Accuracy of clinical diagnosis of cirrhosis among alcohol-abusing men.
There is a considerable variation among specialists in the use of liver biopsy for the diagnosis of alcoholic cirrhosis, which is often based solely on clinical findings, sometimes supplemented with blood tests.
To assess the diagnostic accuracy that may be achieved by this approach, we related items of the history, symptoms and signs, and routine blood tests to the presence/absence of cirrhosis in a unique, previously established, consecutive series of 303 alcohol-abusing men, in whom liver biopsy was performed irrespective of the clinical and biochemical findings.
Using logistic regression analyses, we created a clinical, a combined clinical and biochemical, and a pure biochemical diagnostic model.
The probability of cirrhosis in patients with the specified characteristics was estimated, the diagnostic accuracy was assessed as functions of diagnostic thresholds for cirrhosis defined by the probability of cirrhosis varying between 0 and 1, and confidence intervals were estimated by bootstrap sampling.
The clinical model, including facial teleangiectasia, vascular spiders, white nails, abdominal veins, fatness, and peripheral edema, could be used with high diagnostic accuracy and it was clearly superior to the biochemical model.
Adding biochemical findings to the clinical model improved the accuracy of the clinical model only slightly. (...)
Mots-clés Pascal : Alcoolisme, Cirrhose, Exploration clinique, Biopsie, Analyse biochimique, Diagnostic, Evaluation performance, Technique, Homme, Etude comparative, Danemark, Europe, Appareil digestif pathologie, Foie pathologie
Mots-clés Pascal anglais : Alcoholism, Cirrhosis, Clinical investigation, Biopsy, Biochemical analysis, Diagnosis, Performance evaluation, Technique, Human, Comparative study, Denmark, Europe, Digestive diseases, Hepatic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0054689
Code Inist : 002B13C03. Création : 21/05/1997.