Performance of serum marker panels for liver fibrosis in chronic hepatitis C

摘要: Background/Aims Chronic hepatitis C (CHC) is characterised by hepatic fibrosis, used as a proxy measure of prognosis. Liver biopsy flawed reference standard and serum markers fibrosis offer an attractive alternative. Methods A systematic review was conducted to assess the performance panels in CHC, incorporating analyses placing clinical context. Results 14 studies were included with 10 different panels. Median AUC validation populations 0.77 training 0.81. Likelihood ratios (LR) ranged from −LR 0.1 0.9, + LR 1.2 33.1, diagnostic odds (DOR) 9.0 (median) range 5 27- mostly below values robust tests. Tests perform either high sensitivity low specificity or vice versa. Cut-off levels that gave clinically relevant predictive for presence/absence significant applicable 35% population. Conclusions Serum can rule-in rule-out up patients, but cannot differentiate stages reliably. Improvement index test needed including evaluation outcomes reference. Improved reporting derive DOR indicators.