Commentary
Several strategies are available for detecting cirrhosis in patients with NAFLD, but their cost effectiveness is not clear. E. Vilar-Gomez et al. (Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA) developed a decision model to quantify the accuracy and costs of 9 single or combination strategies, including FIB-4, vibration-controlled transient elastography, and magnetic resonance elastography, and liver biopsy, for the detection of cirrhosis in patients with NAFLD. This cost-effectiveness analysis is based on the US health care system.
These authors found that results from FIB-4, followed by either VCTE, MRE, or liver biopsy, detect cirrhosis in patients with NAFLD with a high level of accuracy and low cost.