Evidence map›Paper›PMID 38601479›Full record

ArticleJHEP reports : innovation in hepatology2024

Validation of NIAAAm-CRP criteria to predict alcohol-associated steatohepatitis on liver histology.

Rudolf E Stauber, Pierre-Emmanuel Rautou, Horia Stefanescu, Adelina Horhat, Maja Thiele, Carolin Lackner, SALVE Histopathology Group

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 9 institutions in 8 countries.

Rudolf E StauberDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Pierre-Emmanuel RautouUniversité Paris-Cité, Inserm, Centre de recherche sur l'inflammation, UMR 1149, Paris, France.
Horia StefanescuLiver Unit, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
Adelina HorhatService d'Hépato-Gastro-Entérologie, Hôpital La Pitié Salpêtrière, Paris, France.
Maja ThieleCenter for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, and Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
Carolin LacknerInstitute of Pathology, Medical University of Graz, Graz, Austria.
SALVE Histopathology Group
Medical University of Graz · ATCentre National de la Recherche Scientifique · FRHeidelberg University · DEHumanitas University · ITInserm · FRInstitutul Regional de Gastroenterologie Prof. Dr. Octavian Fodor · ROIuliu Hațieganu University of Medicine and Pharmacy · RONational and Kapodistrian University of Athens · GRUniversity of Southern Denmark · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background & Aims: In clinical practice, the diagnosis of alcohol-associated hepatitis (AH) is mostly based on non-invasive criteria, which were defined at a consensus conference by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). These criteria were recently modified by adding C-reactive protein (CRP) and termed NIAAAm-CRP criteria, which showed superior diagnostic accuracy for presence of alcohol-associated steatohepatitis (ASH) on liver histology. The aim of our study was to validate the diagnostic accuracy of both original NIAAA criteria and NIAAAm-CRP criteria for presence of ASH on liver histology in an independent cohort. Methods: Data from a large multinational cohort of 445 patients with alcohol-associated liver disease (ALD) that served to establish a novel grading and staging system of alcohol-associated liver disease were analyzed retrospectively. Diagnosis of ASH was based on presence of hepatocyte ballooning plus lobular neutrophil infiltration and established in virtual consensus meetings of multiple expert liver pathologists. Results: Complete data including CRP values were available in 346 patients. Overall diagnostic accuracy for prediction of ASH was 73% for NIAAA criteria and 77% for NIAAAm-CRP criteria. In a subgroup with suspected severe AH (MELD >20, n = 123), overall diagnostic accuracy for prediction of ASH was 69% for NIAAA criteria and 74% for NIAAAm-CRP criteria. Conclusion: Our findings confirm recent data on suboptimal diagnostic accuracy of original NIAAA criteria and validate slightly better but still suboptimal performance of NIAAAm-CRP criteria for presence of ASH. Impact and Implications: Alcohol-associated steatohepatitis (ASH) is diagnosed on liver histology but liver biopsy is not always feasible. Non-invasive diagnosis based on clinical findings has been proposed using the National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria and recently improved using NIAAAm-CRP criteria. Our findings validate slightly better but still suboptimal performance of NIAAAm-CRP criteria for the presence of histological ASH. Clinical trials of novel drugs should focus on histologically proven ASH.

Indexed as

Alcohol-associated liver diseasehistologynoninvasive

Identifiers

PMID38601479
PMCPMC11002864
OpenAlexW4392561735

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.