A clinical prediction rule and platelet count predict esophageal varices in children (2024)

Gana, J. C., Turner, D., Mielivergani, G., Davenport, M., Miloh, T., Avitzur, Y., Yap, J., Morinville, V., Brill, H., & Ling, S. C. (2011). A clinical prediction rule and platelet count predict esophageal varices in children. Gastroenterology, 141(6), 2009-2016. https://doi.org/10.1053/j.gastro.2011.08.049

Gana, Juan Cristóbal ; Turner, Dan ; Mielivergani, Giorgina et al. / A clinical prediction rule and platelet count predict esophageal varices in children. In: Gastroenterology. 2011 ; Vol. 141, No. 6. pp. 2009-2016.

@article{c7e19f50f8764eb1838e4b7b399c15d4,

title = "A clinical prediction rule and platelet count predict esophageal varices in children",

abstract = "Background & Aims: The validation of noninvasive tests to diagnose esophageal varices is a priority in children because repeated endoscopic evaluations are too invasive. We measured the ability of a previously developed noninvasive clinical prediction rule (CPR) to predict the presence of esophageal varices in children. Methods: We analyzed data from 108 children, younger than age 18, who received endoscopies at 8 centers, to assess portal hypertension from chronic liver disease or portal vein obstruction. Blood test and abdominal ultrasound scan results were obtained within 4 months of endoscopy. Grading of varices identified by endoscopy was confirmed by independent blinded review. Spleen size, based on data from the ultrasound scan, was expressed as a standard deviation score relative to normal values for age. Results: Of the children studied, 74 had esophageal varices (69%), including 35 with large varices (32%). The best noninvasive predictors of esophageal varices of any size were as follows: platelet:spleen size z-score ratio (area under the receiver operating characteristic curve [AUROC], 0.84; 95% confidence interval [CI] 0.750.93), CPR (AUROC, 0.80; 95% CI, 0.700.91), and platelet count (AUROC, 0.79; 95% CI, 0.690.90). The positive predictive values for the CPR and platelet count were 0.87 and 0.86, the negative predictive values were 0.64 and 0.63, the positive likelihood ratios were 3.06 and 2.76, and the negative likelihood ratios were 0.64 and 0.63, respectively. Based on positive and negative predictive values, the most accurate noninvasive tests were the CPR and platelet counts. Conclusions: Noninvasive tests such as CPR and platelet count can assist in triaging children for endoscopy to identify esophageal varices.",

keywords = "Diagnostic Tests, Pediatric Chronic Liver Disease, Portal Hypertension",

author = "Gana, {Juan Crist{\'o}bal} and Dan Turner and Giorgina Mielivergani and Mark Davenport and Tamir Miloh and Yaron Avitzur and Jason Yap and Veronique Morinville and Herbert Brill and Ling, {Simon C.}",

year = "2011",

month = dec,

doi = "10.1053/j.gastro.2011.08.049",

language = "אנגלית",

volume = "141",

pages = "2009--2016",

journal = "Gastroenterology",

issn = "0016-5085",

publisher = "W.B. Saunders Ltd",

number = "6",

}

Gana, JC, Turner, D, Mielivergani, G, Davenport, M, Miloh, T, Avitzur, Y, Yap, J, Morinville, V, Brill, H & Ling, SC 2011, 'A clinical prediction rule and platelet count predict esophageal varices in children', Gastroenterology, vol. 141, no. 6, pp. 2009-2016. https://doi.org/10.1053/j.gastro.2011.08.049

A clinical prediction rule and platelet count predict esophageal varices in children. / Gana, Juan Cristóbal; Turner, Dan; Mielivergani, Giorgina et al.
In: Gastroenterology, Vol. 141, No. 6, 12.2011, p. 2009-2016.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A clinical prediction rule and platelet count predict esophageal varices in children

AU - Gana, Juan Cristóbal

AU - Turner, Dan

AU - Mielivergani, Giorgina

AU - Davenport, Mark

AU - Miloh, Tamir

AU - Avitzur, Yaron

AU - Yap, Jason

AU - Morinville, Veronique

AU - Brill, Herbert

AU - Ling, Simon C.

PY - 2011/12

Y1 - 2011/12

N2 - Background & Aims: The validation of noninvasive tests to diagnose esophageal varices is a priority in children because repeated endoscopic evaluations are too invasive. We measured the ability of a previously developed noninvasive clinical prediction rule (CPR) to predict the presence of esophageal varices in children. Methods: We analyzed data from 108 children, younger than age 18, who received endoscopies at 8 centers, to assess portal hypertension from chronic liver disease or portal vein obstruction. Blood test and abdominal ultrasound scan results were obtained within 4 months of endoscopy. Grading of varices identified by endoscopy was confirmed by independent blinded review. Spleen size, based on data from the ultrasound scan, was expressed as a standard deviation score relative to normal values for age. Results: Of the children studied, 74 had esophageal varices (69%), including 35 with large varices (32%). The best noninvasive predictors of esophageal varices of any size were as follows: platelet:spleen size z-score ratio (area under the receiver operating characteristic curve [AUROC], 0.84; 95% confidence interval [CI] 0.750.93), CPR (AUROC, 0.80; 95% CI, 0.700.91), and platelet count (AUROC, 0.79; 95% CI, 0.690.90). The positive predictive values for the CPR and platelet count were 0.87 and 0.86, the negative predictive values were 0.64 and 0.63, the positive likelihood ratios were 3.06 and 2.76, and the negative likelihood ratios were 0.64 and 0.63, respectively. Based on positive and negative predictive values, the most accurate noninvasive tests were the CPR and platelet counts. Conclusions: Noninvasive tests such as CPR and platelet count can assist in triaging children for endoscopy to identify esophageal varices.

AB - Background & Aims: The validation of noninvasive tests to diagnose esophageal varices is a priority in children because repeated endoscopic evaluations are too invasive. We measured the ability of a previously developed noninvasive clinical prediction rule (CPR) to predict the presence of esophageal varices in children. Methods: We analyzed data from 108 children, younger than age 18, who received endoscopies at 8 centers, to assess portal hypertension from chronic liver disease or portal vein obstruction. Blood test and abdominal ultrasound scan results were obtained within 4 months of endoscopy. Grading of varices identified by endoscopy was confirmed by independent blinded review. Spleen size, based on data from the ultrasound scan, was expressed as a standard deviation score relative to normal values for age. Results: Of the children studied, 74 had esophageal varices (69%), including 35 with large varices (32%). The best noninvasive predictors of esophageal varices of any size were as follows: platelet:spleen size z-score ratio (area under the receiver operating characteristic curve [AUROC], 0.84; 95% confidence interval [CI] 0.750.93), CPR (AUROC, 0.80; 95% CI, 0.700.91), and platelet count (AUROC, 0.79; 95% CI, 0.690.90). The positive predictive values for the CPR and platelet count were 0.87 and 0.86, the negative predictive values were 0.64 and 0.63, the positive likelihood ratios were 3.06 and 2.76, and the negative likelihood ratios were 0.64 and 0.63, respectively. Based on positive and negative predictive values, the most accurate noninvasive tests were the CPR and platelet counts. Conclusions: Noninvasive tests such as CPR and platelet count can assist in triaging children for endoscopy to identify esophageal varices.

KW - Diagnostic Tests

KW - Pediatric Chronic Liver Disease

KW - Portal Hypertension

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U2 - 10.1053/j.gastro.2011.08.049

DO - 10.1053/j.gastro.2011.08.049

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AN - SCOPUS:81855167470

SN - 0016-5085

VL - 141

SP - 2009

EP - 2016

JO - Gastroenterology

JF - Gastroenterology

IS - 6

ER -

Gana JC, Turner D, Mielivergani G, Davenport M, Miloh T, Avitzur Y et al. A clinical prediction rule and platelet count predict esophageal varices in children. Gastroenterology. 2011 Dec;141(6):2009-2016. doi: 10.1053/j.gastro.2011.08.049