Derivation of 'Egyptian varices prediction (EVP) index': A novel noninvasive index for diagnosing esophageal varices in HCV Patients
| Autor: | Mahmoud ElHefnawi, Wafaa El-Akel, Mohamed M. Ezz, Shehab Gamalel-Din, Shimaa M. Abd-Elsalam, Gamal Esmat |
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| Rok vydání: | 2022 |
| Předmět: |
0301 basic medicine
Medicine (General) medicine.medical_specialty Science (General) Index (economics) Liver disease diagnosis Binary logistic regression Esophageal varices Esophageal and Gastric Varices Logistic regression Endoscopy Gastrointestinal Varicose Veins Q1-390 03 medical and health sciences Liver disease R5-920 0302 clinical medicine Humans Medicine Derivation ComputingMethodologies_COMPUTERGRAPHICS Multidisciplinary medicine.diagnostic_test business.industry medicine.disease Hepatitis C Naïve Bayes Endoscopy 030104 developmental biology 030220 oncology & carcinogenesis Abdominal ultrasonography Egypt Biomedical informatics Radiology business Varices |
| Zdroj: | Journal of Advanced Research, Vol 35, Iss, Pp 87-97 (2022) Journal of Advanced Research |
| ISSN: | 2090-1232 |
| DOI: | 10.1016/j.jare.2021.02.005 |
| Popis: | Graphical abstract Highlights • Esophageal Varices is one complication of chronic liver disease that leads to deaths globally due to hemorrhage. • The prediction of presence the Esophageal Varices is essential to avoid bleeding for patients. • Now the only diagnostic method for Esophageal Varices by the upper gastrointestinal endoscopy but it has many disadvantages. • Only ten variables are the most significant for diagnosing the varices: PLT, Stiffness, PC, liver texture, spleen, HCV-RNA, Albumin, gender, Total bilirubin, and PV diameter. • We Evaluated the effectiveness of several noninvasive markers for predicting Varices. • We Introduced a novel (EVP) index with acceptable performance for diagnosing Varices and compared with the exist, it could save operating the upper endoscopic by nearly 46.5%. Introduction Esophageal Varices (EVs) is one of the major dangerous complications of liver fibrosis. Upper Gastrointestinal (UGI) Endoscopy is necessary for its diagnosis. Repeated examinations for EVs screening severely burden endoscopic units in terms of cost and other side implications; moreover, the lack of public health resources in rural areas and primary hospitals should be considered, particularly in developing countries. So, an accurate noninvasive marker for EV is highly needed for liver disease patients. Objectives This study sought to evaluate the values of several indices to determine how adequate are they in predicting EV and build a novel accurate prediction index. Methods Five thousand and thirteen patients were enrolled. The laboratory tests, abdominal ultrasonography, liver stiffness measurement using Fibro-scan, and UGI endoscopy were performed. Ten common indices: Fib-4 score, AST-to-platelet ratio index, Fibrosis index, AST/ALT ratio Varices Prediction Rule, Baveno VI, APRI-Fib4 Combo, King score, “Model for End-Stage Liver Disease”, and Lok Score were calculated. The significant predictors for EVs were identified by using “P-value Correlation-based Filter Selection” method, where a novel Egyptian Varices Prediction (EVP) index was developed using binary logistic regression. The diagnostic performance was evaluated by some parameters and the Area Under Curve (AUC). Results EVP Index was correlated to EVs at 0.5; it achieved higher performance (AUC 0.788, accuracy 73.3%, and sensitivity 78%) than the other indices at a cutoff point of 0.423. Conclusion EVP Index was a good noninvasive predictor. It had an acceptable performance for diagnosing EVs and it was only required regular laboratory tests and imaging data. It can provide a tool for classifying or arranging the patients according to the degree pre-emptive for selective endoscopy and the degree of severity. Also, it will enable clinicians to concentrate on one marker instead of a wide set of parameters. |
| Databáze: | OpenAIRE |
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