{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:46:35Z","timestamp":1791423995067,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T00:00:00Z","timestamp":1453248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The progression of hepatic fibrosis into cirrhosis is a main prognostic factor for survival in people with alcoholic liver disease. The range of cut\u2010off values characterising the stage of hepatic fibrosis seems to be dependent on the aetiology of the liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the diagnostic accuracy of transient elastography (the index test) for diagnosis of fibrosis in alcoholic liver disease when compared with liver biopsy (the reference standard), using the <jats:styled-content style=\"fixed-case\">METAVIR<\/jats:styled-content> scoring system. To establish the optimal cut\u2010off values for the hepatic fibrosis stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed Cochrane Methodology for diagnostic test accuracy reviews. We identified 14 studies. Among the study participants with alcoholic liver disease, 834 provided numerical data for analysis (August 2014). Only half of the studies were monoaetiology studies. We used the bivariate model and estimated the summary sensitivities and summary specificities. Hence, we calculated the summary likelihood ratios (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>s) to rule in or rule out hepatic fibrosis. We investigated pre\u2010defined sources of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severe fibrosis (F3 or worse): summary (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) sensitivity 0.92(0.89\u20130.96) and specificity 0.70(0.61\u20130.79); <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>+ 3.1(2.1\u20134.1), <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\u2212 0.11(95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.06\u20130.16). Cirrhosis (F4): summary (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) sensitivity of 0.95(0.87\u20130.98) and specificity 0.71(0.56\u20130.82); <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>+ 3.3(2.1\u20135.0); <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\u2212 0.07(0.03\u20130.19).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transient elastography may be used as a diagnostic method to exclude cirrhosis or severe fibrosis when the test is negative. Cut\u2010off values of around 12.5\u00a0kPa for cirrhosis may be used in clinical practice, but caution is needed, as the values reported in the review are not yet prospectively validated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13524","type":"journal-article","created":{"date-parts":[[2016,1,21]],"date-time":"2016-01-21T01:42:48Z","timestamp":1453340568000},"page":"575-585","source":"Crossref","is-referenced-by-count":61,"title":["Systematic review with meta\u2010analysis: diagnostic accuracy of transient elastography for staging of fibrosis in people with alcoholic liver disease"],"prefix":"10.1111","volume":"43","author":[{"given":"C. S.","family":"Pavlov","sequence":"first","affiliation":[{"name":"The Cochrane Hepato\u2010Biliary Group Copenhagen Trial Unit Centre for Clinical Intervention Research Copenhagen University Hospital Copenhagen Denmark"},{"name":"Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology I.M. Sechenov First Moscow State Medical University Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Casazza","sequence":"additional","affiliation":[{"name":"The Cochrane Hepato\u2010Biliary Group Copenhagen Trial Unit Centre for Clinical Intervention Research Copenhagen University Hospital Copenhagen Denmark"},{"name":"Dipartimento di Scienze Biomediche e Cliniche \u201cL. Sacco\u201d Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Nikolova","sequence":"additional","affiliation":[{"name":"The Cochrane Hepato\u2010Biliary Group Copenhagen Trial Unit Centre for Clinical Intervention Research Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5069-2461","authenticated-orcid":false,"given":"E.","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"Sheila Sherlock Liver Centre Royal Free Hospital and the UCL Institute of Liver and Digestive Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gluud","sequence":"additional","affiliation":[{"name":"The Cochrane Hepato\u2010Biliary Group Copenhagen Trial Unit Centre for Clinical Intervention Research Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,20]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization.Global strategy to reduce the harmful use of alcohol 2010. 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