Fig. 3: Performance of biomarkers of liver fibrosis (APRI, GPR, FIB-4) and ALT using transient elastography as a reference for the diagnosis.
The diagnosis of A LSM > 12.2 kPa (associated with cirrhosis) and B LSM > 7.9 kPa (associated with significant fibrosis): Bayesian random effects modela. Point estimates are shown as red circles with 95% credible intervals shown as error bars. CrI credible interval, APRI aspartate aminotransferase-to-platelet ratio index, FIB-4 fibrosis-4 score, GPR gamma[1]glutamyl transferase-to-platelet ratio, ALT alanine aminotransferase, LSM liver stiffness measurement. aBayesian bivariate random effects model (n = 3548 biologically independent samples) adjusted for sex, study, hazardous alcohol consumption, reason for testing (suspected liver disease or asymptomatic screening) and categorical body mass index; summary statistics show population average. Youden’s J = maximisation of Youden’s J statistic, with equal weight to sensitivity and specificity (J = sensitivity + specificity − 1). Rule-in models were chosen where specificity exceeds 90%; rule-out models where sensitivity >80%.
