Diagnostic accuracy, reproducibility and robustness of fibrosis blood tests in chronic hepatitis C: a meta-analysis
Vincent Leroy1, Philippe Halfon, Yannick Bacq
1Clinique d'Hépato-Gastroentérologie, Pôle Digestif-DUNE, CHU, Grenoble, France. VLeroy@chu-grenoble.fr
Objectives:
To evaluate the diagnostic accuracy of liver fibrosis tests and its influencing factors in a meta-analysis with individual data.
Design And Methods:
Four independent centers provided four blood tests and Metavir staging from 825 patients with chronic hepatitis C.
Results:
FibroMeter AUROC (0.840) for significant fibrosis was superior to those of Fibrotest (0.803, p=0.049), APRI (0.789, p=0.001) and Hepascore (0.781, p<0.001). The misclassification rate was lower for FibroMeter (23%) than for Fibrotest and Hepascore (both 28%, p<0.001). The variation in the diagnostic cut-offs of tests among centers, reflecting the overall reproducibility, was: FibroMeter: 4.2%, APRI: 24.0%, Fibrotest: 24.2%, Hepascore: 35.0%. Accordingly, the proportion of patients diagnosed with significant fibrosis changed: FibroMeter: 0.8%, Hepascore: 2.4% (p=0.02 vs FibroMeter), Fibrotest: 5.8% (p<10(-3)), APRI: 18.2% (p<10(-3)).
Conclusions:
This study on clinical applicability shows significant differences in diagnostic accuracy, inter-center reproducibility, and robustness of biomarkers to changes in population characteristics between blood tests.
Related Concept Videos
Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Cirrhosis I: Introduction
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Cirrhosis II: Pathophysiology

