{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:33:15Z","timestamp":1790249595985,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>The performance of non\u2010invasive liver tests (NITs) is known to vary across settings and subgroups. We systematically evaluated whether the performance of three NITs in detecting advanced fibrosis in patients with metabolic dysfunction\u2010associated steatotic liver disease (MASLD) varies with age, sex, body mass index (BMI), type 2 diabetes mellitus (T2DM) status or liver enzymes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 586 adult LITMUS Metacohort participants with histologically characterised MASLD were included. The diagnostic performance of the Fibrosis\u20104 Index (FIB\u20104), enhanced liver fibrosis (ELF) and vibration\u2010controlled transient elastography liver stiffness measurement (VCTE LSM) was evaluated. Performance was expressed as the area under the receiver operating characteristics curve (AUC). Thresholds for detecting advanced fibrosis (\u2265F3) were calculated for each NIT for fixed (high) sensitivity, specificity and predictive values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Differences in AUC between all subgroups were small and statistically not significant, indicating comparable performance in detecting \u2265F3, irrespective of these clinical factors. However, different thresholds were needed to achieve the same level of accuracy with each test. For example, for a fixed sensitivity and specificity, the thresholds for all three NITs were higher in patients with T2DM. Effects for sex, age and liver enzymes were less pronounced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Performance of the selected NITs in detecting advanced liver fibrosis does not vary substantially with clinical characteristics. However, different thresholds have to be selected to achieve the same sensitivity, specificity and predictive values in the respective subgroups. Large prospective studies are called for to study NIT accuracy considering multiple patient characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.16240","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T07:38:28Z","timestamp":1737790708000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Precision in Liver Diagnosis: Varied Accuracy Across Subgroups and the Need for Variable Thresholds in Diagnosis of <scp>MASLD<\/scp>"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7002-118X","authenticated-orcid":false,"given":"Yasaman","family":"Vali","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam University Medical Centres  Amsterdam The 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ICAT 4208 Universit\u00e9 d'Angers  Angers France"},{"name":"Service d'H\u00e9pato\u2010Gastroent\u00e9rologie et Oncologie Digestive Centre Hospitalier Universitaire d'Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Ratziu","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re ICAN (Institute of Cardiometabolism and Nutrition), Sorbonne University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Yunis","sequence":"additional","affiliation":[{"name":"Pfizer Research and Development, Pfizer Inc  Lake Mary Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn M.","family":"Schattenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medine II Saarland University Medical Center  Homburg Germany"},{"name":"Saarland University  Saarbr\u00fccken 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