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

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.