Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis

BMC Gastroenterology

Table 3 Diagnostic performance of FibroTest, ELF and Transient Elastography in the prediction of significant fibrosis (F≥2), severe fibrosis (F≥3), and cirrhosis for all patients, for HCV patients only, and for PBC patients only

Test	Diagnosis	Fibrosis Stage	Cut-off	Sensitivity	Specificity	PPV	NPV	Positive LR	Negative LR
FibroTest	All patients [7]	F ≥ 2	0.32	0.57	0.60	0.74	0.42	1.43	0.71
		F ≥ 3	0.59	0.39	0.88	0.71	0.67	3.33	0.69
		F = 4	0.73	0.64	0.90	0.54	0.93	6.68	0.40
	HCV only [7]	F ≥ 2	0.32	0.81	0.60	0.84	0.55	2.02	0.32
		F ≥ 3	0.59	0.65	0.79	0.73	0.71	3.07	0.45
		F = 4	0.73	0.67	0.81	0.54	0.88	3.60	0.41
	PBC only [7]	F ≥ 2	0.32	0.30	0.75	0.75	0.30	1.20	0.93
		F ≥ 3	0.59	0.08	1.00	1.00	0.56	invalid	0.92
		F = 4	0.73	0.00	0.96	0.00	0.96	0.00	1.04
ELF	All patients [9, 18]	F ≥ 2	* 9.78	0.78	0.80	0.88	0.65	3.88	0.28
		F ≥ 3	* 10.22	0.74	0.70	0.64	0.79	2.45	0.37
		F = 4	* 10.31	0.91	0.62	0.29	0.98	2.39	0.15
	HCV only [9]	F ≥ 2	9.78	0.85	0.80	0.92	0.67	4.23	0.19
		F ≥ 3	10.22	0.82	0.74	0.74	0.82	3.13	0.24
		F = 4	10.31	0.89	0.63	0.44	0.94	2.40	0.18
	PBC only [22]	F ≥ 2	9.69	0.65	0.75	0.87	0.46	2.60	0.47
		F ≥ 3	9.71	0.62	0.53	0.53	0.62	1.32	0.72
		F = 4	9.89	1.00	0.52	0.07	1.00	2.01	0.00
TE	All patients [32–34]	F ≥ 2	* 7.20 kPa	0.64	0.76	0.85	0.50	2.71	0.47
		F ≥ 3	* 12.50 kPa	0.50	0.87	0.74	0.70	3.80	0.58
		F = 4	* 17.60 kPa	0.82	0.91	0.64	0.96	9.00	0.20
	HCV only [33]	F ≥ 2	7.10 kPa	0.79	0.50	0.79	0.50	1.58	0.42
		F ≥ 3	9.50 kPa	0.67	0.79	0.71	0.75	3.17	0.42
		F = 4	12.50 kPa	0.78	0.84	0.64	0.91	4.86	0.27
	PBC only [34]	F ≥ 2	7.30 kPa	0.39	1.00	1.00	0.31	invalid	0.61
		F ≥ 3	9.80 kPa	0.25	0.91	0.75	0.53	2.75	0.83
		F = 4	17.30 kPa	1.00	0.95	0.50	1.00	22.00	0.00

The cut-offs were evaluated in previous studies, the references are cited in the diagnosis column in brackets for all patients, for HCV, and PBC respectively and can be found in the reference list. For all patients the individual cut-offs for HCV and PBC were used if available, and for HBV the cut-offs of TE were used from a study [32] evaluating patients with different chronic liver diseases, and of ELF the cut-offs of HCV [9] were used. For FibroTest no cut-offs for PBC have been evaluated, the cut-offs for viral hepatitis [7] were used, respectively
TE = transient elastography, PPV = positive predictive value, NPV = negative predictive value, LR = likelihood ratio

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