scholarly journals Applicability of logistic regression (LR) risk modelling to decision making in lung cancer resection

2003 ◽  
Vol 2 (1) ◽  
pp. 12-15 ◽  
Author(s):  
G VARELA ◽  
N NOVOA ◽  
M JIMENEZ ◽  
G SANTOS
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Logistic Regression ◽  
Risk Modelling ◽  
Cancer Resection

Preoperative Heparin for Lung Cancer Resection Increases Risk of Reoperation for Bleeding

2020 ◽  
Vol 32 (2) ◽  
pp. 337-343 ◽  
Author(s):  
Robert M. Van Haren ◽  
Ravi Rajaram ◽  
Arlene M. Correa ◽  
Reza J. Mehran ◽  
Mara B. Antonoff ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Resection

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

scholarly journals Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly

2021 ◽  
Vol 6 (1) ◽  
pp. 238146832098477
Author(s):  
Ya-Chen Tina Shih ◽  
Ying Xu ◽  
Lisa M. Lowenstein ◽  
Robert J. Volk
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Private Insurance ◽  
Lung Cancer Screening ◽  
Shared Decision ◽  
Factors Associated ◽  
Coverage Policy ◽  
Privately Insured

Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will likely adopt this coverage policy. This study examined the implementation of SDM in the context of LCS among the privately insured. Methods. We constructed two study cohorts from MarketScan Commercial Claims and Encounters database 2016-2017: a LDCT cohort who received LDCT for LCS and an SDM cohort who had an LCS-related SDM visit. For the LDCT cohort, we examined the trend and factors associated with the receipt of SDM within 3 months prior to LDCT. For the SDM cohort, we studied the trend and factors associated with LDCT within 3 months after an SDM visit. Results. For privately insured adults aged <64, 93% (19,681/21,084) of the LDCT cohort did not have a billing claim indicating SDM, although the uptake of SDM increased from 3.1% in 1Q2016 to 8.2% in 4Q2017 ( P < 0.0001). For the SDM cohort, 46% (948/2048) did not have a claim for an LDCT for lung cancer screening in the 3 months after the SDM visit; this percentage increased from 29.5% in 1Q2016 to 61.8% in 3Q2017 ( P < 0.0001). Limitations. Findings cannot be generalized to other nonelderly adults without private insurance. Additionally, the rate of SDM identified from claims may be underreported. Conclusions. We found a growing but low uptake of SDM among privately insured individuals who underwent LDCT. The higher rate of LDCT in the SDM cohort than the rate reported in national studies emphasized the importance of patient awareness.

scholarly journals A Prolonged Air Leak Score for Lung Cancer Resection: An Analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database

2019 ◽  
Vol 108 (5) ◽  
pp. 1478-1483 ◽  
Author(s):  
Christopher W. Seder ◽  
Sanjib Basu ◽  
Timothy Ramsay ◽  
Gaetano Rocco ◽  
Shanda Blackmon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Air Leak ◽  
Cancer Resection ◽  
Prolonged Air Leak ◽  
General Thoracic Surgery

scholarly journals Assessing the storage potential of Australian rainforest seeds: a decision-making key to aid rapid conservation

2021 ◽  
Author(s):  
K. D. Sommerville ◽  
G. Errington ◽  
Z-J. Newby ◽  
G. S. Liyanage ◽  
C. A. Offord
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Dry Weight ◽  
Germination Percentage ◽  
Fleshy Fruit ◽  
Seed Moisture Content ◽  
Fresh Seed ◽  
Desiccation Sensitivity ◽  
Seed Moisture ◽  
Seed Characteristics

AbstractSeed banking of rainforest species is hindered by lack of knowledge as to which species are tolerant of desiccation and freezing. We assessed 313 Australian rainforest species for seed banking suitability by comparing the germination percentage of fresh seeds to seeds dried at 15% RH and seeds stored at −20 °C after drying. We then compared desiccation responses to environmental, habit, fruit and seed characteristics to identify the most useful predictors of desiccation sensitivity. Of 162 species with ≥ 50% initial germination, 22% were sensitive to desiccation, 64% were tolerant and 10% were partially tolerant; the responses of 4% were uncertain. Of 107 desiccation tolerant species tested for response to freezing, 24% were freezing sensitive or short-lived in storage at −20 °C. Median values for fresh seed moisture content (SMC), oven dry weight (DW) and the likelihood of desiccation sensitivity (PD-S) were significantly greater for desiccation sensitive than desiccation tolerant seeds. Ninety-four to 97% of seeds with SMC < 29%, DW < 20 mg or PD-S < 0.01 were desiccation tolerant. Ordinal logistic regression of desiccation response against environmental, habit, fruit and seed characteristics indicated that the likelihood of desiccation sensitivity was significantly increased by a tree habit, fleshy fruit, increasing fresh SMC and increasing PD-S. The responses observed in this study were combined with earlier studies to develop a simple decision key to aid prediction of desiccation responses in untested rainforest species.

scholarly journals A systematic review and meta-analysis of treatment-related toxicities of curative and palliative radiation therapy in non-small cell lung cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Or ◽  
B. Liu ◽  
J. Lam ◽  
S. Vinod ◽  
W. Xuan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cardiac Events ◽  
Grade 3

AbstractTreatment-related toxicity is an important component in non-small cell lung cancer (NSCLC) management decision-making. Our aim was to evaluate and compare the toxicity rates of curative and palliative radiotherapy with and without chemotherapy. This meta-analysis provides better quantitative estimates of the toxicities compared to individual trials. A systematic review of randomised trials with > 50 unresectable NSCLC patients, treated with curative or palliative conventional radiotherapy (RT) with or without chemotherapy. Data was extracted for oesophagitis, pneumonitis, cardiac events, pulmonary fibrosis, myelopathy and neutropenia by any grade, grade ≥ 3 and treatment-related deaths. Mantel–Haenszel fixed-effect method was used to obtain pooled risk ratio. Forty-nine trials with 8609 evaluable patients were included. There was significantly less grade ≥ 3 acute oesophagitis (6.4 vs 22.2%, p < 0.0001) and any grade oesophagitis (70.4 vs 79.0%, p = 0.04) for sequential CRT compared to concurrent CRT, with no difference in pneumonitis (grade ≥ 3 or any grade), neutropenia (grade ≥ 3), cardiac events (grade ≥ 3) or treatment-related deaths. Although the rate of toxicity increased with intensification of treatment with RT, the only significant difference between treatment regimens was the rate of oesophagitis between the use of concurrent and sequential CRT. This can aid clinicians in radiotherapy decision making for NSCLC.

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