Sharma, C;
Cococcia, S;
Ellis, N;
Parkes, J;
Rosenberg, W;
(2021)
Systematic review: Accuracy of The Enhanced Liver Fibrosis Test for diagnosing advanced liver fibrosis and cirrhosis.
Journal of Gastroenterology and Hepatology
10.1111/jgh.15482.
(In press).
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Abstract
BACKGROUND & AIMS: The rising incidence of chronic liver disease (CLD) has increased the need for early recognition. This systematic review assesses the diagnostic accuracy of the Enhanced Liver Fibrosis (ELF) test in cases of advanced fibrosis and cirrhosis due to multiple aetiologies in at-risk populations. METHODS: Studies evaluating the ELF accuracy in identifying advanced fibrosis or cirrhosis, defined as METAVIR stage F ≥ 3 and F=4 or equivalent, in patients with non-alcoholic fatty liver disease (NAFLD), alcohol liver disease (ALD), or viral hepatitis were included. Liver biopsy was used as the reference standard. Medline and Embase databases were searched. The QUADAS-2 tool was used as a framework to assess risk of bias and applicability. The Area Under the Receiver Operator Curve (AUROC) was extracted as a summary measure of diagnostic accuracy. RESULTS: 36 studies were included: 11 hepatitis C, 4 hepatitis B, 9 NAFLD, 2 ALD, and 10 mixed. The ELF test showed good diagnostic performance in detecting advanced fibrosis in patients with viral hepatitis (AUROC 0.69-0.98) and excellent performance in NAFLD (AUROC 0.78 to 0.97) and ALD (AUROC from 0.92 to 0.94). There is also evidence of good diagnostic performance for detecting cirrhosis in patients with viral hepatitis (AUROC 0.63 to 0.99), good performance in NAFLD (AUROC 0.85 to 0.92) and excellent performance in patients with ALD (AUROC 0.93 to 0.94). CONCLUSION: This systematic review supports the use of the ELF test across a range of CLD as a possible alternative to liver biopsy in selected cases.
| Type: | Article |
|---|---|
| Title: | Systematic review: Accuracy of The Enhanced Liver Fibrosis Test for diagnosing advanced liver fibrosis and cirrhosis |
| Location: | Australia |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/jgh.15482 |
| Publisher version: | http://dx.doi.org/10.1111/jgh.15482 |
| Language: | English |
| Additional information: | © 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Diagnostic accuracy, Enhanced liver fibrosis test, Liver biopsy, Liver fibrosis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10124333 |
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