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"Clinical prediction"

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https://www.readbyqxmd.com/read/28330889/robust-microbiota-based-diagnostics-for-inflammatory-bowel-disease
#1
A Eck, E F J de Groot, T G J de Meij, M Welling, P H M Savelkoul, A E Budding
Strong evidence suggests that gut microbiota is altered in inflammatory bowel disease (IBD), indicating its potential role in non-invasive diagnostics. However, no clinical applications are currently used for routine patient care. The main obstacle to implementing a gut microbiota test for IBD is the lack of standardization, which leads to high inter-laboratory variations. We studied the between-hospital and between-platform batch effects and their effect on predictive accuracy for IBD.Fecal samples from 91 pediatric IBD patients and 58 healthy children were collected...
March 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28327985/the-need-to-approximate-the-use-case-in-clinical-machine-learning
#2
Sohrab Saeb, Luca Lonini, Arun Jayaraman, David C Mohr, Konrad P Kording
Background: The availability of smartphone and wearable sensor technology is leading to a rapid accumulation of human subject data, and machine learning is emerging as a technique to map that data into clinical predictions. As machine learning algorithms are increasingly used to support clinical decision making, it is vital to reliably quantify their prediction accuracy. Cross-validation is the standard approach where the accuracy of such algorithms is evaluated on data the algorithm has not seen during training...
March 15, 2017: GigaScience
https://www.readbyqxmd.com/read/28326011/the-virtual-trial
#3
Willem de Haan
Although brain network analysis in neurodegenerative disease is still a fairly young discipline, expectations are high. The robust theoretical basis, the straightforward detection and explanation of otherwise intangible complex system phenomena, and the correlations of network features with pathology and cognitive status are qualities that show the potential power of this new instrument. We expect "connectomics" to eventually better explain and predict that essential but still poorly understood aspect of dementia: the relation between pathology and cognitive symptoms...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28324889/evaluation-of-clinicopathological-factors-in-pd-1-response-derivation-and-validation-of-a-prediction-scale-for-response-to-pd-1-monotherapy
#4
Adi Nosrati, Katy K Tsai, Simone M Goldinger, Paul Tumeh, Barbara Grimes, Kimberly Loo, Alain P Algazi, Thi Dan Linh Nguyen-Kim, Mitchell Levesque, Reinhard Dummer, Omid Hamid, Adil Daud
BACKGROUND: Anti-PD-1 therapy has shown significant clinical activity in advanced melanoma. We developed and validated a clinical prediction scale for response to anti- PD-1 monotherapy. METHODS: A total of 315 patients with advanced melanoma treated with pembrolizumab (2 or 10 mg kg(-1) Q2W or Q3W) or nivolumab (3 mg kg(-1) Q2W) at four cancer centres between 2011 to 2013 served as the setting for the present cohort study. Variables with significant association to response on a univariate analysis were entered into a forward stepwise logistic regression model and were given a score based on ORs to calculate a clinical prediction scale...
March 21, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28320991/pre-procedural-risk-score-of-contrast-induced-nephropathy-in-elderly-patients-undergoing-elective-coronary-angiography
#5
Dan Lian, Yong Liu, Yuan-Hui Liu, Hua-Long Li, Chong-Yang Duan, Dan-Qing Yu
To establish a scoring model to predict the risk of contrast-induced nephropathy (CIN) in elderly patients undergoing elective coronary angiography (CAG).A total of 1286 patients aged > 65 years who had undergone elective CAG between August 2009 and February 2013 were enrolled in this study. They were randomly (3:2) assigned to a development (n = 756) or validation dataset (n = 530). Independent predictors of CIN were identified by using logistic regression and were assigned a weighted integer, which was used to establish a score model...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28316153/-assessment-of-predictive-factors-for-survival-in-patients-with-locally-advanced-rectal-cancer-after-neoadjuvant-chemoradiotherapy
#6
G J Wu, T Yu, W W Jia, Q An, G Xiao, X Wang
Objective: To evaluate the clinical predictive factors for survival prognosis in patients with locally advanced rectal cancer after neoadjuvant chemoradiotheraphy. Methods: The study included 87 patients with middle and lower locally advanced rectal cancer, who underwent neoadjuvant chemoradiotheraphy followed by radical surgery between April 2007 and May 2015. The clinical factors associated with 3-year disease-free survival (DFS) and overall survival (OS) were analyzed.Kaplan-Meier analysis of disease-free survival and overall survival was performed for all patients...
March 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28304357/clinical-prediction-of-suicide-and-undetermined-death-a-pseudo-prospective-clinical-and-medico-legal-study-of-substance-abusers
#7
Louise Brådvik, Mats Berglund, Arne Frank, Peter Löwenhielm
This study examines aspects of prediction of suicide and death of undetermined intent. We investigated all consecutive, autopsied patients between 1993 and 1997 who had been in contact with the Addiction Centre in Malmö from 1968 onwards. The staff was asked, shortly after autopsy but before they knew of the manner of death, if they thought the patient had committed suicide. The case records were blindly evaluated, and toxicological autopsy findings for alcohol in blood samples investigated. The specificity of prediction was 83% and significantly more often correct than the sensitivity, which was only 45% for suicide and for suicide/death of undetermined intent (93% versus 39%)...
March 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#8
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28285457/group-a-streptococcus-acute-rheumatic-fever-and-rheumatic-heart-disease-epidemiology-and-clinical-considerations
#9
REVIEW
Liesl J Zühlke, Andrea Beaton, Mark E Engel, Christopher T Hugo-Hamman, Ganesan Karthikeyan, Judith M Katzenellenbogen, Ntobeko Ntusi, Anna P Ralph, Anita Saxena, Pierre R Smeesters, David Watkins, Peter Zilla, Jonathan Carapetis
Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28284301/perioperative-acute-kidney-injury-risk-factors-and-predictive-strategies
#10
REVIEW
Charles Hobson, Rupam Ruchi, Azra Bihorac
Acute kidney injury (AKI) is a common complication in surgical patients and is associated with increases in mortality, an increased risk for chronic kidney disease and hemodialysis after discharge, and increased cost. Better understanding of the risk factors that contribute to perioperative AKI has led to improved AKI prediction and will eventually lead to improved prevention of AKI, mitigation of injury when AKI occurs, and enhanced recovery in patients who sustain AKI. The development of advanced clinical prediction scores for AKI, new imaging techniques, and novel biomarkers for early detection of AKI provides new tools toward these ends...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28279999/simplified-mortality-score-for-the-intensive-care-unit-sms-icu-protocol-for-the-development-and-validation-of-a-bedside-clinical-prediction-rule
#11
Anders Granholm, Anders Perner, Mette Krag, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Søren Marker, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
INTRODUCTION: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU)...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28274964/predicting-aki-in-emergency-admissions-an-external-validation-study-of-the-acute-kidney-injury-prediction-score-aps
#12
L E Hodgson, B D Dimitrov, P J Roderick, R Venn, L G Forni
OBJECTIVES: Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). DESIGN, SETTING AND PARTICIPANTS: External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr)...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28272242/predictive-factors-and-clinical-practice-profile-for-strictures-post-necrotising-enterocolitis
#13
Han Zhang, Jiaping Chen, Yan Wang, Chun Deng, Lei Li, Chunbao Guo
Intestinal stricture is a severe and common complication of necrotizing enterocolitis (NEC), causing severe and prolonged morbidity. Our goal was to investigate the clinical predictors for strictures developing after NEC and evaluate the management outcome of the post-NEC strictures to better orient their medicosurgical care.A total of 188 patients diagnosed with NEC with identical treatment protocols throughout the period under study were retrospectively reviewed from 4 academic neonatal centers between from January 1, 2011, and October 31, 2016...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267756/a-stillbirth-calculator-development-and-internal-validation-of-a-clinical-prediction-model-to-quantify-stillbirth-risk
#14
Amanda S Trudell, Methodius G Tuuli, Graham A Colditz, George A Macones, Anthony O Odibo
OBJECTIVE: To generate a clinical prediction tool for stillbirth that combines maternal risk factors to provide an evidence based approach for the identification of women who will benefit most from antenatal testing for stillbirth prevention. DESIGN: Retrospective cohort study. SETTING: Midwestern United States quaternary referral center. POPULATION: Singleton pregnancies undergoing second trimester anatomic survey from 1999-2009...
2017: PloS One
https://www.readbyqxmd.com/read/28264830/diagnosing-malignant-melanoma-in-ambulatory-care-a-systematic-review-of-clinical-prediction-rules
#15
Emma Harrington, Barbara Clyne, Nieneke Wesseling, Harkiran Sandhu, Laura Armstrong, Holly Bennett, Tom Fahey
OBJECTIVES: Malignant melanoma has high morbidity and mortality rates. Early diagnosis improves prognosis. Clinical prediction rules (CPRs) can be used to stratify patients with symptoms of suspected malignant melanoma to improve early diagnosis. We conducted a systematic review of CPRs for melanoma diagnosis in ambulatory care. DESIGN: Systematic review. DATA SOURCES: A comprehensive search of PubMed, EMBASE, PROSPERO, CINAHL, the Cochrane Library and SCOPUS was conducted in May 2015, using combinations of keywords and medical subject headings (MeSH) terms...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#16
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: Pulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data...
March 2, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28259520/derivation-and-external-validation-of-the-plasmic-score-for-rapid-assessment-of-adults-with-thrombotic-microangiopathies-a-cohort-study
#17
Pavan K Bendapudi, Shelley Hurwitz, Ashley Fry, Marisa B Marques, Stephen W Waldo, Ang Li, Lova Sun, Vivek Upadhyay, Ayad Hamdan, Andrew M Brunner, John M Gansner, Srinivas Viswanathan, Richard M Kaufman, Lynne Uhl, Christopher P Stowell, Walter H Dzik, Robert S Makar
BACKGROUND: Among the syndromes characterised by thrombotic microangiopathy, thrombotic thrombocytopenic purpura is distinguished by a severe deficiency in the ADAMTS13 enzyme. Patients with this disorder need urgent treatment with plasma exchange. Because ADAMTS13 activity testing typically requires prolonged turnaround times and might be unavailable in resource-poor settings, a method to rapidly assess the likelihood of severe ADAMTS13 deficiency is needed. METHODS: All consecutive adult patients presenting to three large academic medical centres in Boston, MA, USA, with thrombotic microangiopathy and a possible diagnosis of thrombotic thrombocytopenic purpura between Jan 8, 2004, and Dec 6, 2015, were included in an ongoing multi-institutional registry (the Harvard TMA Research Collaborative)...
March 1, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28258840/increased-prognostic-accuracy-of-tbi-when-a-brain-electrical-activity-biomarker-is-added-to-loss-of-consciousness-loc
#18
Dallas Hack, J Stephen Huff, Kenneth Curley, Roseanne Naunheim, Samanwoy Ghosh Dastidar, Leslie S Prichep
BACKGROUND: Extremely high accuracy for predicting CT+ traumatic brain injury (TBI) using a quantitative EEG (QEEG) based multivariate classification algorithm was demonstrated in an independent validation trial, in Emergency Department (ED) patients, using an easy to use handheld device. This study compares the predictive power using that algorithm (which includes LOC and amnesia), to the predictive power of LOC alone or LOC plus traumatic amnesia. PARTICIPANTS: ED patients 18-85years presenting within 72h of closed head injury, with GSC 12-15, were study candidates...
February 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28258458/clinical-prediction-rules-for-appendicitis-in-adults-which-is-best
#19
REVIEW
Malsha Kularatna, Melanie Lauti, Cheyaanthan Haran, Wiremu MacFater, Laila Sheikh, Ying Huang, John McCall, Andrew D MacCormick
BACKGROUND: Clinical prediction rules (CPRs) provide an objective method of assessment in the diagnosis of acute appendicitis. There are a number of available CPRs for the diagnosis of appendicitis, but it is unknown which performs best. AIM: The aim of this study was to identify what CPRs are available and how they perform when diagnosing appendicitis in adults. METHOD: A systematic review was performed in accordance with the PRISMA guidelines...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28257617/examination-of-the-validity-of-a-clinical-prediction-rule-to-identify-patients-with-shoulder-pain-likely-to-benefit-from-cervicothoracic-manipulation
#20
Paul E Mintken, Amy W McDevitt, Lori A Michener, Robert E Boyles, Amber R Beardslee, Scott A Burns, Matthew D Haberl, Lauren A Binder, Joshua A Cleland
Study Design Secondary analysis of a randomized controlled trial. Background Prognostic variables identifying patients with shoulder pain who are likely to respond to cervicothoracic (CT) manipulation have been reported, however they have yet to be validated. Objective To examine the validity of previously reported prognostic variables in predicting which patients with shoulder pain will respond to cervicothoracic manipulation. Methods Participants (n=140) with a report of shoulder pain were randomly assigned to receive either 2 sessions of range of motion (ROM) exercises plus 6 sessions of stretching and strengthening exercises (Ex group), or 2 sessions of CT manipulation and ROM exercises followed by 6 sessions of stretching and strengthening exercise (MT+Ex group)...
March 3, 2017: Journal of Orthopaedic and Sports Physical Therapy
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