aMAP is a cross-etiology and cross-population model that uses age, sex, bilirubin, albumin, and platelet count to estimate HCC risk.

A risk score, known as the age–male–ALBI–platelets (aMAP) score, was devised using the above 4 variables weighted by their regression coefficients in the multivariable Cox model (Table 2), and then the score range was standardised to 1–100:

aMAPriskscore=({0.06×age+0.89×sex⁡(Male:1,Female:0)+0.48×[(log10bilirubin×0.66)+(albumin×−0.085)]−0.01×platelets}+7.4)/14.77×100,

where age is in year, bilirubin in μmol/l, albumin in g/l and platelets in 10³/mm³. The 5-year baseline survival function of the aMAP Risk Score was:

𝑆0⁡(t)=exp⁡(−𝐻0⁡(t))=0.984.

The C-index of the aMAP score was 0.82 (95% CI: 0.77–0.86). The C-index did not improve substantially when cirrhosis (0.82, 95% CI: 0.78–0.87) or the LSM value (0.82, 95% CI: 0.78–0.87) was included in the model. The C-index was 0.80 (95% CI: 0.74–0.87) and 0.84 (95% CI: 0.77–0.90) among patients with or without achieving a negative HBV DNA status, respectively, and 0.74 (95% CI: 0.67–0.81) and 0.75 (95% CI: 0.67–0.84) in patients with and without cirrhosis, respectively (Table 3). The time-dependent ROC curves of aMAP score for predicting 1-, 2-, 3-, 4- and 5-year HCC showed that the prediction model had good prediction accuracy during each period of follow-up (Fig. S3).

	Search-B training cohort	Search-B validation cohort	REALM cohort	Gilead Asian CHB cohort	European PAGE-B cohort	Gilead Caucasian CHB cohort	Japanese HCV cohort	UK SVR cirrhotic cohort	Gilead SVR cirrhotic cohort	Japanese NVH cohort
Overall	0.82 (0.77, 0.86)	0.84 (0.79, 0.89)	0.87 (0.82, 0.91)	0.83 (0.74, 0.92)	0.82 (0.78, 0.86)	0.87 (0.78, 0.97)	0.85 (0.79, 0.91)	/	/	0.85 (0.79, 0.90)
Cirrhosis	0.74 (0.67, 0.81)	0.75 (0.68, 0.82)	0.64 (0.54, 0.74)	0.83 (0.66, 1.00)	0.71 (0.65, 0.77)	0.61 (0.29, 0.94)	0.74 (0.64, 0.85)	0.77 (0.71, 0.83)	0.68 (0.61, 0.74)	0.61 (0.49, 0.73)
Non-cirrhosis	0.75 (0.67, 0.84)	0.77 (0.66, 0.89)	0.89 (0.82, 0.95)	0.82 (0.71, 0.93)	0.83 (0.77, 0.90)	0.96 (0.93, 0.99)	0.82 (0.73, 0.91)	/	/	0.84 (0.71, 0.98)
Negative HBV DNA	0.80 (0.74, 0.87)	0.81 (0.71, 0.90)	/	/	0.80 (0.73, 0.87)	/	/	/	/	/
Positive HBV DNA	0.84 (0.77, 0.90)	0.88 (0.84, 0.91)	/	/	0.81 (0.75, 0.87)	/	/	/	/	/

Table 3

C-index (95% Cl) values of aMAP score for hepatocellular carcinoma development among patients in each cohort and its subgroups.

aMAP score for HCC risk in chronic liver disease

Core inputs