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Enhanced Liver Fibrosis (ELF) test accurately identifies liver fibrosis in patients with chronic hepatitis C

Parkes, J., Guha, I.N., Roderick, P., Harris, Scott, Cross, R., Manos, M.M., Irving, W., Zaitoun, A., Wheatley, M., Ryder, S. and Rosenberg, William (2011) Enhanced Liver Fibrosis (ELF) test accurately identifies liver fibrosis in patients with chronic hepatitis C Journal of Viral Hepatitis, 18, (1), pp. 23-31. (doi:10.1111/j.1365-2893.2009.01263.x).

Record type: Article



Assessment of liver fibrosis is important in
determining prognosis and evaluating interventions. Due
to limitations of accuracy and patient hazard of liver
biopsy, non-invasive methods have been sought to provide
information on liver fibrosis, including the European liver
fibrosis (ELF) test, shown to have good diagnostic accuracy
for the detection of moderate and severe fibrosis. Access to
independent cohorts of patients has provided an opportunity
to explore if this test could be simplified. This paper
reports the simplification of the ELF test and its ability to identity severity of liver fibrosis in external validation studies in patients with chronic hepatitis C (CHC).

Paired biopsy and serum samples from 347 na?¨ve patients with CHC in three independent cohorts were analysed. Diagnostic performance characteristics were derived (AUROC,
sensitivity and specificity, predictive values), and clinical utility modelling performed to determine the proportion of biopsies that could have been avoided if ELF test was used in this patient group. It was possible to simplify the original ELF test without loss of performance and the new algorithm is reported. The simplified ELF test was able to predict severe fibrosis [pooled AUROC of 0.85 (95% CI 0.81–0.89)] and using clinical utility modelling to predict severe fibrosis (Ishak stages 4–6; METAVIR stages 3 and 4) 81% of biopsies could have been avoided (65% correctly).

Issues of spectrum effect in diagnostic test
evaluations are discussed. In chronic hepatitis C a simplified ELF test can detect severe liver fibrosis with good accuracy.

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Published date: 2011
Keywords: enhanced liver fibrosis panel, hepatitis C, liver fibrosis, serum marker panel
Organisations: Primary Care & Population Sciences


Local EPrints ID: 155337
ISSN: 1352-0504
PURE UUID: 5432f46a-24fb-4d56-9e91-3e05816b3517
ORCID for P. Roderick: ORCID iD

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Date deposited: 27 May 2010 13:37
Last modified: 18 Jul 2017 12:45

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Author: J. Parkes
Author: I.N. Guha
Author: P. Roderick ORCID iD
Author: Scott Harris
Author: R. Cross
Author: M.M. Manos
Author: W. Irving
Author: A. Zaitoun
Author: M. Wheatley
Author: S. Ryder
Author: William Rosenberg

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