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decision curve

Victor E Staartjes, Marlies P de Wispelaere, W Peter Vandertop, Marc L Schröder
BACKGROUND CONTEXT: There is considerable variability in patient-reported outcome measures (PROM) following surgery for lumbar disk herniation (LDH). Individualized prediction tools that are derived from center- or even surgeon-specific data could provide valuable insights for shared decision-making. PURPOSE: To evaluate the feasibility of deriving robust deep learning-based predictive analytics from single-center, single-surgeon data. STUDY DESIGN: Derivation of predictive models from a prospective registry...
November 16, 2018: Spine Journal: Official Journal of the North American Spine Society
Ben Kang, So Yoon Choi, Young Ok Choi, Soo-Youn Lee, Sun-Young Baek, Insuk Sohn, Byung-Ho Choe, Hae Jeong Lee, Yon Ho Choe
Background and Aims: Mucosal healing is an important treatment goal in Crohn's disease. We investigated the association between serum infliximab trough levels and mucosal healing, and the infliximab cut-off levels required for mucosal healing in paediatric patients. Methods: In this multicentre, retrospective, cross-sectional study, medical records and electronic data of paediatric patients with luminal Crohn's disease, who had received infliximab for ≥1 year, were examined...
November 19, 2018: Journal of Crohn's & Colitis
Joseph T Poterucha, Saraschandra Vallabhajosyula, Alexander C Egbe, Joseph S Krien, Devon O Aganga, Kimberly Holst, Adele W Golden, Joseph A Dearani, Sheri S Crow
BACKGROUND: High levels of vasoactive inotrope support (VIS) after congenital heart surgery are predictive of morbidity in pediatric patients. We sought to discern if this relationship applies to adults with congenital heart disease (ACHD). METHODS: We retrospectively studied adult patients (≥18 years old) admitted to the intensive care unit after cardiac surgery for congenital heart disease from 2002 to 2013 at Mayo Clinic. Vasoactive medication dose values within 96 hours of admission were examined to determine the relationship between VIS score and poor outcome of early mortality, early morbidity, or complication related morbidity...
November 19, 2018: Congenital Heart Disease
Yechiel Lamash, Sila Kurugol, Simon K Warfield
We propose a 3D residual convolutional neural network (CNN) algorithm with an integrated distance prior for segmenting the small bowel lumen and wall to enable extraction of pediatric Crohns disease (pCD) imaging markers from T1-weighted contrast-enhanced MR images. Our proposed segmentation framework enables, for the first time, to quantitatively assess luminal narrowing and dilation in CD aimed at optimizing surgical decisions as well as analyzing bowel wall thickness and tissue enhancement for assessment of response to therapy...
September 2018: Deep Learn Med Image Anal Multimodal Learn Clin Decis Support (2018)
P Samper Ots, A Luis Cardo, C Vallejo Ocaña, M A Cabeza Rodríguez, L A Glaria Enríquez, M L Couselo Paniagua, J Olivera Vegas
OBJECTIVES: To evaluate the diagnostic performance of 18 F-choline PETCT in staging prostate cancer (PC) and whether the use of this imaging modality changes the therapeutic decision in patients previously staged by conventional imaging. The secondary aim was to determine the prognostic factors associated with positive choline PETCT findings in both detection of disseminated disease and in changes in the therapeutic indication. MATERIALS AND METHODS: Multicentre, retrospective, observational study of 269 patients diagnosed with PC...
November 17, 2018: Clinical & Translational Oncology
Elina Eleftheria Pliakos, Nikolaos Andreatos, Giannoula S Tansarli, Panayiotis D Ziakas, Eleftherios Mylonakis
BACKGROUND: The use of corticosteroids as adjunct treatment for community-acquired pneumonia (CAP) is associated with potential clinical benefits and the aim of this study was to evaluate the cost-effectiveness of this approach. METHODS: We constructed a decision-analytic model comparing the use of corticosteroids+antibiotics to that of placebo+antibiotics for the treatment of CAP. Cost-effectiveness was determined by calculating deaths averted and incremental cost-effectiveness ratios (ICER)...
November 15, 2018: Chest
Mitsuru Yagi, Naobumi Hosogane, Nobuyuki Fujita, Eijiro Okada, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
PURPOSE: ASD surgery improves a patient's health-related quality of life, but it has a high complication rate. The aim of this study was to create a predictive model for complications after surgical treatment for adult spinal deformity (ASD), using spinal alignment, demographic data, and surgical invasiveness. METHODS: This study included 195 surgically treated ASD patients who were > 50 years old and had 2-year follow-up from multicenter database. Variables which included age, gender, BMI, BMD, frailty, fusion level, UIV and LIV, primary or revision surgery, pedicle subtraction osteotomy, spinal alignment, Schwab-SRS type, surgical time, and blood loss were recorded and analyzed at least 2 years after surgery...
November 16, 2018: European Spine Journal
Jumpei Tsukuda, Shigeki Fujitani, Kenichiro Morisawa, Nobuhiko Shimozawa, Brandon D Lohman, Kentaro Okamoto, Takeshi Kawaguchi, Yuka Takamatsu, Shuichi Fujii, Masayuki Ozaki, Mahbubur Rahman, Yasuhiko Taira
STUDY OBJECTIVES: Near-infrared spectroscopy is a modality that can monitor tissue oxygenation index (TOI) and has potential to evaluate return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR). This study's objectives were to evaluate whether TOI could be associated with ROSC and used to help guide the decision to either terminate CPR or proceed to extracorporeal CPR (ECPR). METHODS: In this observational study, we assessed the patients with out-of-hospital cardiac arrest with non-traumatic cause receiving CPR on arrival at our ED between 2013 and 2016...
November 16, 2018: Emergency Medicine Journal: EMJ
David D'Andrea, Francesco Soria, Mohammad Abufaraj, Kilian Gust, Beat Foerster, Mihai D Vartolomei, Shoji Kimura, Andrea Mari, Alberto Briganti, Mesut Remzi, Christian K Seitz, Romain Mathieu, Pierre I Karakiewicz, Shahrokh F Shariat
PURPOSE: To evaluate the predictive and prognostic role as well as the clinical impact on decision-making of serum cholinesterase (ChoE) levels in patients treated with radical prostatectomy for clinically nonmetastatic prostate cancer. MATERIALS AND METHODS: We conducted a retrospective analysis of our multi institutional database. Preoperative ChoE was evaluated as continuous and dichotomized variable using a visual assessment of the functional form of the association of ChoE with biochemical recurrence (BCR)-free survival...
November 13, 2018: Urologic Oncology
Hui Liu, Dong Cen, Yunxian Yu, Yanting Wang, Xiao Liang, Hui Lin, Xiujun Cai
BACKGROUND: Liver fibrosis is involved in hepatocellular carcinoma (HCC), but its effect on the survival of patients with HCC remains controversial. This study aims to explore whether the severity of liver fibrosis has an impact on HCC overall survival (OS) and disease-specific survival (DSS) in Surveilance, Epidemiology, and End-Results (SEER) database. METHODS: A total of 11,783 HCC patients diagnosed between 2004 and 2014 from SEER database were enrolled. Cox proportional hazard regression models were used to estimate crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for fibrosis group associated with survival...
November 16, 2018: BMC Cancer
Sara Pudas, Michael Rönnlund
Objectives: Evidence is accumulating that early-life characteristics and experiences contribute significantly to differences in cognitive aging. This study investigated whether school performance at age 12 predicted late-life level and rate of memory change over 15-25 years, and whether its potential protective influence on memory change was mediated by educational attainment or income. Methods: Latent growth curve models were fitted to 15-25 year longitudinal memory data from a population-based sample, stratified on age-cohorts (n=227 born 1909-1935; n=301 born 1938-1954)...
November 16, 2018: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
Zhihao Li, Liya He, Shuhua Li, Waner He, Caihui Zha, Wanxing Ou, Qiaozhen Hou, Weiying Wang, Sun Xin, Liang Huiying
OBJECTIVE: This study evaluated the diagnostic value of measuring the levels of procalcitonin (PCT) and C-reactive protein (CRP) to differentiate children co-infected with H1N1 influenza and bacteria from children infected with H1N1 influenza alone. METHODS: Consecutive patients (children aged <5 years) with laboratory-confirmed H1N1 influenza who were hospitalized or received outpatient care from a tertiary-care hospital in Canton, China, between 1 January 2012 and 1 September 2017 were included in the present study...
November 16, 2018: Influenza and Other Respiratory Viruses
Shulin Chen, Xiaohui Li, Hui Lv, Xiaoyan Wen, Qiuying Ding, Ning Xue, Hongkai Su, Hao Chen
Chronic inflammation plays an important role in tumor progression. The aim of this study was to develop an effective predictive dynamic nomogram integrated with inflammation-based factors to predict overall survival (OS) of non-small cell lung cancer (NSCLC) patients with chronic hepatitis B viral (HBV) infection. We retrospectively analyzed NSCLC patients with HBV infection from Sun Yat-sen University Cancer Center between 2008 and 2010. Univariate and multivariate Cox survival analyses were performed to identify prognostic factors associated with OS of patients...
2018: International Journal of Biological Sciences
Oliver Ibarrondo, Isabel Álvarez-López, Frederick Freundlich, Arantzazu Arrospide, Elena Galve-Calvo, María Gutiérrez-Toribio, Arrate Plazaola, Javier Mar
OBJECTIVE: To carry out a cost-utility analysis of the application of the Oncotype genomic test to inform the decision to use or not to use chemotherapy in the Basque Country (Spain). METHOD: The cost-utility study was carried out using a discrete event simulation model representing the natural history of breast cancer. The decision of treatment with chemotherapy based on Oncotype was compared with the standard of treatment based on clinical-pathological criteria...
November 12, 2018: Gaceta Sanitaria
Abdul Baseer Buriro, Reza Shoorangiz, Stephen J Weddell, Richard D Jones
Microsleeps are brief and involuntary instances of complete loss of sleep-related consciousness. We present a novel approach of creating overlapping clusters of subjects and training of an ensemble classifier to enhance the prediction of microsleep states from EEG. Overlapping clusters are created using Kullback-Leibler divergence between responsive state features of each pair of training subjects. Highly correlated features within each overlapping cluster are discarded. The remaining features are selected via Fisher score based ranking followed by an average of 5-fold cross-validation areas under the curves of receiver operating characteristics (AUCRoc) of a linear discriminant analysis (LDA) classifier...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Martin Schwartz, Petros Martirosian, Bin Yang, Fritz Schick
Combination of surface electromyography (EMG) with diffusion-weighted magnetic resonance imaging (DW-MRI) enables improved studies of spontaneous mechanical contractions in resting human musculature (SMAM). Mechanical muscular activities follow characteristic electrical neuromuscular activities after a delay of several tens of milliseconds. A low-cost standalone system for simultaneous surface EMG measurements during DW-MRI with a real-time model-based surface EMG activity detection is demonstrated which controls the MR sequence...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Laura J Brattain, Brian A Telfer, Manish Dhyani, Joseph R Grajo, Anthony E Samir
Diffuse liver disease is common, primarily driven by high prevalence of non-alcoholic fatty liver disease (NAFLD). It is currently assessed by liver biopsy to determine fibrosis, often staged as F0 (normal) - F4 (cirrhosis). A noninvasive assessment method will allow a broader population to be monitored longitudinally, facilitating risk stratification and treatment efficacy assessment. Ultrasound shear wave elastography (SWE) is a promising noninvasive technique for measuring tissue stiffness that has been shown to correlate with fibrosis stage...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Alexandre Jentzer, Anne-Emmanuelle Berger, Rémi Labetoulle, Alice Haccourt, Xavier Roblin, Stephane Paul
BACKGROUND: SB2, an infliximab (IFX) biosimilar to the reference infliximab (R.I.) product (Remicade), received approval in the European Union for all IFX indications. Many decision algorithms based on the measurement of IFX trough levels and antibodies to infliximab are being increasingly used to optimize IFX treatment. The aim of our study was to evaluate whether the biosimilar SB2 could be efficiently monitored using the LISA-TRACKER IFX and anti-IFX assays developed by Theradiag (Croissy Beaubourg, France)...
December 2018: Therapeutic Drug Monitoring
Ping Yin, Ning Mao, Chao Zhao, Jiangfen Wu, Lei Chen, Nan Hong
BACKGROUND: Preoperative differentiation between primary sacral chordoma (SC), sacral giant cell tumor (SGCT), and sacral metastatic tumor (SMT) is important for treatment decisions. PURPOSE: To develop and validate a triple-classification radiomics model for the preoperative differentiation of SC, SGCT, and SMT based on T2-weighted fat saturation (T2w FS) and contrast-enhanced T1-weighted (CE T1w) MRI. STUDY TYPE: Retrospective. POPULATION: A total of 120 pathologically confirmed sacral patients (54 SCs, 30 SGCTs, and 36 SMTs) were retrospectively analyzed and divided into a training set (n = 83) and a validation set (n = 37)...
November 14, 2018: Journal of Magnetic Resonance Imaging: JMRI
Shi Jiang, Biyong Tan, Xingqiang Zhang
Colon adenocarcinoma (COAD) is one of the most common cancers, and its carcinogenesis and progression is influenced by multiple long non-coding RNAs (lncRNA), especially through the miRNA sponge effect. In this study, more than 4000 lncRNAs were re-annotated from the microarray datasets through probe sequence mapping to obtain reliable lncRNA expression profiles. As a systems biology method for describing the correlation patterns among genes across microarray samples, weighted gene co-expression network analysis was conducted to identify lncRNA modules associated with the five stepwise stages from normal colonic samples to COAD (n = 94)...
November 14, 2018: Journal of Cellular Biochemistry
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