ABSTRACT
INTRODUCTION AND OBJECTIVES: Autoimmune hepatitis (AIH) is a prevalent noninfectious liver disease. However, there is currently a lack of noninvasive tests appropriate for evaluating liver fibrosis in AIH patients. The objective of this study was to develop and validate a predictive model for noninvasive assessment of significant liver fibrosis (S ≥ 2) in patients to provide a reliable method for evaluating liver fibrosis in individuals with AIH. MATERIALS AND METHODS: The clinical data of 374 AIH patients were analyzed. A prediction model was established through logistic regression in the training set, and bootstrap method was used to validate the models internally. In addition, the clinical data of 109 AIH patients were collected for external verification of the model.The model was expressed as a nomogram, and area under the curve (AUC) of the receiver operating characteristic (ROC), calibration curve, and decision curve analysis were used to evaluate the accuracy of the prediction model. RESULTS: Logistic regression analysis revealed that age, platelet count (PLT), and the A/G ratio were identified as independent risk factors for liver fibrosis in AIH patients (P < 0.05). The diagnostic model that was composed of age, PLT and A/G was superior to APRI and FIB-4 in both the internal validation (0.872, 95%CI: 0.819-0.924) and external validation (0.829, 95%CI: 0.753-0.904). CONCLUSIONS: Our predictive model can predict significant liver fibrosis in AIH patients more accurately, simply, and noninvasively.
Subject(s)
Hepatitis, Autoimmune , Liver Cirrhosis , Nomograms , Predictive Value of Tests , ROC Curve , Humans , Hepatitis, Autoimmune/complications , Hepatitis, Autoimmune/blood , Hepatitis, Autoimmune/diagnosis , Liver Cirrhosis/diagnosis , Liver Cirrhosis/blood , Female , Male , Middle Aged , Adult , Platelet Count , Logistic Models , Risk Factors , Reproducibility of Results , China/epidemiology , Decision Support Techniques , Area Under Curve , Age Factors , Biomarkers/blood , Retrospective Studies , Young Adult , Asian People , Aged , East Asian PeopleABSTRACT
PURPOSE: We wanted to examine the accuracy of the lower limb alignment and implant positioning that was obtained with using the electromagnetic (EM) navigation technique. MATERIALS AND METHODS: We examined 64 patients who underwent 100 TKAs with using EM navigation technique from July 2006 to February 2007. Sixty-two patients who underwent 100 TKAs with using the conventional technique between August 2005 and July 2006 were used as controls. We assessed the mechanical axis and the alpha, beta, gamma and delta angles in the postoperative radiograph of each patient and we compared them among the two groups. RESULTS: The patients in the EM navigation group achieved better accuracy than did the conventional group in terms of the postoperative mean mechanical axis (1.2degrees vs. 2.3degrees). Less variations in the coronal femoral component and the tibial component angle were observed in the navigation group (femur: 89.3degrees vs. 88.7degrees; tibia: 89.6degrees vs. 89.3degrees, respectively), although the difference in the coronal tibial component angle was not significant. CONCLUSION: The use of EM navigation technique in TKA does not always guarantee the precise alignment of the mechanical axis in all planes, as compared to using the conventional technique. Yet it is useful for obtaining better coronal alignment of the femoral component.