Validation of AGILE-3+ Score for Assessing Advanced Fibrosis in Indian Patients with Nonalcoholic Fatty Liver Disease (NAFLD): An Interim Analysis of the Multicentric Indian Consortium on NAFLD (ICON D) Study

Background and Aim: Non-invasive tests (NITs) are important tools for ruling-out advanced fibrosis in NAFLD. However, many patients still require liver-biopsy due to the comparatively poor positive predictive value (PPV) substantial grey-zone associated with NITs. AGILE-3+ score is a novel NIT which includes liver stiffness measurement (LSM) on transient elastography commonly measured clinical parameters (age, gender, AST, ALT, platelet count presence or absence of DM). Methods: In an on-going real-life study ICON-D, interim data across 42 centers over 4 years (n=8043) was analysed explore diagnostic accuracy comparison APRI, NFS, FIB-4 LSM among biopsy proven Results: Data available 381 [males:63.2%, age:42(32-52)] patients. Advanced (F3) present 70 (18.3%) showed good calibration (p=0. 474 Hosmer-Lemeshow test, 95 % CI slope: 0.82 1.218, 95% x-intercept: -0.05 0.04) our cohort The AUROC discriminating histology 0.78 significantly higher than that (0.72, p=0.001) NFS (0.69, p=0.028) but similar (0.78, p=0.78). rule cut-off (0.68) had PPV 52.6% sensitivity specificity 43.4% 61.6%, respectively. out (0.45) NPV 91.9% (sensitivity:88.7% specificity:94.2%). Only 46(12%) (0.45-0.68). proportion lower (12%) compared (29.9%, p<0.001), (37.5%, (27.5%, p<0.001) APRI (56.4%, p<0.001). Conclusion: detecting histology. impressive reduction may help reducing number requiring confirmatory biopsy.