Banini et al reported a Portal Hypertension Assessment Tool (PHAT) to identify clinically significant portal hypertension in a patient with liver disease. The authors are from Virginia Commonwealth University, Yale University, and Hunter-Holmes McGuire Veterans Affairs Medical Center.
Patient selection: chronic liver disease
Parameters:
(1) liver stiffness measure (LSM) in kPa
(2) FIB-4
(3) gender
Parameter
Finding
Points
LSM
0.06 * (LSM)
FIB-4
0.63 * (FIB-4)
gender
female
0
male
-1.62
PHAT =
= SUM(points for all of the parameters) - 4.59
Interpretation:
• In the study population the scores ranged from -5.35 to 1.18.
• A score >= -2.76 is associated with high risk for clinically significant portal hypertension.
Performance:
• The negative predictive value was 0.99 but the positive predictive value was 0.27.
• The area under the ROC curve was 0.83 for internal validation and 0.79 for external validation.
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