{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:12:07Z","timestamp":1790244727854,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010613","name":"Taipei Medical University Hospital","doi-asserted-by":"publisher","award":["115TMU\u2010TMUH\u201022"],"award-info":[{"award-number":["115TMU\u2010TMUH\u201022"]}],"id":[{"id":"10.13039\/501100010613","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Serum\u2010based fibrosis scores are widely used for noninvasive risk stratification in chronic liver disease; however, direct comparisons across liver disease etiologies remain limited, particularly in Asian populations with a high prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. This study retrospectively analyzed the data of adults who underwent transient elastography (FibroScan) at a university\u2010affiliated hospital. Three fibrosis scores were evaluated: Fibrosis\u20104 index (FIB\u20104), aspartate aminotransferase\u2010to\u2010platelet ratio index (APRI), and metabolic dysfunction\u2010associated fibrosis\u20105 (MAF\u20105). Associations with advanced fibrosis (F3\u2013F4) were examined using logistic regression. Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC). Of the 2355 participants, the etiologic subgroups included metabolic dysfunction\u2013associated steatotic liver disease (MASLD;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091070), HBV infection (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091459), and HCV infection (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009250); 10.4% of the participants had advanced fibrosis (F3\u2013F4). In the overall cohort, all scores were significantly associated with advanced fibrosis (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and demonstrated similar overall discrimination with AUROC in a range of 0.824\u20130.839. MAF\u20105 had the highest AUROC (0.839; 95% confidence interval [CI], 0.811\u20130.867) and greater risk classification compared with FIB\u20104 (net reclassification improvement\u2009=\u20090.168; 95% CI, 0.093\u20130.244). Subgroup analysis revealed that MAF\u20105 exhibited consistent discrimination across etiologies, with AUROCs of 0.822 (0.781\u20130.863) in MASLD, 0.843 (95% CI, 0.804\u20130.882) in HBV, and 0.810 (95% CI, 0.735\u20130.886) in HCV. Commonly used serum\u2010based fibrosis scores exhibited comparable discrimination for advanced fibrosis. However, the metabolically informed MAF\u20105 score modestly improved risk classification across diverse liver disease etiologies.\n                  <\/jats:p>","DOI":"10.1002\/kjm2.70296","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:42:58Z","timestamp":1790242978000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Serum\u2010Based Fibrosis Scores for Clinically Significant Liver Fibrosis in an East Asian Cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-2184","authenticated-orcid":false,"given":"Sheng\u2010Feng","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Public Health, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"School of Public Health, College of Public Health Taipei Medical University  Taipei Taiwan"},{"name":"Department of Emergency Medicine Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Center of Evidence\u2010Based Medicine Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Department of Medical Research Taipei Medical University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-1559","authenticated-orcid":false,"given":"Chun\u2010Chao","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University  Taipei Taiwan"},{"name":"TMU Research Center for Digestive Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1002\/hep.29085","article-title":"Increased Risk of Mortality by Fibrosis Stage in Nonalcoholic Fatty Liver Disease: Systematic Review and Meta\u2010Analysis","volume":"65","author":"Dulai P. 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H.","year":"2023","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"6","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1007\/s10620-023-07943-z","article-title":"Prognostic Effects of Liver Fibrosis and Steatosis Determined Using Transient Elastography in Patients With Chronic Hepatitis B or C","volume":"68","author":"Wang C. L.","year":"2023","journal-title":"Digestive Diseases and Sciences"},{"issue":"3","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/hep.22742","article-title":"Liver Biopsy\u2020","volume":"49","author":"Rockey D. C.","year":"2009","journal-title":"Hepatology"},{"issue":"12","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/j.ultrasmedbio.2003.07.001","article-title":"Transient Elastography: A New Noninvasive Method for Assessment of Hepatic Fibrosis","volume":"29","author":"Sandrin L.","year":"2003","journal-title":"Ultrasound in Medicine & Biology"},{"issue":"17","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1056\/NEJMra2403308","article-title":"Noninvasive Assessment of Liver Fibrosis","volume":"393","author":"Castera L.","year":"2025","journal-title":"New England Journal of Medicine"},{"issue":"6","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1053\/j.gastro.2019.01.042","article-title":"Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease","volume":"156","author":"Eddowes P. 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