title: Performance of transient elastography assessing fibrosis of single hepatitis B virus infection: a systematic review and meta-analysis of a diagnostic test.
abstract: BACKGROUND
  Transient elastography has good diagnostic accuracy for predicting fibrosis and cirrhosis related to hepatitis B virus. However, the enrolled subjects in some studies have also included chronic hepatitis B patients with chronic hepatitis C coinfection or other etiologies of liver diseases. This might under- or overestimate the role of transient elastography in chronic hepatitis B patients.
  
  
  METHODS
  A systematic review was conducted on records in PubMed, EMBASE and the Cochrane Library electronic databases until 31 December 2013. We systematically assessed the effectiveness and accuracy of transient elastography for predicting the fibrosis and cirrhosis of the single hepatitis B virus. The questionnaire for quality assessment of diagnostic accuracy studies was used.
  
  
  RESULTS
  In this meta-analysis, out of 257 articles evaluated for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis. Eventually, our final data set for the meta-analysis contained 19 studies. The areas under the summary receiver-operating characteristic curve for transient elastography of significant fibrosis and cirrhosis were 0.8225 and 0.9108, respectively. The pooled diagnostic odds ratios for transient elastography of significant fibrosis and cirrhosis were 11.19 (95 % CI 6.63-18.89) and 26.87 (95 % CI 17.88-40.38), respectively. In Europe, the areas of significant fibrosis and cirrhosis were 0.803 and 0.905; those in Asia were 0.871 and 0.914, respectively.
  
  
  CONCLUSIONS
  Based on this meta-analysis we claim that liver stiffness measurement using transient elastography has good diagnostic accuracy for predicting single hepatitis B virus-related significant fibrosis and cirrhosis, especially in Asian populations.
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. bangjunjun@163.com.
authors.forename: Xueying
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. ocean107703@163.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Urinary Surgery, Changhai Hospital, Shanghai, People's Republic of China. lori_win88@yahoo.com.cn.
authors.forename: Ruixiang
authors.initials: R
authors.lastname: Song
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. ivorsy@163.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sheng
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. netaiwensi@126.com.
authors.forename: Wensi
authors.initials: W
authors.lastname: Ai
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. wuxiaofei1030@163.com.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People's Republic of China. hbliu@mail.cmu.edu.cn.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Liu
mesh_terms: D054459:Elasticity Imaging Techniques / Q000379:methods*; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology; D012372:ROC Curve; D012720:Severity of Illness Index
keywords: Fibrosis; Hepatitis B virus; Meta-regression; SROC; Transient elastography