title: Diagnosis of Chronic Pancreatitis Incorporating Endosonographic Features, Demographics, and Behavioral Risk.
abstract: Diagnosing chronic pancreatitis remains challenging. Endoscopic ultrasound (EUS) is utilized to evaluate pancreatic disease. Abnormal pancreas function test is considered the "nonhistologic" criterion standard for chronic pancreatitis. We derived a prediction model for abnormal endoscopic pancreatic function test (ePFT) by enriching EUS findings with patient demographic and pancreatitis behavioral risk characteristics.
  
  
  
  Demographics, behavioral risk characteristics, EUS findings, and peak bicarbonate results were collected from patients evaluated for pancreatic disease. Abnormal ePFT was defined as peak bicarbonate of less than 75 mEq/L. We fit a logistic regression model and converted it to a risk score system. The risk score was validated using 1000 bootstrap simulations.
  
  
  
  A total of 176 patients were included; 61% were female with median age of 48 years (interquartile range, 38-57 years). Abnormal ePFT rate was 39.2% (69/176). Four variables formulated the risk score: alcohol or smoking status, number of parenchymal abnormalities, number of ductal abnormalities, and calcifications. Abnormal ePFT occurred in 10.7% with scores 4 or less versus 92.0% scoring 20 or greater. The model C-statistic was 0.78 (95% confidence interval, 0.71-0.85).
  
  
  
  Number of EUS pancreatic duct and parenchymal abnormalities, presence of calcification, and smoking/alcohol status were predictive of abnormal ePFT. This simple model has good discrimination for ePFT results.
authors.affiliation: From the *Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA; †Department of Clinical Research, CareFusion, San Diego, CA; and ‡Division of Gastroenterology, Hepatology, and Nutrition, Ohio State University Medical Center, Columbus, OH.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Lee
authors.forename: Ying P
authors.initials: YP
authors.lastname: Tabak
authors.forename: Vivek
authors.initials: V
authors.lastname: Kadiyala
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Sun
authors.forename: Shadeah
authors.initials: S
authors.lastname: Suleiman
authors.forename: Richard S
authors.initials: RS
authors.lastname: Johannes
authors.forename: Peter A
authors.initials: PA
authors.lastname: Banks
authors.forename: Darwin L
authors.initials: DL
authors.lastname: Conwell
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010186:Pancreatic Function Tests / Q000379:methods; D010189:Pancreatic Juice / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors; D012907:Smoking