Diagnostic accuracy, reproducibility and robustness of fibrosis blood tests in chronic hepatitis C: a meta-analysis with individual data |
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| Authors: | Leroy Vincent Halfon Philippe Bacq Yannick Boursier Jérôme Rousselet Marie Christine Bourlière Marc de Muret Anne Sturm Nathalie Hunault Gilles Penaranda Guillaume Bréchot Marie-Claude Trocme Candice Calès Paul |
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| Institution: | 1. Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK;2. University Witten/Herdecke, Germany;3. The Binding Site Group Ltd, Birmingham, UK;4. Neurology Department, University Hospital North Staffordshire, Stoke-on-Trent, UK;5. Department of Neurology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK;1. Department of Neurology, University Medical Centre Ljubljana, Zaloska c. 2, SI-1525 Ljubljana, Slovenia;2. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1104 Ljubljana, Slovenia;3. Clinical Institute of Clinical chemistry and Biochemistry, University Medical Centre Ljubljana, Njegoseva 4, SI-1525 Ljubljana, Slovenia;1. Department of Experimental Medicine and Surgery, \"Tor Vergata\" University Hospital, Rome, Italy;2. Department of Systems Medicine, “Tor Vergata” University Hospital & IRCCS Fondazione Santa Lucia, Rome, Italy;1. Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, 250# Changgang East Road, Guangzhou 510260 Guangdong Province, China;2. Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, 250# Changgang East Road, Guangzhou 510260, Guangdong Province, China;3. Department of Emergency, the Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang east Road, GuangZhou, 510260 Guangdong Province, China |
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| Abstract: | ObjectivesTo evaluate the diagnostic accuracy of liver fibrosis tests and its influencing factors in a meta-analysis with individual data.Design and methodsFour independent centers provided four blood tests and Metavir staging from 825 patients with chronic hepatitis C.ResultsFibroMeter AUROC (0.840) for significant fibrosis was superior to those of Fibrotest (0.803, p = 0.049), APRI (0.789, p = 0.001) and Hepascore (0.781, p < 0.001). The misclassification rate was lower for FibroMeter (23%) than for Fibrotest and Hepascore (both 28%, p < 0.001). The variation in the diagnostic cut-offs of tests among centers, reflecting the overall reproducibility, was: FibroMeter: 4.2%, APRI: 24.0%, Fibrotest: 24.2%, Hepascore: 35.0%. Accordingly, the proportion of patients diagnosed with significant fibrosis changed: FibroMeter: 0.8%, Hepascore: 2.4% (p = 0.02 vs FibroMeter), Fibrotest: 5.8% (p < 10? 3), APRI: 18.2% (p < 10? 3).ConclusionsThis study on clinical applicability shows significant differences in diagnostic accuracy, inter-center reproducibility, and robustness of biomarkers to changes in population characteristics between blood tests. |
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