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A two-step approach using Fibrosis-4 index and enhanced liver fibrosis testing offers a non-invasive, efficient solution for detecting advanced fibrosis in chronic liver disease, minimizing biopsies and enhancing care pathways.
A recent real-world retrospective study in MDPI- Diagnostics journal has validated the effectiveness of a sequential diagnostic approach using the Fibrosis-4 index (FIB-4) score followed by the enhanced liver fibrosis (ELF) test in predicting advanced liver fibrosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This innovative two-step method aligns with the American Association for the Study of Liver Disease recommendations backening the combination of non-invasive tests to enhance diagnostic accuracy while minimizing unnecessary procedures.
Conducted on 153 MASLD patients, Yeo-Wool Kang and colleagues demonstrated that this diagnostic approach successfully maintained high accuracy, sparing 71.8% of patients from undergoing invasive liver biopsies. With an area under the receiver operating characteristic curve (AUROC) of 0.791 and strong sensitivity and specificity metrics, the FIB-4 and ELF combination reliably identified cases requiring further intervention.
What sets this approach apart is its feasibility in primary care settings, as it does not rely on specialized equipment or advanced imaging techniques. By enabling MASLD severity assessments at the primary care level, the strategy lessens the burden on tertiary institutions and ensures timely, accurate management of liver disease.
MDPI - Diagnostics
Sequential Diagnostic Approach Using FIB-4 and ELF for Predicting Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease
Yeo-Wool Kang et al.
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