scholarly journals A Risk Scoring System to Predict Progression to Severe Pneumonia in Patients with Covid-19

2020 ◽  
Author(s):  
Ji Yeon Lee ◽  
Byung-Ho Nam ◽  
Mhinjine Kim ◽  
Jongmin Hwang ◽  
Jin Young Kim ◽  
...  
Keyword(s):  
High Risk ◽  
Sensitivity And Specificity ◽  
Scoring System ◽  
Resource Constraints ◽  
Validation Cohort ◽  
Severe Pneumonia ◽  
High Risk Group ◽  
Risk Scores ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Rapid outbreak of coronavirus disease 2019 (Covid-19) raised major concern regarding medical resource constraints. We constructed and validated a scoring system for early prediction of progression to severe pneumonia in patients with Covid-19. A total of 561 patients from a Covid-19 designated hospital in Daegu, South Korea were randomly divided into two cohorts: development cohort (N=421) and validation cohort (N=140). We used multivariate logistic regression to identify four independent risk predictors for progression to severe pneumonia and constructed a risk scoring system by giving each factor a number of scores corresponding to its regression coefficient. We calculated risk scores for each patient and defined two groups: low risk (0 to 8 points) and high risk (9 to 20 points). In the development cohort, the sensitivity and specificity were 83.8% and 78.9%. In the validation cohort, the sensitivity and specificity were 70.8% and 79.3%, respectively. The C-statistics was 0.884 (95% CI, 0.833-0.934) in the development cohort and 0.828 (95% CI, 0.733-0.923) in the validation cohort. This risk scoring system is useful to identify high-risk group for progression to severe pneumonia in Covid-19 patients and can prevent unnecessary overuse of medical care in limited-resource settings.

scholarly journals Development of a Sex-Specific Risk Scoring System for Predicting Cognitive Normal to Mild Cognitive Impairment (SRSS-CNMCI)

2021 ◽  
Author(s):  
Wen Luo ◽  
Hao Wen ◽  
Shuqi Ge ◽  
Chunzhi Tang ◽  
Xiufeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Scoring System ◽  
External Validation ◽  
Scoring Systems ◽  
Cutoff Point ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: We aim to develop a sex-specific risk scoring system for predicting cognitive normal (CN) to mild cognitive impairment (MCI), abbreviated SRSS-CNMCI, to provide a reliable tool for the prevention of MCI.Methods: Participants aged 61-90 years old with a baseline diagnosis of CN and an endpoint diagnosis of MCI were screened from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database with at least one follow-up. Multivariable Cox proportional hazards models were used to identify risk factors associated with conversion from CN to MCI and to build risk scoring systems for male and female groups. Receiver operating characteristic (ROC) curve analysis was applied to determine the risk probability cutoff point corresponding to the optimal prediction effect. We ran an external validation of the discrimination and calibration based on the Harvard Aging Brain Study (HABS) database.Results: A total of 471 participants, including 240 women (51%) and 231 men (49%), aged 61 to 90 years, were included in the study cohort for subsequent primary analysis. The final multivariable models and the risk scoring systems for females and males included age, APOE ε4, Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). The scoring systems for females and males revealed C statistics of 0.902 (95% CI 0.840-0.963) and 0.911 (95% CI 0.863-0.959), respectively, as measures of discrimination. The cutoff point of high and low risk was 33% in females, and more than 33% was considered high risk, while more than 9% was considered high risk for males. The external validation effect of the scoring systems was good: C statistic 0.950 for the females and C statistic 0.965 for the males. Conclusions: Our parsimonious model accurately predicts conversion from CN to MCI with four risk factors and can be used as a predictive tool for the prevention of MCI.

scholarly journals The Efficacy of Risk Score System Establishment and Methylprednisolone Stratification Treatment for Pre-Engraftment Syndrome after Unrelated Cord Blood Transplantation: A Retrospective (development) and a Prospective (validation) Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4501-4501
Author(s):  
Xiaoyu Zhu ◽  
Jiang Zhu ◽  
Baolin Tang ◽  
Kaidi Song ◽  
Linlin Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Scoring System ◽  
Cord Blood Transplantation ◽  
High Risk Factors ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Different Doses

Introduction Pre-engraftment syndrome (PES) is a common immune reaction prior to neutrophil engraftment after unrelated cord blood transplantation (UCBT), with a unique clinical manifestation of non-infectious fever and skin rash. The reported incidence of PES ranges from 20% to 78%. Although many researchers believe that PES is associated with a high incidence of acute graft-versus-host disease (GVHD) but not with transplant-related mortality (TRM) , relapse, or overall survival (OS), they did not stratify the risk factors of PES, and how to carry out different doses of methylprednisolone (MP) stratified intervention therapy still remains unknown. Method s First, 136 hematological malignancy patients treated with UCBT from April 2000 to February 2012 in our transplantation center were retrospectively analysis. Among them, 92 patients occurred PES. High-risk factors for 180-day TRM in PES patients were established by univariate and multivariate analysis. Then, from January 2013 to August 2016, 221 PES patients were scored according to the risk scoring system and stratified treated with different doses of MP. Finally, in order to validate the efficacy of MP stratification treatment, we conducted a prospective, open label and non-randomized clinical trial including 240 PES patients who underwent UCBT from September 2016 to December 2018. This trial is registered at www.chictr.org.cn as ChiCTR-ONC-16009013. Results The cumulative incidence of neutrophil and platelet engraftment was significantly higher in PES group than non-PES group (97.8% vs 70.5%, P<0.001; 75.0% vs 54.5%, P=0.05). In 92 PES patients, multivariate analysis showed that failed MP treatment, multiple clinical symptoms and early onset of PES were independent high risk factors affecting180-day TRM. One high risk factor was scored as 1. The 92 PES patients were divided into PES-0, PES-1,PES-2 and PES-3, and the higher the score, the higher the TRM (17.7% vs 21.9% vs 62.5% vs 100%,respectively; P<0.001), and the lower the OS (68.3% vs 56.2% vs 25.0% vs 0%, respectively; P<0.001). Then, from January 2013 to August 2016, 221 PES patients were scored as PES-0, PES-1 and PES-2 according to the following two high risk factors (multiple clinical symptoms and early onset of PES) and stratified treated with different doses of MP (0.5mg/kg/d for PES-0, 1mg/kg/d for PES-1 and 2mg/kg/d for PES-2). Compared to the previous PES patients with the same risk score, the 180-day TRM of PES-1 and PES-2 patients was significantly reduced and the OS, disease free survival (DFS), and GVHD-free and Relapse-free survival (GRFS) were significantly increased after stratified treatment. The results in the prospective trial were similar to the retrospective study. In addition, although stratified therapy could significantly improve the prognosis of PES-2 patients cohort, the cumulative incidence of acute GVHD and GRFS are still the worst compared with other risk score patients. Therefore, how to improve the outcomes of PES-2 patients remains to be further studied. Conclusion s PES after UCBT is benefit for engraftment, but should be graded according the risk scoring system. Different doses of MP stratified intervention therapy can significantly improve the prognosis of severe PES patients. The risk scoring system of PES after UCBT and MP stratification treatment are worthy of clinical application. But the cumulative incidence of acute GVHD and GRFS in severe PES patients still need to be ameliorated in the further study. Disclosures No relevant conflicts of interest to declare.

A risk scoring system to identify travellers who qualify for pre-exposure rabies vaccination

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Mieke Croughs ◽  
Patrick Soentjens
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Evidence Based ◽  
Risk Scoring ◽  
Risk Predictors ◽  
Risk Scoring System ◽  
Rabies Vaccination

We want to introduce a free online scoring system to identify high risk travellers who qualify for pre-travel rabies vaccination. The system uses evidence based risk predictors and the probable availability of HRIG at the destination.

scholarly journals Development and Validation of a New Risk Scoring System for Cancer Patients with Suspected Infection

2021 ◽  
Author(s):  
Bora Chae ◽  
Seonok Kim ◽  
Yoon-Seon Lee
Keyword(s):  
Cancer Patients ◽  
Scoring System ◽  
Validation Cohort ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Peripheral Oxygen Saturation ◽  
Suspected Infection ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
New Scoring

Abstract Purpose: This study aimed to develop a new prognostic model for predicting 30-day mortality in cancer patients with suspected infection.Methods: This study is a retrospective cohort study and was conducted from August 2019 to December 2019 at a single center. Adult active cancer patients with suspected infection were enrolled among visitors to the emergency room (ER). Logistic regression analysis was used to identify potential predictors for a new model. Results: A total of 899 patients were included; 450 in the development cohort and 449 in the validation cohort. Six independent variables predicted 30-day mortality: Eastern Cooperative Oncology Group (ECOG) performance status (PS), peripheral oxygen saturation (SpO2), creatinine, bilirubin, C-reactive protein (CRP), and lactate. The C-statistic of the new scoring system was 0.799 in the development cohort and 0.793 in the validation cohort. The C-statistics in the development cohort was significantly higher than those of SOFA [0.723 (95% CI: 0.663–0.783)], qSOFA [0.596 (95% CI: 0.537–0.655)], and SIRS [0.547 (95% CI: 0.483–0.612)]. Conclusions: The discriminative capability of the new cancer-specific risk scoring system was good in cancer patients with suspected infection. The new scoring system was superior to SOFA, qSOFA, and SIRS in predicting mortality.

scholarly journals MicroRNA‐based risk scoring system to identify early‐stage oral squamous cell carcinoma patients at high‐risk for cancer‐specific mortality

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 1699-1712 ◽  
Author(s):  
Angela J. Yoon ◽  
Shuang Wang ◽  
David I. Kutler ◽  
Richard D. Carvajal ◽  
Elizabeth Philipone ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Scoring System ◽  
Early Stage ◽  
Specific Mortality ◽  
Risk Scoring ◽  
Cancer Specific Mortality ◽  
Risk Scoring System

scholarly journals An Inflammatory Polymorphisms Risk Scoring System for the Differentiation of Ischemic Stroke Subtypes

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Elena Muiño ◽  
Jurek Krupinski ◽  
Caty Carrera ◽  
Cristina Gallego-Fabrega ◽  
Joan Montaner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Genetic Risk ◽  
Scoring System ◽  
Cardioembolic Stroke ◽  
Risk Scores ◽  
Stroke Subtype ◽  
Stroke Subtypes ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Independent Cohort

Inflammation has been associated with atherothrombotic stroke and recently with cardioembolic stroke. Different genetic risk factors have been specifically associated with the subtypes of ischemic stroke (cardioembolic, atherothrombotic, and lacunar). However, there are no studies that have generated genetic risk scores for the different subtypes of ischemic stroke using polymorphisms associated with inflammation.Methods.We have analyzed 68 polymorphisms of 30 inflammatory mediator genes in 2,685 subjects: 1,987 stroke cases and 698 controls. We generated a genetic scoring system with the most significant polymorphisms weighted by the odds ratio of every polymorphism and taken into consideration the stroke subtype.Results.Three polymorphisms, rs1205 (CRPgene), rs1800779, and rs2257073 (NOS3gene), were associated with cardioembolic stroke (pvalue<0.05). The score generated was only associated with the cardioembolic stroke subtype (pvalue: 0.001) and was replicated in an independent cohort (pvalue: 0.017). The subjects with the highest score presented a cardioembolic stroke in 92.2% of the cases (pvalue: 0.002).Conclusion.The genetics of inflammatory markers is more closely associated with cardioembolic strokes than with atherothrombotic or lacunar strokes. The genetic risk scoring system could be useful in the prediction and differentiation of ischemic stroke; however, it might be specific to particular ischemic stroke subtypes.

scholarly journals A Comparative Study of JASO TP15002-Based Security Risk Assessment Methods for Connected Vehicle System Design

2019 ◽  
Vol 2019 ◽  
pp. 1-35 ◽  
Author(s):  
Yasuyuki Kawanishi ◽  
Hideaki Nishihara ◽  
Daisuke Souma ◽  
Hirotaka Yoshida ◽  
Yoichi Hata
Keyword(s):  
Risk Assessment ◽  
Comparative Study ◽  
Scoring System ◽  
Risk Scores ◽  
Connected Vehicle ◽  
Security Risk ◽  
Multiple Use ◽  
Vehicle Systems ◽  
Risk Scoring ◽  
Risk Scoring System

In recent years, much attention has been paid to autonomous vehicles and security threats on such vehicles have become an important issue. One of these examples is a command injection issue on a gateway ECU, which was reported in 2016. In order to mitigate these threats, the secure design of connected vehicle systems, which is done at the concept phase during development, has become increasingly important in industry. From this perspective, a security guideline such as JASO TP15002 which specifies two concrete methods, CRSS (CVSS Based Risk Scoring System) and RSMA (Risk Scoring Methodology for Automotive System), was made public in 2015. The latest work on the application of TP15002 to the ITU-T X.1373 standard was published in 2017. However, the risk assessment in this publication seems limited. It is not clear from this publication how systematically the risk assessment task in TP15002 can be performed at the implementation level. Another interesting question is how different methods affect the risk scores of connected vehicle systems. In this paper, we focus on the risk assessment phase in JASO TP15002. For a systematic risk assessment, we introduce an idea of asset container and propose to extend CRSS to a novel RSS (Risk Scoring System), RSS-CVSSv3, by appropriately replacing CVSSv2 vulnerability scoring system on which CRSS is based with CVSSv3. To address the above questions, we perform a comparative study on CRSS, RSMA, and RSS-CVSSv3 for multiple use cases such as a CGW (Central Gateway) and a drone, to examine the efficiency and usefulness of our methods. For this comparative purpose, we devise an interesting approach for the refinement of RSMA to the obstacles in comparing CRSS with RSMA.

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