The performance of enhanced liver fibrosis (ELF) test for the staging of liver fibrosis: a meta-analysis

Qingsong Xie; Xiaohu Zhou; Pengfei Huang; Jianfeng Wei; Weilin Wang; Shusen Zheng

doi:10.1371/journal.pone.0092772

The performance of enhanced liver fibrosis (ELF) test for the staging of liver fibrosis: a meta-analysis

PLoS One. 2014 Apr 15;9(4):e92772. doi: 10.1371/journal.pone.0092772. eCollection 2014.

Authors

Qingsong Xie¹, Xiaohu Zhou¹, Pengfei Huang¹, Jianfeng Wei¹, Weilin Wang¹, Shusen Zheng¹

Affiliation

¹ Division of Hepatobilitary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Zhejiang Province, Hangzhou, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, China.

Abstract

Background: The enhanced liver fibrosis test (ELF) has been shown to accurately predict significant liver fibrosis in several liver diseases.

Aims: To perform a meta-analysis to assess the performance of the ELF test for the assessment of liver fibrosis.

Study: Electronic and manual searches were performed to identify studies of the ELF test. After methodological quality assessment and data extraction, pooled estimates of the sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (sROC) were assessed systematically. The extent of heterogeneity and reasons for it were assessed.

Results: Nine studies were identified for analysis. The pooled sensitivity, specificity, positive LR, negative LR, and DOR values of ELF test, for assessment of significant liver fibrosis, were 83% (95% CI=0.80-0.86), 73% (95% CI=0.69-0.77), 4.00 (95% CI=2.50-6.39), 0.24 (95% CI=0.17-0.34), and 16.10 (95% CI=8.27-31.34), respectively; and, for evaluation of severe liver fibrosis, were 78% (95% CI=0.74-0.81), 76% (95% CI=0.73-0.78), 4.39 (95% CI=2.76-6.97), 0.27 (95% CI=0.16-0.46), and 16.01 (95% CI: 7.15-35.82), respectively; and, for estimation of cirrhosis, were 80% (95% CI=0.75-0.85), 71% (95% CI=0.68-0.74), 3.13 (95% CI=2.01-4.87), 0.29 (95% CI=0.19-0.44), and 14.09 (95% CI: 5.43-36.59), respectively.

Conclusions: The ELF test shows good performance and considerable diagnostic value for the prediction of histological fibrosis stage.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Biopsy
Elasticity Imaging Techniques*
Humans
Liver Cirrhosis / diagnosis*
Liver Cirrhosis / pathology*
Odds Ratio
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81172315/H1617) and the research Special Fund For public welfare industry of health and the translational research of early diagnosis and comprehensive treatment in pancreatic cancer (201202007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.