Huang et al reported the NAFLD Familial Risk Score to identify a patient with non-alcoholic fatty liver disease who is at risk to having advanced hepatic fibrosis. The authors are from the United States, Singapore, and Finland.
Patient selection: >= 18 years of age
Exclusion: other causes of chronic liver disease
Parameters:
(1) age in years
(2) type 2 diabetes mellitus
(3) obesity
(4) family history
Parameters
Findings
Points
age in years
< 50 years
0
>= 50 years
1
type 2 diabetes
no
0
yes
1
obesity
no
0
yes
2
family history
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• If the score is >= 4 then the patient should undergo fibrosis assessment by non-invasive imaging.
• If the score is < 4 then the patient should have risk factors modified.
Performance:
• The area under the ROC curve was 0.85 in the derivation and 0.94 in the validation cohorts.
• The area under the ROC curve for the FIB-4 was 0.70.
• The score may be sensitive, but unclear how it can be specific using this data.
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