{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:53:15Z","timestamp":1781607195916,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Fibro\u2010Scope is an artificial intelligence\/neural network system for the noninvasive diagnosis of hepatic fibrosis in patients with metabolic dysfunction\u2010associated steatotic liver disease. We aimed to examine the diagnostic performance of a two\u2010step method that used the Fibrosis\u20104 (FIB\u20104) index and Fibro\u2010Scope system for the assessment of Japanese patients with metabolic dysfunction\u2010associated steatotic liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed a longitudinal study cohort of 796 Japanese patients with biopsy\u2010proven metabolic dysfunction\u2010associated steatotic liver disease during a follow\u2010up period of 6.4\u00a0years. The predictive performance of the two\u2010step method of FIB\u20104 index and Fibro\u2010Scope for liver\u2010related events and prognostic performance of that were assessed in the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the 796 patients, by classifying the intermediate zone, defined by FIB\u20104 index 1.30\u20132.67, using the Fibro\u2010Scope, the final classification was 69.6% low risk, 28.3% high risk, and 2.1% in the middle\u2010risk group. The sensitivity and specificity for predicting advanced fibrosis (\u2265F3) was 84.0% and 84.0%. During the follow\u2010up period, 52 (6.5%) patients developed liver\u2010related events and 35 died. Multivariate analysis revealed that high\u2010risk patients derived from the two\u2010step method had hazard ratios of 30.1 or the development of liver\u2010related events and 7.8 for outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The two\u2010step method using the FIB\u20104 index and Fibro\u2010Scope contributed to improving the diagnostic performance by picking up high\u2010risk patients from those classified as intermediate risk with the FIB\u20104 index. This noninvasive method, which uses a blood sample is a cost\u2010effective screening method, is suitable for clinical practice in Japan.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14121","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T16:40:05Z","timestamp":1729010405000},"page":"211-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic performance of a two\u2010step method using the Fibro\u2010Scope system for metabolic dysfunction\u2010associated steatotic liver disease"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3658-5894","authenticated-orcid":false,"given":"Yuya","family":"Seko","sequence":"first","affiliation":[{"name":"Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto 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