Validation of Seven Noninvasive Diagnostic Models for Prediction of Liver Fibrosis in Patients With Chronic Hepatitis B

Abstract

Background and AimsSeveral noninvasive models have been developed for fibrosis assessment in patients with chronic hepatitis B. However, the sensitivity, specificity and diagnostic accuracy in evaluating liver fibrosis of these methods have not been validated and compared in the same group of patients. The aim of this study was to verify the diagnostic performance, reproducibility and applicability of 7 reported noninvasive models in a large cohort of Asian CHB patients.MethodsThe diagnostic performance of 7 noninvasive models (HALF index, FibroScan, S index, Zeng model, Youyi model, Hui model and APAG) was assessed against the liver histology by ROC curve analysis in CHB patients. The reproducibility and applicability of the seven models were evaluated by comparing the diagnostic performance at the optimal cut-off values obtained from the present study and at the cut-off values defined by the original studies.ResultsFive models (HALF index, FibroScan, Zeng model, Youyi model and S index) had areas under ROC curves higher than 0.70 in predicting any fibrosis stage and 2 of them had best diagnostic performance with AUROCs to predict F≥2, F≥3 and F4 being 0.83, 0.89 and 0.89 for HALF index, 0.82, 0.87 and 0.87 for FibroScan, respectively. Four models (HALF index, FibroScan, Zeng model and Youyi model) showed similar diagnostic performances (Sen, Spe, PPV and NPV) at optimal cut-off values derived from the current study and those from the original studies.ConclusionsHALF index, FibroScan, Zeng model, Youyi model and S index had a good diagnostic performance and 4 of them, except S index, had good reproducibility and applicability for evaluating liver fibrosis in CHB patients. Background and AimsSeveral noninvasive models have been developed for fibrosis assessment in patients with chronic hepatitis B. However, the sensitivity, specificity and diagnostic accuracy in evaluating liver fibrosis of these methods have not been validated and compared in the same group of patients. The aim of this study was to verify the diagnostic performance, reproducibility and applicability of 7 reported noninvasive models in a large cohort of Asian CHB patients. Several noninvasive models have been developed for fibrosis assessment in patients with chronic hepatitis B. However, the sensitivity, specificity and diagnostic accuracy in evaluating liver fibrosis of these methods have not been validated and compared in the same group of patients. The aim of this study was to verify the diagnostic performance, reproducibility and applicability of 7 reported noninvasive models in a large cohort of Asian CHB patients. MethodsThe diagnostic performance of 7 noninvasive models (HALF index, FibroScan, S index, Zeng model, Youyi model, Hui model and APAG) was assessed against the liver histology by ROC curve analysis in CHB patients. The reproducibility and applicability of the seven models were evaluated by comparing the diagnostic performance at the optimal cut-off values obtained from the present study and at the cut-off values defined by the original studies. The diagnostic performance of 7 noninvasive models (HALF index, FibroScan, S index, Zeng model, Youyi model, Hui model and APAG) was assessed against the liver histology by ROC curve analysis in CHB patients. The reproducibility and applicability of the seven models were evaluated by comparing the diagnostic performance at the optimal cut-off values obtained from the present study and at the cut-off values defined by the original studies. ResultsFive models (HALF index, FibroScan, Zeng model, Youyi model and S index) had areas under ROC curves higher than 0.70 in predicting any fibrosis stage and 2 of them had best diagnostic performance with AUROCs to predict F≥2, F≥3 and F4 being 0.83, 0.89 and 0.89 for HALF index, 0.82, 0.87 and 0.87 for FibroScan, respectively. Four models (HALF index, FibroScan, Zeng model and Youyi model) showed similar diagnostic performances (Sen, Spe, PPV and NPV) at optimal cut-off values derived from the current study and those from the original studies. Five models (HALF index, FibroScan, Zeng model, Youyi model and S index) had areas under ROC curves higher than 0.70 in predicting any fibrosis stage and 2 of them had best diagnostic performance with AUROCs to predict F≥2, F≥3 and F4 being 0.83, 0.89 and 0.89 for HALF index, 0.82, 0.87 and 0.87 for FibroScan, respectively. Four models (HALF index, FibroScan, Zeng model and Youyi model) showed similar diagnostic performances (Sen, Spe, PPV and NPV) at optimal cut-off values derived from the current study and those from the original studies. ConclusionsHALF index, FibroScan, Zeng model, Youyi model and S index had a good diagnostic performance and 4 of them, except S index, had good reproducibility and applicability for evaluating liver fibrosis in CHB patients. HALF index, FibroScan, Zeng model, Youyi model and S index had a good diagnostic performance and 4 of them, except S index, had good reproducibility and applicability for evaluating liver fibrosis in CHB patients.