title: Accuracy of a predictive model for severe hepatic fibrosis or cirrhosis in chronic hepatitis C.
abstract: OBJECTIVE
  To assess the accuracy of a model in diagnosing severe fibrosis/cirrhosis in chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  The model, based on the sequential combination of the Bonacini score (BS: ALT/AST ratio, platelet count and INR) and ultrasonography liver surface characteristics, was applied to 176 patients with chronic HCV infection. Assuming a pre-test probability of 35%, the model defined four levels of post-test probability of severe fibrosis/cirrhosis: <10% (low), 10-74% (not diagnostic), 75-90% (high) and >90% (almost absolute). The predicted probabilities were compared with the observed patientso distribution according to the histology (METAVIR).
  
  
  RESULTS
  Severe fibrosis/cirrhosis was found in 67 patients (38%). The model discriminated patients in three comparable groups: 34% with a very high (>90%) or low (<10%) probability of severe fibrosis, 33% with a probability ranging from 75% to 90%, and 33% with an uncertain diagnosis (i.e., a probability ranging from 10% to 74%). The observed frequency of severe fibrosis/cirrhosis was within the predefined ranges.
  
  
  CONCLUSIONS
  The model can correctly identify 67% of patients with a high (>75%) or low (<10%) probability of cirrhosis, leaving only 33% of the patients still requiring liver biopsy.
authors.affiliation: Postgraduate School of Gastroenterology, Padiglione Granelli 3 piano, IRCCS -Ospedale Maggiore, Via F. Sforza 35, 20122 Milan, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Colli
authors.forename: Alice
authors.initials: A
authors.lastname: Colucci
authors.forename: Silvia
authors.initials: S
authors.lastname: Paggi
authors.forename: Mirella
authors.initials: M
authors.lastname: Fraquelli
authors.forename: Sara
authors.initials: S
authors.lastname: Massironi
authors.forename: Marco
authors.initials: M
authors.lastname: Andreoletti
authors.forename: Vittorio
authors.initials: V
authors.lastname: Michela
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D019934:International Normalized Ratio; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D008954:Models, Biological; D010976:Platelet Count; D011237:Predictive Value of Tests; D014463:Ultrasonography
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase