News & Events
Published On: 9/1/2020
EASL 2020: TARGET-NASH Oral Presentation & Abstract Poster Recap
In August 2020, Target RWE attended the annual Digital International Liver Congress, a virtual conference which replaced the in-person London, UK event in originally scheduled in April. Target RWE was selected to present a poster entitled “Predicting advanced fibrosis using non-invasive clinical tests and modern machine learning methods in TARGET-NASH.” It was presented by Peter Mesenbrink, PhD, Executive Director of Biostatistics from Novartis Pharmaceuticals.
The focus of the talk was on predicting advanced fibrosis (stage 3-4 for Brunt or NAS score) in patients with non-alcoholic fatty liver disease (NAFLD) using the individual variables that contribute to either the Fibrosis-4 (FIB-4) index or NAFLD Fibrosis Score (NFS). Common thresholds for FIB-4 and NFS in the literature often result in either high specificity but low sensitivity, or high sensitivity but low specificity for predicting advanced fibrosis. Several modern prediction methodologies were trained and validated using 859 biopsies in a 3:1 ratio.
Analyzing the individual variables for commonly used non-invasive clinical tests provides a good balance between several performance characteristics for predicting advanced fibrosis, with several of the models exhibiting high sensitivity and specificity. However, this improved performance may come at the expense of less easily interpretable models or may require applications to classify patients using their available data.
The authors also note that the costs of correct and incorrect misclassification should be considered to develop the most useful model in practice. For example, they illustrate that placing greater weight on the correct prediction for advanced fibrosis (versus not) can improve the overall performance characteristics of the models.
An additional TARGET-NASH abstract was also accepted to the Digital International Liver Congress and will be published only, titled “Weight loss and change in alanine aminotransferase (ALT) among patients with nonalcoholic fatty liver disease (NAFLD) receiving standard care in real world clinical practice: TARGET-NASH” (abstract #3748).
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