The biochemical parameters seen in a cohort of patients in Newcastle undergoing endoscopy were linked to the presence or absence of varices at endoscopy. This allowed the development of a tool which used this information to predict the outcome of that endoscopy (1). The tool has subsequently been validated in further cohorts of patients from Newcastle, Cambridge and Toronto. Entry of patient data into the tool allows the likelihood of varices were endoscopy to be undertaken to be predicted. Other elements of the tool explore the benefits (in terms of endoscopies and bleeds avoided) of adopting different screening strategies for varices in PBC. This is designed to assist in configuring local clinical services

Important Note: What level of likelihood triggers endoscopy is a clinical decision to be taken in the context of an individual patients risk. The tool is designed to help decision making not replace endoscopy and cannot be used to exclude risk. Clinical concern about the possibility of varices in a PBC patient should always be followed up with endoscopy.



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1. Patanwala I, Walton R, Mells G, Newton JL, Alexander G, Hudson M, Jones DEJ. The clinical impact of varices and a new externally validated non-invasive inexpensive tool to predict their presence in PBC. J Hepatol 2012;56:S380-S380.