Document Detail


Diagnostic accuracy, reproducibility and robustness of fibrosis blood tests in chronic hepatitis C: a meta-analysis with individual data.
MedLine Citation:
PMID:  18655779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the diagnostic accuracy of liver fibrosis tests and its influencing factors in a meta-analysis with individual data. DESIGN AND METHODS: Four independent centers provided four blood tests and Metavir staging from 825 patients with chronic hepatitis C. RESULTS: FibroMeter 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)). CONCLUSIONS: This 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.
Authors:
Vincent Leroy; Philippe Halfon; Yannick Bacq; Jérôme Boursier; Marie Christine Rousselet; Marc Bourlière; Anne de Muret; Nathalie Sturm; Gilles Hunault; Guillaume Penaranda; Marie-Claude Bréchot; Candice Trocme; Paul Calès
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2008-07-11
Journal Detail:
Title:  Clinical biochemistry     Volume:  41     ISSN:  1873-2933     ISO Abbreviation:  Clin. Biochem.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-10     Completed Date:  2008-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0133660     Medline TA:  Clin Biochem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1368-76     Citation Subset:  IM    
Affiliation:
Clinique d'Hépato-Gastroentérologie, Pôle Digestif-DUNE, CHU, Grenoble, France. VLeroy@chu-grenoble.fr
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MeSH Terms
Descriptor/Qualifier:
Female
Fibrosis
Hematologic Tests / standards*
Hepatitis C, Chronic / blood,  diagnosis*,  pathology*
Humans
Male
ROC Curve
Reproducibility of Results
Sensitivity and Specificity

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