Accuracy of Spleen Stiffness Measurement in Detection of Esophageal Varices in Patients With Chronic Liver Disease: Systematic Review and Meta-analysis  Siddharth Singh, John E. Eaton, Mohammad H. Murad, Hironori Tanaka, Hiroko Iijima, Jayant A. Talwalkar  Clinical Gastroenterology and Hepatology  Volume 12, Issue 6, Pages 935-945.e4 (June 2014) DOI: 10.1016/j.cgh.2013.09.013 Copyright © 2014 AGA Institute Terms and Conditions

Figure 1 Flow diagram summarizing study identification and selection. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions

Figure 2 (A) Forest plots and meta-analyses of studies evaluating the sensitivity of SSM compared with EGD for the detection of any EVs in patients with chronic liver disease. (B) Forest plots and meta-analyses of studies evaluating the specificity of SSM compared with EGD for the detection of any EVs in patients with chronic liver disease. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions

Figure 3 (A) Forest plots and meta-analyses of studies evaluating the sensitivity of SSM compared with EGD for the detection of clinically significant EVs in patients with chronic liver disease. (B) Forest plots and meta-analyses of studies evaluating the specificity of SSM compared with EGD for the detection of clinically significant EVs in patients with chronic liver disease. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions

Supplementary Figure 1 Summary ROC curve for all 12 studies examining SSM compared with EGD for the detection of any EVs. SE, standard error. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions

Supplementary Figure 2 Fagan nomogram estimating the post-test probability of EV, depending on the pretest clinical suspicion and results of spleen elastography. (A) With a pretest probability of EV of 25% (low clinical suspicion, as observed in patients with compensated cirrhosis), the post-test probability of EV, given a negative SSM (red), is 6%, and given a positive SSM (blue), is 53%. (B) With a pretest probability of EV of 50% (as observed in patients with decompensated cirrhosis), the post-test probability of EV, given a negative SSM (red), is 16%, and given a positive SSM (blue), is 78%. (C) With a hypothetical pretest probability of EV of 75%, the posttest probability of EV, given a negative SSM (red), is 36% and given a positive SSM (blue), is 91%. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions

Supplementary Figure 3 Summary ROC curve for 9 studies examining SSM compared with EGD for the detection of clinically significant EVs. SE, standard error. Clinical Gastroenterology and Hepatology 2014 12, 935-945.e4DOI: (10.1016/j.cgh.2013.09.013) Copyright © 2014 AGA Institute Terms and Conditions