{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:55:09Z","timestamp":1791050109477,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although numerous noninvasive indices have been proposed to assess significant fibrosis (SF), none have been validated specifically in young adults with metabolic dysfunction\u2010associated steatotic liver disease (MASLD). This study evaluated their performance in younger patients across two cohorts with distinct screening goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed two MASLD cohorts: a primary care (PC) cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009972) and a tertiary care (TC) cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009342). SF was defined as liver stiffness \u2265\u20097.0\u2009kPa on vibration\u2010controlled transient elastography. The diagnostic performance of emerging indices\u2014fibrosis\u20108 index, steatosis\u2010associated fibrosis estimator, metabolic\u2010associated fibrosis score\u20105\u2014was compared with traditional scores\u2014fibrosis\u20104 index, aspartate aminotransferase\u2010to\u2010platelet ratio index, and nonalcoholic fatty liver disease fibrosis score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across both settings, emerging indices consistently outperformed traditional scores for SF discrimination. The areas under the receiver operating characteristic curves were higher for the emerging indices than for the traditional indices in both cohorts. Decision curve analyses demonstrated that emerging indices provided greater net clinical benefit and larger reductions in unnecessary procedures, with thresholds differing by setting such that lower thresholds favored referral in the PC cohort, whereas higher thresholds were more appropriate for biopsy decisions in the TC cohort. Conventional cutoffs widely used in practice demonstrated limited sensitivity in this population, suggesting that refinement may be required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Traditional noninvasive fibrosis indices showed limited performance in young adults with MASLD, whereas emerging indices appeared more suitable for achieving the screening goals of referral in PC and biopsy decision\u2010making in TC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70636","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T03:16:21Z","timestamp":1786504581000},"page":"2925-2937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emerging Indices Outperform Traditional Fibrosis Scores in Young Metabolic Dysfunction\u2010Associated Steatotic Liver Disease Across Divergent Screening Goals"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1690-5280","authenticated-orcid":false,"given":"Ahlim","family":"Lee","sequence":"first","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine The Catholic University of Korea  Suwon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4308-239X","authenticated-orcid":false,"given":"Chang\u00a0In","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Armed Forces Goyang Hospital  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0922-6588","authenticated-orcid":false,"given":"Keungmo","family":"Yang","sequence":"additional","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6588-9806","authenticated-orcid":false,"given":"Hyun","family":"Yang","sequence":"additional","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil\u00a0Soo","family":"Sung","sequence":"additional","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si\u00a0Hyun","family":"Bae","sequence":"additional","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4402-9350","authenticated-orcid":false,"given":"Jaejun","family":"Lee","sequence":"additional","affiliation":[{"name":"The Catholic University Liver Research Center, Department of Biomedicine &amp; Health Sciences, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"},{"name":"Division of Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9082626"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2020.06.022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2021.0371"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.12.012"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2025.0045"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27368"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322786"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/343828"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0246"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0506"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.04.031"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000845"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2021.0178"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32545"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.03.017"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i15.1563"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30077-3"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.453"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25435"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.665"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.7570\/jomes22024"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2003.07.001"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-317334"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23312"},{"issue":"6","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0157358","article-title":"Discrimination of Nonalcoholic Steatohepatitis Using Transient Elastography in Patients With Nonalcoholic Fatty Liver Disease","volume":"11","author":"Lee H. 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