Cost-Effectiveness of Strategies for Identifying Nonalcoholic Fatty Liver Disease–Related Cirrhosis

How do the multiple strategies used for diagnosing nonalcoholic fatty liver disease (NAFLD)–related cirrhosis compare in cost-effectiveness?

To answer this question, researchers developed a decision model estimating diagnostic accuracy and cost of currently available diagnostic tools, used either singly or in combination. These included the fibrosis (FIB)-4 serum test, vibration-controlled transient elastography (VCTE), magnetic resonance elastography (MRE), and liver biopsy. Data on cost, diagnostic accuracy, and adverse events were obtained from published studies.

For all three cirrhosis prevalence values modeled (0.27%, 2% and 4%), the combination of FIB-4 plus MRE had the highest diagnostic accuracy (92.4%, 91.6%, and 90.6%, respectively)…