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Poor accuracy and s...
Poor accuracy and sustainability of the first-step FIB4 EASL pathway for stratifying steatotic liver disease risk in the general population.
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De Vincentis, Antonio (author)
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Tavaglione, Federica (author)
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Namba, Shinichi (author)
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Kanai, Masahiro (author)
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Okada, Yukinori (author)
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Kamatani, Yoichiro (author)
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Maurotti, Samantha (author)
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Pedone, Claudio (author)
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Antonelli Incalzi, Raffaele (author)
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Valenti, Luca (author)
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- Romeo, Stefano, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Vespasiani-Gentilucci, Umberto (author)
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Alimentary pharmacology & therapeutics. - 1365-2036.
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- The European Association for the Study of the Liver introduced a clinical pathway (EASL CP) for screening significant/advanced fibrosis in people at risk of steatotic liver disease (SLD). We assessed the performance of the first-step FIB4 EASL CP in the general population across different SLD risk groups (MASLD, Met-ALD and ALD) and various age classes.We analysed a total of 3372 individuals at risk of SLD from the 2017-2018 National Health and Nutrition Examination Survey (NHANES17-18), projected to 152.3million U.S. adults, 300,329 from the UK Biobank (UKBB) and 57,644 from the Biobank Japan (BBJ). We assessed liver stiffness measurement (LSM) ≥8kPa and liver-related events occurring within 3 and 10years (3/10year-LREs) as outcomes. We defined MASLD, MetALD, and ALD according to recent international recommendations.FIB4 sensitivity for LSM≥8kPa was low (27.7%), but it ranged approximately 80%-90% for 3-year LREs. Using FIB4, 22%-57% of subjects across the three cohorts were identified as candidates for vibration-controlled transient elastography (VCTE), which was mostly avoidable (positive predictive value of FIB4≥1.3 for LSM≥8kPa ranging 9.5%-13% across different SLD categories). Sensitivity for LSM≥8kPa and LREs increased with increasing alcohol intake (ALD>MetALD>MASLD) and age classes. For individuals aged ≥65years, using the recommended age-adjusted FIB4 cut-off (≥2) substantially reduced sensitivity for LSM≥8kPa and LREs.The first-step FIB4 EASL CP is poorly accurate and feasible for individuals at risk of SLD in the general population. It is crucial to enhance the screening strategy with a first-step approach able to reduce unnecessary VCTEs and optimise their yield.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- ref (subject category)
- art (subject category)
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De Vincentis, An ...
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Tavaglione, Fede ...
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Namba, Shinichi
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Kanai, Masahiro
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Okada, Yukinori
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Kamatani, Yoichi ...
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show more...
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Maurotti, Samant ...
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Pedone, Claudio
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Antonelli Incalz ...
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Valenti, Luca
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Romeo, Stefano, ...
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Vespasiani-Genti ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Alimentary pharm ...
- By the university
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University of Gothenburg