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"Clinical prediction rules"

J Straatman, L C B Groen, N van der Wielen, E P Jansma, F Daams, M A Cuesta, D L van der Peet
Over the coming years octogenarians will make up an increasingly large proportion of the population. With the rise in octogenarians more paraesophageal hiatal hernias may be identified. In research for the optimal treatment for paraesophageal hiatal hernias, octogenarians are often omitted and the optimal surgical strategy for this patient group remains unclear. A systematic search in PubMed, Embase, and The Cochrane Library was conducted, including articles compromising 'surgery,' 'paraesophageal hiatal hernia,' and 'octogenarians...
March 12, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Inge Wegner, Robert Vincent, Laura S M Derks, Simone P Rauh, Martijn W Heymans, Inge Stegeman, Wilko Grolman
OBJECTIVES/HYPOTHESIS: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. STUDY DESIGN: A retrospective cohort study of prospectively gathered data in a tertiary referral center. METHODS: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection...
March 9, 2018: Laryngoscope
Garrett S Bowen, Michelle S Diop, Lan Jiang, Wen-Chih Wu, James L Rudolph
OBJECTIVES: To derive and validate a 30-day mortality clinical prediction rule for heart failure based on admission data and prior healthcare usage. A secondary objective was to determine the discriminatory function for mortality at 1 and 2 years. DESIGN: Observational cohort. SETTING: Veterans Affairs inpatient medical centers (n=124). PARTICIPANTS: The derivation (2010-12; n=36,021) and validation (2013-15; n=30,364) cohorts included randomly selected veterans admitted for HF exacerbation (mean age 71±11; 98% male)...
March 6, 2018: Journal of the American Geriatrics Society
Maximilian B Bibok, Kristine Votova, Robert F Balshaw, Mary L Lesperance, Nicole S Croteau, Anurag Trivedi, Jaclyn Morrison, Colin Sedgwick, Andrew M Penn
BACKGROUND: To evaluate the performance of a novel triage system for Transient Ischemic Attack (TIA) units built upon an existent clinical prediction rule (CPR) to reduce time to unit arrival, relative to the time of symptom onset, for true TIA and minor stroke patients. Differentiating between true and false TIA/minor stroke cases (mimics) is necessary for effective triage as medical intervention for true TIA/minor stroke is time-sensitive and TIA unit spots are a finite resource. METHODS: Prospective cohort study design utilizing patient referral data and TIA unit arrival times from a regional fast-track TIA unit on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP)...
February 27, 2018: BMC Health Services Research
Jeffrey A Kline
No abstract text is available yet for this article.
February 13, 2018: JAMA: the Journal of the American Medical Association
Lely Solari, Alonso Soto, Patrick van der Stuyft
OBJECTIVES: Diagnosis of Tuberculous Meningitis (TM) is a challenge in countries with a high burden of the disease and constrained resources and Clinical Prediction Rules (CPRs) could be of assistance. We aimed at developing a CPR for diagnosis of TM in a Latin American setting with high tuberculosis incidence and a concentrated HIV epidemic. METHODS: We enrolled adult patients with clinical suspicion of TM attending two hospitals in Lima, Peru. We obtained information on potential anamnestic, clinical and laboratory predictive findings that are easy to collect and promptly available...
February 15, 2018: Tropical Medicine & International Health: TM & IH
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: To develop a Clinical Prediction Rule (CPR) for diagnosis of Pleural Tuberculosis (PT) in patients with pleural exudates in Peru. METHODS: We obtained clinical and laboratory information in patients attending 2 reference hospitals in Lima, Peru with exudative pleural effusion. Predictive findings associated with pleural tuberculosis in a multiple logistic regression model were used to develop the CPR. Definite diagnosis of PT was based on a composite reference standard including bacteriologic and/or histologic analysis of pleural fluid and pleural biopsy specimens...
February 2, 2018: International Journal of Infectious Diseases: IJID
Jean-Francois Esculier, Laurent J Bouyer, Blaise Dubois, Jean Leblond, Mélanie Brisson, Luc Chau, Jean-Sébastien Roy
OBJECTIVES: To identify predictors of outcome to a rehabilitation program focused on education and management of training loads in runners with patellofemoral pain (PFP). DESIGN: Secondary analyses of a randomized clinical trial. METHODS: Fifty-eight runners with PFP (62% female, aged 31.2±6.6years, running 20.3±5.6km/week) were included in analyses. Following baseline collection of demographics, anthropometry, symptomatology, isometric strength, running mechanics and radiological data, runners were randomized to one of the three 8-week intervention program: (1) Education on symptoms management and training modifications; (2) Education+Exercise program; (3) Education+Gait retraining...
January 27, 2018: Journal of Science and Medicine in Sport
Kelly R Reveles, Eric M Mortensen, Jim M Koeller, Kenneth A Lawson, Mary Jo V Pugh, Sarah A Rumbellow, Jacqueline R Argamany, Christopher R Frei
STUDY OBJECTIVE: Prior studies have identified risk factors for recurrent Clostridium difficile infection (CDI), but few studies have integrated these factors into a clinical prediction rule that can aid clinical decision making. The objective of this study was to derive and validate a CDI recurrence prediction rule to identify patients at risk for first recurrence in a national cohort of veterans. DESIGN: Retrospective cohort study. DATA SOURCE: Veterans Affairs Informatics and Computing Infrastructure...
February 2, 2018: Pharmacotherapy
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Endoscopy
Nick van Es, Martha Louzada, Marc Carrier, Vicky Tagalakis, Peter L Gross, Sudeep Shivakumar, Marc A Rodger, Philip S Wells
BACKGROUND: The risk of recurrent venous thromboembolism (VTE) in cancer patients despite anticoagulant therapy is high. Clinical factors and pro-coagulant markers may identify high-risk patients and guide decisions about intensifying anticoagulation therapy. AIMS: To evaluate whether serial measurements of pro-coagulant markers can identify patients at high risk of recurrent VTE. METHODS: In this multicenter, prospective cohort study, patients with active cancer and acute deep vein thrombosis or pulmonary embolism were enrolled...
January 9, 2018: Thrombosis Research
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: This study aimed to calculate the multiple-level likelihood ratios (LRs) and posttest probabilities for a positive, indeterminate, or negative test result for multidetector computed tomography pulmonary angiography (MDCTPA) ± computed tomography venography (CTV) and magnetic resonance pulmonary angiography (MRPA) ± magnetic resonance venography (MRV) for each clinical probability level (two-, three-, and four-level) for the nine most commonly used clinical prediction rules (CPRs) (Wells, Geneva, Miniati, and Charlotte)...
January 11, 2018: Academic Radiology
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
Susana García-Gutierrez, Miren Orive, Cristina Sarasqueta, Maria Jose Legarreta, Nerea Gonzalez, Maximino Redondo, Amado Rivero, Pedro Serrano-Aguilar, Xavier Castells, Jose Maria Quintana, Maria Sala
BACKGROUND: Though breast cancer remains a major health problem, there is a lack of information on health care provided to patients with this disease and associated costs. In addition, there is a need to update and validate risk stratification tools in Spain. Our purpose is to evaluate the health services provided for breast cancer in Spain, from screening and diagnosis to treatment and prognosis. METHODS: Prospective cohort study involving 13 hospitals in Spain with a follow-up period of up to 5 years after diagnostic biopsy...
January 8, 2018: BMC Cancer
Carlos Andrés Quezada, Celia Zamarro, Vicente Gómez, Ina Guerassimova, Rosa Nieto, Esther Barbero, Diana Chiluiza, Deisy Barrios, Raquel Morillo, David Jiménez
BACKGROUND AND OBJECTIVE: To determine the accuracy of clinical gestalt to identify patients with acute symptomatic pulmonary embolism (PE) at low-risk for short-term complications. PATIENTS AND METHODS: This study included a total of 154 consecutive patients diagnosed with acute symptomatic PE in a tertiary university hospital. We compared the prognostic accuracy of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI), and clinical gestalt of 1) 2senior physicians (one with and one without experience in the management of patients with PE), 2) a fourth-year resident of Pneumology, 3) a third-year resident of Pneumology, and 4) a second-year resident of Pneumology...
December 21, 2017: Medicina Clínica
Maximilian B Bibok, Andrew M Penn, Mary L Lesperance, Kristine Votova, Robert Balshaw
We validate our previously developed (DOI: 10.1101/089227) clinical prediction rule for diagnosing transient ischemic attack on the basis of presenting clinical symptoms and compare its performance with the ABCD2 score in first-contact patient settings. Two independent and prospectively collected patient validation cohorts were used: (a) referral cohort-prospectively referred emergency department and general practitioner patients ( N = 877); and (b) SpecTRA cohort-participants recruited as part of the SpecTRA biomarker project ( N = 545)...
December 1, 2017: Health Informatics Journal
E Nguyen, J T Caranfa, G H Lyman, N M Kuderer, C Stirbis, M Wysocki, C I Coleman, E R Weeda, C G Kohn
Essentials Clinical prediction rules (CPRs) can stratify patients with pulmonary embolism (PE) and cancer. A meta-analysis was done to assess prognostic accuracy in CPRs for mortality in these patients. Eight studies evaluating ten CPRs were included in this study. CPRs should continue to be used with other patient factors for mortality risk stratification. SUMMARY: Background Cancer treatment is commonly complicated by pulmonary embolism (PE), which remains a leading cause of morbidity and mortality in these patients...
February 2018: Journal of Thrombosis and Haemostasis: JTH
A Rabinovich, T Ducruet, S R Kahn
Essentials We developed a prediction model for postthrombotic syndrome (PTS) after deep vein thrombosis (DVT). High risk predictors were iliac vein DVT, BMI>35 and moderate-severe Villalta category. Patients with a score ≥4 had an odds ratio of 5.9 (95% CI 2.1-16.6) for PTS. SOX-PTS score may select DVT patients for close monitoring or aggressive strategies to treat DVT. SUMMARY: Background Postthrombotic syndrome (PTS) is a chronic complication that develops in 20-50% of patients after deep vein thrombosis (DVT)...
February 2018: Journal of Thrombosis and Haemostasis: JTH
Chin Pang Wong, Chun Tat Lui, Jonathan Gabriel Sung, Ho Lam, Hin Tat Fung, Ping Wa Yam
BACKGROUND: Assessment of patients with chest pain is a regular challenge in the emergency department (ED). Recent guidelines recommended quantitative assessment of ischemic risk by means of risk scores. OBJECTIVE: Our aim was to assess the performance of Thrombosis in Myocardial Infarction (TIMI); Global Registry of Acute Coronary Events (GRACE); history, electrocardiogram, age, risk factors, and troponin (HEART) scores; and the North America Chest Pain Rule (NACPR) without components of clinical gestalt in predicting 30-day major adverse cardiac events (MACE)...
February 2018: Journal of Emergency Medicine
Marina Rossato Adami, Carlos Oscar Kieling, Fernando Pereira Schwengber, Vania N Hirakata, Sandra Maria Gonçalves Vieira
OBJECTIVE: Esophageal variceal bleeding is a severe complication of portal hypertension. The standard diagnostic screening test and therapeutic procedure for esophageal varices (EV) is endoscopy, which is invasive in pediatric patients. This study aimed to evaluate the role of noninvasive parameters as predictors of large varices in children with intrahepatic portal hypertension. METHODS: Participants included in this cross-sectional study underwent a screening endoscopy...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
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