FIB‐4 and incident severe liver outcomes in patients with undiagnosed chronic liver disease: A Fine‐Gray competing risk analysis

The Fibrosis‐4 index (FIB‐4) can reliably assess fibrosis risk in patients with chronic liver disease, and advanced fibrosis is associated with severe liver disease (SLD) outcomes. However, CLD is underdiagnosed in primary care. We examined the association between FIB‐4 risk strata and the incidence of SLD preceding a CLD diagnosis while considering incident CLD diagnoses as competing risks.

[1]  M. Gebregziabher,et al.  The Association of Fibrosis-4 Index Scores with Severe Liver Outcomes in Primary Care , 2022, Journal of General Internal Medicine.

[2]  J. Marsden,et al.  Nonalcoholic Fatty Liver Disease Underdiagnosis in Primary Care: What Are We Missing? , 2021, Journal of General Internal Medicine.

[3]  C. Mantzoros,et al.  Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease. , 2021, Gastroenterology.

[4]  M. Friedrich-Rust,et al.  Easl Clinical Practice Guidelines (Cpgs) On Non-Invasive Tests For Evaluation Of Liver Disease Severity And Prognosis- 2020 Update. , 2021, Journal of hepatology.

[5]  P. Bork,et al.  Prognostic performance of 7 biomarkers compared to liver biopsy in early alcohol-related liver disease , 2021, Journal of hepatology.

[6]  J. Ludvigsson,et al.  Cancer Risk in Patients With Biopsy‐Confirmed Nonalcoholic Fatty Liver Disease: A Population‐Based Cohort Study , 2021, Hepatology.

[7]  A. Singer,et al.  Who is asked about alcohol consumption? A retrospective cohort study using a national repository of Electronic Medical Records , 2021, Preventive medicine reports.

[8]  V. Wong,et al.  Administrative Coding in Electronic Health Care Record‐Based Research of NAFLD: An Expert Panel Consensus Statement , 2021, Hepatology.

[9]  A. Andreasson,et al.  Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease. , 2020, Journal of hepatology.

[10]  E. Tapper,et al.  Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis. , 2020, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[11]  A. Andreasson,et al.  Ability of Noninvasive Scoring Systems to Identify Individuals in the Population at Risk for Severe Liver Disease. , 2019, Gastroenterology.

[12]  D. Thorburn,et al.  Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease. , 2019, Journal of hepatology.

[13]  P. Tandon,et al.  Impact of Implementing a “FIB‐4 First” Strategy on a Pathway for Patients With NAFLD Referred From Primary Care , 2019, Hepatology communications.

[14]  Michael L Wilson,et al.  The Top 25 Laboratory Tests by Volume and Revenue in Five Different Countries , 2018, American journal of clinical pathology.

[15]  Yoosoo Chang,et al.  Alcoholic and Nonalcoholic Fatty Liver Disease and Liver-Related Mortality: A Cohort Study , 2019, The American journal of gastroenterology.

[16]  Peter J. Richardson,et al.  Positive Predictive Value of International Classification of Diseases, 10th Revision, Codes for Cirrhosis and Its Related Complications , 2018, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[17]  Michael Charlton,et al.  The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases , 2018, Hepatology.

[18]  R. Hultcrantz,et al.  Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD. , 2017, Journal of hepatology.

[19]  Jason P Fine,et al.  Practical recommendations for reporting Fine‐Gray model analyses for competing risk data , 2017, Statistics in medicine.

[20]  V. Wong,et al.  Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta‐analysis , 2017, Hepatology.

[21]  S. Sharp,et al.  The spectrum effect in tests for risk prediction, screening, and diagnosis , 2016, British Medical Journal.

[22]  Jason P. Fine,et al.  Statistical Primer for Cardiovascular Research Introduction to the Analysis of Survival Data in the Presence of Competing Risks , 2022 .

[23]  European Association for the Study of the Liver,et al.  EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease , 2016, Obesity Facts.

[24]  Christopher A. Clark,et al.  Use of Administrative Claims Data for Identifying Patients with Cirrhosis , 2013, Journal of clinical gastroenterology.

[25]  D. Mehrotra,et al.  An efficient alternative to the stratified Cox model analysis , 2012, Statistics in medicine.

[26]  A. Burt,et al.  Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease , 2022 .

[27]  Y. Paik,et al.  Validation of FIB‐4 and comparison with other simple noninvasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus‐infected patients , 2010, Liver international : official journal of the International Association for the Study of the Liver.

[28]  A. Sanyal,et al.  Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[29]  S. Pol,et al.  The accuracy of the FIB‐4 index for the diagnosis of mild fibrosis in chronic hepatitis B , 2009, Alimentary pharmacology & therapeutics.

[30]  Y. Ngo,et al.  Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver disease , 2009, Hepatology.

[31]  A. West,et al.  Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis assay , 2008, Hepatology.

[32]  H. Quan,et al.  Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database. , 2008, Health services research.

[33]  G. Verset,et al.  The predictive value of FIB‐4 versus FibroTest, APRI, FibroIndex and Forns index to noninvasively estimate fibrosis in hepatitis C and nonhepatitis C liver diseases , 2008, Hepatology.

[34]  S. Pol,et al.  FIB‐4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest , 2007, Hepatology.

[35]  G. D’Amico,et al.  Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. , 2006, Journal of hepatology.

[36]  H. Quan,et al.  Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data , 2005, Medical care.

[37]  R. Groszmann,et al.  American association for the study of liver diseases , 1992 .

[38]  D. Kleinbaum.  Survival Analysis: A Self-Learning Text , 1997 .