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"Clinical prediction rules"

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https://www.readbyqxmd.com/read/28517021/low-discriminating-power-of-the-modified-ottawa-vte-risk-score-in-a-cohort-of-patients-with-cancer-from-the-riete-registry
#1
Adriano Alatri, Lucia Mazzolai, Carme Font, Alfonso Tafur, Reina Valle, Pablo Javier Marchena, Aitor Ballaz, Eros Tiraferri, Llorenç Font, Manuel Monreal
Treatment of patients with cancer-associated venous thromboembolism (VTE) remains a major challenge. The modified Ottawa score is a clinical prediction rule evaluating the risk of VTE recurrences during the first six months of anticoagulant treatment in patients with cancer-related VTE. We aimed to validate the Ottawa score using data from the RIETE registry. A total of 11,123 cancer patients with VTE were included in the analysis. According to modified Ottawa score, 2,343 (21 %) were categorised at low risk for VTE recurrences, 4,525 (41 %) at intermediate risk, and 4,255 (38 %) at high risk...
May 18, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28512853/derivation-and-validation-of-the-append-score-an-acute-appendicitis-clinical-prediction-rule
#2
Hinetamatea Mikaere, Irene Zeng, Melanie Lauti, Malsha Kularatna, Andrew D MacCormick
BACKGROUND: Although many clinical prediction rules (CPRs) for appendicitis exist, none have been developed for a New Zealand population presenting with right iliac fossa (RIF) pain. The aim of this study was to derive and validate an appendicitis CPR for our population. METHOD: This is a retrospective review of all patients from December 2010 to February 2012 of at least 15 years of age presenting to the general surgery service with RIF pain. Patient data were divided into derivation and validation groups...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28487168/clinical-predictors-and-clinical-prediction-rules-to-estimate-initial-patient-risk-for-infective-endocarditis-in-staphylococcus-aureus-bacteremia-a-systematic-review-and-meta-analysis
#3
REVIEW
Anthony D Bai, Arnav Agarwal, Marilyn Steinberg, Adrienne Showler, Lisa Burry, George A Tomlinson, Chaim M Bell, Andrew M Morris
OBJECTIVES: We conducted a meta-analysis to summarize diagnostic properties of risk factors and clinical prediction rules for diagnosing infective endocarditis (IE) in Staphylococcus aureus bacteremia (SAB). METHODS: We searched MEDLINE, Embase and Cochrane Database from inception to January 6, 2016 to identify studies evaluating risk factors and clinical prediction rules for IE in SAB patients. Pooled estimates of diagnostic properties for main risk factors were calculated using a bivariate random effects model...
May 6, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28470651/scoring-systems-for-diagnosis-of-acute-venous-thromboembolism
#4
Grégoire Le Gal, Marc Righini, Philip S Wells
Modern diagnostic strategies for venous thromboembolism almost all rely on an initial assessment of the pretest probability. Assessing the patient's pretest probability for venous thromboembolism is a critical step in the diagnostic strategy and for therapeutic management. Clinical prediction rules combine medical signs and symptoms to provide accurate and reproducible estimates of the probability of a disease before diagnostic tests are performed. The use of scoring systems in patients with suspected acute venous thromboembolism should be encouraged, as their implementation in guidelines for venous thromboembolism diagnosis results in cost-effective care with improved patient outcomes...
May 3, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28439386/usefulness-of-clinical-prediction-rules-d-dimer-and-arterial-blood-gas-analysis-to-predict-pulmonary-embolism-in-cancer-patients
#5
Asifa Karamat, Shazia Awan, Muhammad Ghazanfar Hussain, Fahad Al Hameed, Faheem Butt, Ali Saeed Wahla
OBJECTIVES: Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. METHODS: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28401498/identification-of-subgroups-of-patients-with-tension-type-headache-with-higher-widespread-pressure-pain-hyperalgesia
#6
César Fernández-de-Las-Peñas, Elena Benito-González, María Palacios-Ceña, Kelun Wang, Matteo Castaldo, Lars Arendt-Nielsen
BACKGROUND: Identification of subgroups of patients with different levels of sensitization and clinical features can help to identify groups at risk and the development of better therapeutic strategies. The aim of this study was to identify subgroups of patients with tension type headache (TTH) with different levels of sensitization, clinical pain features, and psychological outcomes. METHODS: A total of 197 individuals with TTH participated. Headache intensity, frequency, and duration and medication intake were collected with a 4-weeks diary...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#7
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28387542/the-risk-of-bleeding-with-the-use-of-antiplatelet-agents-for-the-treatment-of-cardiovascular-disease
#8
Ashwin S Nathan, Sounok Sen, Robert W Yeh
In the presence of injured coronary vascular endothelium, platelets become activated to form hemostatic plugs. While this represents a normal healing response to disrupted vascular endothelium, occlusive cardiovascular disease, as a result of maladaptive thrombus formation, is a major cause of morbidity and mortality. Due to the platelet predominance of arterial thrombi, antiplatelet agents are the mainstay of therapy for arterial cardiovascular disease, though come with a significantly increased risk of bleeding...
May 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#9
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28285457/group-a-streptococcus-acute-rheumatic-fever-and-rheumatic-heart-disease-epidemiology-and-clinical-considerations
#10
REVIEW
Liesl J Zühlke, Andrea Beaton, Mark E Engel, Christopher T Hugo-Hamman, Ganesan Karthikeyan, Judith M Katzenellenbogen, Ntobeko Ntusi, Anna P Ralph, Anita Saxena, Pierre R Smeesters, David Watkins, Peter Zilla, Jonathan Carapetis
Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28279999/simplified-mortality-score-for-the-intensive-care-unit-sms-icu-protocol-for-the-development-and-validation-of-a-bedside-clinical-prediction-rule
#11
Anders Granholm, Anders Perner, Mette Krag, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Søren Marker, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
INTRODUCTION: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU)...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28274964/predicting-aki-in-emergency-admissions-an-external-validation-study-of-the-acute-kidney-injury-prediction-score-aps
#12
L E Hodgson, B D Dimitrov, P J Roderick, R Venn, L G Forni
OBJECTIVES: Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). DESIGN, SETTING AND PARTICIPANTS: External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr)...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28264830/diagnosing-malignant-melanoma-in-ambulatory-care-a-systematic-review-of-clinical-prediction-rules
#13
Emma Harrington, Barbara Clyne, Nieneke Wesseling, Harkiran Sandhu, Laura Armstrong, Holly Bennett, Tom Fahey
OBJECTIVES: Malignant melanoma has high morbidity and mortality rates. Early diagnosis improves prognosis. Clinical prediction rules (CPRs) can be used to stratify patients with symptoms of suspected malignant melanoma to improve early diagnosis. We conducted a systematic review of CPRs for melanoma diagnosis in ambulatory care. DESIGN: Systematic review. DATA SOURCES: A comprehensive search of PubMed, EMBASE, PROSPERO, CINAHL, the Cochrane Library and SCOPUS was conducted in May 2015, using combinations of keywords and medical subject headings (MeSH) terms...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#14
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: Pulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data...
May 2017: Academic Radiology
https://www.readbyqxmd.com/read/28258458/clinical-prediction-rules-for-appendicitis-in-adults-which-is-best
#15
REVIEW
Malsha Kularatna, Melanie Lauti, Cheyaanthan Haran, Wiremu MacFater, Laila Sheikh, Ying Huang, John McCall, Andrew D MacCormick
BACKGROUND: Clinical prediction rules (CPRs) provide an objective method of assessment in the diagnosis of acute appendicitis. There are a number of available CPRs for the diagnosis of appendicitis, but it is unknown which performs best. AIM: The aim of this study was to identify what CPRs are available and how they perform when diagnosing appendicitis in adults. METHOD: A systematic review was performed in accordance with the PRISMA guidelines...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28257617/examination-of-the-validity-of-a-clinical-prediction-rule-to-identify-patients-with-shoulder-pain-likely-to-benefit-from-cervicothoracic-manipulation
#16
Paul E Mintken, Amy W McDevitt, Lori A Michener, Robert E Boyles, Amber R Beardslee, Scott A Burns, Matthew D Haberl, Lauren A Hinrichs, Joshua A Cleland
Study Design Secondary analysis of a randomized controlled trial. Background Prognostic variables identifying patients with shoulder pain who are likely to respond to cervicothoracic manipulation have been reported; however, they have yet to be validated. Objective To examine the validity of previously reported prognostic variables in predicting which patients with shoulder pain will respond to cervicothoracic manipulation. Methods Participants (n = 140) with a report of shoulder pain were randomly assigned to receive either 2 sessions of range-of-motion exercises plus 6 sessions of stretching and strengthening exercises (exercise group), or 2 sessions of cervicothoracic manipulation and range-of-motion exercises followed by 6 sessions of stretching and strengthening exercise (manipulative-therapy-plus-exercise group)...
April 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28246315/prospective-validation-of-a-clinical-decision-rule-to-identify-patients-presenting-to-the-emergency-department-with-chest-pain-who-can-safely-be-removed-from-cardiac-monitoring
#17
Shahbaz Syed, Mathieu Gatien, Jeffrey J Perry, Hina Chaudry, Soo-Min Kim, Kenneth Kwong, Muhammad Mukarram, Venkatesh Thiruganasambandamoorthy
BACKGROUND: Most patients with chest pain in the emergency department are assigned to cardiac monitoring for several hours, blocking access for patients in greater need. We sought to validate a previously derived decision rule for safe removal of patients from cardiac monitoring after initial evaluation in the emergency department. METHODS: We prospectively enrolled adults (age ≥ 18 yr) who presented with chest pain and were assigned to cardiac monitoring at 2 academic emergency departments over 18 months...
January 30, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28225772/symptomatic-spinal-metastasis-a-systematic-literature-review-of-the-preoperative-prognostic-factors-for-survival-neurological-functional-and-quality-of-life-in-surgically-treated-patients-and-methodological-recommendations-for-prognostic-studies
#18
Anick Nater, Allan R Martin, Arjun Sahgal, David Choi, Michael G Fehlings
PURPOSE: While several clinical prediction rules (CPRs) of survival exist for patients with symptomatic spinal metastasis (SSM), these have variable prognostic ability and there is no recognized CPR for health related quality of life (HRQoL). We undertook a critical appraisal of the literature to identify key preoperative prognostic factors of clinical outcomes in patients with SSM who were treated surgically. The results of this study could be used to modify existing or develop new CPRs...
2017: PloS One
https://www.readbyqxmd.com/read/28208193/approach-to-suspected-acute-pulmonary-embolism-should-we-use-scoring-systems
#19
Marc Righini, Grégoire Le Gal, Henri Bounameaux
Modern diagnostic strategies for pulmonary embolism diagnosis almost all rely on an initial assessment of the pretest probability. Clinical prediction rules are decision-making tools using combinations of easily available clinical predictors to define the probability of a disease. The assessment of the clinical probability of pulmonary embolism has an important impact on the diagnostic strategy and on therapeutic management. Clinical prediction rules provide accurate and reproducible estimates of clinical probability...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28196932/a-clinical-prediction-rule-for-rebound-hyperbilirubinemia-following-inpatient-phototherapy
#20
Pearl W Chang, Michael W Kuzniewicz, Charles E McCulloch, Thomas B Newman
OBJECTIVES: The American Academy of Pediatrics provides little guidance on when to discontinue phototherapy in newborns treated for hyperbilirubinemia. We sought to develop a prediction rule to estimate the probability of rebound hyperbilirubinemia after inpatient phototherapy. METHODS: Subjects for this retrospective cohort study were infants born in 2012 to 2014 at ≥35 weeks' gestation at 16 Kaiser Permanente Northern California hospitals who received inpatient phototherapy before age 14 days...
March 2017: Pediatrics
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