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. 2017 Dec 13;7(1):17493.
doi: 10.1038/s41598-017-17685-4.

Nomogram for cirrhosis in patients with chronic hepatitis B: A simple self-assessed scale for individual risk of cirrhosis

Zhiqiao Zhang  1 , Jing Li  1 , Peng Wang  2 , Tingshan He  1 , Yanling Ouyang  1 , Yiyan Huang  1
Affiliations

Nomogram for cirrhosis in patients with chronic hepatitis B: A simple self-assessed scale for individual risk of cirrhosis

Zhiqiao Zhang et al. Sci Rep. .

Abstract

The aim of this retrospective study was to establish a simple self-assessed scale for individual risk of cirrhosis in patients with chronic hepatitis B. A total of 1808 consecutive patients were enrolled and analyzed. According to the results of multivariate logistic regression analysis, a simple nomogram was calculated for cirrhosis. The area under receiver operating characteristic curves (AUROCs) were calculated to compare the diagnostic accuracy of nomogram with aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the four factors (FIB-4), and S index. The AUROCs of nomogram for cirrhosis were 0.807 (adjusted AUROC 0.876) in model group and 0.794 (adjusted AUROC0.866) in validation group. DeLong's test and Brier Score further demonstrated that nomogram was superior to APRI, FIB-4 and S index in both model group and validation group. The patients with nomogram <0.07 could be defined as low risk group with cirrhosis prevalence lower than 4.3% (17/397). The patients with nomogram >0.52 could be defined as high risk group with cirrhosis prevalence higher than 73.0% (119/163). In conclusion, as a self-assessed style, simple, non-invasive, economical, convenient, and repeatable scale, nomogram is suitable to serve as a massive health screening tool for cirrhosis in CHB patients and further external validation is needed.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Nomogram for cirrhosis. AFP, α-fetoprotein; GGT, γ-glutamyl transferase; HA, hyaluronic acid; PLT, platelet.
Figure 2
Figure 2
ROC curves of four predictive indexes for cirrhosis in different groups: (A) model group; (B) validation group.
Figure 3
Figure 3
Internal calibration curve of nomogram for cirrhosis. Calibration curve showed good agreement between the predicted and observed probabilities for cirrhosis.
Figure 4
Figure 4
ROC curves of four predictive indexes for cirrhosis in patients without antivirus therapy: (A) model group; (B) validation group.
See this image and copyright information in PMC

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