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Clinical decision rules

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https://www.readbyqxmd.com/read/28081211/development-and-validation-of-a-clinical-prediction-rule-for-bacteremia-among-maintenance-hemodialysis-patients-in-outpatient-settings
#1
Sho Sasaki, Takeshi Hasegawa, Hiroo Kawarazaki, Atsushi Nomura, Daisuke Uchida, Takahiro Imaizumi, Masahide Furusho, Hiroki Nishiwaki, Shingo Fukuma, Yugo Shibagaki, Shunichi Fukuhara
BACKGROUND: To our knowledge, no reliable clinical prediction rule (CPR) for identifying bacteremia in hemodialysis (HD) patients has been established. The aim of this study was to develop a CPR for bacteremia in maintenance HD patients visiting the outpatient department. METHODS: This multicenter cohort study involved consecutive maintenance HD patients who visited the outpatient clinic or emergency room of seven Japanese institutions between August 2011 and July 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28056911/prospective-cohort-study-of-procalcitonin-levels-in-children-with-cancer-presenting-with-febrile-neutropenia
#2
Victoria Hemming, Adam D Jakes, Geoff Shenton, Bob Phillips
BACKGROUND: Febrile neutropenia (FNP) causes significant morbidity and mortality in children undergoing treatment for cancer. The development of clinical decision rules to help stratify risks in paediatric FNP patients and the use of inflammatory biomarkers to identify high risk patients is an area of recent research. This study aimed to assess if procalcitonin (PCT) levels could be used to help diagnose or exclude severe infection in children with cancer who present with febrile neutropenia, both as a single measurement and in addition to previously developed clinical decision rules...
January 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28050952/zika-virus-and-assisted-reproductive-technology-to-test-or-not-to-test-that-is-the-question-is-it-an-unnecessary-cost-the-first-two-months-of-mandatory-testing-in-an-outbreak-area-in-rio-de-janeiro-brazil
#3
Maria do Carmo B de Souza, Veronica Raupp, Fernanda Sobrinho, Mariana Menezes, Tatiana R Panaino, Maria A Tamm, Ana C A Mancebo, Ana L R Costa, Roberto A Antunes
OBJECTIVE: Infection by the Zika virus is a Public Health Emergency of International Concern as defined by the World Health Organization. Resolution no. 72, issued by the Collegiate Board of the Brazilian Health Surveillance Agency (ANVISA) on March 30, 2016, made ZKV testing mandatory prior to procedures involving germ cells and tissues. This paper aims to discuss the aforementioned Resolution from the standpoint of evidence and cost-effectiveness of the measures taken within the first two months of mandatory testing...
December 1, 2016: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/28050714/characterization-of-change-and-significance-for-clinical-findings-in-radiology-reports-through-natural-language-processing
#4
Saeed Hassanpour, Graham Bay, Curtis P Langlotz
We built a natural language processing (NLP) method to automatically extract clinical findings in radiology reports and characterize their level of change and significance according to a radiology-specific information model. We utilized a combination of machine learning and rule-based approaches for this purpose. Our method is unique in capturing different features and levels of abstractions at surface, entity, and discourse levels in text analysis. This combination has enabled us to recognize the underlying semantics of radiology report narratives for this task...
January 3, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28049389/external-validation-of-two-classification-and-regression-tree-models-to-predict-the-outcome-of-inpatient-cardiopulmonary-resuscitation
#5
Ryan W R Guilbault, Marcus Andreas Ohlsson, Anna M Afonso, Mark H Ebell
OBJECTIVE: To prospectively validate a previously developed classification and regression tree (CART) model that predicts the likelihood of a good outcome among patients undergoing inpatient cardiopulmonary resuscitation. DESIGN: Prospective validation of a clinical decision rule. SETTING: Skåne University Hospital in Malmo, Sweden. PATIENTS: All adult patients (N = 287) experiencing in-hospital cardiopulmonary arrest and undergoing cardiopulmonary resuscitation between 2007 and 2010...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28045960/modelling-predictors-of-molecular-response-to-frontline-imatinib-for-patients-with-chronic-myeloid-leukaemia
#6
Haneen Banjar, Damith Ranasinghe, Fred Brown, David Adelson, Trent Kroger, Tamara Leclercq, Deborah White, Timothy Hughes, Naeem Chaudhri
BACKGROUND: Treatment of patients with chronic myeloid leukaemia (CML) has become increasingly difficult in recent years due to the variety of treatment options available and challenge deciding on the most appropriate treatment strategy for an individual patient. To facilitate the treatment strategy decision, disease assessment should involve molecular response to initial treatment for an individual patient. Patients predicted not to achieve major molecular response (MMR) at 24 months to frontline imatinib may be better treated with alternative frontline therapies, such as nilotinib or dasatinib...
2017: PloS One
https://www.readbyqxmd.com/read/28028823/point-estimation-and-p-values-in-phase-ii-adaptive-two-stage-designs-with-a-binary-endpoint
#7
K Kunzmann, M Kieser
Clinical trials in phase II of drug development are frequently conducted as single-arm two-stage studies with a binary endpoint. Recently, adaptive designs have been proposed for this setting that enable a midcourse modification of the sample size. While these designs are elaborated with respect to hypothesis testing by assuring control of the type I error rate, the topic of point estimation has up to now not been addressed. For adaptive designs with a prespecified sample size recalculation rule, we propose a new point estimator that both assures compatibility of estimation and test decision and minimizes average mean squared error...
December 27, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/28027674/ethical-decision-making-regarding-infant-viability
#8
Janet Kelly, Emma Welch
BACKGROUND: There are no universally agreed rules of healthcare ethics. Ethical decisions and standards tend to be linked to professional codes of practice when dealing with complex issues. OBJECTIVES: This paper aims to explore the ethical complexities on who should decide to give infants born on the borderline of viability lifesaving treatment, parents or the healthcare professionals. METHOD: The paper is a discussion using the principles of ethics, professional codes of practice from the UK, Nursing Midwifery Council and UK legal case law and statute...
January 1, 2016: Nursing Ethics
https://www.readbyqxmd.com/read/28009621/a-meta-review-of-the-safety-of-electroconvulsive-therapy-in-pregnancy
#9
Preeti Sinha, Parth Goyal, Chittaranjan Andrade
BACKGROUND: Four systematic reviews have examined the safety of electroconvulsive therapy (ECT) in pregnancy. These have varied widely in methods, findings, and conclusions. METHODS: We compared these reviews with regard to search strategy, study selection criteria, total number of studies identified, total number of patients included, findings related to safety and adverse events, and interpretation of results. RESULTS: The number of studies (number of cases) included in the reviews ranged from 16 (n = 300) to 67 (n = 169) with only one review stating reasons for exclusion of nonselected studies...
December 21, 2016: Journal of ECT
https://www.readbyqxmd.com/read/28002683/a-prediction-model-to-help-with-the-assessment-of-adenopathy-in-lung-cancer-hal
#10
Oisin J O'Connell, Francisco A Almeida, Michael J Simoff, Lonny Yarmus, Ray Lazarus, Benjamin Young, Yu Chen, Roy Semaan, Timothy M Saettele, Joseph Cicenia, Harmeet Bedi, Corrine Kliment, Liang Li, Sonali Sethi, Javier Diaz-Mendoza, David Feller-Kopman, Juhee Song, Thomas Gildea, Hans Lee, Horiana B Grosu, Michael Machuzak, Macarena Rodriguez-Vial, George A Eapen, Carlos A Jimenez, Roberto F Casal, David E Ost
RATIONALE: Estimating the probability of finding N2 or N3 (prN2/3) malignant nodal disease on EBUS-TBNA in patients with non-small cell lung cancer (NSCLC) can facilitate the selection of subsequent management strategies. OBJECTIVE: The goal of this study was to develop a clinical prediction model for estimating the prN2/3. METHODS: We used the AQuIRE registry to identify patients with NSCLC with clinical radiographic stage T1-3, N0-3, M0 disease that had EBUS-TBNA for staging...
December 21, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27999021/development-of-operationalized-intravenous-to-oral-antibiotic-switch-criteria
#11
H Akhloufi, M Hulscher, D C Melles, J M Prins, H van der Sijs, A Verbon
OBJECTIVES: Despite huge overlap in suggested criteria for a safe intravenous (iv)-to-oral antibiotic switch, there is considerable variation in their operationalization. The objective of this study was to develop a set of measurable conditions that should be met in adult hospitalized patients for a safe iv-to-oral switch. METHODS: A RAND-modified Delphi procedure was performed to develop a set of operationalized iv-to-oral switch criteria. Switch criteria and their accompanying suggested measurable conditions were extracted from the literature and appraised by a multidisciplinary expert panel during two questionnaire rounds with a face-to-face meeting between these two rounds...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27998283/a-genotypic-method-for-determining-hiv-2-coreceptor-usage-enables-epidemiological-studies-and-clinical-decision-support
#12
Matthias Döring, Pedro Borrego, Joachim Büch, Andreia Martins, Georg Friedrich, Ricardo Jorge Camacho, Josef Eberle, Rolf Kaiser, Thomas Lengauer, Nuno Taveira, Nico Pfeifer
BACKGROUND: CCR5-coreceptor antagonists can be used for treating HIV-2 infected individuals. Before initiating treatment with coreceptor antagonists, viral coreceptor usage should be determined to ensure that the virus can use only the CCR5 coreceptor (R5) and cannot evade the drug by using the CXCR4 coreceptor (X4-capable). However, until now, no online tool for the genotypic identification of HIV-2 coreceptor usage had been available. Furthermore, there is a lack of knowledge on the determinants of HIV-2 coreceptor usage...
December 20, 2016: Retrovirology
https://www.readbyqxmd.com/read/27995660/a-new-paradigm-for-clinical-communication-critical-review-of-literature-in-cancer-care
#13
REVIEW
Peter Salmon, Bridget Young
OBJECTIVES: To: (i) identify key assumptions of the scientific 'paradigm' that shapes clinical communication research and education in cancer care; (ii) show that, as general rules, these do not match patients' own priorities for communication; and (iii) suggest how the paradigm might change to reflect evidence better and thereby serve patients better. METHODS: A critical review, focusing on cancer care. We identified assumptions about patients' and clinicians' roles in recent position and policy statements...
December 20, 2016: Medical Education
https://www.readbyqxmd.com/read/27995140/rapid-retrieval-of-lung-nodule-ct-images-based-on-hashing-and-pruning-methods
#14
Ling Pan, Yan Qiang, Jie Yuan, Lidong Wu
The similarity-based retrieval of lung nodule computed tomography (CT) images is an important task in the computer-aided diagnosis of lung lesions. It can provide similar clinical cases for physicians and help them make reliable clinical diagnostic decisions. However, when handling large-scale lung images with a general-purpose computer, traditional image retrieval methods may not be efficient. In this paper, a new retrieval framework based on a hashing method for lung nodule CT images is proposed. This method can translate high-dimensional image features into a compact hash code, so the retrieval time and required memory space can be reduced greatly...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27995044/a-concise-drug-alerting-rule-set-for-chinese-hospitals-and-its-application-in-computerized-physician-order-entry-cpoe
#15
Yinsheng Zhang, Xin Long, Weihong Chen, Haomin Li, Huilong Duan, Qian Shang
BACKGROUND: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. OBJECTIVES: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. SETTING: A 2600-bed general hospital in China. METHODS: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27991651/oxygen-therapy-for-acute-myocardial-infarction
#16
REVIEW
Juan B Cabello, Amanda Burls, José I Emparanza, Susan E Bayliss, Tom Quinn
BACKGROUND: Oxygen (O2) is widely used in people with acute myocardial infarction (AMI). Previous systematic reviews concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on heart ischaemia or infarct size. Our first Cochrane review in 2010 also concluded there was insufficient evidence to know whether oxygen should be used. Since 2010, the lack of evidence to support this widely used intervention has attracted considerable attention, prompting further trials of oxygen therapy in myocardial infarction patients...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27990383/biologics-use-in-indian-psoriasis-patients
#17
Murlidhar Rajagopalan, Asit Mital
The biologics currently in use for psoriasis in India are etanercept, infliximab and recently introduced itolizumab and secukinumab. Biosimilars, expected to play a significant role in psoriasis management in future, have also been available for the last few years. Patients with psoriasis may be considered eligible to receive treatment with any of the licensed biologic interventions when they fulfill the eligibility criteria. The decision to proceed with treatment must be made in collaboration with the patient and include a careful assessment of the associated risks and benefits...
November 2016: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/27972881/cross-validation-of-a-7-item-clinical-decision-rule-for-detecting-panic-related-anxiety-in-emergency-medicine-patients
#18
S C Sung, A J Rush, A Earnest, L E Lim, S H Lim, Ong
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27966103/the-drift-diffusion-model-as-the-choice-rule-in-reinforcement-learning
#19
Mads Lund Pedersen, Michael J Frank, Guido Biele
Current reinforcement-learning models often assume simplified decision processes that do not fully reflect the dynamic complexities of choice processes. Conversely, sequential-sampling models of decision making account for both choice accuracy and response time, but assume that decisions are based on static decision values. To combine these two computational models of decision making and learning, we implemented reinforcement-learning models in which the drift diffusion model describes the choice process, thereby capturing both within- and across-trial dynamics...
December 13, 2016: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/27966005/eprescribing-reducing-costs-through-in-class-therapeutic-interchange
#20
Shane P Stenner, Rohini Chakravarthy, Kevin B Johnson, William L Miller, Julie Olson, Marleen Wickizer, Nate N Johnson, Rick Ohmer, David R Uskavitch, Gordon R Bernard, Erin B Neal, Christoph U Lehmann
INTRODUCTION: Spending on pharmaceuticals in the US reached $373.9 billion in 2014. Therapeutic interchange offers potential medication cost savings by replacing a prescribed drug for an equally efficacious therapeutic alternative. METHODS: Hard-stop therapeutic interchange recommendation alerts were developed for four medication classes (HMG-CoA reductase inhibitors, serotonin receptor agonists, intranasal steroid sprays, and proton-pump inhibitors) in an electronic prescription-writing tool for outpatient prescriptions...
December 14, 2016: Applied Clinical Informatics
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