P4601 - Comprehensive Score vs FIB-4 Score to Identify Hepatic Fibrosis

George Trad, MD, Maryiam Syed, , Syed Abdul Basit, MD, John Ryan, MD
Southern Hills Medical Center, Las Vegas, NV

Introduction: Early diagnosis of hepatic fibrosis is an essential step for proper management. Last year, we published a study for our novel Comprehensive score that showed promising results in ability to identify no-minimal hepatic fibrosis when using score <2 as a cut off [1]. Our study was furthered confirmed by updated data and presented at the 2024 Gastroenterology Fellowship conference in DC. The fibrosis 4 (FIB 4) scoring system is a well-recognized scoring system that was originally published in 2006 and has been used since then to evaluate hepatic fibrosis [2]. Our goal is to compare the sensitivity of comprehensive score vs. Fibrosis (FIB-4) score in identifying no-minimal hepatic fibrosis.

Methods: We conducted a retrospective study evaluating patients that have obtained a transient electrography test. Total of 188 patients were enrolled. 27 patients were excluded due to age < 35 as FIB-4 score has been proven in the past to preforms poorly in that age group [3]. The remaining 161 patients were divided into two groups based on their fibrosis score. Group 1 included patients with fibrosis score of F1 and F2 (2kPa-10kPa). Group 2 included patients with fibrosis score of F3 or F4 ( >10kPa). Comprehensive score and FIB-4 score were obtained for each patients. Negative productive value and sensitivity were calculated for each score and compared.

Results: Comprehensive score of 2 or less had a negative productive value of 95.83% with sensitivity of 97.62% while FIB-4 score had a negative productive value of 84.69% with a sensitivity of 64.29%. The specificity of comprehensive score was only 19.33% vs. 69.75% for FIB-4 score. Comprehensive score was able to identify 23 patients correctly with no-minimal hepatic fibrosis and had only one false negative result. FIB-4 score was able to identify 83 patients correctly with no-minimal hepatic fibrosis, however had a total of 15 false negative result that scored < 1.45 on FIB-4 and in fact had advanced hepatic fibrosis (F3 or F4).

Discussion: This study has demonstrated that Comprehensive score is a test that has a higher negative productive value with a higher sensitivity to identify patients with no-minimal hepatic fibrosis compared to FIB-4 score. Although FIB-4 score identified more patients with no-minimal hepatic fibrosis, the drawback was the significant higher amount of false negative. Given that the original intend of comprehensive score is to be able to identify patients with no-minimal hepatic fibrosis, it shown to be superior to FIB-4 score.


Disclosures:


George Trad, MD, Maryiam Syed, , Syed Abdul Basit, MD, John Ryan, MD. P4601 - Comprehensive Score vs FIB-4 Score to Identify Hepatic Fibrosis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.