{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:12:18Z","timestamp":1779207138977,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T00:00:00Z","timestamp":1488844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009680","name":"Yale Liver Center","doi-asserted-by":"publisher","award":["P30 DK34989"],"award-info":[{"award-number":["P30 DK34989"]}],"id":[{"id":"10.13039\/100009680","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Guidelines recommend variceal screening in patients with cirrhosis to identify varices at high risk of bleeding requiring primary prophylaxis. Non\u2010invasive criteria to rule out high\u2010risk varices will avoid unnecessary endoscopies. Recent Baveno <jats:styled-content style=\"fixed-case\">VI<\/jats:styled-content> criteria define patients with compensated cirrhosis in whom endoscopy can be avoided as those with a liver stiffness by transient elastography &lt;20 <jats:styled-content style=\"fixed-case\">kP<\/jats:styled-content>a and a platelet count &gt;150\u00a0000\/mm<jats:sup>3.<\/jats:sup><\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To validate Baveno criteria in two cohorts with a different prevalence of high\u2010risk varices and to determine whether alternate parameters not including liver stiffness would be equal\/more accurate in ruling out high\u2010risk varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective study evaluating patients with liver stiffness &gt;10 <jats:styled-content style=\"fixed-case\">kP<\/jats:styled-content>a who had liver stiffness and endoscopy within 1\u00a0year of each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 161 patients from the US cohort (14 [9%] with high\u2010risk varices) and 101 patients from an Italian cohort (17 [17%] with high\u2010risk varices). Of patients meeting Baveno criteria (41 in the <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>, 16 in Italy), none had high\u2010risk varices and therefore 26% (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>) and 16% (Italy) endoscopies could have been avoided. Sensitivity and negative predictive value were 100%. A stepwise strategy using platelet count &gt;150\u00a0000 and <jats:styled-content style=\"fixed-case\">MELD<\/jats:styled-content>=6, increased the number of endoscopies avoided to 54% (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>) while maintaining a sensitivity and negative predictive value of 100%. Excellent sensitivity and negative predictive value were validated in the Italian cohort and in another cohort of patients with a clinical diagnosis of cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study validates Baveno <jats:styled-content style=\"fixed-case\">VI<\/jats:styled-content> criteria, particularly in sites with a low prevalence of high\u2010risk varices and describes a new accurate strategy that does not include liver stiffness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13379","type":"journal-article","created":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T21:00:19Z","timestamp":1486155619000},"page":"1177-1183","source":"Crossref","is-referenced-by-count":96,"title":["Validating, deconstructing and refining Baveno criteria for ruling out high\u2010risk varices in patients with compensated 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Diseases VA\u2010Connecticut Healthcare System  West Haven CT USA"},{"name":"Section of Digestive Diseases Yale School of Medicine  New Haven CT USA"},{"name":"Department of Medicine Federal University of Sao Carlos  Sao Carlos Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Schepis","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Azienda Ospedaliero\u2010Universitaria di Modena and University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Villa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Azienda Ospedaliero\u2010Universitaria di Modena and University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guadalupe","family":"Garcia\u2010Tsao","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases VA\u2010Connecticut Healthcare 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