Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease

Zohair Ahmed,1 Jinma Ren,2 Adam Gonzalez,3 Umair Ahmed,4 Saqib Walayat,4 Daniel K Martin,5 Harsha Moole,4 Sherri Yong,6 Sean Koppe,7 Sonu Dhillon5 1Department of Gastroenterology and Hepatology, University of Illinois at Chicago, IL, USA; 2Department of Center for Outcomes Research, University of Il...

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Autores principales:	Ahmed Z, Ren J, Gonzalez A, Ahmed U, Walayat S, Martin DK, Moole H, Yong S, Koppe S, Dhillon S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Cirrhosis Liver Fibrosis Diagnosis Screening NAFLD HCV Alcohol. Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/fb11f54bc72b447bb04133ff0dcf9b2f
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spelling	oai:doaj.org-article:fb11f54bc72b447bb04133ff0dcf9b2f2021-12-02T01:46:03ZUniversal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease1179-1535https://doaj.org/article/fb11f54bc72b447bb04133ff0dcf9b2f2018-10-01T00:00:00Zhttps://www.dovepress.com/universal-index-for-cirrhosis-uic-index-the-development-and-validation-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Zohair Ahmed,1 Jinma Ren,2 Adam Gonzalez,3 Umair Ahmed,4 Saqib Walayat,4 Daniel K Martin,5 Harsha Moole,4 Sherri Yong,6 Sean Koppe,7 Sonu Dhillon5 1Department of Gastroenterology and Hepatology, University of Illinois at Chicago, IL, USA; 2Department of Center for Outcomes Research, University of Illinois College of Medicine, Peoria, IL, USA; 3University of Illinois College of Medicine, Peoria, IL, USA; 4Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA; 5Department of Gastroenterology and Hepatology, University of Illinois College of Medicine, Peoria, IL, USA; 6Department of Pathology, University of Illinois College of Medicine, Peoria, IL, USA; 7Department of Hepatology, University of Illinois at Chicago, IL, USA Aim: The purpose of this study was to create and validate a novel serological diagnostic index to predict cirrhosis of all etiologies.Methods: This was a retrospective observational study of 771 patients, age >18 years, who underwent a liver biopsy. The stage of fibrosis and routine laboratory values were recorded. The data were randomly separated into 2 datasets (training 50% and testing 50%). A stepwise logistic regression model was used to develop the novel index. The area under the curve of receiver operating characteristic (AUROC) was applied to compare the new index to existing ones (Fibro-Q, FIB4, APRI, AAR), which was also validated in the testing dataset.Results: Variables associated with the presence of cirrhosis were first assessed by univariate analysis then by multivariable analysis, which indicated serum glutamic-oxaloacetic acid transaminase, serum glutamic-pyruvic transaminase, international normalized ratio, albumin, blood urea nitrogen, glucose, platelet count, total protein, age, and race were the independent predictors of cirrhosis (P<0.05). Regression formula for prediction of cirrhosis was generated and a novel index was subsequently created. The diagnostic performance of the novel index for predicting cirrhosis was assessed using the receiver operating characteristic curve. The new index had significantly higher AUROC (0.83, 95% CI: 0.79–0.87) than Fibro-Q (0.80, 95% CI: 0.76–0.85), FIB4 (0.79, 95% CI: 0.74–0.83), APRI (0.74, 95% CI: 0.69–0.78), and AAR (0.72, 95% CI: 0.67–0.78).Conclusion: The novel index had the highest AUROC curve when compared with current indices and can be applied to all etiologies of chronic liver disease. Keywords: cirrhosis, liver, fibrosis, diagnosis, screening, NAFLD, HCV, alcoholAhmed ZRen JGonzalez AAhmed UWalayat SMartin DKMoole HYong SKoppe SDhillon SDove Medical PressarticleCirrhosisLiverFibrosisDiagnosisScreeningNAFLDHCVAlcohol.Diseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 10, Pp 133-138 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cirrhosis Liver Fibrosis Diagnosis Screening NAFLD HCV Alcohol. Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Cirrhosis Liver Fibrosis Diagnosis Screening NAFLD HCV Alcohol. Diseases of the digestive system. Gastroenterology RC799-869 Ahmed Z Ren J Gonzalez A Ahmed U Walayat S Martin DK Moole H Yong S Koppe S Dhillon S Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
description	Zohair Ahmed,1 Jinma Ren,2 Adam Gonzalez,3 Umair Ahmed,4 Saqib Walayat,4 Daniel K Martin,5 Harsha Moole,4 Sherri Yong,6 Sean Koppe,7 Sonu Dhillon5 1Department of Gastroenterology and Hepatology, University of Illinois at Chicago, IL, USA; 2Department of Center for Outcomes Research, University of Illinois College of Medicine, Peoria, IL, USA; 3University of Illinois College of Medicine, Peoria, IL, USA; 4Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA; 5Department of Gastroenterology and Hepatology, University of Illinois College of Medicine, Peoria, IL, USA; 6Department of Pathology, University of Illinois College of Medicine, Peoria, IL, USA; 7Department of Hepatology, University of Illinois at Chicago, IL, USA Aim: The purpose of this study was to create and validate a novel serological diagnostic index to predict cirrhosis of all etiologies.Methods: This was a retrospective observational study of 771 patients, age >18 years, who underwent a liver biopsy. The stage of fibrosis and routine laboratory values were recorded. The data were randomly separated into 2 datasets (training 50% and testing 50%). A stepwise logistic regression model was used to develop the novel index. The area under the curve of receiver operating characteristic (AUROC) was applied to compare the new index to existing ones (Fibro-Q, FIB4, APRI, AAR), which was also validated in the testing dataset.Results: Variables associated with the presence of cirrhosis were first assessed by univariate analysis then by multivariable analysis, which indicated serum glutamic-oxaloacetic acid transaminase, serum glutamic-pyruvic transaminase, international normalized ratio, albumin, blood urea nitrogen, glucose, platelet count, total protein, age, and race were the independent predictors of cirrhosis (P<0.05). Regression formula for prediction of cirrhosis was generated and a novel index was subsequently created. The diagnostic performance of the novel index for predicting cirrhosis was assessed using the receiver operating characteristic curve. The new index had significantly higher AUROC (0.83, 95% CI: 0.79–0.87) than Fibro-Q (0.80, 95% CI: 0.76–0.85), FIB4 (0.79, 95% CI: 0.74–0.83), APRI (0.74, 95% CI: 0.69–0.78), and AAR (0.72, 95% CI: 0.67–0.78).Conclusion: The novel index had the highest AUROC curve when compared with current indices and can be applied to all etiologies of chronic liver disease. Keywords: cirrhosis, liver, fibrosis, diagnosis, screening, NAFLD, HCV, alcohol
format	article
author	Ahmed Z Ren J Gonzalez A Ahmed U Walayat S Martin DK Moole H Yong S Koppe S Dhillon S
author_facet	Ahmed Z Ren J Gonzalez A Ahmed U Walayat S Martin DK Moole H Yong S Koppe S Dhillon S
author_sort	Ahmed Z
title	Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
title_short	Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
title_full	Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
title_fullStr	Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
title_full_unstemmed	Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease
title_sort	universal index for cirrhosis (uic index): the development and validation of a novel index to predict advanced liver disease
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/fb11f54bc72b447bb04133ff0dcf9b2f
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Universal Index for Cirrhosis (UIC index): The development and validation of a novel index to predict advanced liver disease

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