ArticleHepatology communications2023
Development and clinical validation of a novel algorithmic score (GAAD) for detecting HCC in prospective cohort studies.
Article in Hepatology communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06601231 (Addition of GAAD Score to Imaging Surveillance for Early Identification of Liver Cancer.), which is not on this map. Cited by 42 papers, 1 of them a synthesis 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.
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.
Addition of GAAD Score to Imaging Surveillance for Early Identification of Liver Cancer.
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations.The Medical journal of Australia · 2025Guideline
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- National guideline for hepatitis B elimination in Thailand: a decentralized health system model for expanding diagnosis and treatment.Hepatology international · 2026Article
- Diagnostic performance of GAAD, PIVKA-II and AFP in hepatocellular carcinoma, chronic liver disease and healthy population: evidence from a Malaysian cohort.BMC gastroenterology · 2026Article
- Serum Midkine as a Biomarker for Hepatocellular Carcinoma Treatment Response and Prognostication.Journal of clinical laboratory analysis · 2026Article
- Machine learning-driven evaluation of protein kinase D3 as a co-diagnostic biomarker in hepatocellular carcinoma.Journal of Zhejiang University. Science. B · 2026Article
- Hepatocellular carcinoma surveillance-is it time to update clinical practice?Hepatobiliary surgery and nutrition · 2026Article
- Development of a longitudinal predictive model for hepatocellular carcinoma occurrence in patients with chronic hepatitis B.Scientific reports · 2026Article
- Comparative analysis of the predictive value of the ASAP model and the GAAD model for liver cancer high risk cohorts.Scientific reports · 2026Article
- Surgery-centered integrated strategies for personalized hepatocellular carcinoma care.Cancer biology & medicine · 2026Review
- Psychosocial impact of false-positive surveillance for hepatocellular carcinoma: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Comparison of diagnostic performance of GAAD, GALAD, and ASAP scores for detecting hepatocellular carcinoma in advanced liver fibrosis patients.Advances in laboratory medicine · 2026Article
- [Expert consensus on the management process within medical institutions for patients with hepatitis B virus infection].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Economic evaluation of biomarker-based surveillance for Hepatocellular Carcinoma in Thai patients with Compensated Liver Cirrhosis.PloS one · 2026Article
- HCC predictors in routine practice for patients with chronic liver diseases: Correspondence to editorial on "High SAFE scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
- Protein Induced by Vitamin K Absence or Antagonist II in Primary Liver Cancer: Basic Research Insights and Clinical Applications.Journal of clinical and translational hepatology · 2025Review
- Utility of Biomarker Panels in the Surveillance and Monitoring of Hepatocellular Carcinoma: Consensus Statements from an International Delphi Panel.Liver cancer · 2025Article
- China Liver Cancer Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2024 Edition).Liver cancer · 2025Article
- Performance of GAAD and GALAD Biomarker Panels for HCC Detection in Patients with MASLD or ALD Cirrhosis.Cancers · 2025Article
- Early screening for liver cancer must be performed.World journal of hepatology · 2025Review
Corrections and comments
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Authors and funding
15 authors at 12 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP), also known as protein induced by vitamin K absence-II (PIVKA-II [DCP]) are biomarkers for HCC with limited diagnostic value when used in isolation. The novel GAAD algorithm is an in vitro diagnostic combining PIVKA-II (DCP) and AFP measurements, age, and gender (biological sex) to generate a semi-quantitative result. We conducted prospective studies to develop, implement, and clinically validate the GAAD algorithm for differentiating HCC (early and all-stage) and benign chronic liver disease (CLD), across disease stages and etiologies.
methodsPatients aged ≥18 years with HCC or CLD were prospectively enrolled internationally into algorithm development [n = 1084; 309 HCC cases (40.7% early-stage) and 736 controls] and clinical validation studies [n = 877; 366 HCC cases (47.6% early-stage) and 303 controls]. Serum samples were analyzed on a cobas® e 601 analyzer. Performance was assessed using receiver operating characteristic curve analyses to calculate AUC.
resultsFor algorithm development, AUC for differentiation between early-stage HCC and CLD was 90.7%, 84.4%, and 77.2% for GAAD, AFP, and PIVKA-II, respectively. The sensitivity of GAAD for the detection of early-stage HCC was 71.8% with 90.0% specificity. Similar results were shown in the clinical validation study; AUC for differentiation between early-stage HCC and CLD was 91.4% with 70.1% sensitivity and 93.7% specificity. GAAD also showed strong specificity, with a lower rate of false positives regardless of disease stage, etiology, or region.
conclusionsThe GAAD algorithm significantly improves early-stage HCC detection for patients with CLD undergoing HCC surveillance. Further phase III and IV studies are warranted to assess the utility of incorporating the algorithm into clinical practice.
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