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Meta-Analysis
. 2015 Oct;94(42):e1795.
doi: 10.1097/MD.0000000000001795.

Diagnostic Accuracy of APRI, AAR, FIB-4, FI, King, Lok, Forns, and FibroIndex Scores in Predicting the Presence of Esophageal Varices in Liver Cirrhosis: A Systematic Review and Meta-Analysis

Han Deng  1 , Xingshun Qi, Xiaozhong Guo
Affiliations
Meta-Analysis

Diagnostic Accuracy of APRI, AAR, FIB-4, FI, King, Lok, Forns, and FibroIndex Scores in Predicting the Presence of Esophageal Varices in Liver Cirrhosis: A Systematic Review and Meta-Analysis

Han Deng et al. Medicine (Baltimore). 2015 Oct.

Erratum in

Abstract

Aspartate aminotransferase-to-platelet ratio (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), FIB-4, FI, King, Lok, Forns, and FibroIndex scores may be simple and convenient noninvasive diagnostic tests, because they are based on the regular laboratory tests and demographic data. This study aimed to systematically evaluate their diagnostic accuracy for the prediction of varices in liver cirrhosis.All relevant papers were searched via PubMed, EMBASE, CNKI, and Wanfang databases. The area under the summary receiver operating characteristic curve (AUSROC), sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), and diagnostic odds ratio (DOR) were calculated.Overall, 12, 4, 5, 0, 0, 4, 3, and 1 paper was identified to explore the diagnostic accuracy of APRI, AAR, FIB-4, FI, King, Lok, Forns, and FibroIndex scores, respectively. The AUSROCs of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of varices were 0.6774, 0.7275, 0.7755, 0.7885, and 0.7517, respectively; and those for the prediction of large varices were 0.7278, 0.7448, 0.7095, 0.7264, and 0.6530, respectively. The diagnostic threshold effects of FIB-4 and Forns scores for the prediction of varices were statistically significant. The sensitivities/specificities/PLRs/NLRs/DORs of APRI, AAR, and Lok scores for the prediction of varices were 0.60/0.67/1.77/0.58/3.13, 0.64/0.63/1.97/0.54/4.18, and 0.74/0.68/2.34/0.40/5.76, respectively. The sensitivities/specificities/PLRs/NLRs/DORs of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of large varices were 0.65/0.66/2.15/0.47/4.97, 0.68/0.58/2.07/0.54/3.93, 0.62/0.64/2.02/0.56/3.57, 0.78/0.63/2.09/0.37/5.55, and 0.65/0.61/1.62/0.59/2.75, respectively.APRI, AAR, FIB-4, Lok, and Forns scores had low to moderate diagnostic accuracy in predicting the presence of varices in liver cirrhosis.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
SROCs of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: FIB-4; panel D: Lok; panel E: Forns.
FIGURE 2
FIGURE 2
SROCs of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of large varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: FIB-4; panel D: Lok; panel E: Forns.
FIGURE 3
FIGURE 3
Summary sensitivities of APRI, AAR, and Lok scores for the prediction of varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: Lok.
FIGURE 4
FIGURE 4
Summary sensitivities of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of large varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: FIB-4; panel D: Lok; panel E: Forns.
FIGURE 5
FIGURE 5
Summary specificities of APRI, AAR, and Lok scores for the prediction of varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: Lok.
FIGURE 6
FIGURE 6
Summary specificities of APRI, AAR, FIB-4, Lok, and Forns scores for the prediction of large varices in liver cirrhosis. Panel A: APRI; panel B: AAR; panel C: FIB-4; panel D: Lok; panel E: Forns.
See this image and copyright information in PMC

References

    1. Biecker E. Portal hypertension and gastrointestinal bleeding: diagnosis, prevention and management. World J Gastroenterol 2013; 19:5035–5050. - PMC - PubMed
    1. Tripathi D, Stanley AJ, Hayes PC, et al. UK guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut 2015. - PMC - PubMed
    1. Turon F, Casu S, Hernandez-Gea V, et al. Variceal and other portal hypertension related bleeding. Best Pract Res Clin Gastroenterol 2013; 27:649–664. - PubMed
    1. Kim MY, Jeong WK, Baik SK. Invasive and non-invasive diagnosis of cirrhosis and portal hypertension. World J Gastroenterol 2014; 20:4300–4315. - PMC - PubMed
    1. Stefanescu H, Procopet B. Noninvasive assessment of portal hypertension in cirrhosis: liver stiffness and beyond. World J Gastroenterol 2014; 20:16811–16819. - PMC - PubMed

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