I'm not sure if all the trial locations do the same blood tests, but I just figured they might. My guess is that they will use different markers than Fibrosure. I'm sure they will give them to you if you request. What to make of them may be a little less clear, but hey, why not keep them on file.
The biopsy is on it's way out, you can bet on that.
But the hepatologists will beef and balk, you can bet on that too.
There goes $2000 right out of their pockets, and if they can't make at least a little money of us that way, they won't be interested in us at all. They shove our tx mostly into the hands of NP's already, who will be left to look after us.
Recently, Dr. de Ledinghen and colleagues reported that FibroScan detects liver fibrosis and cirrhosis in patients coinfected with HIV and HCV (See Reuters Health report, "Elastography noninvasively assesses hepatic fibrosis in HIV/HVC patients" 2006-02-24 13:16:48.)
In the current study, the researchers investigated the accuracy of the system in detecting cirrhosis in 711 patients with chronic liver disease. Median liver stiffness was significantly higher in patients with cirrhosis (31.1 kilopascals) than in patients with severe fibrosis (18.7 kPa), the authors report.
Based on the stiffness measurement distributions, the researchers established cutoff levels of 7.2 kPa for moderate fibrosis, 12.5 kPa for severe fibrosis, and 17.6 kPa for cirrhosis. "With a cutoff value of 17.6 kPa, negative and positive predictive values for the diagnosis of cirrhosis were 92% and 91%, respectively," the team writes.
For patients with severe fibrosis, the investigators also established cutoffs for the presence of stage 2/3 esophageal varices (27.5 kPa), cirrhosis Child BC (37.5 kPa), hepatocellular carcinoma (53.7 kPa), and esophageal bleeding (62.7 kPa).
Jazz: My kPa score was 4.9
Stop bragging :) I have mine buried somewhere but it wasn't calf liver :) In any event, first kPa score (mid treatment) correlated with stage 3, second (5 months post tx) correlated with a low stage 2. If I can dig up my kPa's I'll post.
Sounds like whatever you're doing, just keep doing it. I was just kidding of course, I'm very happy with my scores after 35 odd years with the virus, especially what appears to be a downward curve after SVR. After a quick look through a pile of stuff, I think it's just going to be easier to call the doctor's office for my scores. Did they do any special blood tests for you? If so, post the scores if you have them, and if not you might want to find out, although probably just experimental stuff.
I'm glad you reminded me about the blood tests they took at Dr. A's office. I need to contact them for a report on that. I'm not even sure what tests they ran with my blood. Do you know? It is something similar to the Fibrosure?
I guess I got a little anxious reading this. My first Fibroscan was a 7 and the researcher said it supported what the biopsy said which was stage 0 grade 0-1. From these posts that doesnt sound like they were telling the truth if a 7 is moderate fibrosis shouldnt my biopsy be higher on the fibrosis scale? My second Fibroscan was 6.7.
What questions shouls I ask?
One of the purposes of collecting data for the FDA trials in the U.S. is to establish correlations between Fibroscan and liver biopsy in large group of *American* patients.
I believe the numbers recently cited here are from European studies, where patients may have different values for a number of reasons including variances in body mass, i.e. Americans are chubbier on the whole :)
Dr A has probably scanned hundreds -- if not more -- American patients by now -- not to mention scans at the other American centers -- I would therefore go with the Fibrosis conversion given to you by Dr A. I can see no reason he would mislead you. If you're still uncomfortable, why don't you just discuss the numbers cited here with DR A for further clarification, however I think they will tell you something similar to above.
Bottom line "6.7" is a real nice scan number on any scale. I forgot my actual number but I know it wasn't that low.
Jazz: My IQR is 0.3
Geez, you seemed a lot more intelligent than that?
Just kidding, sorry couldn't help myself :) Presumably you're talking about IQR (interquartile range) in terms of your scan results. IQR is a statistical measurement of range/dispersion and that is about as far as I can go. Guessing -- it seems low so I guess that is good.
Be well and work on those puzzle-solving skills :)
Okay, now I'm red-faced. Statistics wasn't part of my college curriculum when I majored in english literature at a liberal arts college. My reading skills are pretty good, though! Writing skills are okay, too. Maybe I can write a "Interquartile Ranges for Dummies" book.
I had a problem with statistics as well. Just didn't have the patience or something (and definitely a hard course to "cram" for :)) Same with math, except Physics where I excelled. Not sure why one is easy and the other more difficult. I like your book title btw. It should would get people to pick it up!
Well, it shows your "a man of culture and taste" if youre getting redfaced over a misconstrued numerical value on a fibroscan reading, considering what's happening in the middle of this thread, glad to know ya!
Goof: I see LAS VEGAS lefts it's mark, unfortunately, perhaps too many viewings of Cirque de Blue Man Group? youre an ill man goofus majoris....
Sorry about that and you just pointed out one problem with the internet where you're not present to see the other person's reaction.
I was trying to tell a joke -- obviously a bit too subtle -- that could easily have been interpreted as an insult. I commend you for your leveled response the first time. "Jokes" like that can start flame wars!
Yes, as you suggest, I was just having fun wordplay with "IQ" and "IQR. I'm the one who should be red faced and should probably reserve the puns for those I've known longer here and therefore would be more apt to give the benefit of the doubt. Glad we got that clarified!
Yes, I do like jazz (along with other types of music, too). I also have several cats.
My all-time favorite artist (who many consider a jazz performer) is Ricki Lee Jones. She's brilliant. However, O saw her in concert once and she was horrendous. Got mad at the audience for some strange reason and literally walked off the stage and didn't return! I believe she even gave us the finger as she stomped off. Must have been high, or something.
The range for Fo-F1 is 4 to 7 Kilopascal ( even for lean Europeans, Jim ) Thus with 6.9 you are in that range.
But if you measure really sure Fo-s like children and no liver problem ever adults you tend to get 4-5. That is all I meant to say before in response to what is "normal". The differentiation between "No fibrosis" and minimal fibrosis has not yet been attempted to my knowledge in a statistically satisfying fashion.
Jims IQR comment was of course correct : a statistical measure of variation between individual fibroscan shots - typically ten are done, then the median - not the mean- is taken. But then Jim did not know that it also stands for IQ of reasonable people....
I only mentioned that because I was told several times that the American trials weren't necessarily going to come up with the same Kilopascal value correlations as the European studies, but of course what they actually are coming up with wasn't fully shared with me. Speaking of IQR in the secondary sense, I thought it "reasonable" to ask the scan tech to "poke" me in a couple of different spots to see how uniform the Kilopascal values were. Didn't happen, but I was told that the scores would be consistent. Is this your understanding as well?
The scores are not always so consistent - see my old comment about the need to be fasting and th fibroscan of people with " regressed fibrosis".
The places in which you can place the probe are limited, because you need enough liver under the point where you start the shock wave. The examinded tissue is about 80mm times 8mm, which is nice since you are looking at a very good chunk of the liver with each shot. But you need enough " meat " under the shot spot. And only in between the ribs, of course.
Remembered the "fasting" post but not the one about "regressed fibrosis" so if you could direct me. If you haven't already, check out the thread above this one. "HTown's" doctor appears to think one of the tests in question was a false postitive, but to me, it seems just as -- if not more reasonable -- to assume that his VL dropped between tests. You might want to comment.
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