Kokoroskos et al used a combination of serum enzymes to diagnose choledocholithiasis. The authors are from Massachusetts General Hospital.
Patient selection: middle-aged adults (33 to 63 years)
Parameters:
(1) serum alkaline phosphatase in U/L
(2) serum aspartate aminotransferase (AST) in U/L
(3) serum total bilirubin in mg/dL
Parameter
Finding
Points
serum alkaline phosphatase
<= 230 U/L
0
> 230 U/L
1
serum AST
<= 120 U/L
> 120 U/L
serum total bilirubin
< 1.8 mg/dL
1.8 to 4.0 mg/dL
> 4 mg/dL
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
Score
Risk Choledocholithiasis
8%
26%
51%
3
77%
4
89%
Performance:
• The area under the ROC curve is 0.82 in the derivation and 0.77 in the validation cohorts.
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Specialty: Gastroenterology
