| Title |
Identifying Nonalcoholic Fatty Liver Disease Advanced Fibrosis in the Veterans Health Administration
|
|---|---|
| Published in |
Digestive Diseases and Sciences, May 2018
|
| DOI | 10.1007/s10620-018-5123-3 |
| Pubmed ID | |
| Authors |
Yuval A. Patel, Elizabeth J. Gifford, Lisa M. Glass, Marsha J. Turner, Byungjoo Han, Cynthia A. Moylan, Steve Choi, Ayako Suzuki, Dawn Provenzale, Christine M. Hunt |
| Abstract |
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Severe NAFLD with advanced fibrosis results in substantial morbidity and mortality. Associated with metabolic syndrome, NAFLD is often initially clinically silent, yet intensive lifestyle intervention with 7% or greater weight loss can improve or resolve NAFLD. Using a Veterans Health Administration (VHA) liver biopsy cohort, we evaluated simple noninvasive fibrosis scoring systems to identify NAFLD with advanced fibrosis (or severe disease) to assist providers. In our retrospective study of a national VHA sample of patients with biopsy-proven NAFLD or normal liver (2005-2015), we segregated patients by fibrosis stage (0-4). Non-NAFLD liver disease was excluded. We evaluated the diagnostic accuracy of the NAFLD fibrosis score (NFS), fibrosis-4 calculator (FIB-4), aspartate aminotransferase-to-alanine aminotransferase ratio (AST/ALT ratio), AST-to-platelet ratio index (APRI), and body mass index, AST/ALT ratio, and diabetes (BARD) score by age groups. We included 329 patients with well-defined liver histology (296 NAFLD and 33 normal controls without fibrosis), in which 92 (28%) had advanced (stage 3-4) fibrosis. Across all age groups, NFS and FIB-4 best predicted advanced fibrosis (NFS with 0.676 threshold: AUROC 0.71-0.76, LR + 2.30-22.05, OR 6.00-39.58; FIB-4 with 2.67 threshold: AUROC of 0.62-0.80, LR + 4.70-27.45, OR 16.34-59.65). While NFS and FIB-4 scores exhibit good diagnostic accuracy, FIB-4 is optimal in identifying NAFLD advanced fibrosis in the VHA. Easily implemented as a point-of-care clinical test, FIB-4 can be useful in directing patients that are most likely to have advanced fibrosis to GI/hepatology consultation and follow-up. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 61 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 20% |
| Student > Master | 9 | 15% |
| Student > Bachelor | 5 | 8% |
| Other | 5 | 8% |
| Professor | 3 | 5% |
| Other | 9 | 15% |
| Unknown | 18 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 39% |
| Nursing and Health Professions | 5 | 8% |
| Biochemistry, Genetics and Molecular Biology | 3 | 5% |
| Agricultural and Biological Sciences | 3 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
| Other | 5 | 8% |
| Unknown | 19 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 May 2018.
All research outputs
#20,316,011
of 24,975,845 outputs
Outputs from Digestive Diseases and Sciences
#3,632
of 4,578 outputs
Outputs of similar age
#261,954
of 336,104 outputs
Outputs of similar age from Digestive Diseases and Sciences
#42
of 72 outputs
Altmetric has tracked 24,975,845 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,578 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one is in the 11th percentile – i.e., 11% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 336,104 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 12th percentile – i.e., 12% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 72 others from the same source and published within six weeks on either side of this one. This one is in the 8th percentile – i.e., 8% of its contemporaries scored the same or lower than it.