Editorial: looking for patients at risk of cirrhosis in the general population—many needles in a haystack

Abstract

Linked content This article is linked to Harman et al paper. To view this article visit https://doi.org/10.1111/apt.14463.

Development and Validation of Hepamet Fibrosis Scoring System–A Simple, Noninvasive Test to Identify Patients With Nonalcoholic Fatty Liver Disease With Advanced Fibrosis

“…By contrast, Hepamet Fibrosis Score did not require to be adjusted for age. Second, it has been estimated that up to two-thirds of cirrhotic patients showed normal levels of transaminases, which represent the main alert of underlying liver disease in clinical practice 24 . HFS showed the highest diagnostic effectiveness of the three scores in the population without hypertransaminasemia, so it could be useful covering the gap of early identification of at-risk NAFLD patients.…”

miRNAs in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis

“…More importantly, the screening of high-risk populations will ensure a high pre-test probability of identifying clinically signif-icant liver disease because a lower prevalence of the disease decreases the accuracy of the diagnostic methods. 79 Moreover, experimental populations should be extended from tertiary referral centres to populations that attend primary care (better reflecting the populations at risk who need to be screened) to avoid selection bias. 80 Finally, determination of potential miR-NAs to be used as biomarkers could facilitate the development of miRNA therapeutic target drugs.…”

Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid- and long-term prediction of hepatocellular carcinoma among cirrhotic patients

“…By using the present combination of SCCA-IgM and AFP, we will enable rational allocation of the limited medical resources to the high-risk patients who most need to be screened, and avoid wasteful and unnecessary distribution to low-risk individuals who had 100% of HCC-free survival rate in the two-year follow-up. Moreover, the disordered PPV that was influenced by the low prevalence of HCC development through using current "one-size-fits-all" surveillance program, further strengthen the necessity of altering surveillance to a subgroup of high-risk population inside the cirrhotic patients that will ensure a high pre-test probability[ 27 ]. Currently there have not been any randomized controlled trial of HCC surveillance in patients with cirrhosis[ 6 ].…”