Evidence map›Paper›PMID 30989464›Full record

ArticleDigestive diseases and sciences2019

Role of Spleen Stiffness Measurement by 2D-Shear Wave Elastography in Ruling Out the Presence of High-Risk Varices in Cirrhotic Patients.

Dimitrios S Karagiannakis, Theodoros Voulgaris, Evgenia Koureta, Elissavet Chloupi, George V Papatheodoridis, John Vlachogiannakos

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Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  15. Non-Invasive Risk Stratification in NAFLD/NASH Patients for Screening EGD.Clinical and experimental gastroenterology · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Dimitrios S KaragiannakisAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece. d_karagiannakis@hotmail.com.ORCID 0000-0003-0082-634X
Theodoros VoulgarisAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.
Evgenia KouretaAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.
Elissavet ChloupiAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.
George V PapatheodoridisAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.
John VlachogiannakosAcademic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimTo evaluate if spleen stiffness measurement (SSM) can rule out the presence of high-risk varices in patients with cirrhosis, avoiding an upper gastrointestinal endoscopy (UGE).

methodsWe enrolled 71 cirrhotic patients irrespective of liver disease's etiology. 2D shear wave elastography (SWE) of spleen and UGE was performed. High-risk varices (HRV) were defined as esophageal varices ≥ 5 mm and/or red spots and any gastric varices.

resultsEsophageal varices were documented in 37 (52.1%) and HRV in 25 (35.2%) patients. SSM was not technically feasible in 7/71 patients (9.8%). From the remaining 64 patients, when those with cholestatic liver disease were excluded (n = 17), SSM < 35.8 kPa was found to exclude well the existence of HRV offering an AUROC of 0.854 (p < 0.001), sensitivity 88.9%, negative predictive value (NPV) 91.3%, specificity 72.4%, and positive predictive value (PPV) 66.7%. Only 2/47 patients (4.3%) were misclassified, and 23 (48.9%) could avoid endoscopy. In the total cohort of 64 patients, SSM < 33.7 kPa was found to exclude well the presence of HRV offering AUROC 0.792 (p < 0.001), sensitivity 91.7%, specificity 60%, NPV 92.3%, and PPV 57.9%. The misclassification rate was 3.1% (2/64), while 26/64 (40.6%) could avoid endoscopy.

conclusions2D-SWE of spleen is a reliable method for ruling out the presence of HRV in cirrhotic patients. If larger studies confirm our results, a large number of endoscopies could be avoided.

Indexed as

AgedArea Under CurveElasticityElasticity Imaging TechniquesEndoscopy, GastrointestinalEsophageal and Gastric VaricesFemaleHumansLiver CirrhosisMaleMiddle AgedPredictive Value of TestsRisk FactorsROC CurveSpleenCirrhosisPortal hypertensionSpleen stiffnessVariceal bleeding

Identifiers

PMID30989464

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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.