Validation of the BARD scoring system for fibrosis detection in nonalcoholic fatty liver disease

TL;DR

The BARD scoring system is effective for detecting liver fibrosis in Bangladeshi patients with nonalcoholic fatty liver disease.

Contribution

Validation of the BARD score's diagnostic accuracy for fibrosis detection in a Bangladeshi NAFLD population.

Findings

The BARD score showed 83.3% sensitivity and 86.4% specificity for significant fibrosis detection.

A strong correlation (r = 0.736) was found between BARD score and fibrosis stage.

BMI ≥28 kg/m² was identified as an independent predictor of significant fibrosis.

Abstract

The diagnostic performance of the BARD scoring system in detecting significant fibrosis (≥F2) among Bangladeshi patients with
biopsy-proven NAFLD is of interest. A cross-sectional study was conducted on 40 adult NAFLD patients at Bangladesh Medical University,
Dhaka. Liver fibrosis was staged histologically from biopsy specimens. The BARD score was calculated for each patient and its diagnostic
accuracy was evaluated using sensitivity, specificity, predictive values and ROC curve analysis. Clinical and biochemical predictors of
fibrosis were also assessed. Among the cohort, 45% had significant fibrosis (F2-F4). The BARD score demonstrated a sensitivity of 83.3%,
specificity of 86.4%, positive predictive value of 83.3%, negative predictive value of 86.4% and an AUROC of 0.908 (p < 0.001). A
strong positive correlation was observed between BARD score and fibrosis stage (r = 0.736). Multivariate analysis identified BMI ≥28
kg/m2 as an independent predictor of significant fibrosis (OR 17.53, p = 0.022). The BARD score is a reliable noninvasive tool for
identifying significant liver fibrosis in Bangladeshi NAFLD patients, facilitating early risk stratification and management in
resource-limited settings.