Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease

Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in...
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Autor*in:	Parkes, Julie [verfasserIn] Guha, Indra Neil Harris, Scott Rosenberg, William MC Roderick, Paul J

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2012

Schlagwörter:	Alcoholic liver disease Systematic review Serum markers Liver fibrosis

Anmerkung:	© Parkes et al.; licensee BioMed Central Ltd. 2012

Übergeordnetes Werk:	Enthalten in: Comparative hepatology - [S.l.] : BioMed Central, 2002, 11(2012), 1 vom: 28. Dez.
Übergeordnetes Werk:	volume:11 ; year:2012 ; number:1 ; day:28 ; month:12

Links:	Volltext

DOI / URN:	10.1186/1476-5926-11-5

Katalog-ID:	SPR029409772

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520			\|a Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis.
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allfields	10.1186/1476-5926-11-5 doi (DE-627)SPR029409772 (SPR)1476-5926-11-5-e DE-627 ger DE-627 rakwb eng Parkes, Julie verfasserin aut Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Parkes et al.; licensee BioMed Central Ltd. 2012 Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213 Guha, Indra Neil aut Harris, Scott aut Rosenberg, William MC aut Roderick, Paul J aut Enthalten in Comparative hepatology [S.l.] : BioMed Central, 2002 11(2012), 1 vom: 28. Dez. (DE-627)355684209 (DE-600)2091772-7 1476-5926 nnns volume:11 year:2012 number:1 day:28 month:12 https://dx.doi.org/10.1186/1476-5926-11-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2012 1 28 12
spelling	10.1186/1476-5926-11-5 doi (DE-627)SPR029409772 (SPR)1476-5926-11-5-e DE-627 ger DE-627 rakwb eng Parkes, Julie verfasserin aut Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Parkes et al.; licensee BioMed Central Ltd. 2012 Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213 Guha, Indra Neil aut Harris, Scott aut Rosenberg, William MC aut Roderick, Paul J aut Enthalten in Comparative hepatology [S.l.] : BioMed Central, 2002 11(2012), 1 vom: 28. Dez. (DE-627)355684209 (DE-600)2091772-7 1476-5926 nnns volume:11 year:2012 number:1 day:28 month:12 https://dx.doi.org/10.1186/1476-5926-11-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2012 1 28 12
allfields_unstemmed	10.1186/1476-5926-11-5 doi (DE-627)SPR029409772 (SPR)1476-5926-11-5-e DE-627 ger DE-627 rakwb eng Parkes, Julie verfasserin aut Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Parkes et al.; licensee BioMed Central Ltd. 2012 Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213 Guha, Indra Neil aut Harris, Scott aut Rosenberg, William MC aut Roderick, Paul J aut Enthalten in Comparative hepatology [S.l.] : BioMed Central, 2002 11(2012), 1 vom: 28. Dez. (DE-627)355684209 (DE-600)2091772-7 1476-5926 nnns volume:11 year:2012 number:1 day:28 month:12 https://dx.doi.org/10.1186/1476-5926-11-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2012 1 28 12
allfieldsGer	10.1186/1476-5926-11-5 doi (DE-627)SPR029409772 (SPR)1476-5926-11-5-e DE-627 ger DE-627 rakwb eng Parkes, Julie verfasserin aut Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Parkes et al.; licensee BioMed Central Ltd. 2012 Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213 Guha, Indra Neil aut Harris, Scott aut Rosenberg, William MC aut Roderick, Paul J aut Enthalten in Comparative hepatology [S.l.] : BioMed Central, 2002 11(2012), 1 vom: 28. Dez. (DE-627)355684209 (DE-600)2091772-7 1476-5926 nnns volume:11 year:2012 number:1 day:28 month:12 https://dx.doi.org/10.1186/1476-5926-11-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2012 1 28 12
allfieldsSound	10.1186/1476-5926-11-5 doi (DE-627)SPR029409772 (SPR)1476-5926-11-5-e DE-627 ger DE-627 rakwb eng Parkes, Julie verfasserin aut Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Parkes et al.; licensee BioMed Central Ltd. 2012 Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213 Guha, Indra Neil aut Harris, Scott aut Rosenberg, William MC aut Roderick, Paul J aut Enthalten in Comparative hepatology [S.l.] : BioMed Central, 2002 11(2012), 1 vom: 28. Dez. (DE-627)355684209 (DE-600)2091772-7 1476-5926 nnns volume:11 year:2012 number:1 day:28 month:12 https://dx.doi.org/10.1186/1476-5926-11-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2012 1 28 12
language	English
source	Enthalten in Comparative hepatology 11(2012), 1 vom: 28. Dez. volume:11 year:2012 number:1 day:28 month:12
sourceStr	Enthalten in Comparative hepatology 11(2012), 1 vom: 28. Dez. volume:11 year:2012 number:1 day:28 month:12
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Alcoholic liver disease Systematic review Serum markers Liver fibrosis
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container_title	Comparative hepatology
authorswithroles_txt_mv	Parkes, Julie @@aut@@ Guha, Indra Neil @@aut@@ Harris, Scott @@aut@@ Rosenberg, William MC @@aut@@ Roderick, Paul J @@aut@@
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Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. 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author	Parkes, Julie
spellingShingle	Parkes, Julie misc Alcoholic liver disease misc Systematic review misc Serum markers misc Liver fibrosis Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
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topic_title	Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease Alcoholic liver disease (dpeaa)DE-He213 Systematic review (dpeaa)DE-He213 Serum markers (dpeaa)DE-He213 Liver fibrosis (dpeaa)DE-He213
topic	misc Alcoholic liver disease misc Systematic review misc Serum markers misc Liver fibrosis
topic_unstemmed	misc Alcoholic liver disease misc Systematic review misc Serum markers misc Liver fibrosis
topic_browse	misc Alcoholic liver disease misc Systematic review misc Serum markers misc Liver fibrosis
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title	Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
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title_full	Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
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author_browse	Parkes, Julie Guha, Indra Neil Harris, Scott Rosenberg, William MC Roderick, Paul J
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title_sort	systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
title_auth	Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
abstract	Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. © Parkes et al.; licensee BioMed Central Ltd. 2012
abstractGer	Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. © Parkes et al.; licensee BioMed Central Ltd. 2012
abstract_unstemmed	Background Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. Conclusions There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis. © Parkes et al.; licensee BioMed Central Ltd. 2012
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title_short	Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
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Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted. Methods Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves. Results 15 studies were included- median participant number = 146 (range 44–1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis. 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Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease

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