P0922 - Exploring the Use of Point of Care Ultrasound in Screening for Non-Alcoholic Fatty Liver Disease: A Systematic Literature Review and Meta-Analysis

Oscar Hernandez, MD¹, Zoilo K. Suarez, MD¹, Talwinder Nagi, MD¹, Muhammad Haider, MD¹, Charles Vallejo, DO², Fatima Ahson, MD^1
1Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL; ²Florida Atlantic University Charles E. Schmidt College of Medicine, Weston, FL

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a major cause of cirrhosis and liver failure globally. It is estimated that within the next 20 years, NAFLD will be the major cause of liver-related morbidity and mortality as well as the leading indication for liver transplantation. Despite its broad impact, screening recommendations for NAFLD remain varied between gastrointestinal societies. Point of care ultrasound (POCUS) has emerged as a new cost-effective form of screening and diagnosing intrabdominal pathologies. We aimed to estimate the effectiveness of POCUS in screening for NAFLD compared to formal ultrasound when screening by general practitioners trained in ultrasonography.

Methods: Data was collected from Cochrane, Pubmed, Embase, and Google Scholar using search terms related to POCUS and NAFLD screening. Observational cross-sectional studies between the years 2010-2023 were included in our analysis. Reviewers evaluated articles for eligibility and extracted data for pooled analysis. The risk of bias was assessed by reviewers using a validated risk of bias assessment tool. Discrepancies between authors were resolved by a third reviewer or by consensus. Statistical analysis included pooled sensitivity, specificity, negative predictive value, and positive predictive value with all associated 95% confidence intervals respectively. Heterogeneity between studies was plotted on a receiver operator characteristic (ROC) curve for analysis.

Results: Our review included three studies (n = 428) that met our eligibility criteria. The cumulative sensitivity for POCUS examination was 93% (95% CI: 85 – 98%), with a negative predictive value of 99%. Additionally, the specificity of POCUS for the detection of fatty liver disease was 98% (95% CI: 96 – 99%) with a positive predictive value of 91%. Our studies were found to have low heterogeneity when evaluated on ROC curve plotting.

Discussion: Our systematic literature review supports the effectiveness of POCUS as a reliable method for screening for fatty liver disease and NAFLD when compared to formal ultrasound. The comparable diagnostic performance, high sensitivity, and specificity of POCUS in detecting hepatic steatosis make it a promising tool for early detection and intervention in NAFLD. Moreover, its portability, accessibility, and potential cost-effectiveness make POCUS a valuable screening option, particularly in resource-limited settings. Further studies are required to validate the findings of our review on POCUS as a screening method.




Disclosures:


Oscar Hernandez, MD¹, Zoilo K. Suarez, MD¹, Talwinder Nagi, MD¹, Muhammad Haider, MD¹, Charles Vallejo, DO², Fatima Ahson, MD¹. P0922 - Exploring the Use of Point of Care Ultrasound in Screening for Non-Alcoholic Fatty Liver Disease: A Systematic Literature Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.