DILI

// Pull in variables
$baselineALT = $_POST[‘baselineALT’];
$currentALT = $_POST[‘currentALT’];
$ULNALT = $_POST[‘ULNALT’];
$currentTBILI = $_POST[‘currentTBILI’];
$ULNTBILI = $_POST[‘ULNTBILI’];
$baselineDBILI = $_POST[‘baselineDBILI’];
$currentDBILI = $_POST[‘currentDBILI’];
$inr = $_POST[‘inr’];
$liversymptoms = $_POST[‘liversymptoms’];
$gilberts = $_POST[‘gilberts’];

// Calculation Elevated baseline
if ($baselineALT >= (1.5 * $ULNALT)) {
$elevated = 1;
$haselevated = “Elevated baseline ALT”;
}
if ($baselineALT < (1.5 * $ULNALT)) { $elevated = 0; $haselevated = "Normal baseline ALT"; } // Calculation X above ULN ALT $numaboveULN = round(($currentALT / $ULNALT), 2); // Calculation X above Baseline ALT $numaboveBASELINE = round(($currentALT / $baselineALT), 2); // Has Liver Symptoms? $hasliversymptoms = "No liver symptoms"; if ($liversymptoms == 1) { $hasliversymptoms = "Has liver symptoms"; } // Has Liver Symptoms? $hasgilberts = "No Gilbert's"; if ($gilberts == 1) { $hasgilberts = "Has Gilbert's"; } // Bilirubin X $changeDBILI = $currentDBILI / $baselineDBILI; // Baseline recommendation $interpretation = "No specific recommendation"; // Table Variables #1 if ($numaboveULN >= 5 AND ($ULNTBILI >= $currentTBILI OR $gilberts == 1) AND $liversymptoms == 0) {
$interpretation = “Repeat ALT, AST, ALP, TBL, in 2‐5 d. Follow‐up for symptoms. Initiate evaluation for other etiologies of abnormal liver tests.”;
}
if (($numaboveBASELINE >= 3 OR $currentALT >=300) AND $elevated == 1 AND ($ULNTBILI >= $currentTBILI OR $gilbrerts == 1) AND $liversymptoms == 0) {
$interpretation = “Repeat ALT, AST, ALP, TBL, in 2‐5 d. Follow‐up for symptoms. Initiate evaluation for other etiologies of abnormal liver tests.”;
}

// Table Variables #2
if ($numaboveULN >= 3 AND ($ULNTBILI >= $currentTBILI OR $gilberts == 1) AND $liversymptoms == 1) {
$interpretation = “Repeat ALT, AST, ALP, TBL, in 2‐5 d. Follow‐up for symptoms. Initiate evaluation for other etiologies of abnormal liver tests.”;
}
if (($numaboveBASELINE >= 2 OR $currentALT >=300) AND $elevated == 1 AND ($ULNTBILI >= $currentTBILI OR $gilberts == 1) AND $liversymptoms == 0) {
$interpretation = “Repeat ALT, AST, ALP, TBL, in 2‐5 d. Follow‐up for symptoms. Initiate evaluation for other etiologies of abnormal liver tests.”;
}

// Table Variables #3
if ($numaboveULN >= 8) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}
if (($numaboveBASELINE >= 5 OR $currentALT >=500) AND $elevated == 1) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}

// Table Variables #4
if ($numaboveULN >= 3 AND ($currentTBILI >= (2 * $ULNTBILI) OR ($gilberts == 1 AND ($changeDBILI >=2 OR $inr > 1.5))) AND $liversymptoms == 0) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}
if (($numaboveBASELINE >= 2 OR $currentALT >=300) AND (($currentTBILI >= (2 * $ULNTBILI)) OR ($gilberts == 1 AND ($changeDBILI >=2 OR $inr > 1.5)) AND $liversymptoms == 0)) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}

// Table Variables #5
if ($liversymptoms == 1 AND $numaboveULN >=5) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}
if ($liversymptoms == 1 AND $elevated == 1 AND ($numaboveULN >= 3 OR $currentALT >=300)) {
$interpretation = “Interrupt study drug. Initiate close monitoring and workup for competing etiologies. Study drug can be restarted only if another etiology is identified and liver enzymes return to baseline.”;
}