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Clinical decision and prediction rules

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https://www.readbyqxmd.com/read/29775736/surgical-consent-practice-in-the-uk-following-the-montgomery-ruling-a-national-cross-sectional-questionnaire-study
#1
Chris McKinnon, Dafydd Loughran, Roísín Finn, Madeline Coxwell-Matthewman, Deva Sanjeeva Jeyaretna, Adam P Williams
BACKGROUND: The Supreme Court case of Montgomery vs Lanarkshire Health Board in 2015 was a landmark case for consent practice in the UK which shifted focus from a traditional paternalistic model of consent towards a more patient-centered approach. Widely recognised as the most significant legal judgment on informed consent in the last 30 years, the case was predicted to have a major impact on the everyday practice of surgeons working in the UK National Health Service (NHS). Two years after the legal definition of informed consent was redefined, we carried out an audit of surgical consent practice across the UK to establish the impact of the Montgomery ruling on clinical practice...
May 15, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29745479/predictors-of-one-and-two-year-mortality-in-patients-with-rectal-cancer
#2
José M Quintana, Nerea González, Santiago Lázaro, Marisa Baré, Nerea Fernandez de Larrea, Maximino Redondo, Eduardo Briones, Antonio Escobar, Cristina Sarasqueta, Susana García-Gutierrez, Ane Antón-Ladislao
AIM: Tools are needed to aid in the assessment of prognosis of patients with rectal cancer regarding the risk of medium-term mortality. The aim of this study was to develop and validate clinical prediction rules for 1- and 2-year mortality in patients undergoing surgery for rectal cancer. METHOD: A prospective cohort study of patients diagnosed with rectal cancer who underwent surgery was carried out. The main outcomes were mortality at 1 and 2 years after surgery...
May 10, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29724248/predicting-unfavorable-long-term-outcome-in-juvenile-idiopathic-arthritis-results-from-the-nordic-cohort-study
#3
Veronika Rypdal, Ellen Dalen Arnstad, Kristiina Aalto, Lillemor Berntson, Maria Ekelund, Anders Fasth, Mia Glerup, Troels Herlin, Susan Nielsen, Suvi Peltoniemi, Marek Zak, Marite Rygg, Martin Rypdal, Ellen Nordal
BACKGROUND: The aim was to develop prediction rules that may guide early treatment decisions based on baseline clinical predictors of long-term unfavorable outcome in juvenile idiopathic arthritis (JIA). METHODS: In the Nordic JIA cohort, we assessed baseline disease characteristics as predictors of the following outcomes 8 years after disease onset. Non-achievement of remission off medication according to the preliminary Wallace criteria, functional disability assessed by Childhood Health Assessment Questionnaire (CHAQ) and Physical Summary Score (PhS) of the Child Health Questionnaire, and articular damage assessed by the Juvenile Arthritis Damage Index-Articular (JADI-A)...
May 3, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29718426/geno2pheno-ngs-freq-a-genotypic-interpretation-system-for-identifying-viral-drug-resistance-using-next-generation-sequencing-data
#4
Matthias Döring, Joachim Büch, Georg Friedrich, Alejandro Pironti, Prabhav Kalaghatgi, Elena Knops, Eva Heger, Martin Obermeier, Martin Däumer, Alexander Thielen, Rolf Kaiser, Thomas Lengauer, Nico Pfeifer
Identifying resistance to antiretroviral drugs is crucial for ensuring the successful treatment of patients infected with viruses such as human immunodeficiency virus (HIV) or hepatitis C virus (HCV). In contrast to Sanger sequencing, next-generation sequencing (NGS) can detect resistance mutations in minority populations. Thus, genotypic resistance testing based on NGS data can offer novel, treatment-relevant insights. Since existing web services for analyzing resistance in NGS samples are subject to long processing times and follow strictly rules-based approaches, we developed geno2pheno[ngs-freq], a web service for rapidly identifying drug resistance in HIV-1 and HCV samples...
May 1, 2018: Nucleic Acids Research
https://www.readbyqxmd.com/read/29709643/development-of-a-tool-predicting-severity-of-allergic-reaction-during-peanut-challenge
#5
R Sharon Chinthrajah, Natasha Purington, Sandra Andorf, Jaime S Rosa, Kaori Mukai, Robert Hamilton, Bridget Marie Smith, Ruchi Gupta, Stephen J Galli, Manisha Desai, Kari C Nadeau
BACKGROUND: Reliable prognostic markers for predicting severity of allergic reactions during oral food challenges (OFC) have not been established. OBJECTIVE: We sought to develop a predictive algorithm of a food challenge severity score (CSS) to identify those at higher risk for severe reactions to a standardized peanut OFC. METHODS: Medical history and allergy tests were obtained for 120 peanut-allergic participants who underwent double-blind, placebo-controlled food challenges (DBPCFCs)...
April 27, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29678058/building-a-knowledge-based-tool-for-auto-assessing-the-cardiovascular-risk
#6
Adrien Ugon, Amel Imene Hadj Bouzid, Marie-Christine Jaulent, Madeleine Favre, Catherine Duclos, Emmanuel Jobez, Hector Falcoff, Jean-Baptiste Lamy, Rosy Tsopra
The prevention of cardiovascular diseases needs first to quantify the cardiovascular risk. To estimate this risk, French national health authorities provided clinical practice guidelines extending the existing European SCORE, which doesn't include all the cardiovascular risk factors (e.g. diabetes). Hence, French national clinical practice guidelines to quantify the cardiovascular risk is able to deal with more clinical situations than the SCORE. The goal of this paper is to formalize knowledge extracted from these guidelines and implement the rules so that they can be used into an auto-assessing tool of cardiovascular risk...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29673601/decision-support-system-for-triage-management-a-hybrid-approach-using-rule-based-reasoning-and-fuzzy-logic
#7
Mahsa Dehghani Soufi, Taha Samad-Soltani, Samad Shams Vahdati, Peyman Rezaei-Hachesu
OBJECTIVES: Fast and accurate patient triage for the response process is a critical first step in emergency situations. This process is often performed using a paper-based mode, which intensifies workload and difficulty, wastes time, and is at risk of human errors. This study aims to design and evaluate a decision support system (DSS) to determine the triage level. METHODS: A combination of the Rule-Based Reasoning (RBR) and Fuzzy Logic Classifier (FLC) approaches were used to predict the triage level of patients according to the triage specialist's opinions and Emergency Severity Index (ESI) guidelines...
June 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29625873/-lower-uterine-segment-trial-a-pragmatic-open-multicenter-randomized-trial
#8
P Rozenberg, P Deruelle, M-V Sénat, R Desbrière, N Winer, E Simon, Y Ville, G Kayem, I Boutron
BACKGROUND: The data from literature show that trial of labor and elective repeat cesarean delivery after a prior cesarean delivery both present significant risks and benefits, and these risks and benefits differ for the woman and her fetus. The benefits to the woman can be at the expense of her fetus and vice-versa. This uncertainty is compounded by the scarcity of high-level evidence that preclude accurate quantification of the risks and benefits that could help provide a fair counseling about a trial of labor and elective repeat cesarean delivery...
April 4, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29622594/clinical-prediction-rules-for-abusive-head-trauma-a-systematic-review
#9
Helena Pfeiffer, Louise Crowe, Alison Mary Kemp, Laura Elizabeth Cowley, Anne S Smith, Franz E Babl
OBJECTIVE: Misdiagnosis of abusive head trauma (AHT) has serious consequences for children and families. This systematic review identifies and compares clinical prediction rules (CPredRs) assisting clinicians in assessing suspected AHT. DESIGN: We searched MEDLINE, Embase, PubMed and Cochrane databases (January 1996 to August 2016). Externally validated CPredRs focusing on the detection of AHT in the clinical setting were included. RESULTS: Of 110 potential articles identified, three studies met the inclusion criteria: the Pediatric Brain Injury Research Network (PediBIRN) 4-Variable AHT CPredR, the Predicting Abusive Head Trauma (PredAHT) tool and the Pittsburgh Infant Brain Injury Score (PIBIS)...
April 5, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29599113/vomiting-with-head-trauma-and-risk-of-traumatic-brain-injury
#10
Meredith L Borland, Stuart R Dalziel, Natalie Phillips, Sarah Dalton, Mark D Lyttle, Silvia Bressan, Ed Oakley, Stephen J C Hearps, Amit Kochar, Jeremy Furyk, John A Cheek, Jocelyn Neutze, Franz E Babl
OBJECTIVES: To determine the prevalence of traumatic brain injuries in children who vomit after head injury and identify variables from published clinical decision rules (CDRs) that predict increased risk. METHODS: Secondary analysis of the Australasian Paediatric Head Injury Rule Study. Vomiting characteristics were assessed and correlated with CDR predictors and the presence of clinically important traumatic brain injury (ciTBI) or traumatic brain injury on computed tomography (TBI-CT)...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29570254/diagnostic-accuracy-of-multiparametric-magnetic-resonance-imaging-in-detecting-extracapsular-extension-in-intermediate-and-high-risk-prostate-cancer
#11
Cristina Dominguez, Mauricio Plata, Juan Guillermo Cataño, Mauricio Palau, Diego Aguirre, Jorge Narvaez, Stephanie Trujillo, Felipe Gómez, Carlos Gustavo Trujillo, Juan Ignacio Caicedo, Camilo Medina
OBJECTIVES: To evaluate the diagnostic performance of preoperative multiparametric magnetic resonance imaging (mp-MRI) as a predictor of extracapsular extension (ECE) and unfavorable Gleason score (GS) in patients with intermediate and high-risk prostate cancer (PCa). MATERIALS AND METHODS: Patients with clinically localized PCa who underwent radical prostatectomy (RP) and had preoperative mp-MRI between May-2011 and December-2013. Mp-MRI was evaluated according to the European Society of Urogenital Radiology MRI prostate guidelines by two different readers...
March 23, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29567970/data-based-decision-rules-to-personalize-depression-follow-up
#12
Ying Lin, Shuai Huang, Gregory E Simon, Shan Liu
Depression is a common mental illness with complex and heterogeneous progression dynamics. Risk grouping of depression treatment population based on their longitudinal patterns has the potential to enable cost-effective monitoring policy design. This paper establishes a rule-based method to identify a set of risk predictive patterns from person-level longitudinal disease measurements by integrating the data transformation, rule discovery and rule evaluation. We further extend the identified rules to create rule-based monitoring strategies to adaptively monitor individuals with different disease severities...
March 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29567071/predictive-test-for-chemotherapy-response-in-resectable-gastric-cancer-a-multi-cohort-retrospective-analysis
#13
Jae-Ho Cheong, Han-Kwang Yang, Hyunki Kim, Woo Ho Kim, Young-Woo Kim, Myeong-Cherl Kook, Young-Kyu Park, Hyung-Ho Kim, Hye Seung Lee, Kyung Hee Lee, Mi Jin Gu, Ha Yan Kim, Jinae Lee, Seung Ho Choi, Soonwon Hong, Jong Won Kim, Yoon Young Choi, Woo Jin Hyung, Eunji Jang, Hyeseon Kim, Yong-Min Huh, Sung Hoon Noh
BACKGROUND: Adjuvant chemotherapy after surgery improves survival of patients with stage II-III, resectable gastric cancer. However, the overall survival benefit observed after adjuvant chemotherapy is moderate, suggesting that not all patients with resectable gastric cancer treated with adjuvant chemotherapy benefit from it. We aimed to develop and validate a predictive test for adjuvant chemotherapy response in patients with resectable, stage II-III gastric cancer. METHODS: In this multi-cohort, retrospective study, we developed through a multi-step strategy a predictive test consisting of two rule-based classifier algorithms with predictive value for adjuvant chemotherapy response and prognosis...
May 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29563837/combining-statistical-techniques-to-predict-postsurgical-risk-of-1-year-mortality-for-patients-with-colon-cancer
#14
Inmaculada Arostegui, Nerea Gonzalez, Nerea Fernández-de-Larrea, Santiago Lázaro-Aramburu, Marisa Baré, Maximino Redondo, Cristina Sarasqueta, Susana Garcia-Gutierrez, José M Quintana
Introduction: Colorectal cancer is one of the most frequently diagnosed malignancies and a common cause of cancer-related mortality. The aim of this study was to develop and validate a clinical predictive model for 1-year mortality among patients with colon cancer who survive for at least 30 days after surgery. Methods: Patients diagnosed with colon cancer who had surgery for the first time and who survived 30 days after the surgery were selected prospectively. The outcome was mortality within 1 year...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29529395/spectrum-effect-and-spectrum-bias-in-the-oscillometric-ankle-brachial-index-to-diagnose-peripheral-arterial-disease-clinical-implications
#15
Ángel Herráiz-Adillo, Iván Cavero-Redondo, Celia Álvarez-Bueno, Johana Bidner, Vicente Martínez-Vizcaíno, Blanca Notario-Pacheco
BACKGROUND AND AIMS: The diagnostic performance of the oscillometric ankle brachial index (ABI) to detect peripheral arterial disease (PAD) varies among populations, suggesting a spectrum effect. When this heterogeneity modifies post-test probabilities, a spectrum bias arises. This study evaluates the presence and influence of spectrum effect and spectrum bias on test performance and clinical decisions. METHODS: Oscillometric and Doppler ABI were compared in two settings: Primary-Care (333 legs) and Vascular-Service (41 legs)...
May 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29471111/mortality-prediction-in-intensive-care-units-icus-using-a-deep-rule-based-fuzzy-classifier
#16
Raheleh Davoodi, Mohammad Hassan Moradi
Electronic health records (EHRs) contain critical information useful for clinical studies. Early assessment of patients' mortality in intensive care units is of great importance. In this paper, a Deep Rule-Based Fuzzy System (DRBFS) was proposed to develop an accurate in-hospital mortality prediction in the intensive care unit (ICU) patients employing a large number of input variables. Our main contribution is proposing a system, which is capable of dealing with big data with heterogeneous mixed categorical and numeric attributes...
March 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29455373/diagnostic-value-of-ultrasonography-for-the-detection-of-disc-displacements-in-the-temporomandibular-joint-a-systematic-review-and-meta-analysis
#17
Naichuan Su, Arjen J van Wijk, Corine M Visscher, Frank Lobbezoo, Geert J M G van der Heijden
OBJECTIVES: The aim was to assess the added diagnostic value of ultrasonography (US) for establishing the presence or absence of disc displacements (DDs) in temporomandibular joints (TMJs). MATERIALS AND METHODS: Pubmed and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of US for the diagnosis of DD, using Magnetic resonance imaging (MRI) as the reference standard. Meta-analyses were performed with Metadisc 1...
February 17, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29452747/accuracy-of-clinician-practice-compared-with-three-head-injury-decision-rules-in-children-a-prospective-cohort-study
#18
Franz E Babl, Ed Oakley, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Charlotte Molesworth, Louise Crowe, Silvia Bressan, Mark D Lyttle
STUDY OBJECTIVE: Three clinical decision rules for head injuries in children (Pediatric Emergency Care Applied Research Network [PECARN], Canadian Assessment of Tomography for Childhood Head Injury [CATCH], and Children's Head Injury Algorithm for the Prediction of Important Clinical Events [CHALICE]) have been shown to have high performance accuracy. The utility of any of these in a particular setting depends on preexisting clinician accuracy. We therefore assess the accuracy of clinician practice in detecting clinically important traumatic brain injury...
February 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29446860/development-of-a-clinical-prediction-rule-for-tuberculous-meningitis-in-adults-in-lima-peru
#19
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: Diagnosis of tuberculous meningitis (TM) is a challenge in countries with a high burden of the disease and constrained resources and clinical prediction rules (CPRs) could be of assistance. We aimed at developing a CPR for diagnosis of TM in a Latin American setting with high tuberculosis incidence and a concentrated HIV epidemic. METHODS: We enrolled adult patients with clinical suspicion of TM attending two hospitals in Lima, Peru. We obtained information on potential anamnestic, clinical and laboratory predictive findings that are easy to collect and promptly available...
April 2018: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29444553/evaluation-of-biomarkers-for-treatment-selection-using-individual-participant-data-from-multiple-clinical-trials
#20
Chaeryon Kang, Holly Janes, Parvin Tajik, Henk Groen, Ben Mol, Corine Koopmans, Kim Broekhuijsen, Eva Zwertbroek, Maria van Pampus, Maureen Franssen
Biomarkers that predict treatment effects may be used to guide treatment decisions, thus improving patient outcomes. A meta-analysis of individual participant data (IPD) is potentially more powerful than a single-study data analysis in evaluating markers for treatment selection. Our study was motivated by the IPD that were collected from 2 randomized controlled trials of hypertension and preeclampsia among pregnant women to evaluate the effect of labor induction over expectant management of the pregnancy in preventing progression to severe maternal disease...
April 30, 2018: Statistics in Medicine
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