{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:56:21Z","timestamp":1780732581983,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["M01RR\u201000051"],"award-info":[{"award-number":["M01RR\u201000051"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["M01RR\u201000827"],"award-info":[{"award-number":["M01RR\u201000827"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["M01RR\u201000065"],"award-info":[{"award-number":["M01RR\u201000065"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The quantitative HepQuant SHUNT test of liver function and physiology generates a disease severity index (DSI) that correlates with risk for clinical complications, such as large oesophageal varices (LEVs). A derivative test, HepQuant DuO, generates an equivalent DSI and simplifies testing by requiring only oral administration of the test solution and two blood samples at 20 and 60\u2009min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Since the DSIs measured from DuO and SHUNT are equivalent, we compared the diagnostic performance for large oesophageal varices (LEVs) between the DSIs measured from DuO and SHUNT tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study combined the data from two prospectively conducted US studies: HALT\u2010C and SHUNT\u2010V. A total of 455 subjects underwent both the SHUNT test and esophagogastroduodenoscopy (EGD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DSI scores correlated with the probability of LEVs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and demonstrated a stepwise increase from healthy lean controls without liver disease to subjects with chronic liver disease and no, small or large varices. Furthermore, a cutoff of DSI\u2009\u2264\u200918.3 from DuO had a sensitivity of 0.98 (missing only one case) and, if applied to the endoscopy (EGD) decision, would have prevented 188 EGDs (41.3%). The AUROC for DSI from DuO did not differ from that of the reference SHUNT test method (0.82 versus 0.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3500).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DSI from HepQuant DuO links liver function and physiology to the risk of LEVs across a wide spectrum of patient characteristics, disease aetiologies and liver disease severity. DuO is minimally invasive, easy to administer, quantitative and may aid the decision to avoid or perform EGD for LEVs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.18054","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:59:40Z","timestamp":1716425980000},"page":"246-256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Liver function and portal\u2010systemic shunting quantified by the oral cholate challenge test and risk for large oesophageal varices"],"prefix":"10.1111","volume":"60","author":[{"given":"Tarek","family":"Hassanein","sequence":"first","affiliation":[{"name":"Southern California Research Center  Coronado California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2355-2433","authenticated-orcid":false,"given":"Andrew P.","family":"Keaveny","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvez","family":"Mantry","sequence":"additional","affiliation":[{"name":"The Liver Institute at Methodist Dallas Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Syneos Health  Morrisville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-9442","authenticated-orcid":false,"given":"Michael P.","family":"McRae","sequence":"additional","affiliation":[{"name":"Custom DX Solutions LLC  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kittelson","sequence":"additional","affiliation":[{"name":"Consultant to HepQuant LLC  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Helmke","sequence":"additional","affiliation":[{"name":"HepQuant LLC  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-3566","authenticated-orcid":false,"given":"Gregory T.","family":"Everson","sequence":"additional","affiliation":[{"name":"HepQuant LLC  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the SHUNT\u2010V Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21907"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2017.07.006"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.022"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13379"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000167"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2007.03389.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2008.03639.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24752"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16283"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500030210"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13980"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.04.006"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2008.03908.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2004.08.003"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2020.12.010"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.13786"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089206777346673"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2022.08.002"},{"key":"e_1_2_11_22_1","unstructured":"McRaeMP HelmkeSM EversonGT.Liver function measured by HepQuant DuO predicts the likelihood for large esophageal varices in Child\u2010Pugh A cirrhosis (late\u2010breaking abstract 5026\u2010C).2024Presented at: The Liver Meeting; 2024 Boston Massachusetts."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102105\u201012\u201077"},{"key":"e_1_2_11_25_1","volume-title":"Applied logistic regression","author":"Hosmer DW","year":"2004"},{"key":"e_1_2_11_26_1","unstructured":"McRaeMP HelmkeSM EversonGT.Next generation HepQuant tests predict clinical outcome in primary sclerosing cholangitis (abstract 4559\u2010C).2023Presented at: the liver meeting; Boston Massachusetts."},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102018\u2010317334"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28824"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000994"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.04.030"}],"container-title":["Alimentary Pharmacology &amp; 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