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November 12, 1982

Biochemical and Hematologic Correlates of Alcoholism and Liver Disease

Author Affiliations

From the Laboratories of Clinical Studies (Dr Ryback) and Preclinical Studies (Dr Eckardt), Division of Intramural Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, Md; the Hepatology Service, Veterans Administration Medical Center, Long Beach, Calif (Dr Felsher); and the Statistical and Mathematical Applications Branch, Alcohol, Drug Abuse, and Mental Health Administration, Rockville, Md (Mr Rawlings).

JAMA. 1982;248(18):2261-2265. doi:10.1001/jama.1982.03330180021025

Quadratic multiple discriminant analysis of 25 commonly ordered laboratory tests resulted in correct classification of 100% of nonalcoholics without overt liver disease, 98% of alcoholism treatment program patients with presumed mild liver involvement, 96% of alcoholics with liver disease, and 89% of nonalcoholics with liver disease. Direct comparison of the biopsy-verified alcoholic and nonalcoholic liver disease groups resulted in 100% discrimination, and removal of traditionally evaluated liver tests from the battery of 25 tests did not substantially alter the original classification accuracy. Alcoholic and nonalcoholic liver disease was still 100% differentiable when equated for number of patients with cirrhosis, hepatitis, and hepatitis combined with cirrhosis or fibrosis. Additional utility of the quadratic discriminant approach was demonstrated when 83% alcoholic and 83% nonalcoholic liver disease cases were diagnosed correctly in a prospective manner. In contrast, use of aspartate aminotransferase to alanine aminotransferase ratios (ie, SGOT to SGPT) identified correctly 75% and 33% of patients, respectively.

(JAMA 1982;248:2261-2265)