Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study
Abstract Background and Aim The American Society of Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) have published guidelines for choledocholithiasis. However, the guidelines were formulated using data from a large number of patients with no to low ris...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12773 |
| _version_ | 1811335200880197632 |
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| author | Suppadech Tunruttanakul Borirak Chareonsil Kotchakorn Verasmith Jayanton Patumanond Chatchai Mingmalairak |
| author_facet | Suppadech Tunruttanakul Borirak Chareonsil Kotchakorn Verasmith Jayanton Patumanond Chatchai Mingmalairak |
| author_sort | Suppadech Tunruttanakul |
| collection | DOAJ |
| description | Abstract Background and Aim The American Society of Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) have published guidelines for choledocholithiasis. However, the guidelines were formulated using data from a large number of patients with no to low risk of common bile duct (CBD) stones. This study aimed to assess the guidelines' predictive performance in a population with a high frequency of stones. Methods Data for three choledocholithiasis standard reference tests were retrospectively reviewed from January 2019 to June 2021. Clinical parameters were used to categorize patients into risk groups according to the guidelines, and then the guidelines' predictive abilities were calculated. Results Among 1185 patients, 521 were included. The stone prevalence was 61.0% (n = 318). Twelve (2.3%), 146 (28.0%), and 363 (69.7%) patients were classified into low‐, intermediate‐, and high‐risk groups according to the ASGE guidelines, and 30 (5.8%), 149 (28.6%), and 342 (65.6%) according to the ESGE guidelines. Focusing on the high‐risk group, the ASGE guidelines had a positive predictive value of 73.6 and a positive likelihood ratio of 1.78. The ESGE guidelines had a positive predictive value of 73.7 and positive likelihood ratio of 1.79. Both guidelines had equivalent areas under the receiver operating characteristic curve of 0.69 (95% confidence interval [CI]: 0.65–0.73) and 0.68 (95% CI: 0.64–0.72), respectively. Conclusion In the high‐risk group, the guidelines increased the chance of detecting choledocholithiasis by approximately 10% (61.0% prevalence to 73.6 and 73.7% positive predictive value). However, statistically, the guidelines had marginal discriminative performance in a population with high stone prevalence. |
| first_indexed | 2024-04-13T17:20:36Z |
| format | Article |
| id | doaj.art-9804217951db4b21a307a2e16d98f1fe |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-13T17:20:36Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-9804217951db4b21a307a2e16d98f1fe2022-12-22T02:38:00ZengWileyJGH Open2397-90702022-06-016643444010.1002/jgh3.12773Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort studySuppadech Tunruttanakul0Borirak Chareonsil1Kotchakorn Verasmith2Jayanton Patumanond3Chatchai Mingmalairak4Department of Surgery Sawanpracharak Hospital Nakhon Sawan ThailandDepartment of Surgery Sawanpracharak Hospital Nakhon Sawan ThailandDepartment of Radiology Sawanpracharak Hospital Nakhon Sawan ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine Chiang Mai University Chiang Mai ThailandDepartment of Surgery, Faculty of Medicine Thammasat University Pathum Thani ThailandAbstract Background and Aim The American Society of Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) have published guidelines for choledocholithiasis. However, the guidelines were formulated using data from a large number of patients with no to low risk of common bile duct (CBD) stones. This study aimed to assess the guidelines' predictive performance in a population with a high frequency of stones. Methods Data for three choledocholithiasis standard reference tests were retrospectively reviewed from January 2019 to June 2021. Clinical parameters were used to categorize patients into risk groups according to the guidelines, and then the guidelines' predictive abilities were calculated. Results Among 1185 patients, 521 were included. The stone prevalence was 61.0% (n = 318). Twelve (2.3%), 146 (28.0%), and 363 (69.7%) patients were classified into low‐, intermediate‐, and high‐risk groups according to the ASGE guidelines, and 30 (5.8%), 149 (28.6%), and 342 (65.6%) according to the ESGE guidelines. Focusing on the high‐risk group, the ASGE guidelines had a positive predictive value of 73.6 and a positive likelihood ratio of 1.78. The ESGE guidelines had a positive predictive value of 73.7 and positive likelihood ratio of 1.79. Both guidelines had equivalent areas under the receiver operating characteristic curve of 0.69 (95% confidence interval [CI]: 0.65–0.73) and 0.68 (95% CI: 0.64–0.72), respectively. Conclusion In the high‐risk group, the guidelines increased the chance of detecting choledocholithiasis by approximately 10% (61.0% prevalence to 73.6 and 73.7% positive predictive value). However, statistically, the guidelines had marginal discriminative performance in a population with high stone prevalence.https://doi.org/10.1002/jgh3.12773abilitycholedocholithiasisguidelineprevalence |
| spellingShingle | Suppadech Tunruttanakul Borirak Chareonsil Kotchakorn Verasmith Jayanton Patumanond Chatchai Mingmalairak Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study JGH Open ability choledocholithiasis guideline prevalence |
| title | Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study |
| title_full | Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study |
| title_fullStr | Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study |
| title_full_unstemmed | Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study |
| title_short | Evaluation of the American Society of Gastrointestinal Endoscopy 2019 and the European Society of Gastrointestinal Endoscopy guidelines' performances for choledocholithiasis prediction in clinically suspected patients: A retrospective cohort study |
| title_sort | evaluation of the american society of gastrointestinal endoscopy 2019 and the european society of gastrointestinal endoscopy guidelines performances for choledocholithiasis prediction in clinically suspected patients a retrospective cohort study |
| topic | ability choledocholithiasis guideline prevalence |
| url | https://doi.org/10.1002/jgh3.12773 |
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