{
  "abstract": "Introduction The FIB-4 score is a widely used non-invasive tool for assessing liver fibrosis, with scores ≥2.67 indicating an 80% positive predictive value and scores <1.30 indicating a 90% negative predictive value. It is widely accepted that for patients with FIB-4 ≥1.30 (if 35–65 years old) and patients with FIB-4 ≥2.0 (if >65 years old), Fibroscan should be performed for secondary risk assessment to further risk stratify liver disease severity. This study aims to compare FIB-4 results with LSM obtained via Fibroscan to determine their correlation and effectiveness in diagnosing advanced fibrosis.Methods We retrospectively reviewed 254 patients attending a nurse-led MASLD clinic over a 9-month period (May 2024 – January 2025). Exclusion criteria included >52 weeks between blood tests and Fibroscan, and age <35 years. We analysed data on the remaining 207 patients, to include age, FIB-4 score, LSM, interquartile range (IQR) and alcohol intake. FIB-4 scores were calculated using standard formulas, and LSM was measured using Fibroscan. Cut off for a low FIB-4 score was <1.30 if 35–65 years and <2.0 if over 65 years. Correlation analysis was performed, and results were stratified by fibrosis stages (F0-F4).Results The correlation coefficient between FIB-4 and Fibroscan results was 0.1720 (p=0.0132), indicating a weak but statistically significant correlation. When analyzing patients with low FIB-4 scores, 37% had advanced fibrosis (F2-F4, defined by a LSM >8kPa) that would have been missed if relying solely on FIB-4.Among patients with F2-F4 fibrosis, 32% had low FIB-4 scores, and 68% had indeterminate or high scores. For patients with F4 fibrosis (defined by a LSM >12kPa), 31% had low FIB-4 scores, and 69% had indeterminate or high scores.Further analysis showed that excluding patients over 65 years improved the correlation coefficient to 0.2340 (p=0.0046), suggesting non-invasive measures are less accurate in older populations. There was no statistical difference between the groups when assessing the IQR or alcohol intake at the time of Fibroscan.Conclusion The study demonstrates a weak correlation between FIB-4 scores and LSM measurements, with a significant proportion of patients with advanced fibrosis being missed by FIB-4 alone. This highlights the importance of assessing the full clinical picture and determining the need for additional diagnostic tools to risk stratify those in whom there is a high clinical suspicion of fibrosis despite low FIB-4 score.",
  "authors": [
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Brooke Layard"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Judith Magill"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Christy Reid"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Patrick McAllister"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Niamh Toland"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, BHSCT, Belfast, UK"
      ],
      "name": "Susan Gilmore"
    }
  ],
  "title": "P18 The great fatty liver showdown: comparison of FIB-4 score to liver stiffness measurement (LSM) on fibroscan in metabolic-dysfunction associated steatosis liver disease (MASLD)",
  "uid": "2d2c9f16-76a9-59b1-afff-c676a0942aa1"
}