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Please, PLEASE: elevated liver stiffness in the general population is NOT fibrosis.
The otherwise great study from @DrMTLong in @HEP_Journal testing #liverstiffness in the Framingham Heart Study (
) provides a good example why... https://pubmed.ncbi.nlm.nih.gov/33125745/
Please, PLEASE: elevated liver stiffness in the general population is NOT fibrosis.
The otherwise great study from @DrMTLong in @HEP_Journal testing #liverstiffness in the Framingham Heart Study (
) provides a good example why... https://pubmed.ncbi.nlm.nih.gov/33125745/
2/
They find LSM>8.2 in 8.8% of participants.
Cut-off is based on the biopsy-controlled study in #NAFLD from @LITMUS_IMI where significant fibrosis (≥F2) was diagnosed with sens=71% and spec=70% https://pubmed.ncbi.nlm.nih.gov/30689971/
They find LSM>8.2 in 8.8% of participants.Cut-off is based on the biopsy-controlled study in #NAFLD from @LITMUS_IMI where significant fibrosis (≥F2) was diagnosed with sens=71% and spec=70% https://pubmed.ncbi.nlm.nih.gov/30689971/
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Lets guesstimate that the true prevalence of significant fibrosis in the Framingham population is 8%
using sensitivity 70% and specificity 71%, the positive predictive value of a patient ACTUALLY having significant fibrosis when LSM is >8.2 kPa is...
... 17%
Lets guesstimate that the true prevalence of significant fibrosis in the Framingham population is 8%using sensitivity 70% and specificity 71%, the positive predictive value of a patient ACTUALLY having significant fibrosis when LSM is >8.2 kPa is... ... 17%
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Meaning that 83% of participants with LSM>8.2kPa do not have significant fibrosis.
The problem can be easily solved: Just state "elevated liver stiffness" instead of "liver fibrosis".
A comment about this back in 2016: https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.28791
Meaning that 83% of participants with LSM>8.2kPa do not have significant fibrosis.
The problem can be easily solved: Just state "elevated liver stiffness" instead of "liver fibrosis".
A comment about this back in 2016: https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.28791
