{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T04:41:31Z","timestamp":1789965691765,"version":"4.0.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T00:00:00Z","timestamp":1520208000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Communications"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>Fibrosis blood tests are usually developed using significant fibrosis, which is a unique diagnostic target; however, these tests are employed for other diagnostic targets, such as cirrhosis. We aimed to improve fibrosis staging accuracy by simultaneously targeting biomarkers for several diagnostic targets. A total of 3,809 patients were included, comprising 1,012 individuals with chronic hepatitis C (CHC) into a derivation population and 2,797 individuals into validation populations of different etiologies (CHC, chronic hepatitis B, human immunodeficiency virus\/CHC, nonalcoholic fatty liver disease, alcohol) using Metavir fibrosis stages as reference. FibroMeter biomarkers were targeted for different fibrosis\u2010stage combinations into classical scores by logistic regression. Independent scores were combined into a single score reflecting Metavir stages by linear regression and called Multi\u2010FibroMeter Version Second Generation (V2G). The primary objective was to combine the advantages of a test targeted for significant fibrosis (FibroMeter<jats:sup>V2G<\/jats:sup>) with those of a test targeted for cirrhosis (CirrhoMeter<jats:sup>V2G<\/jats:sup>). In the derivation CHC population, we first compared Multi\u2010FibroMeter<jats:sup>V2G<\/jats:sup> to FibroMeter<jats:sup>V2G<\/jats:sup> and observed significant increases in the cirrhosis area under the receiver operating characteristic curve (AUROC), Obuchowski index (reflecting all fibrosis\u2010stage AUROCs), and classification metric (six classes expressed as a correctly classified percentage) and a nonsignificant increase in significant fibrosis AUROC. Thereafter, we compared it to CirroMeter<jats:sup>V2G<\/jats:sup> and observed a nonsignificant increase in the cirrhosis AUROC. In all 3,809 patients, respective accuracies for Multi\u2010FibroMeter<jats:sup>V2G<\/jats:sup> and FibroMeter<jats:sup>V2G<\/jats:sup> were the following: cirrhosis AUROC, 0.906 versus 0.878 (<jats:italic toggle=\"yes\">P &lt;<\/jats:italic> 0.001; versus CirroMeter<jats:sup>V2G<\/jats:sup>, 0.897, <jats:italic toggle=\"yes\">P =<\/jats:italic> 0.014); Obuchowski index, 0.795 versus 0.791 (<jats:italic toggle=\"yes\">P =<\/jats:italic> 0.059); classification, 86.0% versus 82.1% (<jats:italic toggle=\"yes\">P &lt;<\/jats:italic> 0.001); significant fibrosis AUROC, 0.833 versus 0.832 (<jats:italic toggle=\"yes\">P =<\/jats:italic> 0.366). Multi\u2010FibroMeter<jats:sup>V2G<\/jats:sup> had the highest correlation with the area of portoseptal fibrosis and the highest reproducibility over time. Correct classification rates of Multi\u2010FibroMeter with hyaluronate (V2G, 86.0%) or without (V3G, 86.1%) did not differ (<jats:italic toggle=\"yes\">P =<\/jats:italic> 0.938). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Multitargeting biomarkers significantly improves fibrosis staging and especially cirrhosis diagnosis compared to classical single\u2010targeted blood tests. (<jats:italic toggle=\"yes\">Hepatology Communications<\/jats:italic> 2018;2:455\u2010466)<\/jats:p>","DOI":"10.1002\/hep4.1161","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T14:12:40Z","timestamp":1520259160000},"page":"455-466","source":"Crossref","is-referenced-by-count":7,"title":["A single blood test adjusted for different liver fibrosis targets improves fibrosis staging and especially cirrhosis diagnosis"],"prefix":"10.1097","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4866-5274","authenticated-orcid":false,"given":"Paul","family":"Cal\u00e8s","sequence":"first","affiliation":[{"name":"Liver\u2010Gastroenterology Department,University Hospital,Angers,France"},{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Boursier","sequence":"additional","affiliation":[{"name":"Liver\u2010Gastroenterology Department,University Hospital,Angers,France"},{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Oberti","sequence":"additional","affiliation":[{"name":"Liver\u2010Gastroenterology Department,University Hospital,Angers,France"},{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Moal","sequence":"additional","affiliation":[{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"},{"name":"Department of Biochemistry and Genetics,University Hospital,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Fouchard Hubert","sequence":"additional","affiliation":[{"name":"Liver\u2010Gastroenterology Department,University Hospital,Angers,France"},{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Bertrais","sequence":"additional","affiliation":[{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Hunault","sequence":"additional","affiliation":[{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Christine","family":"Rousselet","sequence":"additional","affiliation":[{"name":"HIFIH Laboratory,Angers University, Bretagne Loire University,Angers,France"},{"name":"Pathology Department,University Hospital,Angers,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"multicentric groups (SNIFF, ANRS HC 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