Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Apr 15;9(4):e92772.
doi: 10.1371/journal.pone.0092772. eCollection 2014.

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

Qingsong Xie  1 , Xiaohu Zhou  1 , Pengfei Huang  1 , Jianfeng Wei  1 , Weilin Wang  1 , Shusen Zheng  1
Affiliations
Meta-Analysis

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

Qingsong Xie et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flowchart for the literature search.
Figure 2
Figure 2. The SROC curves for the studies examining ELF test versus liver biopsy for the assessment of (A) significant liver fibrosis, (B) severe liver fibrosis and (C) cirrhosis.
Figure 3
Figure 3. Forest plot and meta-analysis of studies assessing (A) the sensitivity, (B) the specificity, (C) the positive LR and (D) the negative LR of ELF test versus biopsy for the detection of significant liver fibrosis.
Figure 4
Figure 4. Forest plot and meta-analysis of studies appraising the diagnostic odds ratio of ELF test versus liver biopsy for the assessment of significant liver fibrosis.
Figure 5
Figure 5. Forest plot and meta-analysis of studies estimating (A) the sensitivity, (B) the specificity, (C) the positive LR and (D) the negative LR of ELF test versus liver biopsy for the detection of severe liver fibrosis.
Figure 6
Figure 6. Forest plot and meta-analysis of studies assessing the diagnostic odds ratio of ELF test versus liver biopsy for the measurement of severe liver fibrosis.
Figure 7
Figure 7. Forest plot and meta-analysis of studies evaluating (A) the sensitivity, (B) the specificity, (C) the positive LR and (D) the negative LR of ELF test versus liver biopsy for the detection of cirrhosis.
Figure 8
Figure 8. Forest plot and meta-analysis of studies assessing the diagnostic odds ratio of ELF test versus liver biopsy for the prediction of cirrhosis.
Figure 9
Figure 9. The comparison of SROC curves between (A) ELF test and (B) transient elastogrphy for assessment of cirrhosis.
Figure 10
Figure 10. The comparison of sensitivity and specificity between (A) ELF test and (B) transient elastography for assessment of cirrhosis.
Figure 11
Figure 11. The comparison of diagnostic odds ratio between (A) ELF test and (B) transient elastography for assessment of cirrhosis.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Institutes of Health Consensus Development Conference (2002) National Institutes of Health Consensus Development Conference Statement: Management of hepatitis C: 2002; June 10–12, 2002; Hepatology. 36: S3–20. - PubMed
    1. Bravo AA, Sheth SG, Chopra S (2001) Liver biopsy. N Engl J Med 344: 495–500. - PubMed
    1. Castera L, Negre I, Samii K, Buffet C (1999) Pain experienced during percutaneous liver biopsy. Hepatology 30: 1529–1530. - PubMed
    1. Bedossa P, Dargere D, Paradis V (2003) Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 38: 1449–1457. - PubMed
    1. Rousselet MC, Michalak S, Dupre F, Croue A, Bedossa P, et al. (2005) Sources of variability in histological scoring of chronic viral hepatitis. Hepatology 41: 257–264. - PubMed

Publication types