title: Validation of the BARD scoring system in Polish patients with nonalcoholic fatty liver disease (NAFLD).
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver diseases, ranging from pure steatosis to nonalcoholic steatohepatitis (NASH), and eventually to liver cirrhosis with its complications. Identifying advanced fibrosis in patients is crucial to evaluating prognosis and possible therapeutic intervention. A novel, simple, and highly accurate scoring system called BARD, which identifies patients with NAFLD and without significant fibrosis, has been recently introduced and validated in North America..The aim of this study is to validate the BARD scoring system in a Polish cohort with NAFLD.
  
  
  METHODS
  A group of 104 Caucasians with biopsy-proven NAFLD were included in this study. Fibrosis in liver biopsies was evaluated according to the Histological Scoring System for Nonalcoholic Fatty Liver Disease. The BARD scoring system was assessed according to Harrison et al.: BMI > or = 28 = 1 point, AST/ALT ratio (AAR) > or = 0.8 = 2 points, type 2 diabetes mellitus = 1 point.
  
  
  RESULTS
  Age over 50 and AAR over 0.8 showed, respectively, a moderate and strong association with advanced fibrosis. A BARD score of 2-4 points was associated with F3 or F4 stages of fibrosis with an odds ratio of 17.333 (95% Cl; 3,639 - 82.558) and negative predictive value of 97%.
  
  
  CONCLUSIONS
  Our results demonstrate that the BARD scoring system has value in the non-invasive diagnosis of advanced fibrosis in NAFLD patients. The vast majority of patients with NAFLD would avoid liver biopsy if BARD was broadly introduced into the clinic.
authors.affiliation: Liver Unit, Pomeranian Medical University, Szczecin, Poland. jorasz@sci.pam.szczecin.pl
authors.forename: Joanna
authors.initials: J
authors.lastname: Raszeja-Wyszomirska
authors.forename: Barbara
authors.initials: B
authors.lastname: Szymanik
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Ławniczak
authors.forename: Maciej
authors.initials: M
authors.lastname: Kajor
authors.forename: Alina
authors.initials: A
authors.lastname: Chwist
authors.forename: Piotr
authors.initials: P
authors.lastname: Milkiewicz
authors.forename: Marek
authors.initials: M
authors.lastname: Hartleb
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011044:Poland; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase