden.; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden., Akbari C; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden., Hirooka M; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Touon, Ehime, Japan., Lee DH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea., Kim W; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea., Okanoue T; Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan., Shima T; Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan., Nakajima A; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan., Yoneda M; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan., Thuluvath PJ; Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, Maryland, USA.; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Li F; Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, Maryland, USA., Berzigotti A; Department for Visceral Medicine and Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Department of Biomedical Research, University of Bern, Bern, Switzerland., Mendoza YP; Department for Visceral Medicine and Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland., Noureddin M; Houston Research Institute, Houston Methodist Hospital, Houston, Texas, USA., Truong E; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA., Fournier-Poizat C; Echosens, Paris, France., Geier A; Division of Hepatology, University Hospital Würzburg, Würzburg, Germany., Tuthill T; Internal Medicine Research Unit, Pfizer Inc, Cambridge, Massachusetts, USA., Yunis C; Clinical Development and Operations, Global Product Development, Pfizer, Inc, Lake Mary, Florida, USA., Anstee QM; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK., Harrison SA; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, OCMR, University of Oxford, Oxford, UK., Bossuyt PM; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Pavlides M; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, OCMR, University of Oxford, Oxford, UK.; Translational Gastroenterology Unit, University of Oxford, Oxford, UK.; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2024 Aug; Vol. 44 (8), pp. 1872-1885. Date of Electronic Publication: 2024 Apr 04.
DOI: 10.1111/liv.15914
Abstrakt: Background & Aims: There is a need to reduce the screen failure rate (SFR) in metabolic dysfunction-associated steatohepatitis (MASH) clinical trials (MASH+F2-3; MASH+F4) and identify people with high-risk MASH (MASH+F2-4) in clinical practice. We aimed to evaluate non-invasive tests (NITs) screening approaches for these target conditions.
Methods: This was an individual participant data meta-analysis for the performance of NITs against liver biopsy for MASH+F2-4, MASH+F2-3 and MASH+F4. Index tests were the FibroScan-AST (FAST) score, liver stiffness measured using vibration-controlled transient elastography (LSM-VCTE), the fibrosis-4 score (FIB-4) and the NAFLD fibrosis score (NFS). Area under the receiver operating characteristics curve (AUROC) and thresholds including those that achieved 34% SFR were reported.
Results: We included 2281 unique cases. The prevalence of MASH+F2-4, MASH+F2-3 and MASH+F4 was 31%, 24% and 7%, respectively. Area under the receiver operating characteristics curves for MASH+F2-4 were .78, .75, .68 and .57 for FAST, LSM-VCTE, FIB-4 and NFS. Area under the receiver operating characteristics curves for MASH+F2-3 were .73, .67, .60, .58 for FAST, LSM-VCTE, FIB-4 and NFS. Area under the receiver operating characteristics curves for MASH+F4 were .79, .84, .81, .76 for FAST, LSM-VCTE, FIB-4 and NFS. The sequential combination of FIB-4 and LSM-VCTE for the detection of MASH+F2-3 with threshold of .7 and 3.48, and 5.9 and 20 kPa achieved SFR of 67% and sensitivity of 60%, detecting 15 true positive cases from a theoretical group of 100 participants at the prevalence of 24%.
Conclusions: Sequential combinations of NITs do not compromise diagnostic performance and may reduce resource utilisation through the need of fewer LSM-VCTE examinations.
(© 2024 The Authors. Liver International published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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