{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:17:37Z","timestamp":1782361057443,"version":"3.54.5"},"reference-count":23,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Compensated advanced chronic liver disease (cACLD) affects millions and carries risk for portal hypertension, large varices, and clinical decompensation. The HepQuant DuO\u00ae test provides a blood-based assessment of liver function and physiology, generating a disease severity index (DSI) validated for risk stratification. A retrospective, real-world, observational analysis was conducted to evaluate the utility of HepQuant DuO\u2019s DSI cutpoint (18.3) in guiding endoscopy and clinical management decisions for patients with cACLD in the United States. Methods: De-identified data from 87 cases with cACLD were extracted from physician-provided Statements of Medical Necessity documenting the reasons for the HepQuant DuO test. The primary endpoint was concordance of endoscopy decisions with DSI \u2264 18.3 (avoid) or &gt;18.3 (proceed). The secondary endpoint was concordance of clinical management intensity with the same cutpoint. Results: Among the 55 cases analyzed for endoscopy decisions, overall concordance with DSI 18.3 was 93% (p &lt; 0.001 by Fisher\u2019s exact test): 96% of cases with DSI \u2264 18.3 avoided endoscopy, and 90% with DSI &gt; 18.3 underwent endoscopy. For the 45 cases assessing management intensity, overall concordance was 89% (p &lt; 0.001): 90% of cases with DSI \u2264 18.3 had reduced follow-up, and 89% with DSI &gt; 18.3 had intensified management. The cohort exhibited broad functional heterogeneity not captured by standard labs or elastography. Conclusions: HepQuant DuO\u2019s DSI cutpoint 18.3 demonstrated strong concordance with real-world clinical decisions, supporting its utility for risk stratification, optimizing endoscopy use, and tailoring management in cACLD.<\/jats:p>","DOI":"10.3390\/jcm15020501","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:10:50Z","timestamp":1767867050000},"page":"501","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Utilization of the Disease Severity Index (DSI) from the HepQuant DuO Test Enhances Clinical Decision Making in Compensated Advanced Chronic Liver Disease"],"prefix":"10.3390","volume":"15","author":[{"given":"Kerry","family":"Whitaker","sequence":"first","affiliation":[{"name":"HepQuant, LLC, Denver, CO 80237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8528-7230","authenticated-orcid":false,"given":"Joanne C.","family":"Imperial","sequence":"additional","affiliation":[{"name":"HepQuant, LLC, Denver, CO 80237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-9442","authenticated-orcid":false,"given":"Michael P.","family":"McRae","sequence":"additional","affiliation":[{"name":"Custom DX Solutions LLC, Houston, TX 77005, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-3566","authenticated-orcid":false,"given":"Gregory T.","family":"Everson","sequence":"additional","affiliation":[{"name":"HepQuant, LLC, Denver, CO 80237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Murphy, S.L., Kochanek, K.D., Xu, J., and Arias, E. 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