{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:01:45Z","timestamp":1787666505868,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The enhanced liver fibrosis (ELF) test is a noninvasive method for diagnosing hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). This multicenter cohort study aimed to evaluate the accuracy of the ELF test and compare it with other noninvasive tests in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 371 Japanese patients with biopsy\u2010proven NAFLD. We constructed area under the receiver operator characteristic curves (AUROC) to determine the diagnostic accuracies of the ELF test, the Mac\u20102\u2010binding protein glycosylation isomer (M2BPGi), the Fibrosis\u20104 (FIB\u20104) index, and combinations of these indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In patients with F0\/F1\/F2\/F3\/F4 fibrosis, the median values of the ELF test were 8.98\/9.56\/10.39\/10.92\/11.41, respectively. The AUROCs of the ELF test for patients with F0 versus F1\u20134, F0\u20131 versus F2\u20134, F0\u20132 versus F3\u20134, and F0\u20133 versus F4 fibrosis were 0.825\/0.817\/0.802\/0.812, respectively. The AUROCs of the ELF test were greater than those of the FIB\u20104 index and M2BPGi at each fibrosis stage. Respective low and high cut\u2010off values yielded sensitivities and specificities for predicting advanced fibrosis (\u2265F3) of 91.1% and 50.8%, and 38.5% and 92.8%, respectively. For F3 or F4 fibrosis, the combined values from the ELF test and FIB\u20104 index showed a sensitivity of 98.5%, and the combined values from the ELF test and M2BPGi assay showed a specificity of 97.5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Japan, the ELF test predicts NAFLD\u2010related fibrosis from its early stages. The diagnostic ability of the ELF test was not inferior to that of other indices, and the combined values of ELF plus other indices were more accurate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.13871","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T10:49:30Z","timestamp":1671187770000},"page":"312-321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Diagnostic accuracy of enhanced liver fibrosis test for nonalcoholic steatohepatitis\u2010related fibrosis: Multicenter study"],"prefix":"10.1111","volume":"53","author":[{"given":"Yuya","family":"Seko","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine  Kyoto 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