{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:58:23Z","timestamp":1785308303517,"version":"3.55.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":189,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health and Labor Sciences Research Grant, Ministry of Health, Labor, and Welfare, Japan"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the utility of the FIB-3 index as a secondary screening tool for liver fibrosis in workplace-based health checkups, by comparing its concordance and negative predictive values (NPVs) with those of the FIB-4 index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cross-sectional study included 12\u2009622 workers from the Hitachi Cohort Study who underwent workplace-based health checkups between April 2021 and March 2022. FIB-4 was calculated using age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count, whereas FIB-3 used the same components except age. To evaluate the utility of FIB-3 in excluding liver fibrosis, NPVs were calculated using FIB-4 thresholds (1.30, 2.01, and 2.67) as references. Concordance between FIB-3 and FIB-4 was examined across different age groups. In addition, multivariate logistic regression analysis was conducted to identify factors associated with false-positive FIB-3 results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The FIB-3 index demonstrated high NPVs for excluding liver fibrosis, with values of 99.9% at FIB-4\u2009\u2265\u20091.30 and 98.2% at FIB-4\u2009\u2265\u20092.67. Strong concordance between FIB-3 and FIB-4 was observed consistently across different age groups. Among participants with elevated ALT (&amp;gt;30\u00a0IU\/L), FIB-3 consistently ruled out fibrosis, whereas FIB-4 positivity increased with advancing age. Multivariate analysis indicated that higher AST levels and increased alcohol intake were significantly associated with false-positive FIB-3 results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The FIB-3 index demonstrated stable performance across age groups while maintaining high concordance and NPV relative to FIB-4. These findings suggest that FIB-3 may serve as a practical screening tool in routine workplace-based health checkups, particularly in mitigating age-related overestimation observed with the FIB-4 index.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/joccuh\/uiaf038","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T17:18:19Z","timestamp":1752081499000},"source":"Crossref","is-referenced-by-count":2,"title":["Comparative evaluation of FIB-3 and FIB-4 indices for liver fibrosis screening in workplace-based health checkups"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-8467","authenticated-orcid":false,"given":"Kota","family":"Fukai","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Tokai University School of Medicine , Isehara 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