Reducing NAFLD-screening time

A comparative study of eight diagnostic methods offering an alternative to ultrasound scans

MICOL Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND & AIMS: The use of ultrasound scan (US) in non-alcoholic fatty liver disease (NAFLD) screening overloads US waiting lists. We hypothesized and tested a hybrid two-step method, consisting of applying a formula, to exclude subjects at low risk, before US.

METHODS: The sample included 2970 males and females (937 with NAFLD) diagnosed by US. We selected eight formulas: Fatty Liver Index (FLI), Hepatic Steatosis Index (HIS), body mass index (BMI), waist circumference (WC), Abdominal Volume Index (AVI), waist-to-height ratio (WHtR), waist/height0.5 (WHT.5R) and Body Roundness Index (BRI), and calculated their performance in the two-step method evaluating percentage reduction of the number of liver US (US reduction percentage), percentage of false negative and percentage of NAFLD identified.

RESULTS: The US reductions percentage were 52.2% (WHtR), 52.1% (HIS), 51.8% (FLI), 50.8% (BRI), 50.7% (BMI and WHt_5R), 46.5% (WC) and 45.2% (AVI). The false negative percentage were 8.5% (WHtR), 7.9% (BRI), 7.3% (WHt_5R), 7.2% (BMI), 6.7% (HIS), 6.6% (FLI), 5.6% (WC) and 5.2% (AVI). The best percentage of NALFD identified was obtained using AVI (83.6%) before US, then WC (82.2%), FLI (79%), HIS (78.9%), BMI (77.3%), WHt_5R (76.9%), BRI (74.8%) and WHtR (73%).

CONCLUSION: The best formula to use in two-step diagnostic NAFLD screening was AVI, which showed a low false negative rate and a higher percentage of identified NAFLD. Other studies evaluating the economic advantages of this screening method are warranted.

Original languageEnglish
Pages (from-to)187-196
Number of pages10
JournalLiver International
Volume39
Issue number1
DOIs
Publication statusPublished - Jan 2019

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Waist Circumference
Fatty Liver
Body Mass Index
Liver
Two-Hybrid System Techniques
Waiting Lists
Economics
Non-alcoholic Fatty Liver Disease
Waist-Height Ratio

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Reducing NAFLD-screening time : A comparative study of eight diagnostic methods offering an alternative to ultrasound scans. / MICOL Group.

In: Liver International, Vol. 39, No. 1, 01.2019, p. 187-196.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND & AIMS: The use of ultrasound scan (US) in non-alcoholic fatty liver disease (NAFLD) screening overloads US waiting lists. We hypothesized and tested a hybrid two-step method, consisting of applying a formula, to exclude subjects at low risk, before US.METHODS: The sample included 2970 males and females (937 with NAFLD) diagnosed by US. We selected eight formulas: Fatty Liver Index (FLI), Hepatic Steatosis Index (HIS), body mass index (BMI), waist circumference (WC), Abdominal Volume Index (AVI), waist-to-height ratio (WHtR), waist/height0.5 (WHT.5R) and Body Roundness Index (BRI), and calculated their performance in the two-step method evaluating percentage reduction of the number of liver US (US reduction percentage), percentage of false negative and percentage of NAFLD identified.RESULTS: The US reductions percentage were 52.2{\%} (WHtR), 52.1{\%} (HIS), 51.8{\%} (FLI), 50.8{\%} (BRI), 50.7{\%} (BMI and WHt_5R), 46.5{\%} (WC) and 45.2{\%} (AVI). The false negative percentage were 8.5{\%} (WHtR), 7.9{\%} (BRI), 7.3{\%} (WHt_5R), 7.2{\%} (BMI), 6.7{\%} (HIS), 6.6{\%} (FLI), 5.6{\%} (WC) and 5.2{\%} (AVI). The best percentage of NALFD identified was obtained using AVI (83.6{\%}) before US, then WC (82.2{\%}), FLI (79{\%}), HIS (78.9{\%}), BMI (77.3{\%}), WHt_5R (76.9{\%}), BRI (74.8{\%}) and WHtR (73{\%}).CONCLUSION: The best formula to use in two-step diagnostic NAFLD screening was AVI, which showed a low false negative rate and a higher percentage of identified NAFLD. Other studies evaluating the economic advantages of this screening method are warranted.",
author = "{MICOL Group} and Filippo Procino and Giovanni Misciagna and Nicola Veronese and Caruso, {Maria G} and Marisa Chiloiro and Cisternino, {Anna M} and Maria Notarnicola and Caterina Bonfiglio and Irene Bruno and Claudia Buongiorno and Angelo Campanella and Valentina Deflorio and Isabella Franco and Rocco Guerra and Leone, {Carla M} and Antonella Mirizzi and Alessandro Nitti and Osella, {Alberto R}",
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T1 - Reducing NAFLD-screening time

T2 - A comparative study of eight diagnostic methods offering an alternative to ultrasound scans

AU - MICOL Group

AU - Procino, Filippo

AU - Misciagna, Giovanni

AU - Veronese, Nicola

AU - Caruso, Maria G

AU - Chiloiro, Marisa

AU - Cisternino, Anna M

AU - Notarnicola, Maria

AU - Bonfiglio, Caterina

AU - Bruno, Irene

AU - Buongiorno, Claudia

AU - Campanella, Angelo

AU - Deflorio, Valentina

AU - Franco, Isabella

AU - Guerra, Rocco

AU - Leone, Carla M

AU - Mirizzi, Antonella

AU - Nitti, Alessandro

AU - Osella, Alberto R

N1 - © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2019/1

Y1 - 2019/1

N2 - BACKGROUND & AIMS: The use of ultrasound scan (US) in non-alcoholic fatty liver disease (NAFLD) screening overloads US waiting lists. We hypothesized and tested a hybrid two-step method, consisting of applying a formula, to exclude subjects at low risk, before US.METHODS: The sample included 2970 males and females (937 with NAFLD) diagnosed by US. We selected eight formulas: Fatty Liver Index (FLI), Hepatic Steatosis Index (HIS), body mass index (BMI), waist circumference (WC), Abdominal Volume Index (AVI), waist-to-height ratio (WHtR), waist/height0.5 (WHT.5R) and Body Roundness Index (BRI), and calculated their performance in the two-step method evaluating percentage reduction of the number of liver US (US reduction percentage), percentage of false negative and percentage of NAFLD identified.RESULTS: The US reductions percentage were 52.2% (WHtR), 52.1% (HIS), 51.8% (FLI), 50.8% (BRI), 50.7% (BMI and WHt_5R), 46.5% (WC) and 45.2% (AVI). The false negative percentage were 8.5% (WHtR), 7.9% (BRI), 7.3% (WHt_5R), 7.2% (BMI), 6.7% (HIS), 6.6% (FLI), 5.6% (WC) and 5.2% (AVI). The best percentage of NALFD identified was obtained using AVI (83.6%) before US, then WC (82.2%), FLI (79%), HIS (78.9%), BMI (77.3%), WHt_5R (76.9%), BRI (74.8%) and WHtR (73%).CONCLUSION: The best formula to use in two-step diagnostic NAFLD screening was AVI, which showed a low false negative rate and a higher percentage of identified NAFLD. Other studies evaluating the economic advantages of this screening method are warranted.

AB - BACKGROUND & AIMS: The use of ultrasound scan (US) in non-alcoholic fatty liver disease (NAFLD) screening overloads US waiting lists. We hypothesized and tested a hybrid two-step method, consisting of applying a formula, to exclude subjects at low risk, before US.METHODS: The sample included 2970 males and females (937 with NAFLD) diagnosed by US. We selected eight formulas: Fatty Liver Index (FLI), Hepatic Steatosis Index (HIS), body mass index (BMI), waist circumference (WC), Abdominal Volume Index (AVI), waist-to-height ratio (WHtR), waist/height0.5 (WHT.5R) and Body Roundness Index (BRI), and calculated their performance in the two-step method evaluating percentage reduction of the number of liver US (US reduction percentage), percentage of false negative and percentage of NAFLD identified.RESULTS: The US reductions percentage were 52.2% (WHtR), 52.1% (HIS), 51.8% (FLI), 50.8% (BRI), 50.7% (BMI and WHt_5R), 46.5% (WC) and 45.2% (AVI). The false negative percentage were 8.5% (WHtR), 7.9% (BRI), 7.3% (WHt_5R), 7.2% (BMI), 6.7% (HIS), 6.6% (FLI), 5.6% (WC) and 5.2% (AVI). The best percentage of NALFD identified was obtained using AVI (83.6%) before US, then WC (82.2%), FLI (79%), HIS (78.9%), BMI (77.3%), WHt_5R (76.9%), BRI (74.8%) and WHtR (73%).CONCLUSION: The best formula to use in two-step diagnostic NAFLD screening was AVI, which showed a low false negative rate and a higher percentage of identified NAFLD. Other studies evaluating the economic advantages of this screening method are warranted.

U2 - 10.1111/liv.13970

DO - 10.1111/liv.13970

M3 - Article

VL - 39

SP - 187

EP - 196

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 1

ER -