{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:49:53Z","timestamp":1790621393663,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006041","name":"Innovate UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Computational quantification reduces observer\u2010related variability in histological assessment of metabolic dysfunction\u2010associated steatotic liver disease (MASLD). We undertook stain\u2010free imaging using the SteatoSITE resource to generate tools directly predictive of clinical outcomes. Unstained liver biopsy sections (<jats:italic>n<\/jats:italic> =\u2009452) were imaged using second\u2010harmonic generation\/two\u2010photon excitation fluorescence (TPEF) microscopy, and all\u2010cause mortality and hepatic decompensation indices constructed. The mortality index had greater predictive power for all\u2010cause mortality (index &gt;.14 vs. &lt;\/=.14, HR 4.49, <jats:italic>p<\/jats:italic> = .003) than the non\u2010alcoholic steatohepatitis\u2010Clinical Research Network (NASH\u2010CRN) (hazard ratio (HR) 3.41, 95% confidence intervals (CI) 1.43\u20138.15, <jats:italic>p<\/jats:italic> = .003) and qFibrosis stage (HR 3.07, 95% CI 1.30\u20137.26, <jats:italic>p<\/jats:italic> = .007). The decompensation index had greater predictive power for decompensation events (index &gt;.31 vs. &lt;\/=.31, HR 5.96, <jats:italic>p<\/jats:italic> &lt; .001) than the NASH\u2010CRN (HR 3.65, 95% CI 1.81\u20137.35, <jats:italic>p<\/jats:italic> &lt; .001) or qFibrosis stage (HR 3.59, 95% CI 1.79\u20137.20, <jats:italic>p<\/jats:italic> &lt; .001). These tools directly predict hard endpoints in MASLD, without relying on ordinal fibrosis scores as a surrogate, and demonstrate predictive value at least equivalent to traditional or computational ordinal fibrosis scores.<\/jats:p>","DOI":"10.1111\/liv.16062","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T10:38:33Z","timestamp":1723027113000},"page":"2511-2516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Outcome prediction in metabolic dysfunction\u2010associated steatotic liver disease using stain\u2010free digital pathological assessment"],"prefix":"10.1111","volume":"44","author":[{"given":"Timothy J.","family":"Kendall","sequence":"first","affiliation":[{"name":"Centre for Inflammation Research, Institute for Regeneration and Repair University of Edinburgh  Edinburgh UK"},{"name":"Edinburgh Pathology University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Chng","sequence":"additional","affiliation":[{"name":"HistoIndex Pte Ltd  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayun","family":"Ren","sequence":"additional","affiliation":[{"name":"HistoIndex Pte Ltd  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Tai","sequence":"additional","affiliation":[{"name":"HistoIndex Pte Ltd  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Ho","sequence":"additional","affiliation":[{"name":"HistoIndex Pte Ltd  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5741-1471","authenticated-orcid":false,"given":"Jonathan A.","family":"Fallowfield","sequence":"additional","affiliation":[{"name":"Centre for Inflammation Research, Institute for Regeneration and Repair University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"WHO Regional Office for Europe.SDR chronic liver disease and cirrhosis all ages per 100\u2009000. European health for all explorer2021. Accessed May 31 2022.https:\/\/gateway.euro.who.int\/en\/indicators\/hfa_236\u20101860\u2010sdr\u2010chronic\u2010liver\u2010disease\u2010and\u2010cirrhosis\u2010all\u2010ages\u2010per\u2010100\u2010000\/"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.10.025"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.11.008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029349"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2309000"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.05.046"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20701"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.043"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.04.034"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2016.03.01"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.227"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.10.015"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.06.018"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02602-2"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31726"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.02.022"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322786"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0199166"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00843-7"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.06.016"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30418"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.16062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T07:51:22Z","timestamp":1728460282000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.16062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,7]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/liv.16062"],"URL":"https:\/\/doi.org\/10.1111\/liv.16062","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,7]]},"assertion":[{"value":"2024-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}