scholarly journals Accuracy of Fibrosis-4 Index in Identification of Patients with Cirrhosis Who Could Potentially Avoid Variceal Screening Endoscopy

2020 ◽  
Vol 9 (11) ◽  
pp. 3510
Author(s):  
Koji Ishida ◽  
Tadashi Namisaki ◽  
Koji Murata ◽  
Yuki Fujimoto ◽  
Souichi Takeda ◽  
...  
Keyword(s):  
High Risk ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Protein Glycosylation ◽  
Fibrosis Score ◽  
Procollagen Type ◽  
Screening Endoscopy ◽  
Cirrhotic Patients ◽  
Index Value

A potential restriction of the Baveno VI consensus, which helps to avoid unnecessary endoscopies, is the limited availability of FibroScan. We aimed to identify serum fibrosis indices that might aid in ruling out the presence of high-risk varices in cirrhotic patients. This retrospective study included 541 consecutive patients with cirrhosis who underwent endoscopy and had data available for nine serum fibrosis indices, including platelet count, hyaluronic acid, 7S fragment of type 4 collagen, procollagen type III N-terminal peptide, tissue inhibitor of metalloproteinases 1, Mac-2 binding protein glycosylation isomer, fibrosis index based on four factors (FIB-4), aspartate transaminase/platelet ratio index and enhanced liver fibrosis score. Optimal index cutoffs for predicting high-risk varices were calculated in an estimation cohort (n = 127) and evaluated in a validation cohort (n = 351). The diagnostic performance of the indices was assessed by receiver operating characteristic curve analysis. In the estimation cohort, a FIB-4 cutoff of 2.78 provided the greatest diagnostic accuracy in predicting both all-grade and high-risk varices. FIB-4 had a negative predictive value of 1.00 for high-risk varices in both cohorts, and 21.3% (27/127) and 14.8% (52/351) of the estimation and validation cohorts, respectively, avoided esophagogastroduodenoscopy; no high-risk varices were missed in either cohort. FIB-4 correctly identifies the absence of high-risk varices in patients with cirrhosis. Therefore, those with a FIB-4 of ≥2.78 should undergo esophagogastroduodenoscopy, and FIB-4 determination should be recommended every 6–12 months concurrently with the other blood tests until the index value reaches 2.78 in those with a FIB-4 of <2.78.

A validated novel preoperative index to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology: A cohort study

2019 ◽  
Vol 30 (7-8) ◽  
pp. 221-228
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh ◽  
Nicholas Hobbs ◽  
Jigar Shah ◽  
Matthew Harris ◽  
...  
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Emergency Laparotomy ◽  
Contamination Index ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Aims To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology. Methods Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination. Results Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively. Conclusions As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.

scholarly journals A prediction nomogram for the 3-year risk of incident diabetes among Chinese adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yang Wu ◽  
Haofei Hu ◽  
Jinlin Cai ◽  
Runtian Chen ◽  
Xin Zuo ◽  
...  
Keyword(s):  
High Risk ◽  
Targeted Delivery ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
External Validation ◽  
Incident Diabetes ◽  
Chinese Adults ◽  
Decision Curve Analysis ◽  
Diabetes Prediction ◽  
Selection Operator

AbstractIdentifying individuals at high risk for incident diabetes could help achieve targeted delivery of interventional programs. We aimed to develop a personalized diabetes prediction nomogram for the 3-year risk of diabetes among Chinese adults. This retrospective cohort study was among 32,312 participants without diabetes at baseline. All participants were randomly stratified into training cohort (n = 16,219) and validation cohort (n = 16,093). The least absolute shrinkage and selection operator model was used to construct a nomogram and draw a formula for diabetes probability. 500 bootstraps performed the receiver operating characteristic (ROC) curve and decision curve analysis resamples to assess the nomogram's determination and clinical use, respectively. 155 and 141 participants developed diabetes in the training and validation cohort, respectively. The area under curve (AUC) of the nomogram was 0.9125 (95% CI, 0.8887–0.9364) and 0.9030 (95% CI, 0.8747–0.9313) for the training and validation cohort, respectively. We used 12,545 Japanese participants for external validation, its AUC was 0.8488 (95% CI, 0.8126–0.8850). The internal and external validation showed our nomogram had excellent prediction performance. In conclusion, we developed and validated a personalized prediction nomogram for 3-year risk of incident diabetes among Chinese adults, identifying individuals at high risk of developing diabetes.

scholarly journals A novel collagen area fraction index to quantitatively assess bowel fibrosis in patients with Crohn’s disease

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue-hua Li ◽  
Zhuang-nian Fang ◽  
Tian-ming Guan ◽  
Jin-jiang Lin ◽  
Can-hui Sun ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Area Fraction ◽  
Strongly Correlated ◽  
Fibrosis Score ◽  
High Repeatability

Abstract Background A validated histopathological tool to precisely evaluate bowel fibrosis in patients with Crohn’s disease is lacking. We attempted to establish a new index to quantify the severity of bowel fibrosis in patients with Crohn’s disease-associated fibrostenosis. Methods We analyzed the histopathological data of 31 patients with Crohn’s disease strictures undergoing surgical resection. The most representative sections of resected strictured segments were stained with Masson trichrome to manifest bowel fibrosis. The collagen area fraction and histological fibrosis score were simultaneously calculated for the same section to evaluate the severity of bowel fibrosis. Results Collagen area fraction strongly correlated with histological fibrosis scores (r = 0.733, P < 0.001). It showed a stronger correlation (r = 0.561, P < 0.001) with the degree of bowel strictures than the histological fibrosis score did (r = 0.468, P < 0.001). It was also shown to be more accurate for diagnosing Crohn’s disease strictures (area under the receiver operating characteristic curve = 0.815, P < 0.001) compared with the histological fibrosis score (area under the curve = 0.771, P < 0.001). High repeatability was observed for the collagen area fraction, with an intraclass correlation coefficient of 0.915 (P < 0.001). Conclusions Collagen area fraction is a simple and reliable index to quantify the severity of bowel fibrosis in patients with Crohn’s disease-associated fibrostenosis.

scholarly journals Nomogram Based on Cytokines for Cardiovascular Diseases in Xinjiang Kazakhs

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Lei Mao ◽  
Xianghui Zhang ◽  
Yunhua Hu ◽  
Xinping Wang ◽  
Yanpeng Song ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Baseline Survey ◽  
Cvd Risk ◽  
Cytokine Levels ◽  
Study Population ◽  
The Town

Background. This study involved the development of a predictive 5-year morbidity nomogram for cardiovascular diseases (CVD) in Xinjiang Kazakhs based on cytokine levels. Methods. The nomogram was based on a baseline survey of the town of Nalati in the Kazakh Autonomous Prefecture of Xinjiang from 2009 to 2013. By 2016, we had monitored 1508 people for a median time of 5.17 years and identified CVD events in the study population by collecting case information from local hospitals. The study population was divided into the training (n=1005) and validation cohorts (n=503) in a 2 : 1 ratio. The area under the receiver operating characteristic curve (AUC) was used to verify the predictive accuracy of the nomogram. The result was assessed in a validation cohort. Results. At the end of the study, the incidence of CVD in Xinjiang Kazakhs was found to be 11.28%. We developed a new nomogram to predict the 5-year incidence of CVD based on age, interleukin-6 (IL-6), and adiponectin (APN) levels, diastolic blood pressure, and dyslipidemia. The AUC for the predictive accuracy of the nomogram was 0.836 (95% confidence interval: 0.802–0.869), which was higher than that for IL-6 and APN. These results were supported by validation studies. Conclusions. The nomogram model can more directly assess the risk of CVD in Kazakhs and can be used for CVD risk assessment.

scholarly journals Comparação da Aplicação da EER Hema-Obs a 250 Gestações da Consulta de Hematologia-Obstetrícia do Centro Hospitalar São João, Portugal Versus EER Galit Sarig a 90 Gestações no Rambam Health Care Campus, Israel

2015 ◽  
Vol 28 (2) ◽  
pp. 189
Author(s):  
Ana Salselas ◽  
Inês Pestana ◽  
Francisco Bischoff ◽  
Mariana Guimarães ◽  
Joaquim Aguiar Andrade
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Pregnant Women ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Risk Groups ◽  
Low Risk ◽  
Very High ◽  
Receiver Operating

<strong>Introduction:</strong> Pregnant women with thromboembolic diseases, previous thrombotic episodes or thrombophilia family history were supervised in a multidisciplinary Obstetrics/ Hematology consultation in Centro Hospitalar São João EPE, Porto, Portugal. For the evaluation and medication of these women, a risk stratification scale was used.<br /><strong>Purposes:</strong> The aim of this study was to validate a Risk Stratification Scale and thromboprophylaxis protocol by means of comparing it with a similar scale, developed and published by Sarig.<br /><strong>Material and Methods:</strong> We have compared: The distribution, by risk groups, obtained through the application of the two scales on pregnant women followed at Centro Hospitalar São João, Porto, Portugal, consultation; the sensibility and specificity for each one of the scales (DeLong scale, applied to Receiver Operating Characteristic) curves; the outcomes in pregnancies followed in Hospital São João, Porto, Portugal<br /><strong>Results:</strong> According to our Hema-Obs risk stratification scale, 29% were allocated to low-risk, 47% to high-risk and 24% to very-high-risk groups. According to Galit Sarig risk stratification scale, 24% were considered low-risk, 53% moderate, 16% high-risk and 7% as very high-risk group. In our study we observed 9% of spontaneous abortions, in comparison with 18% in the Galit Sarig cohort. From the application of Receiver Operating Characteristic curve to both risk stratification scales, the results of the calculated areas were 58,8% to our Hema-Obs risk stratification scale and 38,7% to Galit Sarig risk stratification scale, with a Delong test significancie of p = 0.0006.<br /><strong>Conclusions:</strong> We concluded that Hema-Obs risk stratification scale is an effective support for clinical monitoring of therapeutic strategies.

scholarly journals Validation of a Prediction Tool for Chemotherapy Toxicity in Older Adults With Cancer

2016 ◽  
Vol 34 (20) ◽  
pp. 2366-2371 ◽  
Author(s):  
Arti Hurria ◽  
Supriya Mohile ◽  
Ajeet Gajra ◽  
Heidi Klepin ◽  
Hyman Muss ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Prediction Model ◽  
Receiver Operating Characteristic Curve ◽  
Predictive Model ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Chemotherapy Toxicity ◽  
Operating Characteristic Curve ◽  
Grade 3

Purpose Older adults are at increased risk for chemotherapy toxicity, and standard oncology assessment measures cannot identify those at risk. A predictive model for chemotherapy toxicity was developed (N = 500) that consisted of geriatric assessment questions and other clinical variables. This study aims to externally validate this model in an independent cohort (N = 250). Patients and Methods Patients age ≥ 65 years with a solid tumor, fluent in English, and who were scheduled to receive a new chemotherapy regimen were recruited from eight institutions. Risk of chemotherapy toxicity was calculated (low, medium, or high risk) on the basis of the prediction model before the start of chemotherapy. Chemotherapy-related toxicity was captured (grade 3 [hospitalization indicated], grade 4 [life threatening], and grade 5 [treatment-related death]). Validation of the prediction model was performed by calculating the area under the receiver-operating characteristic curve. Results The study sample (N = 250) had a mean age of 73 years (range, 65 to 94 [standard deviation, 5.8]). More than one half of patients (58%) experienced grade ≥ 3 toxicity. Risk of toxicity increased with increasing risk score (36.7% low, 62.4% medium, 70.2% high risk; P < .001). The area under the curve of the receiver-operating characteristic curve was 0.65 (95% CI, 0.58 to 0.71), which was not statistically different from the development cohort (0.72; 95% CI, 0.68 to 0.77; P = .09). There was no association between Karnofsky Performance Status and chemotherapy toxicity (P = .25). Conclusion This study externally validated a chemotherapy toxicity predictive model for older adults with cancer. This predictive model should be considered when discussing the risks and benefits of chemotherapy with older adults.

scholarly journals A Five-MicroRNA Signature Predicts the Prognosis in Nasopharyngeal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Shixiong Wu ◽  
Cen Zhang ◽  
Jing Xie ◽  
Shuang Li ◽  
Shuo Huang
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Nasopharyngeal Carcinoma ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Risk Group ◽  
Characteristic Curve ◽  
High Risk Group ◽  
Prognostic Signature ◽  
Operating Characteristic Curve

BackgroundThere is no effective prognostic signature that could predict the prognosis of nasopharyngeal carcinoma (NPC).MethodsWe constructed a prognostic signature based on five microRNAs using random forest and Least Absolute Shrinkage And Selection Operator (LASSO) algorithm on the GSE32960 cohort (N = 213). We verified its prognostic value using three independent external validation cohorts (GSE36682, N = 62; GSE70970, N = 246; and TCGA-HNSC, N = 523). Through principal component analysis, receiver operating characteristic curve analysis, and C-index calculation, we confirmed the predictive accuracy of this prognostic signature.ResultsWe calculated the risk score based on the LASSO algorithm and divided the patients into high- and low-risk groups according to the calculated optimal cutoff value. The patients in the high-risk group tended to have a worse prognosis outcome and chemotherapy response. The time-dependent receiver operating characteristic curve showed that the 1-year overall survival rate of the five-microRNA signature had an area under the curve of more than 0.83. A functional annotation analysis of the five-microRNA signature showed that the patients in the high-risk group were usually accompanied by activation of DNA repair and MYC-target pathways, while the patients in the low-risk group had higher immune-related pathway signals.ConclusionsWe constructed a five-microRNA prognostic signature, which could accurately predict the prognosis of nasopharyngeal carcinoma, and constructed a nomogram that could conveniently predict the overall survival of patients.

scholarly journals Simple Scoring Tool to Estimate Risk of Hospitalization and Mortality in Ambulatory and Emergency Department Patients with COVID-19

2021 ◽  
Author(s):  
Brandon J. Webb ◽  
Nicholas M. Levin ◽  
Nancy Grisel ◽  
Samuel M. Brown ◽  
Ithan D. Peltan ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
High Risk ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
External Validation ◽  
Receiver Operator Characteristic Curve ◽  
Multivariable Logistic Regression Model ◽  
White Race ◽  
Derivation Cohort ◽  
Scoring Tool

AbstractBackgroundAccurate methods of identifying patients with COVID-19 who are at high risk of poor outcomes has become especially important with the advent of limited-availability therapies such as monoclonal antibodies. Here we describe development and validation of a simple but accurate scoring tool to classify risk of hospitalization and mortality.MethodsAll consecutive patients testing positive for SARS-CoV-2 from March 25-October 1, 2020 within the Intermountain Healthcare system were included. The cohort was randomly divided into 70% derivation and 30% validation cohorts. A multivariable logistic regression model was fitted for 14-day hospitalization. The optimal model was then adapted to a simple, probabilistic score and applied to the validation cohort and evaluated for prediction of hospitalization and 28-day mortality.Results22,816 patients were included; mean age was 40 years, 50.1% were female and 44% identified as non-white race or Hispanic/Latinx ethnicity. 6.2% required hospitalization and 0.4% died. Criteria in the simple model included: age (0.5 points per decade); high-risk comorbidities (2 points each): diabetes mellitus, severe immunocompromised status and obesity (body mass index≥30); non-white race/Hispanic or Latinx ethnicity (2 points), and 1 point each for: male sex, dyspnea, hypertension, coronary artery disease, cardiac arrythmia, congestive heart failure, chronic kidney disease, chronic pulmonary disease, chronic liver disease, cerebrovascular disease, and chronic neurologic disease. In the derivation cohort (n=16,030) area under the receiver-operator characteristic curve (AUROC) was 0.82 (95% CI 0.81-0.84) for hospitalization and 0.91 (0.83-0.94) for 28-day mortality; in the validation cohort (n=6,786) AUROC for hospitalization was 0.8 (CI 0.78-0.82) and for mortality 0.8 (CI 0.69-0.9).ConclusionA prediction score based on widely available patient attributes accurately risk stratifies patients with COVID-19 at the time of testing. Applications include patient selection for therapies targeted at preventing disease progression in non-hospitalized patients, including monoclonal antibodies. External validation in independent healthcare environments is needed.

Clinical value and potential mechanisms of LINC00221 in hepatocellular carcinoma based on integrated analysis

Epigenomics ◽  
2021 ◽  
Author(s):  
Yanlin Feng ◽  
Souraka Tapara Dramani Maman ◽  
Xinyu Zhu ◽  
Xuefang Liu ◽  
Christian Cedric Bongolo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Bioinformatics Analysis ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Integrated Analysis ◽  
Clinical Value ◽  
Serum Samples ◽  
Functional Roles

This study aimed to unveil the functional roles of LINC00221 in hepatocellular carcinoma (HCC). A discovery cohort and a validation cohort were respectively used to identify and verify the clinical value of LINC00221 in HCC. Bioinformatics analysis was performed to explore its potential mechanisms. LINC00221 was upregulated in HCC tissues and serum samples. Survival analysis and receiver operating characteristic curve further revealed its prognostic and diagnostic roles. Exploration of the mechanism showed that LINC00221 might exert a pro-cancer role via the lncRNA–miRNA–mRNA network. Our study reveals that upregulated LINC00221 can serve as a potential diagnostic and prognostic biomarker and provides novel clues as to the role of LINC00221 in HCC.

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