{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:59:44Z","timestamp":1787666384197,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/V037331\/1"],"award-info":[{"award-number":["MR\/V037331\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013322","name":"European Federation of Pharmaceutical Industries and Associations","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sequential use of non\u2010invasive fibrosis tests (NITs) to identify patients with advanced hepatic fibrosis is recommended. However, it remains unclear how reliable clinicians are staging liver fibrosis using combinations of NITs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Our aim was to assess concordance between NIT\u2010based \u2018clinician fibrosis assessment (CFA)\u2019 and histology in patients with metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and compare this with established algorithmic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six experienced hepatologists independently staged 230 MASLD patients for advanced fibrosis (F0\u20102 vs F3\u20104) using FIB\u20104, FIB\u20104+ELF, FIB\u20104+ vibration controlled transient elastography (VCTE; Fibroscan\u2122) and FIB\u20104+ELF+VTCE. Concordance between histology and CFA or algorithmic approaches were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 230 patients were included (median age 54 [22\u201378] years; 55% female; median FIB\u20104 1.21 [IQR: 0.78\u20131.91]; ELF 9.3 [IQR: 8.6\u201310.2]; VCTE 9.4 [IQR: 6.3\u201314.3]; 41% F0\u20101, 22% F2, 21% F3 and 16% F4). Overall, area under the receiver operator curves for histologic F3\u20104 for the raw tests were 0.84 for FIB\u20104, 0.86 for ELF and 0.86 for VCTE. Concordance between the hepatologists was good (FIB4,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.64; FIB\u20104+ELF,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.70; FIB\u20104+VCTE,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.69; FIB\u20104+ELF+VCTE,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.70). Concordance between individual CFA and histology was variable, which was reflected in variability in sensitivity (44%\u201384%) and specificity (76%\u201394%). Concordance with histology was better when clinicians used NIT combinations. Purely algorithmic approaches, particularly sequential use of FIB\u20104 then VCTE, tended to perform better than the CFA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adhering to the recommended algorithmic approaches using NITs to stage fibrosis tended to perform more accurately than less\u2010structured clinician NIT\u2010based assessments conducted by experienced hepatologists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.18061","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T13:57:06Z","timestamp":1718114226000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["How effective are experienced hepatologists at staging fibrosis using non\u2010invasive fibrosis tests in patients with metabolic dysfunction\u2010associated steatotic liver disease?"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-2453","authenticated-orcid":false,"given":"Stuart","family":"McPherson","sequence":"first","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"},{"name":"Newcastle NIHR Biomedical Research Centre The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational &amp; Clinical Research Institute, Faculty of Medical Sciences, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K.","family":"Dyson","sequence":"additional","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"},{"name":"Newcastle NIHR Biomedical Research Centre The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational &amp; Clinical Research Institute, Faculty of Medical Sciences, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Jopson","sequence":"additional","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1041-9844","authenticated-orcid":false,"given":"Steven","family":"Masson","sequence":"additional","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"},{"name":"Newcastle NIHR Biomedical Research Centre The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational &amp; Clinical Research Institute, Faculty of Medical Sciences, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preya","family":"Patel","sequence":"additional","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9518-0088","authenticated-orcid":false,"given":"Quentin M.","family":"Anstee","sequence":"additional","affiliation":[{"name":"Liver Unit The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital  Newcastle upon Tyne UK"},{"name":"Newcastle NIHR Biomedical Research Centre The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational &amp; Clinical Research Institute, Faculty of Medical Sciences, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.11.034"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.043"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00020-6"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.036"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.042"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.216077"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324243"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00061-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32665"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.453"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28843"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00017-1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2020.106175"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20701"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2020-101480"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.05.033"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.06.025"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.18061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T19:51:21Z","timestamp":1767037881000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.18061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,11]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/apt.18061"],"URL":"https:\/\/doi.org\/10.1111\/apt.18061","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,11]]},"assertion":[{"value":"2024-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}