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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.
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“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]
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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
Accuracy and completeness of mortality data in the Department of Veterans Affairs
Sohn, M., Arnold, N., Maynard, C., & Hynes, D. (2006) · Population Health Metrics · doi:10.1186/1478-7954-4-2 · Cited by 533
Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease
Said, A. (2004) · Journal of Hepatology · doi:10.1016/j.jhep.2004.02.010 · Cited by 430
Cholongitas, Ε., Papatheodoridis, G., Vangeli, M., Terreni, N. M., Patch, D., & Burroughs, A. K. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02691.x · Cited by 421
Uno, H., Tian, L., Cai, T., Kohane, I. S., & Wei, L. J. (2012) · Statistics in Medicine · doi:10.1002/sim.5647 · Cited by 390
Predictive Indices of Morbidity and Mortality After Liver Resection
Schroeder, R. A., Marroquin, C. E., Phillips‐Bute, B. G., Khuri, S. F., Henderson, W. G., & Kuo, P. C. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000201483.95911.08 · Cited by 337
Kramer, J. R., Davila, J. A., MILLER, E. D., Richardson, P., Giordano, T. P., & EL‐SERAG, H. B. (2007) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2007.03572.x · Cited by 269
Farnsworth, N. N., Fagan, S. P., Berger, D. H., & Awad, S. S. (2004) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2004.07.034 · Cited by 265
The Safety of Intra-abdominal Surgery in Patients With Cirrhosis
Befeler, A. S. (2005) · Archives of Surgery · doi:10.1001/archsurg.140.7.650 · Cited by 235
. Towards a combined prognostic index for survival in HIV infection: the role of non-HIV biomarkers.
Justice, A., McGinnis, K., Skanderson, M., Chang, C., Gibert, C., Goetz, M., Rimland, D., Rodriguez‐Barradas, M., Oursler, K., Brown, S., et al. (2010) · HIV Medicine · doi:10.1111/j.1468-1293.2009.00757.x · Cited by 159
Self-citationRe, V. L., Lim, J. K., Goetz, M. B., Tate, J., Bathulapalli, H., Klein, M. B., Rimland, D., Rodriguez‐Barradas, M. C., Butt, A. A., Gibert, C. L., et al. (2011) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.2148 · Cited by 156
Development and Validation of a Comorbidity Scoring System for Patients With Cirrhosis
Jepsen, P., Vilstrup, H., & Lash, T. L. (2013) · Gastroenterology · doi:10.1053/j.gastro.2013.09.019 · Cited by 123
Utilization of Screening for Hepatocellular Carcinoma in the United States
Davila, J. A., Weston, A., Smalley, W. E., & El‐Serag, H. B. (2007) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3180381560 · Cited by 113
Delis, S., Bakoyiannis, A., Madariaga, J., Bramis, J., Tassopoulos, N., & Dervenis, C. (2009) · Surgical Endoscopy · doi:10.1007/s00464-009-0588-y · Cited by 100
Myers, R. P., Quan, H., Hubbard, J. N., Shaheen, A. A., & Kaplan, G. G. (2008) · Hepatology · doi:10.1002/hep.22676 · Cited by 92
Brown, D. B., Fundakowski, C., Lisker‐Melman, M., Crippin, J. S., Pilgram, T. K., Chapman, W. C., & Darcy, M. D. (2004) · Journal of Vascular and Interventional Radiology · doi:10.1097/01.rvi.0000128123.04554.c1 · Cited by 88
Hoteit, M.-A. (2008) · World Journal of Gastroenterology · doi:10.3748/wjg.14.1774 · Cited by 83
Ho, Y., Chen, Y., Yang, C., Lien, J., Chu, Y., Fang, J., Chiu, C., Chen, P., & Tsai, M.-H. (2004) · Journal of Intensive Care Medicine · doi:10.1177/0885066603261991 · Cited by 59
Butt, A. K. (1998) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(98)00587-5 · Cited by 48
Butt, A. K., Khan, A. A., Alam, A., et al. (1998) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1998.00706.x · Cited by 40
Boin, I. D. F. S. F., Leonardi, M. I., Pinto, A., Leme, R. S. R., Udo, E. Y., Stucchi, R. S. B., Soares, E. C., & Leonardi, L. S. (2004) · Transplantation Proceedings · doi:10.1016/j.transproceed.2004.03.095 · Cited by 29
Reichman, T., Bahramipour, P., Barone, A., Koneru, B., Fisher, A., Contractor, D., Wilson, D. J., Torre, A. D., Cho, K. C., Samanta, A. K., et al. (2005) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2004.11.002 · Cited by 18
Harrell, F., Jr. (1996) · doi:10.1002/(sici)1097-0258(19960229)15:4
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
Hagström, H., Adams, L. A., Allen, A. M., Byrne, C. D., Chang, Y., Grønbæk, H., Ismail, M. H., Jepsen, P., Kanwal, F., Kramer, J. R., et al. (2021) · Hepatology · doi:10.1002/hep.31726 · Cited by 265
Mahmud, N., Kaplan, D. E., Taddei, T. H., & Goldberg, D. S. (2019) · Hepatology · doi:10.1002/hep.30494 · Cited by 190
Self-citationRisk Prediction Models for Post‐Operative Mortality in Patients With Cirrhosis
Mahmud, N., Fricker, Z. P., Hubbard, R. A., Ioannou, G. N., Lewis, J. D., Taddei, T. H., Rothstein, K. D., Serper, M., Goldberg, D. S., & Kaplan, D. E. (2020) · Hepatology · doi:10.1002/hep.31558 · Cited by 177
Self-citationKanwal, F., Kramer, J. R., Li, L., Yang, Y., Cao, Y., Yu, X., Samuel, R. E., Ali, B., Desiderio, R., Cholankeril, G. T., et al. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.4661 · Cited by 170
Kaplan, D. E., Serper, M. A., Mehta, R., Fox, R., John, B., Aytaman, A., Baytarian, M., Hunt, K., Albrecht, J., Njei, B., et al. (2019) · Gastroenterology · doi:10.1053/j.gastro.2019.01.026 · Cited by 145
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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
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