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http://dx.doi.org/10.5223/pghn.2018.21.2.118

Accuracy of the 2008 Simplified Criteria for the Diagnosis of Autoimmune Hepatitis in Children  

Arcos-Machancoses, Jose Vicente (Department of Pediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Deu Hospital (SJDH))
Busoms, Cristina Molera (Department of Pediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Deu Hospital (SJDH))
Tatis, Ecaterina Julio (Department of Pediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Deu Hospital (SJDH))
Bovo, Maria Victoria (Department of Pediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Deu Hospital (SJDH))
Bernabeu, Jesus Quintero (Department of Pediatric Gastroenterology and Hepatology, Vall d'Hebron Hospital (VHH))
Goni, Javier Juamperez (Department of Pediatric Gastroenterology and Hepatology, Vall d'Hebron Hospital (VHH))
Martinez, Vanessa Crujeiras (Department of Pediatric Gastroenterology and Hepatology, University Hospital Complex of Santiago de Compostela)
Martin de Carpi, Javier (Department of Pediatric Gastroenterology, Hepatology and Nutrition, Sant Joan de Deu Hospital (SJDH))
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.21, no.2, 2018 , pp. 118-126 More about this Journal
Abstract
Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.
Keywords
Autoimmune hepatitis; Diagnosis; Sensitivity and specificity;
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