{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:53:10Z","timestamp":1781844790306,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this study was to develop and validate a nomogram for diagnosing tuberculous peritoneal effusion (TPE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This was a retrospective, single-center study. We collected data on basic characteristics, laboratory tests, and clinical information from consecutive patients with TPE and non-tuberculous peritoneal effusion (non-TPE) using an electronic medical record database. The data were randomly divided into a training group and a validation group at a 7:3 ratio. Variables were selected using LASSO regression, and a predictive model was established using multivariable stepwise logistic regression to construct the diagnostic nomogram. The diagnostic performance of the nomogram was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 351 patients were included in the study, with 245 in the training group and 106 in the validation group. Age, fever, ascites adenosine deaminase (ADA), ascites carcinoembryonic antigen (CEA), ascites total protein (TP), serum CEA, and serum creatinine (Cr) were identified as independent predictors. Based on these seven variables, we developed a diagnostic nomogram. The area under the curve (AUC) of the nomogram model was 0.974 for the training group and 0.955 for the validation group. The calibration curves showed good agreement, and DCA indicated that the model provides the greatest net benefit within the threshold probability range for both the training and validation cohorts. The analysis of the model\u2019s probability rationality demonstrated that the diagnostic performance of the nomogram was superior to that of any single indicator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We developed and validated a nomogram model for diagnosing TPE based on seven clinical parameters. This model demonstrates excellent diagnostic performance in distinguishing TPE from non-TPE cases and provides a solid foundation for clinicians to formulate diagnostic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1823510","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:30Z","timestamp":1781843370000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a prediction model for tuberculous peritoneal effusion"],"prefix":"10.3389","volume":"13","author":[{"given":"Libin","family":"Liu","sequence":"first","affiliation":[{"name":"Centre of Laboratory Medicine, Hangzhou Red Cross Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Fang","sequence":"additional","affiliation":[{"name":"Centre of Laboratory Medicine, Hangzhou Red Cross Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Peng","sequence":"additional","affiliation":[{"name":"Centre of Laboratory Medicine, Hangzhou Red Cross Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wei","sequence":"additional","affiliation":[{"name":"Centre of Laboratory Medicine, Hangzhou Red Cross Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Cai","sequence":"additional","affiliation":[{"name":"Centre of Laboratory Medicine, Hangzhou Red Cross Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref1","year":"2026"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1111\/j.1365-2036.2005.02645.x","article-title":"Systematic review: tuberculous peritonitis--presenting features, diagnostic strategies and treatment","volume":"22","author":"Sanai","year":"2005","journal-title":"Aliment Pharmacol Ther"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1002\/hep.22853","article-title":"Management of adult patients with ascites due to cirrhosis: an update","volume":"49","author":"Runyon","year":"2009","journal-title":"Hepatology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1186\/s12876-022-02480-x","article-title":"Utility of ascitic tumor markers and adenosine deaminase for differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis","volume":"22","author":"Du","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12876-022-02171-7","article-title":"Recent advances in the diagnosis of intestinal tuberculosis","volume":"22","author":"Maulahela","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.tmaid.2011.12.001","article-title":"Peritoneal tuberculosis in Qatar: a five-year hospital-based study from 2005 to 2009","volume":"10","author":"Khan","year":"2012","journal-title":"Travel Med Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"585180","DOI":"10.3389\/fmed.2020.585180","article-title":"Diagnostic value of T-SPOT.TB assay for tuberculous peritonitis: a meta-analysis","volume":"7","author":"Luo","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"acmi000414","DOI":"10.1099\/acmi.0.000414","article-title":"Acid fast bacillus smear, mycobacterial culture and Xpert MTB\/RIF assay for the diagnosis of tuberculous peritonitis in patients with and without end stage renal failure","volume":"4","author":"Misra","year":"2022","journal-title":"Access Microbiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3947\/ic.2023.0014","article-title":"An updated systematic review and meta-analysis for the diagnostic test accuracy of Ascitic fluid adenosine deaminase in tuberculous peritonitis","volume":"55","author":"Mahajan","year":"2023","journal-title":"Infect Chemother"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1097\/00004836-200609000-00009","article-title":"Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis","volume":"40","author":"Riquelme","year":"2006","journal-title":"J Clin Gastroenterol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.diagmicrobio.2013.12.010","article-title":"Diagnostic value of adenosine deaminase in ascites for tuberculosis ascites: a meta-analysis","volume":"79","author":"Tao","year":"2014","journal-title":"Diagn Microbiol Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1186\/s12879-020-04965-0","article-title":"Use of adenosine deaminase (ADA) to diagnose suspected peritoneal tuberculosis in Rwanda: a cross-sectional study","volume":"20","author":"Ntwari","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"168","DOI":"10.4166\/kjg.2021.068","article-title":"Reappraisal of the role of Ascitic fluid adenosine deaminase for the diagnosis of peritoneal tuberculosis in cirrhosis","volume":"78","author":"Dahale","year":"2021","journal-title":"Korean J Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1159\/000480824","article-title":"Clinical stage, prostate-specific antigen and Gleason grade to predict extracapsular disease or nodal metastasis in men with newly diagnosed, previously untreated prostate cancer. A multicenter study. A. Ur. O. Cooperative group","volume":"32","author":"Puppo","year":"1997","journal-title":"Eur Urol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1016\/S1470-2045(14)71116-7","article-title":"Nomograms in oncology: more than meets the eye","volume":"16","author":"Balachandran","year":"2015","journal-title":"Lancet Oncol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"997713","DOI":"10.3389\/fpubh.2022.997713","article-title":"From past to future: bibliometric analysis of global research productivity on nomogram (2000-2021)","volume":"10","author":"Wang","year":"2022","journal-title":"Front Public Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/j.1440-1843.2010.01723.x","article-title":"Update on tuberculous pleural effusion","volume":"15","author":"Light","year":"2010","journal-title":"Respirology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/0041-3879(90)90007-U","article-title":"Adenosine deaminase (ADA) in peritoneal tuberculosis: diagnostic value in ascitic fluid and serum","volume":"71","author":"Bhargava","year":"1990","journal-title":"Tubercle"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1054\/tube.2001.0289","article-title":"The use of adenosine deaminase as a diagnostic tool for peritoneal tuberculosis","volume":"81","author":"Burgess","year":"2001","journal-title":"Tuberculosis (Edinb)"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1002\/hep.510240617","article-title":"Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States","volume":"24","author":"Hillebrand","year":"1996","journal-title":"Hepatology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"215","DOI":"10.7326\/0003-4819-117-3-215","article-title":"The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites","volume":"117","author":"Runyon","year":"1992","journal-title":"Ann Intern Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S0002-9343(97)89456-9","article-title":"Diagnostic features of tuberculous peritonitis in the absence and presence of chronic liver disease: a case control study","volume":"100","author":"Shakil","year":"1996","journal-title":"Am J Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1097\/00005792-199807000-00002","article-title":"Nephrogenic ascites. Analysis of 16 cases and review of the literature","volume":"77","author":"Han","year":"1998","journal-title":"Medicine (Baltimore)"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/S0002-9610(03)00079-5","article-title":"Indication for peritoneal biopsy in tuberculous peritonitis","volume":"185","author":"Chow","year":"2003","journal-title":"Am J Surg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1111\/ggi.12412","article-title":"Age and sex distribution in malignant and tuberculous serous effusions: a study of 127 patients and review of the literature","volume":"15","author":"Das","year":"2015","journal-title":"Geriatr Gerontol Int"},{"key":"ref26","first-page":"418","article-title":"Diagnostic value of carcinoembryonic antigen in malignancy-related ascites: systematic review and meta-analysis","volume":"77","author":"Ahadi","year":"2014","journal-title":"Acta Gastroenterol Belg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"3363","DOI":"10.3390\/jcm12103363","article-title":"Acute kidney failure: current challenges and new perspectives","volume":"12","author":"Chen","year":"2023","journal-title":"J Clin Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1823510\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:31Z","timestamp":1781843371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1823510\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":27,"alternative-id":["10.3389\/fmed.2026.1823510"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1823510","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"article-number":"1823510"}}