Evidence map›Paper›PMID 37276449›Full record

ArticlePharmacoepidemiology and drug safety2023

Performance of an automated deep learning algorithm to identify hepatic steatosis within noncontrast computed tomography scans among people with and without HIV.

Jessie Torgersen, Scott Akers, Yuankai Huo, James G Terry, J Jeffrey Carr, Alexander T Ruutiainen, Melissa Skanderson, Woody Levin, Joseph K Lim, Tamar H Taddei and 10 more

Open access · bronzeAbstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 11 institutions in 3 countries.

Jessie TorgersenDepartment of Medicine, Penn Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-7861-1421
Scott AkersCorporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
Yuankai HuoDepartment of Computer Science, Vanderbilt University, Nashville, Tennessee, USA.
James G TerryDepartment of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
J Jeffrey CarrDepartment of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Alexander T RuutiainenCorporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
Melissa SkandersonDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Woody LevinDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Joseph K LimDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Tamar H TaddeiDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Kaku So-ArmahDepartment of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
Debika BhattacharyaVA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Christopher T RentschDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0002-1408-7907
Li ShenDepartment of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Rotonya CarrDepartment of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA.
Russell T ShinoharaDepartment of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Michele McClainVA Office of Information and Technology, Frederick, Maryland, USA.
Matthew FreibergDepartment of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Amy C JusticeDepartment of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Vincent Lo ReDepartment of Medicine, Penn Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-7955-0600
Yale University · USVanderbilt University · USPenn Center for AIDS Research · USPhiladelphia VA Medical Center · USBoston University · USFrederick Community College · USLaboratoire d’Imagerie Biomédicale · FRUniversity of London · GBUniversity of Pennsylvania · USUniversity of Washington · USVA Greater Los Angeles Healthcare System · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Virus & Reservoirs CoreP30AI045008 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI DAVID S METZGER · 1999 to 2026
$78.6M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Alcohol Associated Outcomes Among HIV+/-Aging VeteransU01AA013566 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2002 to 2005
$10.1M
Alcohol and Multisubstance Use in the Veterans Aging Cohort StudyU01AA020790 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$7.7M
Sex Disparities in Overall Response to ART Among HIV Infected IndividualsU24AA020794 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$5.5M
Molecular Mechanisms Of Post-Transplant Recurrent Alcoholic Liver DiseaseR01AA026302 · NIAAA · UNIVERSITY OF WASHINGTON · PI ROTONYA M CARR · 2017 to 2026
$3.2M
(PQ4)HIV and Aging Mechanisms for Hepatocellular CancerR01CA206465 · NCI · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE, LO RE, VINCENT · 2016 to 2020
$2.5M
Use of Deep Learning Algorithms to Enable Evaluation of the Determinants and Outcomes of Hepatic Steatosis, by HIV StatusK08DK132977 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI Jessie Torgersen · 2022 to 2026
$840k
NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1 TR001863NCI NIH HHS R01 CA206465NIAAA NIH HHS R01 AA026302NIAAA NIH HHS U01 AA013566NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U24 AA020794NIAID NIH HHS P30 AI045008NIDDK NIH HHS K08 DK132977
6 · The paper itself

Abstract

purposeHepatic steatosis (fatty liver disease) affects 25% of the world's population, particularly people with HIV (PWH). Pharmacoepidemiologic studies to identify medications associated with steatosis have not been conducted because methods to evaluate liver fat within digitized images have not been developed. We determined the accuracy of a deep learning algorithm (automatic liver attenuation region-of-interest-based measurement [ALARM]) to identify steatosis within clinically obtained noncontrast abdominal CT images compared to manual radiologist review and evaluated its performance by HIV status.

methodsWe performed a cross-sectional study to evaluate the performance of ALARM within noncontrast abdominal CT images from a sample of patients with and without HIV in the US Veterans Health Administration. We evaluated the ability of ALARM to identify moderate-to-severe hepatic steatosis, defined by mean absolute liver attenuation <40 Hounsfield units (HU), compared to manual radiologist assessment.

resultsAmong 120 patients (51 PWH) who underwent noncontrast abdominal CT, moderate-to-severe hepatic steatosis was identified in 15 (12.5%) persons via ALARM and 12 (10%) by radiologist assessment. Percent agreement between ALARM and radiologist assessment of absolute liver attenuation <40 HU was 95.8%. Sensitivity, specificity, positive predictive value, and negative predictive value of ALARM were 91.7% (95%CI, 51.5%-99.8%), 96.3% (95%CI, 90.8%-99.0%), 73.3% (95%CI, 44.9%-92.2%), and 99.0% (95%CI, 94.8%-100%), respectively. No differences in performance were observed by HIV status.

conclusionsALARM demonstrated excellent accuracy for moderate-to-severe hepatic steatosis regardless of HIV status. Application of ALARM to radiographic repositories could facilitate real-world studies to evaluate medications associated with steatosis and assess differences by HIV status.

Indexed as

Deep LearningFatty LiverHIV InfectionsCross-Sectional StudiesHumansRetrospective StudiesTomography, X-Ray Computedfatty liver diseasehepatic steatosismachine learningvalidation

Identifiers

PMID37276449
PMCPMC10527049
OpenAlexW4379508610

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.