scholarly journals Identification of High-risk Groups of Suicide from the Depressed Elderly using Decision Tree Analysis

2019 ◽  
Vol 30 (2) ◽  
pp. 130 ◽  
Author(s):  
Sehoon Hong ◽  
Dongwon Lee
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Risk Groups ◽  
Decision Tree Analysis ◽  
Tree Analysis

scholarly journals Nomogram Predicting Survival to Assist Decision-Making of Metastasectomy in Patients With Metastatic Renal Cell Carcinoma

2020 ◽  
Vol 10 ◽  
Author(s):  
Kan Wu ◽  
Zhihong Liu ◽  
Yanxiang Shao ◽  
Xiang Li
Keyword(s):  
Renal Cell Carcinoma ◽  
Decision Tree ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Risk Groups ◽  
Low Risk ◽  
Patient Stratification ◽  
Decision Tree Analysis ◽  
Tree Analysis

The survival benefit of metastasectomy (MSX) in patients with metastatic renal cell carcinoma (mRCC) remains unclear. A reliable model to predict an individuals’ risk of cancer-specific mortality (CSM) and to identify optimal candidates for MSX is needed. We identified 2,911 mRCC patients who underwent cytoreductive nephrectomy from the Surveillance, Epidemiology, and End Results database (2010–2015). Based on the Fine and Gray competing risks analyses, we created a nomogram to predict the survival of mRCC patients. Decision tree analysis was useful for patient stratification. The impact of MSX was assessed among three different subgroups. Overall, 579 (19.9%) cases underwent MSX. In the entire patients, the 1-, 2-, and 3-year cumulative incidence of CSM were 32.8, 47.2, and 57.9%, respectively. MSX was significantly associated with improved survival (hazard ratio [HR] = 0.875, 95% confidence interval [CI] 0.773–0.991; P = 0.015). Based on risk scores, patients were divided into three risk groups using decision tree analysis. In the low-risk group, MSX was significantly associated with a 12.8% risk reduction of 3-year CSM (HR = 0.689, 95% CI 0.507–0.938; P = 0.008), while MSX was not associated with survival in intermediate- and high-risk groups. We proposed a novel nomogram and patient stratification approach to identify suitable patients for MSX. The newly identified patient subgroup with a low-risk of CSM might benefit more from aggressive surgery. These results should be further validated and improved by the prospective trials.

scholarly journals Clinical Prediction Rule for Bacteremia Among Patients with Pyelonephritis and Hospitalization Judgment: Chi-Squared Automatic Interaction Detector (CHAID) Decision Tree Analysis Model

2021 ◽  
Author(s):  
Sayato Fukui ◽  
Akihiro Inui ◽  
Mizue Saita ◽  
Daiki Kobayashi ◽  
Toshio Naito
Keyword(s):  
High Risk ◽  
Blood Culture ◽  
Decision Tree ◽  
Blood Cell ◽  
White Blood Cell ◽  
Decision Tree Analysis ◽  
Analysis Model ◽  
Tree Analysis ◽  
Chi Squared ◽  
Automatic Interaction Detector

Abstract Background: Positive risk factors for bacteremia among patients with pyelonephritis have not been defined using a Chi-Squared Automatic Interaction Detector (CHAID) Decision Tree Analysis Model. Purpose: We sought to identify predictive factors for bacteremia among patients with pyelonephritis and therefore which patients need hospitalization.Methods: This retrospective cross-sectional survey was performed at the Juntendo University Nerima Hospital, Tokyo, Japan and comprised all patients with pyelonephritis from whom blood cultures were taken from January 1, 2010 to July 31, 2020. At the time of blood culture sample collection, clinical information was obtained from medical charts, along with vital signs, quick Sequential Organ Failure Assessment (qSOFA), subjective symptoms, objective physical findings, laboratory findings, and results of blood and urine cultures. Factors potentially predictive of bacteremia among patients with pyelonephritis were analyzed using the Student’s t-test or chi-squared test and the CHAID decision tree analysis model.Results: A total of 198 patients (male:female, 60 (30.3%):138 (69.7%), ages (mean±SD) 74.69±15.27 years) were included in this study, of whom 92 (46.4%) had positive blood culture results. The CHAID decision tree analysis revealed that patients with White blood cell >21,000/μL had a quite-high-risk (89.5%) of developing bacteremia. Patients with White blood cell ≤21,000/μL plus Chill plus Aspartate aminotransferase >19 IU/L represented a high-risk group (69.0%). Conversely, patients with White blood cell ≤21,000/μL plus non-Chill plus Albumin >3.60 g/dL were at a low risk (16.3%) of developing bacteremia.Conclusion: Our results emphasize the importance of hospitalization among high-risk and quite-high-risk groups of pyelonephritis patients.

scholarly journals Clinical prediction rule for bacteremia with pyelonephritis and hospitalization judgment: chi-square automatic interaction detector (CHAID) decision tree analysis model

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110656
Author(s):  
Sayato Fukui ◽  
Akihiro Inui ◽  
Mizue Saita ◽  
Daiki Kobayashi ◽  
Toshio Naito
Keyword(s):  
High Risk ◽  
Blood Culture ◽  
Decision Tree ◽  
Blood Cell ◽  
Decision Tree Analysis ◽  
Analysis Model ◽  
Blood Cell Count ◽  
Chi Square ◽  
Tree Analysis ◽  
Automatic Interaction Detector

Objective This study was performed to identify predictive factors for bacteremia among patients with pyelonephritis using a chi-square automatic interaction detector (CHAID) decision tree analysis model. Methods This retrospective cross-sectional survey was performed at Juntendo University Nerima Hospital, Tokyo, Japan and included all patients with pyelonephritis from whom blood cultures were taken. At the time of blood culture sample collection, clinical information was extracted from the patients’ medical charts, including vital signs, symptoms, laboratory data, and culture results. Factors potentially predictive of bacteremia among patients with pyelonephritis were analyzed using Student’s t-test or the chi-square test and the CHAID decision tree analysis model. Results In total, 198 patients (60 (30.3%) men, 138 (69.7%) women; mean age, 74.69 ± 15.27 years) were included in this study, of whom 92 (46.4%) had positive blood culture results. The CHAID decision tree analysis revealed that patients with a white blood cell count of >21,000/μL had a very high risk (89.5%) of developing bacteremia. Patients with a white blood cell count of ≤21,000/μL plus chills plus an aspartate aminotransferase concentration of >19 IU/L constituted the high-risk group (69.0%). Conclusion The present results are extremely useful for predicting the results of bacteremia among patients with pyelonephritis.

scholarly journals Predicting risk of early discontinuation of exclusive breastfeeding at a Brazilian referral hospital for high-risk neonates and infants: a decision-tree analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maíra Domingues Bernardes Silva ◽  
Raquel de Vasconcellos Carvalhaes de Oliveira ◽  
Davi da Silveira Barroso Alves ◽  
Enirtes Caetano Prates Melo
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Hospital Stay ◽  
Decision Trees ◽  
Hospital Discharge ◽  
Exclusive Breastfeeding ◽  
World Health ◽  
Feeding Practice ◽  
Decision Tree Analysis ◽  
Tree Analysis

Abstract Background Determinants at several levels may affect breastfeeding practices. Besides the known historical, socio-economic, cultural, and individual factors, other components also pose major challenges to breastfeeding. Predicting existing patterns and identifying modifiable components are important for achieving optimal results as early as possible, especially in the most vulnerable population. The goal of this study was building a tree-based analysis to determine the variables that can predict the pattern of breastfeeding at hospital discharge and at 3 and 6 months of age in a referral center for high-risk infants. Methods This prospective, longitudinal study included 1003 infants and was conducted at a high-risk public hospital in the following three phases: hospital admission, first visit after discharge, and monthly telephone interview until the sixth month of the infant’s life. Independent variables were sorted into four groups: factors related to the newborn infant, mother, health service, and breastfeeding. The outcome was breastfeeding as per the categories established by the World Health Organization (WHO). For this study, we performed an exploratory analysis at hospital discharge and at 3 and at 6 months of age in two stages, as follows: (i) determining the frequencies of baseline characteristics stratified by breastfeeding indicators in the three mentioned periods and (ii) decision-tree analysis. Results The prevalence of exclusive breastfeeding (EBF) was 65.2% at hospital discharge, 51% at 3 months, and 20.6% at 6 months. At hospital discharge and the sixth month, the length of hospital stay was the most important predictor of feeding practices, also relevant at the third month. Besides the mother’s and child’s characteristics (multiple births, maternal age, and parity), the social context, work, feeding practice during hospitalization, and hospital practices and policies on breastfeeding influenced the breastfeeding rates. Conclusions The combination algorithm of decision trees (a machine learning technique) provides a better understanding of the risk predictors of breastfeeding cessation in a setting with a large variability in expositions. Decision trees may provide a basis for recommendations aimed at this high-risk population, within the Brazilian context, in light of the hospital stay at a neonatal unit and period of continuous feeding practice.

scholarly journals Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1094
Author(s):  
Michael Wong ◽  
Nikolaos Thanatsis ◽  
Federica Nardelli ◽  
Tejal Amin ◽  
Davor Jurkovic
Keyword(s):  
Decision Tree ◽  
Expectant Management ◽  
Decision Tree Model ◽  
Decision Tree Analysis ◽  
Focal Lesions ◽  
Tree Model ◽  
Normal Endometrium ◽  
Endometrial Polyps ◽  
Tree Analysis ◽  
Interaction Detection

Background and aims: Postmenopausal endometrial polyps are commonly managed by surgical resection; however, expectant management may be considered for some women due to the presence of medical co-morbidities, failed hysteroscopies or patient’s preference. This study aimed to identify patient characteristics and ultrasound morphological features of polyps that could aid in the prediction of underlying pre-malignancy or malignancy in postmenopausal polyps. Methods: Women with consecutive postmenopausal polyps diagnosed on ultrasound and removed surgically were recruited between October 2015 to October 2018 prospectively. Polyps were defined on ultrasound as focal lesions with a regular outline, surrounded by normal endometrium. On Doppler examination, there was either a single feeder vessel or no detectable vascularity. Polyps were classified histologically as benign (including hyperplasia without atypia), pre-malignant (atypical hyperplasia), or malignant. A Chi-squared automatic interaction detection (CHAID) decision tree analysis was performed with a range of demographic, clinical, and ultrasound variables as independent, and the presence of pre-malignancy or malignancy in polyps as dependent variables. A 10-fold cross-validation method was used to estimate the model’s misclassification risk. Results: There were 240 women included, 181 of whom presented with postmenopausal bleeding. Their median age was 60 (range of 45–94); 18/240 (7.5%) women were diagnosed with pre-malignant or malignant polyps. In our decision tree model, the polyp mean diameter (≤13 mm or >13 mm) on ultrasound was the most important predictor of pre-malignancy or malignancy. If the tree was allowed to grow, the patient’s body mass index (BMI) and cystic/solid appearance of the polyp classified women further into low-risk (≤5%), intermediate-risk (>5%–≤20%), or high-risk (>20%) groups. Conclusions: Our decision tree model may serve as a guide to counsel women on the benefits and risks of surgery for postmenopausal endometrial polyps. It may also assist clinicians in prioritizing women for surgery according to their risk of malignancy.

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