FibroGENE: A gene-based model for staging liver fibrosis

M. Eslam, A.M. Hashem, M. Romero-Gomez, T. Berg, G.J. Dore, A. Mangia, H.L.Y. Chan, W.L. Irving, D. Sheridan, M.L. Abate, Leon Adams, M. Weltman, E. Bugianesi, U. Spengler, O. Shaker, J. Fischer, Lindsay Mollison, W. Cheng, J. Nattermann, S. RiordanL. Miele, K.S. Kelaeng, J. Ampuero, G. Ahlenstiel, D. Mcleod, E. Powell, C. Liddle, M.W. Douglas, D.R. Booth, J. George

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    Abstract

    © 2015 European Association for the Study of the Liver. Background & Aims The extent of liver fibrosis predicts long-term outcomes, and hence impacts management and therapy. We developed a non-invasive algorithm to stage fibrosis using non-parametric, machine learning methods designed for predictive modeling, and incorporated an invariant genetic marker of liver fibrosis risk. Methods Of 4277 patients with chronic liver disease, 1992 with chronic hepatitis C (derivation cohort) were analyzed to develop the model, and subsequently validated in an independent cohort of 1242 patients. The model was assessed in cohorts with chronic hepatitis B (CHB) (n = 555) and non-alcoholic fatty liver disease (NAFLD) (n = 488). Model performance was compared to FIB-4 and APRI, and also to the NAFLD fibrosis score (NFS) and Forns' index, in those with NAFLD. Results Significant fibrosis (≥F2) was similar in the derivation (48.4%) and validation (47.4%) cohorts. The FibroGENE-DT yielded the area under the receiver operating characteristic curve (AUROCs) of 0.87, 0.85 and 0.804 for the prediction of fast fibrosis progression, cirrhosis and significant fibrosis risk, respectively, with comparable results in the validation cohort. The model performed well in NAFLD and CHB with AUROCs of 0.791, and 0.726, respectively. The negative predictive value to exclude cirrhosis was >0.96 in all three liver diseases. The AUROC of the FibroGENE-DT performed better than FIB-4, APRI, and NFS and Forns' index in most comparisons. Conclusion A non-invasive decision tree model can predict liver fibrosis risk and aid decision making.
    Original languageEnglish
    Pages (from-to)390-398
    Number of pages9
    JournalJournal of Hepatology
    Volume64
    Issue number2
    Early online date1 Dec 2015
    DOIs
    Publication statusPublished - 1 Feb 2016

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