External validation of the Medication Risk Score (MERIS) in polypharmacy patients in general practice: a tool for prioritising patients at greatest risk of potential drug‐related problems.

2021 ◽  
Author(s):  
Kirsten Høj ◽  
Henrik Schou Pedersen ◽  
Anne Sofie Baymler Lundberg ◽  
Flemming Bro ◽  
Lars Peter Nielsen ◽  
...  
Keyword(s):  
General Practice ◽  
Risk Score ◽  
External Validation ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Medication Risk

scholarly journals Screening Tools Used by Clinical Pharmacists to Identify Elderly Patients at Risk of Drug-Related Problems on Hospital Admission: A Systematic Review

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 64 ◽  
Author(s):  
Amanda Brady ◽  
Chris E. Curtis ◽  
Zahraa Jalal
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Risk Prediction ◽  
Risk Score ◽  
Prediction Models ◽  
External Validation ◽  
Screening Tools ◽  
Cochrane Library ◽  
Drug Related Problems ◽  
Increased Risk

In recent years, a number of studies have examined tools to identify elderly patients who are at increased risk of drug-related problems (DRPs). There has been interest in developing tools to prioritise patients for clinical pharmacist (CP) review. This systematic review (SR) aimed to identify published primary research in this area and critically evaluate the quality of prediction tools to identify elderly patients at increased risk of DRPs and/or likely to need CP intervention. The PubMed, EMBASE, OVID HMIC, Cochrane Library, PsychInfo, CINAHL PLUS, Web of Science and ProQuest databases were searched. Keeping up to date with research and citations, the reference lists of included articles were also searched to identify relevant studies. The studies involved the development, utilisation and/or validation of a prediction tool. The protocol for this SR, CRD42019115673, was registered on PROSPERO. Data were extracted and systematically assessed for quality by considering the four key stages involved in accurate risk prediction models—development, validation, impact and implementation—and following the Checklist for the critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). Nineteen studies met the inclusion criteria. Variations in study design, participant characteristics and outcomes made meta-analysis unsuitable. The tools varied in complexity. Most studies reported the sensitivity, specificity and/or discriminatory ability of the tool. Only four studies included external validation of the tool(s), namely of the BADRI model and the GerontoNet ADR Risk Score. The BADRI score demonstrated acceptable goodness of fit and good discrimination performance, whilst the GerontoNet ADR Risk Score showed poor reliability in external validation. None of the models met the four key stages required to create a quality risk prediction model. Further research is needed to either refine the tools developed to date or develop new ones that have good performance and have been externally validated before considering the potential impact and implementation of such tools.

Abstract # OR-20: External Validation of the Leicester Self-Assessment Diabetes Risk Score in a Population with Intellectual Disability

2016 ◽  
Vol 22 ◽  
pp. 12
Author(s):  
Laura Gray ◽  
Yogini Chudasama ◽  
Alison Dunkley ◽  
Freya Tyrer ◽  
Rebecca Spong ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Risk Score ◽  
External Validation ◽  
Diabetes Risk ◽  
Self Assessment ◽  
Diabetes Risk Score

External Validation of the VOCAL‐Penn Cirrhosis Surgical Risk Score in Two Large, Independent Health Systems

2021 ◽  
Author(s):  
Nadim Mahmud ◽  
Zachary Fricker ◽  
Sarjukumar Panchal ◽  
James D. Lewis ◽  
David S. Goldberg ◽  
...  
Keyword(s):  
Health Systems ◽  
Risk Score ◽  
External Validation ◽  
Surgical Risk

Risk of Conversion to Arthroplasty After Hip Arthroscopy: Validation of a Published Risk Score Using an Independent, Prospectively Collected Database

2021 ◽  
pp. 036354652199382
Author(s):  
Mario Hevesi ◽  
Devin P. Leland ◽  
Philip J. Rosinsky ◽  
Ajay C. Lall ◽  
Benjamin G. Domb ◽  
...  
Keyword(s):  
Risk Score ◽  
Roc Curve ◽  
Hip Arthroscopy ◽  
External Validation ◽  
Area Under The Curve ◽  
Harris Hip Score ◽  
Brier Score ◽  
Level Of Evidence ◽  
Center Edge ◽  
Modified Harris Hip Score

Background: Hip arthroscopy is rapidly advancing and increasingly commonly performed. The most common surgery after arthroscopy is total hip arthroplasty (THA), which unfortunately occurs within 2 years of arthroscopy in up to 10% of patients. Predictive models for conversion to THA, such as that proposed by Redmond et al, have potentially substantial value in perioperative counseling and decreasing early arthroscopy failures; however, these models need to be externally validated to demonstrate broad applicability. Purpose: To utilize an independent, prospectively collected database to externally validate a previously published risk calculator by determining its accuracy in predicting conversion of hip arthroscopy to THA at a minimum 2-year follow-up. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: Hip arthroscopies performed at a single center between November 2015 and March 2017 were reviewed. Patients were assessed pre- and intraoperatively for components of the THA risk score studied—namely, age, modified Harris Hip Score, lateral center-edge angle, revision procedure, femoral version, and femoral and acetabular Outerbridge scores—and followed for a minimum of 2 years. Conversion to THA was determined along with the risk score’s receiver operating characteristic (ROC) curve and Brier score calibration characteristics. Results: A total of 187 patients (43 men, 144 women, mean age, 36.0 ± 12.4 years) underwent hip arthroscopy and were followed for a mean of 2.9 ± 0.85 years (range, 2.0-5.5 years), with 13 patients (7%) converting to THA at a mean of 1.6 ± 0.9 years. Patients who converted to THA had a mean predicted arthroplasty risk of 22.6% ± 12.0%, compared with patients who remained arthroplasty-free with a predicted risk of 4.6% ± 5.3% ( P < .01). The Brier score for the calculator was 0.04 ( P = .53), which was not statistically different from ideal calibration, and the calculator demonstrated a satisfactory area under the curve of 0.894 ( P < .001). Conclusion: This external validation study supported our hypothesis in that the THA risk score described by Redmond et al was found to accurately predict which patients undergoing hip arthroscopy were at risk for converting to subsequent arthroplasty, with satisfactory discriminatory, ROC curve, and Brier score calibration characteristics. These findings are important in that they provide surgeons with validated tools to identify the patients at greatest risk for failure after hip arthroscopy and assist in perioperative counseling and decision making.

Predicting 90-day mortality after bariatric surgery: an independent, external validation of the OS-MRS prognostic risk score

2014 ◽  
Vol 10 (5) ◽  
pp. 774-779 ◽  
Author(s):  
David Arterburn ◽  
Eric S. Johnson ◽  
Melissa G. Butler ◽  
David Fisher ◽  
Elizabeth A. Bayliss
Keyword(s):  
Bariatric Surgery ◽  
Risk Score ◽  
External Validation

External validation and comparison of risk score models in pediatric heart transplants

2021 ◽  
Author(s):  
Alia Dani ◽  
Justin S. Heidel ◽  
Tingting Qiu ◽  
Yin Zhang ◽  
Yizhao Ni ◽  
...  
Keyword(s):  
Risk Score ◽  
External Validation ◽  
Heart Transplants

scholarly journals The Roth score as a triage tool for detecting hypoxaemia in general practice: a diagnostic validation study in patients with possible COVID-19

2021 ◽  
Vol 22 ◽  
Author(s):  
Charlotte E.M. ten Broeke ◽  
Jelle C.L. Himmelreich ◽  
Jochen W.L. Cals ◽  
Wim A.M. Lucassen ◽  
Ralf E. Harskamp
Keyword(s):  
General Practice ◽  
Validation Study ◽  
Virus Disease ◽  
External Validation ◽  
Added Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Single Breath ◽  
C Statistic ◽  
Counting Time

Abstract Aim: To validate the Roth score as a triage tool for detecting hypoxaemia. Backgrounds: The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as a triage tool for detecting hypoxaemia remotely in potential COVID-19 patients in general practice. Methods: This cross-sectional validation study was conducted in Dutch general practice. Patients aged ≥18 with suspected or confirmed COVID-19 were asked to rapidly count from 1 to 30 in a single breath. The Roth score involves the highest number counted during exhalation (counting number) and the time taken to reach the maximal count (counting time). Outcome measures were (1) the correlation between both Roth score measurements and simultaneous pulse oximetry (SpO2) on room air and (2) discrimination (c-statistic), sensitivity, specificity and predictive values of the Roth score for detecting hypoxaemia (SpO2 < 95%). Findings: A total of 33 physicians enrolled 105 patients (52.4% female, mean age of 52.6 ± 20.4 years). A positive correlation was found between counting number and SpO2 (rs = 0.44, P < 0.001), whereas only a weak correlation was found between counting time and SpO2 (rs = 0.15, P = 0.14). Discrimination for hypoxaemia was higher for counting number [c-statistic 0.91 (95% CI: 0.85–0.96)] than for counting time [c-statistic 0.77 (95% CI: 0.62–0.93)]. Optimal diagnostic performance was found at a counting number of 20, with a sensitivity of 93.3% (95% CI: 68.1–99.8) and a specificity of 77.8% (95% CI: 67.8–85.9). A counting time of 7 s showed the best sensitivity of 85.7% (95% CI: 57.2–98.2) and specificity of 81.1% (95% CI: 71.5–88.6). Conclusions: A Roth score, with an optimal counting number cut-off value of 20, maybe of added value for signalling hypoxaemia in general practice. Further external validation is warranted before recommending integration in telephone triage.

scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 218-224
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar
Keyword(s):  
Drug Use ◽  
Clinical Pharmacist ◽  
Medication Review ◽  
Pediatric Patients ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

scholarly journals IDENTIFICATION OF POTENTIAL DRUG RELATED PROBLEMS OF IMPROPER DOSAGE AND ADVERSE DRUG REACTIONS CATEGORIES IN OSTEOARTHRITIS OUTPATIENTS IN RSUD JOMBANG 2016

2018 ◽  
Vol 3 (1) ◽  
pp. 23
Author(s):  
Ayu Tria Nurjannah Muslim ◽  
Abdul Hakim ◽  
Meilina Ratna Dianti
Keyword(s):  
Adverse Drug Reactions ◽  
Drug Users ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Systematic Random Sampling ◽  
Chronic Disorder ◽  
Potential Case ◽  
Drug Regimens ◽  
Complex Drug

<em>Osteoarthritis is a chronic disorder of synovial joints, characterized by progressive softening and disintegration of cartilage in joints. This is the most common type of arthritis in Indonesia with prevalence about 23.6 to 31.3% and generally suffered by middle age patients. Drug therapy for treating osteoarthritis is NSAIDs, supplements and corticosteroids. The increasing number of available drugs, drug users and more complex drug regimens caused  more side effect and potential drug interaction and  lead to another problem, it is Drug Related Problems. The purpose of this study was to identify potential Drug Related Problem categories of improper dosage and Adverse Drug Reactions in osteoarthritis outpatient in RSUD Jombang during 2016. This research is a non-experimental descriptive study conducted retrospectively, carried out in March 2017 at RSUD Jombang.  Research sample is 87 respondents of osteoarthritis outpatient which taken by systematic random sampling method. The data presented in percentage of improper dosage and Adverse Drug reactions potential case. The result found potential of improper dosage in respondent about 82,76% and Adverse Drug Reactions about 20,69%.</em>

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