Clinical calculator summary
Liver & HCC Parallel Results Panel
Clinical calculator summary
Liver & HCC Parallel Results Panel
A strict software orchestrator that projects one exact input envelope into six independently verified child implementations.
Evidence-based context for fast calculator use
- Purpose:
- Display source-specific component results and unavailable states without synthesizing a clinical recommendation.
- Population:
- Adults with confirmed HCC at initial assessment; contemporaneous unconfounded liver values; calculated adult MELD context.
- Factors:
- Liver laboratory values, CTP clinical categories, Adult MELD sex and dialysis, HCC-related ECOG, Liver status, Raw HCC burden, Distinct IVI, extrahepatic vascular invasion, and spread
- Reference:
- Each component retains its own public source and version in the result trace.
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Liver & HCC Parallel Results Panel
Confirm an adult with established chronic liver disease and confirmed HCC at initial complete staging, using contemporaneous liver values, an INR not materially confounded by anticoagulation or nonhepatic disease, and an OPTN calculated-MELD context. Otherwise use the standalone calculators.
µmol/L
g/L
The compact panel uses the INR Child-Pugh variant. Use the standalone Child-Pugh calculator for PT prolongation or a confounded INR.
µmol/L
mmol/L
Select Yes for at least 2 dialysis treatments or at least 24 hours of continuous venovenous hemodialysis within 7 days.
Select Yes only when diffuse disease has been assessed; count and diameter are then not requested.
First-order or smaller portal branches or hepatic veins; Absent means assessed and absent.
Absent means assessed and absent.
Regional nodal or distant spread; Absent means assessed and absent.
Clinical Context & Background
This panel is a neutral orchestrator for six separately verified components:
1. Child-Turcotte-Pugh, standard-bilirubin INR variant in this compact panel
2. Original ALBI grade
3. OPTN Calculated MELD 3.0 under Policy 9.1.D
4. Corrected BCLC 2026 HCC stage
5. Original HKLC-9 (2014)
6. Original Milan (1996) tumor-burden criteria
The public form asks for 18 clinical values that can change at least one displayed result, plus one scope confirmation. That single confirmation replaces repeated questions about adult chronic liver disease, confirmed HCC, initial complete staging, contemporaneous unconfounded liver values, and calculated-MELD context. The verified parent engine retains its exact 32-key internal contract.
Partial completion is intentional. Missing Child-Pugh data suppresses Child-Pugh and HKLC only; missing sodium suppresses MELD only; missing tumor-burden data suppresses only the dependent staging results.
No source supports a combined liver/HCC score, consensus stage, worst-result rule, agreement/discordance judgment, treatment choice, transplant decision, eligibility conclusion, or individualized prognosis. Expected differences are model-scope differences.
Formula Logic
Parallel orchestration only: exact parent contract -> six source-specific child projections -> component availability summary.Reference Data
| Component | Source lock | Panel output boundary |
|---|---|---|
| Child-Turcotte-Pugh | 1964/1973 standard-bilirubin PT or INR table | Separate total/class/status/trace |
| ALBI | Johnson et al. 2015 original grade | Separate raw/display score, grade, status, trace |
| OPTN MELD 3.0 | Policy 9.1.D effective 2023-07-13 | Separate calculated score/branch/status/trace |
| BCLC 2026 | Corrected 2026 update and erratum | Separate stage/status/trace; Child-Pugh is context only |
| Original HKLC-9 | Yau et al. 2014 | Separate stage/status/trace; requires interpreted Child-Pugh |
| Original Milan | Mazzaferro et al. 1996 | Separate tumor-burden classification/status/trace |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use Liver & HCC Parallel Results Panel when six liver/HCC results from 18 clinical inputs and one concise scope confirmation, with component-specific availability.
- Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.
How To Interpret
- Interpret the displayed result using the calculator-specific formula and reference table, spanning Child-Turcotte-Pugh through Original Milan.
- A boundary result should prompt input verification and clinical review rather than false precision.
What To Do Next
- Review every component result separately; if models disagree, verify inputs and follow the more cautious disease-specific pathway rather than averaging scores.
- Document the inputs, result, timing, and clinical context so the assessment can be reproduced.
Limitations
- A panel improves comparison but does not make component models interchangeable or create a new validated composite score.
- The result supports clinician judgment and does not independently determine treatment.
Validated Population
patients whose clinical question requires the component models displayed in the combined panel
How to apply this result
For a representative case, verify Compact panel scope, Total bilirubin, Albumin, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed production cases passed through visible controls across complete six-component results, MELD-only unavailability when sodium is omitted, and the compact-panel scope guard.
- The complete case separately rendered Child-Turcotte-Pugh Class A, ALBI Grade 2, calculated MELD 3.0 of 10, BCLC Stage 0, HKLC-9 Stage I, and within original Milan criteria.
- The published panel uses an Independent result summary and no longer displays agreement/discordance synthesis, a combined score, stale controls, literal undefined/null values, or a visible error boundary.
Case-level production evidence is retained in validation/browser-revalidation/panel-liver-hcc-production-closure-2026-08-03.json.
: Local independent-component summary remediation
- Three visible-control cases covered a complete six-component result, missing-sodium component isolation, and the not-confirmed scope gate.
- The concise receipt now labels the second column `Independent result` and contains no agreement/discordance instruction or cross-model synthesis.
- All six complete outputs and the MELD-only unavailable state matched their source-locked expectations; 12,292/12,292 assertions passed and the browser console was clean.
Case evidence is retained in validation/browser-revalidation/panel-liver-hcc-local-remediation-2026-08-03.json.
: Production browser revalidation — UI finding retained
- Three source-backed cases were exercised through the visible production controls; all six complete component results, missing-sodium isolation, and the scope gate matched their expected source-locked behavior.
- Production still labels the panel summary column `RESULT / AGREEMENT` and instructs users to `review agreement or discordance clinically`, which is outside the neutral parallel-orchestration contract.
- Overall production status remains failed-ui-safety until that residual synthesis wording is removed and revalidated; no browser-console error was observed.
Case-level evidence and exact reproduction are retained in validation/browser-revalidation/panel-liver-hcc-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Ten source-backed cases passed through visible controls on the corrected local route across 11 submissions.
- Child-Pugh, ALBI, MELD, BCLC, HKLC-9, and Milan rendered as six independent component results. Diffuse tumor and missing sodium produced component-specific incomplete/unavailable states without suppressing valid siblings.
- No unified score, combined assessment, agreement score, discordance score, or dominant stage was displayed. The original production findings remain open until deployment and public revalidation.
Case-level local remediation evidence is retained in validation/browser-production/panel-liver-hcc.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 1/10 case records passed their expected-versus-observed assertions across 0 visible submissions.
- Overall browser status: failed-ui-safety. critical: Every rendered panel result was headed `Unified Panel Results`, described as a `Combined assessment from multiple tools`, and later instructed users to compare `agreement and discordance alongside the unified panel result`. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/panel-liver-hcc.json.
: Actionable unavailable-result guidance
- Replaced unexplained unit and liver-transplant abbreviations in unavailable-result explanations with full clinician-facing terms.
- Corrective explanations use "Please review" and identify exact visible inputs in parentheses; MELD missing-data and range failures identify only the affected laboratory entries, and HKLC dependency guidance identifies only the missing Child-Turcotte-Pugh entries.
- Revalidated all 12,292 panel assertions and added a cross-panel regression audit without changing formulas, thresholds, projections, or applicability rules.
User-interface guidance update; current implementation-verification report remains applicable.
: Compact clinician-facing contract and explicit scope confirmation
- Reduced the public form from 32 questions to 19 controls: 18 clinical inputs that can change a displayed component plus one concise required scope confirmation.
- Replaced repeated applicability questions with an explicit adult chronic-liver-disease, confirmed-HCC, initial-complete-staging, contemporaneous/unconfounded-values, calculated-MELD scope gate; users outside that scope are directed to the standalone calculators.
- Preserved all three truthful MELD listing pathways, combined ECOG with attribution, combined BCLC liver status with LT context, and retained the exact verified 32-key engine behind a deterministic adapter.
- Revalidated the complete neutral panel orchestration at 12,292/12,292 assertions with no child formula, threshold, unit, floor, cap, result, or interpretation change.
: MELD age and waitlist-pathway input simplification
- Replaced three MELD calendar-date controls with direct age-at-assessment and current-waitlist-pathway choices, reducing the panel contract from 33 to 32 fields.
- Verified the under-12 PELD boundary, age 12–17 branch, adult registered/re-listed and hypothetical branches, continuous-listing-since-before-18 branch, conditional sex handling, hidden-value clearing, and five-sibling preservation.
- Revalidated the complete neutral panel orchestration at 12,292/12,292 assertions without changing a child formula, threshold, unit, floor, cap, result, or interpretation.
Superseded by the latest report.
: Component-specific optional-input guidance
- Added a prominent partial-completion note and an “Optional for panel” plus “Used by” marker beside every input, mapped to the actual Child-Pugh, ALBI, MELD 3.0, BCLC 2026, HKLC-9, and Milan dependencies.
- No formula, projection, threshold, applicability rule, or result serialization changed.
- Revalidated intentional omission by leaving the MELD-specific group blank: MELD alone becomes unavailable while the other five components remain interpreted; the full panel audit remains 12,292/12,292.
Superseded by the latest report.
: Browser input correction and form-safety revalidation
- Corrected the panel UI adapter so canonical number strings emitted by real HTML number controls are deserialized before the strict child engines are called; complete valid browser input now returns all six component results.
- Added pre-calculation enforcement for declared input limits and MELD date-order/age-branch consistency so known-invalid entries are highlighted at the field instead of rendered as a result.
- Revalidated the unchanged six child calculations and neutral panel orchestration at 12,292/12,292 deterministic assertions.
Superseded by the latest report.
: Full panel implementation validation
- 12,292/12,292 deterministic assertions passed across the strict envelope, exhaustive tumor projections, liver-function and MELD dependencies, suppression masks, sibling isolation, UI contracts, sources, history, ledger, report, and evidence mirrors.
- This is software implementation verification, not prospective or independent clinical validation.
Superseded by the latest report.
: Panel content reconciliation
- Reframed the route and directly linked guide as a neutral parallel-results orchestrator rather than a combined liver/HCC score, treatment selector, transplant decision, prognosis model, or agreement analysis.
- Updated component identities to OPTN Calculated MELD 3.0, corrected BCLC 2026, and original HKLC-9; clarified that BCLC staging is independent of Child-Pugh.
: Panel orchestration and input-contract correction
- Introduced an exact 33-own-key immutable contract, removed duplicated HCC, timing, spread, and vascular inputs, and corrected numeric tumor-count projection into the Milan categories.
- Added component-specific applicability and suppression, exact vascular derivations, fixed six-card output order, neutral partial-status summaries, complete source traces, empty-state behavior, and risk-gauge suppression.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
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Frequently Asked Questions
When should Liver & HCC Parallel Results Panel be used?
Use it for patients whose clinical question requires the component models displayed in the combined panel when all required inputs and the intended clinical setting are confirmed.
Can Liver & HCC Parallel Results Panel determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
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