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. 2021 Feb 11;11(2):e044952. doi: 10.1136/bmjopen-2020-044952

Table 2.

Prediction of a first serious liver event (SLE), liver admission with or without SLE (liver disease or SLE), or mortality in validation dataset 1 (UHS cohort) and prediction of a first SLE or liver admission with or without SLE in validation dataset 2 (CHIE cohort), within 5 years of the CIRRUS index test

  CIRRUS Risk factor Event (SLE)/total Prevalence Sensitivity Specificity PPV NPV PLR NLR
Validation dataset 1 (UHS cohort)
 SLE CvRAG Liver risk factor (alc/DM2/VH) 1733/31 939 5.93 0.63 0.92 0.33 0.98 7.71 0.40
CRvAG 0.72 0.87 0.26 0.98 5.65 0.32
CvRAG No liver risk factors 1311/362 314 0.37 0.49 0.97 0.05 1.00 14.85 0.53
CRvAG 0.57 0.94 0.04 1.00 10.18 0.46
CvRAG Alcohol 1053/10 642 10.89 0.76 0.87 0.42 0.97 5.91 0.28
CRvAG 0.83 0.82 0.35 0.97 4.48 0.21
CvRAG Type 2 diabetes 649/20 499 3.35 0.48 0.94 0.21 0.98 7.53 0.56
CRvAG 0.58 0.89 0.16 0.98 5.50 0.47
CvRAG Viral hepatitis 288/1890 30.00 0.59 0.88 0.68 0.83 5.06 0.47
CRvAG 0.72 0.83 0.65 0.87 4.26 0.33
 Liver disease or SLE CvRAG Liver risk factor (alc/DM2/VH) 4467/31 939 13.99 0.44 0.92 0.47 0.91 5.36 0.61
CRvAG 0.54 0.87 0.41 0.92 4.26 0.52
CvRAG No liver risk factors 5491/362 314 1.52 0.28 0.97 0.12 0.99 8.46 0.75
CRvAG 0.35 0.94 0.09 0.99 6.33 0.69
 Dead CvRAG Liver risk factor (alc/DM2/VH) 4638/27 734 14.5 0.36 0.91 0.40 0.89 3.9 0.70
CRvAG 0.45 0.86 0.35 0.90 3.2 0.64
CvRAG No liver risk factors 4612/362 314 5.3 0.24 0.97 0.35 0.96 9.6 0.78
CRvAG 0.31 0.95 0.28 0.96 6.8 0.72
Validation dataset 2 (CHIE cohort)
 SLE CvRAG Liver risk factor (alc/DM2) 876/35 832 2.54 0.49 0.97 0.29 0.99 15.56 0.53
CRvAG 0.59 0.93 0.18 0.99 8.62 0.44
CvRAG No liver risk factors 294/147 213 0.20 0.30 0.99 0.04 1.00 21.20 0.71
CRvAG 0.39 0.97 0.02 1.00 11.36 0.63
CvRAG Alcohol 636/14 666 4.55 0.56 0.95 0.36 0.98 11.57 0.47
CRvAG 0.65 0.90 0.25 0.98 6.82 0.38
CvRAG Type 2 diabetes 441/23 896 1.92 0.41 0.97 0.24 0.99 16.35 0.60
CRvAG 0.52 0.94 0.15 0.99 8.91 0.51
 Liver disease or SLE CvRAG Liver risk factor (alc/DM2) 2259/35 832 6.30 0.28 0.97 0.37 0.95 8.88 0.74
CRvAG 0.37 0.93 0.27 0.96 5.40 0.68
CvRAG No liver risk factors 1985/147 213 1.35 0.10 0.99 0.09 0.99 7.36 0.91
CRvAG 0.15 0.97 0.06 0.99 4.41 0.88

Validation dataset 1 (UHS cohort) liver risk factors: any of the following preidentified risk factors for liver disease: alcohol (previous admission with an alcohol ICD code), diabetes (elevated HbA1C or a previous admission with type 2 diabetes), viral hepatitis (HBsAg, HBV DNA or HCV RNA).

Validation dataset 2 (CHIE cohort) liver risk factors: any of the following preidentified risk factors for liver disease: alcohol (previous admission with an alcohol ICD code, harmful dependent drinking or an alcohol comorbidity in the primary care record) or diabetes (type 2 diabetes in primary or secondary care records).

In each dataset, the control population were patients with no liver admissions.

An SLE was defined as a hospital admission with an ICD code for either varices, liver-related ascites or cirrhosis.

CHIE, Care and Health Information Exchange; CIRRUS, CIRRhosis Using Standard tests; CRvAG, crimson or red test ‘vs’ amber or green result; CvRAG, crimson test ‘vs’ red, amber or green result; DM2, type 2 diabetes mellitus; NLR, negative likelihood ratio; NPV, negative predictive value; PLR, positive likelihood ratio; PPV, positive predictive value; SLE, serious liver event; UHS, University Hospital Southampton.