{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:50:17Z","timestamp":1792158617281,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Triple A Plus (AAA+) is a recently proposed survival prediction model for essential thrombocythaemia (ET) intended for settings in which next\u2010generation sequencing is unavailable. However, independent validation in non\u2010Western populations remains limited. A retrospective cohort of 995 consecutive patients diagnosed with ET at a single centre between 2001 and 2022 was screened. Primary external validation was performed in 850 patients who had complete baseline variables required for the original AAA+ calculation. In the external\u2010validation cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009850; deaths\u2009=\u2009116), AAA+ demonstrated strong discrimination for overall survival (\n                    <jats:italic>C<\/jats:italic>\n                    \u2010index 0.892, 95% confidence interval 0.866\u20130.917). Time\u2010dependent analyses indicated superior discrimination across follow\u2010up, with 5\u2010 and 10\u2010year area under the curve values of 0.902 and 0.912, respectively, exceeding those of AAA (0.873 and 0.894) and International Prognostic Score for Essential Thrombocythemia (0.759 and 0.857). For 10\u2010year all\u2010cause mortality, decision\u2010curve analysis based on locally recalibrated absolute risks showed that AAA+ provided favourable net benefit across most clinically relevant thresholds. Diagnostic period\u2010adjusted analyses showed higher hazards of death in intermediate\u2010 and high\u2010risk patients than in low\u2010risk patients, with no clear evidence of temporal heterogeneity or monotonic attenuation of the AAA+ risk gradient over time. AAA+ exhibited robust risk stratification and good discrimination for overall survival in this large Chinese ET cohort.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70764","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T23:39:44Z","timestamp":1787096384000},"page":"1725-1734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["External validation of the\n                    <scp>AAA<\/scp>\n                    + survival model in a large Chinese cohort with essential thrombocythaemia"],"prefix":"10.1111","volume":"209","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3885-3217","authenticated-orcid":false,"given":"Lin","family":"Zhang","sequence":"first","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Tianjin Key Laboratory of Gene Therapy for Blood Diseases National Clinical Research Center for Blood Diseases, Institute of Hematology &amp; Blood Diseases Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Tianjin China"},{"name":"Tianjin Institutes of Health Science  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-7666","authenticated-orcid":false,"given":"Wenjing","family":"Gu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Tianjin Key Laboratory of Gene Therapy for Blood Diseases National Clinical Research Center for Blood Diseases, Institute of Hematology &amp; Blood Diseases Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Tianjin China"},{"name":"Tianjin Institutes of Health Science  Tianjin 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Research Center for Blood Diseases, Institute of Hematology &amp; Blood Diseases Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Tianjin China"},{"name":"Tianjin Institutes of Health Science  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-3924","authenticated-orcid":false,"given":"Feng","family":"Xue","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Tianjin Key Laboratory of Gene Therapy for Blood Diseases National Clinical Research Center for Blood Diseases, Institute of Hematology &amp; Blood Diseases Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Tianjin China"},{"name":"Tianjin Institutes of Health Science  Tianjin 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