Geeratragool et al reported a simple score for identifying a patient with chronic hepatitis B who should be treated. The authors are from Mahidol University and Chulalongkorn University in Thailand.
HePAA is an acronym for HBE, platelet, ALT, and albumin.
Patient selection: chronic HBV
Parameters:
(1) HBeAg
(2) platelet count per microliter
(3) serum ALT in IU/L
(4) serum albumin in g/dL
|
Parameter
|
Finding
|
beta-coefficient
|
Points
|
|
HBEAg
|
negative
|
0
|
0
|
|
|
positive
|
0.899
|
1
|
|
platelet count
|
>= 150,000 per µL
|
0
|
0
|
|
|
< 150,000 per µL
|
2.405
|
1
|
|
serum ALT
|
< 30 IU/L
|
0
|
0
|
|
|
30 to 39
|
0.097
|
1
|
|
|
40 to 49
|
0.194
|
2
|
|
|
>= 50
|
0.201
|
3
|
|
serum albumin
|
>= 4.0 g/dL
|
0
|
0
|
|
|
< 4.0 g/dL
|
-0.838
|
1
|
where:
• Since a low serum albumin increases risk, the beta-coefficients may be switched from what they should be.
value of X =
= SUM(points for all of the beta-coefficients) - 1.604
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >= 2 and >= 3 had equivalent Youden index.
• A score >= 2 was used to identify a patient who is eligible for treatment.
Performance:
• The area under the ROC curve is 0.93.
