Optimizing the Use of the Gamma-Glutamyl Transpeptidase-to-Platelet Ratio and Transient Elastography to Identify Liver Cirrhosis in Patients with Chronic Hepatitis B Concurrent with Nonalcoholic Fatty Liver Disease

Table 3

Performance of TE and GPR for ruling in or ruling out cirrhosis using liver biopsy as a reference standard.

Variables	GPR (ruling out)	GPR (ruling in)	TE (ruling out)	TE (ruling in)
Cutoff value	0.21	0.66	9.0 kPa	10.9 kPa
Sensitivity (%)	95.0 (75.1, 99.9)	55.0 (31.5, 76.9)	95.0 (75.1, 99.9)	80.0 (56.3, 94.3)
Specificity (%)	37.6 (29.1, 46.7)	94.4 (88.8, 97.7)	82.4 (74.6, 88.6)	93.6 (87.8, 97.2)
PPV (%)	19.6 (12.2, 28.9)	61.1 (35.7, 82.7)	46.3 (30.7, 62.6)	66.7 (44.7, 84.4)
NPV (%)	97.9 (88.9, 99.9)	92.9 (87.0, 96.7)	99.0 (94.8, 100)	96.7 (91.8, 99.1)
Positive LR	1.52 (1.3, 1.8)	9.82 (4.3, 22.3)	5.40 (3.6, 8.0)	10.00 (5.3, 18.8)
Negative LR	0.13 (0.02, 0.9)	0.48 (0.3, 0.8)	0.061 (0.01, 0.4)	0.21 (0.09, 0.5)

The dual cutoff values for cirrhosis were determined by using multilevel likelihood ratios. Likelihood ratios above 10 and below 0.1 were considered strong evidence to rule in or rule out liver cirrhosis. Data in parentheses were 95% confidence interval. TE: transient elastography; GPR: gamma-glutamyl transpeptidase-to-platelet ratio; PPV: positive predictive value; NPV: negative predictive value; LR: likelihood ratio.