scholarly journals Development of a nomogram incorporating serum C-reactive protein level to predict overall survival of patients with advanced urothelial carcinoma and its evaluation by decision curve analysis

2012 ◽  
Vol 107 (7) ◽  
pp. 1031-1036 ◽  
Author(s):  
J Ishioka ◽  
K Saito ◽  
M Sakura ◽  
M Yokoyama ◽  
Y Matsuoka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Urothelial Carcinoma ◽  
Protein Level ◽  
Curve Analysis ◽  
C Reactive Protein ◽  
Decision Curve Analysis ◽  
Reactive Protein ◽  
Advanced Urothelial Carcinoma

Contribution of C-reactive protein to predicting overall survival in patients with advanced urothelial carcinoma: Development of a nomogram and evaluation by decision curve analysis.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 280-280
Author(s):  
Junichiro Ishioka ◽  
Kazutaka Saito ◽  
Mizuaki Sakura ◽  
Minato Yokoyama ◽  
Yoh Matsuoka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Urothelial Carcinoma ◽  
Predictive Accuracy ◽  
Curve Analysis ◽  
Negative Consequences ◽  
C Reactive Protein ◽  
Net Benefit ◽  
Decision Curve Analysis ◽  
Reactive Protein ◽  
Advanced Urothelial Carcinoma

280 Background: To accurately estimate the individual survival of patients with advanced urothelial carcinoma (UC), the application of prediction models such as nomograms has been warranted in clinical use. We therefore constructed a nomogram which included C-reactive protein (CRP) as a novel biomarker in order to increase its predictive accuracy. Furthermore, the clinical usefulness of this nomogram was evaluated by decision curve analysis which incorporated the negative consequences of each decision to generate a net benefit (Vickers et al, BMC Med Inform Decis Mak, 2008). Methods: A total of 232 consecutive patients with locally advanced or metastatic urothelial carcinoma (UC) were treated at our institute. Among them, 9 patients with missing data were excluded. The current study cohort was comprised of the remaining 223 patients. A nomogram predicting 6- and 12-month survival probability was developed based on the results of the final multivariate analytic model. To evaluate the efficacy of this nomogram, a quantified concordance-index (c-index) was computed and a decision curve analysis was performed. Results: Overall, 184 patients died of the primary disease and the remaining 39 were censored. The median follow-up period and length of overall survival were 5 and 6 months, respectively. The 6- and 12-month survival rates were 48% and 30% respectively. A nomogram was developed which included the parameters of age, PS, visceral metastasis, hemoglobin and CRP. The c-index of this prediction model was 0.79 compared with 0.75 for that of a model without CRP. The decision curve analysis revealed that a novel nomogram which incorporated CRP had a superior net benefit to that without CRP for most of the examined threshold probabilities. Conclusions: Incorporation of CRP increased the predictive accuracy of a prognostic nomogram for advanced UC. In clinical practice, this nomogram would contribute to the decision making process in the treatment of patients suffering from this form of carcinoma.

scholarly journals Impact of C-reactive Protein Flare Response in Patients With Advanced Urothelial Carcinoma Who Received Pembrolizumab

In Vivo ◽  
2021 ◽  
Vol 35 (6) ◽  
pp. 3563-3568
Author(s):  
IKKO TOMISAKI ◽  
MIRII HARADA ◽  
KEI TOKUTSU ◽  
AKINORI MINATO ◽  
YUJIRO NAGATA ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Flare Response ◽  
Advanced Urothelial Carcinoma

scholarly journals MP49-05 PROGNOSTIC IMPACT OF C-REACTIVE PROTEIN KINETICS ON SURVIVAL OF PATIENTS WITH ADVANCED UROTHELIAL CARCINOMA

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Junichiro Ishioka ◽  
Kazutaka Saito ◽  
Masaharu Inoue ◽  
Masaya Itoh ◽  
Soichiro Yoshida ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Prognostic Impact ◽  
C Reactive Protein ◽  
Protein Kinetics ◽  
Reactive Protein ◽  
Advanced Urothelial Carcinoma

scholarly journals C-reactive protein as a triage tool for adults with presumptive pulmonary tuberculosis in South Africa: a prospective cohort study

2021 ◽  
Author(s):  
Claire J Calderwood ◽  
Byron WP Reeve ◽  
Tiffeney Mann ◽  
Zaida Palmer ◽  
Georgina Nyawo ◽  
...  
Keyword(s):  
South Africa ◽  
Diagnostic Accuracy ◽  
Clinical Utility ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Hiv Status ◽  
C Reactive Protein ◽  
Decision Curve Analysis ◽  
Reactive Protein ◽  
Triage Test

Background: Identification of an accurate, low-cost triage test for pulmonary TB among people presenting to healthcare facilities is an urgent global research priority. We assessed the diagnostic accuracy and clinical utility of C-reactive protein (CRP) for TB triage among symptomatic adult outpatients, irrespective of HIV status. Methods: We prospectively enrolled adults reporting at least one (for people with HIV) or two (for people without HIV) symptoms of cough, fever, night sweats, or weight loss at two TB clinics in Cape Town, South Africa. Participants provided sputum for culture and Xpert MTB/RIF Ultra. We evaluated the diagnostic accuracy of CRP (measured using a laboratory-based assay) against a TB-culture reference standard as the area under the receiver operating characteristic curve (AUROC) and sensitivity and specificity at pre-specified thresholds. We assessed clinical utility using decision curve analysis, benchmarked against WHO recommendations. Results: Of 932 included individuals, 255 (27%) had culture-confirmed TB and 389 (42%) were living with HIV. CRP demonstrated an AUROC of 0.80 (95% confidence interval 0.77-0.83), with sensitivity 93% (89-95%) and specificity 54% (50-58%) using a primary cut-off of ≥10mg/L. Performance was similar among people with HIV to those without. In decision curve analysis, CRP-based triage offered greater clinical utility than confirmatory testing for all up to a number willing to test threshold of 20 confirmatory tests per true positive TB case diagnosed. Conclusions: CRP approached the WHO-defined minimum performance for a TB triage test and showed evidence of clinical utility among symptomatic outpatients, irrespective of HIV status.

scholarly journals Predictive factors of perforated appendicitis: Impact of the C-reactive protein level

2021 ◽  
Author(s):  
Shiori Yamazaki ◽  
Yusuke Shimodaira ◽  
Akira Kobayashi ◽  
Manabu Takata ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Protein Level ◽  
Perforated Appendicitis ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Dynamic nomograms combining N classification with ratio-based nodal classifications to predict long-term survival for patients with lung adenocarcinoma after surgery: a SEER population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suyu Wang ◽  
Yue Yu ◽  
Wenting Xu ◽  
Xin Lv ◽  
Yufeng Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Adenocarcinoma ◽  
External Validation ◽  
Predictive Performance ◽  
Information Criterion ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Concordance Index ◽  
Cancer Specific Survival ◽  
Decision Curve Analysis

Abstract Background The prognostic roles of three lymph node classifications, number of positive lymph nodes (NPLN), log odds of positive lymph nodes (LODDS), and lymph node ratio (LNR) in lung adenocarcinoma are unclear. We aim to find the classification with the strongest predictive power and combine it with the American Joint Committee on Cancer (AJCC) 8th TNM stage to establish an optimal prognostic nomogram. Methods 25,005 patients with T1-4N0–2M0 lung adenocarcinoma after surgery between 2004 to 2016 from the Surveillance, Epidemiology, and End Results database were included. The study cohort was divided into training cohort (13,551 patients) and external validation cohort (11,454 patients) according to different geographic region. Univariate and multivariate Cox regression analyses were performed on the training cohort to evaluate the predictive performance of NPLN (Model 1), LODDS (Model 2), LNR (Model 3) or LODDS+LNR (Model 4) respectively for cancer-specific survival and overall survival. Likelihood-ratio χ2 test, Akaike Information Criterion, Harrell concordance index, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to evaluate the predictive performance of the models. Nomograms were established according to the optimal models. They’re put into internal validation using bootstrapping technique and external validation using calibration curves. Nomograms were compared with AJCC 8th TNM stage using decision curve analysis. Results NPLN, LODDS and LNR were independent prognostic factors for cancer-specific survival and overall survival. LODDS+LNR (Model 4) demonstrated the highest Likelihood-ratio χ2 test, highest Harrell concordance index, and lowest Akaike Information Criterion, and IDI and NRI values suggested Model 4 had better prediction accuracy than other models. Internal and external validations showed that the nomograms combining TNM stage with LODDS+LNR were convincingly precise. Decision curve analysis suggested the nomograms performed better than AJCC 8th TNM stage in clinical practicability. Conclusions We constructed online nomograms for cancer-specific survival and overall survival of lung adenocarcinoma patients after surgery, which may facilitate doctors to provide highly individualized therapy.

scholarly journals Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Protein Level ◽  
Clinical Characteristics ◽  
Single Center ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Survivor Group ◽  
Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

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