Department of Internal Medicine, Marshall University School of Medicine, Huntington, WV, USA.
Gut Liver. 2013 May;7(3):323-8. doi: 10.5009/gnl.2013.7.3.323. Epub 2013 Apr 25.
BACKGROUND/AIMS: The BARD score is a model to detect advanced liver fibrosis in nonalcoholic fatty liver disease (NAFLD) patients. The aims of this study were to identify additional factors and then to build an enhanced version of the BARD score.
One hundred seven patients with biopsy-proven NAFLD were enrolled retrospectively. Logistic regressions were performed to identify independent risk factors for advanced liver fibrosis (stage 3 or 4). An enhanced model of the BARD score (BARDI score) was built and evaluated with a receiver operating characteristic (ROC) curve.
In multivariate analysis, age (odds ratio [OR], 0.89; p=0.04), aspartate aminotransferase/alanine aminotransferase ratio (OR, 1.73; p<0.01), and international normalized ratio (INR) (OR, 8.85; p<0.01) were independently significant factors. The BARDI score was created by adding the INR to the BARD. The area under the ROC curve of the BARDI score was significantly larger than that of the BARD score (0.881 vs 0.808, p<0.01). A BARDI score of 3 or more showed a positive predictive value (PPV) of 51.0% and a negative predictive value (NPV) of 96.0%.
The BARDI score had an improved PPV over the BARD score and maintained an excellent NPV. Further study is warranted for its external validation and comparison with other models.
背景/目的：BARD 评分是一种用于检测非酒精性脂肪性肝病（NAFLD）患者中晚期肝纤维化的模型。本研究旨在确定其他因素，并构建 BARD 评分的增强版本。
回顾性纳入 107 例经肝活检证实的 NAFLD 患者。采用逻辑回归分析确定晚期肝纤维化（3 或 4 期）的独立危险因素。构建并通过接受者操作特征（ROC）曲线评估 BARD 评分（BARDI 评分）的增强模型。
多因素分析中，年龄（比值比 [OR]，0.89；p=0.04）、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比值（OR，1.73；p<0.01）和国际标准化比值（INR）（OR，8.85；p<0.01）是独立的显著因素。BARDI 评分是通过将 INR 添加到 BARD 中创建的。BARDI 评分的 ROC 曲线下面积显著大于 BARD 评分（0.881 对 0.808，p<0.01）。BARDI 评分≥3 分的阳性预测值（PPV）为 51.0%，阴性预测值（NPV）为 96.0%。
BARDI 评分的 PPV 优于 BARD 评分，且保持了极好的 NPV。需要进一步的研究来验证其外部有效性并与其他模型进行比较。
