Discrimination of DILI and AIH by Artificial Intelligence

Research Objectives:

• To develop a machine learning-based model from retrospective data.
• To validate the machine learning-based model from internal dataset and external datasets nationwide.
• To setup a website or application based on the above model to discriminate Drug-induced liver injury and Autoimmune hepatitis.

Inclusion criteria

• Drug-induced liver injury

• RUCAM ≥6 and met one of the following biochemical conditions: a.) ALT≥5 ULN, b.) or ALP ≥2 ULN, iii) or ALT≥3 ULN and TBil≥2 ULN.
• RUCAM was between 3-5, the medical records were further reviewed by the three authors to determine the eligibility.
• Autoimmune hepatitis

• The revised International Autoimmune Hepatitis Group (IAIHG) diagnostic score≥6 points.
• Liver biopsy available, which is compatible with typical features of AIH.
• If liver biopsy was unavailable, patients who achieved biochemical resolution after sustained immunosuppressive therapy.

Exclusion criteria

• Drug-induced liver injury

• Hepatotropic viral infection: hepatitis A, B, C, D and E.
• Non-hepatotropic viral infection: cytomegalovirus (CMV) and Epstein-Barr virus (EBV), etc.
• Hypoxic ischemic hepatitis and congestive liver disease.
• Alcohol consumption: male >40g/d, female >20g/d, and ≥5 years.
• Biliary obstruction, primary biliary cholangitis; primary sclerosing cholangitis.
• Autoimmune hepatitis.
• Parasitic infection.
• Sepsis.
• Previous liver transplantation or bone marrow transplantation.
• Pregnancy or lactation.
• Genetic and metabolic liver diseases.
• Autoimmune hepatitis

• Hepatotropic viral infection: hepatitis A, B, C, D and E.
• Non-hepatotropic viral infection: cytomegalovirus (CMV) and Epstein-Barr virus (EBV), etc.
• Hypoxic ischemic hepatitis and congestive liver disease.
• Alcohol consumption: male >40g/d, female >20g/d, and ≥5 years.
• Biliary obstruction, primary biliary cholangitis; primary sclerosing cholangitis.
• Drug-induced liver injury.
• Parasitic infection.
• Sepsis.
• Previous liver transplantation or bone marrow transplantation.
• Pregnancy or lactation.
• Genetic and metabolic liver diseases.