Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00345-5
J Calvin Coffey, Yi Li, Dara Walsh, Tara M Connelly
No Abstract
没有抽象的
{"title":"Mesenteric sparing or extended resection in primary ileocolic resection for Crohn's disease","authors":"J Calvin Coffey, Yi Li, Dara Walsh, Tara M Connelly","doi":"10.1016/s2468-1253(24)00345-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00345-5","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"21 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00274-7
Katrine P Lindvig, Katrine H Thorhauge, Johanne K Hansen, Maria Kjærgaard, Camilla D Hansen, Stine Johansen, Ellen Lyngbeck, Mads Israelsen, Peter Andersen, Katrine T Bech, Nikolaj Torp, Helle L Schnefeld, Sönke Detlefsen, Sören Möller, Isabel Graupera, Morten B Trelle, Steen Antonsen, Rebecca Harris, Line L Kårhus, Kirsten S Bjørnsbo, Maja Thiele
<h3>Background</h3>Clinically significant liver fibrosis is associated with future adverse events in patients with steatotic liver disease. We designed a software tool for detection of clinically significant liver fibrosis in primary care.<h3>Methods</h3>In this prospective cohort study, we developed and validated LiverPRO using six independent cohorts from Denmark, Germany, and England that included patients from primary and secondary care with steatotic liver disease related to alcohol or metabolic dysfunction. We used clinically significant fibrosis (histology stage ≥F2) and advanced fibrosis (≥F3) as outcomes for variable selection in the development cohort and built the model with fractional polynomial regression. In all cohorts, we independently validated the tool for prediction of elevated liver stiffness by transient elastography (≥8 kPa and ≥12 kPa) and for the 2-year and 5-year risk of liver-related events. Diagnostic performance was assessed using the area under the receiver operating curve (AUC), with clinical performance evaluated through sensitivity, specificity, and Harrell's C-statistic for prognostic purposes.<h3>Findings</h3>In the development cohort (n=462), we derived 466 multivariable models consisting of age in combination with three to nine variables from a list of nine blood tests (aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, international normalised ratio, albumin, sodium, bilirubin, platelet count, and cholesterol). In the development cohort, LiverPRO diagnosed clinically significant fibrosis with good accuracy (transient elastography ≥8 kPa area under the receiver operating characteristic curve [AUC] 0·86 [95% CI 0·83–0·90]). In the DECIDE validation cohort (n=6468), LiverPRO detected participants with a transient elastography of 8 kPa or higher with good accuracy (AUC 0·80 [95% CI 0·78–0·82]), comparable to enhanced liver fibrosis testing (0·78 [0·75–0·80]) and the LiverRisk score (0·81 [0·79–0·84]), but superior to the Fibrosis-4 index (0·69 [0·66–0·72]) and NAFLD Fibrosis Score (0·74 [0·72–0·77]). Findings were consistent in three other validation cohorts (n=2554), albeit accuracy was slightly lower. Using a rule-out cutoff of less than 25% (indicating no further examinations required), LiverPRO had a rule-out sensitivity of 80·6% (95% CI 76·4–84·3) and a rule-out negative predictive value of 98·0% (95% CI 97·5–98·4) in the DECIDE cohort. Similarly, with a rule-out cutoff of less than 1·3, FIB-4 had a rule-out sensitivity of 53·8% (48·5–58·9) and a rule-out negative predictive value of 95·8% (95·1–96·4). For rule-in thresholds, using a cutoff of more than 65% (indicating referral to a hepatologist required) LiverPRO had a rule-in specificity of 95·5% (95% CI 94·9–96·0) and a rule-in positive predictive value of 33·0% (95% CI 28·5–37·8) in the DECIDE cohort whereas FIB-4, with a rule-in threshold of 2·67, had a rule-in specificity of 98·7% (94·9–96·0) and a rule-in positive predictive
{"title":"Development, validation, and prognostic evaluation of LiverPRO for the prediction of significant liver fibrosis in primary care: a prospective cohort study","authors":"Katrine P Lindvig, Katrine H Thorhauge, Johanne K Hansen, Maria Kjærgaard, Camilla D Hansen, Stine Johansen, Ellen Lyngbeck, Mads Israelsen, Peter Andersen, Katrine T Bech, Nikolaj Torp, Helle L Schnefeld, Sönke Detlefsen, Sören Möller, Isabel Graupera, Morten B Trelle, Steen Antonsen, Rebecca Harris, Line L Kårhus, Kirsten S Bjørnsbo, Maja Thiele","doi":"10.1016/s2468-1253(24)00274-7","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00274-7","url":null,"abstract":"<h3>Background</h3>Clinically significant liver fibrosis is associated with future adverse events in patients with steatotic liver disease. We designed a software tool for detection of clinically significant liver fibrosis in primary care.<h3>Methods</h3>In this prospective cohort study, we developed and validated LiverPRO using six independent cohorts from Denmark, Germany, and England that included patients from primary and secondary care with steatotic liver disease related to alcohol or metabolic dysfunction. We used clinically significant fibrosis (histology stage ≥F2) and advanced fibrosis (≥F3) as outcomes for variable selection in the development cohort and built the model with fractional polynomial regression. In all cohorts, we independently validated the tool for prediction of elevated liver stiffness by transient elastography (≥8 kPa and ≥12 kPa) and for the 2-year and 5-year risk of liver-related events. Diagnostic performance was assessed using the area under the receiver operating curve (AUC), with clinical performance evaluated through sensitivity, specificity, and Harrell's C-statistic for prognostic purposes.<h3>Findings</h3>In the development cohort (n=462), we derived 466 multivariable models consisting of age in combination with three to nine variables from a list of nine blood tests (aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, international normalised ratio, albumin, sodium, bilirubin, platelet count, and cholesterol). In the development cohort, LiverPRO diagnosed clinically significant fibrosis with good accuracy (transient elastography ≥8 kPa area under the receiver operating characteristic curve [AUC] 0·86 [95% CI 0·83–0·90]). In the DECIDE validation cohort (n=6468), LiverPRO detected participants with a transient elastography of 8 kPa or higher with good accuracy (AUC 0·80 [95% CI 0·78–0·82]), comparable to enhanced liver fibrosis testing (0·78 [0·75–0·80]) and the LiverRisk score (0·81 [0·79–0·84]), but superior to the Fibrosis-4 index (0·69 [0·66–0·72]) and NAFLD Fibrosis Score (0·74 [0·72–0·77]). Findings were consistent in three other validation cohorts (n=2554), albeit accuracy was slightly lower. Using a rule-out cutoff of less than 25% (indicating no further examinations required), LiverPRO had a rule-out sensitivity of 80·6% (95% CI 76·4–84·3) and a rule-out negative predictive value of 98·0% (95% CI 97·5–98·4) in the DECIDE cohort. Similarly, with a rule-out cutoff of less than 1·3, FIB-4 had a rule-out sensitivity of 53·8% (48·5–58·9) and a rule-out negative predictive value of 95·8% (95·1–96·4). For rule-in thresholds, using a cutoff of more than 65% (indicating referral to a hepatologist required) LiverPRO had a rule-in specificity of 95·5% (95% CI 94·9–96·0) and a rule-in positive predictive value of 33·0% (95% CI 28·5–37·8) in the DECIDE cohort whereas FIB-4, with a rule-in threshold of 2·67, had a rule-in specificity of 98·7% (94·9–96·0) and a rule-in positive predictive ","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"20 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00398-4
Further to the Expression of concern The Lancet Gastroenterology & Hepatology issued in September 20241 for an Article presenting country, regional, and global estimates of lactose malabsorption,2 the Editors worked with the authors of the paper to determine whether further data included in the paper did not fully meet the study's stated eligibility criteria. Estimates for a substantial number of countries were identified as being derived, either wholly or in part, from studies that were not representative of the general population, or from studies that did not fulfil other eligibility criteria. As such, the findings of the Article are unreliable and we are now retracting the Article.
{"title":"Retraction—Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis","authors":"","doi":"10.1016/s2468-1253(24)00398-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00398-4","url":null,"abstract":"Further to the Expression of concern <em>The Lancet Gastroenterology & Hepatology</em> issued in September 2024<span><span><sup>1</sup></span></span> for an Article presenting country, regional, and global estimates of lactose malabsorption,<span><span><sup>2</sup></span></span> the Editors worked with the authors of the paper to determine whether further data included in the paper did not fully meet the study's stated eligibility criteria. Estimates for a substantial number of countries were identified as being derived, either wholly or in part, from studies that were not representative of the general population, or from studies that did not fulfil other eligibility criteria. As such, the findings of the Article are unreliable and we are now retracting the Article.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"1 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00382-0
Christopher F D Li Wai Suen, Matthew C Choy, Danny Con, Peter De Cruz
No Abstract
没有抽象的
{"title":"Intensified infliximab induction therapy for steroid-refractory acute severe ulcerative colitis – Authors’ reply","authors":"Christopher F D Li Wai Suen, Matthew C Choy, Danny Con, Peter De Cruz","doi":"10.1016/s2468-1253(24)00382-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00382-0","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"12 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00399-6
In this Comment,1 the authors cite and interpret data based on an Article we now know to be unreliable and that has now been retracted.2 The Committee on Publication Ethics advises that, in such circumstances, the linked Comment should also be retracted to avoid any misunderstanding among readers. We are therefore retracting this Comment.
{"title":"Retraction—What is normal and abnormal in lactose digestion?","authors":"","doi":"10.1016/s2468-1253(24)00399-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00399-6","url":null,"abstract":"In this Comment,<span><span><sup>1</sup></span></span> the authors cite and interpret data based on an Article we now know to be unreliable and that has now been retracted.<span><span><sup>2</sup></span></span> The Committee on Publication Ethics advises that, in such circumstances, the linked Comment should also be retracted to avoid any misunderstanding among readers. We are therefore retracting this Comment.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"11 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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