{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:37:48Z","timestamp":1792172268271,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["5\/8\/5\/45\/multicentric study\/2019\/ECD\u20101"],"award-info":[{"award-number":["5\/8\/5\/45\/multicentric study\/2019\/ECD\u20101"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Antitubercular drug\u2010induced liver injury (AT\u2010DILI) is the leading cause of drug\u2010induced liver injury in India, yet integrated risk stratification models remain inadequately defined. This study aimed to identify baseline determinants of AT\u2010DILI and to develop machine learning models for its risk prediction at two Indian tertiary centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicentre prospective cohort study conducted from August 2021 to January 2025, 695 treatment\u2010na\u00efve adults with newly diagnosed tuberculosis were followed during first\u2010line therapy. AT\u2010DILI was diagnosed using modified American Thoracic Society (ATS) criteria. Baseline demographic, clinical, biochemical and nutritional variables informed predictive modelling. Nine machine learning algorithms were evaluated using stratified shuffle split cross\u2010validation (10 iterations; 66:34 train\u2013test split) and assessed by the area under the receiver operating characteristic curve (AUC\u2010ROC), area under the precision\u2010recall curve (AUPRC), F1\u2010score, precision, recall and calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AT\u2010DILI incidence was 79\/695 patients (11.4%), with geographic variation (Jodhpur: 8.5% [37\/435]; Manipal: 16.2% [42\/260]). State\u2010based differences reached significance (OR:1.67; 95% CI:1.02\u20132.74). The baseline urea\u2010to\u2010albumin ratio was significantly elevated in patients who developed AT\u2010DILI (6.13\n                      <jats:italic>vs<\/jats:italic>\n                      . 5.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.015), whereas conventional liver function tests lacked predictive value. Most cases (84.2%) manifested by Week 2 (65.8% at Week 2; 18.4% earlier), marked by elevated alanine aminotransferase (ALT) (115\n                      <jats:italic>vs<\/jats:italic>\n                      . 19\u2009IU L\n                      <jats:sup>\u22121<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001), aspartate aminotransferase (AST) (124\n                      <jats:italic>vs<\/jats:italic>\n                      . 24\u2009IU L\n                      <jats:sup>\u22121<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001), and bilirubin (0.67\n                      <jats:italic>vs<\/jats:italic>\n                      . 0.52\u2009mg dL\n                      <jats:sup>\u22121<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.002). Gradient boosting showed the highest discrimination (AUC 0.97; precision 0.95; F1\u2010score 0.75; recall 0.62), followed by random forest (AUC 0.92).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline demographic, clinical and biochemical profiling enhances AT\u2010DILI risk stratification. Gradient boosting demonstrated the highest performance (AUC 0.97), followed by random forest (AUC 0.92).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70838","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:58:42Z","timestamp":1790341122000},"source":"Crossref","is-referenced-by-count":1,"title":["Machine learning framework for prediction of drug\u2010induced liver injury in patients on antitubercular therapy: Multicentric study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-3076","authenticated-orcid":false,"given":"Mithu","family":"Banerjee","sequence":"first","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7106-8545","authenticated-orcid":false,"given":"Manoj","family":"Khokhar","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitali","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namya","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Mohandas","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashi","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snigdha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sojit","family":"Tomo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Dutt","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarika","family":"Kombade","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahadev","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levin","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha","family":"Saravu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Kasturba Medical College, Manipal, Manipal Academy of Higher Education  Manipal Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidhar","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Kasturba Medical College, Manipal, Manipal Academy of Higher Education  Manipal Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant","family":"Borana","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine S.N. 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