Parameters:
(1) serum hyaluronic acid in µg/L
(2) prothrombin index in percent
Factors favoring cirrhosis:
(1) serum hyaluronic acid >= 60 µg/L (sensitivity 97%, specificity 73%)
(2) prothrombin index < 85% (sensitivity 80%, specificity 88%)
As shown in Table 6, both tests are most valuable to identify patients for whom cirrhosis is unlikely based on the negative predictive value.
A serum hyaluronic acid < 60 µg/L has a negative predictive value of 0.98 to 1.00, depending on the prevalence of cirrhosis in the population.
A prothrombin index > 85% is good evidence against cirrhosis, with a negative predictive value ranging from 0.91 to 1.00 depending on prevalence in the population. One modification is to convert the prothrombin index to the comparable prothrombin time (see Chapter 4).
The positive predictive values are low except when testing is done in a high risk population.
|
Serum Hyaluronic Acid
|
Prothrombin Index
|
Probability of Cirrhosis
|
|
< 60 µg/L
|
> 85%
|
very low
|
|
< 60 µg/L
|
<= 85%
|
very low
|
|
>= 60 µg/L
|
> 85%
|
low
|
|
>= 60 µg/L
|
<= 85%
|
moderate
|
