scholarly journals External validation of the United Kingdom‐primary biliary cholangitis risk scores of patients with primary biliary cholangitis treated with ursodeoxycholic acid

2018 ◽  
Vol 2 (6) ◽  
pp. 676-682 ◽  
Author(s):  
Angela C. Cheung ◽  
Aliya F. Gulamhusein ◽  
Brian D. Juran ◽  
Erik M. Schlicht ◽  
Bryan M. McCauley ◽  
...  
Keyword(s):  
United Kingdom ◽  
Ursodeoxycholic Acid ◽  
External Validation ◽  
Risk Scores ◽  
Primary Biliary Cholangitis ◽  
The United Kingdom

scholarly journals A validation study of the 4-variable and 8-variable kidney failure risk equation in transplant recipients in the United Kingdom

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ibrahim Ali ◽  
Philip A. Kalra
Keyword(s):  
United Kingdom ◽  
Kidney Failure ◽  
Graft Failure ◽  
Risk Scores ◽  
Transplant Recipients ◽  
Good Discrimination ◽  
Risk Equation ◽  
The United Kingdom ◽  
Failure Risk ◽  
Risk Patients

Abstract Background There is emerging evidence that the 4-variable Kidney Failure Risk Equation (KFRE) can be used for risk prediction of graft failure in transplant recipients. However, geographical validation of the 4-variable KFRE in transplant patients is lacking, as is whether the more extensive 8-variable KFRE improves predictive accuracy. This study aimed to validate the 4- and 8-variable KFRE predictions of the 5-year death-censored risk of graft failure in patients in the United Kingdom. Methods A retrospective cohort study involved 415 transplant recipients who had their first renal transplant between 2003 and 2015 and were under follow-up at Salford Royal NHS Foundation Trust. The KFRE risk scores were calculated on variables taken 1-year post-transplant. The area under the receiver operating characteristic curves (AUC) and calibration plots were evaluated to determine discrimination and calibration of the 4- and 8-variable KFREs in the whole cohort as well as in a subgroup analysis of living and deceased donor recipients and in patients with an eGFR< 45 ml/min/1.73m2. Results There were 16 graft failure events (4%) in the whole cohort. The 4- and 8-variable KFREs showed good discrimination with AUC of 0.743 (95% confidence interval [CI] 0.610–0.876) and 0.751 (95% CI 0.629–0.872) respectively. In patients with an eGFR< 45 ml/min/1.73m2, the 8-variable KFRE had good discrimination with an AUC of 0.785 (95% CI 0.558–0.982) but the 4-variable provided excellent discrimination in this group with an AUC of 0.817 (0.646–0.988). Calibration plots however showed poor calibration with risk scores tending to underestimate risk of graft failure in low-risk patients and overestimate risk in high-risk patients, which was seen in the primary and subgroup analyses. Conclusions Despite adequate discrimination, the 4- and 8-variable KFREs are imprecise in predicting graft failure in transplant recipients using data 1-year post-transplant. Larger, international studies involving diverse patient populations should be considered to corroborate these findings.

scholarly journals Clinical application of the GLOBE and United Kingdom‐primary biliary cholangitis risk scores in a trial cohort of patients with primary biliary cholangitis

2018 ◽  
Vol 2 (6) ◽  
pp. 683-692 ◽  
Author(s):  
Marco Carbone ◽  
Maren H. Harms ◽  
Willem J. Lammers ◽  
Tonya Marmon ◽  
Richard Pencek ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Application ◽  
Risk Scores ◽  
Primary Biliary Cholangitis

scholarly journals External Validation of UDCA Response Score in Slovak and Croatian Patients with Primary Biliary Cholangitis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jakub Gazda ◽  
Martin Janicko ◽  
Sylvia Drazilova ◽  
Ivica Grgurevic ◽  
Tajana Filipec Kanizaj ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Treatment Response ◽  
Characteristic Curve ◽  
External Validation ◽  
Response Probability ◽  
Predictive Performance ◽  
Primary Biliary Cholangitis ◽  
Discrimination Ability ◽  
Treatment Naïve ◽  
Response Score

Background. Ursodeoxycholic acid response score (URS) is a prognostic model that estimates the baseline probability of treatment response after 12 months of ursodeoxycholic acid (UDCA) therapy in patients with primary biliary cholangitis (PBC). Aim. To independently evaluate the predictive performance of the URS model. Methods. We used a cohort of Slovak and Croatian treatment-naïve PBC patients to quantify the discrimination ability using the area under receiver operating characteristic curve (AUROC) and its 95% confidence interval (CI). Furthermore, we evaluated the calibration using calibration belts. The primary outcome was treatment response after 12 months of UDCA therapy defined as values of alkaline phosphatase ≤1.67 × upper limit of normal. Results. One hundred and ninety-four patients were included. Median pretreatment age was 56 years (interquartile range 49–62). Treatment response was achieved in 79.38% of patients. AUROC of the URS was 0.81 (95% CI 0.73–0.88) and the calibration belt revealed that response rates were correctly estimated by predicted probabilities. Conclusion. Our results confirm that the URS can be used in treatment-naïve PBC patients for estimating the treatment response probability after 12 months of UDCA therapy.

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