Table 3 Diagnostic performance of each approach for predicting advanced fibrosis in cohort with a 3.7% prevalence of advanced fibrosis.

From: A 3-step approach to predict advanced fibrosis in nonalcoholic fatty liver disease: impact on diagnosis, patient burden, and medical costs

Ā 

Se, %

Sp, %

PPV, %

NPV, %

Diagnosed as high risk/

all cases, %

Referral cases/

all cases, %

FIB-4

91.2 ± 10.7

(71.4 to 100.0)

43.7 ± 3.7

(36.6 to 50.8)

5.8 ± 0.7

(4.2 to 7.1)

99.2 ± 0.9

(97.2 to 100.0)

–

-

2-step:

FIB-4–VCTE

84.4 ± 13.7

(57.1 to 100.0)

73.5 ± 3.3

(67.2 to 79.8)

11.0 ± 2.0

(6.9 to 14.9)

99.2 ± 0.7

(97.7 to 100.0)

28.7 ± 3.2

(22.6 to 34.7)

57.6 ± 3.6

(50.5 to 64.7)

3-step:

FIB-4–ELF–VCTE

81.5 ± 14.7

(57.1 to 100.0)

79.0 ± 3.0

(73.2 to 84.7)

13.1 ± 2.7

(7.8 to 18.4)

99.1 ± 0.7

(97.7 to 100.0)

23.2 ± 2.9

(17.4 to 28.9)

40.0 ± 3.5

(33.2 to 46.8)

Difference (vs. 2-step)

ā€‰āˆ’ā€‰2.9 ± 6.3

(āˆ’ā€‰14.3 to 0.0)

5.5 ± 1.7

(2.7 to 8.8)

2.1 ± 1.3

(āˆ’ā€‰0.6 to 4.7)

ā€‰āˆ’ā€‰0.1 ± 0.3

(āˆ’ā€‰0.7 to 0.2)

ā€‰āˆ’ā€‰5.4 ± 1.6

(āˆ’ā€‰8.9 toā€‰āˆ’ā€‰2.6)

ā€‰āˆ’ā€‰17.7 ± 2.8

(āˆ’ā€‰23.2 toā€‰āˆ’ā€‰12.6)

3-step:

FIB-4–T4C7S–VCTE

83.4 ± 14.0

(57.1 to 100.0)

78.4 ± 3.1

(72.1 to 84.2)

13.1 ± 2.6

(8.0 to 18.2)

99.2 ± 0.7

(97.8 to 100.0)

23.8 ± 3.0

(17.9 to 30.0)

36.3 ± 3.4

(29.5 to 43.2)

Difference (vs. 2-step)

ā€‰āˆ’ā€‰1.0 ± 3.7

(āˆ’ā€‰14.3 to 0.0)

5.0 ± 1.6

(2.2 to 8.2)

2.1 ± 1.0

(āˆ’ā€‰0.1 to 4.3)

0.0 ± 0.2

(āˆ’ā€‰0.7 to 0.2)

ā€‰āˆ’ā€‰4.8 ± 1.5

(āˆ’ā€‰7.9 toā€‰āˆ’ā€‰2.1)

ā€‰āˆ’ā€‰21.3 ± 3.0

(āˆ’ā€‰27.3 toā€‰āˆ’ā€‰15.8)

  1. Upper line indicates mean ± SD, and lower line indicates 95% CI.
  2. Bold letters indicate a significant difference compared to the 2-step approach.
  3. CI, confidence interval; ELF, enhanced liver fibrosis test; FIB-4, Fibrosis-4 index; NPV, negative predictive value; PPV, positive predictive value; Se, sensitivity; Sp, specificity; T4C7S, type IV collagen 7S domain; VCTE, vibration-controlled transient elastography.