Diagnostic role of transient elastography in patients with autoimmune liver diseases: A systematic review and meta-analysis

Table 2 Summary sensitivities, specificities, positive likelihood ratio and negative likelihood ratio of noninvasive methods at various diagnostic thresholds for prediction of significant fibrosis, advanced fibrosis and cirrhosis in autoimmune liver diseases patients

Disease	Diagnostic model/Stage	Cutoff values	No. of patients (n)	Summary sensitivity	Summary specificity	Summary PLR	Summary NLR
AIH	APRI
	SF	0.27-0.70	2 (195)	0.80 (0.72-0.86)	0.35 (0.23-0.48)	1.46 (0.55-3.89)	0.36 (0.061-2.09)
		0.88-1.55	3 (264)	0.74 (0.68-0.80)	0.51 (0.38-0.63)	1.52 (1.18-1.96)	0.50 (0.36-0.69)
	AF	0.38-0.90	4 (379)	0.86 (0.81-0.90)	0.48 (0.41-0.56)	1.60 (1.18-2.15)	0.33 (0.24-0.47)
		1.12-3.40	6 (538)	0.80 (0.72-0.86)	0.35 (0.23-0.48)	0.57 (0.51-0.64)	0.68 (0.62-0.73)
	Cirrhosis	0.55-1.81	3 (330)	0.65 (0.56-0.74)	0.47 (0.40-0.54)	1.49 (0.93-2.39)	0.62 (0.46-0.83)
		1.85-2.00	3 (213)	0.70 (0.57-0.81)	0.73 (0.65-0.79)	2.48 (1.75-3.52)	0.42 (0.28-0.62)
	AAR
	SF	0.72-0.93	2 (129)	0.67 (0.57-0.77)	0.68 (0.49-0.83)	2.22 (1.32-3.72)	0.46 (0.23-0.90)
	AF	0.76-1.18	7 (532)	0.61 (0.54-0.68)	0.72 (0.66-0.77)	2.01 (1.59-2.53)	0.58 (0.46-0.73)
	Cirrhosis	0.94-1.40	3 (213)	0.61 (0.47-0.74)	0.83 (0.76-0.88)	3.31 (1.96-5.59)	0.49 (0.36-0.69)
	FIB-4
	SF	1.95-2.90	3 (303)	0.64 (0.58-0.71)	0.71 (0.61-0.81)	2.20 (1.48-3.27)	0.50 (0.38-0.65)
		3.20-5.07	2 (156)	0.60 (0.51-0.69)	0.77 (0.60-0.90)	2.66 (1.44-4.92)	0.52 (0.39-0.69)
	AF	1.75-2.37	6 (476)	0.66 (0.59-0.72)	0.63 (0.57-0.69)	2.05 (1.56-2.70)	0.40 (0.20-0.81)
		3.21-5.60	5 (486)	0.47 (0.41-0.54)	0.73 (0.67-0.79)	1.83 (1.24-2.71)	0.68 (0.50-0.92)
	Cirrhosis	2.21-3.40	5 (440)	0.75 (0.67-0.82)	0.56 (0.50-0.62)	2.06 (1.53-2.77)	0.37 (0.19-0.71)
		6.44	1 (103)	0.68	0.64	1.88	0.51
	TE
	SF	5.80-7.00	7 (423)	0.83 (0.78-0.87)	0.73 (0.65-0.80)	2.89 (2.23-3.76)	0.23 (0.12-0.42)
		9.10-10.05	2 (100)	0.77 (0.67-0.86)	0.94 (0.70-1.00)	7.65 (1.66-35.32)	0.18 (0.02-1.47)
	AF	8.18-9.00	3 (286)	0.80 (0.72-0.87)	0.80 (0.73-0.86)	4.09 (2.64-6.33)	0.24 (0.17-0.35)
		10.40-12.10	4 (174)	0.73 (0.60-0.83)	0.93 (0.86-0.97)	7.67 (2.89-20.31)	0.27 (0.12-0.61)
	Cirrhosis	11.00-12.67	4 (213)	0.89 (0.82-0.94)	0.88 (0.81-0.93)	6.89 (4.38-10.85)	0.14 (0.09-0.23)
		16.00-19.00	3 (147)	0.88 (0.74-0.96)	0.97 (0.92-0.99)	22.08 (5.35-91.22)	0.16 (0.08-0.33)
	2D-SWE
	SF	8.20-10.00	3 (234)	0.89 (0.83-0.93)	0.72 (0.59-0.83)	3.25 (1.67-6.32)	0.17 (0.11-0.28)
	AF	12.20-15.80	3 (234)	0.82 (0.73-0.89)	0.79 (0.72-0.86)	3.92 (2.79-5.52)	0.24 (0.13-0.44)
	Cirrhosis	14.30-19.30	4 (297)	0.83 (0.74-0.90)	0.86 (0.81-0.91)	5.85 (4.09-8.37)	0.21 (0.13-0.34)
PBC	APRI
	SF	0.26-1.20	4 (584)	0.84 (0.80-0.87)	0.63 (0.56-0.70)	1.98 (1.54-2.55)	0.34 (0.23-0.51)
	AF	0.3.0-0.75	8 (858)	0.62 (0.57-0.68)	0.54 (0.50-0.58)	1.39 (1.09-1.79)	0.68 (0.48-0.98)
		0.93-2.00	7 (731)	0.73 (0.68-0.78)	0.68 (0.64-0.72)	2.68 (1.80-3.97)	0.46 (0.36-0.58)
	Cirrhosis	0.65-1.39	6 (852)	0.75 (0.67-0.83)	0.51 (0.48-0.55)	2.19 (1.38-3.50)	0.31 (0.10-0.99)
	AAR
	SF	0.92-1.00	3 (323)	0.69 (0.61-0.76)	0.56 (0.48-0.63)	1.61 (1.33-1.95)	0.52 (0.31-0.87)
	AF	0.81-1.01	5 (559)	0.54 (0.47-0.62)	0.73 (0.68-0.77)	2.15 (1.52-3.03)	0.63 (0.44-0.91)
	Cirrhosis	1.00-1.10	4 (407)	0.81 (0.70-0.90)	0.77 (0.72-0.82)	4.55 (1.98-10.49)	0.28 (0.10-0.79)
	FIB-4
	SF	1.39-3.90	3 (462)	0.85 (0.81-0.89)	0.77 (0.69-0.83)	2.89 (2.10-3.98)	0.26 (0.10-0.66)
	AF	2.05-2.63	7 (865)	0.77 (0.72-0.81)	0.57 (0.53-0.61)	1.95 (1.51-2.52)	0.31 (0.16-0.61)
		2.81-4.60	6 (431)	0.63 (0.55-0.71)	0.80 (0.75-0.85)	3.25 (1.78-5.94)	0.49 (0.30-0.81)
	Cirrhosis	2.05-4.60	6 (852)	0.87 (0.80-0.93)	0.61 (0.58-0.65)	2.79 (1.92-4.07)	0.16 (0.05-0.52)
	TE
	SF	5.90-8.80	4 (402)	0.81 (0.76-0.85)	0.95 (0.89-0.98)	10.51 (2.03-54.36)	0.23 (0.12-0.44)
		16.00	1 (44)	0.94	0.81	4.90	0.07
	AF	6.75-7.60	4 (377)	0.80 (0.73-0.86)	0.81 (0.76-0.86)	4.19 (2.35-7.46)	0.19 (0.05-0.79)
		9.60-10.70	3 (317)	0.91 (0.84-0.95)	0.82 (0.77-0.87)	5.68 (2.55-12.69)	0.12 (0.07-0.21)
		11.90-17.90	3 (180)	0.75 (0.60-0.86)	0.94 (0.88-0.97)	11.76 (2.29-60.48)	0.22 (0.06-0.80)
	Cirrhosis	11.40-14.40	3 (256)	0.84 (0.69-0.93)	0.94 (0.90-0.97)	13.46 (7.66-23.65)	0.19 (0.10-0.38)
		15.60-25.10	3 (227)	0.90 (0.74-0.98)	0.93 (0.89-0.96)	22.8 (0.81-639.69)	0.12 (0.04-0.34)
	RPR
	AF	0.10-0.14	4 (362)	0.49 (0.40-0.58)	0.89 (0.84-0.92)	4.27 (2.22-8.22)	0.59 (0.47-0.74)
	M2BP
	AF	1.00-1.40	4 (370)	0.68 (0.59-0.77)	0.80 (0.75-0.85)	4.26 (1.82-9.96)	0.32 (0.14-0.75)
PSC	TE
	SF	8.80	2 (121)	0.76 (0.62-0.87)	0.88 (0.79-0.95)	6.34 (3.25-12.37)	0.29 (0.18-0.46)
	AF	9.60	3 (177)	0.82 (0.70-0.91)	0.83 (0.75-0.89)	4.75 (2.21-10.19)	0.15 (0.02-1.04)
	Cirrhosis	13.70-14.40	4 (207)	0.82 (0.68-0.91)	0.89 (0.83-0.94)	7.46 (3.74-14.88)	0.25 (0.15-0.43)

2D-SWE: Two-dimensional shear wave elastography; AAR: Aspartate aminotransferase to alanine aminotransferase ratio; AF: Advanced fibrosis; AIH: Autoimmune hepatitis; APRI: Aspartate aminotransferase to platelet ratio index; FIB-4: Fibrosis-4 index; M2BP: Mac-2-binding protein; NLR: Negative likelihood ratio; PLR: Positive likelihood ratio; PBC: Primary biliary cholangitis; PSC: Primary sclerosing cholangitis; RPR: Red cell distribution width to platelet ratio; SF: Significant fibrosis; TE: Transient elastography.