Design and validation of a noninvasive diagnostic criteria for biliary atresia in infants based on the STROBE compliant

Liu, Xiaoguai; Peng, Xiaokang; Huang, Yanxia; Shu, Chang; Liu, Pan; Xie, Weike; Dang, Shuangsuo

doi:10.1097/md.0000000000013837

Cited by 8 publications

(2 citation statements)

References 22 publications

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“…Recent studies have investigated the use of other scoring systems to identify BA in infants with cholestasis (3,11,17,27). Kim et al reported that accurate diagnosis of BA among neonates with cholestasis was achieved using a new scoring system that combined clinical, US, and hepatobiliary scintigraphy findings (17).…”

Section: Discussionmentioning

confidence: 99%

Web-based calculator for biliary atresia screening in neonates and infants with cholestasis

Zhao¹,

Gu²,

Gong³

et al. 2021

Transl Pediatr

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Background: Distinguishing biliary atresia from non-biliary atresia in patients with cholestasis is challenging, as these conditions have a similar clinical presentation. We developed and externally validated a screening model for biliary atresia and devised a web-based calculator for use in clinical settings.Methods: A screening model was developed based on data from 227 cholestatic infants (82 and 145 with and without biliary atresia, respectively) and validated in 234 infants (90 and 144 with and without biliary atresia, respectively) admitted to three hospitals. Variables were selected from routine examination results using the least absolute shrinkage and selection operator method and entered into a logistic regression model to construct a biliary-atresia-risk-predicting equation. Cutoff values for risk stratification were estimated using model sensitivity, derived from the receiver-operating characteristic curves. Results:The final screening model included seven variables (i.e., weight at admission, clay-colored stools, γ-glutamyl transpeptidase and albumin levels at admission, abnormal gallbladder, triangular cord sign, and change in total bilirubin levels). The model generated an area under the curve of 0.94 with a sensitivity of 91.46 and specificity of 86.62 in the derivation cohort. This was confirmed in the validation cohort, as we found an area under the curve of 0.93 with a sensitivity of 93.1 and specificity of 80.15. Patients were stratified into three risk groups (low-, moderate-, and high-risk groups). Biliary atresia was excluded in the low-risk group. The high-risk group showed a higher detection rate of biliary atresia compared to the stool color screening method alone. This model was integrated into a user-friendly web-based system. Conclusions:The screening tool had a high predictive value and may help in decision-making by physicians at tertiary and community hospitals.

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Section: Discussionmentioning

confidence: 99%

Web-based calculator for biliary atresia screening in neonates and infants with cholestasis

Zhao¹,

Gu²,

Gong³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

show abstract

“…Notably, in a large ret-rospective cohort, GGT values higher than 500 IU/L were found only in BA patients [64] . Conversely, a normal GGT level is may suggest a poor prognosis [65] as in progressive intrahepatic familial cholestasis type 1 and 2 and other inborn defects of canalicular transport or synthesis of bile acids [63] . Elevated (above 7 μmol/L) total serum bile acids can be considered a very sensitive biomarker of cholestasis.…”

Section: Further Investigationsmentioning

confidence: 99%

Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working group

Ranucci

Corte

Alberti

et al. 2022

Digestive and Liver Disease

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Three-color risk stratification for improving the diagnostic accuracy for biliary atresia

Chen

Zhao

et al. 2020

Eur Radiol

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Design and validation of a noninvasive diagnostic criteria for biliary atresia in infants based on the STROBE compliant

Abstract: Supplemental Digital Content is available in the text

Cited by 8 publications

References 22 publications

Web-based calculator for biliary atresia screening in neonates and infants with cholestasis

Web-based calculator for biliary atresia screening in neonates and infants with cholestasis

Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working group

Three-color risk stratification for improving the diagnostic accuracy for biliary atresia

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