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Corrigendum|Articles in Press

Corrigendum to “Ethyl glucuronide in hair detects a high rate of harmful alcohol consumption in presumed non-alcoholic fatty liver disease” [J Hepatol 77 (2022) 918–930]

Published:March 13, 2023DOI:https://doi.org/10.1016/j.jhep.2023.01.018

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      It has come to our attention that there were errors in Fig. 2C and in the presentation of positive and negative predictive values in Table 3 of our manuscript.
      In Fig. 2C, the labels were reversed. The dark blue bars should represent no TDM/IGT, while the light blue bars should represent T2DM/IGT. The corrected figure is included below.
      To address the aforementioned errors in Table 3, we revised the table to provide positive predictive values and negative predictive values from patients in whom each alcohol test was available from the same day in line with the dataset used for AUC, sensitivity, and specificity calculations. Additionally, the table was updated to follow STARD reporting guidelines. The corrected table and updated table legend are provided below.
      Table 3Diagnostic accuracy of alcohol markers to detect moderate to excessive (≥10 g EtOH/day) and excessive (≥60 g EtOH/day) alcohol consumption.
      Alcohol testAUC (95% CI)Sens (%)Spec (%)PPV (%)NPV (%)TP/FP/TN/FN (n)Youden Index
      All patients, n = 182
      Moderate to excessive EtOH consumption
       hEtG >7 pg/mg0.927 (0.867–0.987)85.410010093.041/0/93/70.854
       uEtG ≥0.1 mg/L0.754 (0.661–0.846)60.490.376.381.629/9/84/190.507
       uEtG ≥0.5 mg/L0.666 (0.564–0.768)35.497.889.574.617/2/91/310.333
       CDT ≥2.3%0.542 (0.439–0.645)8.310010067.94/0/93/440.083
       MCV >98.0 fl0.494 (0.393–0.595)4.294.628.665.72/5/88/46-0.012
       GGT ≥60 U/L (m), ≥40 U/L (f)0.539 (0.439–0.639)58.349.537.369.728/47/46/200.078
       ANI score ≥-12.820.628 (0.535–0.720)89.638.743.087.743/57/36/50.283
       AUDIT-C ≥4 (m), ≥3 (f)0.733 (0.638–0.827)58.388.271.880.428/11/82/200.465
      Excessive EtOH consumption
       hEtG >30 pg/mg0.974 (0.915–1.000)94.710010099.218/0/122/10.947
       uEtG ≥0.1 mg/L0.740 (0.611–0.869)68.479.534.294.213/25/97/60.479
       uEtG ≥0.5 mg/L0.665 (0.517–0.814)42.191.042.191.08/11/111/110.331
       CDT ≥2.3%0.544 (0.397–0.692)10.598.450.087.62/2/120/170.089
       MCV >98.0 fl0.502 (0.361–0.642)5.395.114.386.61/6/116/180.003
       GGT ≥60 U/L (m), ≥40 U/L (f)0.649 (0.524–0.773)78.950.820.093.915/60/62/40.298
       ANI score ≥-10.100.757 (0.656–0.857)10045.122.110019/67/55/00.451
       AUDIT-C ≥4 (m), ≥3 (f)0.736 (0.607–0.865)68.478.733.394.113/26/96/60.471
      Presumed NAFLD, n = 112
      Moderate to excessive EtOH consumption
       hEtG >7 pg/mg0.897 (0.814–0.980)79.410010089.227/0/58/70.794
       uEtG ≥0.1 mg/L0.766 (0.656–0.876)61.891.480.880.321/5/53/130.531
       uEtG ≥0.5 mg/L0.659 (0.536–0.782)35.396.685.771.812/2/56/220.318
       CDT ≥2.3%0.544 (0.419–0.669)8.810010065.23/0/58/310.088
       MCV >98.0 fl0.500 (0.377–0.623)0.0100n.a.63.00/0/58/340.000
       GGT ≥60 U/L (m), ≥40 U/L (f)0.569 (0.447–0.691)50.063.844.768.517/21/37/170.138
       ANI score ≥-12.820.781 (0.685–0.878)85.362.156.987.829/22/36/50.474
       AUDIT-C ≥4 (m), ≥3 (f)0.722 (0.606–0.838)52.991.478.376.818/5/53/160.443
      Excessive EtOH consumption
       hEtG >30 pg/mg1.000 (1.000–1.000)10010010010010/0/82/01.000
       uEtG ≥0.1 mg/L0.790 (0.637–0.943)80.078.030.897.08/18/64/20.580
       uEtG ≥0.5 mg/L0.751 (0.562–0.940)60.090.242.994.96/8/74/40.502
       CDT ≥2.3%0.538 (0.338–0.737)10.097.633.389.91/2/80/90.076
       MCV >98.0 fl0.500 (0.309–0.691)0.0100n.a.89.10/0/82/100.000
       GGT ≥60 U/L (m), ≥40 U/L (f)0.605 (0.418–0.791)60.061.015.892.66/32/50/40.210
       ANI score ≥-10.100.861 (0.764–0.958)10064.625.610010/29/53/00.646
       AUDIT-C ≥4 (m), ≥3 (f)0.752 (0.579–0.926)70.080.530.495.77/16/66/30.505
      ALD, n = 70
      Moderate to excessive EtOH consumption
       hEtG >7 pg/mg1.000 (1.000–1.000)10010010010014/0/35/01.000
       uEtG ≥0.1 mg/L0.729 (0.556–0.901)57.188.666.783.88/4/31/60.457
       uEtG ≥0.5 mg/L0.679 (0.492–0.865)35.710010079.55/0/35/90.357
       CDT ≥2.3%0.536 (0.350–0.721)7.110010072.91/0/35/130.071
       MCV >98.0 fl0.500 (0.319–0.681)14.385.728.671.42/5/30/120.000
       GGT ≥60 U/L (m), ≥40 U/L (f)0.521 (0.343–0.700)78.625.729.775.011/26/9/30.043
       ANI score ≥6.520.514 (0.308–0.721)28.694.366.776.74/2/33/100.229
       AUDIT-C ≥4 (m), ≥3 (f)0.771 (0.614–0.929)71.482.962.587.910/6/29/40.543
      Excessive EtOH consumption
       hEtG >30 pg/mg0.944 (0.823–1.000)88.910010097.68/0/40/10.889
       uEtG ≥0.1 mg/L0.690 (0.481–0.899)55.682.541.789.25/7/33/40.381
       uEtG ≥0.5 mg/L0.574 (0.352–0.795)22.292.540.084.12/3/37/70.147
       CDT ≥2.3%0.556 (0.333–0.778)11.110010083.31/0/40/80.111
       MCV >98.0 fl0.481 (0.274–0.687)11.185.014.381.01/6/34/8-0.039
       GGT ≥60 U/L (m), ≥40 U/L (f)0.650 (0.480–0.820)10030.024.31009/28/12/00.300
       ANI score ≥3.000.600 (0.361–0.839)55.677.535.788.65/9/31/40.331
       AUDIT-C ≥4 (m), ≥3 (f)0.708 (0.512–0.905)66.775.037.590.96/10/30/30.417
      AUC for hEtG, uEtG, CDT, MCV, GGT and AUDIT-C were treated as binary predictors based on well-established cut-offs. AUC for ANI score was calculated using ANI as a continuous variable to provide respective cut-offs for repeated moderate to excessive, and excessive alcohol intake, respectively. These cut-offs are given in the table. Missing values were not replaced. Calculations presented in this table were performed in patients in whom each alcohol test was available from the same day (all patients: 141/182, presumed NAFLD: 92/122, ALD: 49/70). Prevalence was calculated as (TP+FN)/N. N = number of patients in whom each alcohol test was available on the same day. Prevalence for the target condition of moderate to excessive, and excessive alcohol consumption was 34.0% and 13.5% for all patients (n = 141), 37.0% and 10.9% for presumed NAFLD (n = 92), and 28.6% and 18.4% for ALD (n = 49), respectively.
      Note: Importantly, the percentage calculated using hEtG to reclassify patients with presumed NAFLD (see Methods section) with moderate risk of alcohol-related liver damage (hEtG >7 pg/mg and ≤30 pg/mg corresponding to ≥10 and <60 g EtOH/day = repeated moderate alcohol consumption), and high risk of alcohol-related liver damage (hEtG >30 pg/mg corresponding to >60 g EtOH/day = excessive alcohol consumption) was 28.6% and 14.3% for all patients (n = 182), 28.6% and 10.7% for presumed NAFLD (n = 112), and 28.6% and 20% for ALD (n = 70), respectively. ANI, ALD/NAFLD index; AUDIT-C, Alcohol Use Disorders Identification Test – Consumption; CDT, carbohydrate deficient transferrin; EtOH, ethanol; FN, false negative; FP, false positive; GGT, gamma glutamyltransferase; hEtG, ethyl glucuronide in hair; MCV, mean corpuscular volume; NPV, negative predictive value; PPV, positive predictive value; Sens, sensitivity; Spec, specificity; TN, true negative; TP, true positive; uEtG, ethyl glucuronide in urine.