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Clinical decision rules

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https://www.readbyqxmd.com/read/29331631/the-edinburgh-ct-and-genetic-diagnostic-criteria-for-lobar-intracerebral-haemorrhage-associated-with-cerebral-amyloid-angiopathy-model-development-and-diagnostic-test-accuracy-study
#1
Mark A Rodrigues, Neshika Samarasekera, Christine Lerpiniere, Catherine Humphreys, Mark O McCarron, Philip M White, James A R Nicoll, Cathie L M Sudlow, Charlotte Cordonnier, Joanna M Wardlaw, Colin Smith, Rustam Al-Shahi Salman
BACKGROUND: Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a prediction model for the identification of CAA-associated lobar intracerebral haemorrhage using CT features and genotype. METHODS: We identified adults with first-ever intracerebral haemorrhage diagnosed by CT, who died and underwent research autopsy as part of the Lothian IntraCerebral Haemorrhage, Pathology, Imaging and Neurological Outcome (LINCHPIN) study, a prospective, population-based, inception cohort...
January 10, 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#2
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330738/a-video-review-of-multiple-concussion-signs-in-national-rugby-league-match-play
#3
Andrew J Gardner, David R Howell, Grant L Iverson
BACKGROUND: Video review has been introduced in many professional sports worldwide to help recognize concussions. However, to date, there has been very little research on the accuracy of using video analysis to identify signs of concussion and the various combinations of observed signs. METHODS: The objective of the study is to determine the accuracy of combinations of clinical signs of concussion identified using video analysis to identify concussions in the National Rugby League (NRL)...
January 12, 2018: Sports Medicine—Open
https://www.readbyqxmd.com/read/29324935/right-putamen-and-age-are-the-most-discriminant-features-to-diagnose-parkinson-s-disease-by-using-123i-fp-cit-brain-spet-data-by-using-an-artificial-neural-network-classifier-a-classification-tree-clt
#4
S Cascianelli, C Tranfaglia, M L Fravolini, F Bianconi, M Minestrini, S Nuvoli, N Tambasco, M E Dottorini, B Palumbo
OBJECTIVE: The differential diagnosis of Parkinson's disease (PD) and other conditions, such as essential tremor and drug-induced parkinsonian syndrome or normal aging brain, represents a diagnostic challenge. 123I-FP-CIT brain SPET is able to contribute to the differential diagnosis. Semiquantitative analysis of radiopharmaceutical uptake in basal ganglia (caudate nuclei and putamina) is very useful to support the diagnostic process. An artificial neural network classifier using 123I-FP-CIT brain SPET data, a classification tree (CIT), was applied...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29324173/the-risk-of-deterioration-in-gcs13-15-patients-with-traumatic-brain-injury-identified-by-computed-tomography-imaging-a-systematic-review-and-meta-analysis
#5
Carl Marincowitz, Fiona E Lecky, William Townend, Aditya Borakati, Andrea Fabbri, Trevor A Sheldon
The optimal management of mild traumatic brain injury (TBI) patients with injuries identified by computed tomography (CT) brain scan is unclear. Some guidelines recommend hospital admission for an observation period of at least 24 h. Others argue that selected lower-risk patients can be discharged from the Emergency Department (ED). The objective of our review and meta-analysis was to estimate the risk of death, neurosurgical intervention, and clinical deterioration in mild TBI patients with injuries identified by CT brain scan, and assess which patient factors affect the risk of these outcomes...
January 11, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29322599/non-invasive-evaluation-of-portal-hypertension-using-shear-wave-elastography-analysis-of-two-algorithms-combining-liver-and-spleen-stiffness-in-191-patients-with-cirrhosis
#6
L Elkrief, M Ronot, F Andrade, M Dioguardi Burgio, T Issoufaly, M Zappa, O Roux, J Bissonnette, A Payancé, D Lebrec, C Francoz, O Soubrane, D Valla, F Durand, V Vilgrain, L Castera, P-E Rautou
BACKGROUND: Two algorithms based on sequential measurements of liver and spleen stiffness using two-dimensional shearwave elastography (2D-SWE) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] ≥10 mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy. AIM: To validate externally these algorithms in a large cohort of patients with cirrhosis. METHODS: One hundred and ninety-one patients with stable cirrhosis (Child-Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D-SWE at the time of HVPG measurement were included...
January 11, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29310641/health-services-research-in-patients-with-breast-cancer-camiss-prospective-study-protocol-for-an-observational-prospective-study
#7
Susana García-Gutierrez, Miren Orive, Cristina Sarasqueta, Maria Jose Legarreta, Nerea Gonzalez, Maximino Redondo, Amado Rivero, Pedro Serrano-Aguilar, Xavier Castells, Jose Maria Quintana, Maria Sala
BACKGROUND: Though breast cancer remains a major health problem, there is a lack of information on health care provided to patients with this disease and associated costs. In addition, there is a need to update and validate risk stratification tools in Spain. Our purpose is to evaluate the health services provided for breast cancer in Spain, from screening and diagnosis to treatment and prognosis. METHODS: Prospective cohort study involving 13 hospitals in Spain with a follow-up period of up to 5 years after diagnostic biopsy...
January 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29300866/diagnostic-utility-of-molecular-and-imaging-biomarkers-in-cytological-indeterminate-thyroid-nodules
#8
Elizabeth J de Koster, Lioe-Fee de Geus-Oei, Olaf M Dekkers, Ilse van Engen-van Grunsven, Jaap Hamming, Eleonora P M Corssmit, Hans Morreau, Abbey Schepers, Jan Smit, Wim J G Oyen, Dennis Vriens
Indeterminate thyroid cytology (Bethesda III and IV) corresponds to follicular-patterned benign and malignant lesions, which are particularly difficult to differentiate on cytology alone. As approximately 25% of these nodules harbor malignancy, diagnostic hemithyroidectomy is still custom. However, advanced preoperative diagnostics are rapidly evolving.This review provides an overview of additional molecular and imaging diagnostics for indeterminate thyroid nodules in a pre-operative clinical setting, including considerations regarding cost-effectiveness, availability, and feasibility of combining techniques...
January 2, 2018: Endocrine Reviews
https://www.readbyqxmd.com/read/29287669/a-multidisciplinary-approach-to-oncology-trials-study-conduct-of-the-anthalya-trial
#9
Youssef Ghazi, Christine Laurent, Julien Dupin, David Pau, Sabine Balouet, Yara Rocha, Florence Joly, Roman Rouzier, Violette Menguy
Clinical trials that combine medical therapy and surgical treatment pose a number of challenges. The ANTHALYA trial investigated the efficacy and safety of adding bevacizumab to neoadjuvant carboplatin-paclitaxel chemotherapy prior to interval debulking surgery (IDS) in patients with ovarian cancer. The success of the trial depended on the efficacy and the safety of the combination and on the surgical effort. Furthermore, at the time of study design, neoadjuvant bevacizumab had not been investigated in ovarian cancer patients and it was unknown if neoadjuvant angiogenic therapy would be well tolerated or would negatively impact the success of IDS...
December 26, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29286314/integration-of-distributed-services-and-hybrid-models-based-on-process-choreography-to-predict-and-detect-type-2-diabetes
#10
Antonio Martinez-Millana, Jose-Luis Bayo-Monton, María Argente-Pla, Carlos Fernandez-Llatas, Juan Francisco Merino-Torres, Vicente Traver-Salcedo
Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease...
December 29, 2017: Sensors
https://www.readbyqxmd.com/read/29283310/mixture-based-gatekeeping-procedures-in-adaptive-clinical-trials
#11
George Kordzakhia, Alex Dmitrienko, Eiji Ishida
Clinical trials with data-driven decision rules often pursue multiple clinical objectives such as the evaluation of several endpoints or several doses of an experimental treatment. These complex analysis strategies give rise to "multivariate" multiplicity problems with several components or sources of multiplicity. A general framework for defining gatekeeping procedures in clinical trials with adaptive multistage designs is proposed in this paper. The mixture method is applied to build a gatekeeping procedure at each stage and inferences at each decision point (interim or final analysis) are performed using the combination function approach...
December 28, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/29249206/early-health-technology-assessment-of-future-clinical-decision-rule-aided-triage-of-patients-presenting-with-acute-chest-pain-in-primary-care
#12
Robert T A Willemsen, Michelle M A Kip, Hendrik Koffijberg, Ron Kusters, Frank Buntinx, Jan F C Glatz, Geert Jan Dinant
The objective of the paper is to estimate the number of patients presenting with chest pain suspected of acute coronary syndrome (ACS) in primary care and to calculate possible cost effects of a future clinical decision rule (CDR) incorporating a point-of-care test (PoCT) as compared with current practice. The annual incidence of chest pain, referrals and ACS in primary care was estimated based on a literature review and on a Dutch and Belgian registration study. A health economic model was developed to calculate the potential impact of a future CDR on costs and effects (ie, correct referral decisions), in several scenarios with varying correct referral decisions...
December 18, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29243880/review-article-best-practice-management-of-common-knee-injuries-in-the-emergency-department-part-3-of-the-musculoskeletal-injuries-rapid-review-series
#13
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Knee injuries are a common presentation to the ED and are often difficult to assess and definitively diagnose due to the patient's acute pain, effusion and guarding. The quality of ED care provided to patients with fractures or soft tissue injuries of the knee is critical to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common knee injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites...
December 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29238270/treatment-of-latent-tuberculosis-infection
#14
REVIEW
Patrick Tang, James Johnston
The treatment of latent tuberculosis infection (LTBI) is an essential component of tuberculosis (TB) elimination in regions that have a low incidence of TB. However, the decision to treat individuals with LTBI must consider the limitations of current diagnostic tests for LTBI, the risk of developing active TB disease, the potential adverse effects from chemoprophylactic therapy, and the importance of treatment adherence. When an individual has been diagnosed with LTBI and active TB has been ruled out, this is followed by an evaluation of the risks and benefits of LTBI treatment within the context of the regional epidemiology of TB and public health priorities...
2017: Current Treatment Options in Infectious Diseases
https://www.readbyqxmd.com/read/29231553/-the-method-and-application-to-construct-experience-recommendation-platform-of-acupuncture-ancient-books-based-on-data-mining-technology
#15
Chuyun Chen, Jiaming Hong, Weilin Zhou, Guohua Lin, Zhengfei Wang, Qufei Zhang, Cuina Lu, Lihong Lu
OBJECTIVE: To construct a knowledge platform of acupuncture ancient books based on data mining technology, and to provide retrieval service for users. METHODS: The Oracle 10 g database was applied and JAVA was selected as development language; based on the standard library and ancient books database established by manual entry, a variety of data mining technologies, including word segmentation, speech tagging, dependency analysis, rule extraction, similarity calculation, ambiguity analysis, supervised classification technology were applied to achieve text automatic extraction of ancient books; in the last, through association mining and decision analysis, the comprehensive and intelligent analysis of disease and symptom, meridians, acupoints, rules of acupuncture and moxibustion in acupuncture ancient books were realized, and retrieval service was provided for users through structure of browser/server (B/S)...
July 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29231056/the-application-of-control-charts-in-regulated-bioanalysis-for-monitoring-long-term-reproducibility
#16
Michel van Bruijnsvoort, John Meijer, Cas van den Beld
In regulated bioanalysis, the acceptance of results is batch-wise. When during clinical development derived pharmacokinetic or pharmacodynamic results from different studies will be combined or compared, it is recommendable to monitor the long-term reproducibility of bioanalytical assays. Long-term reproducibility can be evaluated by control charts generated from control samples included in each batch. We present a methodology for the implementation, construction and evaluation of control charts next to the regular batch acceptance of bioanalytical results...
December 2017: Bioanalysis
https://www.readbyqxmd.com/read/29229178/cervical-spine-clearance-in-adults-following-blunt-trauma-a-national-survey-across-major-trauma-centres-in-england
#17
G Chilvers, K Porter, S Choudhary
AIM: To assess current practice in cervical spine clearance across major trauma centres in England and review current guidelines. MATERIALS AND METHODS: An electronic survey was sent to lead trauma clinicians at 22 major trauma centres in England. This assessed the clinical decision tools used, the choice of initial imaging technique, and the methods used to clear the cervical spine in alert and obtunded patients without focal neurology, and where initial imaging was normal...
December 8, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/29227168/assessment-of-communication-abilities-in-multilingual-children-language-rights-or-human-rights
#18
Madalena Cruz-Ferreira
Communication involves a sender, a receiver and a shared code operating through shared rules. Breach of communication results from disruption to any of these basic components of a communicative chain, although assessment of communication abilities typically focuses on senders/receivers, on two assumptions: first, that their command of features and rules of the language in question (the code), such as sounds, words or word order, as described in linguists' theorisations, represents the full scope of linguistic competence; and second, that languages are stable, homogeneous entities, unaffected by their users' communicative needs...
December 11, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29223137/sysmex-uf-1000i-flow-cytometer-to-screen-urinary-tract-infections-the-uriscam-multicentre-study
#19
O Herráez, M A Asencio, R Carranza, M M Jarabo, M Huertas, O Redondo, A Arias, S Jiménez-Álvarez, S Solís, P Zamarrón, M S Illescas, M A Galán
The new Sysmex UF-1000i analyzer - which incorporates bacteria morphology distinction - allows to automatically screen samples to be cultured at microbiology laboratories. We have evaluated the feasibility and accuracy of Sysmex UF-1000i to screen urine tract infections (UTIs). A total amount of 2,468 urine samples from six Spanish hospitals were analysed. Demographic and clinical data such as age, gender, source and sample type, preserving conditions, cytometer parameters (bacteria, leucocytes, and bacteria morphology) as well as urine culture results (gold standard) were recorded...
December 9, 2017: Letters in Applied Microbiology
https://www.readbyqxmd.com/read/29218901/using-simulation-and-optimization-approach-to-improve-outcome-through-warfarin-precision-treatment
#20
Chih-Lin Chi, Lu He, Kourosh Ravvaz, John Weissert, Peter J Tonellato
We apply a treatment simulation and optimization approach to develop decision support guidance for warfarin precision treatment plans. Simulation include the use of ∼1,500,000 clinical avatars (simulated patients) generated by an integrated data-driven and domain-knowledge based Bayesian Network Modeling approach. Subsequently, we simulate 30-day individual patient response to warfarin treatment of five clinical and genetic treatment plans followed by both individual and subpopulation based optimization. Sub-population optimization (compared to individual optimization) provides a cost effective and realistic means of implementation of a precision-driven treatment plan in practical settings...
2018: Pacific Symposium on Biocomputing
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