Development and internal validation of a nomogram-based screening tool for concurrent autoimmune hepatitis in children with intestinal diseases: a retrospective cohort study.
- 1Department of Pediatric Ward One, Kaifeng Central Hospital, Kaifeng, Henan, China.
Abstract
Background
Autoimmune hepatitis (AIH) can complicate paediatric intestinal diseases, but practical tools for early screening and risk stratification are limited.Methods
This retrospective cohort study included 346 children with intestinal diseases treated at a tertiary centre from 2015 to 2023, including 68 with concurrent AIH and 278 without AIH. Baseline clinical and laboratory variables measured at the initial gastroenterology evaluation were analysed. Candidate variables were selected using least absolute shrinkage and selection operator logistic regression and entered into multivariable logistic regression to construct a nomogram-based screening model. Model performance was assessed using receiver operating characteristic curve analysis, calibration metrics, bootstrap internal validation, and decision curve analysis.Results
Eight variables associated with concurrent AIH were included: disease duration ≥12 months, C-reactive protein ≥15 mg/L, immunoglobulin G ≥16 g/L, erythrocyte sedimentation rate ≥25 mm/h, antinuclear antibody positivity, corticosteroid use, pancolitis, and family history of autoimmune disease. The model showed an apparent area under the curve (AUC) of 0.974 and a bootstrap-corrected AUC of 0.893. Calibration was acceptable, with a slope of 0.87, intercept of -0.03, Brier score of 0.098, and a non-significant Hosmer-Lemeshow test (p = 0.398). Decision curve analysis indicated a greater net benefit for referral-oriented screening than single-predictor or default strategies.Conclusion
The nomogram may help screen children with intestinal diseases who warrant early hepatological evaluation for concurrent AIH. It should not be used as a standalone diagnostic instrument, and external validation is required before routine clinical use.
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BibTeX
@article{hou2026development,
title = {{Development and internal validation of a nomogram-based screening tool for concurrent autoimmune hepatitis in children with intestinal diseases: a retrospective cohort study.}},
author = {YanFang Hou},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1861363},
url = {https://europepmc.org/article/MED/42908787},
note = {CC BY},
}
RIS
TY - JOUR
TI - Development and internal validation of a nomogram-based screening tool for concurrent autoimmune hepatitis in children with intestinal diseases: a retrospective cohort study.
AU - YanFang Hou
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1861363
UR - https://europepmc.org/article/MED/42908787
AB - Background Autoimmune hepatitis (AIH) can complicate paediatric intestinal diseases, but practical tools for early screening and risk stratification are limited.Methods This retrospective cohort study included 346 children with intestinal diseases treated at a tertiary centre from 2015 to 2023, including 68 with concurrent AIH and 278 without AIH. Baseline clinical and laboratory variables measured at the initial gastroenterology evaluation were analysed. Candidate variables were selected using least absolute shrinkage and selection operator logistic regression and entered into multivariable logistic regression to construct a nomogram-based screening model. Model performance was assessed using receiver operating characteristic curve analysis, calibration metrics, bootstrap internal validation, and decision curve analysis.Results Eight variables associated with concurrent AIH were included: disease duration ≥12 months, C-reactive protein ≥15 mg/L, immunoglobulin G ≥16 g/L, erythrocyte sedimentation rate ≥25 mm/h, antinuclear antibody positivity, corticosteroid use, pancolitis, and family history of autoimmune disease. The model showed an apparent area under the curve (AUC) of 0.974 and a bootstrap-corrected AUC of 0.893. Calibration was acceptable, with a slope of 0.87, intercept of -0.03, Brier score of 0.098, and a non-significant Hosmer-Lemeshow test (p = 0.398). Decision curve analysis indicated a greater net benefit for referral-oriented screening than single-predictor or default strategies.Conclusion The nomogram may help screen children with intestinal diseases who warrant early hepatological evaluation for concurrent AIH. It should not be used as a standalone diagnostic instrument, and external validation is required before routine clinical use.
SN - 2296-858X
ER -