Liu et al reported a simple score and nomogram to identify a cholestatic patient with biliary atresia. The authors are from Capital Medical University, Shanghai Medical College, and First Medical University of Shandong in China.
Patient selection: infants with cholestasis (ages 6 to 12 weeks)
Parameters:
(1) clay stool
(2) gallbladder emptying index (GEI)
(3) shear wave elastography in kPa
(4) serum GGT in IU/L
Parameter
Finding
Points
clay stool
no
0
yes
1
gallbladder emptying index
normal
0
q
abnormal
1
shear wave elastography
<= 10 kPa
0
> 10 kPa
1
serum GGT
<=200 IU/L
0
201 to 300 IU/L
1
> 300 IU/L
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
Total Score
Risk Category
Risk of Biliary Atresia
0 or 1
low
<= 10%
2 or 3
intermediate
37-80%
4 or 5
high
98-100%
Performance:
• The authors claim an area under the ROC curve os 0.97.
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