Evidence map›Paper›PMID 35677505›Full record

ArticleJournal of clinical and experimental hepatology

Application of Noninvasive Tools to Decide the Need for Beta-Blockers for Variceal Bleeding Prophylaxis in Compensated Advanced Liver Disease: A Decision Curve Analysis.

Samagra Agarwal, Sanchit Sharma, Ankur Jindal, Sushrut Singh, Rakesh Jagdish, Deepak Gunjan, Shiv K Sarin, Anoop Saraya

Open access · bronzeAbstract read
In one paragraph

Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 53% of its field
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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Samagra AgarwalDepartment of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110026, India.
Sanchit SharmaDepartment of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110026, India.
Ankur JindalDepartment of Hepatology and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Sushrut SinghDepartment of Hepatology and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Rakesh JagdishDepartment of Hepatology and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Deepak GunjanDepartment of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110026, India.
Shiv K SarinDepartment of Hepatology and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Anoop SarayaDepartment of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110026, India.
All India Institute of Medical Sciences · INInstitute of Liver and Biliary Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and aims: Noninvasive tools (NITs) reliably categorise patients with compensated advanced chronic liver disease (cACLD) into high-risk and low-risk group for harbouring varices needing treatment. Here, we assess the ability of these NITs to predict the need for nonselective beta-blockers at baseline based on risk of variceal bleeding (VB) on follow-up. Methods: This was a retrospective multicentre analysis of patients with cACLD categorised at baseline into different risk groups by NITs (Baveno-VI, expanded Baveno-VI, platelet-albumin, platelet-model for end-stage liver disease (MELD) and anticipate study platelet criteria) and by endoscopy (high risk vs low risk/no varices). VB event rates on follow-up were estimated in different risk strata. Decision curve analysis (DCA) was used to estimate the benefit of administering nonselective beta-blockers (NSBB) using NITs over endoscopic classification at different threshold probabilities of VB event rates and estimating the number needed to treat (NNT) to identify one additional bleeder over endoscopy. Results: A total of 1284 patients (mean age: 44.7 ± 13.5 years, 72.4% males) of hepatitis B (29.2%), nonalcoholic fatty liver disease (24.9%), hepatitis C (20.1%), and alcohol (17.5%)-related cACLD were included with 323 (25.2%) having high-risk varices. Ninety-eight (7.6%) patients developed VB over a median follow-up of 20 (9-35) months. The 1-year and 3-year rate of VB with all NITs was 5.7-7.4% and 13.2-16.4% among high-risk and 0-2.3% and 0-5% among low-risk subgroups, respectively ( Conclusions: The use of both elastography and blood-based NITs at baseline can accurately identify the need for NSBB for VB prophylaxis in patients of cACLD on follow-up.

Indexed as

Baveno-VIcACLD, Compensated advanced chronic liver diseaseDCA, Decision curve analysisdecision thresholdsEBL, Endoscopic band ligationHCC, Hepatocellular carcinomaHE, Hepatic encephalopathyHRVs, High risk varicesLRVs, Low risk varicesLSM, Liver stiffness measurementNITs, Non-invasive toolsNNT, Number needed to treatnoninvasive toolsNSBB, Non-selective beta blockersPVT, Portal venous thrombosisvariceal bleedingvarices needing treatmentVB, Variceal bleedingVNT, Varices needing treatment

Identifiers

PMID35677505
PMCPMC9168689
OpenAlexW3202213683

What OpenQuestion holds

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Registered trials

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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.