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Clinical decision rule

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https://www.readbyqxmd.com/read/27910703/co-calibration-of-two-self-reported-measures-of-adherence-to-antiretroviral-therapy
#1
Robin M Nance, J A Chris Delaney, Carol E Golin, Wendee M Wechsberg, Chinazo Cunningham, Frederick Altice, Katerina Christopoulos, Kevin Knight, Vu Quan, Michael S Gordon, Sandra Springer, Jeremy Young, Paul K Crane, Kenneth H Mayer, Michael J Mugavero, Carlos Del Rio, Richard A Kronmal, Heidi M Crane
Adherence to antiretroviral therapy (ART) is an important determinant of clinical success assessed in many HIV studies. Harmonizing adherence data from studies that use different measures is difficult without a co-calibration equation to convert between validated instruments. Our purpose was to co-calibrate two commonly used adherence measures: the AIDS Clinical Trials Group (ACTG) questionnaire and the Visual Analog Scale (VAS). We used robust linear regression to develop a co-calibration equation in a clinical care cohort...
December 2, 2016: AIDS Care
https://www.readbyqxmd.com/read/27904602/comparison-of-different-risk-stratification-systems-in-predicting-short-term-serious-outcome-of-syncope-patients
#2
Saeed Safari, Alireza Baratloo, Behrooz Hashemi, Farhad Rahmati, Mohammad Mehdi Forouzanfar, Maryam Motamedi, Ladan Mirmohseni
BACKGROUND: Determining etiologic causes and prognosis can significantly improve management of syncope patients. The present study aimed to compare the values of San Francisco, Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL), Boston, and Risk Stratification of Syncope in the Emergency Department (ROSE) score clinical decision rules in predicting the short-term serious outcome of syncope patients. MATERIALS AND METHODS: The present diagnostic accuracy study with 1-week follow-up was designed to evaluate the predictive values of the four mentioned clinical decision rules...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27902658/understanding-negative-predictive-value-of-diagnostic-tests-used-in-clinical-practice
#3
Reba A Umberger, Linda A Hatfield, Patricia M Speck
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27900363/integration-of-genomics-and-histology-revises-diagnosis-and-enables-effective-therapy-of-refractory-cancer-of-unknown-primary-with-pdl1-amplification
#4
Stefan Gröschel, Martin Bommer, Barbara Hutter, Jan Budczies, David Bonekamp, Christoph Heining, Peter Horak, Martina Fröhlich, Sebastian Uhrig, Daniel Hübschmann, Christina Geörg, Daniela Richter, Nicole Pfarr, Katrin Pfütze, Stephan Wolf, Peter Schirmacher, Dirk Jäger, Christof von Kalle, Benedikt Brors, Hanno Glimm, Wilko Weichert, Albrecht Stenzinger, Stefan Fröhling
Identification of the tissue of origin in cancer of unknown primary (CUP) poses a diagnostic challenge and is critical for directing site-specific therapy. Currently, clinical decision-making in patients with CUP primarily relies on histopathology and clinical features. Comprehensive molecular profiling has the potential to contribute to diagnostic categorization and, most importantly, guide CUP therapy through identification of actionable lesions. We here report the case of an advanced-stage malignancy initially mimicking poorly differentiated soft-tissue sarcoma that did not respond to multiagent chemotherapy...
November 2016: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/27899756/coagulation-testing-in-acute-ischemic-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants
#5
Jan C Purrucker, Kirsten Haas, Timolaos Rizos, Shujah Khan, Sven Poli, Peter Kraft, Christoph Kleinschnitz, Rainer Dziewas, Andreas Binder, Frederick Palm, Sebastian Jander, Hassan Soda, Peter U Heuschmann, Roland Veltkamp
BACKGROUND AND PURPOSE: In patients who present with acute ischemic stroke while on treatment with non-vitamin K antagonist oral anticoagulants (NOACs), coagulation testing is necessary to confirm the eligibility for thrombolytic therapy. We evaluated the current use of coagulation testing in routine clinical practice in patients who were on NOAC treatment at the time of acute ischemic stroke. METHODS: Prospective multicenter observational RASUNOA registry (Registry of Acute Stroke Under New Oral Anticoagulants; February 2012-2015)...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27898976/development-and-validation-of-a-deep-learning-algorithm-for-detection-of-diabetic-retinopathy-in-retinal-fundus-photographs
#6
Varun Gulshan, Lily Peng, Marc Coram, Martin C Stumpe, Derek Wu, Arunachalam Narayanaswamy, Subhashini Venugopalan, Kasumi Widner, Tom Madams, Jorge Cuadros, Ramasamy Kim, Rajiv Raman, Philip C Nelson, Jessica L Mega, Dale R Webster
Importance: Deep learning is a family of computational methods that allow an algorithm to program itself by learning from a large set of examples that demonstrate the desired behavior, removing the need to specify rules explicitly. Application of these methods to medical imaging requires further assessment and validation. Objective: To apply deep learning to create an algorithm for automated detection of diabetic retinopathy and diabetic macular edema in retinal fundus photographs...
November 29, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27894634/a-clinical-decision-rule-for-thoracolumbar-spine-imaging-in-blunt-trauma
#7
Jeff Riddell, Kenji Inaba, Paul Jhun, Mel Herbert
No abstract text is available yet for this article.
December 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27885107/a-systematic-review-of-clinical-prediction-scores-for-deep-vein-thrombosis
#8
REVIEW
Marina Kafeza, Joseph Shalhoub, Nina Salooja, Lucy Bingham, Konstantina Spagou, Alun H Davies
OBJECTIVE: Diagnosis of deep vein thrombosis remains a challenging problem. Various clinical prediction rules have been developed in order to improve diagnosis and decision making in relation to deep vein thrombosis. The purpose of this review is to summarise the available clinical scores and describe their applicability and limitations. METHODS: A systematic search of PubMed, MEDLINE and EMBASE databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance using the keywords: clinical score, clinical prediction rule, risk assessment, clinical probability, pretest probability, diagnostic score and medical Subject Heading terms: 'Venous Thromboembolism/diagnosis' OR 'Venous Thrombosis/diagnosis'...
November 24, 2016: Phlebology
https://www.readbyqxmd.com/read/27882560/a-computer-prescribing-order-entry-clinical-decision-support-system-designed-for-neonatal-care-results-of-the-preselected-prescription-concept-at-the-bedside
#9
B Gouyon, S Iacobelli, E Saliba, C Quantin, A Pignolet, E Jacqz-Aigrain, J B Gouyon
WHAT IS KNOWN: The neonatal intensive care units (NICUs) are at the highest risk of drug dose error of all hospital wards. NICUs also have the most complicated prescription modalities. The computerization of the prescription process is currently recommended to decrease the risk of preventable adverse drug effects (pADEs) in NICUs. However, Computer Prescribing Order Entry-Clinical Decision Support (C.P.O.E./C.D.S.) systems have been poorly studied in NICUs, and their technical compatibility with neonatal specificities has been limited...
November 23, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27877117/general-habit-propensity-relates-to-the-sensation-seeking-subdomain-of-impulsivity-but-not-obesity
#10
Anja Dietrich, Sanne de Wit, Annette Horstmann
According to dual-system theory, instrumental learning and performance depend on the balance between goal-directed and habitual action control. Overreliance on habits has been argued to characterize clinical conditions such as drug addiction or obsessive-compulsive disorder as well as obesity and excessive impulsivity. A tendency toward habitual action control in obesity has already been indicated in the food domain. However, impairments might not be restricted to eating behavior. This has been suggested by domain-general obesity-associated disturbances in executive function as well as alterations in corticostriatal circuits underlying the goal-directed and habitual systems...
2016: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/27876174/artificial-neural-networks-predicting-head-ct-findings-in-elderly-patients-presenting-with-minor-head-injury-after-a-fall
#11
Michael W Dusenberry, Charles K Brown, Kori L Brewer
OBJECTIVES: To construct an artificial neural network (ANN) model that can predict the presence of acute CT findings with both high sensitivity and high specificity when applied to the population of patients≥age 65years who have incurred minor head injury after a fall. METHODS: An ANN was created in the Python programming language using a population of 514 patients ≥ age 65 years presenting to the ED with minor head injury after a fall. The patient dataset was divided into three parts: 60% for "training", 20% for "cross validation", and 20% for "testing"...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27870815/the-cape-town-clinical-decision-rule-for-streptococcal-pharyngitis-in-children
#12
Mark Emmanuel Engel, Karen Cohen, Ronald Gounden, Andre P Kengne, Dylan Dominic Barth, Andrew C Whitelaw, Veronica Francis, Motasim Badri, Annemie Stewart, James B Dale, Bongani M Mayosi, Gary Maartens
BACKGROUND: Existing clinical decision rules (CDR) to diagnose group A streptococcal (GAS) pharyngitis have not been validated in sub-Saharan Africa. We developed a locally applicable CDR while evaluating existing CDRs for diagnosing GAS pharyngitis in South African children. METHODS: We conducted a prospective cohort study and enrolled 997 children aged 3-15 years presenting to primary care clinics with a complaint of sore throat, and whose parents provided consent...
November 18, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27862642/external-validation-of-the-pecarn-head-trauma-prediction-rules-in-japan
#13
Kentaro Ide, Satoko Uematsu, Kenichi Tetsuhara, Satoshi Yoshimura, Takahiro Kato, Tohru Kobayashi
OBJECTIVES: The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country...
November 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27862628/history-physical-exam-laboratory-testing-and-emergency-department-ultrasonography-for-the-diagnosis-of-acute-cholecystitis
#14
Ashika Jain, Ninfa Mehta, Michael Secko, Joshua Schecter, Dimitri Papanagnou, Shreya Pandya, Richard Sinert
BACKGROUND: Acute Cholecystitis (AC) is a common differential for patients presenting to the Emergency Department (ED) with abdominal pain. The diagnostic accuracy of history, physical exam and bedside lab tests for AC have not been quantitatively described. OBJECTIVES: We performed a systematic review to determine the utility of History/Physical exam (H&P), Laboratory studies and Ultrasonography (US) in diagnosing AC in the ED. METHODS: We searched medical literature from January 1965 to March 2016 in PubMed, EMBASE and SCOPUS using a strategy derived from the following formulation of our clinical question: Patients: ED patients suspected of AC...
November 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27860223/validation-of-risk-stratification-for-children-with-febrile-neutropenia-in-a-pediatric-oncology-unit-in-india
#15
Anirban Das, Amita Trehan, Sapna Oberoi, Deepak Bansal
PURPOSE: The study aims to validate a score predicting risk of complications in pediatric patients with chemotherapy-related febrile neutropenia (FN) and evaluate the performance of previously published models for risk stratification. PATIENTS AND METHODS: Children diagnosed with cancer and presenting with FN were evaluated in a prospective single-center study. A score predicting the risk of complications, previously derived in the unit, was validated on a prospective cohort...
November 15, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27858189/ambulatory-or-inpatient-management-of-mild-tbi-in-children-a-post-concussion-analysis
#16
Danielle S Wendling-Keim, Adriana König, Hans-Georg Dietz, Markus Lehner
BACKGROUND: Diagnosis and treatment of children with mild traumatic brain injury (mTBI) remain a challenge since initial signs and symptoms do not always indicate the severity of the trauma. Therefore, guidelines regarding the decision upon imaging methods and ambulatory or hospitalized treatment are needed. The goal of our study was to investigate if the standard that was allied from the PECARN rules and is applied in this study can ensure that patients with clinically important brain injury are recognized and leads to outcomes with a low complication rate, a high patient satisfaction and minimal post-concussion syndrome incidence...
November 17, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27853033/performance-of-waist-circumference-and-proposed-cutoff-levels-for-defining-overweight-and-obesity-in-nigerians
#17
Christian I Okafor, Taiwo H Raimi, Ibrahim D Gezawa, Anas A Sabir, Ofem Enang, Fabian Puepet, Olufemi A Fasanmade, Esther N Ofoegbu, Olatunde Odusan
BACKGROUND: Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. OBJECTIVES: To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. SUBJECTS AND METHODS: Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study...
October 2016: Annals of African Medicine
https://www.readbyqxmd.com/read/27852237/using-cognitive-pre-testing-methods-in-the-development-of-a-new-evidenced-based-pressure-ulcer-risk-assessment-instrument
#18
S Coleman, J Nixon, J Keen, D Muir, L Wilson, E McGinnis, N Stubbs, C Dealey, E A Nelson
BACKGROUND: Variation in development methods of Pressure Ulcer Risk Assessment Instruments has led to inconsistent inclusion of risk factors and concerns about content validity. A new evidenced-based Risk Assessment Instrument, the Pressure Ulcer Risk Primary Or Secondary Evaluation Tool - PURPOSE-T was developed as part of a National Institute for Health Research (NIHR) funded Pressure Ulcer Research Programme (PURPOSE: RP-PG-0407-10056). This paper reports the pre-test phase to assess and improve PURPOSE-T acceptability, usability and confirm content validity...
November 16, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27842904/yield-of-computed-tomography-of-the-cervical-spine-in-cases-of-simple-assault
#19
Matthew L Uriell, Jason W Allen, Brendan P Lovasik, Marc D Benayoun, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-impact, non-penetrating or "simple" assault at our institution and others. Common clinical decision tools for C-spine imaging in the setting of trauma include the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). While NEXUS and CCR have served to decrease the amount of unnecessary imaging of the C-spine, overutilization of CT is still of concern...
October 29, 2016: Injury
https://www.readbyqxmd.com/read/27834223/social-capital-interventions-targeting-older-people-and-their-impact-on-health-a-systematic-review
#20
REVIEW
Laura Coll-Planas, Fredrica Nyqvist, Teresa Puig, Gerard Urrútia, Ivan Solà, Rosa Monteserín
BACKGROUND: Observational studies show that social capital is a protective health factor. Therefore, we aim to assess the currently unclear health impact of social capital interventions targeting older adults. METHODS: We conducted a systematic review based on a logic model. Studies published between January 1980 and July 2015 were retrieved from MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. We included randomised controlled trials targeting participants over 60 years old and focused on social capital or its components (eg, social support and social participation)...
November 10, 2016: Journal of Epidemiology and Community Health
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