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Clinical prediction rule

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https://www.readbyqxmd.com/read/28647160/a-clinical-decision-rule-to-predict-zygomatico-maxillary-fractures
#1
Simon Haworth, Anthony Bates, Andrea Beech, Greg Knepil
Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation...
May 25, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28646941/postwash-total-motile-sperm-count-should-it-be-included-as-a-standard-male-infertility-work-up
#2
Khaled Madbouly, Ahmed Isa, Mohamad Habous, Raed Almannie, Basim Abu-Rafea, Saleh Binsaleh
INTRODUCTION: Pregnancy rates after intrauterine insemination (IUI) varies greatly. We aimed to identify pre and post processing semen analysis parameters that may be predictive of successful pregnancy in couples undergoing IUI. MATERIALS AND METHODS: A retrospective study of the records of all couples underwent IUI for a 2 year period at our infertility center. Different characteristics of female subjects, pre and post processing semen parameters and treatment parameters were compared statistically...
June 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28643793/genomic-rearrangements-in-sporadic-lymphangioleiomyomatosis-an-evolving-genetic-story
#3
Stephen J Murphy, Simone B Terra, Faye R Harris, Aqsa Nasir, Jesse S Voss, James B Smadbeck, Sarah H Johnson, Vishnu Serla, Jay H Ryu, Eunhee S Yi, Benjamin R Kipp, George Vasmatzis, Eva M Carmona
Sporadic lymphangioleiomyomatosis is a progressive pulmonary cystic disease resulting from the infiltration of smooth muscle-like lymphangioleiomyomatosis cells into the lung. The migratory/metastasizing properties of the lymphangioleiomyomatosis cell together with the presence of somatic mutations, primarily in the tuberous sclerosis complex gene (TSC2), lead many to consider this a low-grade malignancy. As malignant tumors characteristically accumulate somatic structural variations, which have not been well studied in sporadic lymphangioleiomyomatosis, we utilized mate pair sequencing to define structural variations within laser capture microdissected enriched lymphangioleiomyomatosis cell populations from five sporadic lymphangioleiomyomatosis patients...
June 23, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28643031/pediatric-emergency-care-applied-research-network-pecarn-prediction-rules-in-identifying-high-risk-children-with-mild-traumatic-brain-injury
#4
B Nakhjavan-Shahraki, M Yousefifard, M J Hajighanbari, A Oraii, S Safari, M Hosseini
PURPOSE: Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prognostic rules is a scoring system for prediction of the need for computed tomography (CT) scanning in children with mild TBI. However, its validation has not been assessed in developing countries. Therefore, the present study was designed to assess the value of PECARN rule in identification of children with clinically important TBI (ciTBI). METHOD: In this prospective cross-sectional study, 594 children (mean age: 7...
June 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28641750/predicting-outcomes-in-congenital-diaphragmatic-hernia
#5
Oluwatomilayo Daodu, Mary E Brindle
Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are evidence-based tools that combine multiple predictors to estimate the probability that a particular outcome in an individual patient will occur. In CDH, a suitable clinical prediction rule can stratify high- and low-risk populations and provide the ability to tailor management strategies based on severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28637595/a-one-year-mortality-clinical-prediction-rule-for-patients-with-heart-failure
#6
Antonio Escobar, Lidia García-Pérez, Gemma Navarro, Amaia Bilbao, Raul Quiros
AIMS: To create and validate a clinical prediction rule which is easy to manage, reproducible and that allows classifying patients admitted for heart failure according to their one-year mortality risk. METHODS: A prospective cohort study carried out with 2565 consecutive patients admitted with heart failure in 13 hospitals in Spain. The derivation cohort was made up of 1283 patients and 1282 formed the validation cohort. In the derivation cohort, we carried out a multivariate logistic model to predict one-year mortality...
June 18, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28635149/underuse-of-risk-assessment-and-overuse-of-ctpa-in-patients-with-suspected-pulmonary-thromboembolism
#7
Michael Perera, Leena Aggarwal, Ian A Scott, Nicholas Cocks
INTRODUCTION: Evidence suggests potential overuse of computerised tomography pulmonary angiography (CTPA) in patients with suspected pulmonary thromboembolism (PTE) in the absence of consistent use of pre-test clinical prediction rules and D-dimer assays. METHODS: 344 consecutive patients undergoing CTPA at a tertiary hospital were studied for use of D-dimer assays and clinical prediction rules for PTE. For each patient, a modified Wells score (mWS), revised Geneva score (rGS) and PISA model were calculated retrospectively; performance characteristics for each rule for PTE were determined in reference to results of CTPA...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28631830/overactive-bladder-symptoms-after-midurethral-sling-surgery-in-women-risk-factors-and-management
#8
Tom Marcelissen, Philip Van Kerrebroeck
INTRODUCTION: Overactive bladder syndrome (OAB) including urgency and urgency urinary incontinence (UUI) occurs frequently after stress urinary incontinence (SUI) surgery. It is important to identify the risk factors for the occurrence of OAB symptoms in order to adequately inform the patient before surgery. Furthermore, when facing OAB after sling surgery it is crucial to know how to manage these symptoms. METHODS: We conducted a literature review in order to assess the risk factors and management of OAB symptoms after SUI surgery...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#9
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28611898/utility-of-the-history-and-physical-examination-in-the-detection-of-acute-coronary-syndromes-in-emergency-department-patients
#10
REVIEW
Zachary Dw Dezman, Amal Mattu, Richard Body
Chest pain accounts for approximately 6% of all emergency department (ED) visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS). This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611849/nonparametric-subgroup-identification-by-prim-and-cart-a-simulation-and-application-study
#11
Armin Ott, Alexander Hapfelmeier
Two nonparametric methods for the identification of subgroups with outstanding outcome values are described and compared to each other in a simulation study and an application to clinical data. The Patient Rule Induction Method (PRIM) searches for box-shaped areas in the given data which exceed a minimal size and average outcome. This is achieved via a combination of iterative peeling and pasting steps, where small fractions of the data are removed or added to the current box. As an alternative, Classification and Regression Trees (CART) prediction models perform sequential binary splits of the data to produce subsets which can be interpreted as subgroups of heterogeneous outcome...
2017: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/28611156/clinical-prediction-rule-for-delayed-hemothorax-after-minor-thoracic-injury-a-multicentre-derivation-and-validation-study
#12
Marcel Émond, Chantal Guimont, Jean-Marc Chauny, Raoul Daoust, Éric Bergeron, Laurent Vanier, Lynne Moore, Miville Plourde, Batomen Kuimi, Valérie Boucher, Nadine Allain-Boulé, Natalie Le Sage
BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury)...
June 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28610567/mlpa-identification-of-dystrophin-mutations-and-in-silico-evaluation-of-the-predicted-protein-in-dystrophinopathy-cases-from-india
#13
Sekar Deepha, Seena Vengalil, Veeramani Preethish-Kumar, Kiran Polavarapu, Atchayaram Nalini, Narayanappa Gayathri, Meera Purushottam
BACKGROUND: Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are X-linked recessive disorders caused by mutations in the DMD gene. The aim of this study was to predict the effect of gene mutations on the dystrophin protein and study its impact on clinical phenotype. METHODS: In this study, 415 clinically diagnosed patients were tested for mutations by Multiplex ligation dependent probe amplification (MLPA). Muscle biopsy was performed in 34 patients with negative MLPA...
June 13, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28609435/predicting-infectious-complications-in-children-with-cancer-an-external-validation-study
#14
Gabrielle M Haeusler, Karin A Thursky, Francoise Mechinaud, Franz E Babl, Richard De Abreu Lourenco, Monica A Slavin, Robert Phillips
BACKGROUND: The aim of this study was to validate the 'Predicting Infectious ComplicatioNs in Children with Cancer' (PICNICC) clinical decision rule (CDR) that predicts microbiologically documented infection (MDI) in children with cancer and fever and neutropenia (FN). We also investigated costs associated with current FN management strategies in Australia. METHODS: Demographic, episode, outcome and cost data were retrospectively collected on 650 episodes of FN...
June 13, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28602070/a-prognostic-evaluation-and-management-of-alcoholic-hepatitis
#15
Ramesh Rana, Sheng-Lan Wang, Jing Li, Lu Xia, Mei-Yi Song, Chang-Qing Yang
Alcoholic hepatitis is an acute and severe form of alcoholic liver disease associated with high morbidity and mortality of 30-50% worldwide, severity ranging from asymptomatic derangement of liver biochemistries to fulminant liver failure or death. Rapidly progressing jaundice and coagulopathy in prolonged excessive alcohol abusers with or without fever, malnutrition, and tender liver are the clinical hallmarks. The prognostic models (MELD, MDF, ABIC, GAHS, Lille's score) not only predict the short term mortality, but also guide the clinicians to choose appropriate specific therapy (corticosteroid or pentoxifylline) and as a stopping rule if there is no significant benefits of it...
June 9, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28601817/the-organisational-value-of-diagnostic-strategies-using-high-sensitivity-troponin-for-patients-with-possible-acute-coronary-syndromes-a-trial-based-cost-effectiveness-analysis
#16
Paul Jülicher, Jaimi H Greenslade, William A Parsonage, Louise Cullen
OBJECTIVES: To evaluate hospital-specific health economic implications of different protocols using high-sensitivity troponin I for the assessment of patients with chest pain. DESIGN: A cost prediction model and an economic microsimulation were developed using a cohort from a single centre recruited as part of the (ADAPT) trial, a prospective observational trial conducted from 2008 to 2011. The model was populated with 40 000 bootstrapped samples in five high-sensitivity troponin I-enabled algorithms versus standard care...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28593800/use-of-copeptin-for-rapid-rule-out-of-acute-myocardial-infarction
#17
Christian Mueller, Martin Möckel, Evangelos Giannitsis, Kurt Huber, Johannes Mair, Mario Plebani, Kristian Thygesen, Allan S Jaffe, Bertil Lindahl
Copeptin is currently understood as a quantitative marker of endogenous stress. It rises rapidly in multiple acute disorders including acute myocardial infarction. As a single variable, it has only modest diagnostic accuracy for acute myocardial infarction. However, the use of copeptin within a dual-marker strategy together with conventional cardiac troponin increases the diagnostic accuracy and particularly the negative predictive value of cardiac troponin alone for acute myocardial infarction. The rapid rule-out of acute myocardial infarction is the only application in acute cardiac care mature enough to merit consideration for routine clinical care...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28591223/why-do-authors-derive-new-cardiovascular-clinical-prediction-rules-in-the-presence-of-existing-rules-a-mixed-methods-study
#18
Jong-Wook Ban, Emma Wallace, Richard Stevens, Rafael Perera
BACKGROUND: Researchers should examine existing evidence to determine the need for a new study. It is unknown whether developers evaluate existing evidence to justify new cardiovascular clinical prediction rules (CPRs). OBJECTIVE: We aimed to assess whether authors of cardiovascular CPRs cited existing CPRs, why some authors did not cite existing CPRs, and why they thought existing CPRs were insufficient. METHOD: Derivation studies of cardiovascular CPRs from the International Register of Clinical Prediction Rules for Primary Care were evaluated...
2017: PloS One
https://www.readbyqxmd.com/read/28589638/inter-observer-reliability-in-reading-amplitude-integrated-electroencephalogram-in-the-newborn-intensive-care-unit
#19
Bhavesh Mehta, Nadine Griffiths, Kaye Spence, Sharon Laing
AIM: Amplitude-integrated electroencephalogram (aEEG) is widely used in neonates to detect electrical seizure and predict outcome following hypoxic ischaemic encephalopathy and other encephalopathy. Because accurate interpretation is important for clinical decision-making and family counselling, inter-observer reliability is a major concern. We aimed to evaluate inter-observer reliability in the interpretation of aEEG tracings in a neonatal intensive care unit. METHODS: Three neonatal intensive care unit clinicians with different levels of experience in reading aEEG independently reviewed and scored aEEG traces using standardised criteria, categories and interpretation rules...
June 7, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28587665/hospitalization-for-community-acquired-febrile-urinary-tract-infection-validation-and-impact-assessment-of-a-clinical-prediction-rule
#20
Janneke E Stalenhoef, Willize E van der Starre, Albert M Vollaard, Ewout W Steyerberg, Nathalie M Delfos, Eliane M S Leyten, Ted Koster, Hans C Ablij, Jan W Van't Wout, Jaap T van Dissel, Cees van Nieuwkoop
BACKGROUND: There is a lack of severity assessment tools to identify adults presenting with febrile urinary tract infection (FUTI) at risk for complicated outcome and guide admission policy. We aimed to validate the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE), a modified form of the pneumonia severity index, and to subsequentially assess its use in clinical practice. METHODS: A prospective observational multicenter study for model validation (2004-2009), followed by a multicenter controlled clinical trial with stepped wedge cluster-randomization for impact assessment (2010-2014), with a follow up of 3 months...
June 6, 2017: BMC Infectious Diseases
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