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Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT‐C cohort
Author(s) -
Lok Anna S. F.,
Ghany Marc G.,
Goodman Zachary D.,
Wright Elizabeth C.,
Everson Gregory T.,
Sterling Richard K.,
Everhart James E.,
Lindsay Karen L.,
Bonkovsky Herbert L.,
Di Bisceglie Adrian M.,
Lee William M.,
Morgan Timothy R.,
Dienstag Jules L.,
Morishima Chihiro
Publication year - 2005
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.20772
Subject(s) - cirrhosis , medicine , cutoff , cohort , logistic regression , receiver operating characteristic , gastroenterology , hepatitis c , gold standard (test) , univariate analysis , liver biopsy , biopsy , multivariate analysis , physics , quantum mechanics
Knowledge of the presence of cirrhosis is important for the management of patients with chronic hepatitis C (CHC). Most models for predicting cirrhosis were derived from small numbers of patients and included subjective variables or laboratory tests that are not readily available. The aim of this study was to develop a predictive model of cirrhosis in patients with CHC based on standard laboratory tests. Data from 1,141 CHC patients including 429 with cirrhosis were analyzed. All biopsies were read by a panel of pathologists (blinded to clinical features), and fibrosis stage was determined by consensus. The cohort was divided into a training set (n = 783) and a validation set (n = 358). Variables that were significantly different between patients with and without cirrhosis in univariate analysis were entered into logistic regression models, and the performance of each model was compared. The area under the receiver‐operating characteristic curve of the final model comprising platelet count, AST/ALT ratio, and INR in the training and validation sets was 0.78 and 0.81, respectively. A cutoff of less than 0.2 to exclude cirrhosis would misclassify only 7.8% of patients with cirrhosis, while a cutoff of greater than 0.5 to confirm cirrhosis would misclassify 14.8% of patients without cirrhosis. The model performed equally well in fragmented and nonfragmented biopsies and in biopsies of varying lengths. Use of this model might obviate the requirement for a liver biopsy in 50% of patients with CHC. In conclusion , a model based on standard laboratory test results can be used to predict histological cirrhosis with a high degree of accuracy in 50% of patients with CHC. (H EPATOLOGY 2005.)