ABC: a novel algorithm to stratify decompensation risk in patients with compensated advanced chronic liver disease (CHESS2108): an international, multicenter cohort study

Liu, Chuan; Li, Jia; Wong, Yu Jun; Xie, Qing; Hirooka, Masashi; Enomoto, Hirayuki; Kim, Tae Hyung; Hanafy, Amr Shaaban; He, Ruiling; Hiasa, Yoichi; Nishimura, Takashi; Iijima, Hiroko; Jung, Young Kul; Yim, Hyung Joon; Ma, Jianzhong; Zeng, Qing‐Lei; Sarin, Shiv Kumar; Qi, Xiaolong

doi:10.1007/s12072-022-10345-4

Cited by 3 publications

(6 citation statements)

References 24 publications

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“…This survey confirmed that the average cost of HVPG measurement in 2022 was 5646.8 CNY—a slight increase from the 2021 cost 9 . HVPG measurement is mostly considered to be restricted by the operation and equipment threshold or cost 1,2,10 . Taken together with our results, where 62.1%(54/87) of institutions we surveyed indicated that the biggest barrier hindering the promotion of this technology is its high cost, this clearly remains an urgent issue to be addressed.…”

Section: Discussionsupporting

confidence: 70%

“…9 HVPG measurement is mostly considered to be restricted by the operation and equipment threshold or cost. 1,2,10 Taken together with our results, where 62.1%(54/87) of institutions we surveyed indicated that the biggest barrier hindering the promotion of this technology is its high cost, this clearly remains an urgent issue to be addressed. In addition, considering that all of the hospitals that participated in the survey had the ability to measure HVPG, the estimation of the threshold of operational difficulty may be insufficient.…”

Section: Completely Unnecessarysupporting

confidence: 74%

“…In previous studies, we proposed a variety of evaluation methods for compensated advanced chronic liver disease that are suitable for guiding the use of HVPG in clinical practice. 10,11 The results of this survey showed that participating experts still believed that the most important reason hindering the clinical application of HVPG was an insufficient understanding of the technology by clinicians rather than its high cost, invasiveness, difficulty, or poor acceptance by patients. In the near future, the CHESS will update and publish the latest version of the "Expert Consensus on Clinical Application of Hepatic Venous Pressure Gradient in China (2023)" and continue to focus on and strengthen the promotion and popularization of the HVGP among frontline doctors.…”

Section: Completely Unnecessarymentioning

confidence: 98%

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One‐year status of hepatic venous pressure gradient measurement from 85 hospitals in China

Wang,

Cui,

Zhang

et al. 2024

Portal Hypertension & Cirrhosis

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AimsSurveys and research on the applications of the hepatic venous pressure gradient (HVPG) are important for understanding the current status and future development of this technology in China. This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022.MethodsWe investigated the overall status of HVPG technology in China—including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications, and current challenges by using online questionnaire. By counting the number and percentages of cases of these results, we hope to clarify the current status of HVPG measurements in China.ResultsAccording to the survey, 85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces. A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022, of which 2813 cases (56.4%) were measured alone. The average cost of HVPG measurement was 5646.8 ± 2327.9 CNY. Of the clinical teams who performed the measurements (sometimes multiple per hospital), 94.3% (82/87) used the balloon method, and the majority of the teams (72.4%, 63/87) used embolectomy catheters.ConclusionsThis survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology. It is still necessary to continue promoting and popularizing this technology in the future.

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Section: Discussionsupporting

confidence: 70%

Section: Completely Unnecessarysupporting

confidence: 74%

Section: Completely Unnecessarymentioning

confidence: 98%

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One‐year status of hepatic venous pressure gradient measurement from 85 hospitals in China

Wang,

Cui,

Zhang

et al. 2024

Portal Hypertension & Cirrhosis

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“…Subsequently, given patients with CSPH are at increased risk of decompensation events, 1,22 the performance of decompensation stratification was an important issue after the development of a non-invasive CSPH diagnosis tool. 4,15,16,[23][24][25][26] In the current study, the high-risk CSPH patients stratified by the novel CSPH risk model presented significantly higher rates (15.8%) of decompensation than the CSPH medium (2.5%) and low (1.7%) risk patients in the follow-up cohort. Notably, the CSPH medium and low-risk subgroups had similarly low rates (2.5% vs 1.7%) of decompensation during a mean follow-up duration of 39.0 (25.2-55.2) months, which synergistically indicates the favorable performance of the novel CSPH risk model.…”

Section: Discussionmentioning

confidence: 83%

“…The final result must be in accordance with the criteria reported in the previous study. 15,16 HVPG was performed with standard balloon catheter technique by experienced interventional specialists. 17 An international multicenter longitudinal follow-up cohort…”

Section: An International Multicenter Cross-sectional Hvpg Cohortmentioning

confidence: 99%

Carvedilol to prevent decompensation of liver cirrhosis in patients with clinically significant portal hypertension stratified by novel non-invasive model

Qi,

Liu,

You

et al. 2023

Preprint

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Objective: To develop a novel non-invasive model for CSPH, and investigate whether carvedilol could reduce the risk of decompensation in patients with high-risk CSPH stratified by the novel model. Methods: International multicenter observational study with a median follow-up time of 38 months. Three cohorts were included in study from 6 countries. In this study, a total of 1,304 patients were fulfilled diagnosis of liver cirrhosis. Patients were treated with carvedilol in longitudinal carvedilol-treating cohort. The primary outcome was the development of the first hepatic decompensation . Results: Six studies from the meta-analysis were involved (n=819), and LSM and platelet count (PLT) were identified as independent risk factors of CSPH, with pooled risk ratios of 1.10 (95% confidence interval [CI] 1.06-1.15) and 0.99 (95% CI 0.98-0.99). A novel model was established. In HVPG cohort (n=151), the areas under the receiver operating characteristic curve (AUC) of the novel model, ANTICIPATE model, and Baveno VII criteria for CSPH were 0.91 (95% CI 0.86-0.95), 0.80 (95% CI 0.73-0.87), and 0.83 (95% CI 0.77-0.89). The novel model narrows down the grey zone to 22.5%, significantly lower than 50.3%, using Baveno VII criteria (p<0.001). In follow-up cohort (n=1,102), the cumulative incidences (1.7% vs 2.5% vs 15.8%) of decompensation events were significantly different by using the novel model cutoff values of >0, 0 to -0.68 (medium-risk), and <-0.68 (p<0.001). In the carvedilol-treating cohort, the patients with high-risk CSPH stratified by the novel model (treating cohort, n=51) had significantly lower rates of decompensation than those of NSBBs untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=102 after PSM, all p<0.05). Conclusion: A novel model provides stratification for CSPH and decompensation in patients with liver cirrhosis. Treatment with carvedilol significantly reduces the risk of decompensation among high-risk CSPH patients stratified by the novel model.

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Deep learning and non-invasive assessment of significant fibrosis: does adding more toppings improve the flavor of prediction?

Verma

Asrani

2022

Hepatol Int

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ABC: a novel algorithm to stratify decompensation risk in patients with compensated advanced chronic liver disease (CHESS2108): an international, multicenter cohort study

Cited by 3 publications

References 24 publications

One‐year status of hepatic venous pressure gradient measurement from 85 hospitals in China

One‐year status of hepatic venous pressure gradient measurement from 85 hospitals in China

Carvedilol to prevent decompensation of liver cirrhosis in patients with clinically significant portal hypertension stratified by novel non-invasive model

Deep learning and non-invasive assessment of significant fibrosis: does adding more toppings improve the flavor of prediction?

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