Gut Liver.  2013 May;7(3):323-328. 10.5009/gnl.2013.7.3.323.

Prediction of Advanced Fibrosis in Nonalcoholic Fatty Liver Disease: An Enhanced Model of BARD Score

• Lee TH
• Han SH
• Yang JD
• Kim D
• Ahmed M

• KMID: 1431350
• DOI: http://doi.org/10.5009/gnl.2013.7.3.323

Abstract

BACKGROUND/AIMS
The BARD score is a model to detect advanced liver fibrosis in nonalcoholic fatty liver disease (NAFLD) patients. The aims of this study were to identify additional factors and then to build an enhanced version of the BARD score.
METHODS
One hundred seven patients with biopsy-proven NAFLD were enrolled retrospectively. Logistic regressions were performed to identify independent risk factors for advanced liver fibrosis (stage 3 or 4). An enhanced model of the BARD score (BARDI score) was built and evaluated with a receiver operating characteristic (ROC) curve.
RESULTS
In multivariate analysis, age (odds ratio [OR], 0.89; p=0.04), aspartate aminotransferase/alanine aminotransferase ratio (OR, 1.73; p<0.01), and international normalized ratio (INR) (OR, 8.85; p<0.01) were independently significant factors. The BARDI score was created by adding the INR to the BARD. The area under the ROC curve of the BARDI score was significantly larger than that of the BARD score (0.881 vs 0.808, p<0.01). A BARDI score of 3 or more showed a positive predictive value (PPV) of 51.0% and a negative predictive value (NPV) of 96.0%.
CONCLUSIONS
The BARDI score had an improved PPV over the BARD score and maintained an excellent NPV. Further study is warranted for its external validation and comparison with other models.

Keyword

Non-alcoholic fatty liver disease; Liver cirrhosis; International normalized ratio

MeSH Terms

Aspartic Acid
Fatty Liver
Fibrosis
Humans
International Normalized Ratio
Liver Cirrhosis
Logistic Models
Multivariate Analysis
Retrospective Studies
Risk Factors
ROC Curve
Aspartic Acid
Fatty Liver