title: Prediction of Advanced Fibrosis in Nonalcoholic Fatty Liver Disease: An Enhanced Model of BARD Score.
abstract: OBJECTIVE
  The BARD score is a model to detect advanced liver fibrosis in nonalcoholic fatty liver disease (NAFLD) patients. The aims of this study were to identify additional factors and then to build an enhanced version of the BARD score.
  
  
  METHODS
  One hundred seven patients with biopsy-proven NAFLD were enrolled retrospectively. Logistic regressions were performed to identify independent risk factors for advanced liver fibrosis (stage 3 or 4). An enhanced model of the BARD score (BARDI score) was built and evaluated with a receiver operating characteristic (ROC) curve.
  
  
  RESULTS
  In multivariate analysis, age (odds ratio [OR], 0.89; p=0.04), aspartate aminotransferase/alanine aminotransferase ratio (OR, 1.73; p<0.01), and international normalized ratio (INR) (OR, 8.85; p<0.01) were independently significant factors. The BARDI score was created by adding the INR to the BARD. The area under the ROC curve of the BARDI score was significantly larger than that of the BARD score (0.881 vs 0.808, p<0.01). A BARDI score of 3 or more showed a positive predictive value (PPV) of 51.0% and a negative predictive value (NPV) of 96.0%.
  
  
  CONCLUSIONS
  The BARDI score had an improved PPV over the BARD score and maintained an excellent NPV. Further study is warranted for its external validation and comparison with other models.
authors.affiliation: Department of Internal Medicine, Marshall University School of Medicine, Huntington, WV, USA.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Seung Hye
authors.initials: SH
authors.lastname: Han
authors.forename: Ju Dong
authors.initials: JD
authors.lastname: Yang
authors.forename: Donghee
authors.initials: D
authors.lastname: Kim
authors.forename: Monjur
authors.initials: M
authors.lastname: Ahmed
keywords: International normalized ratio; Liver cirrhosis; Non-alcoholic fatty liver disease