Review
Copyright ©The Author(s) 2023.
World J Hepatol. May 27, 2023; 15(5): 609-640
Published online May 27, 2023. doi: 10.4254/wjh.v15.i5.609
Table 8 Composite scores for the detection of fibrosis in nonalcoholic fatty liver disease
Ref.
Scores
Country
Categories Tested
Sample size (n)
Dx
Cutoff
AUROC (95%CI)
Sens (%)
Spec (%)
PPV (%)
NPV (%)
P value
Mosca et al[101], 2019APRIItalyPresence of ≥ F2No/borderline NASH (n = 115), definite NASH (n = 89)Biopsy> 0.240.765980709243
Mosca et al[101], 2019APRIItalyPresence of F3No/borderline NASH (n = 115), definite NASH (n = 89)Biopsy> 0.260.853510049100100
Mosca et al[142], 2022APRIItaly> F1NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.61962.852
Mosca et al[142], 2022APRIItaly> F2NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.748678.1
Mansoor et al[140], 2015APRIUnited StatesPresence of F1-F4NAFLD (n = 92)Biopsy0.800 (0.695-0.904)
Mansoor et al[140], 2015APRIUnited StatesPresence of F2-F4NAFLD (n = 92)Biopsy0.666 (0.553-0.778)
Mansoor et al[140], 2015APRIUnited StatesPresence of F3-F4NAFLD (n = 92)Biopsy0.628 (0.478-0.778)
Mansoor et al[140], 2015AST/ALT ratioUnited StatesPresence of F1-F4NAFLD (n = 92)Biopsy0.572 (0.350, 0.793)
Mansoor et al[140], 2015AST/ALT ratioUnited StatesPresence of F2-F4NAFLD (n = 92)Biopsy0.585 (0.466-0.703)
Mansoor et al[140], 2015AST/ALT ratioUnited StatesPresence of F3 - F4NAFLD (n = 92)Biopsy0.441 (0.316-0.565)
Mandelia et al[84], 2016CK18 + WC per-centileItalyPresence of ≥ F1NAFLD (n = 201), F0 (n = 65), F1–F3 (n = 136)Biopsy≥ 350.84 (0.79-0.90)97387686
Mandelia et al[84], 2016CK18 + WC per-centileItalyPresence of ≥ F1NAFLD (n = 201), F0 (n = 65), F1–F3 (n = 136)Biopsy> 8259889151
Gawrieh et al[150], 2021ELFUnited StatesAny fibrosis (≥ F1)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.60 (0.50–0.70)0.11
Gawrieh et al[150], 2021ELFUnited StatesClinically significant (≥ F2)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.70 (0.60–0.80)< 0.001
Gawrieh et al[150], 2021ELFUnited StatesAdvanced fibrosis (≥ F3)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.79 (0.69–0.89)< 0.001
Chaidez et al[105], 2022FAST scoreUnited StatesSignificant liver disease (NAS ≥ 4 and Ishak ≥ 3) vs NAS < 4 / Ishak < 3)Chronic liver disease (n = 206; 116 with NAFLD)Biopsy≥ 0.670.75 (0.56-0.94)8962
Mosca et al[101], 2019FIB-4ItalyPresence of ≥ F2No/borderline NASH (n = 115), definite NASH (n = 89)Biopsy> 0.220.741264728839
Mosca et al[101], 2019FIB-4ItalyPresence of F3No/borderline NASH (n = 115), definite NASH (n = 89)Biopsy> 0.240.76878671999
Arsik et al[54], 2018Mean ALT over 96 weeksUnited StatesFibrosisFibrosis (n = 128), NASH (n = 131)Biopsy58.5656.564.6
Mosca et al[142], 2022FIB-4Italy> F1NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.5456252
Mosca et al[142], 2022FIB-4Italy> F2NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.588
Mansoor et al[140], 2015FIB-4United StatesPresence of F1-F4NAFLD (n = 92)Biopsy0.547 (0.375-0.719)
Mansoor et al[140], 2015FIB-4United StatesPresence of F2-F4NAFLD (n = 92)Biopsy0.686 (0.576-0.797)
Mansoor et al[140], 2015FIB-4United StatesPresence of F3-F4NAFLD (n = 92)Biopsy0.367 (0.231-0.503)
Gawrieh et al[150], 2021HAUnited StatesAny fibrosis (≥ F1)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.57 (0.47–0.67)0.32
Gawrieh et al[150], 2021HAUnited StatesSignificant fibrosis (≥ F2)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.64 (0.54–0.74)0.002
Gawrieh et al[150], 2021HAUnited StatesAdvanced fibrosis (≥ F3)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.77 (0.66–0.88)0.001
Mosca et al[142], 2022HepametItaly≥ F2NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.7388.876.6
Mosca et al[142], 2022HepametItaly> F1NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.77863.261.3
Mansoor et al[140], 2015NFSUnited StatesPresence of F1-F4NAFLD (n = 92)Biopsy0.470 (0.259-0.681)
Mansoor et al[140], 2015NFSUnited StatesPresence of F2-F4NAFLD (n = 92)Biopsy0.554 (0.435-0.673)
Mansoor et al[140], 2015NFSUnited StatesPresence of F3-F4NAFLD (n = 92)Biopsy0.521 (0.385-0.657)
Mosca et al[142], 2022NFSItaly> F1NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.5376252
Mosca et al[142], 2022NFSItaly> F2NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.6
Gawrieh et al[150], 2021PIIINPUnited StatesAny fibrosis (≥ F1)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.55 (0.45–0.65)0.18
Gawrieh et al[150], 2021PIIINPUnited StatesClinically significant (≥ F2)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.66 (0.57–0.75)0.002
Gawrieh et al[150], 2021PIIINPUnited StatesAdvanced fibrosis (≥ F3)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.65 (0.53–0.76)0.06
Mosca et al[142], 2022PNFIItaly> F1NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.8190.375.4
Nobili et al[148], 2009PNFIItaly≥ F1NAFLD (n = 203), Fibrosis (n = 141), no fibrosis (n = 62), stage 1 fibrosis (n = 115), stage 2 fibrosis (n = 9), stage 3 fibrosis (n = 17)Biopsy≥ 90.85 (0.80-0.90)98.5
Mosca et al[142], 2022PNFIItaly> F2NAFLD (n = 286), F0 (n = 105), F1 (n = 140), F2 (n = 31), F3 (n = 2)Biopsy0.8497.572.6
Gawrieh et al[150], 2021TIMP-1United StatesAny fibrosis (≥ F1)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.63 (0.54–0.72)0.02
Gawrieh et al[150], 2021TIMP-1United StatesClinically significant (≥ F2)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.63 (0.53–0.72)0.01
Gawrieh et al[150], 2021TIMP-1United StatesAdvanced fibrosis (≥ F3)NAFLD (n = 173), borderline/suspicious NASH (n = 73), definite NASH (n = 71)Biopsy0.76 (0.64–0.88)< 0.001
ALT: Alanine aminotransferase; AUROC: Area under the receiver operating characteristic curve; AST: Aspartate aminotransferase; APRI: AST to platelet ratio index; CI: Confidence interval; Dx: Diagnosis; ELF: Enhanced liver fibrosis; F: Fibrosis stage; FAST: FibroScan-aspartate aminotransferase; FIB-4: Fibrosis-4, Fibrosis-4; HA: Hyaluronic acid; NAS: NAFLD activity score; NAFLD: Nonalcoholic fatty liver disease; NFS: NAFLD Fibrosis Score; NPV: Negative predictive value; PIIINP: Amino-terminal propeptide of type III procollagen; PNFI: Pediatric NAFLD Fibrosis Index; PPV: Positive predictive value; Sens: Sensitivity; Spec: Specificity; TIMP-1: Tissue inhibitor of metalloproteinase-1; WC, waist circumference.