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https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#1
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28730111/cumulative-sum-analysis-score-and-phacoemulsification-competency-learning-curve
#2
Gustavo Vedana, Filipe G Cardoso, Alexandre S Marcon, Licio E K Araújo, Matheus Zanon, Daniella C Birriel, Guilherme Watte, Albert S Jun
AIM: To use the cumulative sum analysis score (CUSUM) to construct objectively the learning curve of phacoemulsification competency. METHODS: Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture (PCR) and best-corrected visual acuity. The acceptable rate for PCR was <5% (lower limit h) and the unacceptable rate was >10% (upper limit h)...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#3
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28729183/differentiation-between-idiopathic-granulomatous-mastitis-and-malignant-breast-lesions-using-strain-ratio-on-ultrasonic-elastography
#4
B Yağcı, I Erdem Toslak, B Çekiç, M Öz, B R Karakaş, M Akdemir, S Yıldız, D Süren, D Bova
PURPOSE: The goal of this study was to investigate the strain elastography imaging characteristics of idiopathic granulomatous mastitis (IGM) and compare strain ratio values of IGM with those of breast cancer. MATERIAL AND METHODS: Twenty-three consecutive women with IGM (mean age, 37.9±6.6 [SD] years; range: 26-52 years) and 45 women with malignant breast tumor (mean age, 52.8±12.0 [SD], range, 32-77 years) who had been scheduled for ultrasound-guided core biopsy were recruited to the study...
July 17, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28729045/fracture-risk-assessment-from-population-to-individual
#5
Tuan V Nguyen, John A Eisman
Fracture caused by osteoporosis remains a major public health burden on contemporary populations because fracture is associated with a substantial increase in the risk of mortality. Early identification of high-risk individuals for prevention is a priority in osteoporosis research. Over the past decade, few risk prediction models, including the Garvan Fracture Risk Calculator (Garvan) and FRAX(®), have been developed to provide absolute (individualized) risk of fracture. Recent validation studies suggested that the area under the receiver operating characteristic curve in fracture discrimination ranged from 0...
July 17, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28725304/high-c-reactive-protein-and-low-albumin-levels-predict-high-30-day-mortality-in-patients-undergoing-percutaneous-endoscopic-gastrotomy
#6
Omer Karasahin, Pinar Tosun Tasar, Ozge Timur, Dogan Nasir Binici, Tugba Kiper Yilmaz, Adem Aslan, Sevnaz Sahin
BACKGROUND: Percutaneous endoscopic gastrotomy (PEG) enables long-term enteral feeding. The aim of this study was to identify biomarkers that may guide the decision of whether to perform the elective procedure of PEG. METHODS: The medical records of all patients who underwent PEG in our hospital from 2010 to 2016 were screened retrospectively. Patients with mortality within a 30-day follow-up period and those without were compared using the Chi-square test, and continuous variables were compared with the Kruskal-Wallis and Mann-Whitney U tests...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28720000/differentiation-between-pyogenic-flexor-tenosynovitis-and-other-finger-infections
#7
Colin D Kennedy, Alexander S Lauder, Jonathan R Pribaz, Stephen A Kennedy
BACKGROUND: Hospital transfer decisions regarding pyogenic flexor tenosynovitis (PFT) are made difficult by emergency department presentations similar to other finger infections, with pain, redness, and functional limitation. Our objectives were to: (1) determine diagnostic sensitivity and specificity of Kanavel signs; and (2) identify existing factors most predictive of PFT during initial presentation. METHODS: Adult patients who underwent surgical consultation for concern of PFT over a 5-year period were identified retrospectively...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718896/nomograms-for-preoperative-prediction-of-axillary-nodal-status-in-breast-cancer
#8
L Dihge, P-O Bendahl, L Rydén
BACKGROUND: Axillary staging in patients with breast cancer and clinically node-negative disease is performed by sentinel node biopsy (SLNB). The aim of this study was to integrate feasible preoperative variables into nomograms to guide clinicians in stratifying treatment options into no axillary staging for patients with non-metastatic disease (N0), SLNB for those with one or two metastases, and axillary lymph node dissection (ALND) for patients with three or more metastases. METHODS: Patients presenting to Skåne University Hospital, Lund, with breast cancer were included in a prospectively maintained registry between January 2009 and December 2012...
July 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28717860/performance-of-the-diarem-score-for-predicting-diabetes-remission-in-two-health-systems-following-bariatric-surgery-procedures-in-hispanic-and-non-hispanic-white-patients
#9
G Craig Wood, Daniel Horwitz, Christopher D Still, Tooraj Mirshahi, Peter Benotti, Manish Parikh, Annemarie G Hirsch
OBJECTIVE: The objective of this study was to determine whether the DiaRem, a score that predicts type 2 diabetes (T2D) remission following roux-en-y gastric bariatric surgery (RYGB), also predicts remission following laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in white and Hispanic patients. BACKGROUND: While bariatric surgery is highly effective in reversing insulin resistance, there are patients for whom surgery will not lead to remission...
July 17, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28716809/determining-clinical-decision-thresholds-for-hiv-positive-patients-suspected-of-having-tuberculosis
#10
Tom Boyles, Isabella Locatelli, Nicolas Senn, Mark Ebell
Clinical decision thresholds may aid the evaluation of diagnostic tests but have rarely been determined for tuberculosis (TB). We presented clinicians with six web-based clinical scenarios, describing patients with HIV and possible TB at various sites and with a range of clinical stability. The probability of disease was varied randomly and clinicians asked to make treatment decisions; threshold curves and therapeutic thresholds were calculated. Test and treatment thresholds were calculated using Bayes theorem and the diagnostic accuracy of Xpert MTB/RIF...
July 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28716562/predictive-factors-for-final-pathologic-ureteral-sections-on-700-radical-cystectomy-specimens-implications-for-intraoperative-frozen-section-decision-making
#11
Alexandra Masson-Lecomte, Thomas Francois, Dimitri Vordos, Carole Cordonnier, Yves Allory, Francois Desgrandchamps, Alexandre de la Taille, Fabien Saint
PURPOSE: To identify preoperative predictive factors for final ureteral section invasion after radical cystectomy (RC) and to validate significant factors on an external independent cohort. MATERIAL AND METHODS: We retrospectively reviewed data of all consecutive RC performed for bladder cancer in 2 high-volume institutions. Clinical, pathological, and follow-up data were collected prospectively and reviewed retrospectively. Pathological evaluation was performed by 2 well-trained uropathologists in each center...
July 14, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28716145/mortality-differences-by-surgical-volume-among-patients-with-stomach-cancer-a-threshold-for-a-favorable-volume-outcome-relationship
#12
Hyeok Choi, Seong-Yoon Yang, Hee-Seung Cho, Woorim Kim, Eun-Cheol Park, Kyu-Tae Han
BACKGROUND: Many studies have assessed the volume-outcome relationship in cancer patients, but most focused on better outcomes in higher volume groups rather than identifying a specific threshold that could assist in clinical decision-making for achieving the best outcomes. The current study suggests an optimal volume for achieving good outcome, as an extension of previous studies on the volume-outcome relationship in stomach cancer patients. METHODS: We used National Health Insurance Service (NHIS) Sampling Cohort data during 2004-2013, comprising healthcare claims for 2550 patients with newly diagnosed stomach cancer...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28714287/bacteremia-prediction-model-for-community-acquired-pneumonia-external-validation-in-a-multicenter-retrospective-cohort
#13
Byunghyun Kim, Jungho Choi, Kyuseok Kim, Sujin Jang, Tae Gun Shin, Won Young Kim, Jung-Youn Kim, Yoo Seok Park, Soo Hyun Kim, Hui Jai Lee, Jonghwan Shin, JeSung You, Kyung Su Kim, Sung Phil Chung
OBJECTIVE: Many studies have described constructing a prediction model for bacteremia in community-acquired pneumonia (CAP), but these studies were not validated in external heterogeneous groups. The objective of this study was to test the generalizability of a previous bacteremia prediction model for CAP by external validation. METHODS: This multicenter retrospective cohort analysis was performed in eight tertiary urban hospital emergency departments (ED). We reviewed adult patients who were hospitalized after presentation to the ED with CAP...
July 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28712627/testing-the-external-validity-of-a-discrete-choice-experiment-method-an-application-to-latent-tuberculosis-infection-treatment
#14
Tima Mohammadi, Nick Bansback, Fawziah Marra, Amir Khakban, Jonathon R Campbell, J Mark FitzGerald, Larry D Lynd, Carlo A Marra
OBJECTIVES: To explore the external validity and predictive power of stated preferences obtained from a discrete choice experiment (DCE) by comparing the predicted behavior of respondents to their actual choices at an individual level. METHODS: A DCE was performed in patients before being offered treatment for latent tuberculosis infection. A mixed logit model was estimated using hierarchical Bayes. The individual-specific preference coefficients were used to calculate the expected probability of choosing the treatment by each patient...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28709178/inflammatory-reaction-found-in-prostate-specific-material-method-standardization-and-proposed-optimal-cut-off-points
#15
P Korrovits, O Poolamets, R Mändar, M Punab
Prostatitis classification as well as treatment decisions are primarily based on differentiation of the inflammatory status in prostate-specific material. At the same time, methods used for detection of inflammation are semi-quantitative and not finally standardized. The main aim of this study was to suggest more precise methods for detection of prostate inflammatory status. Additional aims were to define optimal cut-off points of various tests in order to discriminate between inflammatory and non-inflammatory condition and to analyze the prevalence of inflammatory prostatitis in the groups of symptomatic prostatitis, lower urinary tract symptoms and control subjects...
July 14, 2017: Andrology
https://www.readbyqxmd.com/read/28708805/serum-adalimumab-levels-predict-successful-remission-and-safe-deintensification-in-inflammatory-bowel-disease-patients-in-clinical-practice
#16
Mariam Aguas Peris, Virginia Bosó, Belén Navarro, Maria R Marqués-Miñana, Guillermo Bastida, Belén Beltrán, Marisa Iborra, Esteban Sáez-González, Emilio Monte-Boquet, Jose L Poveda-Andrés, Pilar Nos
BACKGROUND: Little is known about the association between the pharmacokinetic features of adalimumab (ADL) and disease outcome in patients with inflammatory bowel disease (IBD). AIMS: To assess the association between random serum ADL levels and clinical or biochemical remission with clinical decision making in daily practice according to these levels; and to determine the cutoff value for successful dose reduction in patients with IBD treated with ADL. METHODS: We conducted a prospective observational study of patients with IBD who received long-term maintenance therapy with ADL...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28704383/predicting-in-hospital-death-during-acute-presentation-with-pulmonary-embolism-to-facilitate-early-discharge-and-outpatient-management
#17
Jerrett K Lau, Vincent Chow, Alex Brown, Leonard Kritharides, Austin C C Ng
BACKGROUND: Pulmonary embolism continues to be a significant cause of death. The aim was to derive and validate a risk prediction model for in-hospital death after acute pulmonary embolism to identify low risk patients suitable for outpatient management. METHODS: A confirmed acute pulmonary embolism database of 1,426 consecutive patients admitted to a tertiary-center (2000-2012) was analyzed, with odd and even years as derivation and validation cohorts respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28698323/performance-of-highly-sensitive-cardiac-troponin-t-assay-to-detect-ischaemia-at-pet-ct-in-low-risk-patients-with-acute-coronary-syndrome-a-prospective-observational-study
#18
Beata Morawiec, Stephane Fournier, Maxime Tapponnier, John O Prior, Pierre Monney, Vincent Dunet, Nathalie Lauriers, Frederique Recordon, Catalina Trana, Juan-Fernando Iglesias, Damian Kawecki, Olivier Boulat, Daniel Bardy, Sabine Lamsidri, Eric Eeckhout, Olivier Hugli, Olivier Muller
BACKGROUND: Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay's performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented. PURPOSE: To assess hs-TnT assay's performance to detect myocardial ischaemia at positron emission tomography/CT (PET-CT) in low-risk patients admitted with chest pain. METHODS: Patients admitted for chest pain with a nonconclusive ECG and negative standard cardiac troponin T results at admission and after 6 hours were prospectively enrolled...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697778/electrical-impedance-tomography-for-predicting-failure-of-spontaneous-breathing-trials-in-patients-with-prolonged-weaning
#19
Johannes Bickenbach, Michael Czaplik, Mareike Polier, Gernot Marx, Nikolaus Marx, Michael Dreher
BACKGROUND: Spontaneous breathing trials (SBTs) on a T-piece can be difficult in patients with prolonged weaning because of remaining de-recruitment phenomena and/or insufficient ventilation. There is no clinically established method existent other than experience for estimating whether an SBT is most probably beneficial. Electrical impedance tomography (EIT) is a clinical useful online monitoring technique during mechanical ventilation, particularly because it enables analysis of effects of regional ventilation distribution...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28694271/proposed-clinical-decision-rules-to-diagnose-acute-rhinosinusitis-among-adults-in-primary-care
#20
Mark H Ebell, Jens Georg Hansen
PURPOSE: To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. METHODS: Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid)...
July 2017: Annals of Family Medicine
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