Daniels et al reported the ADAPT algorithm to identify a patient with NAFLD who has advanced hepatic fibrosis. The authors are from multiple institutions in Denmark, Australia, Egypt, England and Japan.
ADAPT is derived from letters in age, diabetes, PRO-C3, and platelet count.
Parameters:
(1) age in years
(2) serum PRO-C3 in ng/mL (marker of type III collagen formation)
(3) platelet count in 10^9/L
(4) diabetes (blood glucose >= 7.0 mmol/L, use of anti-diabetic drug or previous diagnosis of diabetes)
|
Parameter
|
Finding
|
Points
|
|
diabetes
|
no
|
0
|
|
|
yes
|
1
|
X =
= (age) * (serum PRO-C3) / SQRT(platelet count)
ADAPT score =
= EXP(LOG10(X)) + (points for diabetes)
Interpretation:
• A score > 6.329 is associated with advanced hepatic fibrosis
• Madsen et al reported use in patients with alcohol-related liver disease.
Performance:
• The area under the ROC curve is 0.86 in the derivation and 0.87 in the validation cohorts of patients with NAFLD.
• The negative predictive value was 0.97.
