Original Article
Question: What is the effectiveness of liver biopsy (histology) and other non-invasive tests in predicting the clinical course of patients with non-alcoholic fatty liver disease (NAFLD)?
Design/Method: An analysis was done on systematic reviews on diagnostic accuracy of imaging and simple non-invasive tests, focusing on all-cause mortality, hepatocellular carcinoma, liver transplantation, or cirrhosis complications. Aggregated survival curves for trichotomised groups were calculated and compared using stratified log-rank tests, calculated areas under the time-dependent receiver operating characteristic curves (tAUC), and performed Cox proportional-hazards regression to adjust for confounding
Setting: European
Patients/ Study community: Patients with NAFLD
Results: The data showed that non-invasive tests, such as LSM-VCTE, FIB-4, and NFS, had varying levels of sensitivity and specificity in predicting outcomes, and their performance was generally comparable to histology
Commentary: This study is significant as it addresses the need for non-invasive tools in the management of NAFLD and provides valuable insights into their performance compared to traditional liver biopsy in predicting clinical outcomes. The data of this study can serve as an initial step towards the adoption of non-invasive tests by clinicians and regulators in the management of NAFLD, ultimately benefiting patients by minimizing the need for invasive liver biopsies
Citation: Mózes F.E, Lee J.A, Vali Y, Alzoubi O, Staufer K. Performance of non-invasive tests and histology for the prediction of clinical outcomes in patients with non-alcoholic fatty liver disease: an individual participant data meta-analysis. Lancet Gastroenterology and Hepatology. 2023; 8: 704–13
DOI: 10.1016/S2468-1253(23)00141-3
https://www.thelancet.com/journals/langas/article/PIIS2468-1253(23)00141-3/fulltext
