Diagnostic accuracy of non-invasive tests to screen for at-risk MASH-An individual participant data meta-analysisopen access
- Authors
- Mozes, Ferenc E.; Lee, Jenny A.; Vali, Yasaman; Selvaraj, Emmanuel A.; Jayaswal, Arjun N. A.; Boursier, Jerome; de Ledinghen, Victor; Lupsor-Platon, Monica; Yilmaz, Yusuf; Chan, Wah-Kheong; Mahadeva, Sanjiv; Karlas, Thomas; Wiegand, Johannes; Tsochatzis, Emmanouil; Liguori, Antonio; Wong, Vincent Wai-Sun; Lee, Dae Ho; Holleboom, Adriaan G.; van Dijk, Anne-Marieke; Mak, Anne Linde; Hagstroem, Hannes; Akbari, Camilla; Hirooka, Masashi; Lee, Dong Hyeon; Kim, Won; Okanoue, Takeshi; Shima, Toshihide; Nakajima, Atsushi; Yoneda, Masato; Thuluvath, Paul J.; Li, Feng; Berzigotti, Annalisa; Mendoza, Yuly P.; Noureddin, Mazen; Truong, Emily; Fournier-Poizat, Celine; Geier, Andreas; Tuthill, Theresa; Yunis, Carla; Anstee, Quentin M.; Harrison, Stephen A.; Bossuyt, Patrick M.; Pavlides, Michael
- Issue Date
- Aug-2024
- Publisher
- WILEY
- Keywords
- at-risk MASH; FAST; FIB-4; LSM-VCTE; MASH; NFS; non-invasive tests
- Citation
- LIVER INTERNATIONAL, v.44, no.8, pp 1872 - 1885
- Pages
- 14
- Journal Title
- LIVER INTERNATIONAL
- Volume
- 44
- Number
- 8
- Start Page
- 1872
- End Page
- 1885
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/92173
- DOI
- 10.1111/liv.15914
- ISSN
- 1478-3223
1478-3231
- Abstract
- 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.
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