Accuracy of prognostic serological biomarkers in predicting liver fibrosis severity in people with metabolic dysfunction-associated steatotic liver disease: a meta-analysis of over 40,000 participants.

Introduction: A prognostic model to predict liver severity in people with metabolic dysfunction-associated steatotic liver disease (MASLD) is very important, but the accuracy of the most commonly used tools is not yet well established. Objective: The meta-analysis aimed to assess the accuracy of different prognostic serological biomarkers in predicting liver fibrosis severity in people with MASLD. Methods: Adults ≥18 years of age with MASLD were included, with the following: liver biopsy and aspartate aminotransferase-to-platelet ratio (APRI), fibrosis index-4 (FIB-4), non-alcoholic fatty liver disease fibrosis score (NFS), body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes score (BARD score), FibroMeter, FibroTest, enhanced liver fibrosis (ELF), Forns score, and Hepascore. Meta-analyses were performed using a random effects model based on the DerSimonian and Laird methods. The study's risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. Results: In total, 138 articles were included, of which 86 studies with 46,514 participants met the criteria for the meta-analysis. The results for the summary area under the receiver operating characteristic (sAUROC) curve, according to the prognostic models, were as follows: APRI: advanced fibrosis (AF): 0.78, any fibrosis (AnF): 0.76, significant fibrosis (SF): 0.76, cirrhosis: 0.72; FIB-4: cirrhosis: 0.83, AF: 0.81, AnF: 0.77, SF: 0.75; NFS: SF: 0.81, AF: 0.81, AnF: 0.71, cirrhosis: 0.69; BARD score: SF: 0.77, AF: 0.73; FibroMeter: SF: 0.88, AF: 0.84; FibroTest: SF: 0.86, AF: 0.78; and ELF: AF: 0.87. Conclusion: The results of this meta-analysis suggest that, when comparing the scores of serological biomarkers with liver biopsies, the following models showed better diagnostic accuracy in predicting liver fibrosis severity in people with MASLD: FIB-4 for any fibrosis, FibroMeter for significant fibrosis, ELF for advanced fibrosis, and FIB-4 for cirrhosis.Clinical trial registration: [https://clinicaltrials.gov/], identifier [CRD 42020180525].

Brazilian instrument for assessing of eating disorders in children and adolescents / Instrumento brasileño para la evaluación de los trastornos alimentarios en niños y adolescentes

Objective: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). Design: Cross-sectional study. Participants: Participants aged between five and twelve years old of both sexes. Main measures: IRT logistic model of two parameters was used to evaluate the item's severity and discrimination and test information curve of symptoms of eating disorders’ latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. Results: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach's Alpha was 0.63 (95% confidence interval), and the result of the Spearman–Brown test was 0.65. Conclusion: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.(AU)

Objetivo: Este estudio tuvo como objetivo desarrollar un instrumento brasileño para la evaluación de los trastornos alimentarios en niños y adolescentes, y testar el análisis psicométrico utilizando la teoría de respuesta al ítem (TRI). Diseño: Estudio observacional, transversal. Participantes: Individuos de ambos sexos entre los 5 y 12 años de edad. Mediciones principales: Se utilizó el modelo logístico TRI de 2 parámetros para evaluar la gravedad y la discriminación del ítem, y probar la curva características del test (CCT) de los síntomas del rasgo latente de los trastornos alimentarios. También se evaluaron la validez de contenido y la confiabilidad. Resultado: La evaluación TRI sugirió que el instrumento contenía ítems que funcionaban de manera diferente en cuanto a severidad, discriminación y la CCT presentando una buena precisión. Hubo concordancia en la claridad del lenguaje (83,3%) y en la relevancia teórica (91,7%), indicando buena validez de contenido. El valor del alfa de Cronbach fue de 0,63 (intervalo de confianza del 95%) y el resultado de la prueba de Spearman-Brown fue de 0,65. Conclusión: Estos resultados indican un buen desempeño de la herramienta de detección en la evaluación del nivel de los trastornos alimentarios en niños y adolescentes.(AU)

Brazilian instrument for assessing of eating disorders in children and adolescents.

OBJECTIVE: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). DESIGN: Cross-sectional study. PARTICIPANTS: Participants aged between five and twelve years old of both sexes. MAIN MEASURES: IRT logistic model of two parameters was used to evaluate the item's severity and discrimination and test information curve of symptoms of eating disorders' latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. RESULTS: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach's Alpha was 0.63 (95% confidence interval), and the result of the Spearman-Brown test was 0.65. CONCLUSION: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.