Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis B-related fibrosis: a leading meta-analysis

BMC Gastroenterology, 02/15/2012

The meta–analysis suggests that aminotransferase–to–platelet ratio index (APRI) show limited value in identifying hepatitis B–related significant fibrosis and cirrhosis.

Methods

  • Areas under summary receiver operating characteristic curves (AUROC), sensitivity and specificity were used to examine the accuracy of the APRI for the diagnosis of hepatitis B-related significant fibrosis and cirrhosis.
  • Heterogeneity was explored using meta-regression.

Results

  • Nine studies were included in this meta-analysis (n=1,798).
  • Prevalence of significant fibrosis and cirrhosis were 53.1% and 13.5%, respectively.
  • The summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.79 and 0.75, respectively.
  • For significant fibrosis, an APRI threshold of 0.5 was 84% sensitive and 41% specific.
  • At the cutoff of 1.5, the summary sensitivity and specificity were 49% and 84%, respectively.
  • For cirrhosis, an APRI threshold of 1.0-1.5 was 54% sensitive and 78% specific.
  • At the cutoff of 2.0, the summary sensitivity and specificity were 28% and 87%, respectively.
  • Meta-regression analysis indicated that the APRI accuracy for both significant fibrosis and cirrhosis was affected by histological classification systems, but not influenced by the interval between Biopsy & APRI or blind biopsy.

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