VFA had moderate sensitivity and high specificity for detecting VF when compared with spinal radiography. However, the present findings are insufficient to assess whether spinal radiography should be replaced by VFA.

SummaryAimThe aim of this study was to assess the effects of ursodeoxycholic acid composite (URSA‐S) on fatigue in patients with elevated liver function tests and/or fatty liver disease.MethodsIn this multi‐centre randomised double‐blinded placebo‐controlled trial, 168 adults who were diagnosed with fatigue based on our criteria and had elevated liver function tests (but not > 5 times the normal level) and/or fatty liver on ultrasonography, were randomised to either the placebo or URSA‐S administration group. The rate of improvement of checklist individual strength (CIS) using a cut‐off of 76 points at the end of the study (8 weeks), the change in fatigue scale [CIS score and visual analogue scale (VAS)] were evaluated. The adverse effects of URSA‐S were also recorded.ResultsThe rate of CIS improvement at the end‐point was 79.76% and 45.68% in the therapy and placebo groups, respectively (p < 0.05). The fatigue recovery rate of the CIS score and VAS were higher in the therapy (−25.44 ± 18.57, −27.84 ± 2.70) than in the placebo group (−16.59 ± 17.29, −19.46 ± 2.81) (p < 0.05). The difference in fatigue recovery rate between the therapy and placebo groups was significant after 8 weeks. When analysed separately in patients with abnormal liver function tests and fatty liver disease, the fatigue recovery rate of the CIS score and VAS at 8 weeks was higher in the therapy than in the placebo group (p < 0.05). The frequency of adverse events in the therapy group was not significantly higher than that in the placebo group.Conclusion URSA‐S is effective for alleviating fatigue in patients with liver dysfunction and/or fatty liver. The adverse effects of URSA‐S are not significant. This study is registered at https://clinicaltrials.gov/ct2/show/ NCT02415777.