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Fibrosis Probability Score

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Fibrosis Probability Score, FIB-4 Index

  • See Also
  1. Metabolic Liver Disease
  • Indications
  1. Hepatitis B risk for fibrosis
  2. Metabolic Liver Disease assessment for Fibrosis (MASH, NASH)
  • Contraindications
  1. Not validated in age <35 years (consider elastography instead in this, younger population)
  • Criteria
  1. Score = (Age x AST) / (PlateletCount x sqrRoot(ALT))
  1. Score <1.30 (<1.9-2 in age >65 years)
    1. Low risk for advanced Hepatic Fibrosis
    2. Negative Predictive Value: 95%
  2. Score 1.3 to 2.67 (or 2 to 2.67 in age >65 years)
    1. Intermediate risk for advanced Hepatic Fibrosis
    2. Requires secondary assessment methods (e.g. elastography, Ultrasound)
  3. Score >2.67
    1. High risk for advanced hepatitc fibrosis
  1. Score <1.45
    1. Negative Predictive Value (NPV) in Hepatitis CVirus related fibrosis: 80%
  2. Score >3.25 (>2.67 in NAFLD)
    1. Positive Predictive Value for Hepatic Fibrosis >80%
  • Efficacy
  1. Test Sensitivity: 85%
  2. Test Specificity: 65%
  • References
  1. Mallet (2009) Aliment Pharmacol Ther 15;29(4):409-15 +PMID: 19035983 [PubMed]