Evidence map›Paper›PMID 38615137›Full record

ArticleScientific reports2024

An explainable machine learning model for prediction of high-risk nonalcoholic steatohepatitis.

Basile Njei, Eri Osta, Nelvis Njei, Yazan A Al-Ajlouni, Joseph K Lim

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07305324 (Validation of an AI Tool for Improving MASLD Advanced Liver Fibrosis Diagnosis in Primary Care), which is not on this map. Cited by 42 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 2 pooled it
15.5field-weighted citation impact, top 1% 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.

NCT07305324 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Validation of an AI Tool for Improving MASLD Advanced Liver Fibrosis Diagnosis in Primary Care: A Provider-Level Crossover Randomized Controlled Trial Pilot

TypeinterventionalSponsorYale UniversityRan2026 to 2027Enrolled40ConditionsMASLD, Fibrosis of LiverArmsFibroX, Usual Care
3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

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  4. A conceptual framework for measuring AI health equity.International journal for equity in health · 2026
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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

5 authors at 5 institutions in 2 countries.

Basile NjeiSection of Digestive Diseases, Yale School of Medicine, New Haven, CT, 06510, USA.
Eri OstaUniversity of Texas Health San Antonio, San Antonio, TX, 78229, USA.
Nelvis NjeiCenters for Medicare and Medicaid Services, Baltimore, MD, USA.
Yazan A Al-AjlouniSchool of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Joseph K LimSection of Digestive Diseases, Yale School of Medicine, New Haven, CT, 06510, USA. joseph.lim@yale.edu.
Centers for Medicare and Medicaid Services · USNew York Medical College · USThe University of Texas Health Science Center at San Antonio · USUniversity of Oxford · GBYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Liver CenterP30DK034989 · NIDDK · YALE UNIVERSITY · PI YASUKO IWAKIRI · 1986 to 2026
$31.1M
NRSA Training CoreTL1TR001864 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$9.9M
NCATS NIH HHS TL1 TR001864NCATS NIH HHS UL1 TR001863NIDDK NIH HHS P30 DK034989
6 · The paper itself

Abstract

Early identification of high-risk metabolic dysfunction-associated steatohepatitis (MASH) can offer patients access to novel therapeutic options and potentially decrease the risk of progression to cirrhosis. This study aimed to develop an explainable machine learning model for high-risk MASH prediction and compare its performance with well-established biomarkers. Data were derived from the National Health and Nutrition Examination Surveys (NHANES) 2017-March 2020, which included a total of 5281 adults with valid elastography measurements. We used a FAST score ≥ 0.35, calculated using liver stiffness measurement and controlled attenuation parameter values and aspartate aminotransferase levels, to identify individuals with high-risk MASH. We developed an ensemble-based machine learning XGBoost model to detect high-risk MASH and explored the model's interpretability using an explainable artificial intelligence SHAP method. The prevalence of high-risk MASH was 6.9%. Our XGBoost model achieved a high level of sensitivity (0.82), specificity (0.91), accuracy (0.90), and AUC (0.95) for identifying high-risk MASH. Our model demonstrated a superior ability to predict high-risk MASH vs. FIB-4, APRI, BARD, and MASLD fibrosis scores (AUC of 0.95 vs. 0.50, 0.50, 0.49 and 0.50, respectively). To explain the high performance of our model, we found that the top 5 predictors of high-risk MASH were ALT, GGT, platelet count, waist circumference, and age. We used an explainable ML approach to develop a clinically applicable model that outperforms commonly used clinical risk indices and could increase the identification of high-risk MASH patients in resource-limited settings.

Indexed as

Elasticity Imaging TechniquesNon-alcoholic Fatty Liver DiseaseAdultArtificial IntelligenceHumansMachine LearningNutrition Surveys

Identifiers

PMID38615137
PMCPMC11016071
OpenAlexW4394784534

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.