A diagnostic model to differentiate simple steatosis from nonalcoholic steatohepatitis based on the likelihood ratio form of Bayes theorem

作者：Sookoian Silvia^*; Castano Gustavo; Laura Burgueno Adriana; Fernandez Gianotti Tomas; Soledad Rosselli Maria; Jose Pirola Carlos

来源：Clinical Biochemistry, 2009, 42(7-8): 624-629.

DOI：10.1016/j.clinbiochem.2008.11.005

• Biomarkers
• Diagnostic model
• Fatty liver NASH
• Nonalcoholic fatty liver disease
• sICAM-1

Objective: To evaluate the performance of a diagnostic model based on a composite index using clinical and laboratory data, including cardiovascular biomarkers, to help practitioners to differentiate patients with simple steatosis from those with nonalcoholic steatohepatitis (NASH).
Design and methods: 101 patients with biopsy proven features of nonalcoholic fatty liver disease were included. We investigated the usefulness of 9 biomarkers in predicting the histological disease severity, including routine biochemical tests, C-reactive protein, soluble intercellular adhesion molecule-1 (sICAM-1) and anthropometric evaluation. Receiver operating characteristic (ROC) curves and likelihood ratios (LRs) were used to evaluate the fit of each test. A composite index was calculated as the product of each individual test LR.
Results: In a model patient who has all positive tests, the post-test probability for NASH would be 99.5%.
Conclusion: The capacity of each individual biomarker to independently predict the disease outcome was lower than a composite index constructed after multiplying the LR for each individual test combined into a "multimarker" score.

• 出版日期2009-5
• 单位河北医科大学