title: A diagnostic model to differentiate simple steatosis from nonalcoholic steatohepatitis based on the likelihood ratio form of Bayes theorem.
abstract: OBJECTIVE
  To evaluate the performance of a diagnostic model based on a composite index using clinical and laboratory data, including cardiovascular biomarkers, to help practitioners to differentiate patients with simple steatosis from those with nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  101 patients with biopsy proven features of nonalcoholic fatty liver disease were included. We investigated the usefulness of 9 biomarkers in predicting the histological disease severity, including routine biochemical tests, C-reactive protein, soluble intercellular adhesion molecule-1 (sICAM-1) and anthropometric evaluation. Receiver operating characteristic (ROC) curves and likelihood ratios (LRs) were used to evaluate the fit of each test. A composite index was calculated as the product of each individual test LR.
  
  
  RESULTS
  In a model patient who has all positive tests, the post-test probability for NASH would be 99.5%.
  
  
  CONCLUSIONS
  The capacity of each individual biomarker to independently predict the disease outcome was lower than a composite index constructed after multiplying the LR for each individual test combined into a "multimarker" score.
authors.affiliation: Department of Molecular Genetics and Biology of Complex Diseases, Laboratory of Clinical and Molecular Hepatology, Institute of Medical Research, University of Buenos Aires-CONICET, Ciudad Autónoma de Buenos Aires, Argentina. ssookoian@lanari.fmed.uba.ar
authors.forename: Silvia
authors.initials: S
authors.lastname: Sookoian
authors.forename: Gustavo
authors.initials: G
authors.lastname: Castaño
authors.forename: Adriana Laura
authors.initials: AL
authors.lastname: Burgueño
authors.forename: Tomas Fernández
authors.initials: TF
authors.lastname: Gianotti
authors.forename: María Soledad
authors.initials: MS
authors.lastname: Rosselli
authors.forename: Carlos Jose
authors.initials: CJ
authors.lastname: Pirola
mesh_terms: D001499:Bayes Theorem; D002097:C-Reactive Protein / Q000378:metabolism; D005234:Fatty Liver / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008107:Liver Diseases / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein