Serum tests, liver stiffness and artificial neural networks for diagnosing cirrhosis and portal hypertension

Procopet, Bogdan; Cristea, Vasile Mircea; Robic, Marie Angele; Grigorescu, Mircea; Agachi, Paul Serban; Metivier, Sophie; Peron, Jean Marie; Selves, Janick; Stefanescu, Horia; Berzigotti, Annalisa; Vinel, Jean Pierre; Bureau, Christophe (2015). Serum tests, liver stiffness and artificial neural networks for diagnosing cirrhosis and portal hypertension. Digestive and liver disease, 47(5), pp. 411-416. Elsevier 10.1016/j.dld.2015.02.001

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BACKGROUND The diagnostic performance of biochemical scores and artificial neural network models for portal hypertension and cirrhosis is not well established. AIMS To assess diagnostic accuracy of six serum scores, artificial neural networks and liver stiffness measured by transient elastography, for diagnosing cirrhosis, clinically significant portal hypertension and oesophageal varices. METHODS 202 consecutive compensated patients requiring liver biopsy and hepatic venous pressure gradient measurement were included. Several serum tests (alone and combined into scores) and liver stiffness were measured. Artificial neural networks containing or not liver stiffness as input variable were also created. RESULTS The best non-invasive method for diagnosing cirrhosis, portal hypertension and oesophageal varices was liver stiffness (C-statistics=0.93, 0.94, and 0.90, respectively). Among serum tests/scores the best for diagnosing cirrhosis and portal hypertension and oesophageal varices were, respectively, Fibrosis-4, and Lok score. Artificial neural networks including liver stiffness had high diagnostic performance for cirrhosis, portal hypertension and oesophageal varices (accuracy>80%), but were not statistically superior to liver stiffness alone. CONCLUSIONS Liver stiffness was the best non-invasive method to assess the presence of cirrhosis, portal hypertension and oesophageal varices. The use of artificial neural networks integrating different non-invasive tests did not increase the diagnostic accuracy of liver stiffness alone.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Berzigotti, Annalisa

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1590-8658

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

31 Mar 2016 15:32

Last Modified:

31 Mar 2016 15:32

Publisher DOI:

10.1016/j.dld.2015.02.001

PubMed ID:

25732434

Uncontrolled Keywords:

HVPG; Liver biopsy; Non-invasive tests; Oesophageal varices; Serological scores; Transient elastography

BORIS DOI:

10.7892/boris.77710

URI:

https://boris.unibe.ch/id/eprint/77710

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