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Clinical prediction rules

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https://www.readbyqxmd.com/read/28727272/performance-of-clinical-prediction-rules-for-diagnosis-of-pleural-tuberculosis-in-a-high-incidence-setting
#1
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource- constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of Pleural Tuberculosis (PT) in Peru. METHODS: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis...
July 20, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28719755/clinical-risk-factors-and-prognostic-model-for-primary-graft-dysfunction-after-lung-transplantation-in-patients-with-pulmonary-hypertension
#2
Mary K Porteous, James C Lee, David J Lederer, Scott M Palmer, Edward Cantu, Rupal J Shah, Scarlett L Bellamy, Vibha N Lama, Sangeeta M Bhorade, Maria M Crespo, John F McDyer, Keith M Wille, A Russell Localio, Jonathan B Orens, Pali D Shah, Ann B Weinacker, Selim Arcasoy, David S Wilkes, Lorraine B Ware, Jason D Christie, Steven M Kawut, Joshua M Diamond
RATIONALE: Pulmonary hypertension from pulmonary arterial hypertension or parenchymal lung disease is associated with an increased risk of primary graft dysfunction after lung transplantation. OBJECTIVE: We evaluated the clinical determinants of severe primary graft dysfunction in pulmonary hypertension and developed and validated a prognostic model. METHODS: We conducted a retrospective cohort study of patients in the multi-center Lung Transplant Outcomes Group with pulmonary hypertension at transplant listing...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28716855/frailty-screening-tools-for-elderly-patients-incident-to-dialysis
#3
Ismay N van Loon, Namiko A Goto, Franciscus T J Boereboom, Michiel L Bots, Marianne C Verhaar, Marije E Hamaker
BACKGROUND AND OBJECTIVES: A geriatric assessment is an appropriate method for identifying frail elderly patients. In CKD, it may contribute to optimize personalized care. However, a geriatric assessment is time consuming. The purpose of our study was to compare easy to apply frailty screening tools with the geriatric assessment in patients eligible for dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 123 patients on incident dialysis ≥65 years old were included <3 weeks before to ≤2 weeks after dialysis initiation, and all underwent a geriatric assessment...
July 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28716636/a-simplified-clinical-prediction-rule-for-prognosticating-independent-walking-after-spinal-cord-injury-a-prospective-study-from-a-canadian-multicenter-spinal-cord-injury-registry
#4
Katharine E Hicks, Yichen Zhao, Nader Fallah, Carly Rivers, Vanessa Noonan, Tova Plashkes, Eugene K Wai, Darren M Roffey, Eve Tsai, Jerome Paquet, Najmedden Attabib, Travis Marion, Henry Ahn, Philippe Phan
BACKGROUND: Context: Traumatic spinal cord injury (SCI) is a debilitating condition with limited treatment options for neurological or functional recovery. The ability to predict the prognosis of walking post-injury with emerging prediction models could aid in rehabilitation strategies and reintegration into the community. PURPOSE: To re-validate an existing clinical prediction model for independent ambulation (van Middendorp et al. 2011) utilising acute and long-term post-injury follow-up data, and to investigate the accuracy of a simplified model using prospectively collected data from a Canadian multicenter SCI database, the Rick Hansen Spinal Cord Injury Registry (RHSCIR)...
July 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28715510/correction-development-and-validation-of-a-clinical-prediction-rule-for-bacteremia-among-maintenance-hemodialysis-patients-in-outpatient-settings
#5
Sho Sasaki, Takeshi Hasegawa, Hiroo Kawarazaki, Atsushi Nomura, Daisuke Uchida, Takahiro Imaizumi, Masahide Furusho, Hiroki Nishiwaki, Shingo Fukuma, Yugo Shibagaki, Shunichi Fukuhara
[This corrects the article DOI: 10.1371/journal.pone.0169975.].
2017: PloS One
https://www.readbyqxmd.com/read/28713042/implementation-of-the-universal-bls-termination-of-resuscitation-rule-in-a-rural-ems-system
#6
Matthew R Jordan, Michael F O'Keefe, David Weiss, C Wes Cubberley, Charles D MacLean, Daniel L Wolfson
BACKGROUND: Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. OBJECTIVE: The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28707499/performance-of-wells-score-to-predict-deep-vein-thrombosis-and-pulmonary-embolism-in-endurance-athletes
#7
Amanda L Zaleski, Beth A Taylor, Linda S Pescatello, Paul D Thompson, Craig Denegar
INTRODUCTION: There are an increasing number of reports describing deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in otherwise healthy endurance athletes. The Wells score is the most commonly used clinical prediction rule to diagnose DVT/PE in clinical populations. However, the Wells score may have limited utility for recognition of DVT/PE in athletes, contributing to missed or delayed diagnosis. OBJECTIVE: We performed an analysis of the ability of the Wells score to identify DVT/PE events in athletes through a review of published case reports...
July 14, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28707449/individualizing-dual-antiplatelet-therapy-duration-prediction-tools-genomics-and-clinical-judgment
#8
EDITORIAL
Arka Chatterjee, William B Hillegass
Prolonged dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) on average reduces the risk of subsequent myocardial infarction (MI) but increases major bleeds. Individualizing duration of DAPT based on the DAPT trial's net benefit prediction tool would likely optimize outcome beyond population average recommendations. Individualizing agent selection and duration of therapy based on genomic data may further improve outcomes. Clinical judgment remains the most important tool to tailor DAPT duration based on a large array of additional relevant factors not captured by predition rules or genomics...
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28701316/diagnostic-performance-of-high-sensitivity-compared-with-contemporary-cardiac-troponin-i-for-the-diagnosis-of-acute-myocardial-infarction
#9
Yader Sandoval, Stephen W Smith, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Anne Sexter, Karen Schulz, Nathaniel L Scott, Jennifer Nicholson, Fred S Apple
BACKGROUND: We examined the diagnostic performance of high-sensitivity cardiac troponin I (hs-cTnI) vs contemporary cTnI with use of the 99th percentile alone and with a normal electrocardiogram (ECG) to rule out acute myocardial infarction (MI) and serial changes (deltas) to rule in MI. METHODS: We included consecutive patients presenting to a US emergency department with serial cTnI on clinical indication (NCT02060760). Diagnostic performance for acute MI, including MI subtypes, and 30-day outcomes were examined...
July 12, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28700585/validation-of-the-sensitivity-of-the-national-emergency-x-radiography-utilization-study-nexus-head-computed-tomographic-ct-decision-instrument-for-selective-imaging-of-blunt-head-injury-patients-an-observational-study
#10
William R Mower, Malkeet Gupta, Robert Rodriguez, Gregory W Hendey
BACKGROUND: Clinicians, afraid of missing intracranial injuries, liberally obtain computed tomographic (CT) head imaging in blunt trauma patients. Prior work suggests that clinical criteria (National Emergency X-Radiography Utilization Study [NEXUS] Head CT decision instrument [DI]) can reliably identify patients with important injuries, while excluding injury, and the need for imaging in many patients. Validating this DI requires confirmation of the hypothesis that the lower 95% confidence limit for its sensitivity in detecting serious injury exceeds 99...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#11
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28696921/aspsirna-a-resource-of-asp-sirnas-having-therapeutic-potential-for-human-genetic-disorders-and-algorithm-for-prediction-of-their-inhibitory-efficacy
#12
Isha Monga, Abid Qureshi, Nishant Thakur, Amit Kumar Gupta, Manoj Kumar
Allele-specific siRNAs (ASP-siRNAs) have emerged as promising therapeutic molecules owing to their selectivity to inhibit the mutant allele or associated single nucleotide polymorphisms (SNPs) sparing the expression of the wild-type counterpart. Thus, a dedicated bioinformatics platform encompassing updated ASP-siRNAs and an algorithm for the prediction of their inhibitory efficacy will be helpful in tackling currently intractable genetic disorders. In the present study, we have developed the ASPsiRNA resource (http://crdd...
July 10, 2017: G3: Genes—Genomes—Genetics
https://www.readbyqxmd.com/read/28692107/whole-blood-ristocetin-activated-platelet-impedance-aggregometry-multiplate-for-the-rapid-detection-of-von-willebrand-disease
#13
David E Schmidt, Maria Bruzelius, Ammar Majeed, Jacob Odeberg, Margareta Holmström, Anna Ågren
Von Willebrand disease (VWD) is the most common bleeding disorder, but no bedside tests specific for Von Willebrand factor are available. The objective of this study was to evaluate the diagnostic accuracy of whole blood ristocetin-induced platelet aggregometry (WB-RIPA) in VWD. WB-RIPA was performed in VWD patients (n=100) and healthy controls (n=17) using the Multiplate® platelet impedance aggregometry platform. The diagnostic properties of the test were described as sensitivity/specificity, positive and negative predictive value, and ROC area under the curve (AUC)...
July 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28688113/assessing-clinical-probability-of-pulmonary-embolism-prospective-validation-of-the-simplified-geneva-score-in-outpatients
#14
H Robert-Ebadi, K Mostaguir, M M Hovens, M Kare, F Verschuren, P Girard, M V Huisman, F Moustafa, P W Kamphuisen, H R Buller, M Righini, G Le Gal
BACKGROUND: Pretest probability assessment by a clinical prediction rule (CPR) is an important step in the management of patients with suspected pulmonary embolism (PE). A limitation to the use of CPR is that their constitutive variables and corresponding number of points are difficult to memorize. A simplified version of the Geneva score (i.e. attributing one point to each variable) has been proposed but never been prospectively validated. AIMS: Prospective validation of the simplified Geneva score (SGS) and comparison with the previous version of the Geneva score (GS)...
July 8, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28685251/corrected-coronary-opacification-decrease-from-coronary-computed-tomography-angiography-validation-with-quantitative-13n-ammonia-positron-emission-tomography
#15
Dominik C Benz, Christoph Gräni, Paola Ferro, Luis Neumeier, Michael Messerli, Mathias Possner, Olivier F Clerc, Catherine Gebhard, Oliver Gaemperli, Aju P Pazhenkottil, Philipp A Kaufmann, Ronny R Buechel
BACKGROUND: To assess the functional relevance of a coronary artery stenosis, corrected coronary opacification (CCO) decrease derived from coronary computed tomography angiography (CCTA) has been proposed. The present study aims at validating CCO decrease with quantitative 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI). METHODS AND RESULTS: This retrospective study consists of 39 patients who underwent hybrid CCTA/PET-MPI. From CCTA, attenuation in the coronary lumen was measured before and after a stenosis and corrected to the aorta to calculate CCO and its decrease...
July 6, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28683900/derivation-and-validation-of-a-novel-prediction-model-to-identify-low-risk-patients-with-acute-pulmonary-embolism
#16
Muthiah Subramanian, Sowmya Gopalan, Srinivasan Ramadurai, Preetam Arthur, Mukund A Prabhu, Rajesh Thachathodiyl, Kumaraswamy Natarajan
Accurate identification of low-risk patients with acute pulmonary embolism (PE) who may be eligible for outpatient treatment or early discharge can have substantial cost-saving benefit. The purpose of this study was to derive and validate a prediction model to effectively identify patients with PE at low risk of short-term mortality, right ventricular dysfunction, and other nonfatal outcomes. This study analyzed data from 400 consecutive patients with acute PE. We derived and internally validated our prediction rule based on clinically significant variables that are routinely available at initial examination and that were categorized and weighted using coefficients in the multivariate logistic regression...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28679639/predicting-risk-of-serious-bacterial-infections-in-febrile-children-in-the-emergency-department
#17
Adam D Irwin, Alison Grant, Rhian Williams, Ruwanthi Kolamunnage-Dona, Richard J Drew, Stephane Paulus, Graham Jeffers, Kim Williams, Rachel Breen, Jennifer Preston, Duncan Appelbe, Christine Chesters, Paul Newland, Omnia Marzouk, Paul S McNamara, Peter J Diggle, Enitan D Carrol
BACKGROUND: Improving the diagnosis of serious bacterial infections (SBIs) in the children's emergency department is a clinical priority. Early recognition reduces morbidity and mortality, and supporting clinicians in ruling out SBIs may limit unnecessary admissions and antibiotic use. METHODS: A prospective, diagnostic accuracy study of clinical and biomarker variables in the diagnosis of SBIs (pneumonia or other SBI) in febrile children <16 years old. A diagnostic model was derived by using multinomial logistic regression and internally validated...
July 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28673674/is-ct-angiography-of-the-pulmonary-arteries-indicated-in-patients-with-high-clinical-probability-of-pulmonary-embolism
#18
L Martínez Montesinos, J M Plasencia Martínez, J M García Santos
When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography...
June 30, 2017: Radiología
https://www.readbyqxmd.com/read/28667205/prospective-observational-study-in-two-dutch-hospitals-to-assess-the-performance-of-inflammatory-plasma-markers-to-determine-disease-severity-of-viral-respiratory-tract-infections-in-children
#19
Inge M L Ahout, Kim H Brand, Aldert Zomer, Wilhelma H van den Hurk, Geurt Schilders, Marianne L Brouwer, Chris Neeleman, Ronald de Groot, Gerben Ferwerda
INTRODUCTION: Respiratory viruses causing lower respiratory tract infections (LRTIs) are a major cause of hospital admissions in children. Since the course of these infections is unpredictable with potential fast deterioration into respiratory failure, infants are easily admitted to the hospital for observation. The aim of this study was to examine whether systemic inflammatory markers can be used to predict severity of disease in children with respiratory viral infections. METHODS: Blood and nasopharyngeal washings from children <3 years of age with viral LRTI attending a hospital were collected within 24 hours (acute) and after 4-6 weeks (recovery)...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28662835/ct-angiography-to-evaluate-coronary-artery-disease-and-revascularization-requirement-before-trans-catheter-aortic-valve-replacement
#20
Alexia Rossi, Carlo N De Cecco, Simon R O Kennon, Lu Zou, Felix G Meinel, William Toscano, Sabrina Segreto, Stephan Achenbach, Jörg Hausleiter, U Joseph Schoepf, Francesca Pugliese
BACKGROUND: Coronary artery disease (CAD) and aortic stenosis share pathophysiological mechanisms and risk factors. We evaluated the clinical utility of coronary computed tomography angiography (CTA) to identify CAD and revascularization requirement in patients with severe aortic stenosis considered for transcatheter aortic valve replacement (TAVR). METHODS: Consecutive patients without known CAD underwent calcium scoring, CTA and invasive coronary angiography (ICA)...
June 22, 2017: Journal of Cardiovascular Computed Tomography
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