Background/Aims: Several noninvasive scoring systems have been developed to determine the risk of advanced fibrosis in nonalcoholic fatty liver disease (NAFLD). We examined the diagnostic accuracy of the fibrosis-4 (FIB-4) score and NAFLD fibrosis score (NFS) in patients with biopsy-proven NAFLD.Methods: For this meta-analysis, various databases including PubMed (MEDLINE), EMBASE, OVID Medline and the Cochrane Library were systematically searched. After the acquired abstracts were reviewed by two investigators, manuscripts were chosen for a full-text examination.Results: Thirty-six studies evaluating biopsy-proven NAFLD were selected for meta-analysis. A total of 14,992 patients were analyzed. The lower cutoff sensitivity of the FIB-4 score predicting histological fibrosis stage 3 or more (≥F3) was 69%, with specificity of 64%, positive likelihood ratio (LR+) of 1.96, and negative likelihood ratio (LR-) of 0.47. The low baseline sensitivity of the NFS score predicting ≥F3 was 70%, with a specificity of 61%, LR+ of 1.83, and LR-of 0.48. The area under the receiver operating characteristic curve (AUC) values of the FIB-4 score predicting ≥F3 and ≥F2 were 76% and 68%, respectively. The AUC values of the NFS score predicting ≥F3 and ≥F2 were 74% and 60%, respectively. Conclusions:The FIB-4 or NFS test can be used to predict the degree of liver fibrosis in NAFLD, and the diagnostic accuracy resulted as relatively high in fibrosis stages of F3 or higher.
Background Graphical abstracts (GAs) have recently been included as an essential element in various journals, including those in the field of Gastroenterology & Hepatology. However, there has been no study on the effect of GAs on the impact factor (IF) of journals, and the citation index or social media exposure of individual articles. Methods We investigated the presence of GAs, total citations and social media exposure of full-length original articles in the top ten journals of gastroenterology and hepatology for three years (2019–2021). Citations and social media exposure were evaluated with the Web of Science citation index, Altmetric Attention score, Dimension recorded citation count, and PlumX index. Results A total of 4,205 articles from ten journals were evaluated for three years. First, journals that have adopted GAs demonstrated significantly higher IF increases for the past three years than those of journals without GAs. The longer GAs have been utilized in a journal, the higher IFs the journal had. Secondly, individual articles with GAs had significantly higher Web of Science citation counts (median 14 vs. 12), more social media exposure (median 23 vs. 5) and more Altmetric.com tweet counts (median 15 vs. 7) than those of articles without GAs. In multiple regression analysis, the inclusion of GAs was particularly effective in increasing the number of Web of Science citations (β = 14.1, SE = 1.9, P < 0.001) and social media exposure (β = 13.3, SE = 6.1, P = 0.030) after adjusting for journal IFs and topics. Conclusion GAs are effective in increasing IFs of journals in the field of gastroenterology and hepatology, as well as increasing citations and social media exposure of individual articles.
Direct‐acting agents (DAAs) have launched a new era of hepatitis C virus (HCV) treatment. As aged individuals comprise a large percentage of HCV‐infected patients, the effectiveness and safety of DAAs in the elderly have come under scrutiny. This meta‐analysis aimed to evaluate the efficacy and safety of DAAs in elderly patients. After a systematic search in PubMed (MEDLINE), Embase, OVID MEDLINE, the Cochrane Library and other databases, two investigators reviewed relevant abstracts and selected manuscripts for examination. The sustained virologic response (SVR) and adverse event (AE) rates were calculated with a random‐effects model. Ninety studies evaluating SVR rates of elderly patients (≥65 years old) receiving DAAs were selected. DAAs in elderly patients exhibited a notable SVR rate of 96% (95% confidence interval [CI]: 95%–97%), accompanied by comparable rates in subgroup analyses. The comparison of SVR rates in elderly and non‐elderly patients indicated no significant discrepancy (odds ratio [OR] 1.01, 95% CI: 1.00–1.01). The overall event rate of AEs was 45% (95% CI: 31%–60%), though AE rates varied by subgroups. Furthermore, AEs were comparatively more frequent (OR 1.15, 95% CI: 1.04–1.28) in the elderly than non‐elderly, especially in subgroups such as SAE (OR 1.89, 95% CI: 1.52–2.36) and dose reduction in ribavirin (OR 1.90, 95% CI: 1.53–2.36). However, in the ribavirin (RBV)‐free regimen, there was no significant difference in the incidence of AEs between the elderly and non‐elderly groups. DAAs have high efficacy in elderly patients. Considering the possibility of AE, the RBV‐free regimen should be given prior consideration for the treatment of elderly patients with HCV.
Graphical abstracts (GAs), also known as visual abstracts, are powerful tools for communicating complex information and ideas clearly and concisely. These visual representations aim to capture the essential findings and central message of a research study, allowing the audience to understand and remember its content quickly. This review article describes the current state of GAs, including their benefits, limitations, and future directions in the development of GAs. It also presents methods and tips for producing a GA. In Korea, more than 10 medical journals have introduced GAs from 2021 to 2022. The number of citations was higher in articles with GAs than in those without GAs in the top 10 gastroenterology journals. There are five types of GAs: conceptual diagrams, flowcharts, infographics, iconographic abstracts, and photograph-like illustrations. A limitation of the GA system is the absence of a universal standard for GAs. The key steps for creating a GA are as follows: (1) start by identifying the main message; (2) choose an appropriate visual style; (3) draw an easy-to-understand graphic; (4) use colors and other design elements; and (5) request feedback. Available tools that are useful for creating GAs include Microsoft PowerPoint, Mind the Graph, Biorender, and Canva. Another effective method is collaborating with experts. Artificial intelligence will soon be able to produce GAs more efficiently from raw data or manuscripts, which will help researchers draw GAs more easily. GAs have become a crucial art for researchers to master, and their use is expected to expand in the future.
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