Diagnostic efficacy of FIB-4 scores, NAFLD-Fibrosis score and BARD score in the assessment of liver fibrosis in NAFLD

Abstract

Background: There is a growing need for a dependable and cost-effective non-invasive marker to evaluate hepatic fibrosis in individuals with non-alcoholic fatty liver disease (NAFLD). This study aimed to assess and compare the diagnostic accuracy of the FIB-4 score, NAFLD fibrosis score (NAFLD-FS), and BARD score in determining liver fibrosis in NAFLD patients. Methods: The Fibrosis-4 (FIB-4) score, Non-Alcoholic Fatty Liver Disease Fibrosis Score (NAFLD-FS), and BARD score were assessed in a cohort of 100 NAFLD patients at a tertiary care center in Dehradun, India. Liver shear wave elastography was used as the reference standard. Sensitivity and specificity for each non-invasive test were evaluated using receiver operating characteristic (ROC) curve analysis. Diagnostic performance was measured by calculating the area under the ROC curve (AUROC), and comparisons were made among the AUROCs of the different non-invasive tests. Results: The C-statistics for diagnostic efficacies of the FIB-4 score, NAFLD-FS, and BARD score in assessing liver fibrosis were statistically significant. The difference between the concordance (C-) statistics of the FIB-4 score and NAFLD-FS regarding their diagnostic efficacy in assessing liver fibrosis was statistically not significant (p = 0.953). FIB-4 score was superior to the BARD score in diagnosing liver fibrosis (p = 0.009). NAFLD-FS was better than the BARD score in diagnosing liver fibrosis (p = 0.017). Conclusions: The FIB-4 score, NAFLD-FS, and BARD score showed very good performance in assessing liver fibrosis in patients with NAFLD. The FIB-4 score and NAFLD-FS showed comparable diagnostic accuracy but both were superior to the BARD score in assessing liver fibrosis in patients with NAFLD.