You are here
Home > Medical Calculator > Modified Maddrey’s discriminant function (mDF)

Modified Maddrey's discriminant function  (mDF)

Modified Maddrey's discriminant function (Score) is a  predictive statistical model  useful for evaluating the severity and prognosis in alcoholic hepatitis1 (especially mortality within 30 days)2 and evaluates the efficacy of using alcoholic hepatitis steroid treatment. 

Requirements: Patient's prothrombin time and a control value along with the current bilirubin level.   

Prothrombin Time (PT) - Patient  sec
  [Normal: 11 - 13.5]
Prothrombin Time (PT) - Control sec 
[Normal: 11 - 13.5]

Serum Total Bilirubin:
  [Normal: < 1.2 mg/dL (0.1 -1.2 mg/dL)]

Background Info

The modified Maddrey's discriminant function) was originally described by Maddrey and Boitnott1 to predict prognosis in alcoholic hepatitis.


mDF= (4.6 x (PT test - control))+ serum bilirubin  (mg/dl)

A value more than 32 implies poor outcome with one month mortality ranging between 35% to 45%.3

Corticosteroid therapy or pentoxifylline have been used with mixed results for patients whose increased mortality is indicated with a value greater than 32.4


1. Maddrey WC, Boitnott JK, Bedine MS, Weber FL Jr, Mezey E, White RI Jr. Corticosteroid therapy of alcoholic hepatitis.  Gastroenterology. 1978 Aug;75(2):193-9.

2. Sheth M, Riggs M, Patel T. "Utility of the Mayo End-Stage Liver Disease (MELD) score in assessing prognosis of patients with alcoholic hepatitis". BMC Gastroenterol. 2002; 2: 2.. doi:10.1186/1471-230X-2-2.  PMID 11835693.

3. Akriviadis E1, Botla R, Briggs W, Han S, Reynolds T, Shakil O. Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial. Gastroenterology. 2000 Dec;119(6):1637-48.

4. Mathurin P, O'Grady J, Carithers RL, Phillips M, Louvet A, Mendenhall CL, Ramond MJ, Naveau S, Maddrey WC, Morgan TR.  Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis: meta-analysis of individual patient data. Gut. 2011 Feb;60(2):255-60.


The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Read the disclaimer