Validation of the EVendo score for the prediction of varices in cirrhotic patients

Alswat, Khalid; Alanazi, Mohammad; Bashmail, Ahmed; Alkhamash, Maram; AlQahtani, Samah; Al–Hamoudi, Waleed; Abdo, AymanA

doi:10.4103/sjg.sjg_624_21

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…This is the case for a novel score called EVendo, which considers several factors: the presence of clinical ascites, hemoglobin (g/dL), platelet count (count/1000), AST (U/L), and blood urea nitrogen (BUN) (mg/dL). EVendo score demonstrated its safety in clinical practice for predicting esophageal varices and varices needing treatment, with a higher number of spared endoscopies than with Baveno VI [ 50 , 51 ].…”

Section: Reviewmentioning

confidence: 99%

The Prediction and Treatment of Bleeding Esophageal Varices in the Artificial Intelligence Era: A Review

Murillo Pineda,

Siu Xiao,

Sanabria Herrera

et al. 2024

Cureus

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Esophageal varices (EVs), a significant complication of cirrhosis, present a considerable challenge in clinical practice due to their high risk of bleeding and associated morbidity and mortality. This manuscript explores the transformative role of artificial intelligence (AI) in the management of EV, particularly in enhancing diagnostic accuracy and predicting bleeding risks. It underscores the potential of AI in offering noninvasive, efficient alternatives to traditional diagnostic methods such as esophagogastroduodenoscopy (EGD). The complexity of EV management is highlighted, necessitating a multidisciplinary approach that includes pharmacological therapy, endoscopic interventions, and, in some cases, surgical options tailored to individual patient profiles. Additionally, the paper emphasizes the importance of integrating AI into medical education and practice, preparing healthcare professionals for the evolving landscape of medical technology. It projects a future where AI significantly influences the management of gastrointestinal bleeding, improving clinical decision-making, patient outcomes, and overall healthcare efficiency. The study advocates for a patient-centered approach in healthcare, balancing the incorporation of innovative technologies with ethical principles and the diverse needs of patients to optimize treatment efficacy and enhance healthcare accessibility.

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Section: Reviewmentioning

confidence: 99%

The Prediction and Treatment of Bleeding Esophageal Varices in the Artificial Intelligence Era: A Review

Murillo Pineda,

Siu Xiao,

Sanabria Herrera

et al. 2024

Cureus

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“…5,[64][65][66] Studies have shown that patients most likely to have high-risk varices are those with decompensated cirrhosis, a platelet count ≤150x10 3 /mm 3 , and liver stiffness ≥20 kPa (determined by transient elastography). 65,67,68 Consequently, most of the experts (>75%) recommended upper gastrointestinal endoscopy within 6 months from study entry to assess the risk of hemorrhage from varices in all patients with HCC prior to initiation of atezolizumab plus bevacizumab therapy in line with published guidelines (Figure 5C). Additionally, atezolizumab could be immunogenic and induce undesirable anti-drug antibody (ADA) responses.…”

Section: Systemic Therapiesmentioning

confidence: 99%

Treatment Patterns and Recommendations for Improving the Management of Hepatocellular Carcinoma in Saudi Arabia

Alolyan,

Alshammari,

Arabi

et al. 2024

JHC

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Hepatocellular carcinoma (HCC) is the sixth most common type of cancer in the world associated with high morbidity and mortality. Despite being a significant healthcare burden there is limited information on the unmet needs and current treatment practices for intermediate and advanced-stage HCC in Saudi Arabia. This article analyzes the gaps and provides expert consensus on the management strategies for unresectable HCC in Saudi Arabia. A pre-meeting online questionnaire, comprising 20 objective questions about the treatment landscape and diagnosis of HCC in Saudi Arabia, was distributed to experts in the field of HCC management. An advisory board meeting including a panel of 13 experts was held in September 2022 where the responses to the survey questionnaire were reviewed and discussed. The survey results and experts’ discussion highlighted the growing incidence of liver cancer in Saudi Arabia. HCC comprised the majority of all liver cancer cases due to rising rates of chronic viral infections and lifestyle-related risk factors. Most physicians in Saudi Arabia follow the Barcelona Clinic Liver Cancer guidelines as a prognostic tool for the detection and staging of patients with HCC. Most of the patients with HCC in Saudi Arabia are diagnosed in the intermediate or advanced stages with poor prognoses and limited therapeutic options. Establishing evidence-based surveillance techniques, a multidisciplinary approach to diagnosis, and better accessibility of treatment options is vital for the management of HCC in Saudi Arabia.

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“…It also revealed a high negative predictive value of 96% in ruling out varices that required treatment. Similarly, Alswat K et al [12] validated EVendo score in an arab population and proposed a higher cutoff of < 4.5 in ruling out the patients with varices requiring treatment with a sensitivity of 83%.However, it lacked specificity.…”

Section: Introductionmentioning

confidence: 99%

Utility of EVendo Score as a Screening Tool for the Detection of High Risk Esophageal Varices in Pakistani Population

Jan

Khan

Ismail

et al. 2023

JAMMR

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Introduction: Endoscopy for the screening of esophageal varices (EVs) is costly and cannot be performed in remote areas with limited resources. Recently, certain non-invasive cost effective models have been proposed for the prediction of EVs but have failed recommendation on a larger scale. EVendo score is a recently developed bedside score for the detection of EVs. Therefore, our aim was to determine the utility of EVendo score as a screening tool for the detection of high risk esophageal varices in Pakistani population. Methods: It was a cross sectional study which was conducted in the department of Hepatogastroenterology from January 2021-June 2022.All the patients of either gender aged greater than 18 years with newly diagnosed cirrhosis were included in the study while those patients with prior history of esophageal varices and variceal bleeding as well as those with acute liver failure, renal impairment, non-cirrhotic portal hypertension and those on anticoagulants were excluded from the study. Area under the receiver operating curve (AUROC) was obtained for EVendo score, Aspartate Transaminase to platelet ratio(APRI) and Platelet count to Splenic Diameter and diagnostic accuracy was obtained for these scores in predicting EVs and also in identifying HRVs. Results: A total of 272 patients were enrolled in the study. Among them, 167(61.4%) were males. Most common cause of chronic liver disease was viral hepatitis.On screening endoscopy, EVs were noted in 118(43.4%) patients while high risk EVs (HRV) were noted in 47(17.3%) patients respectively. AUROC was obtained for EVendo score, APRI and Platelet count to Splenic Diameter in predicting EVs and also for identifying HRVs and it was 0.93 (p-value <0.001), 0.821(<0.001) and 0.842(p<0.001) respectively for the prediction of EVs with diagnostic accuracy of 86.76% and 0.852 (p-value <0.001), 0.835(<0.001) and 0.814(p<0.001) respectively for identifying HRVs with a diagnostic accuracy of 84.19%. Conclusion: The performance of EVendo score was reliable and better than the other non-invasive scores in predicting EVs in our population with an excellent sensitivity and diagnostic accuracy in predicting the EVs and also in identifying HRVs. However, studies comprising larger sample sizes are required in this regard.

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Validation of the EVendo score for the prediction of varices in cirrhotic patients

Cited by 8 publications

References 28 publications

The Prediction and Treatment of Bleeding Esophageal Varices in the Artificial Intelligence Era: A Review

The Prediction and Treatment of Bleeding Esophageal Varices in the Artificial Intelligence Era: A Review

Treatment Patterns and Recommendations for Improving the Management of Hepatocellular Carcinoma in Saudi Arabia

Utility of EVendo Score as a Screening Tool for the Detection of High Risk Esophageal Varices in Pakistani Population

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