{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:04:22Z","timestamp":1790816662956,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Liver disease is frequently asymptomatic, challenging early identification in the primary care setting. The fibrosis 4 (FIB4) index is a liver fibrosis biomarker that is a potential alternative to liver biopsy for diagnosing and managing liver disease. This study aimed to calculate the FIB4 index for screening individuals at high risk of liver disease at the community level. This was a retrospective real-world study analyzing blood and serum test results from a central laboratory. The primary outcome was the number of individuals within each risk category for hepatic fibrosis: high risk (FIB4 \u2265 3.25) and low risk (FIB4 &lt; 1.3). The analysis included samples from 31,753 patients, of which 18,102 were aged 40 to 75 years. In these patients, the FIB4 index had been explicitly requested in 1852 (10.2%) cases and estimated ad hoc in the rest. Of the 263 (1.5%) cases with FIB4 \u2265 3.25, the FIB4 index was requested in 46 (17.5%), and 52 (19.8%) showed evidence of liver fibrosis in their medical records, while the rest did not report any data regarding liver fibrosis. FIB4 is a simple score that can play a role as a \u201cred flag\u201d for early identification of patients at high risk of advanced liver fibrosis and their referral to specialized care.<\/jats:p>","DOI":"10.3390\/diagnostics11122236","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T04:48:37Z","timestamp":1638247717000},"page":"2236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Assessing Liver Fibrosis Using the FIB4 Index in the Community Setting"],"prefix":"10.3390","volume":"11","author":[{"given":"Albert","family":"Blanco-Grau","sequence":"first","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Gabriel-Medina","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-2141","authenticated-orcid":false,"given":"Francisco","family":"Rodriguez-Algarra","sequence":"additional","affiliation":[{"name":"Blizard Institute, Barts and The London School of Medicine and Dentistry, London E1 2AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-0498","authenticated-orcid":false,"given":"Yolanda","family":"Villena","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Lopez-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"August\u00edn","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0985-3320","authenticated-orcid":false,"given":"M\u00f2nica","family":"Pons","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz-Maria","family":"Cruz","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4555-7286","authenticated-orcid":false,"given":"Ariadna","family":"Rando-Segura","sequence":"additional","affiliation":[{"name":"Clinical Microbiology (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belen","family":"Enfedaque","sequence":"additional","affiliation":[{"name":"Community and Primary Care Management, Catalan Institute of Health, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-2052","authenticated-orcid":false,"given":"Mar","family":"Riveiro","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28029 Madrid, Spain"},{"name":"Medicine and Science School, Universitat Aut\u00f2noma de Barcelona, Bellaterra, 08193 Barcelona, Spain"},{"name":"Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Casis","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8925-3172","authenticated-orcid":false,"given":"Roser","family":"Ferrer-Costa","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Buti","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28029 Madrid, Spain"},{"name":"Medicine and Science School, Universitat Aut\u00f2noma de Barcelona, Bellaterra, 08193 Barcelona, Spain"},{"name":"Department of Internal Medicine, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Rodriguez-Frias","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (Clinical Laboratories), Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28029 Madrid, Spain"},{"name":"Medicine and Science School, Universitat Aut\u00f2noma de Barcelona, Bellaterra, 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1053\/j.gastro.2020.01.052","article-title":"Nonalcoholic Fatty Liver Disease 2020: The State of the 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