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"Clinical prediction"

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https://www.readbyqxmd.com/read/28727272/performance-of-clinical-prediction-rules-for-diagnosis-of-pleural-tuberculosis-in-a-high-incidence-setting
#1
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource- constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of Pleural Tuberculosis (PT) in Peru. METHODS: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis...
July 20, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28725661/assessment-of-stereotactic-radiosurgery-treatment-response-for-brain-metastases-using-mri-based-diffusion-index
#2
Zengai Chen, Jinyan Zu, Lei Li, Xiaojie Lu, Jianming Ni, Jianrong Xu
INTRODUCTION: To investigate the clinical predictive values of the apparent diffusion coefficient (ADC) as a biomarker in radiation response of brain metastases. METHOD: Forty-one patients with brain metastases treated with stereotactic radiosurgery (SRS) were imaged at baseline, one month post SRS, and six months post SRS using diffusion weighted MRI. The mean of ADC for metastases and tumor volume was calculated. A diffusion index (DI) was generated using the sum of 1/ADC among all the voxels in a tumor...
2017: European Journal of Radiology Open
https://www.readbyqxmd.com/read/28722146/implementing-clinical-prediction-models-pushing-the-needle-towards-precision-pharmacotherapy
#3
S R Dorajoo, A Chan
Clinical prediction models promise a future of precision drug therapy. However, very few models are used in practice. Although models can eliminate unwanted clinical guesswork, several barriers hinder model implementation in practice. Here we discuss the less well-recognized barriers hindering model implementation for precision prescribing, highlighting areas that warrant attention, primarily relating to ethical and regulatory considerations that are requisite in paving the way towards a future of precision pharmacotherapy...
July 19, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28720374/the-4kscore-predicts-the-grade-and-stage-of-prostate-cancer-in-the-radical-prostatectomy-specimen-results-from-a-multi-institutional-prospective-trial
#4
Sanoj Punnen, Bruno Nahar, Nachiketh S Prakash, Daniel D Sjoberg, Stephen M Zappala, Dipen J Parekh
BACKGROUND: The 4Kscore accurately predicts aggressive prostate cancer (PCa) on prostate biopsy. OBJECTIVE: We assessed how well the 4Kscore predicts pathology at radical prostatectomy (RP). DESIGN, SETTING, AND PARTICIPANTS: Among 1312 men who prospectively underwent a 4Kscore and biopsy of the prostate at 26 sites throughout the United States from October 2013 to April 2014, we selected men who were diagnosed with cancer and underwent RP...
February 2017: European Urology Focus
https://www.readbyqxmd.com/read/28720000/differentiation-between-pyogenic-flexor-tenosynovitis-and-other-finger-infections
#5
Colin D Kennedy, Alexander S Lauder, Jonathan R Pribaz, Stephen A Kennedy
BACKGROUND: Hospital transfer decisions regarding pyogenic flexor tenosynovitis (PFT) are made difficult by emergency department presentations similar to other finger infections, with pain, redness, and functional limitation. Our objectives were to: (1) determine diagnostic sensitivity and specificity of Kanavel signs; and (2) identify existing factors most predictive of PFT during initial presentation. METHODS: Adult patients who underwent surgical consultation for concern of PFT over a 5-year period were identified retrospectively...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716636/a-simplified-clinical-prediction-rule-for-prognosticating-independent-walking-after-spinal-cord-injury-a-prospective-study-from-a-canadian-multicenter-spinal-cord-injury-registry
#6
Katharine E Hicks, Yichen Zhao, Nader Fallah, Carly Rivers, Vanessa Noonan, Tova Plashkes, Eugene K Wai, Darren M Roffey, Eve Tsai, Jerome Paquet, Najmedden Attabib, Travis Marion, Henry Ahn, Philippe Phan
BACKGROUND: Context: Traumatic spinal cord injury (SCI) is a debilitating condition with limited treatment options for neurological or functional recovery. The ability to predict the prognosis of walking post-injury with emerging prediction models could aid in rehabilitation strategies and reintegration into the community. PURPOSE: To re-validate an existing clinical prediction model for independent ambulation (van Middendorp et al. 2011) utilising acute and long-term post-injury follow-up data, and to investigate the accuracy of a simplified model using prospectively collected data from a Canadian multicenter SCI database, the Rick Hansen Spinal Cord Injury Registry (RHSCIR)...
July 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28716055/temporal-and-geographical-external-validation-study-and-extension-of-the-mayo-clinic-prediction-model-to-predict-egfr-in-the-younger-population-of-swiss-adpkd-patients
#7
Laura Girardat-Rotar, Julia Braun, Milo A Puhan, Alison G Abraham, Andreas L Serra
BACKGROUND: Prediction models in autosomal dominant polycystic kidney disease (ADPKD) are useful in clinical settings to identify patients with greater risk of a rapid disease progression in whom a treatment may have more benefits than harms. Mayo Clinic investigators developed a risk prediction tool for ADPKD patients using a single kidney value. Our aim was to perform an independent geographical and temporal external validation as well as evaluate the potential for improving the predictive performance by including additional information on total kidney volume...
July 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28715510/correction-development-and-validation-of-a-clinical-prediction-rule-for-bacteremia-among-maintenance-hemodialysis-patients-in-outpatient-settings
#8
Sho Sasaki, Takeshi Hasegawa, Hiroo Kawarazaki, Atsushi Nomura, Daisuke Uchida, Takahiro Imaizumi, Masahide Furusho, Hiroki Nishiwaki, Shingo Fukuma, Yugo Shibagaki, Shunichi Fukuhara
[This corrects the article DOI: 10.1371/journal.pone.0169975.].
2017: PloS One
https://www.readbyqxmd.com/read/28713042/implementation-of-the-universal-bls-termination-of-resuscitation-rule-in-a-rural-ems-system
#9
Matthew R Jordan, Michael F O'Keefe, David Weiss, C Wes Cubberley, Charles D MacLean, Daniel L Wolfson
BACKGROUND: Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. OBJECTIVE: The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28707499/performance-of-wells-score-to-predict-deep-vein-thrombosis-and-pulmonary-embolism-in-endurance-athletes
#10
Amanda L Zaleski, Beth A Taylor, Linda S Pescatello, Paul D Thompson, Craig Denegar
INTRODUCTION: There are an increasing number of reports describing deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in otherwise healthy endurance athletes. The Wells score is the most commonly used clinical prediction rule to diagnose DVT/PE in clinical populations. However, the Wells score may have limited utility for recognition of DVT/PE in athletes, contributing to missed or delayed diagnosis. OBJECTIVE: We performed an analysis of the ability of the Wells score to identify DVT/PE events in athletes through a review of published case reports...
July 14, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28698741/association-of-the-pro12ala-polymorphism-with-the-metabolic-parameters-in-women-with-polycystic-ovary-syndrome
#11
Moushira Zaki, Naglaa Hassan, Hala T El-Bassyouni, Sanaa Kamal, Walaa Basha, Osama Azmy, Khalda Amr
AIM: To investigate the association of peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala polymorphism with polycystic ovary syndrome (PCOS) and its effect on the metabolic parameters in PCOS women. METHODS: The study used PCR to identify the presence of the PPARG Pro12Ala polymorphism in 100 PCOS women and 120 age-matched healthy women. All participants were subjected to anthropometry, biochemical and metabolic evaluation. RESULTS: Significant difference in the genotypes distributions of PPARG Pro12Ala polymorphism was observed among PCOS women and controls (p = 0...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#12
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28688113/assessing-clinical-probability-of-pulmonary-embolism-prospective-validation-of-the-simplified-geneva-score-in-outpatients
#13
H Robert-Ebadi, K Mostaguir, M M Hovens, M Kare, F Verschuren, P Girard, M V Huisman, F Moustafa, P W Kamphuisen, H R Buller, M Righini, G Le Gal
BACKGROUND: Pretest probability assessment by a clinical prediction rule (CPR) is an important step in the management of patients with suspected pulmonary embolism (PE). A limitation to the use of CPR is that their constitutive variables and corresponding number of points are difficult to memorize. A simplified version of the Geneva score (i.e. attributing one point to each variable) has been proposed but never been prospectively validated. AIMS: Prospective validation of the simplified Geneva score (SGS) and comparison with the previous version of the Geneva score (GS)...
July 8, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28687910/ct-findings-associated-with-survival-in-chronic-hypersensitivity-pneumonitis
#14
Jonathan H Chung, Steven M Montner, Ayodeji Adegunsoye, Justin M Oldham, Aliya N Husain, Rekha Vij, Imre Noth, Mary E Strek
OBJECTIVES: To identify CT findings in chronic hypersensitivity pneumonitis (cHP) associated with survival. MATERIAL AND METHODS: Two thoracic radiologists assessed CT scans for specific imaging findings and patterns in 132 subjects with cHP. Survival analyses were performed. RESULTS: The majority of subjects had an inconsistent with usual interstitial pneumonitis pattern on CT (55.3%,73/132). Hypersensitivity pneumonitis (HP) diagnosis on CT was less common in those with fibrosis (66...
July 7, 2017: European Radiology
https://www.readbyqxmd.com/read/28662632/timing-of-delivery-in-a-high-risk-obstetric-population-a-clinical-prediction-model
#15
Dane A De Silva, Sarka Lisonkova, Peter von Dadelszen, Anne R Synnes, Laura A Magee
BACKGROUND: The efficacy of antenatal corticosteroid treatment for women with threatened preterm birth depends on timely administration within 7 days before delivery. We modelled the probability of delivery within 7 days of admission to hospital among women presenting with threatened preterm birth, using routinely collected clinical characteristics. METHODS: Data from the Canadian Perinatal Network (CPN) were used, 2005-11, including women admitted to hospital with preterm labour, preterm pre-labour rupture of membranes, short cervix without contractions, or dilated cervix or prolapsed membranes without contractions at preterm gestation...
June 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28655511/tobacco-use-as-a-screener-for-clostridium-difficile-infection-outcomes
#16
Anna K Barker, Ashley Van Galen, Ajay K Sethi, Daniel Shirley, Nasia Safdar
We conducted a retrospective cohort study to evaluate the utility of self-reported tobacco use for developing a clinical prediction rule for poor outcomes of Clostridium difficile infection. We found that patients with any history of smoking were significantly less likely than never smokers to be cured of their infection within two weeks. Disease recurrence, readmission within thirty days, death before treatment completion, and the severity of Clostridium difficile infection were not associated with smoking status...
June 24, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28651935/derivation-and-validation-of-a-novel-risk-score-for-safe-discharge-after-acute-lower-gastrointestinal-bleeding-a-modelling-study
#17
Kathryn Oakland, Vipul Jairath, Raman Uberoi, Richard Guy, Lakshmana Ayaru, Neil Mortensen, Mike F Murphy, Gary S Collins
BACKGROUND: Acute lower gastrointestinal bleeding is a common reason for emergency hospital admission, and identification of patients at low risk of harm, who are therefore suitable for outpatient investigation, is a clinical and research priority. We aimed to develop and externally validate a simple risk score to identify patients with lower gastrointestinal bleeding who could safely avoid hospital admission. METHODS: We undertook model development with data from the National Comparative Audit of Lower Gastrointestinal Bleeding from 143 hospitals in the UK in 2015...
June 23, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28649441/clinical-responses-to-erk-inhibition-in-braf-v600e-mutant-colorectal-cancer-predicted-using-a-computational-model
#18
Daniel C Kirouac, Gabriele Schaefer, Jocelyn Chan, Mark Merchant, Christine Orr, Shih-Min A Huang, John Moffat, Lichuan Liu, Kapil Gadkar, Saroja Ramanujan
Approximately 10% of colorectal cancers harbor BRAF(V600E) mutations, which constitutively activate the MAPK signaling pathway. We sought to determine whether ERK inhibitor (GDC-0994)-containing regimens may be of clinical benefit to these patients based on data from in vitro (cell line) and in vivo (cell- and patient-derived xenograft) studies of cetuximab (EGFR), vemurafenib (BRAF), cobimetinib (MEK), and GDC-0994 (ERK) combinations. Preclinical data was used to develop a mechanism-based computational model linking cell surface receptor (EGFR) activation, the MAPK signaling pathway, and tumor growth...
2017: NPJ Systems Biology and Applications
https://www.readbyqxmd.com/read/28641750/predicting-outcomes-in-congenital-diaphragmatic-hernia
#19
Oluwatomilayo Daodu, Mary E Brindle
Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are evidence-based tools that combine multiple predictors to estimate the probability that a particular outcome in an individual patient will occur. In CDH, a suitable clinical prediction rule can stratify high- and low-risk populations and provide the ability to tailor management strategies based on severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28637780/sex-based-differences-in-the-performance-of-the-heart-score-in-patients-presenting-to-the-emergency-department-with-acute-chest-pain
#20
Ingrid E M Bank, Vince C de Hoog, Dominique P V de Kleijn, Gerard Pasterkamp, Pieter A Doevendans, Hester M den Ruijter, Geertje Dalmeijer, Thierry X Wildbergh, Arend Mosterd, Leo Timmers
BACKGROUND: Sex-based differences in clinical presentation, pathophysiology, and outcomes of patients with acute chest pain are increasingly being recognized, but are not implemented in guidelines and clinical prediction tools. We evaluated the performance of the HEART score in women versus men, because sex-based differences may exist among the algorithm's components: history, electrocardiogram, age, risk factors, and admission troponin level. METHODS AND RESULTS: The HEART score was retrospectively assessed in 831 women and 1084 men presenting to the emergency department with acute chest pain, assigning patients to the low-, intermediate-, or high-risk category for the occurrence of major adverse cardiac events (MACE) within 6 weeks...
June 21, 2017: Journal of the American Heart Association
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