Lammers et al reported the GOBE score for evaluating patients with primary biliary cirrhosis (PBC) who have been treated with ursodeoxycholic acid (UDCA). This can help to identify a patient who may benefit from more aggressive management. The authors are from the Global PBC Study Group representing multiple sites from around the world.
Patient selection: primary billiary cirrhosis on ursodeoxycholic acid (UDCA)
Parameters:
(1) age at start of UDCA therapy
(2) serum total bilirubin in mg/dL after 1 year follow-up
(3) upper limit of the normal reference range for total serum bilirubin in mg/dL
(4) serum alkaline phosphatase in IU/L at 1 year follow-up
(5) upper limit of the normal reference range for serum alkaline phosphatase in IU/L
(6) serum albumin in g/L at 1-year follow-up
(7) lower limit of normal for serum albumin in g/L
(8) platelet count per 10^9/L at 1 year follow-up
ratio serum total bilirubin to ULN =
= (serum bilirubin) / (ULN for bilirubin)
ratio serum alkaline phosphatase to ULN =
= (serum alkaline phosphatase) / (ULN for serum alkaline phosphatase)
ratio of serum albumin to LLN =
= (serum albumin) / (LLN for serum albumin)
GLOBE score =
= (0.044378 * (age in years)) + (0.93982 * LN(bilirubin ratio)) + (0.335648 * LN(alkaline phosphatase ratio)) - (2.266708 * (albumin ratio)) - (0.002581 * (platelet count)) + 1.216865
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Time Interval (t)
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S0(t)
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3 years
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0.9652
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5 years
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0.9385
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10 years
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0.8429
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15 years
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0.7361
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transplant free survival for a time period =
= S0(t)^(EXP(GLOBE score))
The score has been implemented at www.globalpbc.com.
