{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:14:51Z","timestamp":1788347691633,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative pancreatic fistula (POPF) complicates 10%\u201325% of pancreatoduodenectomies (PDs). This study sought to validate the recent Auditing Fistula Risk Score (Auditing\u2010FRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PDs recorded in the 2015\u20132023 National Surgical Quality Improvement Program (NSQIP) were analyzed. Multivariable logistic regression confirmed independent predictors. Discrimination was quantified using the area under the receiver operating characteristic curve (AUC). Calibration was assessed using the Brier score, and decision\u2010curve analysis (DCA) evaluated clinical utility across overall, open (OPD), laparoscopic (LPD), and robotic (RPD) subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 25\u2009250 PDs, POPF occurred in 12.6% of cases. All Auditing\u2010FRS predictors remained independently associated with POPF. The AUC was 0.694 (95% confidence interval [CI] 0.684\u20130.704) for the overall cohort, with comparable performance across operative subgroups: OPD 0.693 (95% CI 0.683\u20130.703), LPD 0.708 (95% CI 0.672\u20130.745), and RPD 0.701 (95% CI 0.657\u20130.744). Predicted and observed POPF probabilities were closely aligned. DCA demonstrated that within the clinically relevant threshold range of 5%\u201330%, the Auditing\u2010FRS consistently offered greater net benefit than treating all or no patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Auditing\u2010FRS demonstrates acceptable discrimination and good calibration in a large NSQIP cohort across open, laparoscopic, and robotic approaches, supporting its use for institutional benchmarking and perioperative risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70657","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T06:55:06Z","timestamp":1775890506000},"page":"1999-2009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["External Validation of the Auditing Fistula Risk Score for Pancreatoduodenectomy"],"prefix":"10.1111","volume":"96","author":[{"given":"Hwee Leong","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore, Academia  Singapore Singapore"},{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4093-4695","authenticated-orcid":false,"given":"Yun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore, Academia  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren Weiquan","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore, Academia  Singapore Singapore"},{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"},{"name":"Liver Transplant Service, SingHealth Duke\u2010National University of Singapore Transplant Centre  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8218-4576","authenticated-orcid":false,"given":"Brian Kim Poh","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore, Academia  Singapore Singapore"},{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"},{"name":"Liver Transplant Service, SingHealth Duke\u2010National University of Singapore Transplant Centre  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Xin","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore, Academia  Singapore Singapore"},{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"},{"name":"Liver Transplant Service, SingHealth Duke\u2010National University of Singapore Transplant Centre  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2008.12.031"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006858"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.09.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002620"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003234"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.01.054"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005532"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.08.016"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2009.00074.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9736"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001192"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_11_14_1","first-page":"307","article-title":"Receiver Operating Characteristic (ROC) Methodology: The State of the Art","volume":"29","author":"Hanley J. 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