Diagnostic accuracy of FibroScan-AST (FAST) score for the non-invasive identification of patients with fibrotic non-alcoholic steatohepatitis: a systematic review and meta-analysis

被引:53
作者
Ravaioli, Federico [1 ,2 ,3 ]
Dajti, Elton [2 ,3 ]
Mantovani, Alessandro [4 ]
Newsome, Philip Noel [5 ,6 ]
Targher, Giovanni [4 ]
Colecchia, Antonio [1 ,7 ]
机构
[1] Univ Modena & Reggio Emilia, Univ Hosp Modena, Dept Med Special, Gastroenterol Unit, Modena, Italy
[2] Univ Bologna, Dept Med & Surg Sci DIMEC, Bologna, Italy
[3] IRCCS Azienda Osped Univ Bologna, Bologna, Italy
[4] Univ & Azienda Osped Univ Integrata Verona, Dept Med, Sect Endocrinol Diabet & Metab, Verona, Italy
[5] Univ Hosp Birmingham NHS Fdn Trust, Natl Inst Hlth Res, Birmingham Biomed Res Ctr, Birmingham, England
[6] Univ Birmingham, Inst Immunol & Immunotherapy, Ctr Liver & Gastrointestinal Res, Birmingham, England
[7] Univ Modena & Reggio Emilia, Dept Med Special, I-41121 Modena, Italy
关键词
NONALCOHOLIC STEATOHEPATITIS; LIVER IMAGING; FATTY LIVER; ULTRASONOGRAPHY; HEPATIC FIBROSIS; HIGH-RISK; VALIDATION; OUTCOMES; MANAGEMENT; MORTALITY; DESIGN; MAST;
D O I
10.1136/gutjnl-2022-328689
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
ObjectiveA simple combined score with liver stiffness, controlled attenuation parameter and serum aspartate aminotransferase (AST), the FibroScan-AST (FAST) score, has been proposed to non-invasively identify patients with fibrotic non-alcoholic steatohepatitis (NASH). We performed a systematic review and meta-analysis of published studies to evaluate the overall diagnostic accuracy of the FAST score in identifying patients with fibrotic NASH. DesignWe systematically searched MEDLINE, Ovid Embase, Scopus and Cochrane Library electronic databases for full-text published articles in any language between 3 February 2020 and 30 April 2022. We included original articles that reported data for the calculation of sensitivity and specificity of the FAST score for identifying adult patients with fibrotic NASH adults, according to previously described rule-out (<= 0.35) and rule-in (>= 0.67) cut-offs. ResultsWe included 12 observational studies for a total of 5835 participants with biopsy-confirmed non-alcoholic fatty liver disease. The pooled prevalence of fibrotic NASH was 28% (95% CI 21% to 34%). The FAST score's pooled sensitivity was 89% (95% CI 82% to 93%), and the pooled specificity was 89% (95% CI 83% to 94%) according to the aforementioned rule-in/rule-out cut-offs. The negative predictive value and positive predictive value of the FAST score were 92% (95% CI 91% to 95%) and 65% (95% CI 53% to 68%), respectively. Subgroup analyses and influential bias analyses did not alter these findings. ConclusionThe results of our meta-analysis show that the FAST score has a good performance for non-invasive diagnosis of fibrotic NASH. Therefore, this score can be used to efficiently identify patients who should be referred for a conclusive liver biopsy and/or consideration for treatment with emerging pharmacotherapies. PROSPERO registration numberCRD42022350945.
引用
收藏
页码:1399 / 1409
页数:11
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