{
  "abstract": "Background Early detection of advanced liver fibrosis is critical to prevent progression to cirrhosis and its complications. In resource-limited settings, access to elastography or liver biopsy is often restricted. Non-invasive fibrosis scoring systems, such as FIB-4 and APRI (Aspartate Aminotransferase to Platelet Ratio Index), may provide a practical solution. This study aimed to evaluate their effectiveness in identifying patients with advanced liver disease.Methods A cross-sectional study was conducted on 150 adult patients with suspected chronic liver disease attending a tertiary care facility. FIB-4 and APRI scores were calculated for each participant based on routine laboratory parameters. Ultrasound imaging was performed to categorize liver disease severity. The diagnostic performance of each score, alone and in combination, was analyzed for sensitivity, specificity, and predictive value in detecting advanced fibrosis.Results FIB-4 demonstrated a sensitivity of 82% and specificity of 76% for detecting advanced fibrosis. APRI had moderate diagnostic accuracy, with a sensitivity of 70% and specificity of 68%. Combining FIB-4 and APRI improved overall predictive value, reducing the need for additional imaging by 35%. The approach allowed for effective stratification of patients into low- and high-risk categories using readily available laboratory tests.Conclusions Non-invasive fibrosis scores, particularly FIB-4 alone or combined with APRI, provide a reliable, cost-effective method for identifying advanced liver disease in settings with limited resources. Their implementation could facilitate timely intervention, reduce reliance on expensive imaging, and improve patient outcomes. Wider adoption in primary and secondary care may strengthen early detection and management strategies in populations at risk of chronic liver disease.",
  "authors": [
    {
      "affiliations": [
        "Rawal Institute of Health Sciences, Pakistan"
      ],
      "name": "Usman Ghani"
    }
  ],
  "title": "IDDF2026-ABS-0442 Non-invasive methods (FIB-4 and APRI) as practical tools to detect advanced liver disease in resource-limited settings, Kahmir, Pakistan",
  "uid": "d4a4fd91-5e7b-5915-a93c-7d88918e3591"
}