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Clinical prediction rules

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https://www.readbyqxmd.com/read/28808792/using-natural-language-processing-of-free-text-radiology-reports-to-identify-type-1-modic-endplate-changes
#1
Hannu T Huhdanpaa, W Katherine Tan, Sean D Rundell, Pradeep Suri, Falgun H Chokshi, Bryan A Comstock, Patrick J Heagerty, Kathryn T James, Andrew L Avins, Srdjan S Nedeljkovic, David R Nerenz, David F Kallmes, Patrick H Luetmer, Karen J Sherman, Nancy L Organ, Brent Griffith, Curtis P Langlotz, David Carrell, Saeed Hassanpour, Jeffrey G Jarvik
Electronic medical record (EMR) systems provide easy access to radiology reports and offer great potential to support quality improvement efforts and clinical research. Harnessing the full potential of the EMR requires scalable approaches such as natural language processing (NLP) to convert text into variables used for evaluation or analysis. Our goal was to determine the feasibility of using NLP to identify patients with Type 1 Modic endplate changes using clinical reports of magnetic resonance (MR) imaging examinations of the spine...
August 14, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28808076/influence-of-the-duration-of-penicillin-prescriptions-on-outcomes-for-acute-sore-throat-in-adults-the-descarte-prospective-cohort-study-in-uk-general-practice
#2
Michael Moore, Beth Stuart, Fd Richard Hobbs, Chris C Butler, Alastair D Hay, John Campbell, Brendan C Delaney, Sue Broomfield, Paula Barratt, Kerenza Hood, Hazel Everitt, Mark Mullee, Ian Williamson, David Mant, Paul Little
BACKGROUND: Guidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice. AIM: To determine whether antibiotic duration predicts adverse outcome of acute sore throat in adults in routine care. DESIGN AND SETTING: A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study of 12 829 adults presenting in UK general practice with acute sore throat...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28803709/low-back-pain-identifying-sub-groups-clinical-prediction-rules-and-measuring-results
#3
REVIEW
Alan Breen
No abstract text is available yet for this article.
August 3, 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28801412/health-practitioners-perceptions-of-adopting-clinical-prediction-rules-in-the-management-of-musculoskeletal-pain-a-qualitative-study-in-australia
#4
Joan Kelly, Michele Sterling, Trudy Rebbeck, Aila Nica Bandong, Andrew Leaver, Martin Mackey, Carrie Ritchie
OBJECTIVES: To investigate health practitioners' understanding and practice behaviours with regards to clinical prediction rules (CPRs) and explore their perceptions of adopting a new whiplash CPR. DESIGN: Qualitative study using six semistructured focus groups. SETTING: Primary and secondary care in New South Wales and Queensland, Australia. PARTICIPANTS: Physiotherapists (n=19), chiropractors (n=6) and osteopaths (n=3) were purposively sampled to include health practitioners who provide routine treatment to people with whiplash-associated disorders...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28796639/development-and-validation-of-a-multivariable-prediction-rule-for-detecting-a-severe-acquired-adamts13-activity-deficiency-in-patients-with-thrombotic-microangiopathies
#5
Jorge M Nieto, Félix De La Fuente-Gonzalo, Fernando A González, Ana Villegas, Rafael Martínez, Manuel E Fuentes, Paloma Ropero
BACKGROUND: Thrombotic microangiopathies (TMAs) are a group of diseases that have different aetiologies and treatments, but a clinical differential diagnosis remains difficult. Among TMAs, thrombotic thrombocytopenic purpura (TTP) is characterised by a severe ADAMTS13 functional deficiency. However, assays exploring ADAMTS13 activity are limited to some specialised laboratories. Our objective was to develop and validate a diagnostic method for TTP in adult patients with TMA. METHODS: We generated a multivariable model (four predictors) on a cohort of 174 TMA patients in order to predict an ADAMTS13 activity deficiency (AUC of 0...
August 10, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28795420/inference-for-multimarker-adaptive-enrichment-trials
#6
Richard Simon, Noah Simon
Identification of treatment selection biomarkers has become very important in cancer drug development. Adaptive enrichment designs have been developed for situations where a unique treatment selection biomarker is not apparent based on the mechanism of action of the drug. With such designs, the eligibility rules may be adaptively modified at interim analysis times to exclude patients who are unlikely to benefit from the test treatment.We consider a recently proposed, particularly flexible approach that permits development of model-based multifeature predictive classifiers as well as optimized cut-points for continuous biomarkers...
August 10, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28790026/dominant-b-cell-receptor-clones-in-peripheral-blood-predict-onset-of-arthritis-in-individuals-at-risk-for-rheumatoid-arthritis
#7
Paul P Tak, Marieke E Doorenspleet, Maria J H de Hair, Paul L Klarenbeek, Marian H van Beers-Tas, Antoine H C van Kampen, Dirkjan van Schaardenburg, Danielle M Gerlag, Frank Baas, Niek de Vries
BACKGROUND: The onset of seropositive rheumatoid arthritis (RA) is preceded by the presence of specific autoantibodies in the absence of synovial inflammation. Only a subset of these at-risk individuals will develop clinical disease. This impedes efforts to implement early interventions that may prevent onset of clinically manifest disease. Here we analyse whether clonal changes in the B cell receptor (BCR) repertoire can reliably predict onset of signs and symptoms. METHODS: In a prospective cohort study in 21 individuals at risk for RA based on the presence of autoantibodies, the BCR repertoire of paired peripheral blood and synovial tissue samples was analysed using next-generation BCR sequencing...
August 8, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28781312/the-prehospital-predictors-of-tracheal-intubation-for-in-patients-who-experience-convulsive-seizures-in-the-emergency-department
#8
Kenichiro Sato, Noritoshi Arai, Aki Omori-Mitsue, Ayumi Hida, Akio Kimura, Sousuke Takeuchi
Objective To identify the prehospital factors predicting the performance of tracheal intubation (TI) at the emergency department (ED) in patients with convulsive seizure or epilepsy. Methods We performed a retrospective analysis of seizure patients who underwent TI at the ED soon after arrival. The clinical variables obtained in the prehospital setting were reviewed. Patients The study population included consecutive adult patients who were transported to an urban tertiary care ED due to convulsive seizure between August 2010 and September 2015...
August 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28776405/power-estimation-in-biomarker-studies-where-events-are-already-observed
#9
Mei-Yin C Polley
Background The clinical utility of a new biomarker should ideally be established in a prospective randomized clinical trial. However, such trials are not always practical. As such, it is common for investigators to identify promising biomarkers using archived specimens and clinical data collected from previously completed therapeutic trials. Simon et al. defined such biomarker studies as prospective-retrospective studies and proposed specific conditions to satisfy for such evaluations to be more than hypothesis generating...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28774702/candida-and-invasive-mould-diseases-in-non-neutropenic-critically-ill-patients-and-patients-with-haematological-cancer
#10
REVIEW
A L Colombo, J N de Almeida Júnior, Monica A Slavin, Sharon C-A Chen, Tania C Sorrell
Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28774508/compliance-with-evidence-based-guidelines-for-computed-tomography-of-children-with-head-and-abdominal-trauma
#11
Ihab Halaweish, Jane Riebe-Rodgers, Amy Randall, Peter F Ehrlich
INTRODUCTION: Recently, two large prospective clinical trials developed and validated prediction rules for children at very low risk for clinically important traumatic brain injuries (ciTBI) or abdominal injury for whom CT is unnecessary. Specific criteria/guidelines were identified which if met would obviate the need for CT scanning. The purpose of this study was to assess compliance at a level one pediatric center with these guidelines as a tool for quality improvement. METHODS: Records of children admitted to our pediatric trauma center one year before and two years after publication of head (Kuppermann '09) and abdominal trauma (Holmes '13) CT imaging guidelines were reviewed...
July 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28766197/predicting-nodal-positivity-in-women-70%C3%A2-years-of-age-and-older-with-hormone-receptor-positive-breast-cancer-to-aid-incorporation-of-a-society-of-surgical-oncology-choosing-wisely-guideline-into-clinical-practice
#12
Jessemae L Welsh, Tanya L Hoskin, Courtney N Day, Elizabeth B Habermann, Matthew P Goetz, Judy C Boughey
PURPOSE: One of the Society of Surgical Oncology Choosing Wisely guidelines recommends avoiding routine sentinel lymph node (SLN) surgery in clinically node-negative women ≥70 years of age with hormone receptor-positive (HR+) breast cancer. We sought to assess the impact of tumor stage and grade on nodal positivity, and to develop a model to identify patients at low-risk of nodal positivity to aid adoption of the guideline. METHODS: We identified women ≥70 years of age with HR+ cN0 invasive breast cancer in the National Cancer Database (NCDB; 2010-2013) and examined the impact of tumor stage and grade on nodal positivity to identify low-risk combinations...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28764221/maximal-aortic-valve-cusp-separation-and-severity-of-aortic-stenosis
#13
K Jayaprakash, V P Dilu, Raju George
INTRODUCTION: An integrated approach that incorporates two dimensional, M mode and Doppler echocardiographic evaluation has become the standard means for accurate quantification of severity of valvular aortic stenosis. Maximal separation of the aortic valve cusps during systole has been shown to correlate well with the severity of aortic stenosis measured by other echocardiographic parameters. AIM: To study the correlation between Maximal Aortic valve Cusp Separation (MACS) and severity of aortic valve stenosis and to find cut-off values of MACS for detecting severe and mild aortic stenosis...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762168/the-role-of-computed-tomography-in-the-diagnosis-of-necrotizing-soft-tissue-infections
#14
Myriam Martinez, Thomas Peponis, Aglaia Hage, Daniel D Yeh, Haytham M A Kaafarani, Peter J Fagenholz, David R King, Marc A de Moya, George C Velmahos
BACKGROUND: The exact role of IV contrast-enhanced computed tomography (CT) in the diagnosis of necrotizing soft tissue infections (NSTIs) has not yet been established. We aimed to explore the role of CT in patients with clinical suspicion of NSTI and assess its sensitivity and specificity for NSTI. METHODS: The medical records of patients admitted between 2009 and 2016, who received IV contrast-enhanced CT to rule out NSTI, were reviewed. CT was considered positive in case of: (a) gas in soft tissues, (b) multiple fluid collections, (c) absence or heterogeneity of tissue enhancement by the IV contrast, and (d) significant inflammatory changes under the fascia...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28762098/preprocessing-prediction-of-advanced-algorithms-for-medical-imaging
#15
Bella Fadida-Specktor
Advanced medical imaging algorithms (such as bone removal, vessel segmentation, or a lung nodule detection) can provide extremely valuable information to the radiologists, but they might sometimes be very time consuming. Being able to run the algorithms in advance can be a possible solution. However, we do not know which algorithm to run on a given dataset before it is actually used. It is possible to manually insert matching rules for preprocessing algorithms, but it requires high maintenance and does not work well in practice...
July 31, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28757654/predicting-triple-negative-breast-cancer-subtype-using-multiple-single-nucleotide-polymorphisms-for-breast-cancer-risk-and-several-variable-selection-methods
#16
Lothar Häberle, Alexander Hein, Matthias Rübner, Michael Schneider, Arif B Ekici, Paul Gass, Arndt Hartmann, Rüdiger Schulz-Wendtland, Matthias W Beckmann, Wing-Yee Lo, Werner Schroth, Hiltrud Brauch, Peter A Fasching, Marius Wunderle
INTRODUCTION: Studies of triple-negative breast cancer have recently been extending the inclusion criteria and incorporating additional molecular markers into the selection criteria, opening up scope for targeted therapies. The screening phases required for studies of this type are often prolonged, since the process of determining the molecular subtype and carrying out additional biomarker assessment is time-consuming. Parameters such as germline genotypes capable of predicting the molecular subtype before it becomes available from pathology might be helpful for treatment planning and optimizing the timing and cost of screening phases...
June 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28754865/gene-methylation-biomarkers-in-sputum-as-a-classifier-for-lung-cancer-risk
#17
Shuguang Leng, Guodong Wu, Donna M Klinge, Cynthia L Thomas, Elia Casas, Maria A Picchi, Christine A Stidley, Sandra J Lee, Seena Aisner, Jill M Siegfried, Suresh Ramalingam, Fadlo R Khuri, Daniel D Karp, Steven A Belinsky
CT screening for lung cancer reduces mortality, but will cost Medicare ~2 billion dollars due in part to high false positive rates. Molecular biomarkers could augment current risk stratification used to select smokers for screening. Gene methylation in sputum reflects lung field cancerization that remains in lung cancer patients post-resection. This population was used in conjunction with cancer-free smokers to evaluate classification accuracy of a validated eight-gene methylation panel in sputum for cancer risk...
July 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28750904/a-comparison-of-rule-based-and-machine-learning-approaches-for-classifying-patient-portal-messages
#18
Robert M Cronin, Daniel Fabbri, Joshua C Denny, S Trent Rosenbloom, Gretchen Purcell Jackson
OBJECTIVE: Secure messaging through patient portals is an increasingly popular way that consumers interact with healthcare providers. The increasing burden of secure messaging can affect clinic staffing and workflows. Manual management of portal messages is costly and time consuming. Automated classification of portal messages could potentially expedite message triage and delivery of care. MATERIALS AND METHODS: We developed automated patient portal message classifiers with rule-based and machine learning techniques using bag of words and natural language processing (NLP) approaches...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28748088/modeling-risk-for-developing-drug-resistant-bacterial-infections-in-an-mdr-naive-critically-ill-population
#19
Rajiv Sonti, Megan E Conroy, Elena M Welt, Yi Hu, George Luta, Daniel B Jamieson
PURPOSE: To create a model predictive of an individual's risk of developing a de novo multidrug-resistant (MDR) infection while in the intensive care unit (ICU). METHODS: This is a case-control study in which 189 ICU patients diagnosed with their first infection with an MDR organism were compared on the basis of demographic, past medical and clinical variables to randomly selected ICU patients without such an infection, era-matched in a 2:1 ratio. A prediction tool was derived using multivariate logistic regression...
July 2017: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/28746217/18f-fluoro-deoxy-glucose-positron-emission-tomography-combined-with-computed-tomography-can-reliably-rule-out-infection-and-cancer-in-patients-with-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-suspected-of-disease-relapse
#20
Evan C Frary, Søren Hess, Oke Gerke, Helle Laustrup
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases characterized by systemic inflammation in small- to medium-sized blood vessels. Although immunosuppressive therapy has greatly improved the prognosis for these patients, there are still significant comorbidities, such as cancer and infection, associated with AAV. These comorbidities are often indistinguishable from an underlying AAV disease relapse, and create a clinical conundrum, as these conditions are normally contraindications for immunosuppressive treatment...
July 2017: Medicine (Baltimore)
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