| Title: | LiverRisk score: An accurate, cost-effective tool to predict fibrosis, liver-related, and diabetes-related mortality in the general population |
| Journal: | Med |
| Published: | 26 Mar 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38554711/ |
| DOI: | https://doi.org/10.1016/j.medj.2024.03.003 |
Publication 10050
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Abstract
BACKGROUND: Noninvasive and early assessment of liver fibrosis is of great significance and is challenging. We aimed to evaluate the predictive performance and cost-effectiveness of the LiverRisk score for liver fibrosis and liver-related and diabetes-related mortality in the general population.</p>
METHODS: The general population from the NHANES 2017-March 2020, NHANES 1999-2018, and UK Biobank 2006-2010 were included in the cross-sectional cohort (n = 3,770), along with the NHANES follow-up cohort (n = 25,317) and the UK Biobank follow-up cohort (n = 17,259). The cost-effectiveness analysis was performed using TreeAge Pro software. Liver stiffness measurements ≥10 kPa were defined as compensated advanced chronic liver disease (cACLD).</p>
FINDINGS: Compared to conventional scores, the LiverRisk score had significantly better accuracy and calibration in predicting liver fibrosis, with an area under the receiver operating characteristic curve (AUC) of 0.76 (0.72-0.79) for cACLD. According to the updated thresholds of LiverRisk score (6 and 10), we reclassified the population into three groups: low, medium, and high risk. The AUCs of LiverRisk score for predicting liver-related and diabetes-related mortality at 5, 10, and 15 years were all above 0.8, with better performance than the Fibrosis-4 score. Furthermore, compared to the low-risk group, the medium-risk and high-risk groups in the two follow-up cohorts had a significantly higher risk of liver-related and diabetes-related mortality. Finally, the cost-effectiveness analysis showed that the incremental cost-effectiveness ratio for LiverRisk score compared to FIB-4 was USD $18,170 per additional quality-adjusted life-year (QALY) gained, below the willingness-to-pay threshold of $50,000/QALY.</p>
CONCLUSIONS: The LiverRisk score is an accurate, cost-effective tool to predict liver fibrosis and liver-related and diabetes-related mortality in the general population.</p>
FUNDING: The National Natural Science Foundation of China (nos. 82330060, 92059202, and 92359304); the Key Research and Development Program of Jiangsu Province (BE2023767a); the Fundamental Research Fund of Southeast University (3290002303A2); Changjiang Scholars Talent Cultivation Project of Zhongda Hospital of Southeast University (2023YJXYYRCPY03); and the Research Personnel Cultivation Program of Zhongda Hospital Southeast University (CZXM-GSP-RC125).</p>
22 Authors
- Shanghao Liu
- Xiaohan Chen
- Xuanwei Jiang
- Xiaochun Yin
- Ginenus Fekadu
- Chuan Liu
- Yan He
- Huihui Chen
- Wenjing Ni
- Ruiying Wang
- Qing-Lei Zeng
- Yuping Chen
- Ling Yang
- Ruihua Shi
- Sheng-Hong Ju
- Jie Shen
- Jingli Gao
- Linhua Zhao
- Wai-Kit Ming
- Victor W Zhong
- Gao-Jun Teng
- Xiaolong Qi
1 Application
| Application ID | Title |
|---|---|
| 101169 | Lifestyle, biological factors, genetic predisposition, and age-related diseases: associations and mechanisms |
Enabling scientific discoveries that improve human health