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"Clinical prediction rules"

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https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#1
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28611156/clinical-prediction-rule-for-delayed-hemothorax-after-minor-thoracic-injury-a-multicentre-derivation-and-validation-study
#2
Marcel Émond, Chantal Guimont, Jean-Marc Chauny, Raoul Daoust, Éric Bergeron, Laurent Vanier, Lynne Moore, Miville Plourde, Batomen Kuimi, Valérie Boucher, Nadine Allain-Boulé, Natalie Le Sage
BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury)...
June 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28591223/why-do-authors-derive-new-cardiovascular-clinical-prediction-rules-in-the-presence-of-existing-rules-a-mixed-methods-study
#3
Jong-Wook Ban, Emma Wallace, Richard Stevens, Rafael Perera
BACKGROUND: Researchers should examine existing evidence to determine the need for a new study. It is unknown whether developers evaluate existing evidence to justify new cardiovascular clinical prediction rules (CPRs). OBJECTIVE: We aimed to assess whether authors of cardiovascular CPRs cited existing CPRs, why some authors did not cite existing CPRs, and why they thought existing CPRs were insufficient. METHOD: Derivation studies of cardiovascular CPRs from the International Register of Clinical Prediction Rules for Primary Care were evaluated...
2017: PloS One
https://www.readbyqxmd.com/read/28587665/hospitalization-for-community-acquired-febrile-urinary-tract-infection-validation-and-impact-assessment-of-a-clinical-prediction-rule
#4
Janneke E Stalenhoef, Willize E van der Starre, Albert M Vollaard, Ewout W Steyerberg, Nathalie M Delfos, Eliane M S Leyten, Ted Koster, Hans C Ablij, Jan W Van't Wout, Jaap T van Dissel, Cees van Nieuwkoop
BACKGROUND: There is a lack of severity assessment tools to identify adults presenting with febrile urinary tract infection (FUTI) at risk for complicated outcome and guide admission policy. We aimed to validate the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE), a modified form of the pneumonia severity index, and to subsequentially assess its use in clinical practice. METHODS: A prospective observational multicenter study for model validation (2004-2009), followed by a multicenter controlled clinical trial with stepped wedge cluster-randomization for impact assessment (2010-2014), with a follow up of 3 months...
June 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28586924/scoring-systems-for-estimating-the-risk-of-recurrent-venous-thromboembolism
#5
Ilaria Nichele, Alberto Tosetto
The risk of recurrence after suspension of anticoagulant treatment in patients with a first episode of unprovoked venous thromboembolism (VTE) is highly variable from patient to patient. Not all patients are candidates for life-long anticoagulant therapy, essentially because there remain concerns for such an option regarding hemorrhagic complications and clinical monitoring. Thus, the "treat all" approach may be inadequate for some patients at low risk of relapse. Proper assessment of the recurrence risk may be helpful to decide the optimal therapeutic strategy in such patients...
June 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28560486/new-scoring-model-darsym-score-to-predict-post-discharge-bleeding-after-successful-second-generation-drug-eluting-stent-implantation
#6
Yohsuke Honda, Masahiro Yamawaki, Keisuke Hirano, Motoharu Araki, Norihiro Kobayashi, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutumi, Takuro Takama, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
We aimed to create a scoring model to predict post-discharge bleeding (PDB) after drug-eluting stent (DES) implantation in Japanese subjects. We enrolled 1912 consecutive patients undergoing DES implantation (age 70 ± 10 years; 72% male). PDB was defined as a composite of type 5, 3, and 2 bleeding using the Bleeding Academic Research Consortium criteria. A Cox proportional hazard model assessed predictors, and we then derived a clinical model stratifying risk of PDB after DES implantation. Ninety-eight patients (6...
May 30, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28559666/thrust-joint-manipulation-utilization-by-u-s-physical-therapists
#7
Emilio J Puentedura, Rebecca Slaughter, Sean Reilly, Erwin Ventura, Daniel Young
STUDY DESIGN: Online survey study. OBJECTIVE: To determine physical therapists' utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. BACKGROUND: Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines...
May 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/28550759/venous-thromboembolism-in-the-elderly-a-narrative-review
#8
REVIEW
T Tritschler, D Aujesky
Persons aged ≥65years not only account for over 60% of venous thromboembolism (VTE) events, they have also a higher mortality and VTE-related morbidity than younger patients, including anticoagulation-related bleeding and the postthrombotic syndrome. However, only few studies have focused specifically on VTE in older persons and practice guidelines commonly extrapolate study results from younger healthier patients to the multimorbid elderly. Evidence suggests that the clinical presentation is more subtle in the elderly with VTE and that commonly used diagnostic modalities, including clinical prediction rules, D-dimer tests, and planar ventilation-perfusion scans are less specific and efficient in older persons...
July 2017: Thrombosis Research
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
REVIEW
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
#17
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
#18
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
#19
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
#20
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
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