TY - JOUR
T1 - Introduction and Validation of a Novel Acute Pancreatitis Digital Tool
T2 - Interrogating Large Pooled Data From 2 Prospectively Ascertained Cohorts
AU - Paragomi, Pedram
AU - Spagnolo, Daniel M.
AU - Breze, Cameron R.
AU - Gougol, Amir
AU - Talukdar, Rupjyoti
AU - Kochhar, Rakesh
AU - Goenka, Mahesh Kumar
AU - Gulla, Aiste
AU - Gonzalez, Jose A.
AU - Singh, Vikesh K.
AU - Ferreira, Miguel
AU - Stevens, Tyler
AU - Barbu, Sorin T.
AU - Nawaz, Haq
AU - Gutierrez, Silvia C.
AU - Zarnescu, Narcis O.
AU - Archibugi, Livia
AU - Easler, Jeffrey J.
AU - Triantafyllou, Konstantinos
AU - Pelaez-Luna, Mario
AU - Thakkar, Shyam
AU - Ocampo, Carlos
AU - de-Madaria, Enrique
AU - Cote, Gregory A.
AU - Wu, Bechien U.
AU - Pothoulakis, Ioannis
AU - Haupt, Mark
AU - Whitcomb, David C.
AU - Papachristou, Georgios I.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - OBJECTIVES: Acute pancreatitis (AP) is a sudden onset, rapidly evolving inflammatory response with systemic inflammation and multiorgan failure (MOF) in a subset of patients. New highly accurate clinical decision support tools are needed to allow local doctors to provide expert care. METHODS: Ariel Dynamic Acute Pancreatitis Tracker (ADAPT) is a digital tool to guide physicians in ordering standard tests, evaluate test results and model progression using available data, propose emergent therapies. The accuracy of the severity score calculators was tested using 2 prospectively ascertained Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience cohorts (pilot University of Pittsburgh Medical Center, n = 163; international, n = 1544). RESULTS: The ADAPT and post hoc expert-calculated AP severity scores were 100% concordant in both pilot and international cohorts. High-risk criteria of all 4 severity scores at admission were associated with moderately-severe or severe AP and MOF (both P < 0.0001) and prediction of no MOF was 97.8% to 98.9%. The positive predictive value for MOF was 7.5% to 14.9%. CONCLUSIONS: The ADAPT tool showed 100% accuracy with AP predictive metrics. Prospective evaluation of ADAPT features is needed to determine if additional data can accurately predict and mitigate severe AP and MOF.
AB - OBJECTIVES: Acute pancreatitis (AP) is a sudden onset, rapidly evolving inflammatory response with systemic inflammation and multiorgan failure (MOF) in a subset of patients. New highly accurate clinical decision support tools are needed to allow local doctors to provide expert care. METHODS: Ariel Dynamic Acute Pancreatitis Tracker (ADAPT) is a digital tool to guide physicians in ordering standard tests, evaluate test results and model progression using available data, propose emergent therapies. The accuracy of the severity score calculators was tested using 2 prospectively ascertained Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience cohorts (pilot University of Pittsburgh Medical Center, n = 163; international, n = 1544). RESULTS: The ADAPT and post hoc expert-calculated AP severity scores were 100% concordant in both pilot and international cohorts. High-risk criteria of all 4 severity scores at admission were associated with moderately-severe or severe AP and MOF (both P < 0.0001) and prediction of no MOF was 97.8% to 98.9%. The positive predictive value for MOF was 7.5% to 14.9%. CONCLUSIONS: The ADAPT tool showed 100% accuracy with AP predictive metrics. Prospective evaluation of ADAPT features is needed to determine if additional data can accurately predict and mitigate severe AP and MOF.
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U2 - 10.1097/MPA.0000000000001686
DO - 10.1097/MPA.0000000000001686
M3 - Article
C2 - 33122514
AN - SCOPUS:85094936088
SN - 0885-3177
VL - 49
SP - 1276
EP - 1282
JO - Pancreas
JF - Pancreas
IS - 10
ER -