title: Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Transient elastography (TE) has been proposed as a promising noninvasive alternative to hepatic venous pressure gradient (HVPG) for detecting portal hypertension (PH). However, previous studies have yielded conflicting results. We gathered evidence from literature on the clinical usefulness of TE versus HVPG for assessing PH.
  
  
  METHODS
  We conducted a systematic review by searching databases for relevant literature evaluating the clinical usefulness of non-invasive TE for assessing PH in patients with cirrhosis. A literature search in Ovid Medline, EMBASE and the Cochrane Library was performed for all studies published prior to December 30, 2015.
  
  
  RESULTS
  Eight studies (1,356 patients) met our inclusion criteria. For the detection of PH (HVPG ≥6 mmHg), the summary sensitivity and specificity were 0.88 (95% confidence interval [CI] 0.86-0.90) and 0.74 (95% CI 0.67-0.81), respectively. Regarding clinically significant PH (HVPG ≥10 mmHg), the summary sensitivity and specificity were 0.85 (95% CI 0.63-0.97) and 0.71 (95% CI 0.50-0.93), respectively. The overall correlation estimate of TE and HVPG was large (0.75, 95% CI: 0.65; 0.82,P<0.0001).
  
  
  CONCLUSIONS
  TE showed high accuracy and correlation for detecting the severity of PH. Therefore, TE shows promise as a reliable and non-invasive procedure for the evaluation of PH that should be integrated into clinical practice.
authors.affiliation: Research Institute for Nursing Science, College of Nursing, Keimyung University, Daegu, Korea.
authors.forename: Gaeun
authors.initials: G
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.|Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea.|Institute of Evidence-based Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
mesh_terms: D019540:Area Under Curve; D016208:Databases, Factual; D054459:Elasticity Imaging Techniques; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000175:diagnosis; D017082:Portal Pressure / Q000502:physiology*; D012372:ROC Curve; D012680:Sensitivity and Specificity
keywords: Elastography; Hypertension, Portal; Liver cirrhosis; Meta-analysis; Review, Systematic