Evidence map›Paper›PMID 41257275›Full record

ArticleWorld journal of gastroenterology2025

Development of a deep learning model for guiding treatment decisions of acute variceal bleeding in patients with cirrhosis.

Yi Xiang, Na Yang, Tian-Lei Zheng, Yi-Fei Huang, Tian-Yu Liu, De-Qiang Ma, Sheng-Juan Hu, Wen-Hui Zhang, Hui-Ling Xiang, Li-Yao Zhang and 38 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
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Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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48 authors.

Yi XiangLiver Disease Center of Integrated Traditional Chinese and Western Medicine, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging and Interventional Radiology (Southeast University), Nanjing 210009, Jiangsu Province, China.
Na YangThe Engineering Research Center of Intelligent Theranostics Technology and Instruments, Ministry of Education, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China.
Tian-Lei ZhengArtificial Intelligence Unit, Department of Medical Equipment Management, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China.
Yi-Fei HuangDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
Tian-Yu LiuDepartment of Gastroenterology, Suining Central Hospital, Suining 629000, Sichuan Province, China.
De-Qiang MaDepartment of Infectious Diseases, Hubei Provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China.
Sheng-Juan HuPeople's Hospital of Ningxia Hui Autonomous Region (Ningxia Medical University Affiliated People's Hospital of Autonomous Region), Yinchuan 750004, Ningxia Hui Autonomous Region, China.
Wen-Hui ZhangDepartment of Digestive System, Beijing Daxing District People's Hospital, Beijing 102600, China.
Hui-Ling XiangDepartment of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Tianjin 300170, China.
Li-Yao ZhangCHESS Center, The Sixth People's Hospital of Shenyang, Shenyang 110006, Liaoning Province, China.
Li-Li YuanDepartment of Gastroenterology, Shanxi Bethune Hospital, Taiyuan 030032, Shanxi Province, China.
Xing WangDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
Tong DangInner Mongolia Institute of Digestive Diseases, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of science and technology, Baotou 014010, Inner Mongolia Autonomous Region, China.
Guo ZhangThe People's Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Bin WuDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
Li-Jun PengDepartment of Gastroenterology, Linyi People's Hospital, Linyi 276003, Shandong Province, China.
Min GaoDepartment of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
Dong-Li XiaDepartment of Gastroenterology, Chongqing University Fuling Hospital, Chongqing 408000, China.
Zhen-Bei LiuDepartment of Gastroenterology, Chongqing University Fuling Hospital, Chongqing 408000, China.
Jia LiDepartment of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin 300192, China.
Ying SongDepartment of Gastroenterology, Xi'an GaoXin Hospital, Xi'an 710075, Shaanxi Province, China.
Xi-Qiao ZhouDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Xing-Si QiDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China.
Jing ZengDepartment of Emergency, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou 516000, Guangdong Province, China.
Xiao-Yan TanDepartment of Gastroenterology, Maoming People's Hospital, Maoming 525000, Guangdong Province, China.
Ming-Ming DengDepartment of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Hai-Ming FangDepartment of Gastroenterology and Hepatology, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
Sheng-Lin QiDepartment of Hepatology, Dalian Sixth People's Hospital, Dalian 116031, Liaoning Province, China.
Song HeDepartment of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
Yong-Feng HeDepartment of Gastroenterology, Endoscopic Center, Ankang Central Hospital, Ankang 725000, Shaanxi Province, China.
Bin YeDepartment of Gastroenterology, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China.
Wei WuDepartment of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
Jiang-Bo ShaoDepartment of Liver Disease, The Third People's Hospital of Zhenjiang, Zhenjiang 212000, Jiangsu Province, China.
Wei WeiDepartment of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China.
Jian-Ping HuDepartment of Gastroenterology, First People's Hospital of Yinchuan City, Yinchuan 750001, Ningxia Hui Autonomous Region, China.
Xin YongDepartment of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610000, Sichuan Province, China.
Chao-Hui HeDepartment of Gastroenterology and Endoscopy, The Fifth affiliated Zhuhai Hospital of Zunyi Medical University, Zhuhai 519000, Guangdong Province, China.
Jin-Lun BaoDepartment of Gastroenterology, Shannan People's Hospital, Shannan 856000, Tibet Autonomous Region, China.
Yue-Ning ZhangCenter of Hepatology and Gastroenterology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China.
Rui JiDepartment of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
Yang BoDepartment of Hepatobiliary Surgery, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750000, Ningxia Hui Autonomous Region, China.
Wei YanDepartment of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
Hong-Jiang LiDepartment of Hepatology, Baoding People's Hospital, Baoding 071000, Hebei Province, China.
Sheng-Li LiClinical Research Institute, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China.
Shi GengArtificial Intelligence Unit, Department of Medical Equipment Management, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China.
Lei ZhaoArtificial Intelligence Unit, Department of Medical Equipment Management, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China.
Bin LiuThe Engineering Research Center of Intelligent Theranostics Technology and Instruments, Ministry of Education, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China.
Xiao-Long QiLiver Disease Center of Integrated Traditional Chinese and Western Medicine, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging and Interventional Radiology (Southeast University), Nanjing 210009, Jiangsu Province, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute variceal bleeding (AVB) in patients with cirrhosis remains life-threatening; moreover, the current risk stratification methods have certain limitations. Rebleeding and mortality after AVB remain major challenges. Although preemptive transjugular intrahepatic portosystemic shunt (p-TIPS) can improve outcomes, not all patients benefit equally. Accurate risk stratification is needed to guide treatment decisions and identify those most likely to benefit from p-TIPS.

aimTo develop an artificial intelligence (AI)-driven model to guide AVB treatment decisions, and identify candidates eligible for p-TIPS.

methodsPatients with cirrhosis and AVB, from two multicenter retrospective cohorts in China, who received endoscopic variceal ligation plus pharmacotherapy (

resultsThe AI-AVB model demonstrated superior predictive performance compared to traditional risk stratification methods. In the internal validation cohort, the model achieved an area under the curve (AUC) of 0.842 for predicting six-week treatment failure and 0.954 for one-year mortality. In the external validation cohort, the AUCs were 0.814 and 0.889, respectively. The model effectively identified patients at high risk of first-line treatment failure who may benefit from aggressive interventions such as p-TIPS. In contrast, advancing the treatment strategy for low-risk patients did not notably improve the short-term prognosis.

conclusionThe AI-AVB model can predict treatment outcomes, stratify the failure risk in cirrhotic patients with AVB, aid in clinical decisions, identify p-TIPS beneficiaries, and optimize personalized treatment strategies.

Indexed as

Clinical Decision-MakingDeep LearningEsophageal and Gastric VaricesGastrointestinal HemorrhageLiver CirrhosisAcute DiseaseAgedChinaFemaleHumansLigationMaleMiddle AgedPortasystemic Shunt, Transjugular IntrahepaticRecurrenceRetrospective StudiesAcute variceal bleedingDeep learningEndoscopic therapyLiver cirrhosisPreemptive transjugular intrahepatic portosystemic shuntRisk stratification

Identifiers

PMID41257275
PMCPMC12620769

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