Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
4 days ago
Nocturia is a risk factor for mortality, according to the results of the Nagahama Study, which boasts of a low incidence of missing data and high representation of the general population.

ELF test delivers limited specificity for predicting advanced fibrosis

23 Jul 2020

The enhanced liver fibrosis (ELF) test is sensitive but has limited specificity for the detection of advanced fibrosis in patients with nonalcoholic fatty liver disease, a recent meta-analysis has found.

Seventeen studies were retrieved from online repositories of scientific studies; only those that enrolled nonalcoholic fatty liver disease patients and used both liver biopsy (as the standard) and ELF were eligible. Heterogeneity in disease severity among those enrolled was notable, with the prevalence of advanced fibrosis ranging from 18 percent to 71 percent.

The performance of the ELF test varied according to different thresholds for the determination of advanced fibrosis. For instance, at the lowest threshold of 7.7 points, ELF had a good sensitivity value of 0.93 but poor specificity of 0.34. At a higher cut-off value of 9.80, specificity improve to 0.86, while sensitivity dropped to 0.65.

Further increasing the threshold to 10.51 and 11.30 led to continuous improvements in specificity (0.93 and 0.96, respectively) and worsening sensitivity (0.51 and 0.36, respectively).

Test performance likewise differed according to clinical setting. In low-prevalence settings, for example, where advanced fibrosis was present in <5 percent of all patients, a low ELF threshold of 7.7 yielded a negative predictive value of 0.99. In higher-prevalence settings (5 percent to 50 percent), this value ranged from 0.99 to 0.83.

“Clinicians should carefully consider the likely a priori disease prevalence in their clinical practice setting and select a suitable test threshold locally, to achieve the desired level of test performance,” researchers said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
4 days ago
Nocturia is a risk factor for mortality, according to the results of the Nagahama Study, which boasts of a low incidence of missing data and high representation of the general population.