Validation of original, expanded Baveno VI, and stepwise & platelet-MELD criteria to rule out varices needing treatment in compensated cirrhosis from various etiologies

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(A) The relative levels of miR-124a between the control group and the LPS, miR-124a mimic, and miR-124a inhibitor groups treated with 500ng/mL LPS, as determined by qRT-PCR analysis, were compared in U937 cells and HepG2 cells. (B) The relative expressions of GRα mRNA between the control group and the LPS, miR-124a mimic, and miR-124a inhibitor groups treated with 500ng/mL LPS, as determined by qRT-PCR analysis, were compared in U937 cells and HepG2 cells. (C, D) Representative western blot bands showing the expressions of GRα, normalized to β-actin as an internal control, after transfection and LPS treatments in U937 cells and HepG2 cells. The symbol * indicates P<0.05, and the symbol ** indicates P<0.01 between groups." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Xin Wang, Hongrui Xu, Yadong Wang, Chuan Shen, Luyuan Ma, Caiyan Zhao" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Xin" "apellidos" => "Wang" ] 1 => array:2 [ "nombre" => "Hongrui" "apellidos" => "Xu" ] 2 => array:2 [ "nombre" => "Yadong" "apellidos" => "Wang" ] 3 => array:2 [ "nombre" => "Chuan" "apellidos" => "Shen" ] 4 => array:2 [ "nombre" => "Luyuan" "apellidos" => "Ma" ] 5 => array:2 [ "nombre" => "Caiyan" "apellidos" => "Zhao" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119322410?idApp=UINPBA00004N" "url" => "/16652681/0000001900000002/v1_202003030740/S1665268119322410/v1_202003030740/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1665268119322380" "issn" => "16652681" "doi" => "10.1016/j.aohep.2019.08.004" "estado" => "S300" "fechaPublicacion" => "2020-03-01" "aid" => "132" "copyright" => "Fundación Clínica Médica Sur, A.C." "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Ann Hepatol. 2020;19:204-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 118 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 67 "PDF" => 43 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "The relative expression of hepatocellular and cholestatic liver enzymes in adult patients with liver disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "204" "paginaFinal" => "208" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Iluz-Freundlich, Manna Zhang, Julia Uhanova, Gerald Y. Minuk" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Iluz-Freundlich" ] 1 => array:2 [ "nombre" => "Manna" "apellidos" => "Zhang" ] 2 => array:2 [ "nombre" => "Julia" "apellidos" => "Uhanova" ] 3 => array:2 [ "nombre" => "Gerald Y." "apellidos" => "Minuk" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119322380?idApp=UINPBA00004N" "url" => "/16652681/0000001900000002/v1_202003030740/S1665268119322380/v1_202003030740/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Validation of original, expanded Baveno VI, and stepwise & platelet-MELD criteria to rule out varices needing treatment in compensated cirrhosis from various etiologies" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "209" "paginaFinal" => "213" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Siwanon Nawalerspanya, Pimsiri Sripongpun, Naichaya Chamroonkul, Chanon Kongkamol, Teerha Piratvisuth" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Siwanon" "apellidos" => "Nawalerspanya" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Pimsiri" "apellidos" => "Sripongpun" "email" => array:1 [ 0 => "spimsiri@medicine.psu.ac.th" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Naichaya" "apellidos" => "Chamroonkul" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Chanon" "apellidos" => "Kongkamol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Teerha" "apellidos" => "Piratvisuth" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Research Unit of Holistic Health and Safety Management in Community, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1133 "Ancho" => 1508 "Tamanyo" => 107271 ] ] "descripcion" => array:1 [ "en" => "Study population." ] ] ] "textoCompleto" => "1IntroductionCirrhosis, late-stage fibrosis caused by chronic inflammation of the liver, is a common problem in general practice. It can be diagnosed by clinical suspicion plus imaging findings compatible with cirrhosis <a class="elsevierStyleCrossRefs" href="#bib0160">[1–3]</a>, or liver biopsy <a class="elsevierStyleCrossRef" href="#bib0170">[3]</a>. The significant and fatal complications of cirrhosis are portal hypertension, end-stage liver failure, and hepatocellular carcinoma. A recent study showed that cirrhosis is the 13th leading cause of death globally <a class="elsevierStyleCrossRef" href="#bib0175">[4]</a>. The risk of variceal bleeding (esophageal varices (EV) and/or gastric varices (GV)) is 5–15% per year in cirrhotic patients <a class="elsevierStyleCrossRef" href="#bib0180">[5]</a>, and the mortality rate is at least 20% at 6 weeks after a bleeding episode <a class="elsevierStyleCrossRef" href="#bib0185">[6]</a>. Nonetheless, EV can be screened and early intervention can be provided to patients with varices needing treatment (VNT) before a bleeding episode occurs. The gold standard procedure for the diagnosis of VNT is esophagogastroduodenoscopy (EGD). Traditionally, it is recommended that all cirrhotic patients should undergo EGD surveillance for varices at the time of diagnosis <a class="elsevierStyleCrossRef" href="#bib0190">[7]</a>, in which 6–12% of VNT is expected to be seen in compensated cirrhotic patients.Despite it being the standard recommendation, EGD is an invasive procedure which carries the risk of uncommon but significant complications, such as pain, bleeding, and perforation. Moreover, it needs to be performed by well-trained healthcare providers in well-equipped centers.In 2015, the international consensus meeting on portal hypertension published the “BAVENO VI recommendation” <a class="elsevierStyleCrossRef" href="#bib0195">[8]</a>. The non-invasive screening method that uses the liver stiffness measurement (LSM) combined with platelet count was introduced with this recommendation in order to avoid unnecessary EGDs. The Baveno VI criteria were validated in subsequent studies showing <5% missed VNT and thus sparing 11–39% EGD <a class="elsevierStyleCrossRefs" href="#bib0200">[9–12]</a>. Later in 2017, the expanded Baveno VI and stepwise platelet-MELD criteria were proposed in order to spare more EGDs while balancing the risk of missed VNT <a class="elsevierStyleCrossRefs" href="#bib0220">[13,14]</a>. This study aims to validate these 3 criteria (the Baveno VI, the expanded Baveno VI, and the stepwise platelet-MELD criteria) in compensated cirrhotic patients from various etiologies.2Materials and methodsWe conducted a single center, cross-sectional study at our institute, which is a tertiary care center. We included all adult (age≥18 years old) compensated cirrhotic patients who underwent routine EGD for EV surveillance at our endoscopic centers between January 2014 and October 2018 and had transient elastography (TE) performed within 6 months of EGD. Exclusion criteria were: (1) patients with a history of decompensation episode(s) e.g. Child–Pugh C cirrhosis, or Child–Pugh B cirrhosis with ascites/variceal hemorrhage/hepatic encephalopathy, (2) coexisting liver tumor during the study period, (3) patients who had limitations to undergo and/or interpret the results of TE i.e. congestive heart failure, ascites, abdominal wound at the TE examination site, aminotransferase levels≥5 times of upper normal limit <a class="elsevierStyleCrossRefs" href="#bib0230">[15–17]</a>, total bilirubin ≥2mg/dL, narrow intercostal spaces, and patients with a body mass index (BMI)≥25mg/m2 in whom size M probe was used in TE <a class="elsevierStyleCrossRef" href="#bib0245">[18]</a>, (4) patients whose TE validity criteria <a class="elsevierStyleCrossRefs" href="#bib0250">[19,20]</a> were not met (success rate >60%, and an IQR <30%), and (5) no available laboratory data for calculating all 3 criteria within 6 months of endoscopy. All transient elastography was performed with a Fibroscan® (Echosens, France). TE was performed by trained doctors at the right lobe of the liver after patients had fasted for at least 2h.The criteria validated in this study were the Baveno VI (original Baveno VI), the expanded Baveno VI, and the stepwise platelet-MELD criteria, which defined patients with a low risk of having VNT as follows:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">-Original Baveno VI<a class="elsevierStyleCrossRef" href="#bib0195">[8]</a>: liver stiffness measurement (LSM)<20kPa (determined by TE) and a platelet count >150,000/mm3</li><li class="elsevierStyleListItem" id="lsti0010">-Expanded Baveno VI<a class="elsevierStyleCrossRef" href="#bib0220">[13]</a>: liver stiffness measurement (LSM) <25kPa (determined by TE) and a platelet count >110,000/mm3</li><li class="elsevierStyleListItem" id="lsti0015">-Stepwise platelet-MELD<a class="elsevierStyleCrossRef" href="#bib0225">[14]</a>: platelet>150,000/mm3 or platelet≤150,000/mm3 but MELD=6.</li></ul>Varices needing treatment (VNT) is defined as the presence of EV≥F2, or EV of any size with high-risk stigmata, or any size of GV on EGD. Cirrhosis was diagnosed by imaging (ultrasonography, computed tomography, magnetic resonance imaging) or liver biopsy.The study protocol was approved by the Institutional Human Research Ethics Committee (HREC). The study protocol was approved in 2017, and we collected patients' data from 2014 to 2018. Hence, for patients who underwent EGD for EV surveillance in 2014–2016, we retrospectively collected the endoscopic reports, transient elastography, and laboratory data and the informed consent was waived; for the patients who underwent EGD in 2017–2018, all the data were prospectively collected, and all the patients who were enrolled in 2017–2018 (after the study protocol was approved by the HREC) provided informed consent before participating in the study.2.1Statistical analysisSample size calculation was based on the sample size estimation in diagnostic test studies of biomedical informatics <a class="elsevierStyleCrossRef" href="#bib0260">[21]</a>. A total of 106 patients were calculated with a significance level of 0.05, yielding an 80% power to detect 99% sensitivity in the Baveno VI criteria for ruling out VNT with a precision of 0.06. Statistical analysis was performed using program R version 3.4.4. Descriptive statistics were used for baseline demographic data. Quantitative measurements were shown as mean±SD or median with IQR according to the distribution of observed values. Categorical variables were expressed using numbers and percentages. The diagnostic performance of the Baveno VI, the expanded Baveno VI, and the stepwise platelet-MELD criteria, including sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV), were reported as percentages. Using the Baveno VI criteria as a reference, Sn and Sp of the remaining 2 criteria were compared with the original Baveno VI using McNemar chi-square test, and the relative predictive value method <a class="elsevierStyleCrossRef" href="#bib0265">[22]</a> was used in the comparisons of PPVs and NPVs. A p-Value <0.05 was considered statistically significant.3Results3.1Baseline characteristics and prevalence of VNTDuring the study period, 177 cirrhotic patients were assessed for eligibility; 49 patients were excluded according to the exclusion criteria (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). A total of 128 patients were included in this study. Baseline characteristics of eligible patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Sixty percent were male, with a mean age of 57.4 years old, and all were in Child–Pugh A. The major etiologies of cirrhosis were chronic viral hepatitis C (HCV) and B (HBV) infection (37.5% and 32.8%, respectively). The other etiologies from <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> comprise Wilson disease (n=1), autoimmune hepatitis (AIH) (n=7), and cryptogenic (n=2). For the patients with >1 etiology, most had viral hepatitis as follows: HBV-HCV co-infection (n=3), HBV+alcohol (n=3), HCV+alcohol (n=3), HBV+non-alcoholic fatty liver disease (NAFLD) (n=2), HCV+NAFLD (n=2), HBV+AIH in 1 patient, and NAFLD+AIH in 1 patient. VNT was identified in 10 patients (7.8%).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>In comparison, patients with VNT included a higher number of the male gender, chronic hepatitis C as the etiology, a higher liver stiffness, aspartate aminotransferase (AST) to Platelet Ratio (APRI), and Fibrosis-4 (FIB-4) scores, and a lower platelet count (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).3.2Diagnostic performances of the original Baveno VI, expanded Baveno VI, and stepwise platelet-MELD criteriaSensitivity, specificity, PPV, NPV, accuracy, number of endoscopies that could be avoided, and missed VNT of all 3 criteria are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. The NPVs to exclude VNT were higher than 95% in all criteria.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In comparison with the original Baveno VI criteria, both the expanded Baveno VI and stepwise platelet-MELD criteria provided a significantly better specificity (61.86% and 59.32% vs 41.53%, p<0.001 for both comparisons), the expanded Baveno VI yielded a significantly better PPV (p=0.03), and the PPV in the stepwise platelet-MELD criteria were numerically higher as well, but a statistically significant level was not reached (p=0.08). The sensitivities and NPVs were comparable. The expanded Baveno VI and the stepwise platelet-MELD criteria could spare more endoscopies than the original criteria (58.59%, 56.25%, and 39.06%, respectively), and the number of missed VNT were low in all criteria.4DiscussionIn the management of cirrhotic patients, the criteria for ruling out VNT are of interest from the aspect of non-invasive techniques, and it is possible to provide a basic screening step for general practitioners before referring patients to endoscopic centers. There are many non-invasive tests for the detection of VNT in the literature, including blood tests, liver and/or spleen stiffness measurement, and imaging characteristics, or a combination of the aforementioned parameters <a class="elsevierStyleCrossRefs" href="#bib0270">[23–25]</a>. In this study, we focused on the original Baveno VI, the expanded Baveno VI, and stepwise platelet-MELD criteria.In the present study, we found that the original Baveno VI criteria could be used to rule out VNT in compensated cirrhotic patients with a sensitivity of 90% and a satisfactorily high NPV of 98%. Endoscopic surveillance could have been avoided in 39% of the patients if the original Baveno VI criteria were used to categorize patients prior to sending them for an EGD surveillance. The result of this approach is concordant with other published studies <a class="elsevierStyleCrossRefs" href="#bib0200">[9–14,26–28]</a> in which missed VNTs in the Baveno VI criteria were consistently lower than 5%, and spared endoscopies were observed in 11.3–39%.However, it has come to our attention that whether we can spare more endoscopies without increasing the number of missed VNTs. Augustin et al. <a class="elsevierStyleCrossRef" href="#bib0220">[13]</a> proposed the expanded Baveno VI in late 2017 with different cut-off levels for LSM and platelet count as mentioned earlier. This approach could double the number of endoscopies spared from 21.5 to 40%, while missed VNTs were almost identical. In our study, the expanded Baveno VI criteria provided a significantly better specificity and PPV compared with the original Baveno VI criteria, while the NPVs were comparable (97.33% vs 98%, p=0.65), and the number of endoscopies that could have been spared was almost 60%. Other studies to validate the expanded criteria in some specific groups of patients were recently published. Petta et al. <a class="elsevierStyleCrossRef" href="#bib0295">[28]</a> validated this approach in only NAFLD patients. Missed VNTs were observed in 3.8–4.4%, and the endoscopies that could be spared in 58%, while in the study of Moctezuma-Velazquez et al. <a class="elsevierStyleCrossRef" href="#bib0290">[27]</a>, the false negative rate was 6% in 147 primary biliary cholangitis (PBC) patients. Bae et al. <a class="elsevierStyleCrossRef" href="#bib0285">[26]</a> found that in their Asian cohort, the missed VNT using the expanded Baveno VI criteria were high in HBV, alcoholic, and NAFLD cirrhotic patients (7.5%, 8%, and 6.7%, respectively). Nevertheless, it is important to note that the VNT in compensated advanced chronic liver disease in the study by Bae et al. was 19.5%, which exceeded the number of expected VNT 6–12% in compensated cirrhotic patients <a class="elsevierStyleCrossRef" href="#bib0190">[7]</a>. Our study results are concordant with other studies in the fact that more endoscopies could be spared by using the expanded Baveno VI criteria. However, larger studies are required in order to aid in the decision of whether we should use this approach to rule out VNT in terms of missed VNT rates.In contrast, both the original and expanded Baveno VI criteria necessitate LSM to categorize patients into low-risk or high-risk of having VNT. Despite its advantages of being non-invasive, easy to perform and interpret, LSM requires a specific device, which the cost might be outrageous to many centers, and failure to attain the measurements was reported in some groups of patients. In early 2017, Jangouk et al. published a study validating the Baveno VI criteria, as well as the proposed stepwise platelet-MELD criteria <a class="elsevierStyleCrossRef" href="#bib0210">[11]</a>, in which LSM was not required, showing that the stepwise platelet-MELD criteria performed as well as the Baveno VI in NPVs, sensitivity, and endoscopies spared. We are interested in this approach as it might be a simple and useful way for general practitioners to screen for cirrhotic patients with a low risk of having VNT. In our study, the stepwise platelet-MELD criteria yielded not only comparably high NPVs compared with the original Baveno VI criteria (97.22% vs 98%, p=0.60), but also a higher specificity (59.32% vs 41.53%, p<0.001), a larger number of endoscopies that could have been spared (56% vs 39%). To date, the stepwise platelet-MELD criteria have been validated in only one study prior to our study <a class="elsevierStyleCrossRef" href="#bib0290">[27]</a>, which demonstrated false negative rates of 0% and 5%, and that endoscopies could be avoided in 31% and 26% in PBC and primary sclerosing cholangitis patients, respectively.The highlights of our study were the comparison of the 3 criteria, including the elastography-based and stepwise platelet-MELD criteria, for the detection of only VNT, which is clinically more meaningful than any size of esophageal varices. We enrolled only the patients with compensated cirrhosis who would have been most likely to benefit from non-invasive approaches, as they had a low prevalence of VNT, while most of other studies included both compensated and decompensated cirrhotic patients.There are some limitations in our study. First, despite including various cirrhosis etiologies, the distribution might not reflect the true order of the etiologies in Thailand, as HCV was accounted for the most common cause in this study, in contrast to the earlier established data in which HBV was more prevalent than HCV in Thailand <a class="elsevierStyleCrossRefs" href="#bib0300">[29,30]</a>. Also, the previously published study based on the Nationwide Hospital Admission Data in 2010 <a class="elsevierStyleCrossRef" href="#bib0310">[31]</a> reported that alcoholic liver disease is the most common cause of cirrhosis in Thai patients. This could be due to the fact that our study was conducted in a tertiary care center in which some biases in patients’ referral exist, because in our country, uncomplicated HBV and alcoholic liver disease patients can be treated by general practitioners, while the treatment of HCV needs to be managed by a gastroenterologist or hepatologist. Second, different endoscopists performed EGD and different doctors performed TE, resulting in an inevitable interobserver variation; nonetheless, it might reflect the real-world situation in clinical practice. Third, we collected the data from both retrospective and prospective part in patients whose data were retrospectively collected, the endoscopist and the doctor who performed TE might be the same person or the EGD results might not been blinded to the doctor who performed TE, however, they were unaware of the study aims at that time, making the misclassification of the outcome bias unlikely. And for the prospective part, all the doctors who performed TE were blinded to the endoscopic results. Lastly, although we calculated the sample size in order to evaluate the diagnostic performances of the criteria, and enrolled the patients according to that sample size, the number of patients may not have been large enough to identify the significant differences in missed VNT rates among the 3 criteria, as the missed VNTs were numerically higher in the expanded Baveno VI and stepwise platelet-MELD criteria than in the original Baveno VI. Thus, a larger study should be conducted.In conclusion, the original Baveno VI criteria have now been validated in many studies and endoscopies could be avoided safely using this approach. From our study, the stepwise platelet-MELD approach might be useful as an alternative method to the Baveno VI criteria in a resource-limited setting where LSM is not widely available, or in patients for whom a measurement cannot be obtained. However, a strong recommendation cannot be made at this time. Future studies should be undertaken from a public health standpoint. Concerning the expanded Baveno VI criteria, although the number of spared endoscopies is consistently high across numerous studies, but missed VNT rates are yet to be validated in a larger study.AbbreviationsEVesophageal varicesGVgastric varicesVNTvarices needing treatmentEGDesophagogastroduodenoscopyLSMliver stiffness measurementplt-MELDplatelet-MELDTEtransient elastographyBMIbody mass indexHREChuman research ethics committeeSnsensitivitySpspecificityPPVpositive predictive valueNPVnegative predictive valueHBVhepatitis B virusHCVhepatitis C virusAIHautoimmune hepatitisNAFLDnon-alcoholic fatty liver diseaseASTaspartate aminotransferaseAPRIaspartate aminotransferase to platelet ratioFIB-4fibrosis-4CTPChild-Turcott-PughThe contributions of each co-authorStudy concept and design: S. Nawalerspanya and P. Sripongpun; data acquisition: S. Nawalerspanya; data analysis and interpretation: S. Nawalerspanya, and P. Sripongpun; drafting of the manuscript: S. Nawalerspanya; critical revision of the manuscript for important intellectual content: P. Sripongpun, N. Chamroonkul, and T. Piratvisuth; statistical analysis: P. Sripongpun and C. Kongkamol; study supervision: P. Sripongpun and T. PiratvisuthStatement of financial supportThis study was funded by Faculty of Medicine, Prince of Songkla University, Thailand.Conflict of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1314425" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1213087" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 4 => array:3 [ "identificador" => "sec0020" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Baseline characteristics and prevalence of VNT" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Diagnostic performances of the original Baveno VI, expanded Baveno VI, and stepwise platelet-MELD criteria" ] ] ] 5 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "The contributions of each co-author" ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Statement of financial support" ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflict of interest" ] 9 => array:2 [ "identificador" => "xack453030" "titulo" => "Acknowledgment" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-06-24" "fechaAceptado" => "2019-08-07" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1213087" "palabras" => array:4 [ 0 => "Baveno VI" 1 => "Non-invasive" 2 => "Chronic liver disease" 3 => "Endoscopy" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Introduction and objectivesThe Baveno VI criteria to rule out varices needing treatment (VNT) was introduced in 2015. Soon after, the expanded Baveno VI and stepwise platelet-MELD criteria were proposed to be equal/more accurate in ruling out VNT; however, neither has been widely validated. We aimed to validate all 3 criteria in compensated cirrhosis from assorted causes. Materials and methodsWe conducted a cross-sectional study including all adult compensated cirrhotic patients who underwent endoscopic surveillance at our center from 2014 to 2018 and had transient elastography (TE), and laboratory data for criteria calculation within 6 months of endoscopies. Exclusion criteria were previous decompensation, unreliable/invalid TE results, and liver cancer. The diagnostic performances of all criteria were evaluated. ResultsA total of 128 patients were included. The major cirrhosis etiologies were hepatitis C and B (37.5% and 32.8%, respectively). VNT was observed in 7.8%. All criteria yielded high negative predictive values (NPVs)>95%, missed VNT was observed in 2%, 2.7%, and 2.8% in the original, expanded Baveno VI, and platelet-MELD criteria, respectively. The expanded Baveno VI and the platelet-MELD criteria yielded significantly better specificities and could spare more endoscopies than the original Baveno VI criteria. ConclusionsAll 3 criteria showed satisfactorily high NPVs in ruling out VNT in compensated cirrhosis from various causes. The expanded Baveno VI and the platelet-MELD criteria could spare more endoscopies than the original Baveno VI criteria. From a public health standpoint, the platelet-MELD criteria might be useful in a resource-limited setting where TE is not widely available." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1133 "Ancho" => 1508 "Tamanyo" => 107271 ] ] "descripcion" => array:1 [ "en" => "Study population." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "BMI, body mass index; HBV, hepatitis B virus; HCV, hepatitis C virus; NAFLD, non-alcoholic fatty liver disease; ALT, alanine aminotransferase; CTP, Child-Turcott-Pugh; LSM, liver stiffness measurement; kPa, kilopascal; APRI, AST to platelet ratio; FIB-4, Fibrosis-4; EV, esophageal varix; GV, gastric varix; VNT, varices needing treatment" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Character \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total (n=128) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No VNT (n=118) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">VNT (n=10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (year), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.4 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.6 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55.1 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.513 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male gender, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 (60.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 (57.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5 (21.4, 24.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5 (21.3, 24.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.7 (23, 24.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.428 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Etiology, n (%)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.047 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HBV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (32.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (35.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HCV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 (37.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (34.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alcohol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NAFLD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (8.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>1 etiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total bilirubin (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66 (0.49, 0.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 (0.5,0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 (0.7,1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.204 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ALT (U/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (20.8, 67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.5 (19.2,66.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (29,65.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.167 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin (g/L), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.103 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CTP score, n (%)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.573 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">117 (92.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">108 (92.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelet (×103/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">162 (106.8, 208.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">165.5 (114, 215.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">108 (80.5, 141.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LSM (kPa) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.6 (8.2, 25.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.4 (8, 24.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.1 (22.5, 33.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">APRI score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.73 (0.4, 1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7 (0.4, 1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 (1, 2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">FIB-4 score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.475 (1.61, 4.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.4 (1.4, 3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3 (3.3, 6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MELD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (8, 9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (7.5, 9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (8, 9.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Varix status, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Significant EV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VNT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2253127.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline characteristics of the study population with data presented in median (IQR) unless stated otherwise." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "NPV, negative predictive value; PPV, positive predictive value; VNT, varices needing treatment. *p-Value<0.001, **p-value<0.05, ***p-value=0.08 compared with the original Baveno VI criteria." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagnostic performances \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Original Baveno VI \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Expanded Baveno VI \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Stepwise platelet-MELD \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sensitivity (%, 95%CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90.00 (59.58–98.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.00 (49.02–94.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.00 (49.02–94.33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Specificity (%, 95%CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.53 (33.04–50.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.86 (52.86–70.12)* \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59.32 (50.30–67.76)* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NPV (%, 95%CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98.00 (89.50–99.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.33 (90.79–99.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.22 (90.43–99.23) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPV (%, 95%CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.54 (6.19–20.50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.09 (7.85–27.05)** \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.29 (7.42–25.74)*** \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accuracy (%, 95%CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45.31 (36.95–53.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63.28 (54.66–71.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.94 (52.28–68.95) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spared endoscopy (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Missed VNT (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2253128.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Diagnostic performances for VNT of all 3 criteria in the study." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0160" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of patients with cirrhosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.S. Ge" 1 => "B.A. Runyon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra1504367" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2016" "volumen" => "375" "paginaInicial" => "767" "paginaFinal" => "777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27557303" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0165" "etiqueta" => "[2]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Besheer" 1 => "H. Elalfy" 2 => "M. Abd El-Maksoud" 3 => "A. Abd El-Razek" 4 => "S. Taman" 5 => "K. Zalata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v25.i11.1366" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2019" "volumen" => "25" "paginaInicial" => "1366" "paginaFinal" => "1377" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30918429" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0170" "etiqueta" => "[3]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Procopet" 1 => "A. Berzigotti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gastroenterol Rep" "fecha" => "2017" "volumen" => "5" "paginaInicial" => "79" "paginaFinal" => "89" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0175" "etiqueta" => "[4]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Causes of Death C Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.B.D. Mortality" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(14)61682-2" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2015" "volumen" => "385" "paginaInicial" => "117" "paginaFinal" => "171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25530442" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0180" "etiqueta" => "[5]" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "North Italian Endoscopic Club for the S, Treatment of Esophageal V. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med. 1988;319:983–9." ] ] ] 5 => array:3 [ "identificador" => "bib0185" "etiqueta" => "[6]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upper digestive bleeding in cirrhosis: post-therapeutic outcome and prognostic indicators" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. D’Amico" 1 => "R. De Franchis" 2 => "G. Cooperative Study" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/jhep.2003.50385" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2003" "volumen" => "38" "paginaInicial" => "599" "paginaFinal" => "612" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12939586" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0190" "etiqueta" => "[7]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practice Guidelines Committee of the American Association for the Study of Liver D Practice Parameters Committee of the American College of G. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Garcia-Tsao" 1 => "A.J. Sanyal" 2 => "N.D. Grace" 3 => "W. Carey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.21907" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2007" "volumen" => "46" "paginaInicial" => "922" "paginaFinal" => "938" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17879356" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0195" "etiqueta" => "[8]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. de Franchis" 1 => "V.I.F. Baveno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hepatol" "fecha" => "2015" "volumen" => "63" "paginaInicial" => "743" "paginaFinal" => "752" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0200" "etiqueta" => "[9]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of the Baveno VI criteria to identify low risk cirrhotic patients not requiring endoscopic surveillance for varices" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.B. Maurice" 1 => "E. Brodkin" 2 => "F. Arnold" 3 => "A. Navaratnam" 4 => "H. Paine" 5 => "S. Khawar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2016.06.021" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2016" "volumen" => "65" "paginaInicial" => "899" "paginaFinal" => "905" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27388923" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0205" "etiqueta" => "[10]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of noninvasive methods to predict the presence of gastroesophageal varices in a cohort of patients with compensated advanced chronic liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Llop" 1 => "M. Lopez" 2 => "J. de la Revilla" 3 => "N. Fernandez" 4 => "M. Trapero" 5 => "M. Hernandez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jgh.13781" "Revista" => array:6 [ "tituloSerie" => "J Gastroenterol Hepatol" "fecha" => "2017" "volumen" => "32" "paginaInicial" => "1867" "paginaFinal" => "1872" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28295587" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0210" "etiqueta" => "[11]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendation on avoidance of screening endoscopy in cirrhotic patients: are we there yet?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Silva" 1 => "C. Bernardes" 2 => "J. Pinto" 3 => "R. Loureiro" 4 => "P. Duarte" 5 => "M. Mendes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "GE Portuguese J Gastroenterol" "fecha" => "2017" "volumen" => "24" "paginaInicial" => "79" "paginaFinal" => "83" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0215" "etiqueta" => "[12]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Baveno VI criteria for predicting esophageal varices: validation in real life practice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Sousa" 1 => "S. Fernandes" 2 => "L. Proenca" 3 => "A.P. Silva" 4 => "S. Leite" 5 => "J. Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva" "fecha" => "2017" "volumen" => "109" "paginaInicial" => "704" "paginaFinal" => "707" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0220" "etiqueta" => "[13]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Augustin" 1 => "M. Pons" 2 => "J.B. Maurice" 3 => "C. Bureau" 4 => "H. Stefanescu" 5 => "M. Ney" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.29363" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2017" "volumen" => "66" "paginaInicial" => "1980" "paginaFinal" => "1988" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28696510" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0225" "etiqueta" => "[14]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validating, deconstructing and refining Baveno criteria for ruling out high-risk varices in patients with compensated cirrhosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Jangouk" 1 => "L. Turco" 2 => "A. De Oliveira" 3 => "F. Schepis" 4 => "E. Villa" 5 => "G. Garcia-Tsao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/liv.13379" "Revista" => array:6 [ "tituloSerie" => "Liver Int" "fecha" => "2017" "volumen" => "37" "paginaInicial" => "1177" "paginaFinal" => "1183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28160373" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0230" "etiqueta" => "[15]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute viral hepatitis increases liver stiffness values measured by transient elastography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U. Arena" 1 => "F. Vizzutti" 2 => "G. Corti" 3 => "S. Ambu" 4 => "C. Stasi" 5 => "S. Bresci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.22007" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2008" "volumen" => "47" "paginaInicial" => "380" "paginaFinal" => "384" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18095306" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0235" "etiqueta" => "[16]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.L. Chan" 1 => "G.L. Wong" 2 => "P.C. Choi" 3 => "A.W. Chan" 4 => "A.M. Chim" 5 => "K.K. Yiu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2893.2008.01037.x" "Revista" => array:6 [ "tituloSerie" => "J Viral Hepat" "fecha" => "2009" "volumen" => "16" "paginaInicial" => "36" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18673426" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0240" "etiqueta" => "[17]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transient elastography: kill two birds with one stone?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.L. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4254/wjh.v5.i5.264" "Revista" => array:6 [ "tituloSerie" => "World J Hepatol" "fecha" => "2013" "volumen" => "5" "paginaInicial" => "264" "paginaFinal" => "274" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23717737" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0245" "etiqueta" => "[18]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan®" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. de Ledinghen" 1 => "V.W. Wong" 2 => "J. Vergniol" 3 => "G.L. Wong" 4 => "J. Foucher" 5 => "S.H. Chu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2011.10.017" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2012" "volumen" => "56" "paginaInicial" => "833" "paginaFinal" => "839" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22173167" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0250" "etiqueta" => "[19]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive evaluation of liver fibrosis using transient elastography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Castera" 1 => "X. Forns" 2 => "A. Alberti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2008.02.008" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2008" "volumen" => "48" "paginaInicial" => "835" "paginaFinal" => "847" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18334275" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0255" "etiqueta" => "[20]" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "European Association for Study of L, Asociacion Latinoamericana para el Estudio del H. EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237–64." ] ] ] 20 => array:3 [ "identificador" => "bib0260" "etiqueta" => "[21]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sample size estimation in diagnostic test studies of biomedical informatics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Hajian-Tilaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jbi.2014.02.013" "Revista" => array:6 [ "tituloSerie" => "J Biomed Inform" "fecha" => "2014" "volumen" => "48" "paginaInicial" => "193" "paginaFinal" => "204" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24582925" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0265" "etiqueta" => "[22]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparing the predictive values of diagnostic tests: sample size and analysis for paired study designs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.S. Moskowitz" 1 => "M.S. Pepe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1191/1740774506cn147oa" "Revista" => array:6 [ "tituloSerie" => "Clin Trials" "fecha" => "2006" "volumen" => "3" "paginaInicial" => "272" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16895044" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0270" "etiqueta" => "[23]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening for esophageal varices in cirrhotic patients – non-invasive methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.Z. Mattos" 1 => "F.C. Schacher" 2 => "G. John Neto" 3 => "A.A. Mattos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.aohep.2019.06.003" "Revista" => array:2 [ "tituloSerie" => "Ann Hepatol" "fecha" => "2019" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0275" "etiqueta" => "[24]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Platelet count combined with right liver volume and spleen volume measured by magnetic resonance imaging for identifying cirrhosis and esophageal varices" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X.L. Chen" 1 => "T.W. Chen" 2 => "X.M. Zhang" 3 => "Z.L. Li" 4 => "N.L. Zeng" 5 => "P. Zhou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v21.i35.10184" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2015" "volumen" => "21" "paginaInicial" => "10184" "paginaFinal" => "10191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26401083" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0280" "etiqueta" => "[25]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.A. Razek" 1 => "S.M. Massoud" 2 => "M.R. Azziz" 3 => "M.M. El-Bendary" 4 => "K. Zalata" 5 => "E.M. Motawea" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00261-015-0391-2" "Revista" => array:6 [ "tituloSerie" => "Abdominal Imaging" "fecha" => "2015" "volumen" => "40" "paginaInicial" => "1465" "paginaFinal" => "1469" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25732406" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0285" "etiqueta" => "[26]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of the Baveno VI and the expanded Baveno VI criteria to identify patients who could avoid screening endoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Bae" 1 => "D.H. Sinn" 2 => "W. Kang" 3 => "G.Y. Gwak" 4 => "M.S. Choi" 5 => "Y.H. Paik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/liv.13732" "Revista" => array:6 [ "tituloSerie" => "Liver Int" "fecha" => "2018" "volumen" => "38" "paginaInicial" => "1442" "paginaFinal" => "1448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29495113" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0290" "etiqueta" => "[27]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive prediction of high-risk varices in patients with primary biliary cholangitis and primary sclerosing cholangitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Moctezuma-Velazquez" 1 => "F. Saffioti" 2 => "S. Tasayco-Huaman" 3 => "S. Casu" 4 => "A. Mason" 5 => "D. Roccarina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41395-018-0265-7" "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "2019" "volumen" => "114" "paginaInicial" => "446" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30315285" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0295" "etiqueta" => "[28]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive prediction of esophageal varices by stiffness and platelet in non-alcoholic fatty liver disease cirrhosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Petta" 1 => "G. Sebastiani" 2 => "E. Bugianesi" 3 => "M. Vigano" 4 => "V.W. Wong" 5 => "A. Berzigotti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2018.05.019" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2018" "volumen" => "69" "paginaInicial" => "878" "paginaFinal" => "885" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29802949" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0300" "etiqueta" => "[29]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on global epidemiology of viral hepatitis and preventive strategies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Jefferies" 1 => "B. Rauff" 2 => "H. Rashid" 3 => "T. Lam" 4 => "S. Rafiq" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12998/wjcc.v6.i13.589" "Revista" => array:6 [ "tituloSerie" => "World J Clin Cases" "fecha" => "2018" "volumen" => "6" "paginaInicial" => "589" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30430114" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0305" "etiqueta" => "[30]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Decreasing hepatitis C virus infection in Thailand in the past decade: evidence from the 2014 national survey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Wasitthankasem" 1 => "N. Posuwan" 2 => "P. Vichaiwattana" 3 => "A. Theamboonlers" 4 => "S. Klinfueng" 5 => "V. Vuthitanachot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0149362" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "e0149362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26871561" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0310" "etiqueta" => "[31]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The burden of cirrhosis and impact of universal coverage public health care system in Thailand: nationwide study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Poovorawan" 1 => "S. Treeprasertsuk" 2 => "K. Thepsuthammarat" 3 => "P. Wilairatana" 4 => "B. Kitsahawong" 5 => "K. Phaosawasdi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5604/16652681.1171773" "Revista" => array:6 [ "tituloSerie" => "Ann Hepatol" "fecha" => "2015" "volumen" => "14" "paginaInicial" => "862" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26436358" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack453030" "titulo" => "Acknowledgment" "texto" => "The study was granted by faculty of Medicine, Prince of Songkla University, Thailand." 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Siwanon Nawalerspanyaa, Pimsiri Sripongpuna,

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spimsiri@medicine.psu.ac.th

Corresponding author at: Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

, Naichaya Chamroonkula, Chanon Kongkamolb, Teerha Piratvisutha

a Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

b Research Unit of Holistic Health and Safety Management in Community, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

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and&#47;or gastric varices &#40;GV&#41;&#41; is 5&#8211;15&#37; per year in cirrhotic patients <a class="elsevierStyleCrossRef" href="#bib0180">&#91;5&#93;</a>&#44; and the mortality rate is at least 20&#37; at 6 weeks after a bleeding episode <a class="elsevierStyleCrossRef" href="#bib0185">&#91;6&#93;</a>&#46; Nonetheless&#44; EV can be screened and early intervention can be provided to patients with varices needing treatment &#40;VNT&#41; before a bleeding episode occurs&#46; The gold standard procedure for the diagnosis of VNT is esophagogastroduodenoscopy &#40;EGD&#41;&#46; Traditionally&#44; it is recommended that all cirrhotic patients should undergo EGD surveillance for varices at the time of diagnosis <a class="elsevierStyleCrossRef" href="#bib0190">&#91;7&#93;</a>&#44; in which 6&#8211;12&#37; of VNT is expected to be seen in compensated cirrhotic patients&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Despite it being the standard recommendation&#44; EGD is an invasive procedure which carries the risk of uncommon but significant complications&#44; such as pain&#44; bleeding&#44; and perforation&#46; Moreover&#44; it needs to be performed by well-trained healthcare providers in well-equipped centers&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In 2015&#44; the international consensus meeting on portal hypertension published the &#8220;BAVENO VI recommendation&#8221; <a class="elsevierStyleCrossRef" href="#bib0195">&#91;8&#93;</a>&#46; The non-invasive screening method that uses the liver stiffness measurement &#40;LSM&#41; combined with platelet count was introduced with this recommendation in order to avoid unnecessary EGDs&#46; The Baveno VI criteria were validated in subsequent studies showing &#60;5&#37; missed VNT and thus sparing 11&#8211;39&#37; EGD <a class="elsevierStyleCrossRefs" href="#bib0200">&#91;9&#8211;12&#93;</a>&#46; Later in 2017&#44; the expanded Baveno VI and stepwise platelet-MELD criteria were proposed in order to spare more EGDs while balancing the risk of missed VNT <a class="elsevierStyleCrossRefs" href="#bib0220">&#91;13&#44;14&#93;</a>&#46; 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e&#46;g&#46; Child&#8211;Pugh C cirrhosis&#44; or Child&#8211;Pugh B cirrhosis with ascites&#47;variceal hemorrhage&#47;hepatic encephalopathy&#44; &#40;2&#41; coexisting liver tumor during the study period&#44; &#40;3&#41; patients who had limitations to undergo and&#47;or interpret the results of TE i&#46;e&#46; congestive heart failure&#44; ascites&#44; abdominal wound at the TE examination site&#44; aminotransferase levels<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5 times of upper normal limit <a class="elsevierStyleCrossRefs" href="#bib0230">&#91;15&#8211;17&#93;</a>&#44; total bilirubin &#8805;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; narrow intercostal spaces&#44; and patients with a body mass index &#40;BMI&#41;<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> in whom size M probe was used in TE <a class="elsevierStyleCrossRef" href="#bib0245">&#91;18&#93;</a>&#44; &#40;4&#41; patients whose TE validity criteria <a class="elsevierStyleCrossRefs" href="#bib0250">&#91;19&#44;20&#93;</a> were not met &#40;success rate &#62;60&#37;&#44; and an IQR &#60;30&#37;&#41;&#44; and &#40;5&#41; no available laboratory data for calculating all 3 criteria within 6 months of endoscopy&#46; All transient elastography was performed with a Fibroscan&#174; &#40;Echosens&#44; France&#41;&#46; TE was performed by trained doctors at the right lobe of the liver after patients had fasted for at least 2<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The criteria validated in this study were the Baveno VI &#40;original Baveno VI&#41;&#44; the expanded Baveno VI&#44; and the stepwise platelet-MELD criteria&#44; which defined patients with a low risk of having VNT as follows&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">Original Baveno VI</span></span><a class="elsevierStyleCrossRef" href="#bib0195">&#91;8&#93;</a>&#58; liver stiffness measurement &#40;LSM&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>kPa &#40;determined by TE&#41; and a platelet count &#62;150&#44;000&#47;mm<span class="elsevierStyleSup">3</span></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">Expanded Baveno VI</span></span><a class="elsevierStyleCrossRef" href="#bib0220">&#91;13&#93;</a>&#58; liver stiffness measurement &#40;LSM&#41; &#60;25<span class="elsevierStyleHsp" style=""></span>kPa &#40;determined by TE&#41; and a platelet count &#62;110&#44;000&#47;mm<span class="elsevierStyleSup">3</span></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">Stepwise platelet-MELD</span></span><a class="elsevierStyleCrossRef" href="#bib0225">&#91;14&#93;</a>&#58; platelet<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>150&#44;000&#47;mm<span class="elsevierStyleSup">3</span> or platelet<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>150&#44;000&#47;mm<span class="elsevierStyleSup">3</span> but MELD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;</p></li></ul></p><p id="par0045" class="elsevierStylePara elsevierViewall">Varices needing treatment &#40;VNT&#41; is defined as the presence of EV<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>F2&#44; or EV of any size with high-risk stigmata&#44; or any size of GV on EGD&#46; Cirrhosis was diagnosed by imaging &#40;ultrasonography&#44; computed tomography&#44; magnetic resonance imaging&#41; or liver biopsy&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The study protocol was approved by the Institutional Human Research Ethics Committee &#40;HREC&#41;&#46; The study protocol was approved in 2017&#44; and we collected patients&#39; data from 2014 to 2018&#46; Hence&#44; for patients who underwent EGD for EV surveillance in 2014&#8211;2016&#44; we retrospectively collected the endoscopic reports&#44; transient elastography&#44; and laboratory data and the informed consent was waived&#59; for the patients who underwent EGD in 2017&#8211;2018&#44; all the data were prospectively collected&#44; and all the patients who were enrolled in 2017&#8211;2018 &#40;after the study protocol was approved by the HREC&#41; provided informed consent before participating in the study&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0045">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Sample size calculation was based on the sample size estimation in diagnostic test studies of biomedical informatics <a class="elsevierStyleCrossRef" href="#bib0260">&#91;21&#93;</a>&#46; A total of 106 patients were calculated with a significance level of 0&#46;05&#44; yielding an 80&#37; power to detect 99&#37; sensitivity in the Baveno VI criteria for ruling out VNT with a precision of 0&#46;06&#46; Statistical analysis was performed using program R version 3&#46;4&#46;4&#46; Descriptive statistics were used for baseline demographic data&#46; Quantitative measurements were shown as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD or median with IQR according to the distribution of observed values&#46; Categorical variables were expressed using numbers and percentages&#46; The diagnostic performance of the Baveno VI&#44; the expanded Baveno VI&#44; and the stepwise platelet-MELD criteria&#44; including sensitivity &#40;Sn&#41;&#44; specificity &#40;Sp&#41;&#44; positive predictive value &#40;PPV&#41;&#44; and negative predictive value &#40;NPV&#41;&#44; were reported as percentages&#46; Using the Baveno VI criteria as a reference&#44; Sn and Sp of the remaining 2 criteria were compared with the original Baveno VI using McNemar chi-square test&#44; and the relative predictive value method <a class="elsevierStyleCrossRef" href="#bib0265">&#91;22&#93;</a> was used in the comparisons of PPVs and NPVs&#46; A <span class="elsevierStyleItalic">p</span>-Value &#60;0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3</span><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0055">Baseline characteristics and prevalence of VNT</span><p id="par0060" class="elsevierStylePara elsevierViewall">During the study period&#44; 177 cirrhotic patients were assessed for eligibility&#59; 49 patients were excluded according to the exclusion criteria &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A total of 128 patients were included in this study&#46; Baseline characteristics of eligible patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Sixty percent were male&#44; with a mean age of 57&#46;4 years old&#44; and all were in Child&#8211;Pugh A&#46; The major etiologies of cirrhosis were chronic viral hepatitis C &#40;HCV&#41; and B &#40;HBV&#41; infection &#40;37&#46;5&#37; and 32&#46;8&#37;&#44; respectively&#41;&#46; The other etiologies from <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> comprise Wilson disease &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#44; autoimmune hepatitis &#40;AIH&#41; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#44; and cryptogenic &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; For the patients with &#62;1 etiology&#44; most had viral hepatitis as follows&#58; HBV-HCV co-infection &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#44; HBV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>alcohol &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#44; HCV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>alcohol &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#44; HBV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>non-alcoholic fatty liver disease &#40;NAFLD&#41; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; HCV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>NAFLD &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; HBV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>AIH in 1 patient&#44; and NAFLD<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>AIH in 1 patient&#46; VNT was identified in 10 patients &#40;7&#46;8&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">In comparison&#44; patients with VNT included a higher number of the male gender&#44; chronic hepatitis C as the etiology&#44; a higher liver stiffness&#44; aspartate aminotransferase &#40;AST&#41; to Platelet Ratio &#40;APRI&#41;&#44; and Fibrosis-4 &#40;FIB-4&#41; scores&#44; and a lower platelet count &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;2</span><span class="elsevierStyleSectionTitle" id="sect0060">Diagnostic performances of the original Baveno VI&#44; expanded Baveno VI&#44; and stepwise platelet-MELD criteria</span><p id="par0070" class="elsevierStylePara elsevierViewall">Sensitivity&#44; specificity&#44; PPV&#44; NPV&#44; accuracy&#44; number of endoscopies that could be avoided&#44; and missed VNT of all 3 criteria are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The NPVs to exclude VNT were higher than 95&#37; in all criteria&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">In comparison with the original Baveno VI criteria&#44; both the expanded Baveno VI and stepwise platelet-MELD criteria provided a significantly better specificity &#40;61&#46;86&#37; and 59&#46;32&#37; vs 41&#46;53&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 for both comparisons&#41;&#44; the expanded Baveno VI yielded a significantly better PPV &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; and the PPV in the stepwise platelet-MELD criteria were numerically higher as well&#44; but a statistically significant level was not reached &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&#41;&#46; The sensitivities and NPVs were comparable&#46; The expanded Baveno VI and the stepwise platelet-MELD criteria could spare more endoscopies than the original criteria &#40;58&#46;59&#37;&#44; 56&#46;25&#37;&#44; and 39&#46;06&#37;&#44; respectively&#41;&#44; and the number of missed VNT were low in all criteria&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">4</span><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">In the management of cirrhotic patients&#44; the criteria for ruling out VNT are of interest from the aspect of non-invasive techniques&#44; and it is possible to provide a basic screening step for general practitioners before referring patients to endoscopic centers&#46; There are many non-invasive tests for the detection of VNT in the literature&#44; including blood tests&#44; liver and&#47;or spleen stiffness measurement&#44; and imaging characteristics&#44; or a combination of the aforementioned parameters <a class="elsevierStyleCrossRefs" href="#bib0270">&#91;23&#8211;25&#93;</a>&#46; In this study&#44; we focused on the original Baveno VI&#44; the expanded Baveno VI&#44; and stepwise platelet-MELD criteria&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In the present study&#44; we found that the original Baveno VI criteria could be used to rule out VNT in compensated cirrhotic patients with a sensitivity of 90&#37; and a satisfactorily high NPV of 98&#37;&#46; Endoscopic surveillance could have been avoided in 39&#37; of the patients if the original Baveno VI criteria were used to categorize patients prior to sending them for an EGD surveillance&#46; The result of this approach is concordant with other published studies <a class="elsevierStyleCrossRefs" href="#bib0200">&#91;9&#8211;14&#44;26&#8211;28&#93;</a> in which missed VNTs in the Baveno VI criteria were consistently lower than 5&#37;&#44; and spared endoscopies were observed in 11&#46;3&#8211;39&#37;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">However&#44; it has come to our attention that whether we can spare more endoscopies without increasing the number of missed VNTs&#46; Augustin et al&#46; <a class="elsevierStyleCrossRef" href="#bib0220">&#91;13&#93;</a> proposed the expanded Baveno VI in late 2017 with different cut-off levels for LSM and platelet count as mentioned earlier&#46; This approach could double the number of endoscopies spared from 21&#46;5 to 40&#37;&#44; while missed VNTs were almost identical&#46; In our study&#44; the expanded Baveno VI criteria provided a significantly better specificity and PPV compared with the original Baveno VI criteria&#44; while the NPVs were comparable &#40;97&#46;33&#37; vs 98&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#41;&#44; and the number of endoscopies that could have been spared was almost 60&#37;&#46; Other studies to validate the expanded criteria in some specific groups of patients were recently published&#46; Petta et al&#46; <a class="elsevierStyleCrossRef" href="#bib0295">&#91;28&#93;</a> validated this approach in only NAFLD patients&#46; Missed VNTs were observed in 3&#46;8&#8211;4&#46;4&#37;&#44; and the endoscopies that could be spared in 58&#37;&#44; while in the study of Moctezuma-Velazquez et al&#46; <a class="elsevierStyleCrossRef" href="#bib0290">&#91;27&#93;</a>&#44; the false negative rate was 6&#37; in 147 primary biliary cholangitis &#40;PBC&#41; patients&#46; Bae et al&#46; <a class="elsevierStyleCrossRef" href="#bib0285">&#91;26&#93;</a> found that in their Asian cohort&#44; the missed VNT using the expanded Baveno VI criteria were high in HBV&#44; alcoholic&#44; and NAFLD cirrhotic patients &#40;7&#46;5&#37;&#44; 8&#37;&#44; and 6&#46;7&#37;&#44; respectively&#41;&#46; Nevertheless&#44; it is important to note that the VNT in compensated advanced chronic liver disease in the study by Bae et al&#46; was 19&#46;5&#37;&#44; which exceeded the number of expected VNT 6&#8211;12&#37; in compensated cirrhotic patients <a class="elsevierStyleCrossRef" href="#bib0190">&#91;7&#93;</a>&#46; Our study results are concordant with other studies in the fact that more endoscopies could be spared by using the expanded Baveno VI criteria&#46; However&#44; larger studies are required in order to aid in the decision of whether we should use this approach to rule out VNT in terms of missed VNT rates&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In contrast&#44; both the original and expanded Baveno VI criteria necessitate LSM to categorize patients into low-risk or high-risk of having VNT&#46; Despite its advantages of being non-invasive&#44; easy to perform and interpret&#44; LSM requires a specific device&#44; which the cost might be outrageous to many centers&#44; and failure to attain the measurements was reported in some groups of patients&#46; In early 2017&#44; Jangouk et al&#46; published a study validating the Baveno VI criteria&#44; as well as the proposed stepwise platelet-MELD criteria <a class="elsevierStyleCrossRef" href="#bib0210">&#91;11&#93;</a>&#44; in which LSM was not required&#44; showing that the stepwise platelet-MELD criteria performed as well as the Baveno VI in NPVs&#44; sensitivity&#44; and endoscopies spared&#46; We are interested in this approach as it might be a simple and useful way for general practitioners to screen for cirrhotic patients with a low risk of having VNT&#46; In our study&#44; the stepwise platelet-MELD criteria yielded not only comparably high NPVs compared with the original Baveno VI criteria &#40;97&#46;22&#37; vs 98&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;60&#41;&#44; but also a higher specificity &#40;59&#46;32&#37; vs 41&#46;53&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; a larger number of endoscopies that could have been spared &#40;56&#37; vs 39&#37;&#41;&#46; To date&#44; the stepwise platelet-MELD criteria have been validated in only one study prior to our study <a class="elsevierStyleCrossRef" href="#bib0290">&#91;27&#93;</a>&#44; which demonstrated false negative rates of 0&#37; and 5&#37;&#44; and that endoscopies could be avoided in 31&#37; and 26&#37; in PBC and primary sclerosing cholangitis patients&#44; respectively&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The highlights of our study were the comparison of the 3 criteria&#44; including the elastography-based and stepwise platelet-MELD criteria&#44; for the detection of only VNT&#44; which is clinically more meaningful than any size of esophageal varices&#46; We enrolled only the patients with compensated cirrhosis who would have been most likely to benefit from non-invasive approaches&#44; as they had a low prevalence of VNT&#44; while most of other studies included both compensated and decompensated cirrhotic patients&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">There are some limitations in our study&#46; First&#44; despite including various cirrhosis etiologies&#44; the distribution might not reflect the true order of the etiologies in Thailand&#44; as HCV was accounted for the most common cause in this study&#44; in contrast to the earlier established data in which HBV was more prevalent than HCV in Thailand <a class="elsevierStyleCrossRefs" href="#bib0300">&#91;29&#44;30&#93;</a>&#46; Also&#44; the previously published study based on the Nationwide Hospital Admission Data in 2010 <a class="elsevierStyleCrossRef" href="#bib0310">&#91;31&#93;</a> reported that alcoholic liver disease is the most common cause of cirrhosis in Thai patients&#46; This could be due to the fact that our study was conducted in a tertiary care center in which some biases in patients&#8217; referral exist&#44; because in our country&#44; uncomplicated HBV and alcoholic liver disease patients can be treated by general practitioners&#44; while the treatment of HCV needs to be managed by a gastroenterologist or hepatologist&#46; Second&#44; different endoscopists performed EGD and different doctors performed TE&#44; resulting in an inevitable interobserver variation&#59; nonetheless&#44; it might reflect the real-world situation in clinical practice&#46; Third&#44; we collected the data from both retrospective and prospective part in patients whose data were retrospectively collected&#44; the endoscopist and the doctor who performed TE might be the same person or the EGD results might not been blinded to the doctor who performed TE&#44; however&#44; they were unaware of the study aims at that time&#44; making the misclassification of the outcome bias unlikely&#46; And for the prospective part&#44; all the doctors who performed TE were blinded to the endoscopic results&#46; Lastly&#44; although we calculated the sample size in order to evaluate the diagnostic performances of the criteria&#44; and enrolled the patients according to that sample size&#44; the number of patients may not have been large enough to identify the significant differences in missed VNT rates among the 3 criteria&#44; as the missed VNTs were numerically higher in the expanded Baveno VI and stepwise platelet-MELD criteria than in the original Baveno VI&#46; Thus&#44; a larger study should be conducted&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; the original Baveno VI criteria have now been validated in many studies and endoscopies could be avoided safely using this approach&#46; From our study&#44; the stepwise platelet-MELD approach might be useful as an alternative method to the Baveno VI criteria in a resource-limited setting where LSM is not widely available&#44; or in patients for whom a measurement cannot be obtained&#46; However&#44; a strong recommendation cannot be made at this time&#46; Future studies should be undertaken from a public health standpoint&#46; Concerning the expanded Baveno VI criteria&#44; although the number of spared endoscopies is consistently high across numerous studies&#44; but missed VNT rates are yet to be validated in a larger study&#46;<span class="elsevierStyleDefList"><span class="elsevierStyleSectionTitle" id="sect0070">Abbreviations</span><span class="elsevierStyleDefTerm">EV</span><span class="elsevierStyleDefDescription"><p id="par0115" class="elsevierStylePara elsevierViewall">esophageal varices</p></span><span class="elsevierStyleDefTerm">GV</span><span class="elsevierStyleDefDescription"><p id="par0120" class="elsevierStylePara elsevierViewall">gastric varices</p></span><span class="elsevierStyleDefTerm">VNT</span><span class="elsevierStyleDefDescription"><p id="par0125" class="elsevierStylePara elsevierViewall">varices needing treatment</p></span><span class="elsevierStyleDefTerm">EGD</span><span class="elsevierStyleDefDescription"><p id="par0130" class="elsevierStylePara elsevierViewall">esophagogastroduodenoscopy</p></span><span class="elsevierStyleDefTerm">LSM</span><span class="elsevierStyleDefDescription"><p id="par0135" class="elsevierStylePara elsevierViewall">liver stiffness measurement</p></span><span class="elsevierStyleDefTerm">plt-MELD</span><span class="elsevierStyleDefDescription"><p id="par0140" class="elsevierStylePara elsevierViewall">platelet-MELD</p></span><span class="elsevierStyleDefTerm">TE</span><span class="elsevierStyleDefDescription"><p id="par0145" class="elsevierStylePara elsevierViewall">transient elastography</p></span><span class="elsevierStyleDefTerm">BMI</span><span class="elsevierStyleDefDescription"><p id="par0150" class="elsevierStylePara elsevierViewall">body mass index</p></span><span class="elsevierStyleDefTerm">HREC</span><span class="elsevierStyleDefDescription"><p id="par0155" class="elsevierStylePara elsevierViewall">human research ethics committee</p></span><span class="elsevierStyleDefTerm">Sn</span><span class="elsevierStyleDefDescription"><p id="par0160" class="elsevierStylePara elsevierViewall">sensitivity</p></span><span class="elsevierStyleDefTerm">Sp</span><span class="elsevierStyleDefDescription"><p id="par0165" class="elsevierStylePara elsevierViewall">specificity</p></span><span class="elsevierStyleDefTerm">PPV</span><span class="elsevierStyleDefDescription"><p id="par0170" class="elsevierStylePara elsevierViewall">positive predictive value</p></span><span class="elsevierStyleDefTerm">NPV</span><span class="elsevierStyleDefDescription"><p id="par0175" class="elsevierStylePara elsevierViewall">negative predictive value</p></span><span class="elsevierStyleDefTerm">HBV</span><span class="elsevierStyleDefDescription"><p id="par0180" class="elsevierStylePara elsevierViewall">hepatitis B virus</p></span><span class="elsevierStyleDefTerm">HCV</span><span class="elsevierStyleDefDescription"><p id="par0185" class="elsevierStylePara elsevierViewall">hepatitis C virus</p></span><span class="elsevierStyleDefTerm">AIH</span><span class="elsevierStyleDefDescription"><p id="par0190" class="elsevierStylePara elsevierViewall">autoimmune hepatitis</p></span><span class="elsevierStyleDefTerm">NAFLD</span><span class="elsevierStyleDefDescription"><p id="par0195" class="elsevierStylePara elsevierViewall">non-alcoholic fatty liver disease</p></span><span class="elsevierStyleDefTerm">AST</span><span class="elsevierStyleDefDescription"><p id="par0200" class="elsevierStylePara elsevierViewall">aspartate aminotransferase</p></span><span class="elsevierStyleDefTerm">APRI</span><span class="elsevierStyleDefDescription"><p id="par0205" class="elsevierStylePara elsevierViewall">aspartate aminotransferase to platelet ratio</p></span><span class="elsevierStyleDefTerm">FIB-4</span><span class="elsevierStyleDefDescription"><p id="par0210" class="elsevierStylePara elsevierViewall">fibrosis-4</p></span><span class="elsevierStyleDefTerm">CTP</span><span class="elsevierStyleDefDescription"><p id="par0215" class="elsevierStylePara elsevierViewall">Child-Turcott-Pugh</p></span></span></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">The contributions of each co-author</span><p id="par0220" class="elsevierStylePara elsevierViewall">Study concept and design&#58; S&#46; Nawalerspanya and P&#46; Sripongpun&#59; data acquisition&#58; S&#46; Nawalerspanya&#59; data analysis and interpretation&#58; S&#46; Nawalerspanya&#44; and P&#46; Sripongpun&#59; drafting of the manuscript&#58; S&#46; Nawalerspanya&#59; critical revision of the manuscript for important intellectual content&#58; P&#46; Sripongpun&#44; N&#46; Chamroonkul&#44; and T&#46; Piratvisuth&#59; statistical analysis&#58; P&#46; Sripongpun and C&#46; Kongkamol&#59; study supervision&#58; P&#46; Sripongpun and T&#46; Piratvisuth</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statement of financial support</span><p id="par0225" class="elsevierStylePara elsevierViewall">This study was funded by <span class="elsevierStyleGrantSponsor" id="gs1">Faculty of Medicine&#44; Prince of Songkla University</span>&#44; Thailand&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Baseline characteristics and prevalence of VNT"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-06-24"
    "fechaAceptado" => "2019-08-07"
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      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1213087"
          "palabras" => array:4 [
            0 => "Baveno VI"
            1 => "Non-invasive"
            2 => "Chronic liver disease"
            3 => "Endoscopy"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The Baveno VI criteria to rule out varices needing treatment &#40;VNT&#41; was introduced in 2015&#46; Soon after&#44; the expanded Baveno VI and stepwise platelet-MELD criteria were proposed to be equal&#47;more accurate in ruling out VNT&#59; however&#44; neither has been widely validated&#46; We aimed to validate all 3 criteria in compensated cirrhosis from assorted causes&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a cross-sectional study including all adult compensated cirrhotic patients who underwent endoscopic surveillance at our center from 2014 to 2018 and had transient elastography &#40;TE&#41;&#44; and laboratory data for criteria calculation within 6 months of endoscopies&#46; Exclusion criteria were previous decompensation&#44; unreliable&#47;invalid TE results&#44; and liver cancer&#46; The diagnostic performances of all criteria were evaluated&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 128 patients were included&#46; The major cirrhosis etiologies were hepatitis C and B &#40;37&#46;5&#37; and 32&#46;8&#37;&#44; respectively&#41;&#46; VNT was observed in 7&#46;8&#37;&#46; All criteria yielded high negative predictive values &#40;NPVs&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95&#37;&#44; missed VNT was observed in 2&#37;&#44; 2&#46;7&#37;&#44; and 2&#46;8&#37; in the original&#44; expanded Baveno VI&#44; and platelet-MELD criteria&#44; respectively&#46; The expanded Baveno VI and the platelet-MELD criteria yielded significantly better specificities and could spare more endoscopies than the original Baveno VI criteria&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">All 3 criteria showed satisfactorily high NPVs in ruling out VNT in compensated cirrhosis from various causes&#46; The expanded Baveno VI and the platelet-MELD criteria could spare more endoscopies than the original Baveno VI criteria&#46; From a public health standpoint&#44; the platelet-MELD criteria might be useful in a resource-limited setting where TE is not widely available&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and objectives"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
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      0 => array:7 [
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        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Study population&#46;</p>"
        ]
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      1 => array:8 [
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; HBV&#44; hepatitis B virus&#59; HCV&#44; hepatitis C virus&#59; NAFLD&#44; non-alcoholic fatty liver disease&#59; ALT&#44; alanine aminotransferase&#59; CTP&#44; Child-Turcott-Pugh&#59; LSM&#44; liver stiffness measurement&#59; kPa&#44; kilopascal&#59; APRI&#44; AST to platelet ratio&#59; FIB-4&#44; Fibrosis-4&#59; EV&#44; esophageal varix&#59; GV&#44; gastric varix&#59; VNT&#44; varices needing treatment</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Character&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>128&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No VNT &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">VNT &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;year&#41;&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;4 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;6 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#46;1 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;513&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Male gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;60&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BMI &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;5 &#40;21&#46;4&#44; 24&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;5 &#40;21&#46;3&#44; 24&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;7 &#40;23&#44; 24&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;428&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Etiology&#44; n &#40;&#37;&#41;</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HBV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;32&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;35&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HCV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;37&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;34&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alcohol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NAFLD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;7&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;1 etiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Specificity &#40;&#37;&#44; 95&#37;CI&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41&#46;53 &#40;33&#46;04&#8211;50&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">61&#46;86 &#40;52&#46;86&#8211;70&#46;12&#41;&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">59&#46;32 &#40;50&#46;30&#8211;67&#46;76&#41;&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&#46;09 &#40;7&#46;85&#8211;27&#46;05&#41;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45&#46;31 &#40;36&#46;95&#8211;53&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
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                            0 => "P&#46;S&#46; Ge"
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                      "doi" => "10.1056/NEJMra1504367"
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                      "titulo" => "Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus"
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                          "autores" => array:6 [
                            0 => "T&#46; Besheer"
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                            2 => "M&#46; Abd El-Maksoud"
                            3 => "A&#46; Abd El-Razek"
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                    0 => array:2 [
                      "doi" => "10.3748/wjg.v25.i11.1366"
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                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2019"
                        "volumen" => "25"
                        "paginaInicial" => "1366"
                        "paginaFinal" => "1377"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30918429"
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                            0 => "G&#46; D&#8217;Amico"
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                      "titulo" => "Practice Guidelines Committee of the American Association for the Study of Liver D Practice Parameters Committee of the American College of G&#46; Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis"
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                        "paginaInicial" => "743"
                        "paginaFinal" => "752"
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                          "autores" => array:6 [
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                            1 => "E&#46; Brodkin"
                            2 => "F&#46; Arnold"
                            3 => "A&#46; Navaratnam"
                            4 => "H&#46; Paine"
                            5 => "S&#46; Khawar"
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                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2016"
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                        "paginaInicial" => "899"
                        "paginaFinal" => "905"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27388923"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
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                          "etal" => true
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                            3 => "N&#46; Fernandez"
                            4 => "M&#46; Trapero"
                            5 => "M&#46; Hernandez"
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                        "tituloSerie" => "J Gastroenterol Hepatol"
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                        "volumen" => "32"
                        "paginaInicial" => "1867"
                        "paginaFinal" => "1872"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28295587"
                            "web" => "Medline"
                          ]
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                            3 => "R&#46; Loureiro"
                            4 => "P&#46; Duarte"
                            5 => "M&#46; Mendes"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "GE Portuguese J Gastroenterol"
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                        "paginaInicial" => "79"
                        "paginaFinal" => "83"
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                    ]
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                    0 => array:2 [
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                            4 => "S&#46; Leite"
                            5 => "J&#46; Silva"
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                        "tituloSerie" => "Revista espanola de enfermedades digestivas&#58; organo oficial de la Sociedad Espanola de Patologia Digestiva"
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                        "paginaInicial" => "704"
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                    0 => array:2 [
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                            2 => "J&#46;B&#46; Maurice"
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                            5 => "M&#46; Ney"
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                        "paginaInicial" => "1980"
                        "paginaFinal" => "1988"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28696510"
                            "web" => "Medline"
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              "identificador" => "bib0225"
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                0 => array:2 [
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                          "etal" => false
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                            4 => "E&#46; Villa"
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                    0 => array:2 [
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                        "tituloSerie" => "Liver Int"
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                        "volumen" => "37"
                        "paginaInicial" => "1177"
                        "paginaFinal" => "1183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28160373"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
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                    0 => array:2 [
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                        "paginaInicial" => "380"
                        "paginaFinal" => "384"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18095306"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
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                            4 => "A&#46;M&#46; Chim"
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                        "tituloSerie" => "J Viral Hepat"
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                        "paginaInicial" => "36"
                        "paginaFinal" => "44"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18673426"
                            "web" => "Medline"
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                          "autores" => array:1 [
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                        "tituloSerie" => "World J Hepatol"
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                        "paginaFinal" => "274"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23717737"
                            "web" => "Medline"
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                          "etal" => true
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                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                    0 => array:2 [
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                        "paginaFinal" => "847"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                        "tituloSerie" => "Clin Trials"
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                        "paginaInicial" => "272"
                        "paginaFinal" => "279"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                        "tituloSerie" => "Ann Hepatol"
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                    ]
                  ]
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                        "paginaFinal" => "10191"
                        "link" => array:1 [
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                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Validation of the Baveno VI and the expanded Baveno VI criteria to identify patients who could avoid screening endoscopy"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            4 => "M&#46;S&#46; Choi"
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                        "paginaFinal" => "1448"
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                          0 => array:2 [
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                        "tituloSerie" => "Am J Gastroenterol"
                        "fecha" => "2019"
                        "volumen" => "114"
                        "paginaInicial" => "446"
                        "paginaFinal" => "452"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30315285"
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                            4 => "V&#46;W&#46; Wong"
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                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2018"
                        "volumen" => "69"
                        "paginaInicial" => "878"
                        "paginaFinal" => "885"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29802949"
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                        "volumen" => "6"
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                        "paginaFinal" => "599"
                        "link" => array:1 [
                          0 => array:2 [
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                        "link" => array:1 [
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Article information

ISSN: 16652681
Original language: English

DOI:10.1016/j.aohep.2019.08.005

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	29	4	33
2024 September	52	5	57
2024 August	50	6	56
2024 July	37	7	44
2024 June	19	2	21
2024 May	39	6	45
2024 April	56	13	69
2024 March	67	23	90
2024 February	99	5	104
2024 January	38	7	45
2023 December	31	3	34
2023 November	49	5	54
2023 October	43	11	54
2023 September	32	6	38
2023 August	28	5	33
2023 July	31	5	36
2023 June	28	2	30
2023 May	46	5	51
2023 April	55	5	60
2023 March	46	4	50
2023 February	19	6	25
2023 January	8	3	11
2022 December	18	7	25
2022 November	14	7	21
2022 October	14	6	20
2022 September	22	12	34
2022 August	18	5	23
2022 July	18	3	21
2022 June	21	6	27
2022 May	35	4	39
2022 April	49	3	52
2022 March	99	10	109
2022 February	96	12	108
2022 January	66	13	79
2021 December	41	18	59
2021 November	47	19	66
2021 October	21	17	38
2021 September	14	18	32
2021 August	29	6	35
2021 July	27	7	34
2021 June	30	10	40
2021 May	37	11	48
2021 April	108	30	138
2021 March	37	17	54
2021 February	30	17	47
2021 January	27	12	39
2020 December	17	5	22
2020 November	20	10	30
2020 October	18	9	27
2020 September	17	9	26
2020 August	18	7	25
2020 July	29	10	39
2020 June	31	9	40
2020 May	23	11	34
2020 April	37	13	50
2020 March	97	49	146
2020 February	6	11	17
2020 January	11	11	22
2019 December	10	9	19
2019 November	6	5	11
2019 October	7	11	18
2019 September	1	4	5

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