This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows:

To assess the diagnostic accuracy of liver stiffness and spleen stiffness, separately or in combination, as measured by vibration-controlled transient elastography (VCTE) in detection of any oesophageal varices in adults with chronic liver disease. We will regard a combination of tests as positive when at least one is positive.

To compare the diagnostic accuracy of individual tests (liver stiffness and spleen stiffness measured by VCTE) directly and versus the combination of both tests (considering positive when at least one is positive) in detecting any oesophageal varices.

To assess the diagnostic accuracy of liver stiffness and spleen stiffness, separately or in combination, as measured by other elastography techniques (2D-shear wave elastography (2D-SWE), point shear wave elastography (pSWE), magnetic resonance elastography (MRE)) in detection of any oesophageal varices in adults with chronic liver disease. We will regard a combination of tests as positive when at least one is positive.

To compare the diagnostic accuracy of liver stiffness and spleen stiffness measured by VCTE with other techniques (pSWE, 2D-SWE, MRE) in detection of any oesophageal varices in adults with chronic liver disease.

Secondary objectives

To assess the diagnostic accuracy of liver stiffness and spleen stiffness, separately or in combination, as measured by vibration-controlled transient elastography (VCTE) in detection of high-risk oesophageal varices (HROVs) in adults with chronic liver disease. We will consider a combination of tests as positive when at least one is positive.

To compare the diagnostic accuracy of individual tests (liver stiffness and spleen stiffness measured by VCTE) directly and versus the combination of both tests (considering positive when at least one is positive) in detecting HROVs.

To assess the diagnostic accuracy of liver stiffness and spleen stiffness, separately or in combination, as measured by other different elastography techniques (2D-shear wave elastography (2D-SWE), point shear wave elastography (pSWE), magnetic resonance elastography (MRE)) in detection of HROVs in adults with chronic liver disease. We will regard a combination of tests as positive when at least one is positive.

To compare the diagnostic accuracy of liver stiffness and spleen stiffness measured by VCTE with other techniques (pSWE, 2D-SWE, MRE) in detection of HROVs in adults with chronic liver disease.

To investigate potential sources of heterogeneity in the results of liver stiffness and spleen stiffness, separately or in combination, as measured by VCTE, in detection of any oesophageal varices and HROVs.