ArticleHepatology (Baltimore, Md.)2020
Primary Sclerosing Cholangitis Risk Estimate Tool (PREsTo) Predicts Outcomes of the Disease: A Derivation and Validation Study Using Machine Learning.
Article in Hepatology (Baltimore, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
86 citing papers in PubMed, 2 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- Efficacy and safety of biologics in primary sclerosing cholangitis with inflammatory bowel disease: A systematic review and meta-analysis.Hepatology communications · 2024Pooled it
- [Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Guideline
- Efficacy and safety of curcumin in primary sclerosing cholangitis: an open label pilot study.Scandinavian journal of gastroenterology · 2019Trial
- Identification of Primary Sclerosing Cholangitis: ICD-10 Code Validation and Comparison with a Large Language Model Approach.Digestive diseases and sciences · 2026Article
- Vitamin B6 predicts poor outcomes in geographically distinct populations with primary sclerosing cholangitis.Journal of hepatology · 2026Article
- Current Treatment of Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: A Comprehensive Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Review
- Association of FUT2 rs601338 Genotype with Colonic Mucosal Microbiome Composition, Post-Transplant Bacteremia, and All-Cause Mortality After Liver Transplantation for Primary Sclerosing Cholangitis: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Plasma Biomarkers of Senescence in Cholestatic Liver Disease: A Signature of Risk Stratification and Progression.Journal of gastroenterology and hepatology · 2026Article
- Artificial intelligence and digital transformation of gastroenterology and hepatology: A critical review of clinical applications and future challenges.World journal of hepatology · 2026Review
- Primary Sclerosing Cholangitis: Diagnosis, Management, and Clinical Challenges.Journal of clinical medicine · 2026Review
- Serum Anti-<italic>Saccharomyces cerevisiae</italic> Antibody Is Associated with Disease Severity in Patients with Primary Sclerosing Cholangitis.Digestive diseases (Basel, Switzerland) · 2026Article
- Gut microbiota pathways linking primary sclerosing cholangitis to colorectal cancer: theFrontiers in microbiology · 2026Article
- A retrospective evaluation of preemptive liver transplantation for bile duct dysplasia in primary sclerosing cholangitis: Balancing risks and benefits.JHEP reports : innovation in hepatology · 2025Article
- Radiomics-Based Prognostication in Primary Sclerosing Cholangitis: A Proof-of-Concept Study.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Emerging role of artificial intelligence in gastroenterology and hepatology.World journal of gastroenterology · 2025Review
- Longitudinal Comparison of Currently Used Risk Scores for Prognostication of Primary Sclerosing Cholangitis (PSC) in a Hungarian Bicenter PSC Cohort.Diagnostics (Basel, Switzerland) · 2025Article
- Machine Learning Prediction Model of Waitlist Outcomes in Patients with Primary Sclerosing Cholangitis.Transplantation direct · 2025Article
- Statin Use Is Associated With Protection Against Acute Cholangitis in Patients With Primary Sclerosing Cholangitis: A Multicenter Retrospective Cohort Study.Clinical and translational gastroenterology · 2025Article
- Primary sclerosing cholangitis.Nature reviews. Disease primers · 2025Review
- Role of Artificial Intelligence in Nanomedicine and Organ-specific Therapy: An Updated Review.Current drug targets · 2025Review
26 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
Improved methods are needed to risk stratify and predict outcomes in patients with primary sclerosing cholangitis (PSC). Therefore, we sought to derive and validate a prediction model and compare its performance to existing surrogate markers. The model was derived using 509 subjects from a multicenter North American cohort and validated in an international multicenter cohort (n = 278). Gradient boosting, a machine-based learning technique, was used to create the model. The endpoint was hepatic decompensation (ascites, variceal hemorrhage, or encephalopathy). Subjects with advanced PSC or cholangiocarcinoma (CCA) at baseline were excluded. The PSC risk estimate tool (PREsTo) consists of nine variables: bilirubin, albumin, serum alkaline phosphatase (SAP) times the upper limit of normal (ULN), platelets, aspartate aminotransferase (AST), hemoglobin, sodium, patient age, and number of years since PSC was diagnosed. Validation in an independent cohort confirms that PREsTo accurately predicts decompensation (C-statistic, 0.90; 95% confidence interval [CI], 0.84-0.95) and performed well compared to Model for End-Stage Liver Disease (MELD) score (C-statistic, 0.72; 95% CI, 0.57-0.84), Mayo PSC risk score (C-statistic, 0.85; 95% CI, 0.77-0.92), and SAP <1.5 × ULN (C-statistic, 0.65; 95% CI, 0.55-0.73). PREsTo continued to be accurate among individuals with a bilirubin <2.0 mg/dL (C-statistic, 0.90; 95% CI, 0.82-0.96) and when the score was reapplied at a later course in the disease (C-statistic, 0.82; 95% CI, 0.64-0.95). Conclusion: PREsTo accurately predicts hepatic decompensation (HD) in PSC and exceeds the performance among other widely available, noninvasive prognostic scoring systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.