scholarly journals Non-Invasive Assessment Of Liver Fibrosis In Patients With Non-Alcoholic Fatty Liver Disease In A Tertiary Care Hospital

2022 ◽  
Vol 9 (3) ◽  
pp. 64-67
Author(s):  
Ishwarya Ramadoss ◽  
Anandaraj Jayaraman ◽  
Shobana Dhanapal
Keyword(s):  
Liver Fibrosis ◽  
Fatty Liver ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Area Under Curve ◽  
Curve Analysis ◽  
Fibrosis Score ◽  
Roc Curve Analysis ◽  
Non Invasive ◽  
Nafld Fibrosis Score

Abstract Aims :To compare the NAFLD fibrosis score and FIBROSIS 4 score to fibroscan, and affirm whether the scores shall be used as a screening tool for liver fibrosis, in place of fibroscan. Methodology: It was a cross-sectional study. Patients with fatty liver on ultrasonological examination with 200 sample size. After obtaining the informed consent the following details were collected socio-demographic details, history, co-morbidities, anthropometric measurements, Laboratory investigations. Results: the ROC curve analysis of fibroscan reveals the area under curve of 0.499 and based on the cut off value of 4.50Kpas the sensitivity and specificity was found to be 85.7% and 83.5% respectively. The ROC curve analysis of fibrosis-4 reveals the area under curve of 0.495 and based on the cut off value of 0.80 the sensitivity and specificity was found to be 91.9% and 92.1% respectively. Analysis of NAFLD fibrosis score reveals the area under curve of 0.476 and based on the cut off value of -1.53 the sensitivity and specificity was found to be 93.1% and 93.9% respectively. Conclusion: Henceforth the study suggests that NAFLD fibrosis score shall be used as a non -invasive bedside assessment of liver fibrosis in high risk population and hence guiding their follow up for prevention of morbidity in resource limited settings.

scholarly journals Sensitivity and specificity of waist circumference as a single screening tool for assessment of overweight and obesity

2017 ◽  
Vol 4 (11) ◽  
pp. 4254
Author(s):  
Anubrata Karmakar ◽  
Shobhit Garg ◽  
Aparajita Dasgupta ◽  
Bobby Paul ◽  
Swanya P. Maharana
Keyword(s):  
Waist Circumference ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Public Health Perspective ◽  
Cross Sectional

Background: Generalised and central obesity are established risk factors for metabolic syndrome and cardiovascular diseases. Easy assessment of overweight or obesity is the need of the hour from public health perspective. Waist circumference (WC) can be a simple screening tool for identifying overweight individuals since measuring WC is simple, inexpensive, less time consuming, convenient for self-monitoring and needs no complicated calculation as BMI.Methods: A community based cross-sectional study was conducted in January-February 2017 among 338 adults, in a village of Singur Block, West Bengal. Height, weight and WC were measured for each subject. Receiver Operating Characteristic (ROC) curve analysis was used to estimate the cut-off values of WC.Results: The sensitivity and specificity of WC ≥90 centimeters for men for identifying overweight (BMI ≥25) were 78.8% and 75.6% respectively, whereas those of WC ≥80 cm for women were 80.3% and 44% respectively. ROC curve analysis revealed good diagnostic accuracy at 88.5 cm for WC cut-off for men (area under curve (AUC) 0.854, sensitivity 86.5%, specificity 67.6%) and fair accuracy (AUC 0.744, sensitivity 80.3%, specificity 44%) for WC cut-off for 80 cm for women.Conclusions: This study shows, WC can be used for screening of overweight individual infield practice as measuring tape is inexpensive and easy-to-carry compared to a weighing scale. More research may be done on larger sample size to establish an optimal WC cut-off value for Indian population. 

scholarly journals Diagnostic accuracy and limitations of non-invasive tests in patients with metabolic-associated fatty liver disease

2021 ◽  
Vol 44 (5) ◽  
pp. 168-172
Author(s):  
Y Sánchez Torrijos ◽  
A Lucena Valera ◽  
J Ampuero Herrojo
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Fibrosis Score ◽  
Non Invasive ◽  
Fatty Liver Index ◽  
Nafld Fibrosis Score ◽  
Hepatic Steatosis Index

Resumen La incidencia de la enfermedad del hígado graso asociada al metabolismo (MAFLD) ha aumentado en los últimos años debido al estilo de vida actual. La biopsia de hígado sigue siendo la herramienta estándar de oro para detectar y estadificar MAFLD. Por otro lado, se están desarrollando múltiples biomarcadores y pruebas no invasivas para superar las limitaciones de la biopsia hepática, incluidos el costo y la invasividad. Las pruebas no invasivas se centran principalmente en la esteatosis y, en particular, en la fibrosis hepática y se pueden clasificar en pruebas patentadas y no patentadas. Si bien hepatic steatosis index y fatty liver index son las pruebas más comunes utilizadas para la detección de esteatosis, Hepamet Fibrosis Score, NAFLD fibrosis score, FIB-4, OWLiver®, y ELF® son las más utilizadas para la fibrosis hepática. Sin embargo, las pruebas no invasivas también tienen limitaciones que conviene resaltar ya que sus resultados podrían verse afectados por la presencia de diabetes, obesidad o por edades extremas que podrían dar lugar a falsos positivos o negativos. Para maximizar la precisión de los tests no invasivos, se han propuesto diferentes combinaciones integradas en algoritmos escalonados. Esta revisión tiene como objetivo destacar las fortalezas y limitaciones de dichos tests para detectar y estadificar MAFLD.

scholarly journals 411. Application of a SARS-CoV-2-specific serologic assay for translational research and surveillance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S273-S273
Author(s):  
Amy C Sherman ◽  
Teresa C Smith ◽  
Daniel Espinoza ◽  
Yerun Zhu ◽  
Jessica Howard-Anderson ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Research Training ◽  
Natural Infection ◽  
Curve Analysis ◽  
Antibody Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rt Pcr ◽  
Research Support ◽  
Roc Curve Analysis

Abstract Background Sensitive and specific SARS-CoV-2 antibody diagnostics are urgently needed to estimate the seroprevalence of SARS-CoV-2 infection in both the general population and special risk groups. Moreover, validated serologic assays are critical to understanding immunity to SARS-CoV-2 infection over time and identifying correlates of protection. Methods An enzyme-linked immunosorbent assay (ELISA) protocol to detect antibodies (IgG) that bind the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein was validated and ROC curve analysis performed by testing a large panel of pre-pandemic sera (n=162) and convalescent sera from RT-PCR-confirmed COVID-19 cases (n=60). We then applied this test in two cohorts: 1) Healthcare personnel (HCP) that were enrolled in a longitudinal surveillance cohort just after peak local transmission and 2) Mildly ill patients being tested for SARS-CoV-2 infection by RT-PCR from NP swabs in an ambulatory testing clinic. Demographics of mildly symptomatic patients tested for SARS-CoV-2 with RT-PCR Results ROC curve analysis yielded an AUC of 0.9953, with a sensitivity and specificity at 91.67% and 99.38% at the optimal OD normalization threshold of 0.20. In 240 HCP surveilled at enrollment, 5.83% had positive IgG results. Of 19 symptomatic patients who presented to the ambulatory clinic, 5/19 had a positive PCR. In convalescence (13–74 days post symptom onset), 3 of those 5 were positive for IgG. Validation of the SARS-CoV-2 RBD ELISA ROC Curve Analysis Conclusion We demonstrated high sensitivity and specificity of the SARS-CoV-2 RBD ELISA. This simple assay is an efficient way to track seroconversion and duration of antibody responses to SARS-CoV-2 for different populations, particularly since RBD-binding antibodies have been shown to correlate with neutralization activity and may be useful to determine protective immunity following natural infection or vaccination. Ongoing work will assess variation in magnitude, character and duration of antibody responses in key populations and seek to maximize deployability of large-scale SARS-CoV-2 serology. Disclosures Jessica Howard-Anderson, MD, MSc, Antibacterial Resistance Leadership Group (ARLG) (Other Financial or Material Support, The ARLG fellowship provides salary support for ID fellowship and mentored research training) Nadine Rouphael, MD, Lilly (Grant/Research Support)Merck (Grant/Research Support)Pfizer (Grant/Research Support)Quidel (Grant/Research Support)Sanofi Pasteur (Grant/Research Support)

scholarly journals Does the FT3-to-FT4 ratio easily predict the progression of NAFLD and NASH cirrhosis?

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110568
Author(s):  
Fatih Türker ◽  
Alihan Oral ◽  
Tolga Şahin ◽  
Betül Çavuşoğlu Türker ◽  
Erdem Koçak ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Aspartate Aminotransferase ◽  
Model Assessment ◽  
Fibrosis Score ◽  
Alcoholic Fatty Liver ◽  
Healthy Group ◽  
Nafld Fibrosis Score

Background Factors causing progression from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH) and liver cirrhosis remain relatively unknown. We aimed to evaluate the power and effectiveness of the free triiodothyronine (FT3)-to-free thyroxine (FT4) ratio to predict non-alcoholic fatty liver disease (NAFLD)/liver fibrosis and NASH cirrhosis severity. Methods Patients (n = 436) with NASH-associated liver cirrhosis (n = 68), patients with liver biopsy-proven NAFLD (n = 226), or healthy participants (n = 142) were enrolled between January 2010 and January 2020. The aspartate aminotransferase-to-thrombocyte ratio (APRI), NAFLD fibrosis score, albumin–bilirubin score (ALBI), aspartate aminotransferase (AST)-to-alanine aminotransferase (ALT) ratio, FT3-to-FT4 ratio, and Fibrosis-4 (FIB-4) were calculated and evaluated. Results All parameters were significantly higher in NASH cirrhosis than in the healthy group. Body mass index, ALT, fasting insulin, homeostatic model assessment for insulin resistance, and triglyceride levels were significantly higher in liver biopsy-proven NAFLD than in the healthy group. The APRI, NAFLD fibrosis score, ALBI, AST-to-ALT ratio, FT3-to-FT4 ratio, and FIB-4 were significantly higher in the NASH cirrhosis group than in the healthy group. In patients with biopsy-proven NAFLD, the FT3-to-FT4 ratio was significantly lower than in the healthy group. Conclusion The FT3-to-FT4 ratio is an effective and useful indicator to predict NAFLD/liver fibrosis and NASH cirrhosis severity.

scholarly journals Study of Serum CEA and Ca 19.9 in Esophageal Squamous Carcinoma and ROC Curve Analysis

2020 ◽  
Vol 5 (4) ◽  
pp. 141-145
Author(s):  
Sawmik Das ◽  
Lopa mudra Kakoti ◽  
Shiraj Ahmed ◽  
Anupam Sarma ◽  
Amal Ch kataki
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Venous Blood ◽  
Squamous Carcinoma ◽  
Curve Analysis ◽  
Diagnostic Sensitivity ◽  
Roc Curve Analysis ◽  
Combined Use ◽  
Ca 19.9 ◽  
Serum Cea

Background: There are very few studies on the comparative diagnostic value of CEA and Ca19.9 in esophageal squamous cell carcinoma (ESCC).Aims and objectives: The aim of the present study was to access the clinical relevance of CEA and CA19.9 in ESCC and to determine whether combined use of these marker could improve diagnostic sensitivity and specificity. Material and Method: Venous blood Samples were collected from total 68 individuals, divided into two categories, group 1 includes 18 healthy individuals and group 2 includes 50 patients with already diagnosed cases of ESCC prior to any treatment. Tests were performed to estimate the value of CEA and Ca19.9. Different statistical analysis has been performed to derive a clinically meaningful value.Results: The mean serum CEA and CA 19.9 levels and also the ratio of CEA/Ca19.9 were higher in patients with ESCC than healthy subjects. In ESCC, the optimal combination of sensitivity and specificity for CEA were determined as 48% and 94% and for CA19.9 were determined as 76% and 72% respectively, whereas combined analysis of CEA/CA19.9 were lower than individual value in patients. Over all accuracy rate was better with CA19. The diagnostic power of CEA and CA19-9 as a screening test for ESCC were assessed by ROC curve analysis. The cut-off value for CEA and CA19-9 in ESCC were found to be 2.9 2 ng/ml and 7.4 ng/ml and were found to be above the cut-off value in 25 (50%) and 42 (84%) of the patients with ESCC respectively.Conclusion: The results of our study indicated that serum CA19.9 has a higher positivity than serum CEA in esophageal cancer. The combined use of CA19-9 and CEA (ratio) could not increase the diagnostic sensitivity in esophageal cancers in our study.

A Cross Sectional Study to Assess Liver Fibrosis in Patients with Diabetes and Metabolic Syndrome

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
Syed Safiullah Ghori ◽  
Hafsa Khalid ◽  
Mohammed Alim ◽  
Mohammed Abdul Quddus
Keyword(s):  
Metabolic Syndrome ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
General Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Nafld Fibrosis Score ◽  
Patients With Diabetes

The present study was conducted in Osmania General Hospital,Hyderabad.The study included evaluation of liver fibrosis in patients with diabetes and metabolic syndrome. Liver fibrosis is now being considered as reversible process which is characterized by excessive accumulation of extra cellular matrix. The use of non-invasive methods to assess liver fibrosis in patients with HCV, Non-Alcoholic Fatty Liver Disease (NAFLD) and alcohol abuse has been well validated. However use of these non-invasive methods in patients with diabetes mellitus and metabolic syndrome assessed might develop fibrosis during asymptomatic stages. Hence we tried to use these non-invasive methods in patients with diabetics and metabolic syndrome who are at high risk of developing NAFLD or liver fibrosis in routine clinical practice. This was a single center, prospective study. 50 patients with diabetes and metabolic syndrome attending the endocrinology department of Osmania General Hospital were assessed for fatty liver and enrolled in to the study. NAFLD fibrosis score was used to assess liver fibrosis and BARD score was used for staging of fibrosis as per metavir classificationThe mean age of the patients was 50.8 ± 8.2 with 22 males and 28 females. 90% of the population was found to have some degree of fibrosis. 56% of the patients were at advance fibrosis stage as per the BARD score.Patients with diabetes and metabolic syndrome should be constantly evaluated for liver fibrosis apart from development of diabetes and other complications and to prevent any adverse effects due to waning of liver functions.

Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study

2015 ◽  
Vol 22 (2) ◽  
pp. 77-84
Author(s):  
Romanas Zykus ◽  
Laimas Jonaitis ◽  
Vitalija Petrenkienė ◽  
Inga Gudinavičienė ◽  
Limas Kupčinskas
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Non Invasive ◽  
Metavir Score ◽  
Combined Use ◽  
Chronic Hcv ◽  
Histological Stage

The work was carried out at the Lithuanian University of Health Sciences Hospital Kaunas Clinics. Background. To date, there is not enough data to conclude whether the combination of different non-invasive liver fibrosis tests could improve the accuracy in prediction of liver fibrosis. The aim of this study was to assess correlation between transient elastography (TE), aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 score (FIB4) and histological stage of fibrosis (F). Materials and methods. In this prospective study the correlation of TE, APRI and FIB4 with the stage of fibrosis was assessed in 140 patients with chronic HCV hepatitis. TE, APRI and FIB4 were measured the same day before biopsy. Fibrosis was evaluated using the METAVIR score. Cut-off values were established by applying the ROC curve analysis. All non-invasive tests were combined into pairs in order to evaluate the accuracy of fibrosis prediction. Results. The stage of fibrosis correlated with TE (R-0.74), FIB4 (R-0.67) and APRI (R-0.58). To detect F4 TE cut-off value 12.1 kPa had 93.8% sensitivity and 85% specificity; APRI cut-off value 1.42 (84.4/81.1) and FIB4 cutoff value 2.89 (84.4/84.0) were established. To determine F ≥ 3 – 10.3 kPa (91.1/83.9), 1.28 (77.8/78.5), 2.28 (84.4/81.7); F ≥ 2 8.5 kPa (80.9/74.3), 1.12 (72.1/78.6), 1.63 (82.4/75.7); F  ≥  1 5.35  kPa (85.4/100), 0.45 (89.2/87.5), 0.89 (87.7/75). Significant increase of accuracy was observed in TE/APRI (p – 0.008) and FIB4/APRI (p – 0.02) groups to predict F ≥ 1, and TE/FIB4 to predict F ≥ 2 (p – 0.04) and F ≥ 1 (p – 0.04). Conclusions. Combined use of TE/APRI, FIB4/APRI increased the accuracy to predict F ≥ 1, and TE/FIB4 combination increased the accuracy to predict F ≥ 2 and F ≥ 1.

scholarly journals Echocardiographic evaluation of total anomalous pulmonary venous connection: comparison of obstructed and unobstructed type

2019 ◽  
Author(s):  
Yonghua Xiang ◽  
Xuehua Zhang ◽  
Jun Qiu ◽  
Qing Gan ◽  
Ke Jin
Keyword(s):  
Retrospective Study ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Echocardiographic Evaluation ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
Anomalous Pulmonary Venous Connection ◽  
First Admission

Abstract Purpose The purpose of this study was to compare the differences between obstructed and unobstructed TAPVC using echocardiography, then to predict PVO by assessing clinical and echocardiographic parameters. Methods We conducted a retrospective study included 70 patients with TAPVC between 2014 and 2018. The morphological and hemodynamic echocardiographic parameters were observed and measured. The clinical and echocardiographic parameters that existed difference between obstructed and unobstructed TAPVC were selected to predict PVO by running ROC curve analysis. Results Between obstructed and unobstructed TAPVC, there were significant differences in ASD size, PA Vmax, MV VE, LVFS, LVEF, SV and the incidence of PDA, but there was no significant difference in birth weight. The first admission age of obstructed TAPVC was earlier than unobstructed type. The ROC curve analysis for the first admission age in predicting PVO showed the sensitivity and specificity were 76.7%, 80% respectively. The ROC curve analysis for multiple echocardiographic parameters showed the sensitivity and specificity were 82.6%, 100% respectively. Conclusions The presence of PVO led to anatomical and functional abnormity of patients with TAPVC, and then led to hospitalize earlier. The first admission age was a simple and feasible parameter in predicting PVO. The integrated use of multiple echocardiographic parameters had an excellent value in predicting PVO.

Value of serum neuroendocrine markers in evaluation of neuroendocrine prostate cancer: A validation study using metastatic biopsies.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 278-278 ◽  
Author(s):  
Panagiotis J. Vlachostergios ◽  
Nicolas Peruzzo ◽  
Jones Nauseef ◽  
Clara Oromendia ◽  
Jyothi Manohar ◽  
...  
Keyword(s):  
Roc Curve ◽  
De Novo ◽  
Predictive Ability ◽  
Curve Analysis ◽  
Continuous Variables ◽  
Roc Curve Analysis ◽  
Non Invasive ◽  
Neuroendocrine Prostate Cancer ◽  
Median Serum ◽  
Genomic Characterization

278 Background: NEPC, de novo or treatment-related in late stage CRPC, is a distinct entity with poor prognosis. Developing non-invasive methods for detection of NEPC is important for clinical practice and trial enrollment. We previously reported on the clinical and genomic characterization of NEPC (Conteduca et al ESMO 2018). A separate study (Aggarwal et al JCO 2018) suggested that low levels of NSE and CgA were associated with a strong NPV for NEPC on biopsy (bx). This study aimed to validate the utility of NSE and CgA in evaluation of NEPC by comparison with met bx. Methods: Our IRB-approved NEPC database was screened for pts who underwent met bx and had concurrent serum NSE, CgA. Clinical data, serum PSA, LDH, ALP, Hb were recorded at time of bx. Comparison of continuous variables between CRPC adeno and NEPC was assessed by nonparametric Kruskal-Wallis test. ROC curve analysis was performed for evaluation of predictive models with serum NE markers. Results: 152 men were identified, median age 71 yrs (49-97). 35 pts had pure/mixed NEPC, while the rest (N=117) had typical adenoca on bx. Half of pts (80/152, 52.6%) received abiraterone or/and enzalutamide. Liver mets were more common in NEPC pts (P=0.001). Median serum NSE (11.2 vs 8.6 ng/mL, P=0.008) and CgA (211 vs 135 ng/mL, P=0.035) were higher in pts with NEPC vs CRPC adeno (Table). Using ROC curve analysis for NSE (normal 3.7-8.9 ng/mL) and CgA (normal 0-95 ng/mL) as independent diagnostic tests, the following cut-offs were identified: NSE 30.1 (Sn: 37%, Sp: 94%, PPV: 34%, NPV: 82%), CgA 170 (Sn: 63%, Sp: 59%, PPV: 23%, NPV: 83%). Conclusions: Our study confirms the potential utility of serum NSE and CgA in excluding a morphological dx of NEPC when below certain thresholds. However, our findings cannot support deferring a met bx in such cases. Larger studies are needed to evaluate for a more robust predictive ability of serum NE markers. [Table: see text]

scholarly journals Thrombin–antithrombin III complex tests

2017 ◽  
Vol 25 (1) ◽  
pp. 017084061668450 ◽  
Author(s):  
Sang Yang Lee ◽  
Takahiro Niikura ◽  
Takashi Iwakura ◽  
Yoshitada Sakai ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Lower Limb ◽  
Antithrombin Iii ◽  
Pelvic Fractures ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Thrombin Antithrombin Iii Complex ◽  
D Dimer

Purpose: Patients with fractures of the pelvis and/or lower extremities are at a high risk of developing postoperative venous thromboembolism (VTE). The purpose of this study was to determine whether the thrombin–antithrombin III complex (TAT) tests could be used for postoperative screening of VTE in patients with lower limb or pelvic fractures. Methods: We enrolled 133 patients who underwent surgical treatment for fracture of the pelvis or lower extremities. TAT and D-dimer levels were compared in patients with and without VTE. Receiver operating characteristic (ROC) curve analysis was done and the appropriate TAT and D-dimer cutoff levels were determined for VTE screening. Results: VTE was diagnosed in 41 patients (30.8%). Patients with VTE had significantly higher levels of TAT and D-dimer on postoperative days 1, 3, and 7 than those without VTE, respectively. ROC curve analysis suggested that TAT test at postoperative day 7 had the highest accuracy for predicting postoperative VTE. With the optimal cutoff TAT level of 3.0 ng/mL, sensitivity and specificity were 93.3% and 70.1%, respectively. With the optimal cutoff D-dimer level of 7.4 µg/mL, sensitivity and specificity were 93.3% and 57.0%, respectively. Conclusion: TAT levels measured at postoperative day 7 could be the most useful parameter for screening postoperative VTE. TAT can be used as a screening tool for screening postoperative VTE in patients with lower limb and pelvic fractures.

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