Comment:
A non-invasive combined model termed FibroScan-aspartate aminotransferase (FAST) was recently proposed for the diagnosis of fibrotic non-alcoholic steatohepatitis (NASH). Conceptualised for patients with elevated non-alcoholic fatty liver disease (NAFLD) activity scores (≥4) and significant fibrosis, FAST combines liver stiffness, serum aspartate aminotransferase (AST), and controlled attenuation parameter measurements.
The aim of this systematic review was to assess FAST’s diagnostic accuracy when identifying fibrotic NASH.
Key learnings:
FAST’s diagnostic performance was found to be satisfactory: its pooled sensitivity and specificity were both 89%, while its negative and positive predictive values were 92% and 65%, respectively. These findings support the use of the FAST score for the non-invasive screening of patients at risk of fibrotic NASH. It may also be a promising tool to identify eligible patients for clinical trials seeking to develop pharmacotherapies for fibrotic NASH.