The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database
Open accessAbstract
Background & methods The Child-Turcotte-Pugh (CTP) score is a widely used and validated predictor of long-term survival in cirrhosis. The CTP score is a composite of 5 subscores, 3 based on objective clinical laboratory values and 2 subjective variables quantifying the severity of ascites and hepatic encephalopathy. To date, no system to quantify CTP score from administrative databases has been validated. The Veterans Outcomes and Costs Associated with Liver Disease study is a multicenter collaborative study to evaluate the outcomes and costs of hepatocellular carcinoma in the U.S. Veterans Health Administration. We developed and validated an algorithm to calculate electronic CTP (eCTP) scores by using data from the Veterans Health Administration Corporate Data Warehouse.Methods Multiple algorithms for determining each CTP subscore from International Classification of Diseases version 9, Common Procedural Terminology, pharmacy, and laboratory data were devised and tested in 2 patient cohorts. For each cohort, 6 site investigators (Boston, Bronx, Brooklyn, Philadelphia, Minneapolis, and West Haven VA Medical Centers) were provided cases from which to determine validity of diagnosis, laboratory data, and clinical assessment of ascites and encephalopathy. The optimal algorithm (designated eCTP) was then applied to 30,840 cirrhotic patients alive in the first quarter of 2008 for whom 5-year overall and transplant-free survival data were available. The ability of the eCTP score and other disease severity scores (Charlson-Deyo index, Veterans Aging Cohort Study index, Model for End-Stage Liver Disease score, and Cirrhosis Comorbidity) to predict survival was then assessed by Cox proportional hazards regression.Results Spearman correlations for administrative and investigator validated laboratory data in the HCC and cirrhotic cohorts, respectively, were 0.85 and 0.92 for bilirubin, 0.92 and 0.87 for albumin, and 0.84 and 0.86 for international normalized ratio. In the HCC cohort, the overall eCTP score matched 96% of patients to within 1 point of the chart-validated CTP score (Spearman correlation, 0.81). In the cirrhosis cohort, 98% were matched to within 1 point of their actual CTP score (Spearman, 0.85). When applied to a cohort of 30,840 patients with cirrhosis, each unit change in eCTP was associated with 39% increase in the relative risk of death or transplantation. The Harrell C statistic for the eCTP (0.678) was numerically higher than those for other disease severity indices for predicting 5-year transplant-free survival. Adding other predictive models to the eCTP resulted in minimal differences in its predictive performance.Conclusion We developed and validated an algorithm to extrapolate an eCTP score from data in a large administrative database with excellent correlation to actual CTP score on chart review. When applied to an administrative database, this algorithm is a highly useful predictor of survival when compared with multiple other published liver disease severity indices.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Ascites and hepatic encephalopathy were ascertained using ICD-9 and ICD-10 codes and medications using a validated algorithm and classified as none, mild or controlled, and severe or uncontrolled.28”
From Depression and anxiety are common among patients with cirrhosis (2022) · cites this paper as [28]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Erdogan, D., Heijnen, B. H. M., Bennink, R. J., Kok, M., Dinant, S., Straatsburg, I. H., Gouma, D. J., & van Gulik, T. M. (2004) · Liver International · doi:10.1111/j.1478-3231.2004.00901.x · Cited by 11,656
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452
Transection of the oesophagus for bleeding oesophageal varices
Pugh, R. N. H., Murray-Lyon, I. M., Dawson, J. L., Pietroni, M. C., & Williams, R. (1973) · Journal of British Surgery · doi:10.1002/bjs.1800600817 · Cited by 7,941
Pencina, M. J., D' Agostino, R. B., D' Agostino, R. B., & Vasan, R. S. (2008) · Statistics in Medicine · doi:10.1002/sim.2929 · Cited by 6,493
D'Amico, G., Garcia-Tsao, G., & Pagliaro, L. (2006) · Journal of Hepatology · doi:10.1016/j.jhep.2005.10.013 · Cited by 2,687
Model for end-stage liver disease (MELD) and allocation of donor livers
Wiesner, R. H., Edwards, E. B., Freeman, R. B., Harper, A., Kim, W. R., Kamath, P. S., Kremers, W. K., Lake, J. R., Howard, T. K., Merion, R. M., et al. (2003) · Gastroenterology · doi:10.1053/gast.2003.50016 · Cited by 2,524
Surgery and portal hypertension.
Child, C. G., & Turcotte, J. (1964) · PubMed · Cited by 1,933
The Liver and Portal Hypertension.
(1964) · Annals of Internal Medicine · doi:10.7326/0003-4819-61-6-1206_2 · Cited by 1,056
Using the outcome for imputation of missing predictor values was preferred
Moons, K. G. M., Donders, R. A. R. T., Stijnen, T., & Harrell, F. E. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.01.009 · Cited by 999
MELD and PELD: Application of survival models to liver allocation
Wiesner, R. H., McDiarmid, S. V., Kamath, P. S., Edwards, E. B., Malinchoc, M., Kremers, W. K., Krom, R. A. F., & Kim, W. R. (2001) · Liver Transplantation · doi:10.1053/jlts.2001.25879 · Cited by 866
Flagged first, then by citations
Research works printed but not linked: 2
- Hassanein, 2005, MELD and SOFA scores as a predictor of transplant tree survival time in patients with end stage liver disease complicated by intractable hepatic encephalopathy grades 3 and 4, Gastroenterology, 128, A705
- Sheehan, 2005, MELD scores,encephalopathy and survival in acute-on-chronic liver failure, Gastroenterology, 128, A-705
Cited by
Sorted by citations
Items 101–138 of 138
Tan, J., Chen, Y., Wang, L., Chan, T., Amer, S., Xu, X., Cai, J., Li, W., Zheng, X., Zhou, M., et al. (2019) · Virology Journal · doi:10.1186/s12985-019-1119-7 · Cited by 4
Treatment of hepatitis C virus infection in patients with hepatocellular carcinoma: Truth or dare?
Mocan, T., Nenu, I., Crăciun, R., & Sparchez, Z. A. (2020) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15376 · Cited by 4
Early thoracentesis correlated with survival benefit in patients with spontaneous bacterial empyema
Albitar, H. A. H., Iyer, V., Nelson, D. R., Kern, R. M., Leise, M. D., & de Moraes, A. G. (2022) · Digestive and Liver Disease · doi:10.1016/j.dld.2022.02.007 · Cited by 4
Lin, Y., Chen, W., Wu, T., Liu, Y., Liu, L.-T., Teng, W., Hsieh, Y., Wu, Y.-M., Huang, C., Hsu, C., et al. (2023) · Diagnostics · doi:10.3390/diagnostics13152578 · Cited by 4
Su, G. L., Zhang, P., Belancourt, P. X., Youles, B., Enchakalody, B. E., Perumalswami, P., Waljee, A. K., & Saini, S. D. (2023) · Hepatology · doi:10.1097/hep.0000000000000750 · Cited by 3
Shenoy, A., Valicevic, A. N., Lin, A., Su, G. L., Saini, S. D., Kim, H. M., & Adams, M. A. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002979 · Cited by 3
Mahmud, N., Parra, N. S., Hecht, A. L., Kaplan, D. E., & Serper, M. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000655 · Cited by 3
Self-citationLiu, Q., Li, X., Liu, J. H., Song, X., Jiang, X., Li, W., Zhang, H., & Pan, C. Q. (2016) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.13124 · Cited by 3
Townsend, L., Blais, P., Huh, A., Nayak, L., Elwing, J. E., & Sayuk, G. S. (2019) · JGH Open · doi:10.1002/jgh3.12290 · Cited by 3
Decompensated cirrhosis but low MELD—Should we wait or refer for liver transplantation?
Singh, N., Wong, Y. J., Burra, P., Selzner, N., & Montaño‐Loza, A. J. (2025) · Liver Transplantation · doi:10.1097/lvt.0000000000000608 · Cited by 2
Matevish, L. E., Guo, J., Bababekov, Y. J., Shubin, A. D., Goldaracena, N., Pedersen, M. R., Mufti, A., Pomposelli, J. J., Hanish, S. I., Vagefi, P. A., et al. (2025) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2025.116512 · Cited by 2
Ochoa‐Allemant, P., Kiran, A., Mezzacappa, C., Kaplan, D. E., & Mahmud, N. (2026) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003966 · Cited by 2
Self-citationGriselda, G., Rahadiyanto, K. Y., & Hidayat, R. (2019) · Bioscientia Medicina Journal of Biomedicine and Translational Research · doi:10.32539/bsm.v3i1.80 · Cited by 2
Yuksek, A., Acehan, S., Satar, S., Gülen, M., Balcik, M., Sevdimbaş, S., İnce, Ç., Koca, A. N., & Taş, A. (2023) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000002646 · Cited by 2
Wang, R. X., Vizzutti, F., Celsa, C., Schepis, F., Kaplan, D. E., & Mahmud, N. (2024) · Hepatology Communications · doi:10.1097/hc9.0000000000000346 · Cited by 2
Self-citationKaplan, D. E., Tan, R., Xiang, C. Q., Mu, F., Hernandez, S., Ogale, S. S., Li, J., Lin, Y., Shi, L., & Singal, A. G. (2024) · Cancers · doi:10.3390/cancers16203508 · Cited by 2
Self-citationMortality and length of hospital stay in patients with liver cirrhosis based on their MELD score
Khan, H., Din, N. U., Iqbal, S., Abbas, G., Yousaf, M., Shah, B. M., & Umam, S. (2024) · Journal of Medical Sciences · doi:10.52764/jms.24.32.1.2 · Cited by 2
Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma
Kaplan, D. E., Mehta, R. L., D’Addeo, K., Valderrama, A., & Taddei, T. H. (2018) · Medicine · doi:10.1097/md.0000000000009757 · Cited by 2
Self-citationHecht, A. L., Mahmud, N., Chaudhry, S., Cao, J. Y., Branigan, G. P., Lee, J., Theiller, E., Roggiani, M., Friedman, E. S., Herman, L., et al. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.03.26.645536 · Cited by 2
Self-citationTran, N. H., Soefje, S. A., Rangarajan, N., Krishnappa, P., Wagner, T. E., Valerio, S. J., Anderson, R., & Olson, J. C. (2025) · Cancers · doi:10.3390/cancers17213499 · Cited by 1
Mahmud, N., Schechter, M. S., Zhang, S. L., Mezzacappa, C., Ochoa‐Allemant, P., Kaplan, D. E., & Serper, M. (2026) · Hepatology · doi:10.1097/hep.0000000000001739 · Cited by 1
Self-citationKumar, A. (2022) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2022.07.240 · Cited by 1
Abou-Shady, M. A., Kassem, A., Radwan, M. S. E., & Ismail, A. (2019) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2019.43077 · Cited by 1
Fortune, B. E., Ciarleglio, M. M., Deng, Y., & García–Tsao, G. (2017) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000000830
Enkhjargal, M., Nakajima, T., Shibuya, K., Shrestha, S., Hirasawa, H., & Tsushima, Y. (2019) · The Kitakanto Medical Journal · doi:10.2974/kmj.69.183
Hatami, B., Asadi, F., Bayani, A., Zali, M. R., & Kavousi, K. (2022) · doi:10.2196/preprints.36567
Rosenthal, P. J. (2019) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.734776893.793555072
The Association Between Homelessness and Key Liver-Related Outcomes in Veterans With Cirrhosis
Pulaski, M., Bittermann, T., Taddei, T. H., Kaplan, D. E., & Mahmud, N. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002535
Self-citationAlturfi, R. R., Majeed, T. A., Al‐Badri, S. G., Saleh, S. A., & Mahmood, A. S. (2024) · Springer eBooks · doi:10.1007/978-3-031-65738-2_7
Impact of Surgery Duration on Postoperative Mortality in Patients With Cirrhosis
Hatipoğlu, D., Parra, N. S., Kaplan, D. E., Abu‐Gazala, S., & Mahmud, N. (2025) · Gastro Hep Advances · doi:10.1016/j.gastha.2025.100771
Self-citationWuyts, S. C. M., Hilbrands, N. J., Aerts, M., Mulder, M. B., Pien, K., Dupont, A. G., Borgsteede, S. D., & Cornu, P. (2025) · Drugs & Therapy Perspectives · doi:10.1007/s40267-025-01200-1
Goldberg, D. S., John, B., Kaplan, D. E., Delgado, C., Gaddipati, N., Gaddipati, S., & Blandon, C. (2026) · Hepatology Communications · doi:10.1097/hc9.0000000000000891
Self-citationAyati, A., Watanabe, A. H., Guillot, J., Azzam, S., Zhang, X., Chaudhri, E., Vendetti, M. L., Fernandes, G. F., Rudrapatna, V. A., & Ge, J. (2026) · npj gut and liver. · doi:10.1038/s44355-026-00057-z
Bansal, S., Amin, P., Williamson, C., Valerio, S. J., & Kaplan, D. E. (2026) · Cancers · doi:10.3390/cancers18071085
Self-citationSinha, A., Chaudhari, B., Chaudhury, S., & Banerjee, D. (2026) · Annals of Indian Psychiatry · doi:10.4103/aip.aip_261_25
Zhang, Q., Tang, H., Zhang, J., Weng, J., Liu, W., Dai, X., & Zhang, M. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2703891
Belliveau, O., Mezzacappa, C., Patel, A., Kapo, J. M., Kaplan, D. E., & Taddei, T. H. (2026) · Journal of Palliative Medicine · doi:10.1177/10966218261488082
Self-citationMahmud, N., McCullough, A. A., Zhang, S., Hao, J., Schaubel, D. E., Kaplan, D. E., & Serper, M. (2026) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2026.09.029
Self-citation
Metadata
- Authors
- Kaplan, D. E., Dai, F., Aytaman, A., Baytarian, M., Fox, R., Hunt, K., Knott, A., Pedrosa, M., Pocha, C., Mehta, R., Duggal, M., Skanderson, M., Valderrama, A., & Taddei, T. H.
- Affiliations
- Philadelphia VA Medical Center (US)
- VA Connecticut Healthcare System (US)
- VA NY Harbor Healthcare System (US)
- VA Boston Healthcare System (US)
- San Francisco VA Medical Center (US)
- James J. Peters VA Medical Center (US)
- Minneapolis VA Health Care System (US)
- Corresponding author
- Kaplan, David E.
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 13
- Issue
- 13
- Pages
- 2333-2341.e6
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC4655141
- OpenAlex
- W901036528
- Cited by
- 139
- References
- 31
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 18 · 2023: 11 · 2022: 20 · 2021: 14 · 2020: 18 · 2019: 16 · 2018: 7 · 2017: 8 · 2016: 6
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (VA999999)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK034989)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- Child-Pugh score, liver cirrhosis, electronic health records, administrative data, algorithm validation, ascites, hepatic encephalopathy, MELD score, overall survival, transplant-free survival, hepatocellular carcinoma, veterans, Veterans Health Administration
- MeSH terms
- Algorithms, Ascites, Female, Hepatic Encephalopathy, Humans, Liver Cirrhosis, Male, Middle Aged, Prognosis, Severity of Illness Index, Survival, United States, Cohort Studies, Databases, Factual, Electronic Health Records
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
