Diagnostic performance of FibroTest-ActiTest, transient elastography, and the fibrosis-4 index in patients with autoimmune hepatitis using histological reference

Table 3 Diagnostic performance of biopsy, FibroTest, fibrosis-4 index, and vibration-controlled transient elastography for significant fibrosis (F2, F3, and F4) and advanced fibrosis (F3 and F4) compared with that of the gold standard model and Bayesian latent class model

Parameters and cutoffs	Biopsy assumed as perfect reference	Bayesian LCM	Gold standard model vs LCM
Number of patients	103	103	Difference (Z-test P-value)
Prevalence significant fibrosis	63.1 (53.0-72.2)	66.2 (56.0-77.0)	3.1% increase (0.67)
Biopsy stage METAVIR ≥ F2
Sensitivity	100	95.4 (83.1-100)	4.6% decrease (NA)
Specificity	100	100 (100-100)	NA (NA)
Positive predictive value	100	100 (100-100)	NA (NA)
Negative predictive value	100	91.9 (67.3-99.9)	8.1% decrease (NA)
FibroTest with cutoff of > 0.48
Sensitivity	73.8 (61.2-83.6)	73.1 (61.5-82.6)	0.7% decrease (0.93)
Specificity	81.6 (65.1-91.7)	86.1 (70.6-98.4)	4.5% increase (0.69)
Positive predictive value	87.3 (74.9-94.3)	91.1 (79.9-99.1)	3.8% increase (0.65)
Negative predictive value	64.6 (49.4-77.4)	62.0 (45.7-75.4)	2.6% decrease (0.82)
FIB-4 with cutoff of ≥ 1.3
Sensitivity	69.2 (56.4-79.8)	70.0 (58.6-80.2)	0.8% increase (0.93)
Specificity	44.7 (29.0-61.5)	49.8 (40.8-66.1)	5.1% increase (0.58)
Positive predictive value	68.2 (55.4-78.8)	73.5 (61.5-85.0)	5.3% increase (0.55)
Negative predictive value	45.9 (29.8-62.9)	46.1 (31.2-61.9)	0.2% increase (0.99)
VCTE with LSM cutoff of ≥ 8 kPa
Sensitivity	81.5 (69.6-89.7)	80.7 (69.9-89.2)	0.8% decrease (0.92)
Specificity	78.9 (62.2-89.9)	83.6 (67.2-97.2)	4.7% increase (0.69)
Positive predictive value	86.9 (75.2-93.8)	90.6 (79.5-98.7)	3.7% increase (0.65)
Negative predictive value	71.4 (55.2-83.8)	68.8 (50.6-82.1)	2.6% decrease (0.83)
Prevalence advanced fibrosis	42.7 (33.1-52.8)	50.2 (37.1-65.2)	7.5% increase (0.37)
Biopsy stage METAVIR ≥ F3
Sensitivity	100	85.2 (64.6-99.8)	14.8% decrease (NA)
Specificity	100	100 (100-100)	NA (NA)
Positive predictive value	100	100 (100-100)	NA (NA)
Negative predictive value	100	87.0 (63.7-99.9)	13% decrease (NA)
FibroTest with cutoff of > 0.58
Sensitivity	70.5 (54.6-82.8)	66.1 (51.2-80.1)	4.4% decrease (0.69)
Specificity	83.1 (70.6-91.1)	86.4 (74.2-96.3)	3.3% increase (0.71)
Positive predictive value	75.6 (59.4-87.1)	83.3 (66.6-95.9)	7.7% increase (0.52)
Negative predictive value	79.0 (66.5-87.9)	71.9 (53.2-85.2)	7.1% decrease (0.54)
FIB-4 with cutoff of ≥ 2.67
Sensitivity	38.6 (24.7-54.5)	38.2 (25.0-52.3)	0.4% decrease (0.97)
Specificity	88.1 (76.5-94.7)	91.7 (79.9-99.5)	3.6% increase (0.67)
Positive predictive value	70.8 (48.8-86.6)	82.4 (56.5-99.2)	11.6% increase (0.50)
Negative predictive value	65.8 (54.2-75.9)	59.8 (44.2-72.6)	6% decrease (0.55)
VCTE with LSM cutoff of ≥ 9.5
Sensitivity	84.1 (69.3-92.8)	84.0 (72.2-92.9)	0.1% decrease (0.94)
Specificity	72.9 (59.5-83.3)	81.7 (65.2-98.8)	8.8% increase (0.42)
Positive predictive value	69.8 (55.5-81.3)	82.2 (62.4-99.0)	12.4% increase (0.32)
Negative predictive value	86.0 (72.6-93.7)	83.5 (69.4-92.9)	2.5% decrease (0.80)

LCM: Latent class model; METAVIR: Meta-analysis of Histological Data in Viral Hepatitis; FIB-4: Fibrosis-4 index; VCTE: Vibration-controlled transient elastography; NA: Not applicable; NA: Not available; LSM: Liver stiffness median.