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

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

• 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.

• 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.