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Clinical prediction rules

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https://www.readbyqxmd.com/read/29048993/personalized-risk-prediction-in-clinical-oncology-research-applications-and-practical-issues-using-survival-trees-and-random-forests
#1
Chen Hu, Jon Arni Steingrimsson
A crucial component of making individualized treatment decisions is to accurately predict each patient's disease risk. In clinical oncology, disease risks are often measured through time-to-event data, such as overall survival and progression/recurrence-free survival, and are often subject to censoring. Risk prediction models based on recursive partitioning methods are becoming increasingly popular largely due to their ability to handle nonlinear relationships, higher-order interactions, and/or high-dimensional covariates...
October 19, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/29039828/-clinical-laboratory-and-instrumental-criteria-for-myocarditis-established-in-comparison-with-myocardial-biopsy-a-non-invasive-diagnostic-algorithm
#2
O V Blagova, Yu V Osipova, A V Nedostup, E A Kogan, V A Sulimov
AIM: To determine the diagnostic value of different clinical, laboratory, and instrumental signs in the diagnosis of myocarditis in patients with the picture of idiopathic arrhythmias, dilated cardiomyopathy (DCM) and in a comparison group when comparing with myocardial morphological examination. SUBJECTS AND METHODS: A study group included 100 patients (35 women; mean age, 44.7±12.5 years) with idiopathic arrhythmias (n=20) and DCM as a syndrome (n=100). All underwent myocardial morphological examination: endomyocardial biopsy (EMB) (n=71), intraoperative biopsy (n=13), study of the explanted heart (n=6), and autopsy (n=11)...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/29032036/relationship-between-the-subcostal-and-right-lateral-views-of-inferior-vena-cava-collapse-implications-for-clinical-use
#3
Rian Shah, Rory Spiegel, Christina Lu, Ivan Crnosija, Sahar Ahmad
BACKGROUND: The collapsibility index of the inferior vena cava (cIVC) is traditionally visualized in from the subcostal region in the sagittal plane (SS view), and is referred to here as cIVCSS. Alternatively, cIVC can be visualized from the right mid-axillary line in the coronal plane (RC view), referred to here as cIVCRC. It is unclear whether values of cIVCRC are comparable to values of cIVCSS as the IVC collapses asymmetrically into an elliptical form, quantified as the Flat Ratio of the IVC (F-IVC)...
October 11, 2017: Chest
https://www.readbyqxmd.com/read/29029074/multimodality-imaging-evaluation-of-chagas-disease-an-expert-consensus-of-brazilian-cardiovascular-imaging-department-dic-and-the-european-association-of-cardiovascular-imaging-eacvi
#4
Maria Carmo P Nunes, Luigi Paolo Badano, J Antonio Marin-Neto, Thor Edvardsen, Covadonga Fernández-Golfín, Chiara Bucciarelli-Ducci, Bogdan A Popescu, Richard Underwood, Gilbert Habib, Jose Luis Zamorano, Roberto Magalhães Saraiva, Ester Cerdeira Sabino, Fernando A Botoni, Márcia Melo Barbosa, Marcio Vinicius L Barros, Eduardo Falqueto, Marcus Vinicius Simões, André Schmidt, Carlos Eduardo Rochitte, Manoel Otávio Costa Rocha, Antonio Luiz Pinho Ribeiro, Patrizio Lancellotti
Aims: To develop a document by Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI) to review and summarize the most recent evidences about the non-invasive assessment of patients with Chagas disease, with the intent to set up a framework for standardized cardiovascular imaging to assess cardiovascular morphologic and functional disturbances, as well as to guide the subsequent process of clinical decision-making. Methods and results: Chagas disease remains one of the most prevalent infectious diseases in Latin America, and has become a health problem in non-endemic countries...
September 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29020511/bayesian-additive-decision-trees-of-biomarker-by-treatment-interactions-for-predictive-biomarkers-detection-and-subgroup-identification
#5
Yang Zhao, Wei Zheng, Daisy Y Zhuo, Yuefeng Lu, Xiwen Ma, Hengchang Liu, Zhen Zeng, Glen Laird
Personalized medicine, or tailored therapy, has been an active and important topic in recent medical research. Many methods have been proposed in the literature for predictive biomarkers detection and subgroup identification. In this paper, we propose a novel decision tree based approach applicable in randomized clinical trials. We model the prognostic effects of the biomarkers using additive regression trees and the biomarker-by-treatment effect using a single regression tree. Bayesian approach is utilized to periodically revise the split variables and the split rules of the decision trees, which provides a better overall fitting...
October 11, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/29020294/predicting-resistance-to-piperacillin-tazobactam-cefepime-and-meropenem-in-septic-patients-with-bloodstream-infection-due-to-gram-negative-bacteria
#6
M Cristina Vazquez-Guillamet, Rodrigo Vazquez, Scott T Micek, Marin H Kollef
Background: Predicting antimicrobial resistance in gram-negative bacteria (GNB) could balance the need for administering appropriate empiric antibiotics while also minimizing the use of clinically unwarranted broad-spectrum agents. Our objective was to develop a practical prediction rule able to identify patients with GNB infection at low risk for resistance to piperacillin-tazobactam (PT), cefepime (CE), and meropenem (ME). Methods: The study included adult patients with sepsis or septic shock due to bloodstream infections caused by GNB admitted between 2008 and 2015 from Barnes-Jewish Hospital...
July 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29016519/clinical-decision-rule-to-identify-orbital-wall-fracture-among-children-retrospective-derivation-and-validation-study
#7
So Hyun Paek, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Sohee Oh
OBJECTIVES: Head and face injuries are leading causes of emergency department visits in children. There is yet no clinical decision rule on face CT such as pediatric head CT rules. The goal was to develop and validate a clinical decision rule for identifying orbital wall fractures in children with periorbital trauma in the emergency department. METHODS: This was a retrospective derivation and validation study. Children younger than 18 years who underwent orbit CT after periorbital trauma were included between January 2011 and December 2013 in 3 emergency centers...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28993007/poor-early-response-to-methotrexate-portends-inadequate-long-term-outcomes-in-patients-with-moderate-to-severe-psoriasis-evidence-from-2-phase-3-clinical-trials
#8
Kenneth B Gordon, Keith A Betts, Murali Sundaram, James E Signorovitch, Junlong Li, Meng Xie, Eric Q Wu, Martin M Okun
BACKGROUND: Most methotrexate-treated psoriasis patients do not achieve a long-term PASI75 (75% reduction from baseline Psoriasis Area and Severity Index score) response. Indications of nonresponse can be apparent after only 4 weeks of treatment. OBJECTIVE: To develop a prediction rule to identify patients unlikely to respond adequately to methotrexate. METHODS: Patient-level data from CHAMPION (NCT00235820, N = 110) was used to construct a prediction model for week 16 PASI75 by using patient baseline characteristics and week 4 PASI25...
October 6, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28991954/tools-clinical-prediction-rules-and-algorithms-for-the-insertion-of-peripheral-intravenous-catheters-in-adult-hospitalized-patients-a-systematic-scoping-review-of-literature
#9
Peter J Carr, Niall S Higgins, Marie L Cooke, James Rippey, Claire M Rickard
BACKGROUND: First-time peripheral intravenous catheter (PIVC) insertion success is dependent on patient, clinician, and product factors. Failed PIVC insertion are an under-recognized clinical phenomenon. OBJECTIVE: To provide a scoping review of decision aids for PIVC insertion including tools, clinical prediction rules, and algorithms (TRAs) and their findings on factors associated with insertion success. METHODS: In June 2016, a systematic literature search was performed using the medical subject heading of peripheral catheterization and tool* or rule* or algorithm*...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28988847/impact-of-bacteremia-prediction-rule-in-cap-before-and-after-study
#10
Byunghyun Kim, Kyuseok Kim, Jieun Lee, Joonghee Kim, Yoo Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
OBJECTIVE: In cases of community acquired pneumonia (CAP), it has been known that blood cultures have low yields and rarely affect clinical outcomes. Despite many studies predicting the likelihood of bacteremia in CAP patients, those results have been rarely implemented in clinical practice, and use of blood culture in CAP is still increasing. This study evaluated impact of implementing a previously derived and validated bacteremia prediction rule. METHODS: In this registry-based before and after study, we used piecewise regression analysis to compare the blood culture rate before and after implementation of the prediction rule...
October 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#11
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28986984/crd-and-beyond-multivariable-regression-models-to-predict-severity-of-hazelnut-allergy
#12
Mareen R Datema, Ronald van Ree, Riccardo Asero, Laura Barreales, Simona Belohlavkova, Frédéric de Blay, Michael Clausen, Ruta Dubakiene, Cristina Fernández-Perez, Philipp Fritsche, David Gislason, Karin Hoffmann-Sommergruber, Monika Jedrzejczak-Czechowicz, Laurian Jongejan, André C Knulst, Marek Kowalski, Tanya Z Kralimarkova, Thuy-My Le, Jonas Lidholm, Nikolaos G Papadopoulos, Todor A Popov, Nayade Del Prado, Ashok Purohit, Isabel Reig, Suranjith L Seneviratne, Athanassios Sinaniotis, Serge A Versteeg, Stefan Vieths, A H Zwinderman, E N Clare Mills, Montserrat Fernández-Rivas, Barbara Ballmer-Weber
BACKGROUND: Component-resolved diagnosis (CRD) has revealed significant associations between IgE against individual allergens and severity of hazelnut allergy. Less attention has been given to combining them with clinical factors in predicting severity. AIM: To analyze associations between severity and sensitization patterns, patient characteristics and clinical history, and to develop models to improve predictive accuracy. METHODS: Patients reporting hazelnut allergy (n=423) from 12 European cities were tested for IgE against individual hazelnut allergens...
October 7, 2017: Allergy
https://www.readbyqxmd.com/read/28986266/pit-pattern-analysis-with-high-definition-chromoendoscopy-and-narrow-band-imaging-for-optical-diagnosis-of-dysplasia-in-patients-with-ulcerative-colitis
#13
Raf Bisschops, Talat Bessissow, Evelien Dekker, James E East, Adolfo Parra-Blanco, Krish Ragunath, Pradeep Bhandari, Matt Rutter, Erik Schoon, Ana Wilson, Jestinah Mahachie John, Kristel Van Steen, Filip Baert, Marc Ferrante
BACKGROUND AND AIMS: Patients with longstanding ulcerative colitis (UC) are at increased risk of developing colorectal neoplasia. Chromoendoscopy (CE) increases detection of lesions, and Kudo pit pattern classification I and II have been suggested to be predictive of benign polyps in UC. Little is known on the use of this classification in non-magnified high-definition (HD) (virtual) CE and narrow-band Imaging (NBI), or on the interobserver agreement. The aim of this pilot study was to assess the diagnostic accuracy and the interobserver agreement of the Kudo pit pattern classification in UC patients undergoing surveillance with methylene blue CE or NBI in a multicenter study...
October 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28982953/neuroimaging-and-endocrine-disorders-in-paediatric-optic-nerve-hypoplasia
#14
Xiaoxiao Qian, Samksha Fouzdar Jain, Linda A Morgan, Travis Kruse, Monina Cabrera, Donny W Suh
PURPOSE: Optic nerve hypoplasia (ONH) is one of the leading causes of blindness among children. The purpose of this retrospective study is to determine the risk factors and association between brain MRI findings, pituitary abnormalities and endocrine disorders with the presence of ONH. METHODS: A retrospective review of patients seen at paediatric ophthalmology clinics from January 2006 to December 2016 at Children's Hospital and Medical Center and the University of Nebraska Medical Center was performed...
October 5, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28972002/direct-comparison-of-cardiac-myosin-binding-protein-c-with-cardiac-troponins-for-the-early-diagnosis-of-acute-myocardial-infarction
#15
Thomas E Kaier, Raphael Twerenbold, Christian Puelacher, Jack Marjot, Nazia Imambaccus, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Zaid Sabti, Maria Rubini Giménez, Karin Wildi, Petra Hillinger, Karin Grimm, Sarah Loeffel, Samyut Shrestha, Dayana Flores Widmer, Janosch Cupa, Nikola Kozhuharov, Òscar Miró, F Javier Martín-Sánchez, Beata Morawiec, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Stefan Osswald, Tobias Reichlin, Ekkehard Weber, Michael Marber, Christian Mueller
BACKGROUND: Cardiac myosin-binding protein C (cMyC) is a cardiac-restricted protein that is more abundant than cardiac troponins (cTn) and is released more rapidly after acute myocardial infarction (AMI). We evaluated cMyC as an adjunct or alternative to cTn in the early diagnosis of AMI. METHODS: Unselected patients (N=1954) presenting to the emergency department with symptoms suggestive of AMI, concentrations of cMyC, and high-sensitivity (hs) and standard-sensitivity cTn were measured at presentation...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28969365/evidence-for-potential-underestimation-of-clinical-folate-deficiency-in-resource-limited-countries-using-blood-tests
#16
Asok C Antony
Although a low serum folate concentration is a useful biomarker of pure folate deficiency, the presence of vitamin B12 deficiency or hemolysis or both in individuals with low folate status predictably raises serum folate levels. Therefore, in resource-limited settings where dietary folate deficiency can coexist with vitamin B12 deficiency or malaria or both, the serum folate concentration can range from normal to high, leading to serious underestimation of tissue folate status. This review traces the genesis of an inappropriate overreliance on the serum folate concentration to rule out folate deficiency in vulnerable populations of women and children...
August 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28969046/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...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28968957/a-risk-prediction-model-for-post-stroke-depression-in-chinese-stroke-survivors-based-on-clinical-and-socio-psychological-features
#18
Rui Liu, Yingying Yue, Haitang Jiang, Jian Lu, Aiqin Wu, Deqin Geng, Jun Wang, Jianxin Lu, Shenghua Li, Hua Tang, Xuesong Lu, Kezhong Zhang, Tian Liu, Yonggui Yuan, Qiao Wang
BACKGROUND: Post-stroke depression (PSD) is a frequent complication that worsens rehabilitation outcomes and patient quality of life. This study developed a risk prediction model for PSD based on patient clinical and socio-psychology features for the early detection of high risk PSD patients. RESULTS: Risk predictors included a history of brain cerebral infarction (odds ratio [OR], 3.84; 95% confidence interval [CI], 2.22-6.70; P < 0.0001) and four socio-psychological factors including Eysenck Personality Questionnaire with Neuroticism/Stability (OR, 1...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28965695/-evaluating-a-child-after-a-febrile-seizure-insights-on-three-important-issues
#19
S Auvin, M Antonios, G Benoist, M-A Dommergues, F Corrard, V Gajdos, C Gras Leguen, E Launay, A Salaün, L Titomanlio, L Vallée, M Milh
Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection...
September 28, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28959224/negative-mood-and-obsessive-compulsive-related-clinical-constructs-an-examination-of-underlying-factors
#20
Gary I Britton, Graham C L Davey
Emerging evidence suggests that many of the clinical constructs used to help understand and explain obsessive-compulsive (OC) symptoms, and negative mood, may be causally interrelated. One approach to understanding this interrelatedness is a motivational systems approach. This approach suggests that rather than considering clinical constructs and negative affect as separable entities, they are all features of an integrated threat management system, and as such are highly coordinated and interdependent. The aim of the present study was to examine if clinical constructs related to OC symptoms and negative mood are best treated as separable or, alternatively, if these clinical constructs and negative mood are best seen as indicators of an underlying superordinate variable, as would be predicted by a motivational systems approach...
2017: Frontiers in Psychology
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