title: Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C.
abstract: OBJECTIVE
  We evaluated the test performance profile (TPP) of blood tests of liver fibrosis.
  
  
  METHODS
  Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS).
  
  
  RESULTS
  Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: >or=F2: 0.79, 0.78, 0.76, >or=0.76; F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% (p=0.0003), >or=F2: 43 vs 31% (p=0.004). There was no center effect.
  
  
  CONCLUSIONS
  In those populations, the four blood tests had a similar performance for significant fibrosis (F>or=2), lying in the lower range of published results which is attributable to a low >or=F2 prevalence, and for >or=F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.
authors.affiliation: Laboratoire Alphabio, 23 rue Friedland, 13006 Marseille, France. philippe.halfon@alphabio.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Halfon
authors.forename: Yannick
authors.initials: Y
authors.lastname: Bacq
authors.forename: Anne
authors.initials: A
authors.lastname: De Muret
authors.forename: Guillaume
authors.initials: G
authors.lastname: Penaranda
authors.forename: Marc
authors.initials: M
authors.lastname: Bourliere
authors.forename: Denis
authors.initials: D
authors.lastname: Ouzan
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
authors.forename: Danielle
authors.initials: D
authors.lastname: Botta
authors.forename: Christophe
authors.initials: C
authors.lastname: Renou
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Bréchot
authors.forename: Claude
authors.initials: C
authors.lastname: Degott
authors.forename: Valérie
authors.initials: V
authors.lastname: Paradis
mesh_terms: D000328:Adult; D000465:Algorithms; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D001792:Blood Platelets / Q000201:enzymology; D018450:Disease Progression; D005260:Female; D006403:Hematologic Tests / Q000379:methods*; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D001219:Aspartate Aminotransferases