{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:58Z","timestamp":1787022178984,"version":"build-2736575974"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Xianyang Science and Technology Planning Project","award":["L2023-ZDYF-SF-055"],"award-info":[{"award-number":["L2023-ZDYF-SF-055"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and clinically significant complication of ERCP, with an incidence of 3.5\u20139.7% in general populations and up to 14.7% in high-risk groups, leading to considerable morbidity, mortality, and healthcare costs. Although numerous multivariable prediction models have been developed, their predictor sets, methodological rigor, and clinical applicability remain highly variable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a PRISMA 2020\u2013compliant systematic review and meta-analysis, prospectively registered in PROSPERO (CRD42024556967). Nine databases were searched to June 1, 2024, for studies developing or validating multivariable PEP risk prediction models. Data on study\/model characteristics, predictors, and performance metrics were extracted. Risk of bias was assessed with PROBAST, and study quality with the Newcastle\u2013Ottawa Scale. Random-effects meta-analyses pooled (i) PEP incidence, (ii) associations of individual predictors, and (iii) overall model performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-four studies (26 models; n\u2009=\u200938,016) published from 2002\u20132024 were included, predominantly retrospective cohorts from East Asia (n\u2009=\u200916). The pooled PEP incidence was 8.48% (95% CI: 6.90\u201310.39%; I\u00b2\u2009=\u200996.4%), highest in East Asia and retrospective cohorts. Strongest predictors included pancreatic duct cannulation (OR=3.50), pancreatic injection (OR=3.50), previous pancreatitis (OR=3.32), and pancreatic guidewire use (OR=2.63); additional consistent factors were female sex, difficult cannulation, elevated bilirubin, low albumin, choledocholithiasis, and prolonged procedure time. The pooled odds ratio for model performance was 0.81 (95% CI: 0.78\u20130.84; I\u00b2\u2009=\u200983.5%), with AUCs ranging 0.560\u20130.915, though calibration was infrequently reported (38%) and external validation undertaken in only 46%. PROBAST indicated high overall risk of bias, chiefly in the analysis (92%) and participants (100%) domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current PEP prediction models generally demonstrate moderate-to-high discrimination but are limited by suboptimal calibration, inadequate external validation, and methodological heterogeneity. Future research should adhere to TRIPOD guidelines, employ multicenter large-sample designs, retain continuous predictors, address missing data with robust imputation methods, and conduct comprehensive temporal, geographic, and domain-specific validation. Integration of artificial intelligence\/machine learning with conventional modeling and embedding validated tools into clinical workflows may enhance predictive accuracy and real-world utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0332378","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:30:20Z","timestamp":1757957420000},"page":"e0332378","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk prediction model for post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7925-7347","authenticated-orcid":true,"given":"Yijun","family":"Mao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1757-183X","authenticated-orcid":true,"given":"Qiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqian","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erqing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanni","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"issue":"2","key":"pone.0332378.ref001","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1055\/a-0822-0832","article-title":"Endoscopic 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