{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:53:16Z","timestamp":1781697196605,"version":"3.54.5"},"reference-count":30,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    : Metabolically-dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in populations with metabolic risk factors, and the liver fibrosis stage is the main determinant of long-term outcomes. The Fibrosis-4 (FIB-4) index is widely recommended as a first-line noninvasive test for fibrosis risk stratification; however, its diagnostic performance may vary across populations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To evaluate the diagnostic performance of the FIB-4 index for detecting advanced liver fibrosis in Qatari residents with MASLD, using liver biopsy as the primary reference standard and FibroScan as a secondary comparator.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology<\/jats:bold>\n                    : This retrospective, cross-sectional diagnostic accuracy study included adults with MASLD evaluated at Hamad Medical Corporation in Qatar between January 2023 and December 2024. FIB-4 was calculated from routine laboratory parameters, and fibrosis was staged using the METAVIR (Meta-Analysis of Histological Data in Viral Hepatitis) scoring system. It is a histological scoring system used to grade necroinflammatory activity (A0\u2013A3) and stage liver fibrosis (F0\u2013F4). Advanced fibrosis was defined as METAVIR stage \u2265F3. Diagnostic performance metrics and the area under the receiver operating characteristic curve (AUROC) were calculated at established cut-offs.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : A total of 117 patients were included; 74 patients (63.2%) underwent liver biopsy, and 91 patients (77.7%) underwent FibroScan assessment. Advanced fibrosis was present in 21 patients (17.9%) on biopsy. At a FIB-4 cut-off of 1.3, sensitivity and specificity for detecting advanced fibrosis were 66.7% and 67.9%, respectively, compared with liver biopsy, with an overall accuracy of 67.6% and a negative predictive value of 83.7%. The AUROC for FIB-4 was 0.76.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : FIB-4 can be used as a first-line, accountable screening tool, followed by another confirmatory tool in high-risk patients.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2026.32","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:09:25Z","timestamp":1781694565000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic accuracy of the Fibrosis-4 (FIB-4) index for advanced liver fibrosis in Qatari patients with MASLD: Comparison with liver biopsy and FibroScan"],"prefix":"10.5339","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2887-8328","authenticated-orcid":true,"given":"Moataz","family":"Derbala","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Hamad Medical Corporation, Doha, Qatar"},{"name":"Theodore Bilharz Research Institute, Warraq Al Hadar, Egypt"},{"name":"Weill Cornell Medical College, Ar-Rayyan, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3074-6842","authenticated-orcid":true,"given":"Ibrahim M.","family":"Obeidat","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-8759","authenticated-orcid":true,"given":"Raya","family":"Abualsuod","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3824-2673","authenticated-orcid":true,"given":"Mahmoud","family":"Draidi","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-7113","authenticated-orcid":true,"given":"Nagah","family":"Selim","sequence":"additional","affiliation":[{"name":"Community and Preventive Medicine Department, Primary Health Care Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-2238","authenticated-orcid":true,"given":"Jihene","family":"Maatoug","sequence":"additional","affiliation":[{"name":"Community and Preventive Medicine Department, Primary Health Care Corporation, Doha, Qatar"},{"name":"Faculty of Medicine of Sousse, Sousse University, Sousse, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0282-3679","authenticated-orcid":true,"given":"Alaa","family":"Elkalamawi","sequence":"additional","affiliation":[{"name":"Epidemiology- Medicine, Lincoln University, Kota Bharu, 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nonalcoholic fatty liver disease: expert review\n. \nGastroenterology\n. \n2023;\n165\n4:\n1080\n8\n. \n\nhttps:\/\/doi.org\/10.1053\/j.gastro.2023.06.013"},{"issue":"9:","key":"B14","series-title":"JGH Open","first-page":"e70281","article-title":"Diagnostic performance of Fibrosis-4 index, nonalcoholic fatty liver disease fibrosis score, AST-to-platelet ratio index, and BARD score among young and older adults for the diagnosis of advanced MASLD fibrosis: a retrospective cohort study","volume":"9","author":"Lin\n \nF","year":"2025;","unstructured":"Lin\n \nF\n\n, \n\nObeid\n \nA\n\n, \n\nSharma\n \nM\n\n, \n\nKaur\n \nP\n\n, \n\nChaput\n \nK\n\n, \n\nLiaquat\n \nH\n\n\n. \nDiagnostic performance of Fibrosis-4 index, nonalcoholic fatty liver disease fibrosis score, AST-to-platelet ratio index, and BARD score among young and older adults for the diagnosis of advanced MASLD fibrosis: a retrospective cohort study\n. \nJGH Open\n. \n2025;\n9\n9:\ne70281\n. 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