Prognostic durability of liver fibrosis tests and improvement in predictive performance for mortality by combining tests

Abstract Background and Aim There is currently no recommended time interval between noninvasive fibrosis measurements for monitoring chronic liver diseases. We determined how long a single liver fibrosis evaluation may accurately predict mortality, and assessed whether combining tests improves prognostic performance. Methods We included 1559 patients with chronic liver disease and available baseline liver stiffness measurement (LSM) by Fibroscan, aspartate aminotransferase to platelet ratio index (APRI), FIB‐4, Hepascore, and FibroMeter V2G . Results Median follow‐up was 2.8 years during which 262 (16.8%) patients died, with 115 liver‐related deaths. All fibrosis tests were able to predict mortality, although APRI (and FIB‐4 for liver‐related mortality) showed lower overall discriminative ability than the other tests (differences in Harrell's C‐index: P