Comparison of models to predict incident chronic liver disease: a systematic review and external validation in Chinese adults

Bibliographic Details
Title: Comparison of models to predict incident chronic liver disease: a systematic review and external validation in Chinese adults
Authors: Xue Cong, Shuyao Song, Yingtao Li, Kaiyang Song, Cameron MacLeod, Yujie Cheng, Jun Lv, Canqing Yu, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Iona Millwood, Shukuan Wu, Xiaoming Yang, Rebecca Stevens, Junshi Chen, Zhengming Chen, Liming Li, Christiana Kartsonaki, Yuanjie Pang, on behalf of the China Kadoorie Biobank Collaborative Group
Source: BMC Medicine, Vol 22, Iss 1, Pp 1-13 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Medicine
Subject Terms: Risk prediction, Chronic liver disease, Hepatocellular carcinoma, Chinese, Systematic review, External validation, Medicine
More Details: Abstract Background Risk prediction models can identify individuals at high risk of chronic liver disease (CLD), but there is limited evidence on the performance of various models in diverse populations. We aimed to systematically review CLD prediction models, meta-analyze their performance, and externally validate them in 0.5 million Chinese adults in the China Kadoorie Biobank (CKB). Methods Models were identified through a systematic review and categorized by the target population and outcomes (hepatocellular carcinoma [HCC] and CLD). The performance of models to predict 10-year risk of CLD was assessed by discrimination (C-index) and calibration (observed vs predicted probabilies). Results The systematic review identified 57 articles and 114 models (28.4% undergone external validation), including 13 eligible for validation in CKB. Models with high discrimination (C-index ≥ 0.70) in CKB were as follows: (1) general population: Li-2018 and Wen 1–2012 for HCC, CLivD score (non-lab and lab) and dAAR for CLD; (2) hepatitis B virus (HBV) infected individuals: Cao-2021 for HCC and CAP-B for CLD. In CKB, all models tended to overestimate the risk (O:E ratio 0.55–0.94). In meta-analysis, we further identified models with high discrimination: (1) general population (C-index ≥ 0.70): Sinn-2020, Wen 2–2012, and Wen 3–2012 for HCC, and FIB-4 and Forns for CLD; (2) HBV infected individuals (C-index ≥ 0.80): RWS-HCC and REACH-B IIa for HCC and GAG-HCC for HCC and CLD. Conclusions Several models showed good discrimination and calibration in external validation, indicating their potential feasibility for risk stratification in population-based screening programs for CLD in Chinese adults.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1741-7015
Relation: https://doaj.org/toc/1741-7015
DOI: 10.1186/s12916-024-03754-9
Access URL: https://doaj.org/article/0e7abb29ce0d41f4a85e2b8a9ecaf327
Accession Number: edsdoj.0e7abb29ce0d41f4a85e2b8a9ecaf327
Database: Directory of Open Access Journals
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More Details
ISSN:17417015
DOI:10.1186/s12916-024-03754-9
Published in:BMC Medicine
Language:English