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https://www.readbyqxmd.com/read/29156504/clinical-risk-reclassification-at-10%C3%A2-years
#1
Nancy R Cook, Olga V Demler, Nina P Paynter
Three papers in this issue focus on the role of calibration in model fit statistics, including the net reclassification improvement (NRI) and integrated discrimination improvement (IDI). This commentary reviews the development of such reclassification statistics along with more recent advances in our understanding of these measures. We show how the two-category NRI and the IDI are affected by changes in the event rate in theory and in an applied example. We also describe the role of calibration and how it may be assessed...
December 10, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29156498/first-things-first-risk-model-performance-metrics-should-reflect-the-clinical-application
#2
Kathleen F Kerr, Holly Janes
Developing new measures of risk model performance is an active line of research, often motivated by the conventional wisdom that area under the ROC curve is an 'insensitive' measure of the additional predictive capacity offered by new biomarkers. Without endorsing area under the ROC curve, we argue that this charge is not substantiated. Three articles in this issue discuss alternative metrics of risk model performance: NRI(p) (two-category net reclassification index at the event rate), integrated discrimination index, and R-squared statistics...
December 10, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29142010/value-of-progression-of-coronary-artery-calcification-for-risk-prediction-of-coronary-and-cardiovascular-events-result-of-the-heinz-nixdorf-recall-hnr-study
#3
Nils Lehmann, Raimund A Erbel, Amir A Mahabadi, Michael Rauwolf, Stefan Möhlenkamp, Susanne Moebus, Hagen Kälsch, Thomas Budde, Axel Schmermund, Andreas Stang, Dagmar Führer-Sakel, Christian Weimar, Ulla Roggenbuck, Nico Dragano, Karl-Heinz Jöckel
Background -Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular (CV) events. Methods -In 3281 participants (45-74 years), free from CV disease until the 2(nd) visit, risk factors and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events as well as total CV events including revascularization were recorded during a follow-up time of 7...
November 15, 2017: Circulation
https://www.readbyqxmd.com/read/29130984/lymphocyte-cell-ratios-and-mortality-among-incident-hemodialysis-patients
#4
Christina Catabay, Yoshitsugu Obi, Elani Streja, Melissa Soohoo, Christina Park, Connie M Rhee, Csaba P Kovesdy, Takayuki Hamano, Kamyar Kalantar-Zadeh
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been previously suggested as oncologic prognostication markers. These are associated with malnutrition and inflammation, and hence, may provide benefit in predicting mortality among hemodialysis patients. METHODS: Among 108,548 incident hemodialysis patients in a large U.S. dialysis organization (2007-2011), we compared the mortality predictability of NLR and PLR with baseline and time-varying covariate Cox models using the receiver operating characteristic curve (AUROC), net reclassification index (NRI), and adjusted R2...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29129262/biochemical-risk-markers-and-10-year-incidence-of-atherosclerotic-cardiovascular-disease-independent-predictors-improvement-in-pooled-cohort-equation-and-risk-reclassification
#5
Emmanuel Akintoye, Alexandros Briasoulis, Luis Afonso
BACKGROUND: The recommendation for statins in primary atherosclerotic cardiovascular disease (ASCVD) prevention begins with risk estimation using the pooled cohort equation (PCE). However, treatment decisions may still remain uncertain after PCE-based assessment. We therefore developed a simple biomarker score that could supplement decision making. METHODS: Using the prospectively collected database of the Multi-Ethnic Study of Atherosclerosis, we identified biochemical risk markers that independently predicted 10-year risk of ASCVD and developed an aggregate biomarker score based on them...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29122806/diagnostic-utility-of-appetite-loss-in-addition-to-existing-prediction-models-for-community-acquired-pneumonia-in-the-elderly-a-prospective-diagnostic-study-in-acute-care-hospitals-in-japan
#6
Toshihiko Takada, Yosuke Yamamoto, Kazuhiko Terada, Mitsuyasu Ohta, Wakako Mikami, Hajime Yokota, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shingo Fukuma, Shunichi Fukuhara
OBJECTIVE: Diagnosis of community-acquired pneumonia (CAP) in the elderly is often delayed because of atypical presentation and non-specific symptoms, such as appetite loss, falls and disturbance in consciousness. The aim of this study was to investigate the external validity of existing prediction models and the added value of the non-specific symptoms for the diagnosis of CAP in elderly patients. DESIGN: Prospective cohort study. SETTING: General medicine departments of three teaching hospitals in Japan...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29121716/risk-prediction-in-post-infarction-patients-with-moderately-reduced-left-ventricular-ejection-fraction-by-combined-assessment-of-the-sympathetic-and-vagal-cardiac-autonomic-nervous-system
#7
W Hamm, L Stülpnagel, N Vdovin, G Schmidt, K D Rizas, A Bauer
AIM: Most deaths after myocardial infarction (MI) occur in patients with normal or moderately reduced left ventricular ejection fraction (LVEF >35%). Periodic repolarization dynamics (PRD) and deceleration capacity (DC) are novel ECG-based markers related to sympathetic and vagal cardiac autonomic nervous system activity. Here, we test the combination of PRD and DC to predict risk in post-infarction patients with LVEF >35%. METHODS AND RESULTS: We included 823 survivors of acute MI with LVEF >35%, aged ≤80years and in sinus rhythm...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29100503/prognostic-and-diagnostic-significance-of-copeptin-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-acute-heart-failure-data-from-the-ace-2-study
#8
Jacob A Winther, Jon Brynildsen, Arne Didrik Høiseth, Heidi Strand, Ivar Følling, Geir Christensen, Ståle Nygård, Helge Røsjø, Torbjørn Omland
BACKGROUND: Copeptin is a novel biomarker that predicts mortality in lower respiratory tract infections and heart failure (HF), but the diagnostic value of copeptin in acute dyspnea and the prognostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not clear. METHOD: We determined copeptin and NT-proBNP concentrations at hospital admission in 314 patients with acute dyspnea who were categorized by diagnosis. Survival was registered after a median follow-up of 816 days, and the prognostic and diagnostic properties of copeptin and NT-proBNP were analyzed in acute HF (n = 143) and AECOPD (n = 84) separately...
November 3, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29097003/skin-autofluorescence-improves-the-finnish-diabetes-risk-score-in-the-detection-of-diabetes-in-a-large-population-based-cohort-the-lifelines-cohort-study
#9
B T Fokkens, R P van Waateringe, D J Mulder, B H R Wolffenbuttel, A J Smit
AIM: The aim of the present study was to investigate whether skin autofluorescence would improve the Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes in a large population-based cohort. METHODS: Included were participants from the Dutch LifeLines Cohort Study. Skin autofluorescence was assessed in an unselected subset of participants using the AGE Reader. After the exclusion of participants with previously diagnosed diabetes (n=1635), pregnant women (n=58) and those using corticosteroids (n=345), 79,248 subjects were eligible for analysis...
October 30, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29067485/the-role-of-previous-falls-in-major-osteoporotic-fracture-prediction-in-conjunction-with-frax-in-older-chinese-men-and-women-the-mr-os-and-ms-os-cohort-study-in-hong-kong
#10
Y Su, J Leung, T Kwok
Falls are a major concern in terms of fracture risk. Although awareness rising for the absence of falls in the FRAX algorithm, our study only identified the independent predictive role of previous recurrent falls and their better conjunction use with FRAX for major osteoporotic fracture prediction in older Chinese men. INTRODUCTION: Although the association of falls with fracture has been widely explored, the impact of previous falls is not included in the FRAX algorithm currently. Our aim was to examine the FRAX-independent associations between falls in the previous year and subsequent fracture risk, as well as the conjunctive use of falls and the FRAX score for major osteoporotic fracture (MOF) prediction in older Chinese people...
October 24, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29064104/antimicrobial-susceptibility-of-flavobacterium-psychrophilum-isolates-from-the-united-kingdom
#11
T P H Ngo, P Smith, K L Bartie, T D Kim, D W Verner-Jeffreys, R Hoare, A Adams
Routine application of antimicrobials is the current treatment of choice for rainbow trout fry syndrome (RTFS) or bacterial coldwater disease (BCWD) caused by Flavobacterium psychrophilum. In this study, the antimicrobial susceptibilities of 133 F. psychrophilum isolates, 118 of which were from the UK, were evaluated by broth microdilution and disc diffusion methods following VET04-A2 and VET03-A guidelines of Clinical and Laboratory Standards Institute (CLSI), respectively. Isolates were categorized as wild type (fully susceptible, WT) or non-wild type (NWT) using normalized resistance interpretation (NRI)-determined cut-off values (COWT )...
October 24, 2017: Journal of Fish Diseases
https://www.readbyqxmd.com/read/29059296/carotid-plaque-thickness-and-carotid-plaque-burden-predict-future-cardiovascular-events-in-asymptomatic-adult-americans
#12
Henrik Sillesen, Samantha Sartori, Benjamin Sandholt, Usman Baber, Roxana Mehran, Valentin Fuster
Introduction: Prediction of cardiovascular events improves using imaging, i.e. coronary calcium score and ultrasound assessment of carotid plaque. This study analysed the predictive value of two ultrasound measures of carotid plaque size: carotid plaque thickness and carotid and intima-media thickness (IMT). Methods and results: A total of 6102 asymptomatic persons underwent assessment of conventional risk factors and imaging by carotid ultrasound. Carotid plaque burden (cPB) and maximum carotid plaque thickness (cPTmax) were measured from 'cross-sectional sweep' video acquisition of the carotid artery...
October 20, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29049301/plant-dna-barcodes-and-assessment-of-phylogenetic-community-structure-of-a-tropical-mixed-dipterocarp-forest-in-brunei-darussalam-borneo
#13
Jacqueline Heckenhauer, Kamariah Abu Salim, Mark W Chase, Kyle G Dexter, R Toby Pennington, Sylvester Tan, Maria Ellen Kaye, Rosabelle Samuel
DNA barcoding is a fast and reliable tool to assess and monitor biodiversity and, via community phylogenetics, to investigate ecological and evolutionary processes that may be responsible for the community structure of forests. In this study, DNA barcodes for the two widely used plastid coding regions rbcL and matK are used to contribute to identification of morphologically undetermined individuals, as well as to investigate phylogenetic structure of tree communities in 70 subplots (10 × 10m) of a 25-ha forest-dynamics plot in Brunei (Borneo, Southeast Asia)...
2017: PloS One
https://www.readbyqxmd.com/read/29045312/validation-of-the-nonlaboratory-based-framingham-cardiovascular-disease-risk-assessment-algorithm-in-the-atherosclerosis-risk-in-communities-dataset
#14
Jacob K Kariuki, Eileen M Stuart-Shor, Suzanne G Leveille, Philimon Gona, Jerry Cromwell, Laura L Hayman
BACKGROUND: Nonlaboratory-based (non-LB) algorithms have been developed to facilitate absolute cardiovascular risk assessment in resource-constrained settings. The non-LB Framingham algorithm, which substitute BMI for lipids in laboratory-based Framingham, exhibits best performance among non-LB algorithms. However, its external validity has not been evaluated. AIM: To examine the validity of non-LB Framingham algorithm in Atherosclerosis Risk in Communities dataset, and contrast performance with the laboratory-based Framingham algorithm...
December 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29036450/crosstalk-between-nitric-oxide-and-mpk1-2-mediates-cold-acclimation-induced-chilling-tolerance-in-tomato
#15
Xiangzhang Lv, Shibei Ge, Golam Jalal Ahammed, Xun Xiang, Zhixin Guo, Jingquan Yu, Yanhong Zhou
The participation of nitric oxide (NO) in the responses of plants towards biotic and abiotic stresses is well established. However, the mechanism involved particularly in cold acclimation-induced chilling tolerance remains elusive. Here we show the cold acclimation induced-chilling tolerance was associated with inductions of nitrate reductase (NR)-dependent NO production, S-nitrosylated glutathione reductase (GSNOR) activity and mitogen-activated protein kinases MPK1/2 activation in tomato plants. Silencing of NR resulted in decreased GSNOR activity and MPK1/2 activation, which subsequently compromised cold acclimation-induced chilling tolerance...
November 1, 2017: Plant & Cell Physiology
https://www.readbyqxmd.com/read/29031213/impairment-of-heart-rhythm-complexity-in-patients-with-drug-resistant-epilepsy-an-assessment-with-multiscale-entropy-analysis
#16
Hongyun Liu, Zhao Yang, Fangang Meng, Yuguang Guan, Yanshan Ma, Shuli Liang, Jiuluan Lin, Longsheng Pan, Mingming Zhao, Wei Qu, Hongwei Hao, Guoming Luan, Jianguo Zhang, Luming Li
OBJECTIVE: Epilepsy and seizures can have dramatic effects on the cardiac function. The aim of this study was to investigate the heart rhythm complexity in patients with drug-resistant epilepsy (DRE). METHODS: Ambulatory 24-h electrocardiograms (ECG) from 70 DRE patients and 50 healthy control subjects were analyzed using conventional heart rate variability (HRV) and multiscale entropy (MSE) methods The variation of complexity indices (CI), which was calculated from MSE profile, was determined...
October 5, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29026969/extended-serum-lipid-profile-predicting-long-term-survival-in-patients-treated-for-abdominal-aortic-aneurysms
#17
Niina Khan, Leo-Pekka Lyytikäinen, Jahangir Khan, Ilkka Seppälä, Antti Lehtomäki, Tommi Kuorilehto, Velipekka Suominen, Terho Lehtimäki, Niku Oksala
BACKGROUND: Individuals treated for abdominal aortic aneurysms (AAAs) are high-risk patients in whom better risk prediction could improve survival. Contemporary serum lipid parameters, such as apolipoproteins and lipoprotein subfractions, may improve or complement the prognostic value of traditional serum lipids. The aim of this study was to ascertain the extended serum lipid profiles, long-term prognosis and their association in AAA patients. METHODS: Altogether 498 patients treated for AAAs and with available serum lipid values were retrospectively analysed...
October 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29024864/association-between-serum-uric-acid-level-and-renal-arteriolar-hyalinization-in-individuals-without-chronic-kidney-disease
#18
Yuta Matsukuma, Kosuke Masutani, Shigeru Tanaka, Akihiro Tsuchimoto, Naoki Haruyama, Yasuhiro Okabe, Masafumi Nakamura, Kazuhiko Tsuruya, Takanari Kitazono
BACKGROUND AND AIMS: Recent studies have reported an association between serum uric acid (SUA) and renal arteriolar changes in patients with chronic kidney disease (CKD). However, the association in individuals without CKD remains unclear. In this study, we investigated the relationship between SUA and renal arteriolar lesions in individuals without CKD from our living kidney donor cohort. METHODS: Between January 2006 and May 2016, 393 living kidney donors underwent "time-zero" biopsy at Kyushu University Hospital...
November 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29020384/fibrosis-as-measured-by-the-biomarker-tissue-inhibitor-metalloproteinase-1-predicts-mortality-in-age-gene-environment-susceptibility-reykjavik-ages-reykjavik-study
#19
Gina LaRocca, Thor Aspelund, Anders M Greve, Gudny Eiriksdottir, Tushar Acharya, Gudmundur Thorgeirsson, Tamara B Harris, Lenore J Launer, Vilmundur Gudnason, Andrew E Arai
Background: Fibrosis is a key pathological process in many chronic inflammatory disease states. Aims: We hypothesized that tissue inhibitor metalloproteinase-1 and matrix metalloproteinase-9 (TIMP-1 and MMP-9), biomarkers of fibrosis, would predict all-cause mortality and we assessed the incremental value of these biomarkers when adjusting for clinical and other biomarkers. Methods: The cohort included 5511 community-dwelling participants in the AGES-Reykjavik Study...
August 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28977114/adalimumab-for-ulcerative-colitis-results-of-a-brazilian-multicenter-observational-study
#20
Patrícia Zacharias, Aderson Omar Mourão Cintra Damião, Antonio Carlos Moraes, Fábio Vieira Teixeira, Juliano Coelho Ludvig, Rodrigo Bremer Nones, Rogerio Saad-Hossne, Ligia Yukie Sassaki, Rosemary Pereira Lino da Silva, Luiza Facchin, Marcia Olandoski, Paulo Gustavo Kotze
BACKGROUND: Adalimumab is a monoclonal antibody, tumor necrosis factor-alpha (TNFα) inhibitor that has efficacy for inducing and maintaining remission in moderate-to-severe ulcerative colitis. Real world studies with adalimumab in Latin American ulcerative colitis patients are scarce. OBJECTIVE: To assess the clinical remission rates in induction and maintenance with adalimumab therapy in ulcerative colitis. METHODS: Observational, multicenter and retrospective study on a case series of patients with moderate-to-severe ulcerative colitis under adalimumab therapy...
October 2, 2017: Arquivos de Gastroenterologia
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