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"Clinical prediction rules"

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https://www.readbyqxmd.com/read/27931012/impact-of-thrombophilia-screening-on-venous-thromboembolism-management-practices
#1
Alejandro Garcia-Horton, Michael J Kovacs, Jameel Abdulrehman, Jay E Taylor, Shobha Sharma, Alejandro Lazo-Langner
BACKGROUND: It is unclear whether thrombophilia testing provides any further information on risk of recurrence or guidance in management of patients with a first episode of idiopathic venous thromboembolism (VTE). Furthermore, after the introduction to clinical practice of clinical prediction rules, thrombophilia screening could be less relevant in anticoagulation decision making. We assessed the potential impact of thrombophilia screening on the decision of maintaining anticoagulation beyond the initially planned anticoagulation period in patients with an unprovoked VTE, before and after the introduction of a clinical prediction rule into practice...
December 1, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27885107/a-systematic-review-of-clinical-prediction-scores-for-deep-vein-thrombosis
#2
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/27852530/clinical-prediction-rules-for-prognosis-and-treatment-prescription-in-neck-pain-a-systematic-review
#3
REVIEW
Joan Kelly, Carrie Ritchie, Michele Sterling
Clinical prediction rules (CPRs) developed to identify sub-groups of people with neck pain for different prognoses (i.e. prognostic) or response to treatments (i.e. prescriptive) have been recommended as a research priority to improve health outcomes for these conditions. A systematic review was undertaken to identify prognostic and prescriptive CPRs relevant to the conservative management of adults with neck pain and to appraise stage of development, quality and readiness for clinical application. Six databases were systematically searched from inception until 4th July 2016...
October 31, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27847252/400-or-more-participants-needed-for-stable-contingency-table-estimates-of-clinical-prediction-rule-performance
#4
Peter Kent, Eleanor Boyle, Jennifer L Keating, Hanne B Albert, Jan Hartvigsen
OBJECTIVE: To quantify variability in the results of statistical analyses based on contingency tables and discuss the implications for the choice of sample size for studies that derive clinical prediction rules. STUDY DESIGN AND SETTING: An analysis of three pre-existing sets of large cohort data (n= 4,062 to 8,674) was performed. In each dataset, repeated random-sampling of various sample sizes, from n=100 up to n=2,000, was performed 100 times at each sample size and the variability in estimates of sensitivity, specificity, positive and negative likelihood ratios, post-test probabilities, odds ratios and risk/prevalence ratios, for each sample size was calculated...
November 12, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27832977/development-and-validation-of-a-parsimonious-and-pragmatic-charm-score-to-predict-mortality-in-patients-with-suspected-sepsis
#5
Kuan-Fu Chen, Su-Hsun Liu, Chih-Huang Li, Chin-Chieh Wu, Chung-Hsien Chaou, I-Shiang Tzeng, Yu-Hsiang Hsieh, Gerald N Blaney, Zhen-Ying Liu, Shih-Tsung Han, Yi-Lin Chan
BACKGROUND: We aimed to derive and validate a parsimonious and pragmatic clinical prediction rule using the concepts of Predisposition, Infection, Response, and Organ Dysfunction to predict in-hospital mortality; and to compare it with other prediction rules, as well as with conventional biomarkers for evaluating the mortality risk of patients with suspected sepsis in the emergency department (ED). METHODS: We conducted a pragmatic cohort study with consecutive ED patients aged 18 or older with documented diagnostic codes of infection and two sets of blood culture ordered by physicians between 2010 and 2012 in a tertiary teaching hospital...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27810250/a-clinical-prediction-rule-to-determine-the-need-for-repeat-ercp-after-endoscopic-treatment-of-postsurgical-bile-leaks
#6
Apostolos V Tsolakis, Paul D James, Gilaad G Kaplan, Robert P Myers, James Hubbard, Todd Wilson, Scott Zimmer, Rachid Mohamed, Martin Cole, Sydney Bass, Mark G Swain, Steven J Heitman
BACKGROUND AND AIMS: In patients who have undergone ERCP with biliary stenting for post-surgical bile leaks, the optimal method (ERCP or gastroscopy) and timing of stent removal is controversial. We developed a clinical prediction rule to identify cases in which a repeat ERCP is unnecessary. METHODS: Population-based study of all patients who underwent ERCP for management of surgically induced bile leaks between 2000 and 2012. Multivariate and binary recursive partitioning analyses were performed to generate a rule predicting the absence of biliary pathology on repeat endoscopic evaluation...
October 31, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27773828/deriving-a-clinical-prediction-rule-for-coronary-artery-disease-in-primary-care-improving-internal-and-external-validity-by-pooling-individual-patient-data-from-five-international-sites
#7
Marc Aerts, Girma Minalu, Stefan Bösner, Frank Buntinx, Bernard Burnand, Jörg Haasenritter, Lilli Herzig, J André Knottnerus, Staffan Nilsson, Walter Renier, Carol Sox, Harold Sox, Norbert Donner-Banzhoff
OBJECTIVE: To construct a clinical prediction rule for coronary artery disease (CAD) presenting with chest pain in primary care. STUDY DESIGN: Meta-Analysis using 3099 patients from 5 studies. To identify candidate predictors, we used random forest trees, multiple imputation of missing values and logistic regression within individual studies. To generate a prediction rule on the pooled data, we applied a regression model that took account of the differing standard data sets collected by the 5 studies...
October 20, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27764881/update-on-the-treatment-of-venous-thromboembolism
#8
Sam Schulman
During the past 7 years, results from phase III trials comparing nonvitamin antagonist K oral anticoagulants (NOACs) with vitamin K antagonists (VKAs) or with placebo, including 34,900 patients, have been published. Recent guidelines have been updated and now suggest treatment with NOACs rather than with VKA. Other updates in the guidelines concern the initial thrombolytic treatment for selected patients with deep vein thrombosis or pulmonary embolism as well as the possibility of withholding anticoagulation for minimal venous thromboembolism...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27763596/predictors-for-mortality-due-to-acute-exacerbation-of-copd-in-primary-care-protocol-for-the-derivation-of-a-clinical-prediction-rule
#9
César Alameda, Ángel Carlos Matía, Verónica Casado
No abstract text is available yet for this article.
October 20, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27749613/king-s-variceal-prediction-score-a-novel-non-invasive-marker-of-portal-hypertension-in-paediatric-chronic-liver-disease
#10
Peter Witters, Dominic Hughes, Palaniswamy Karthikeyan, Somashekara Ramakrishna, Mark Davenport, Anil Dhawan, Tassos Grammatikopoulos
BACKGROUND AND AIMS: Variceal haemorrhage can be a life-threatening complication of chronic liver disease in children. There is limited evidence about the optimal prophylactic management and selection criteria of children who will benefit from upper gastrointestinal endoscopy. METHODS: Children presenting in our centre with suspected portal hypertension or gastrointestinal bleeding and undergoing their first oesophagogastroduodenoscopy between 2005-2012 were included...
October 4, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27745699/-comparison-of-the-canadian-ct-head-rule-and-the-new-orleans-criteria-in-patients-with-minor-head-injury-in-a-spanish-hospital
#11
Joaquín Valle Alonso, Francisco Javier Fonseca Del Pozo, Manuel Vaquero Álvarez, Elisa Lopera Lopera, Marisol Garcia Segura, Ricardo García Arévalo
BACKGROUND AND OBJECTIVE: To compare two scales for assessment of patients with mild head injury. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) according to their diagnostic accuracy in patients attending an emergency department, and to determine the most important predictive values. METHOD: Cross-sectional study in a first-level Hospital in the period of January 2011 to January 2013. Patients with mild head injury criteria were included. All the patients underwent a computed tomography (CT) of the head as part of internal protocol and the CCHR and NOC criteria were recorded for each patient...
October 10, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27720446/use-of-clinical-prediction-rules-and-d-dimer-tests-in-the-diagnostic-management-of-pregnant-patients-with-suspected-acute-pulmonary-embolism
#12
L M Van der Pol, A T A Mairuhu, C Tromeur, F Couturaud, M V Huisman, F A Klok
Because pregnant women have an increased risk of venous thromboembolism (VTE) and at the same time normal pregnancy is associated with symptoms, mimicking those present in the setting of acute pulmonary embolism (PE), the latter diagnosis is frequently suspected in this patient category. Since imaging tests expose both mother and foetus to ionizing radiation, the ability to rule out PE based on non-radiological diagnostic tests is of paramount importance. However, clinical decision rules have only been scarcely evaluated in the pregnant population with suspected PE, while D-dimer levels lose diagnostic accuracy due to a physiological increase during normal pregnancy...
September 29, 2016: Blood Reviews
https://www.readbyqxmd.com/read/27695337/clinical-prediction-rules-for-failed-nonoperative-reduction-of-intussusception
#13
Jiraporn Khorana, Jayanton Patumanond, Nuthapong Ukarapol, Mongkol Laohapensang, Pannee Visrutaratna, Jesda Singhavejsakul
PURPOSE: The nonoperative reduction of intussusception in children can be performed safely if there are no contraindications. Many risk factors associated with failed reduction were defined. The aim of this study was to develop a scoring system for predicting the failure of nonoperative reduction using various determinants. PATIENTS AND METHODS: The data were collected from Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012. Inclusion criteria consisted of patients with intussusception aged 0-15 years with no contraindications for nonoperative reduction...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27689244/clinical-predictors-of-vestibulo-ocular-dysfunction-in-pediatric-sports-related-concussion
#14
Michael J Ellis, Dean M Cordingley, Sara Vis, Karen M Reimer, Jeff Leiter, Kelly Russell
OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015...
September 30, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27673569/supraspinal-control-predicts-locomotor-function-and-forecasts-responsiveness-to-training-after-spinal-cord-injury
#15
Edelle Field-Fote, Jaynie F Yang, D Michele Basso, Monica A Gorassini
Restoration of walking ability is an area of great interest in the rehabilitation of persons with spinal cord injury. Since many cortical, subcortical, and spinal neural centers contribute to locomotor function, it is important that intervention strategies be designed to target neural elements at all levels of the neuraxis that are important for walking ability. While to date most strategies have focused on activation of spinal circuits, more recent studies are investigating the value of engaging supraspinal circuits...
September 27, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27642521/the-value-of-abcd2f-scoring-system-abcd2-combined-with-atrial-fibrillation-to-predict-90-day-recurrent-brain-stroke
#16
Mostafa Almasi, Nader Hodjati Firoozabadi, Faeze Ghasemi, Mojtaba Chardoli
Background. The ABCD2 score is now identified as a useful clinical prediction rule to determine the risk for stroke in the days following brain ischemic attacks. Aim. The present study aimed to introduce a new scoring system named "ABCD2F" and compare its value with the previous ABCD2 system to predict recurrent ischemic stroke within 90 days of the initial cerebrovascular accident (CVA). Methods. 138 consecutive patients with the final diagnosis of ischemic CVA or TIAs who referred to emergency ward of Rasoul-e-Akram general hospital in Tehran from September 2012 to December 2013 were eligible...
2016: Neurology Research International
https://www.readbyqxmd.com/read/27639424/best-clinical-practice-blood-culture-utility-in-the-emergency-department
#17
Brit Long, Alex Koyfman
BACKGROUND: Bacteremia affects 200,000 patients per year, with the potential for significant morbidity and mortality. Blood cultures are considered the most sensitive method for detecting bacteremia and are commonly obtained in patients with fever, chills, leukocytosis, focal infections, and sepsis. OBJECTIVE: We sought to provide emergency physicians with a review of the literature concerning blood cultures in the emergency department. DISCUSSION: The utility of blood cultures has been a focus of controversy, prompting research evaluating effects on patient management...
November 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27612060/determinants-and-predictors-of-absenteeism-and-return-to-work-in-workers-with-shoulder-disorders
#18
François Desmeules, Caroline Braën, Martin Lamontagne, Clermont E Dionne, Jean-Sébastien Roy
BACKGROUND: Shoulder disorders lead to substantial productivity loss and determinants and predictors of sick leave are poorly known. OBJECTIVE: To perform a systematic review on determinants and predictors of sick leave and delayed return-to-work (RTW) in workers with shoulder disorders. METHODS: A systematic literature search was conducted and we included studies on workers with shoulder disorders that contained information on determinants or predictors for sick leave or RTW, The risk of bias of included studies was evaluated with a validated tool...
September 8, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/27599400/development-of-a-clinical-prediction-score-for-congestive-heart-failure-diagnosis-in-the-emergency-care-setting-the-brest-score
#19
Adrien Basset, Emmanuel Nowak, Philippe Castellant, Christophe Gut-Gobert, Grégoire Le Gal, Erwan L'Her
OBJECTIVE: To derive and validate a clinical prediction rule of acute congestive heart failure obtainable in the emergency care setting. DESIGN: Derivation of the score was performed on a retrospective 927 patients cohort admitted to our Emergency Department for dyspnea. The prediction model was externally validated on an independent 206-patient prospective cohort. INTERVENTIONS AND MEASURES: During the derivation phase, variables associated with acute congestive heart failure were included in a multivariate regression model...
August 14, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27594661/recovery-pathways-and-prognosis-after-whiplash-injury
#20
Carrie Ritchie, Michele Sterling
Synopsis Recovery from a whiplash injury is varied and complex. Some individuals recover quickly and fully, while others experience ongoing pain and disability. Three distinct patterns of predicted recovery (trajectories) have been identified using disability and psychological outcome measures. These trajectories are not linear, and show that recovery, if it is going to occur, tends to happen within the first 3 months of the injury, with little improvement after this period. Identification of factors associated with poor recovery is accumulating, and since 2000 there have been at least 10 published systematic reviews on prognostic factors for whiplash-associated disorder...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
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