Efficacy and Effectiveness of Liver Screening Program to Detect Fatty Liver in the Periodic Health Check‐Ups
- 1 November 2004
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Occupational Health
- Vol. 46 (6), 423-428
- https://doi.org/10.1539/joh.46.423
Abstract
To determine whether the current liver screening program for fatty liver has sufficient scientific evidence to justify its continued implementation. The liver screening program to detect fatty liver was performed on 411 Japanese workers utilizing serum aspartate aminotransferase (ALT), alanine aminotransferase (AST), and gammaglutamyl transpeptidase (γ-GTP). Based on the preceding studies, subjects with viral and alcohol hepatitis were excluded from the evaluation. The diagnosis of fatty liver was based on ultrasound findings. The program was evaluated by efficacy and effectiveness; efficacy was measured according to the receiver operating characteristic (ROC) curves in comparison with the Body Mass Index (BMI). Effectiveness, based on the efficacy determinations, was assessed by means of the positive predictive value (PPV) test performance, the disease characteristics, and the program price.The diagnostic performances of ALT and BMI were nearly acceptable but far from excellent. The areas under the curves of the two indices were 0.69 and 0.63, respectively and these were statistically equivalent. The PPV ranged from 15 to 28% where the prevalence of fatty liver was 12.3%. The price of the program was estimated at US 4 dollars per person based on the medical reimbursement fee rate. The efficacy of the liver screening program was found to be insufficient and BMI monitoring may provide a more suitable and inexpensive alternative. Furthermore, the effectiveness of the program is open to question, considering the generally benign prognosis of the disease in the absence of any accompanying morbid conditions and the high price of the program.Keywords
This publication has 12 references indexed in Scilit:
- Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT valuesHepatology, 2003
- Non‐alcoholic steatohepatitis: What is it, and why is it important in the Asia–Pacific region?Journal of Gastroenterology and Hepatology, 2003
- Socio-economic status, dietary intake and 10 y trends: the Dutch National Food Consumption SurveyEuropean Journal of Clinical Nutrition, 2003
- Cardiovascular Risk Factors in a Tourist Town: Association with Job-related Factors.Journal of PHYSIOLOGICAL ANTHROPOLOGY and Applied Human Science, 2002
- Test validity of periodic liver function tests in a population of Japanese male bank employeesJournal of Clinical Epidemiology, 2001
- The natural history of nonalcoholic fatty liver: A follow-up studyHepatology, 1995
- The natural history of nonalcoholic fatty liver: A follow-up studyHepatology, 1995
- A study on fatty liver in health examination participants.Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene), 1989
- The accuracy of ultrasound in the detection of fatty infiltration of the liverThe British Journal of Radiology, 1980
- Index for rating diagnostic testsCancer, 1950