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"Clinical prediction"

Meral M Patel, Curtis D Travers, Jana A Stockwell, Ezaldeen A Numur, Robert J Geller, Pradip P Kamat, Jocelyn R Grunwell
OBJECTIVE: To derive and validate clinical prediction models to identify children at low risk of clinically significant intoxications for whom intensive care admission is unnecessary. DESIGN: Retrospective review of data in the National Poison Data Systems from 2011 to 2014 and Georgia Poison Center cases from July to December 2016. SETTING: United States PICUs and poison centers participating in the American Association of Poison Control Centers from 2011 to 2016...
December 8, 2017: Pediatric Critical Care Medicine
Glen P Martin, Matthew Sperrin, Peter F Ludman, Mark A de Belder, Simon R Redwood, Jonathan N Townend, Mark Gunning, Neil E Moat, Adrian P Banning, Iain Buchan, Mamas A Mamas
OBJECTIVE: Existing clinical prediction models (CPM) for short-term mortality after transcatheter aortic valve implantation (TAVI) have limited applicability in the UK due to moderate predictive performance and inconsistent recording practices across registries. The aim of this study was to derive a UK-TAVI CPM to predict 30-day mortality risk for benchmarking purposes. METHODS: A two-step modelling strategy was undertaken: first, data from the UK-TAVI Registry between 2009 and 2014 were used to develop a multivariable logistic regression CPM using backwards stepwise regression...
December 7, 2017: Heart: Official Journal of the British Cardiac Society
Chanika Alahakoon, Tharaka Lagath Dassanayake, Indika Bandara Gawarammana, Vajira Senaka Weerasinghe
INTRODUCTION: Ingestion of organophosphorus insecticides (OPI) is a common method of deliberate self harm in the developing world. Deaths mainly follow as a result of the respiratory failure associated with both cholinergic crisis and the intermediate syndrome. Even though death can be prevented by early mechanical ventilation of these patients, limited studies are available regarding the prediction of intermediate syndrome and subsequent respiratory failure. OBJECTIVE: To systematically review articles that are published with regard to possible prediction of intermediate syndrome using clinical, biochemical and electrophysiological parameters...
December 4, 2017: Neurotoxicology
E Nguyen, J Caranfa, G H Lyman, N M Kuderer, C Stirbis, M Wysocki, C I Coleman, E R Weeda, C G Kohn
BACKGROUND: Cancer treatment is commonly complicated by pulmonary embolism (PE), which remains a leading cause of morbidity and mortality in these patients. Some guidelines recommend the use of clinical prediction rules (CPRs) to help clinicians identify patients at low-risk for mortality to guide care. OBJECTIVE: To determine and compare the accuracy of available CPRs for identifying cancer patients with PE at low-risk for mortality. METHODS: A literature search of Medline and Scopus (01/01/2000-08/01/2017) was performed...
December 7, 2017: Journal of Thrombosis and Haemostasis: JTH
Paul Blanche, Thomas A Gerds, Claus T Ekstrøm
A prediction model is calibrated if, roughly, for any percentage x we can expect that x subjects out of 100 experience the event among all subjects that have a predicted risk of x%. Typically, the calibration assumption is assessed graphically but in practice it is often challenging to judge whether a "disappointing" calibration plot is the consequence of a departure from the calibration assumption, or alternatively just "bad luck" due to sampling variability. We propose a graphical approach which enables the visualization of how much a calibration plot agrees with the calibration assumption to address this issue...
December 6, 2017: Lifetime Data Analysis
P K Randleff-Rasmussen, A Leblond, J Cappelle, J Bontemps, S Belluco, M R Popoff, C Marcillaud-Pitel, J Tapprest, P Tritz, I Desjardins
Equine grass sickness (EGS) (equine dysautonomia) is a neurodegenerative condition of grazing equines. Pre-mortem diagnosis of EGS is a challenge for practitioners as definitive diagnosis requires ileal/myenteric lymph node biopsies. This study aimed to develop a clinical score that could be used by practitioners to improve the detection of acute or subacute EGS cases in the field. Suspected EGS cases were declared by veterinary practitioners. A case was classified as confirmed positive if ileal or rectal biopsy samples showed neuronal degeneration typical of EGS...
December 4, 2017: Veterinary Research Communications
J Xu, X F Hu, W Huang, P Y Shen, W Zhang, H Ren, X Li, W M Wang, N Chen, X X Pan
Objective: To analyze the clinicopathological characteristics of renal lesions in type 2 diabetic patients and to differentiate diabetic nephropathy (DN) from non-diabetic renal diseases(NDRD). Methods: Type 2 diabetic patients who received renal biopsy in Ruijin Hospital from January 2011 to December 2015 were recruited in this study. Clinical history, laboratory results and pathological data were retrospectively collected. According to the pathological findings, the patients were divided into 3 groups: DN, NDRD, DN+NDRD...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Yuan Luo, Peter Szolovits, Anand S Dighe, Jason M Baron
Objective: A key challenge in clinical data mining is that most clinical datasets contain missing data. Since many commonly used machine learning algorithms require complete datasets (no missing data), clinical analytic approaches often entail an imputation procedure to "fill in" missing data. However, although most clinical datasets contain a temporal component, most commonly used imputation methods do not adequately accommodate longitudinal time-based data. We sought to develop a new imputation algorithm, 3-dimensional multiple imputation with chained equations (3D-MICE), that can perform accurate imputation of missing clinical time series data...
November 30, 2017: Journal of the American Medical Informatics Association: JAMIA
Maciej Haberka, Michał Lelek, Tomasz Bochenek, Adam Kowalówka, Rafał Młynarski, Katarzyna Mizia-Stec, Zbigniew Gąsior
BACKGROUND AND AIMS: Cardiovascular (CV) risk assessment based on conventional risk factors has a limited performance in the prediction of obstructive coronary artery disease (CAD). Therefore, our aim was to provide a complete assessment on the associations between single or combined cardiovascular ultrasound indexes and the complexity of CAD in high and very-high risk patients. METHODS: Two hundred fifteen patients scheduled for elective coronary angiography were enrolled in the study (F/M: 80/135 pts; age: 61...
September 15, 2017: Atherosclerosis
Daniel C Williams, Anbesaw W Selassie, William S Russell, Keith T Borg, William T Basco
OBJECTIVES: This study aimed to assess management of pediatric isolated skull fracture (ISF) patients by determining frequency of admission and describing characteristics associated with patients admitted for observation compared with patients discharged directly from the emergency department (ED) and those requiring a prolonged hospitalization. METHODS: We evaluated children younger than 5 years who presented with ISF using the South Carolina Traumatic Brain Injury Surveillance and Registry System data from 2001 to 2011...
December 2017: Pediatric Emergency Care
A Rabinovich, T Ducruet, S R Kahn
BACKGROUND: Post-thrombotic syndrome (PTS) is a chronic complication that develops in 20-50% of patients after deep vein thrombosis (DVT). While individual risk factors for PTS have been characterized, the ability to predict which DVT patients are likely to develop PTS remains limited. OBJECTIVE: We aimed to develop a clinical prediction score for PTS in patients with DVT. METHODS: The derivation cohort consisted of participants in the SOX Trial, a randomized double-blind placebo controlled trial of elastic compression stockings vs...
November 28, 2017: Journal of Thrombosis and Haemostasis: JTH
Chin Pang Wong, Chun Tat Lui, Jonathan Gabriel Sung, Ho Lam, Hin Tat Fung, Ping Wa Yam
BACKGROUND: Assessment of patients with chest pain is a regular challenge in the emergency department (ED). Recent guidelines recommended quantitative assessment of ischemic risk by means of risk scores. OBJECTIVE: Our aim was to assess the performance of Thrombosis in Myocardial Infarction (TIMI); Global Registry of Acute Coronary Events (GRACE); history, electrocardiogram, age, risk factors, and troponin (HEART) scores; and the North America Chest Pain Rule (NACPR) without components of clinical gestalt in predicting 30-day major adverse cardiac events (MACE)...
November 27, 2017: Journal of Emergency Medicine
Sheng Chen, Binjie Zhao, Wei Wang, Ligen Shi, Cesar Reis, Jianmin Zhang
Despite years of effort, intracerebral hemorrhage (ICH) remains the most devastating form of stroke with more than 40% 30-day mortality worldwide. Hematoma expansion (HE), which occurs in one third of ICH patients, is strongly predictive of worse prognosis and potentially preventable if high-risk patients were identified in the early phase of ICH. In this review, we summarize data from recent studies on HE prediction and classify those potential indicators into four categories: clinical (severity of consciousness disturbance; blood pressure; blood glucose at and after admission); laboratory (hematologic parameters of coagulation, inflammation and microvascular integrity status), radiographic (interval time from ICH onset; baseline volume, shape and density of hematoma; intraventricular hemorrhage; especially the spot sign and modified spot sign) and integrated predictors (9-point or 24-point clinical prediction algorithm and PREDICT A/B)...
October 24, 2017: Oncotarget
Kara Rossfeld, Erinn M Hade, Alexandra Gangi, Matthew Perez, Emily N Kinsey, Joanna Grabska, Ashley Ederle, Jonathan Zager, April K Salama, Thomas E Olencki, Georgia M Beasley
Immune checkpoint inhibitors have dramatically changed the prognosis for patients with metastatic melanoma. However, not all patients respond to therapy and toxicities can be severe leaving need for reliable clinical predictive markers. Methods: We examined primary tumor characteristics including ulceration, BRAF mutation status, and Breslow depth in patients who subsequently developed stage IV disease and were treated with ipilimumab at 3 institutions. Patients in this study were not treated on clinical trials...
October 2017: International Journal of Surgery. Oncology
Marina R Adami, Carlos Oscar Kieling, Fernando Pereira Schwengber, Vania N Hirakata, Sandra Maria Gonçalves Vieira
OBJECTIVE: Esophageal variceal bleeding is a severe complication of portal hypertension. The standard diagnostic screening test and therapeutic procedure for esophageal varices is endoscopy, which is invasive in pediatric patients. This study aimed to evaluate the role of noninvasive parameters as predictors of large varices in children with intrahepatic portal hypertension. METHODS: Participants included in this cross-sectional study underwent a screening endoscopy...
November 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
Ewout W Steyerberg, Hajime Uno, John P A Ioannidis, Ben van Calster, Chinedu Ukaegbu, Tara Dhingra, Sapna Syngal, Fay Kastrinos
OBJECTIVE: To evaluate limitations of common statistical modeling approaches in deriving clinical prediction models and explore alternative strategies. STUDY DESIGN AND SETTING: A previously published model predicted the likelihood of having a mutation at the time of diagnosis of colorectal cancer. This model was based on a cohort where 38 mutations were found among 870 participants, with validation in an independent cohort with 35 mutations. The modeling strategy included stepwise selection of predictors from a pool of 37 candidate predictors and dichotomization of continuous predictors...
November 23, 2017: Journal of Clinical Epidemiology
Jordan M Albaum, Sarah Carsley, Yang Chen, David W H Dai, Gerald Lebovic, Brian W McCrindle, Jonathon L Maguire, Patricia C Parkin, Catherine S Birken
OBJECTIVES: To examine patterns of non-high-density lipoprotein (HDL) cholesterol in early childhood and identify factors associated with persistent high non-HDL cholesterol in healthy urban children. STUDY DESIGN: We identified all children enrolled in a primary care practice-based research network called TARGet Kids! (The Applied Research Group for Kids) with ≥3 laboratory measurements of non-HDL cholesterol. Latent class growth model analysis was performed to identify distinct trajectory groups for non-HDL cholesterol...
December 2017: Journal of Pediatrics
Antonio Loforte, Francesco Grigioni, Giuseppe Marinelli
Right ventricular failure (RVF) still results as the major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite overall improved outcomes and lower rates of RVF with the use of the newer, continuous-flow (CF) LVADs over pulsatile-flow devices, and development of clinical prediction scores to facilitate preoperative identification of patients at risk for RVF after implantation, RVF occurs in 13% to 40% of continuous-flow device. Areas covered: In this article, a review has been carried out on the current evidence for preoperative assessment of RV function and RVF risk for appropriate patient selection mainly focusing on current imaging and invasive assessment tools...
November 25, 2017: Expert Review of Medical Devices
Mominah Bhatti, Ashradha Ketheeswaran, Amy Arnold, Erin Nesbitt-Hawes, Rebecca Deans, HaRyun Won, Jason Abbott
OBJECTIVE: To investigate whether pelvic examination may be meaningfully taught to novice medical students and its accuracy in predicting operating times for laparoscopic excision of endometriosis at a single surgical procedure. METHODS: Women with suspected endometriosis scheduled for laparoscopy underwent pelvic examination to estimate operative time by medical students (novices), trainees, senior clinicians with <10 years surgical experience (experts) and ≥10 years (masters)...
November 23, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
A Wolf, T R Fanshawe, A Sariaslan, R Cornish, H Larsson, S Fazel
BACKGROUND: Current approaches to assess violence risk in secure hospitals are resource intensive, limited by accuracy and authorship bias and may have reached a performance ceiling. This study seeks to develop scalable predictive models for violent offending following discharge from secure psychiatric hospitals. METHODS: We identified all patients discharged from secure hospitals in Sweden between January 1, 1992 and December 31, 2013. Using multiple Cox regression, pre-specified criminal, sociodemographic, and clinical risk factors were included in a model that was tested for discrimination and calibration in the prediction of violent crime at 12 and 24 months post-discharge...
August 4, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
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