Predictive value of clinical evaluation in the follow-up of children with a brain tumor

2002 ◽  
Vol 38 (4) ◽  
pp. 254-257 ◽  
Author(s):  
Nanko de Graaf ◽  
Joffre M. Hew ◽  
Johanna M. Fock ◽  
Willem A. Kamps ◽  
Siebold S.N. de Graaf
Keyword(s):  
Brain Tumor ◽  
Clinical Evaluation ◽  
Predictive Value

scholarly journals A machine learning approach for predicting suicidal thoughts and behaviours among college students

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melissa Macalli ◽  
Marie Navarro ◽  
Massimiliano Orri ◽  
Marie Tournier ◽  
Rodolphe Thiébaut ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Tools ◽  
Receiver Operating Curve ◽  
Depression Symptoms ◽  
Suicidal Thoughts ◽  
One Year

AbstractSuicidal thoughts and behaviours are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviours among college students within one-year of baseline assessment. We used data collected in 2013–2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviours. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviours in a community sample of college students.

Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease

Respiration ◽  
2021 ◽  
pp. 1-8
Author(s):  
Clemens F. Hinke ◽  
Rudolf A. Jörres ◽  
Peter Alter ◽  
Robert Bals ◽  
Florian Bornitz ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Predictive Value ◽  
Hemoglobin Concentration ◽  
Blood Gas Analysis ◽  
Study Data ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Acute Exacerbations ◽  
All Cause Mortality

<b><i>Background:</i></b> Oxygenated hemoglobin(OxyHem) is a simple-to-measure marker of oxygen content capable of predicting all-cause mortality in stable chronic obstructive pulmonary disease (COPD). <b><i>Objectives:</i></b> We aimed to analyze its predictive value during acute exacerbations of COPD (AECOPD). <b><i>Methods:</i></b> In this retrospective study, data from 227 patients discharged after severe AECOPD at RoMed Clinical Center Rosenheim, Germany, between January 2012 and March 2018, was analyzed. OxyHem (hemoglobin concentration [Hb] × fractional SpO<sub>2</sub>, g/dL) was calculated from oxygen saturation measured by pulse oximetry and hemoglobin assessed within 24 h after admission. The follow-up (1.7 ± 1.5 years) covered all-cause mortality, including readmissions for severe AECOPD. <b><i>Results:</i></b> During the follow-up period, 127 patients died, 56 due to AECOPD and 71 due to other reasons. Survivors and non-survivors showed differences in age, FVC % predicted, C-reactive protein, hemoglobin, Cr, Charlson Comorbidity Index (CCI), and OxyHem (<i>p</i> &#x3c; 0.05 each). Significant independent predictors of survival were BMI, Cr or CCI, FEV<sub>1</sub> % predicted or FVC % predicted, Hb, or OxyHem. The predictive value of OxyHem (<i>p</i> = 0.006) was superior to that of Hb or SpO<sub>2</sub> and independent of oxygen supply during blood gas analysis. OxyHem was also predictive when using a cutoff value of 12.1 g/dL identified via receiver operating characteristic curves in analyses including either the CCI (hazard ratio 1.85; 95% CI 1.20, 2.84; <i>p</i> = 0.005) or Cr (2.04; 95% CI 1.35, 3.10; <i>p</i> = 0.001) as covariates. <b><i>Conclusion:</i></b> The concentration of OxyHem provides independent, easy-to-assess information on long-term mortality risk in COPD, even if measured during acute exacerbations. It therefore seems worth to be considered for broader clinical use.

scholarly journals Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2320
Author(s):  
Paolo Ferroli ◽  
Ignazio Gaspare Vetrano ◽  
Silvia Schiavolin ◽  
Francesco Acerbi ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Performance Status ◽  
Tumor Resection ◽  
Patient Specific ◽  
Invasive Treatment ◽  
Tertiary Referral Center ◽  
Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

2020 ◽  
pp. 1-8
Author(s):  
Melissa Oosthuizen ◽  
Rubina Razack ◽  
Jenny Edge ◽  
Pawel Tomasz Schubert
Keyword(s):  
Predictive Value ◽  
Best Practice ◽  
Internal Audit ◽  
Needle Aspiration ◽  
Male Breast ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

<b><i>Objective:</i></b> This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. <b><i>Study Design:</i></b> Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. <b><i>Results:</i></b> The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. <b><i>Conclusion:</i></b> This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

scholarly journals Potential predictive value of axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage defects over a mean follow-up of four years

2020 ◽  
Vol 28 (2) ◽  
pp. 215-222 ◽  
Author(s):  
S.R. Apprich ◽  
M.M. Schreiner ◽  
P. Szomolanyi ◽  
G.H. Welsch ◽  
U.K. Koller ◽  
...  
Keyword(s):  
Predictive Value ◽  
T2 Mapping ◽  
3 Tesla ◽  
Cartilage Defects ◽  
Patellar Cartilage ◽  
3 Tesla Mri

Benefit of Static FET PET in Pretreated Pediatric Brain Tumor Patients with Equivocal Conventional MRI Results

2021 ◽  
Author(s):  
Frederik Grosse ◽  
Florian Wedel ◽  
Ulrich-Wilhelm Thomale ◽  
Ingo Steffen ◽  
Arend Koch ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Tumor Tissue ◽  
Pediatric Brain Tumor ◽  
Ct Scans ◽  
Tumor Patients ◽  
Fet Pet ◽  
Conventional Mri ◽  
Pet Ct ◽  
Pediatric Brain

Abstract Background MRI has shortcomings in differentiation between tumor tissue and post-therapeutic changes in pretreated brain tumor patients. Patients We assessed 22 static FET-PET/CT-scans of 17 pediatric patients (median age 12 years, range 2–16 years, ependymoma n=4, medulloblastoma n=4, low-grade glioma n=6, high-grade glioma n=3, germ cell tumor n=1, choroid plexus tumor n=1, median follow-up: 112 months) with multimodal treatment. Method FET-PET/CT-scans were analyzed visually by 3 independent nuclear medicine physicians. Additionally quantitative FET-Uptake for each lesion was determined by calculating standardized uptake values (SUVmaxT/SUVmeanB, SUVmeanT/SUVmeanB). Histology or clinical follow-up served as reference. Results Static FET-PET/CT reliably distinguished between tumor tissue and post-therapeutic changes in 16 out of 17 patients. It identified correctly vital tumor tissue in 13 patients and post-therapeutic changes in 3 patients. SUV-based analyses were less sensitive than visual analyses. Except from a choroid plexus carcinoma, all tumor entities showed increased FET-uptake. Discussion Our study comprises a limited number of patients but results corroborate the ability of FET to detect different brain tumor entities in pediatric patients and discriminate between residual/recurrent tumor and post-therapeutic changes. Conclusions We observed a clear benefit from additional static FET-PET/CT-scans when conventional MRI identified equivocal lesions in pretreated pediatric brain tumor patients. These results warrant prospective studies that should include dynamic scans.

Echocardiography for the 10-year prediction of cardiomyopathy in long-term survivors of childhood cancer

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.M Leerink ◽  
H.J.H Van Der Pal ◽  
E.A.M Feijen ◽  
P.G Meregalli ◽  
M.S Pourier ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Median Time ◽  
Cancer Diagnosis ◽  
Predictive Value ◽  
Validation Cohort ◽  
Funding Source ◽  
Derivation Cohort ◽  
After Cancer ◽  
Radiotherapy Dose

Abstract Background Childhood cancer survivors (CCS) treated with anthracyclines and/or chest-directed radiotherapy receive life-long echocardiographic surveillance to detect cardiomyopathy early. Current risk stratification and surveillance frequency recommendations are based on anthracycline- and chest-directed radiotherapy dose. We assessed the added prognostic value of an initial left ventricular ejection fraction (EF) measurement at &gt;5 years after cancer diagnosis. Patients and methods Echocardiographic follow-up was performed in asymptomatic CCS from the Emma Children's Hospital (derivation; n=299; median time after diagnosis, 16.7 years [inter quartile range (IQR) 11.8–23.15]) and from the Radboud University Medical Center (validation; n=218, median time after diagnosis, 17.0 years [IQR 13.0–21.7]) in the Netherlands. CCS with cardiomyopathy at baseline were excluded (n=16). The endpoint was cardiomyopathy, defined as a clinically significant decreased EF (EF&lt;40%). The predictive value of the initial EF at &gt;5 years after cancer diagnosis was analyzed with multivariable Cox regression models in the derivation cohort and the model was validated in the validation cohort. Results The median follow-up after the initial EF was 10.9 years and 8.9 years in the derivation and validation cohort, respectively, with cardiomyopathy developing in 11/299 (3.7%) and 7/218 (3.2%), respectively. Addition of the initial EF on top of anthracycline and chest radiotherapy dose increased the C-index from 0.75 to 0.85 in the derivation cohort and from 0.71 to 0.92 in the validation cohort (p&lt;0.01). The model was well calibrated at 10-year predicted probabilities up to 5%. An initial EF between 40–49% was associated with a hazard ratio of 6.8 (95% CI 1.8–25) for development of cardiomyopathy during follow-up. For those with a predicted 10-year cardiomyopathy probability &lt;3% (76.9% of the derivation cohort and 74.3% of validation cohort) the negative predictive value was &gt;99% in both cohorts. Conclusion The addition of the initial EF &gt;5 years after cancer diagnosis to anthracycline- and chest-directed radiotherapy dose improves the 10-year cardiomyopathy prediction in CCS. Our validated prediction model identifies low-risk survivors in whom the surveillance frequency may be reduced to every 10 years. Calibration in both cohorts Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Dutch Heart Foundation

scholarly journals New screening approach to detecting congenital syphilis in China: a retrospective cohort study

2020 ◽  
pp. archdischild-2020-320549
Author(s):  
Fang Hu ◽  
Shuai-Jun Guo ◽  
Jian-Jun Lu ◽  
Ning-Xuan Hua ◽  
Yan-Yan Song ◽  
...  
Keyword(s):  
Predictive Value ◽  
Congenital Syphilis ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Operating Characteristics ◽  
Loss To Follow Up ◽  
Sensitivity Specificity ◽  
Mother To Child ◽  
Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

scholarly journals Extension and refinement of the predictive value of different classes of markers in ADNI: Four-year follow-up data

2014 ◽  
Vol 10 (6) ◽  
pp. 704-712 ◽  
Author(s):  
Jesus J. Gomar ◽  
Concepcion Conejero-Goldberg ◽  
Peter Davies ◽  
Terry E. Goldberg ◽  
Keyword(s):  
Predictive Value
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