Evidence map›Paper›PMID 40498365›Full record

Trial reportLangenbeck's archives of surgery2025

Development and validation of a nomogram for predicting the clearance of jaundice in children with biliary Atresia after Kasai portoenterostomy.

Zhengchen Lu, Zequan Ding, Ruyi Zhang, Zhongxian Zhu, Wei Li, Hua Xie, Weibing Tang

Abstract readValidation StudyRandomized Controlled Trial
In one paragraph

Trial report in Langenbeck's archives of surgery, 2025. 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
–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

1 citing paper in PubMed.

  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

7 authors.

Zhengchen LuDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Zequan DingDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Ruyi ZhangDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Zhongxian ZhuDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Wei LiDepartment of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Hua XieDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China. xiehua3955@126.com.
Weibing TangDepartment of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China. twbcn@163.com.

Funding

National Natural Science Foundation of China 82300573National Natural Science Foundation of China 82370523Postgraduate Research & Practice Innovation Program of Jiangsu Province SJCX22_0649
6 · The paper itself

Abstract

purposeKasai portoenterostomy (KPE) is a major treatment option for biliary atresia (BA). A rapid and early clearance of jaundice (CJ) following KPE is essential for a good long-term prognosis of BA. The present study aims to use the perioperative tests to create a nomogram for predicting early CJ in children with BA after KPE.

methodsA total of 123 children with BA were randomized into a training cohort (n = 87) and a testing cohort (n = 36). Based on the value of total bilirubin (TB) at 3 months after KPE, subjects were divided into CJ group and unsuccessful clearance of jaundice (UCJ) group. Stepwise univariate and multivariate analyses were performed to identify risk factors of CJ, and a nomogram was created to predict CJ at 3 months after KPE in children with BA through the multivariate logistic regression analysis. Internal validation and calibration of the nomogram were conducted in both the training and testing cohorts.

resultsAge at KPE, postoperative aspartate transaminase (AST) level at two weeks, change ratio (CR) of direct bilirubin (DB) at two weeks post-KPE and fibrosis score (F-score) at KPE were independent risk factors of CJ at 3 months after KPE in children with BA. A nomogram to predict CJ at 3 months after KPE in children with BA was plotted involving the above four risk factors, achieving area under curves (AUC) of 0.861 and 0.885 in the training cohort and validation cohort, respectively. The calibration curve and decision curve analysis (DCA) validated the acceptable diagnostic performance of the nomogram in discriminating CJ at 3 months after KPE in children with BA of both cohorts.

conclusionThis study developed and validated a nomogram incorporating four indictors, including Age at KPE, postoperative AST level at two weeks, CR of DB at two weeks post-KPE and F-score at KPE, may be useful for predicting CJ at 3 months after KPE in children with BA.

Indexed as

Biliary AtresiaJaundiceNomogramsPortoenterostomy, HepaticBilirubinChild, PreschoolFemaleHumansInfantInfant, NewbornMalePostoperative ComplicationsPredictive Value of TestsRisk FactorsTreatment OutcomeBilirubinBiliary AtresiaClearance of jaundiceKasai portoenterostomyNomogramPredict model

Identifiers

PMID40498365
PMCPMC12159121

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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.