scholarly journals DIALYSIS START TIMING: DEVELOPMENT AND VALIDATION OF START SCORING SCALE

2018 ◽  
Vol 20 (2) ◽  
pp. 47-60 ◽  
Author(s):  
A. Yu. Zemchenkov ◽  
R. P. Gerasimchuk ◽  
A. B. Sabodash ◽  
K. A. Vishnevskii ◽  
G. A. Zemchenkov ◽  
...  
Keyword(s):  
Decision Making ◽  
Mortality Risk ◽  
Mortality Prediction ◽  
Validation Dataset ◽  
Optimal Time ◽  
Survival Prediction ◽  
Diabetes Status ◽  
The Difference ◽  
Validation Set ◽  
And Gender

Aim.The optimal time for initiating of chronic dialysis remains unknown. The scale for mortality risk assessment could help in decision-making concerning dialysis start timing.Methods.We randomly divided 1856 patients started dialysis in 2009–2016 into developmental and validation group (1:1) to create and validate scoring system «START» predicting mortality risk at dialysis initiation in order to fi nd unmodifi able and modifi able factors which could help in the decision-making of dialysis start. In the series of univariate regression models in the developmental set, we evaluated the mortality risk linked with available parameters: age, eGFR, serum phosphate, total calcium, hemoglobin, Charlson comorbidity index, diabetes status, urgency of start (turned to be signifi cant) and gender, serum sodium, potassium, blood pressure (without impact on survival). Similar hazard ratios were converted to score points.Results.The START score was highly predictive of death: C-statistic was 0.82 (95% CI 0.79–0.85) for the developmental dataset and 0.79 (95% CI 0.74–0.84) for validation dataset (both p < 0.001). On applying the cutoff between 7–8 points in the developmental dataset, the risk score was highly sensitive 81.1% and specifi c 67.9%; for validation dataset, the sensitivity was 78.9%, specifi city 67.9%. We confi rmed the similarity in survival prediction in the validation set to developmental set in low, medium and high START score groups. The difference in survival between three levels of START-score in validation set remained similar to that of developmental set: Wilcoxon = 8.78 (p = 0.02) vs 15.31 (p < 0.001) comparing low–medium levels and 25.18 (p < 0.001) vs 39.21 (p < 0.001) comparing medium–high levels.Conclusion.Developed START score system including modifi able factors showed good mortality prediction and could be used in dialysis start decision-making. 

scholarly journals Development and Validation of a Sepsis Mortality Risk Score for Sepsis-3 Patients in Intensive Care Unit

2021 ◽  
Vol 7 ◽  
Author(s):  
Kai Zhang ◽  
Shufang Zhang ◽  
Wei Cui ◽  
Yucai Hong ◽  
Gensheng Zhang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mortality Risk ◽  
External Validation ◽  
Model Development ◽  
Mortality Prediction ◽  
Sepsis Mortality ◽  
Severity Scores ◽  
Validation Set ◽  
Development And Validation ◽  
Risk Stratification Score

Background: Many severity scores are widely used for clinical outcome prediction for critically ill patients in the intensive care unit (ICU). However, for patients identified by sepsis-3 criteria, none of these have been developed. This study aimed to develop and validate a risk stratification score for mortality prediction in sepsis-3 patients.Methods: In this retrospective cohort study, we employed the Medical Information Mart for Intensive Care III (MIMIC III) database for model development and the eICU database for external validation. We identified septic patients by sepsis-3 criteria on day 1 of ICU entry. The Least Absolute Shrinkage and Selection Operator (LASSO) technique was performed to select predictive variables. We also developed a sepsis mortality prediction model and associated risk stratification score. We then compared model discrimination and calibration with other traditional severity scores.Results: For model development, we enrolled a total of 5,443 patients fulfilling the sepsis-3 criteria. The 30-day mortality was 16.7%. With 5,658 septic patients in the validation set, there were 1,135 deaths (mortality 20.1%). The score had good discrimination in development and validation sets (area under curve: 0.789 and 0.765). In the validation set, the calibration slope was 0.862, and the Brier value was 0.140. In the development dataset, the score divided patients according to mortality risk of low (3.2%), moderate (12.4%), high (30.7%), and very high (68.1%). The corresponding mortality in the validation dataset was 2.8, 10.5, 21.1, and 51.2%. As shown by the decision curve analysis, the score always had a positive net benefit.Conclusion: We observed moderate discrimination and calibration for the score termed Sepsis Mortality Risk Score (SMRS), allowing stratification of patients according to mortality risk. However, we still require further modification and external validation.

scholarly journals Construction of a survival prediction model for high-and low -grade UTUC after tumor resection based on “SEER database”: a multicenter study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mengmeng Wang ◽  
Xin Ren ◽  
Ge Wang ◽  
Xiaomin Sun ◽  
Shifeng Tang ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Training Dataset ◽  
Validation Dataset ◽  
Survival Prediction ◽  
Low Grade ◽  
Seer Database ◽  
Discriminative Ability ◽  
Internal Validation ◽  
The Difference ◽  
Good Calibration

Abstract Background There are differences in survival between high-and low-grade Upper Tract Urothelial Carcinoma (UTUC). Our study aimed to develop a nomogram to predict overall survival (OS) of patients with high- and low-grade UTUC after tumor resection, and to explore the difference between high- and low-grade patients. Methods Patients confirmed to have UTUC between 2004 and 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. The UTUCs were identified and classified as high- and low-grade, and 1-, 3- and 5-year nomograms were established. The nomogram was then validated using the Chinese multicenter dataset (patients diagnosed in Shandong, China between January 2010 and October 2020). Results In the high-grade UTUC patients, nine important factors related to survival after tumor resection were identified to construct nomogram. The C index of training dataset was 0.740 (95% confidence interval [CI]: 0.727–0.754), showing good calibration. The C index of internal validation dataset was 0.729(95% CI:0.707–0.750). On the other hand, Two independent predictors were identified to construct nomogram of low-grade UTUC. The C index was 0.714 (95% CI: 0.671–0.758) for the training set,0.731(95% CI:0.670–0.791) for the internal validation dataset. Encouragingly, the nomogram was clinically useful and had a good discriminative ability to identify patients at high risk. Conclusion We constructed a nomogram and a corresponding risk classification system predicting the OS of patients with an initial diagnosis of high-and low-grade UTUC.

scholarly journals Education and gender wage gap: Evidence from Indonesia

Accounting ◽  
2021 ◽  
pp. 33-40 ◽  
Author(s):  
Suharyono Suharyono ◽  
Kumba Digdowiseiso
Keyword(s):  
Decision Making ◽  
Decomposition Method ◽  
Gender Wage Gap ◽  
Wage Gap ◽  
Decision Making Process ◽  
Economic Survey ◽  
The Difference ◽  
And Gender ◽  
The Relationship ◽  
Government Level

This paper empirically tried to analyze the effects of education on the gender wage gap in Indonesia and to examine whether globalization could alter such a relationship. We modified a decomposition method for the panel dataset that corresponds to the National Socio-Economic Survey from 1996 to 2016. Overall, we found that schooling could significantly influence the salary discrepancy. We also proved that globalization did matter in explaining the relationship between the educational attainment and the salary gap. Here, it could widen the difference in the remuneration. Based on the results, strengthening the gender-responsive budget at the national government level might be one of the solutions. Basically, it actually started with a new awareness of the budget that was not genderneutral. Thus, the positioning of women in education and decision-making process is very crucial for the future of development.

scholarly journals Investigation of Empathy Skills and Moral Decision-Making Attitudes in Athlete Students in Terms of Some Variables

2021 ◽  
Vol 7 (2) ◽  
pp. 275
Author(s):  
Ercan Çirmi ◽  
Serhat Turan
Keyword(s):  
Decision Making ◽  
Personal Information ◽  
Team Sports ◽  
Moral Decision ◽  
Moral Decision Making ◽  
Negative Behaviors ◽  
Significant Difference ◽  
Long Time ◽  
The Difference ◽  
And Gender

It is observed that the appearance of aggression and violent anti-social behavior in sports contradicts the Olimpia culture inherent in sports. Therefore, this research was conducted in order to reveal the causes and consequences of negative behaviors observed in sports, to examine the empathy skills and moral decision-making attitudes of athletes in terms of different variables. The research was arranged by the screening survey model. A total of 319 athletes, 180 men, and 139 women, engaged in individual and team sports in the city where the research was conducted, voluntarily participated in this research. Personal information form, “Prediction in Sports and Empathy in Sports” and “Attitudes to Moral Decision-making in Youth Sport Questionnaire” were applied to the participants. In the analysis of the data, the Manova test and the LSD test were used to determine the source of the difference. As a result of the research, while a significant difference was found in favor of men in terms of gender in empathy skills(p < .05); there was not found a significant difference in terms of sports branch and sports year(p > .05). In terms of the sports year variable, the moral decision-making attitude scores of individuals who have just started sports (0-2 years) compared to individuals who have been doing sports for a long time(9+ years) were found to be higher and this result was found to indicate a statistically significant difference(p < .05). There was not found a significant difference in moral decision-making attitudes scores in terms of sports year and gender.

The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

2020 ◽  
Author(s):  
Marie Eggeling ◽  
Anna Meinhardt ◽  
Ulrike Cress ◽  
Joachim Kimmerle ◽  
Martina Bientzle
Keyword(s):  
Decision Making ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
General Information ◽  
Treatment Preference ◽  
Controlled Study ◽  
Treatment Preferences ◽  
Hypothetical Scenario ◽  
And Gender ◽  
The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P&lt;.001). Decision certainty (P&lt;.001) and satisfaction (P&lt;.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P&lt;.001; physiotherapy recommendation: P&lt;.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

Information support for expert evaluation of the states of the external environment

2020 ◽  
pp. 71-76
Author(s):  
Rasol Murtadha Najah
Keyword(s):  
Decision Making ◽  
Environmental Conditions ◽  
Fuzzy Inference ◽  
Environmental Parameters ◽  
Information Support ◽  
Expert Assessment ◽  
Fuzzy Variables ◽  
Decision Making Models ◽  
The Difference ◽  
State Of The Environment

This article discusses the application of methods to enhance the knowledge of experts to build a decision-making model based on the processing of physical data on the real state of the environment. Environmental parameters determine its ecological state. To carry out research in the field of expert assessment of environmental conditions, the analysis of known works in this field is carried out. The results of the analysis made it possible to justify the relevance of the application of analytical, stochastic models and models based on methods of enhancing the knowledge of experts — experts. It is concluded that the results of using analytical and stochastic objects are inaccurate, due to the complexity and poor mathematical description of the objects. The relevance of developing information support for an expert assessment of environmental conditions is substantiated. The difference of this article is that based on the analysis of the application of expert methods for assessing the state of the environment, a fuzzy logic adoption model and information support for assessing the environmental state of the environment are proposed. The formalization of the parameters of decision-making models using linguistic and fuzzy variables is considered. The formalization of parameters of decision-making models using linguistic and fuzzy variables was considered. The model’s description of fuzzy inference is given. The use of information support for environment state assessment is shown on the example of experts assessing of the land desertification stage.

Integrating gender in rice research

2019 ◽  
Vol 56 (Special) ◽  
pp. 164-168
Author(s):  
BN Sadangi ◽  
Biswajit Mondal
Keyword(s):  
Decision Making ◽  
Impact Assessment ◽  
Farming System ◽  
Work Participation ◽  
Gender Mainstreaming ◽  
Limited Resources ◽  
Men And Women ◽  
Planning Project ◽  
Systematic Understanding ◽  
And Gender

Gender mainstreaming in agriculture is new trend to address the inequalities of resources and work participation between men and women for ensuring equity in gender. Though women constitute about half of the total agricultural labour, their access to resources as well as decision making power is limited. Particularly, women in rice-based farming system though undertake hard work, own or share very limited resources and benefits in comparison to other systems. Various needs of women, while undertake research and technologies developed should be addressed appropriately through gender focussed planning, project implementation, monitoring as well as impact assessment. A systematic understanding and capacity building of the planners, researchers, development and extension machineries on innovative mechanism and gender sensitive perspectives would bring socioeconomic upliftment of not only women but the whole society.

A novel q-rung orthopair fuzzy TODIM approach for multi-criteria group decision making based on Shapley value and relative entropy

2021 ◽  
Vol 40 (1) ◽  
pp. 235-250
Author(s):  
Liuxin Chen ◽  
Nanfang Luo ◽  
Xiaoling Gou
Keyword(s):  
Decision Making ◽  
Relative Entropy ◽  
Group Decision Making ◽  
Shapley Value ◽  
Group Decision ◽  
Similarity Measures ◽  
Entropy Measure ◽  
Shapley Values ◽  
Interactive Relationship ◽  
The Difference

In the real multi-criteria group decision making (MCGDM) problems, there will be an interactive relationship among different decision makers (DMs). To identify the overall influence, we define the Shapley value as the DM’s weight. Entropy is a measure which makes it better than similarity measures to recognize a group decision making problem. Since we propose a relative entropy to measure the difference between two systems, which improves the accuracy of the distance measure.In this paper, a MCGDM approach named as TODIM is presented under q-rung orthopair fuzzy information.The proposed TODIM approach is developed for correlative MCGDM problems, in which the weights of the DMs are calculated in terms of Shapley values and the dominance matrices are evaluated based on relative entropy measure with q-rung orthopair fuzzy information.Furthermore, the efficacy of the proposed Gq-ROFWA operator and the novel TODIM is demonstrated through a selection problem of modern enterprises risk investment. A comparative analysis with existing methods is presented to validate the efficiency of the approach.

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