{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:50:56Z","timestamp":1791975056270,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":286,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011074","name":"Liver Center, University of California, San Francisco","doi-asserted-by":"publisher","award":["P30DK026743"],"award-info":[{"award-number":["P30DK026743"]}],"id":[{"id":"10.13039\/100011074","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32DK060414"],"award-info":[{"award-number":["T32DK060414"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with primary sclerosing cholangitis (PSC) experience numerous symptoms that impact quality of life. We sought to identify PSC\u2010specific symptom clusters and relationships between symptoms to better understand the lived experience of PSC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Presence and severity of 16 symptoms were identified from the international \u201cOur Voices\u201d survey collected by PSC Partners Seeking A Cure in 2020. LASSO\u2010regularized partial correlation network analysis was performed using Spearman correlations. The primary analysis utilized symptoms reported within the past 6\u2009months of survey completion, with subgroup analyses conducted on patients with and without inflammatory bowel disease (IBD). Expected influence was computed to quantify the importance of each measure within networks. The Spinglass algorithm was employed to identify communities within networks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 970 total participants, 54% were women, and 70% had IBD. Four dominant communities were identified across networks, including global symptoms, psychological symptoms, gastrointestinal symptoms, and cholestatic\u2010related symptoms. Of the 16 symptoms included in network analyses, fatigue and weakness had the most positive influence across multiple networks and across different communities within each network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The complex relationship between co\u2010occurring symptoms in PSC organizes into four dominant symptom clusters. FTG and WEA emerged as strongly influential symptoms that consistently were associated with other symptoms. Our analyses emphasize the complex, co\u2010occurring nature of PSC symptoms, identify highly influential symptoms, and highlight the need to develop patient\u2010reported outcome symptom measures to assess changes in these key symptoms in clinical trials and clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjgh\/5291248","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:16:57Z","timestamp":1791973017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Network Analysis in Patients With Primary Sclerosing Cholangitis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1305-8362","authenticated-orcid":false,"given":"Melinda","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of California  San Francisco California USA  berkeley.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-6910","authenticated-orcid":false,"given":"Amy M.","family":"Shui","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA  berkeley.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4326-8720","authenticated-orcid":false,"given":"Joanne","family":"Hatchett","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7037-7079","authenticated-orcid":false,"given":"Stephen J.","family":"Rossi","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth-Anne","family":"Pai","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5111-4568","authenticated-orcid":false,"given":"Rachel","family":"Gomel","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4673-0088","authenticated-orcid":false,"given":"Mary Pressley","family":"Vyas","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure Canada  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8947-1767","authenticated-orcid":false,"given":"Sarah Curup","family":"Callif","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricky","family":"Safer","sequence":"additional","affiliation":[{"name":"PSC Partners Seeking a Cure  Greenwood Village Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2105-1256","authenticated-orcid":false,"given":"Jessica","family":"Rubin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of California  San Francisco California USA  berkeley.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3906-6811","authenticated-orcid":false,"given":"Christopher","family":"Bowlus","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA  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