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"Clinical prediction rules"

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
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
César Alameda, Ángel Carlos Matía, Verónica Casado
No abstract text is available yet for this article.
October 20, 2016: NPJ Primary Care Respiratory Medicine
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
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
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
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
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
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
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
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...
September 14, 2016: Journal of Emergency Medicine
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
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
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
Woranuch Saengcharoen, Pornchanok Jaisawang, Palita Udomcharoensab, Kittika Buathong, Sanguan Lerkiatbundit
Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria and to identify factors related to antibiotic dispensing. Setting 1040 Thai community pharmacists. Method A cross-sectional survey of community pharmacists was conducted in November 2012 to March 2013...
October 2016: International Journal of Clinical Pharmacy
Grahame M Knox, Suzanne J Snodgrass, Tasha R Stanton, David H Kelly, Bill Vicenzino, Benedict M Wand, Darren A Rivett
OBJECTIVES: Clinical reasoning can be difficult to teach to pre-professional physiotherapy students due to their lack of clinical experience. It may be that tools such as clinical prediction rules (CPRs) could aid the process, but there has been little investigation into their use in physiotherapy clinical education. This study aimed to determine the perceptions and experiences of physiotherapy students regarding CPRs, and whether they are learning about CPRs on clinical placement. DESIGN: Cross-sectional survey using a paper-based questionnaire...
April 18, 2016: Physiotherapy
Ryo Tanaka, Takuya Umehara, Takafumi Fujimura, Junya Ozawa
OBJECTIVES: To develop and assess a clinical prediction rule (CPR) to predict declines in activities of daily living (ADL) at 6 months after surgery for hip fracture repair. DESIGN: Prospective, cohort study. SETTING: From hospital to home. PARTICIPANTS: Patients (N=104) with hip fractures after surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ADL were assessed using the Barthel Index at 6 months after surgery...
August 13, 2016: Archives of Physical Medicine and Rehabilitation
Toshimi Aizawa, Yasuhisa Tanaka, Toru Yokoyama, Yoichi Shimada, Ken Yamazaki, Hiroshi Takei, Shin-Ichi Konno, Chikashi Kawahara, Eiji Itoi, Shoichi Kokubun
BACKGROUND: There are no diagnostic support tools composed of a simple, single-sheet, self-administered, self-reported history questionnaire (SSHQ) for patients with leg symptoms caused by either lumbar spinal stenosis (LSS) or lumbar disc herniation (LDH), at the same time, can discriminate the two diseases. METHODS: We conducted retrospective and prospective derivation studies and a prospective validation study. Based on data from 137 patients with LSS and 206 with LDH, we identified key prediction factors to establish the diagnosis of LSS and LDH, which became the basis of a temporary SSHQ...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Fay Crawford, Alina Andras, Karen Welch, Karen Sheares, David Keeling, Francesca M Chappell
BACKGROUND: Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common...
2016: Cochrane Database of Systematic Reviews
Andrew Bernstetter
PURPOSE: Cervical traction is a commonly utilized intervention in the treatment of patients with neck pain. In 2009, a clinical prediction rule (CPR) was developed as a way to assist clinicians in determining the patient population most likely to respond to cervical traction, though this CPR has yet to be validated. The purpose of this case report is to demonstrate the application of that CPR. CASE DESCRIPTION: The patient was a 46-year-old female with a four-week history of right-sided neck and shoulder pain, with numbness and tingling of her thumb and index finger...
October 2016: Physiotherapy Theory and Practice
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