PT05.3: Clinical Classification of Adult Patients with Chronic Intestinal Failure (CIF): An International Cross-Sectional Survey

2016 ◽  
Vol 35 ◽  
pp. S31 ◽  
Author(s):  
L. Pironi
Gut ◽  
2020 ◽  
Vol 69 (10) ◽  
pp. 1787-1795 ◽  
Author(s):  
Loris Pironi ◽  
Ezra Steiger ◽  
Francisca Joly ◽  
Geert J A Wanten ◽  
Cecile Chambrier ◽  
...  

Background and aimNo marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity.MethodsAt baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1–2, 2–3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI).ResultsFifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day).ConclusionsThe type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.


2011 ◽  
Vol 14 (12) ◽  
pp. 2254-2259 ◽  
Author(s):  
Anna C Holland ◽  
Matthew C Kennedy ◽  
Stephen W Hwang

AbstractObjectiveTo compare the Household Food Insecurity Access Scale (HFIAS), the US Food Security Survey Module (US FSSM) and a modified version of the US FSSM in which references to buying food were changed to references to getting food, in terms of their classification of food security levels among homeless individuals, and to determine which of these instruments was most preferred by homeless individuals.DesignA cross-sectional survey.SettingRecruitment of participants took place at seven shelters and from three drop-in programmes that serve homeless individuals in Toronto, Canada.SubjectsFifty individuals who were ≥18 years of age, able to communicate in English and currently homeless.ResultsThe modified US FSSM assigned 20 % of participants to a lower ordinal food security category compared with the US FSSM, and only 8 % to a higher food security category. The HFIAS assigned 30 % of participants to a lower food security category compared with either the US FSSM or the modified US FSSM, and only 10–16 % of participants to a higher food security category. When asked to compare all three instruments, the majority of respondents (62 %) selected the HFIAS as the best instrument for people who are homeless.ConclusionsA majority of homeless individuals selected the HFIAS as the best food security instrument for people who are homeless. Our findings suggest that the HFIAS is a more appropriate instrument than the US FSSM for measuring food security in the homeless population.


2021 ◽  
Author(s):  
Leon M Aksman ◽  
Peter A Wijeratne ◽  
Neil P Oxtoby ◽  
Arman Eshaghi ◽  
Cameron Shand ◽  
...  

Progressive disorders are highly heterogeneous. Symptom-based clinical classification of these disorders may not reflect the underlying pathobiology. Data-driven subtyping and staging of patients has the potential to disentangle the complex spatiotemporal patterns of disease progression. Tools that enable this are in high demand from clinical and treatment-development communities. Here we describe the pySuStaIn software package, a Python-based implementation of the Subtype and Stage Inference (SuStaIn) algorithm. SuStaIn unravels the complexity of heterogeneous diseases by inferring multiple disease progression patterns (subtypes) and individual severity (stages) from cross-sectional data. The primary aims of pySuStaIn are to enable widespread application and translation of SuStaIn via an accessible Python package that supports simple extension and generalization to novel modelling situations within a single, consistent architecture.


2021 ◽  
Vol 9 ◽  
Author(s):  
Markus Wübbeler ◽  
Sebastian Geis ◽  
Jovana Stojanovic ◽  
Lise Elliott ◽  
Iñaki Gutierrez-Ibarluzea ◽  
...  

Introduction: An important requirement for successful public health interventions is a standardized classification in order to make these health technologies comparable in all contexts and recognized by all parties. The WHO International Classification of Health Interventions (ICHI), including an integrated public health component, has been developed to propose such an international standard.Methods: To test (a) the translation of public health interventions to ICHI codes and (b) the technical handling and general coding in public health, we used a set of public health interventions from a recent cross-sectional survey among Health Technology Assessment professionals.Results: Our study showed that handling of the ICHI interface is stable, that there is a need for specificity and adequate detail of intervention descriptions and desired outcomes to code adequately with ICHI and that the professional background of the coder, as well as his/her sex might influence the selection of codes.Conclusion: International Classification of Health Interventions provides a good coverage of public health interventions. However, the broader character of system wide interventions, often involving a variety of institutions and stakeholders, may present a challenge to the application of ICHI coding. Based on this experience, we would tailor future surveys more specifically to the needs of the classification and we advise training for health professionals before coding with ICHI. Standards of reporting will likely strengthen insights about the efficiency of primary prevention interventions and thus benefit long-term health of populations and structured HTA reporting process.


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