Nishigawa et al reported a score for identifying a patient with chronic HBV infection who has advanced hepatic fibrosis without need for a liver biopsy. The authors are from Hyogo College of Medicine in Japan.
Patient selection: chronic viral hepatitis B
Outcome: hepatic fibrosis F3 or F4
The GMPH score is named for its 4 components.
Parameters:
(1) serum GGT in IU/L
(2) WFA+-M2BP (Wisteria floribunda agglutin-positive Mac-2-binding protein), cutoff index from 0 to 12
(3) platelet count in 10^4 per µL (not 10^3)
(4) serum hyaluronic acid in ng/mL
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Parameter
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Points
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GGT
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-0.015 * (GGT)
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WFA+-M2BP
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-0.268 * (WFA+-M2BP)
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platelet count in 10^4/µL
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0.167 * (platelet count)
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serum hyaluronic acid
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0.003 * (hyaluronic acid)
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score =
= SUM(points for all 4 parameters) - 0.755
Interpretation:
• The GMPH score ranged from -5.406 to 5.094 in the study patients.
• The risk of advanced fibrosis decreased with higher scores.
• The cutoff was < 1.17, with a sensitivity of 72% and specificity of 80% in the derivation set.
Performance:
• The area under the ROC curve was 0.80 in the training set and 0.78 in the validation set.
