Design and validation of a diagnostic score for biliary atresia
| Autor: | Mostafa Mohamed Sira, Ahmad Mohamed Sira, Alif Allam, Tahany Abdel-Hameed Salem, Osama Lotfy El-Abd, Hatem Abdel-Sattar Konsowa, Mohamed Abdel-Salam El-Guindi, Dina S El-Azab |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Statistical difference Intraoperative cholangiography Logistic regression Gastroenterology Sensitivity and Specificity Cohort Studies Diagnosis Differential Fusarium Biliary atresia Biliary Atresia Predictive Value of Tests Internal medicine Depsipeptides medicine Humans Neonatal cholestasis Prospective Studies Ultrasonography Cholestasis Hepatology Receiver operating characteristic medicine.diagnostic_test business.industry Gallbladder Infant Newborn Infant medicine.disease medicine.anatomical_structure Early Diagnosis Logistic Models Liver Liver biopsy Female business Cholangiography |
| Zdroj: | Journal of hepatology. 61(1) |
| ISSN: | 1600-0641 |
| Popis: | Background & Aims The dilemma of early diagnosis of biliary Atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis is challenging. The aim was to design and validate a scoring system for early discrimination of BA from other causes of neonatal cholestasis. Methods A twelve-point scoring system was proposed according to clinical, laboratory, ultrasonographic, and histopathological parameters. A total of 135 patients with neonatal cholestasis in two sets were recruited to design (n=60) and validate (n=75) a scoring system. Parameters with significant statistical difference between BA (n=30) and non-BA (n=30) patients in the design set were analyzed by logistic regression to predict the presence or absence of BA then a scoring system was designed and validated. Results The total score ranged from 0 to 37.18 and a cut-off value of >23.927 could discriminate BA from other causes of neonatal cholestasis with sensitivity and specificity of 100% each. By applying this score in the validation set, the accuracy was 98.83% in predicting BA. The diagnosis of BA was proposed correctly in 100% and the diagnosis of non-BA was proposed correctly in 97.67% of patients. By applying this model, unnecessary intraoperative cholangiography would be avoided in non-BA patients. Conclusions This scoring system accurately separates infants with BA and those with non-BA, rendering intraoperative cholangiography for confirming or excluding BA unnecessary in a substantial proportion of patients. |
| Databáze: | OpenAIRE |
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