- •Discrimination of MELD is widely reported as fair to good, although its calibration is still unclear.
- •In 2 cirrhosis cohorts we found barely acceptable c-statistics, which were significantly worse in patients with non-viral etiology.
- •Calibration was largely unsatisfactory with the Mayo and UNOS MELD versions.
- •Validated recalibrations of MELD-Mayo and UNOS versions are presented which allow reliable predictions for clinical practice.
- •Age, albumin and ascites as the indication for TIPS are candidate variables for an update to the MELD-TIPS score.
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- A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts.Hepatology. 2000; 31: 864-871
- A model to predict survival in patients with end-stage liver disease.Hepatology. 2001; 33: 464-470
- The new liver allocation system: moving towards evidence based transplantation policy.Liver Transplant. 2002; 8: 851-858
OPTN policy 9. https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf. Page 167. Accessed on October 22nd 2020.
https://www.mayoclinic.org/medical-professionals/transplant-medicine/calculators/probability-of-mortality-following-transjugular-intrahepatic-portosystemic-shunts/itt-20434720 (accessed on june the 12th 2020).
https://www.mayoclinic.org/medical-professionals/transplant-medicine/calculators/meld-model/itt-20434705 (accessed on june the 12th 2020).
https://optn.transplant.hrsa.gov/resources/allocation-calculators/meld-calculator/(accessed on june the 12th 2020).
- The model for end-stage liver disease (MELD).Hepatology. 2007; 45: 797-805
- A systematic review of the performance of the Model for End-Stage Liver Disease (MELD) in the setting of liver transplantation.Liv Transpl. 2006; 12: 1049-1061
- Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD exception study group and conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula.Liver Transplant. 2006; 12: S128-S136
- An integrated MELD model including serum sodium and age improves the prediction of early mortality in patients with cirrhosis.Liver Transpl. 2007; 13: 1174-1180
- Transection of the esophagus for bleeding oesophageal varices.Br J Surg. 1973; 60: 646-649
- World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.JAMA. 2013; 310: 2191-2194https://doi.org/10.1001/jama.2013.281053
- Competing risks. A practical perspective.John Wiley & Sons, Chichester2006
- Regression models and life-Tables (with discussion).J R Statist Soc B. 1972; 34: 187-220
- Practical recommendations for reporting Fine-Gray model analyses for competing risk data.Stat Med. 2017; 36 (4991-4400)
- A new framework to enhance the interpretation of external validation studies of clinical prediction models.J Clin Epidemiol. 2015; 68: 279-289https://doi.org/10.1016/j.jclinepi.2014.06.018
- Clinical prediction models. A practical approach to development, validation and updating.2nd ed. © Springer Nature Switzerland AG, 2019
- The meaning and use of the area under a receiver operating characteristic (ROC) curve.Radiology. 1982; 143: 29-36
- A comparison of goodness-of-fit tests for the logistic regression model.Stat Med. 1997; 16: 965-980
- A proportional hazards model for the subdistribution of competing risk.J Am Stat Ass. 1999; 94: 496-509
- Cystatin C is a strong predictor of survival in patients with cirrhosis: is a cystatin C-based MELD better?.Liver Int. 2012 Sep; 32: 1211-1216
- Application of a biochemical and clinical model to predict individual survival in patients with end-stage liver disease.World J Gastroenterol. 2009 Jun 14; 15: 2768-2777
- The Model for End-stage Liver Disease accurately predicts 90-day liver transplant wait-list mortality in Atlantic Canada.Can J Gastroenterol. 2011 Jul; 25: 359-364
- Refining prediction of survival after TIPS with the novel Freiburg index of post-TTIPS survival.J Hepatol. 2021; 74: 1362-1372https://doi.org/10.1016/j.jhep.2021.05.042