title: Performances of Elasto-FibroTest(®), a combination between FibroTest(®) and liver stiffness measurements for assessing the stage of liver fibrosis in patients with chronic hepatitis C.
abstract: BACKGROUND
  FibroTest(®) (FT), and liver stiffness measurement (LSM) are the most validated techniques for the non-invasive assessment of fibrosis in patients with chronic hepatitis C (CHC). The combination between FibroTest(®) and LSM has never been assessed using methods assuming that biopsy is not a perfect gold standard.
  
  
  OBJECTIVE
  The aim was to assess the performance of a new test the Elasto-FibroTest(®) (EFT) combining FibroTest(®) and LSM.
  
  
  METHODS
  An integrated data base of 1289 patients with biopsy and 604 healthy volunteers was analyzed. EFT took into account the applicability of both tests, included two algorithms taking one for the diagnosis of advanced fibrosis (EFT-F2) and one for the diagnosis of cirrhosis (EFT-F4). Performances of EFTs were assessed by three methods: area under the ROC curve (AUROC), "Obuchowski method" (OBU) and 1 TAGS the "Latent class with random factor".
  
  
  RESULTS
  For the diagnosis of advanced fibrosis EFT-F2 performances (specificity=0.99 and sensitivity=0.83) were not greater than the performances of FibroTest(®) alone (specificity=0.93 and sensitivity=0.99). For the diagnosis of cirrhosis, EFT-F4 performances were greater than those of FibroTest(®) alone, particularly for the sensitivity (0.88 vs. 0.74); when compared with LSM, EFT-F4 performances (specificity=0.99 and sensitivity=0.99) were also greater than those of LSM alone particularly because of its lower specificity (0.92).
  
  
  CONCLUSIONS
  For the diagnosis of cirrhosis the Elasto-FibroTest(®) has higher performances than FibroTest(®) or FibroScan(®) alone. No improvement in performance has been observed for the diagnosis of advanced fibrosis vs. FibroTest(®) alone.
authors.affiliation: UPMC Liver Center, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. tpoynard@teaser.fr
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Victor
authors.initials: V
authors.lastname: de Ledinghen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zarski
authors.forename: Carol
authors.initials: C
authors.lastname: Stanciu
authors.forename: Mona
authors.initials: M
authors.lastname: Munteanu
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.forename: Julie
authors.initials: J
authors.lastname: France
authors.forename: Anca
authors.initials: A
authors.lastname: Trifan
authors.forename: Gilles
authors.initials: G
authors.lastname: Lenaour
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Vaillant
authors.forename: Vlad
authors.initials: V
authors.lastname: Ratziu
authors.forename: Frederic
authors.initials: F
authors.lastname: Charlotte
mesh_terms: D003938:Diagnostic Techniques, Digestive System; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged