{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:48:44Z","timestamp":1790790524217,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"3-4","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":66,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100016308","name":"Wuxi Health and Family Planning Commission","doi-asserted-by":"publisher","award":["M202340"],"award-info":[{"award-number":["M202340"]}],"id":[{"id":"10.13039\/501100016308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The Drum Tower Severity Scoring (DTSS) system is a novel tool designed for assessing the outcome of anticoagulation therapy and disease severity in patients with pyrrolizidine alkaloid\u2010induced hepatic sinusoidal obstruction syndrome (PA\u2010HSOS). The aim of this study was to validate the predictive performance of the DTSS system in PA\u2010HSOS patient outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of 111 PA\u2010HSOS patients who received standard anticoagulation\u2013transjugular intrahepatic portosystemic shunt (TIPS) stepwise therapy from six hospitals in China. Patients were categorized into two groups based on whether they responded to anticoagulation therapy. The predictive performance of the DTSS system was evaluated through the efficacy of anticoagulation therapy, the area under the receiver operating characteristic curve (AUROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The response rates to anticoagulation therapy varied among patients with DTSS of different severity, being 94.12% for mild, 57.81% for moderate, and 13.33% for severe cases. The DTSS system demonstrated a robust predictive performance, with an AUROC of 0.864. The calibration curve indicated a close match between the predicted and observed effects of the DTSS system. Good calibration was confirmed by the Hosmer\u2013Lemeshow test (<jats:italic>p<\/jats:italic>\u2009=\u20090.704), and both the DCA and CIC analysis indicated high clinical utility of the DTSS system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The DTSS system is a practical tool that uses easily accessible data to predict the initial response to anticoagulation therapy in PA\u2010HSOS patients, showing robust predictive performance and significant clinical benefit in guiding personalized management strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13347","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T05:23:16Z","timestamp":1746595396000},"page":"150-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Validation of Drum Tower Severity Scoring (<scp>DTSS<\/scp>) System for Pyrrolizidine Alkaloid\u2010Induced Hepatic Sinusoidal Obstruction Syndrome"],"prefix":"10.1111","volume":"26","author":[{"given":"Li Li","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing Jiangsu Province China"},{"name":"Department of Gastroenterology Jiangnan University Medical Center Wuxi No. 2 People's Hospital  Wuxi Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery Xuzhou Medical University Affiliated Hospital  Xuzhou Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4178-4916","authenticated-orcid":false,"given":"Yu Hu","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Nantong Third People's Hospital  Nantong Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen Yu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Yixing People's Hospital  Yixing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Jie","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Huai'an First People's Hospital  Huai'an Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-5930","authenticated-orcid":false,"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing Jiangsu Province 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