{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:01:40Z","timestamp":1790031700204,"version":"4.0.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["62302066"],"award-info":[{"award-number":["62302066"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016809","name":"Bureau of Science and Technology Nanchong Municipality","doi-asserted-by":"publisher","award":["23JCYJPT0034"],"award-info":[{"award-number":["23JCYJPT0034"]}],"id":[{"id":"10.13039\/100016809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Genet."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early identification of cirrhosis among patients with hepatitis is important for timely risk stratification and clinical management, yet conventional non-invasive scores such as the fibrosis-4 index (FIB-4) and the aspartate aminotransferase-to-platelet ratio index (APRI) may provide limited discrimination. In clinical datasets, missingness patterns may also carry predictive information, but their value for cirrhosis identification remains insufficiently investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 672 individuals, comprising 334 patients with hepatitis and 338 patients with cirrhosis, and randomly divided them into training and testing sets at in 8:2 ratio. FIB-4, APRI and multiple machine-learning models were developed using routinely available laboratory parameters; missing values were handled by median imputation, and binary missingness indicators were incorporated into selected models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Machine-learning models showed better discriminatory performance than conventional scores. The Extra Trees model incorporating missingness indicators (ET + indicator) achieved the highest AUC (0.841), whereas the support vector machine model incorporating missingness indicators (SVM + indicator) achieved the highest AUPRC (0.813). By contrast, FIB-4 and APRI had AUC values of 0.537 and 0.519, respectively. Incorporating missingness indicators further improved the performance of ET, SVM and HGB models, and reducing the ET + indicator threshold from 0.50 to 0.42 increased sensitivity from 0.765 to 0.882.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Missingness-aware machine-learning models based on routine laboratory parameters may improve hepatitis-to-cirrhosis discrimination and support risk stratification in real-world screening settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgene.2026.1936507","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:10:28Z","timestamp":1790028628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Missingness-aware machine learning using routine laboratory data for distinguishing hepatitis from cirrhosis"],"prefix":"10.3389","volume":"17","author":[{"given":"Qin","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuerui","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qirong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengxing","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjie","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Kang","sequence":"additional","affiliation":[{"name":"Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Tang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Non-Coding RNA and Drug Discovery at Chengdu Medical College of Sichuan Province, School of Basic Medical Sciences, Chengdu Medical College","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]},{"name":"Sichuan Branch of National Clinical Research Center for Digestive Diseases","place":["Nanchong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"967","DOI":"10.4254\/wjh.v9.i22.967","article-title":"Serum cholinesterase: a predictive biomarker of hepatic reserves in chronic hepatitis D","volume":"9","author":"Abbas","year":"2017","journal-title":"World J. 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