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Integrated clinical prediction rule

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https://www.readbyqxmd.com/read/29783934/the-impact-of-pharmacokinetic-gene-profiles-across-human-cancers
#1
Michael T Zimmermann, Terry M Therneau, Jean-Pierre A Kocher
BACKGROUND: The right drug to the right patient at the right time is one of the ideals of Individualized Medicine (IM) and remains one of the most compelling promises of the post-genomic age. The addition of genomic information is expected to increase the precision of an individual patient's treatment, resulting in improved outcomes. While pilot studies have been encouraging, key aspects of interpreting tumor genomics information, such as somatic activation of drug transport or metabolism, have not been systematically evaluated...
May 21, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29742588/derivation-and-validation-of-a-biomarker-based-clinical-algorithm-to-rule-out-sepsis-from-noninfectious-systemic-inflammatory-response-syndrome-at-emergency-department-admission-a-multicenter-prospective-study
#2
Filippo Mearelli, Nicola Fiotti, Carlo Giansante, Chiara Casarsa, Daniele Orso, Marco De Helmersen, Nicola Altamura, Maurizio Ruscio, Luigi Mario Castello, Efrem Colonetti, Rossella Marino, Giulia Barbati, Andrea Bregnocchi, Claudio Ronco, Enrico Lupia, Giuseppe Montrucchio, Maria Lorenza Muiesan, Salvatore Di Somma, Gian Carlo Avanzi, Gianni Biolo
OBJECTIVES: To derive and validate a predictive algorithm integrating a nomogram-based prediction of the pretest probability of infection with a panel of serum biomarkers, which could robustly differentiate sepsis/septic shock from noninfectious systemic inflammatory response syndrome. DESIGN: Multicenter prospective study. SETTING: At emergency department admission in five University hospitals. PATIENTS: Nine-hundred forty-seven adults in inception cohort and 185 adults in validation cohort...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29678058/building-a-knowledge-based-tool-for-auto-assessing-the-cardiovascular-risk
#3
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/29567970/data-based-decision-rules-to-personalize-depression-follow-up
#4
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/29560054/a-predictive-model-facilitates-early-recognition-of-spinal-epidural-abscess-in-adults
#5
Andrew W Artenstein, Jennifer Friderici, Paul Visintainer
Introduction: Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model. Methods: Using data from a 10-year, retrospective, case-control study of adults presenting for care at a tertiary-care, regional, academic medical center, we used the Integrated Discrimination Improvement Index (IDI) to identify candidate discriminators and created a multivariable logistic regression model, refined based on p-value significance...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29435442/the-carpediem-algorithm-a-rule-based-system-for-identifying-heart-failure-phenotype-with-a-precision-public-health-approach
#6
Michela Franchini, Stefania Pieroni, Claudio Passino, Michele Emdin, Sabrina Molinaro
Modern medicine remains dependent on the accurate evaluation of a patient's health state, recognizing that disease is a process that evolves over time and interacts with many factors unique to that patient. The CARPEDIEM project represents a concrete attempt to address these issues by developing reproducible algorithms to support the accuracy in detection of complex diseases. This study aims to establish and validate the CARPEDIEM approach and algorithm for identifying those patients presenting with or at risk of heart failure (HF) by studying 153,393 subjects in Italy, based on patient information flow databases and is not reliant on the electronic health record to accomplish its goals...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29427011/self-learning-computers-for-surgical-planning-and-prediction-of-postoperative-alignment
#7
Renaud Lafage, Sébastien Pesenti, Virginie Lafage, Frank J Schwab
PURPOSE: In past decades, the role of sagittal alignment has been widely demonstrated in the setting of spinal conditions. As several parameters can be affected, identifying the driver of the deformity is the cornerstone of a successful treatment approach. Despite the importance of restoring sagittal alignment for optimizing outcome, this task remains challenging. Self-learning computers and optimized algorithms are of great interest in spine surgery as in that they facilitate better planning and prediction of postoperative alignment...
February 2018: European Spine Journal
https://www.readbyqxmd.com/read/29395632/predictors-of-clinical-success-in-runners-with-patellofemoral-pain-secondary-analyses-of-a-randomized-clinical-trial
#8
Jean-Francois Esculier, Laurent J Bouyer, Blaise Dubois, Jean Leblond, Mélanie Brisson, Luc Chau, Jean-Sébastien Roy
OBJECTIVES: To identify predictors of outcome to a rehabilitation program focused on education and management of training loads in runners with patellofemoral pain (PFP). DESIGN: Secondary analyses of a randomized clinical trial. METHODS: Fifty-eight runners with PFP (62% female, aged 31.2±6.6years, running 20.3±5.6km/week) were included in analyses. Following baseline collection of demographics, anthropometry, symptomatology, isometric strength, running mechanics and radiological data, runners were randomized to one of the three 8-week intervention program: (1) Education on symptoms management and training modifications; (2) Education+Exercise program; (3) Education+Gait retraining...
January 27, 2018: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/29393522/derivation-and-validation-of-a-clostridium-difficile-infection-recurrence-prediction-rule-in-a-national-cohort-of-veterans
#9
Kelly R Reveles, Eric M Mortensen, Jim M Koeller, Kenneth A Lawson, Mary Jo V Pugh, Sarah A Rumbellow, Jacqueline R Argamany, Christopher R Frei
STUDY OBJECTIVE: Prior studies have identified risk factors for recurrent Clostridium difficile infection (CDI), but few studies have integrated these factors into a clinical prediction rule that can aid clinical decision-making. The objectives of this study were to derive and validate a CDI recurrence prediction rule to identify patients at risk for first recurrence in a national cohort of veterans. DESIGN: Retrospective cohort study. DATA SOURCE: Veterans Affairs Informatics and Computing Infrastructure...
March 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29374105/validating-the-telestroke-mimic-score-a-prediction-rule-for-identifying-stroke-mimics-evaluated-over-telestroke-networks
#10
MULTICENTER STUDY
Syed F Ali, Gordian J Hubert, Jeffrey A Switzer, Jennifer J Majersik, Roland Backhaus, L Wylie Shepard, Kishore Vedala, Lee H Schwamm
BACKGROUND AND PURPOSE: Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population...
March 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29324771/impact-of-grouping-complications-on-mortality-in-traumatic-brain-injury-a-nationwide-population-based-study
#11
Chung-Han Ho, Fu-Wen Liang, Jhi-Joung Wang, Chung-Ching Chio, Jinn-Rung Kuo
Traumatic brain injury (TBI) is an important health issue with high mortality. Various complications of physiological and cognitive impairment may result in disability or death after TBI. Grouping of these complications could be treated as integrated post-TBI syndromes. To improve risk estimation, grouping TBI complications should be investigated, to better predict TBI mortality. This study aimed to estimate mortality risk based on grouping of complications among TBI patients. Taiwan's National Health Insurance Research Database was used in this study...
2018: PloS One
https://www.readbyqxmd.com/read/29303453/stereotactic-radiosurgery-for-who-grade-i-posterior-fossa-meningiomas-long-term-outcomes-with-volumetric-evaluation
#12
Mohana Rao Patibandla, Cheng-Chia Lee, Athreya Tata, Gokul Chowdary Addagada, Jason P Sheehan
OBJECTIVE Research over the past 2 decades has been characterizing the role of stereotactic radiosurgery (SRS) in the treatment of benign intracranial tumors, including meningiomas. However, few studies have examined the long-term outcomes of SRS treatment for posterior fossa meningiomas (PFMs). Furthermore, previous studies have typically used single diameter measurements when reporting outcomes, which can yield misleading results. The authors describe the use of SRS in the treatment of benign WHO grade I PFMs and correlate volumetric analysis with long-term outcomes...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29286314/integration-of-distributed-services-and-hybrid-models-based-on-process-choreography-to-predict-and-detect-type-2-diabetes
#13
Antonio Martinez-Millana, Jose-Luis Bayo-Monton, María Argente-Pla, Carlos Fernandez-Llatas, Juan Francisco Merino-Torres, Vicente Traver-Salcedo
Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease...
December 29, 2017: Sensors
https://www.readbyqxmd.com/read/29247599/sterilization-of-hydrogels-for-biomedical-applications-a-review
#14
REVIEW
Raquel Galante, Terezinha J A Pinto, Rogério Colaço, Ana Paula Serro
Despite the beneficial properties and outstanding potential of hydrogels for biomedical applications, several unmet challenges must be overcome, especially regarding to their known sensitivity to conventional sterilization methods. It is crucial for any biomaterial to withstand an efficient sterilization to obtain approval from regulatory organizations and to safely proceed to clinical trials. Sterility assurance minimizes the incidence of medical device-related infections, which still constitute a major concern in health care...
December 16, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29103159/model-based-optimization-of-g-csf-treatment-during-cytotoxic-chemotherapy
#15
Sibylle Schirm, Christoph Engel, Sibylle Loibl, Markus Loeffler, Markus Scholz
PURPOSE: Although G-CSF is widely used to prevent or ameliorate leukopenia during cytotoxic chemotherapies, its optimal use is still under debate and depends on many therapy parameters such as dosing and timing of cytotoxic drugs and G-CSF, G-CSF pharmaceuticals used and individual risk factors of patients. METHODS: We integrate available biological knowledge and clinical data regarding cell kinetics of bone marrow granulopoiesis, the cytotoxic effects of chemotherapy and pharmacokinetics and pharmacodynamics of G-CSF applications (filgrastim or pegfilgrastim) into a comprehensive model...
February 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29078878/machine-learning-to-identify-multigland-disease-in-primary-hyperparathyroidism
#16
Joseph R Imbus, Reese W Randle, Susan C Pitt, Rebecca S Sippel, David F Schneider
BACKGROUND: 20%-25% of patients with primary hyperparathyroidism will have multigland disease (MGD). Preoperatative imaging can be inaccurate or unnecessary in MGD. Identification of MGD could direct the need for imaging and inform operative approach. The purpose of this study is to use machine learning (ML) methods to predict MGD. METHODS: Retrospective review of a prospective database. The ML platform, Waikato Environment for Knowledge Analysis, was used, and we selected models for (1) overall accuracy and (2) preferential identification of MGD...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29066114/tissue-transport-affects-how-treatment-scheduling-increases-the-efficacy-of-chemotherapeutic-drugs
#17
Dan E Ganz, Briana Sexton-Stallone, Emily L Brackett, Neil S Forbes
A method to predict the effect of tissue transport on the scheduling of chemotherapeutic treatment could increase efficacy. Many drugs with desirable pharmacokinetic properties fail in vivo due to poor transport through tissue. To predict the effect of treatment schedule on drug efficacy we developed an in silico method that integrates diffusion through tissue and cell binding into a pharmacokinetic model. The model was evaluated with an array of theoretical drugs that had different rates of diffusivity, binding, and clearance...
February 7, 2018: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28969365/evidence-for-potential-underestimation-of-clinical-folate-deficiency-in-resource-limited-countries-using-blood-tests
#18
REVIEW
Asok C Antony
Although a low serum folate concentration is a useful biomarker of pure folate deficiency, the presence of vitamin B12 deficiency or hemolysis or both in individuals with low folate status predictably raises serum folate levels. Therefore, in resource-limited settings where dietary folate deficiency can coexist with vitamin B12 deficiency or malaria or both, the serum folate concentration can range from normal to high, leading to serious underestimation of tissue folate status. This review traces the genesis of an inappropriate overreliance on the serum folate concentration to rule out folate deficiency in vulnerable populations of women and children...
August 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28959224/negative-mood-and-obsessive-compulsive-related-clinical-constructs-an-examination-of-underlying-factors
#19
Gary I Britton, Graham C L Davey
Emerging evidence suggests that many of the clinical constructs used to help understand and explain obsessive-compulsive (OC) symptoms, and negative mood, may be causally interrelated. One approach to understanding this interrelatedness is a motivational systems approach. This approach suggests that rather than considering clinical constructs and negative affect as separable entities, they are all features of an integrated threat management system, and as such are highly coordinated and interdependent. The aim of the present study was to examine if clinical constructs related to OC symptoms and negative mood are best treated as separable or, alternatively, if these clinical constructs and negative mood are best seen as indicators of an underlying superordinate variable, as would be predicted by a motivational systems approach...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28922552/an-individualized-gene-expression-signature-for-prediction-of-lung-adenocarcinoma-metastases
#20
Lishuang Qi, Tianhao Li, Gengen Shi, Jiasheng Wang, Xin Li, Sainan Zhang, Libin Chen, Yuan Qin, Yunyan Gu, Wenyuan Zhao, Zheng Guo
Our laboratory previously reported an individual-level signature consisting of nine gene pairs, named 9-GPS. This signature was developed by training on microarray expression data and validated using three independent integrated microarray data sets, with samples of stage I non-small-cell lung cancer after complete surgical resection. In this study, we first validated the cross-platform robustness of 9-GPS by demonstrating that 9-GPS could significantly stratify the overall survival of 213 stage I lung adenocarcinoma (LUAD) patients detected with RNA-sequencing platform in The Cancer Genome Atlas (TCGA; log-rank P = 0...
November 2017: Molecular Oncology
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