External Transportability Validation, Implementation Readiness, and Outcome Association of the TransHepMet-Mort Liver Metabolic Mortality Risk Model

Inclusion criteria

• Age ≥ 18 years at the time of the health examination.
• Presence of health examination records at our hospital's health examination center between January 1, 2018, and December 31, 2024.
• Availability of fatty liver-related records, including hepatic steatosis indicated by liver ultrasound, controlled attenuation parameter (CAP), liver stiffness measurement (LSM), or screening-related checkup items.
• Complete documentation of essential baseline characteristics, minimally including age, sex, and the exact date of the physical examination.
• Possession of a unique in-hospital patient identifier or a study-specific identification code generated by the data management department to enable reliable deduplication and outcome linkage.

Exclusion criteria

• Age < 18 years.
• Absence of critical data fields required to establish basic eligibility, such as missing records for age, sex, or the date of the health examination.
• Presence of duplicate records that cannot be reliably resolved, or irresolvable conflicts during participant identity mapping.
• Physiologically implausible data without a verifiable audit trail for correction, such as anthropometric indices, CAP, LSM, or liver enzymes falling outside biologically reasonable ranges.
• Explicit prior refusal by the participant (opt-out) to allow their medical or health examination data to be utilized for clinical research.
• Any other conditions or restrictions stipulated by the Institutional Review Board (IRB) or the hospital's data management department that preclude inclusion.