Predictive Algorithm for Hepatic Steatosis Detection Using Elastography Data in the Veterans Affairs Electronic Health Records

Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Early detection can identify at-risk patients who can be linked to hepatology care. The vibration-controlled transient elastography (VCTE) controlled attenuation parameter (CAP) is biopsy validated to diag...

Full description

Saved in:
Bibliographic Details
Published in:Digestive diseases and sciences 2023-12, Vol.68 (12), p.4474-4484
Main Authors: Bangaru, Saroja, Sundaresh, Ram, Lee, Anna, Prause, Nicole, Hao, Frank, Dong, Tien S., Tincopa, Monica, Cholankeril, George, Rich, Nicole E., Kawamoto, Jenna, Bhattacharya, Debika, Han, Steven B., Patel, Arpan A., Shaheen, Magda, Benhammou, Jihane N.
Format: Article
Language:English
Subjects:
Algorithms
Biochemistry
Biopsy
Elasticity Imaging Techniques - methods
Electronic Health Records
Gastroenterology
Hepatology
Humans
Liver - pathology
Liver Cirrhosis - diagnosis
Liver diseases
Liver Diseases, Alcoholic - complications
Medicine
Medicine & Public Health
Non-alcoholic Fatty Liver Disease - pathology
Oncology
Original Article
Prospective Studies
ROC Curve
Transplant Surgery
Veterans
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Early detection can identify at-risk patients who can be linked to hepatology care. The vibration-controlled transient elastography (VCTE) controlled attenuation parameter (CAP) is biopsy validated to diagnose hepatic steatosis (HS). We aimed to develop a novel clinical predictive algorithm for HS using the CAP score at a Veterans’ Affairs hospital. Methods We identified 403 patients in the Greater Los Angeles VA Healthcare System with valid VCTEs during 1/2018–6/2020. Patients with alcohol-associated liver disease, genotype 3 hepatitis C, any malignancies, or liver transplantation were excluded. Linear regression was used to identify predictors of NAFLD. To identify a CAP threshold for HS detection, receiver operating characteristic analysis was applied using liver biopsy, MRI, and ultrasound as the gold standards. Results The cohort was racially/ethnically diverse (26% Black/African American; 20% Hispanic). Significant positive predictors of elevated CAP score included diabetes, cholesterol, triglycerides, BMI, and self-identifying as Hispanic. Our predictions of CAP scores using this model strongly correlated ( r  = 0.61, p  
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-023-08043-8