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Sample records for outcome score hoos

  1. Cross-cultural adaptation and validation of the Turkish version of the Hip disability and Osteoarthritis Outcome Score-Physical function Short-form (HOOS-PS).

    PubMed

    Yilmaz, Ozlem; Gul, Ebru Demir; Bodur, Hatice

    2014-01-01

    The purpose of this study is to adapt the Hip disability and Osteoarthritis Outcome Score-Physical function Short-form (HOOS-PS) to Turkish language and to evaluate the psychometric properties of the Turkish version in patients with primary hip osteoarthritis. After the translation from the source language (English) to the target language (Turkish), synthesis, back translation, revision, and pretest stages were done. Next, 50 patients with primary hip osteoarthritis were asked to fill out the Turkish version of the HOOS-PS two times with one week interval. Internal consistency was tested using the Cronbach's alpha coefficient, and test-retest reliability was assessed by calculating the intra-class correlation coefficient (ICC). Construct validity was investigated by comparing the results of the HOOS-PS and WOMAC, Lequesne questionnaries using Spearman's rank correlation coefficient. Internal consistency was good with a Cronbach's alpha of 0.778 (>0.7) and ICC was 0.911 (>0.7). Both scores verify that the Turkish HOOS-PS is a reliable tool. Spearman's rank correlation coefficients between the HOOS-PS and overall WOMAC (r = 0.653), WOMAC physical functions (r = 0.626), WOMAC pain (r = 0.629) subscales, overall Lequesne (r = 0.650), and Lequesne daily living activities (r = 0.620) subscales were high (r > 0.6), and moderate correlations were found between the HOOS-PS and WOMAC stiffness (r = 0.511), Lequesne pain (r = 0.569), and Lequesne-walking distance (r = 0.578) subscales (0.6 > r > 0.2), thus providing proof for the validity of the Turkish form. The Turkish HOOS-PS was found to be reliable and valid for patients with primary hip osteoarthritis. PMID:24026527

  2. Legend of Wan Hoo

    NASA Technical Reports Server (NTRS)

    2004-01-01

    According to one ancient legend, a Chinese official named Wan Hoo attempted a flight to the moon using a large wicker chair to which were fastened 47 large rockets. Forty seven assistants, each armed with a torch, rushed forward to light the fuses. In a moment, there was a tremendous roar accompanied by billowing clouds of smoke. When the smoke cleared, the flying chair and Wan Hoo were gone.

  3. A Genomic Score Prognostic of Outcome in Trauma Patients

    PubMed Central

    Warren, H Shaw; Elson, Constance M; Hayden, Douglas L; Schoenfeld, David A; Cobb, J Perren; Maier, Ronald V; Moldawer, Lyle L; Moore, Ernest E; Harbrecht, Brian G; Pelak, Kimberly; Cuschieri, Joseph; Herndon, David N; Jeschke, Marc G; Finnerty, Celeste C; Brownstein, Bernard H; Hennessy, Laura; Mason, Philip H; Tompkins, Ronald G

    2009-01-01

    Traumatic injuries frequently lead to infection, organ failure, and death. Health care providers rely on several injury scoring systems to quantify the extent of injury and to help predict clinical outcome. Physiological, anatomical, and clinical laboratory analytic scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE], Injury Severity Score [ISS]) are utilized, with limited success, to predict outcome following injury. The recent development of techniques for measuring the expression level of all of a person’s genes simultaneously may make it possible to develop an injury scoring system based on the degree of gene activation. We hypothesized that a peripheral blood leukocyte gene expression score could predict outcome, including multiple organ failure, following severe blunt trauma. To test such a scoring system, we measured gene expression of peripheral blood leukocytes from patients within 12 h of traumatic injury. cRNA derived from whole blood leukocytes obtained within 12 h of injury provided gene expression data for the entire genome that were used to create a composite gene expression score for each patient. Total blood leukocytes were chosen because they are active during inflammation, which is reflective of poor outcome. The gene expression score combines the activation levels of all the genes into a single number which compares the patient’s gene expression to the average gene expression in uninjured volunteers. Expression profiles from healthy volunteers were averaged to create a reference gene expression profile which was used to compute a difference from reference (DFR) score for each patient. This score described the overall genomic response of patients within the first 12 h following severe blunt trauma. Regression models were used to compare the association of the DFR, APACHE, and ISS scores with outcome. We hypothesized that patients with a total gene response more different from uninjured volunteers would tend to have poorer

  4. Scoring Systems for Outcome Prediction of Patients with Perforation Peritonitis

    PubMed Central

    Litake, Manjusha Madhusudhan

    2016-01-01

    Introduction Peritonitis continues to be one of the major infectious problems confronting a surgeon. Mannheim Peritonitis Index (MPI), Physiological and Operative Severity Score for en Umeration of Mortality (POSSUM) and Morbidity and sepsis score of Stoner and Elebute have been devised for risk assessment and for prediction of postoperative outcome. Aim The aim of this study was to find the accuracy of these scores in predicting outcome in terms of mortality in patients undergoing exploratory laprotomy for perforation peritonitis. Materials and Methods The prospective study was carried out in 100 diagnosed cases of perforation at our centre in a single unit over a period of 21 months from December 2012 to August 2014. Study was conducted on all cases of peritonitis albeit primary, tertiary, iatrogenic and those with age less than 12 years were excluded from the study. All the relevant data were collected and three scores were computed from one set of data from the patient. The main outcome measure was survival of the patient. The Receiver Operator Characteristics (ROC) curves were obtained for the three scores. Area Under the Curves (AUC) was calculated. Sensitivity and specificity were calculated at a cut off point obtained from the ROC curves. Results POSSUM had an AUC of 0.99, sepsis score had an AUC of 0.98 and MPI had an AUC of 0.95. The cut off point score of 51 for POSSUM had an accuracy of 93.8 and positive predictive value of 70.5, the score of 29 for MPI had an accuracy of 82.8 and positive predictive value of 46 and the score of 22 for sepsis score had an accuracy of 95.9 and positive predictive value of 86.67. Conclusion POSSUM score was found to be superior in prediction of mortality as compared to sepsis score of Stoner and Elebute and MPI. POSSUM and MPI over predicted mortality in some cases. None of these scores are strictly preoperative. PMID:27134924

  5. Nephrolithometric Scoring Systems to Predict Outcomes of Percutaneous Nephrolithotomy

    PubMed Central

    Vernez, Simone L; Okhunov, Zhamshid; Motamedinia, Piruz; Bird, Vincent; Okeke, Zeph; Smith, Arthur

    2016-01-01

    Currently, there is no single agreement upon an ideal predictive model that characterizes the complexity of renal stones and predicts surgical outcomes following percutaneous nephrolithotomy (PCNL). New predictive tools have recently emerged to systematically and quantitatively assess kidney stone complexity to predict outcomes following PCNL: the Guy’s Stone Score, the CROES nomogram, S.T.O.N.E. nephrolithometry, and S-ReSC score. An ideal scoring system should include variables that both influence surgical planning and are predictive of postoperative outcomes. This review discusses the strengths, weaknesses, and commonalities of each of the above scoring systems. Additionally, we propose future directions for the development and analysis of surgical treatment for stone disease, namely, the importance of assessing radiation exposure and patient quality of life when counseling patients on treatment options. PMID:27162508

  6. Covariate Selection in Propensity Scores Using Outcome Proxies

    ERIC Educational Resources Information Center

    Kelcey, Ben

    2011-01-01

    This study examined the practical problem of covariate selection in propensity scores (PSs) given a predetermined set of covariates. Because the bias reduction capacity of a confounding covariate is proportional to the concurrent relationships it has with the outcome and treatment, particular focus is set on how we might approximate…

  7. Frailty score on admission predicts outcomes in elderly burn injury.

    PubMed

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  8. Patellar resurfacing in total knee arthroplasty: functional outcome differs with different outcome scores

    PubMed Central

    Aunan, Eirik; Næss, Grethe; Clarke-Jenssen, John; Sandvik, Leiv; Kibsgård, Thomas Johan

    2016-01-01

    Background and purpose — Recent research on outcomes after total knee arthroplasty (TKA) has raised the question of the ability of traditional outcome measures to distinguish between treatments. We compared functional outcomes in patients undergoing TKA with and without patellar resurfacing, using the knee injury and osteoarthritis outcome score (KOOS) as the primary outcome and 3 traditional outcome measures as secondary outcomes. Patients and methods — 129 knees in 115 patients (mean age 70 (42–82) years; 67 female) were evaluated in this single-center, randomized, double-blind study. Data were recorded preoperatively, at 1 year, and at 3 years, and were assessed using repeated-measures mixed models. Results — The mean subscores for the KOOS after surgery were statistically significantly in favor of patellar resurfacing: sport/recreation, knee-related quality of life, pain, and symptoms. No statistically significant differences between the groups were observed with the Knee Society clinical rating system, with the Oxford knee score, and with visual analog scale (VAS) for patient satisfaction. Interpretation — In the present study, the KOOS—but no other outcome measure used—indicated that patellar resurfacing may be beneficial in TKA. PMID:26540368

  9. Bilateral Hallux Valgus: A Utility Outcome Score Assessment.

    PubMed

    Makhdom, Asim M; Sinno, Hani; Aldebeyan, Sultan; Cota, Adam; Hamdy, Reggie Charles; Alzahrani, Mohammad; Janelle, Chantal

    2016-01-01

    Hallux valgus is the most common forefoot problem in adults. Although it can cause considerable disability and affect the quality of life of those affected, many patients seek medical attention because of cosmetic concerns. Our aim was to objectively measure the perceived health burden of living with bilateral hallux valgus. Previously validated utility outcome measures, including the visual analog scale, time trade-off, and standard gamble tests, were used to quantify the health burden for single-eye blindness, double-eye blindness, and bilateral hallux valgus in 103 healthy subjects using an online survey. The Student t test and linear regression analysis were used for statistical analysis. The mean visual analog scale, time trade-off, and standard gamble scores for bilateral hallux valgus were 0.86 ± 1.6, 0.95 ± 0.5, and 0.95 ± 0.14, respectively. These were significantly greater than the utility scores for single-eye and double-eye blindness (p < .05). Age, gender, race, income, and education were not statistically significant independent predictors of the utility scores for hallux valgus. In conclusion, we have objectively demonstrated the effect of living with bilateral hallux valgus deformities. Our sample population reported being willing to undergo a procedure with a 5% mortality rate and sacrifice 1.8 years of life to attain perfect health and avoid the bilateral hallux valgus health state. Our findings will guide us in counseling our patients and understanding how they perceive their foot deformity. PMID:27289218

  10. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty.

    PubMed

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-03-18

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  11. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

    PubMed Central

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-01-01

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  12. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis—A Cross-Sectional Study

    PubMed Central

    Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren; Jensen, Carsten

    2016-01-01

    Background The Gait Deviation Index summarizes overall gait ‘quality’, based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study was to investigate associations between Gait Deviation Index as a measure of gait ‘quality’ and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. Method Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the ‘Physical Function Short-form of the Hip disability and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL). Results Mean Gait Deviation Index was positively associated with hip abduction strength (p<0.01, r = 0.40), hip flexion strength (p = 0.01, r = 0.37), HOOS-Physical Function (p<0.01, r = 0.41) HOOS-QOL (p<0.01, r = 0.41), and negatively associated with HOOS-Pain after walking (p<0.01, r = -0.45). Adjusting the analysis for walking speed did not affect the association. Conclusion Patients with the strongest hip abductor and hip flexor muscles had the best gait ‘quality’. Furthermore, patients with higher physical function, quality of life scores and lower pain levels demonstrated better gait ‘quality’. These findings indicate that interventions aimed at improving hip muscle strength and pain management may to a moderate degree improve the overall gait ‘quality’ in patients with primary hip OA. PMID:27065007

  13. Comparison of AIMS65 Score and Other Scoring Systems for Predicting Clinical Outcomes in Koreans with Nonvariceal Upper Gastrointestinal Bleeding

    PubMed Central

    Park, Sung Min; Yeum, Seok Cheon; Kim, Byung-Wook; Kim, Joon Sung; Kim, Ji Hee; Sim, Eun Hui; Ji, Jeong-Seon; Choi, Hwang

    2016-01-01

    Background/Aims The AIMS65 score has not been sufficiently validated in Korea. The objective of this study was to compare the AIMS65 and other scoring systems for the prediction of various clinical outcomes in Korean patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). Methods The AIMS65 score, clinical and full Rockall scores (cRS and fRS) and Glasgow-Blatchford (GBS) score were calculated in patients with NVUGIB in a single center retrospectively. The performance of these scores for predicting mortality, rebleeding, transfusion requirement, and endoscopic intervention was assessed by calculating the area under the receiver-operating characteristic curve. Results Of the 523 patients, 3.4% died within 30 days, 2.5% experienced rebleeding, 40.0% required endoscopic intervention, and 75.7% needed transfusion. The AIMS65 score was useful for predicting the 30-day mortality, the need for endoscopic intervention and for transfusion. The fRS was superior to the AIMS65, GBS, and cRS for predicting endoscopic intervention and the GBS was superior to the AIMS65, fRS, and cRS for predicting the transfusion requirement. Conclusions The AIMS65 score was useful for predicting the 30-day mortality, transfusion requirement, and endoscopic intervention in Korean patients with acute NVUGIB. However, it was inferior to the GBS and fRS for predicting the transfusion requirement and endoscopic intervention, respectively. PMID:27377742

  14. How Criterion Scores Predict the Overall Impact Score and Funding Outcomes for National Institutes of Health Peer-Reviewed Applications

    PubMed Central

    Eblen, Matthew K.; Wagner, Robin M.; RoyChowdhury, Deepshikha; Patel, Katherine C.; Pearson, Katrina

    2016-01-01

    Understanding the factors associated with successful funding outcomes of research project grant (R01) applications is critical for the biomedical research community. R01 applications are evaluated through the National Institutes of Health (NIH) peer review system, where peer reviewers are asked to evaluate and assign scores to five research criteria when assessing an application’s scientific and technical merit. This study examined the relationship of the five research criterion scores to the Overall Impact score and the likelihood of being funded for over 123,700 competing R01 applications for fiscal years 2010 through 2013. The relationships of other application and applicant characteristics, including demographics, to scoring and funding outcomes were studied as well. The analyses showed that the Approach and, to a lesser extent, the Significance criterion scores were the main predictors of an R01 application’s Overall Impact score and its likelihood of being funded. Applicants might consider these findings when submitting future R01 applications to NIH. PMID:27249058

  15. Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score

    PubMed Central

    Aggarwal, Rishi Anil; Srivastava, Sudhir Kumar; Bhosale, Sunil Krishna; Nemade, Pradip Sharad

    2016-01-01

    Context: Preoperative severity of myelopathy, age, and duration of symptoms have been shown to be highly predictive of the outcome in compressive cervical myelopathy (CCM). The role of radiological parameters is still controversial. Aims: Define the prognostic factors in CCM and formulate a prognostic score to predict the outcome following surgery in CCM. Settings and Design: Retrospective. Materials and Methods: This study included 78 consecutive patients with CCM treated surgically. The modified Japanese Orthopaedic Association (mJOA) scale was used to quantify severity of myelopathy at admission and at 12-month follow-up. The outcome was defined as good if the patient had mJOA score ≥16 and poor if the score was <16. Age, sex, duration of symptoms, comorbidities, intrinsic hand muscle wasting (IHMW), diagnosis, surgical technique, Torg ratio, instability on dynamic radiographs, and magnetic resonance imaging (MRI) signal intensity changes were assessed. Statistics: Statistical Package for the Social Sciences (SPSS) (version 20.0) was used for statistical analysis. The association was assessed amongst variables using logistic regression analysis. Parameters having a statistically significant correlation with the outcome were included in formulating a prognostic score. Results: Severity of myelopathy, IHMW, age, duration, diabetes, and instability on radiographs were predictive of the outcome with a P value <0.01. Genders, diagnosis, surgical procedure, Torg ratio, and intensity changes on MRI were not significantly related to the outcome. A 8-point scoring system was devised incorporating the significant clinicoradiological parameters, and it was found that nearly all patients (97.82%) with a score below 5 had good outcome and all patients (100%) with a score above 5 had poor outcome. The outcome is difficult to predict with a score of 5. Conclusions: Clinical parameters are better predictors of the outcome as compared to radiological findings, following

  16. Using IRT Trait Estimates versus Summated Scores in Predicting Outcomes

    ERIC Educational Resources Information Center

    Xu, Ting; Stone, Clement A.

    2012-01-01

    It has been argued that item response theory trait estimates should be used in analyses rather than number right (NR) or summated scale (SS) scores. Thissen and Orlando postulated that IRT scaling tends to produce trait estimates that are linearly related to the underlying trait being measured. Therefore, IRT trait estimates can be more useful…

  17. Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

    PubMed

    Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

    2008-01-01

    A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form. PMID:18536848

  18. An Empirical Investigation of Dispositional Antecedents and Performance-Related Outcomes of Credit Scores

    ERIC Educational Resources Information Center

    Bernerth, Jeremy B.; Taylor, Shannon G.; Walker, H. Jack; Whitman, Daniel S.

    2012-01-01

    Many organizations use credit scores as an employment screening tool, but little is known about the legitimacy of such practices. To address this important gap, the reported research conceptualized credit scores as a biographical measure of financial responsibility and investigated dispositional antecedents and performance-related outcomes. Using…

  19. Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.

    PubMed

    Gillick, K; Elbeltagi, H; Bhattacharya, S

    2016-01-01

    Introduction Introduced originally to stratify risk for developing decubitus ulcers, the Waterlow scoring system is recorded routinely for surgical admissions. It is a composite score, reflecting patients' general condition and co-morbidities. The aim of this study was to investigate whether the Waterlow score can be used as an independent surrogate marker to predict severity and adverse outcome in acute pancreatitis. Methods In this retrospective analysis, a consecutive cohort was studied of 250 patients presenting with acute pancreatitis, all of whom had their Waterlow score calculated on admission. Primary outcome measures were length of hospital stay and mortality. Secondary outcome measures included rate of intensive care unit (ICU) admission and development of complications such as peripancreatic free fluid, pancreatic necrosis and pseudocyst formation. Correlation of the Waterlow score with some known markers of disease severity and outcomes was also analysed. Results The Waterlow score correlated strongly with the most commonly used marker of disease severity, the Glasgow score (analysis of variance, p=0.0012). Inpatient mortality, rate of ICU admission and length of hospital stay increased with a higher Waterlow score (Mann-Whitney U test, p=0.0007, p=0.049 and p=0.0002 respectively). There was, however, no significant association between the Waterlow score and the incidence of three known complications of pancreatitis: presence of peripancreatic fluid, pancreatic pseudocyst formation and pancreatic necrosis. Receiver operating characteristic curve analysis demonstrated good predictive power of the Waterlow score for mortality (area under the curve [AUC]: 0.73), ICU admission (AUC: 0.65) and length of stay >7 days (AUC: 0.64). This is comparable with the predictive power of the Glasgow score and C-reactive protein. Conclusions The Waterlow score for patients admitted with acute pancreatitis could provide a useful tool in prospective assessment of disease

  20. An empirical investigation of dispositional antecedents and performance-related outcomes of credit scores.

    PubMed

    Bernerth, Jeremy B; Taylor, Shannon G; Walker, H Jack; Whitman, Daniel S

    2012-03-01

    Many organizations use credit scores as an employment screening tool, but little is known about the legitimacy of such practices. To address this important gap, the reported research conceptualized credit scores as a biographical measure of financial responsibility and investigated dispositional antecedents and performance-related outcomes. Using personality data collected from employees, objective credit scores obtained from the Fair Isaac Corporation, and performance data provided by supervisors, we found conscientiousness to be positively related and agreeableness to be negatively related to credit scores. Results also indicate significant relationships between credit scores and task performance and organizational citizenship behaviors. Credit scores did not, however, predict workplace deviance. Implications for organizations currently using or planning to use credit scores as part of the screening process are discussed. PMID:22023073

  1. Personality predictors of academic outcomes: big five correlates of GPA and SAT scores.

    PubMed

    Noftle, Erik E; Robins, Richard W

    2007-07-01

    The authors examined relations between the Big Five personality traits and academic outcomes, specifically SAT scores and grade-point average (GPA). Openness was the strongest predictor of SAT verbal scores, and Conscientiousness was the strongest predictor of both high school and college GPA. These relations replicated across 4 independent samples and across 4 different personality inventories. Further analyses showed that Conscientiousness predicted college GPA, even after controlling for high school GPA and SAT scores, and that the relation between Conscientiousness and college GPA was mediated, both concurrently and longitudinally, by increased academic effort and higher levels of perceived academic ability. The relation between Openness and SAT verbal scores was independent of academic achievement and was mediated, both concurrently and longitudinally, by perceived verbal intelligence. Together, these findings show that personality traits have independent and incremental effects on academic outcomes, even after controlling for traditional predictors of those outcomes. ((c) 2007 APA, all rights reserved). PMID:17605593

  2. Translation and cultural adaptation of the Hip Outcome Score to the Portuguese language☆☆☆

    PubMed Central

    de Oliveira, Liszt Palmeira; Moura Cardinot, Themis; Nunes Carreras Del Castillo, Letícia; Cavalheiro Queiroz, Marcelo; Cavalli Polesello, Giancarlo

    2014-01-01

    Objective to translate the Hip Outcome Score clinical evaluation questionnaire into Portuguese and culturally adapt it for Brazil. Methods the Hip Outcome Score questionnaire was translated into Portuguese following the methodology consisting of the steps of translation, back-translation, pretesting and final translation. Results the pretesting was applied to 30 patients with hip pain without arthrosis. In the domain relating to activities of daily living, there were no difficulties in comprehending the translated questionnaire. In presenting the final translation of the questionnaire, all the questions were understood by more than 85% of the individuals. Conclusion the Hip Outcome Score questionnaire was translated and adapted to the Portuguese language and can be used in clinical evaluation on the hip. Additional studies are underway with the objective of evaluating the reproducibility and validity of the Brazilian translation. PMID:26229816

  3. Prognostic Scoring Indicator in Evaluation of Clinical Outcome In Intestinal Perforations

    PubMed Central

    Ahuja, Ashish; Pal, Ravinder

    2013-01-01

    Introduction: Acute generalised peritonitis coming forth due to underlying intestinal perforation is a critical & life-threatening medical condition. It is a common surgical emergency most of the times across the world. Misleading data on crude morbidity and mortality due to the condition usually contaminates substantially the very purpose of medical audit. Thus, early prognostic evaluation is not only desirable but mandate to much extent. High-risk patients require timely & aggressive treatment especially in severe peritonitis & to select them reasonably well, evaluation through prognostic scoring is an approach of choice. Well sought after & reasonably reliable APACHE II scoring system is used for the purpose & scores are correlated well to accentuate & measure the various factors needed for better management of condition. Material and Methods: The study was conducted over the period of 18 months (Jan 2010 to June 2011) on 50 patients with confirmed diagnosis of intestinal perforation. APACHE II score was calculated and correlated with their symptoms & clinical outcomes regarding morbidity and mortality. Results: APACHE II score correlated well with the outcome of the study, showing score affects of two major aspects in the treatment outcome & management.1.) APACHE II score of less than 10 included 30 low risk group patients discharged in a satisfactory gratifying manner. Three out of four in high risk group with APACHE II score >20, shown adverse outcomes. 2.)Mean ICU stay of 9.75 days was found in patients with APACHE II score 20 or more compared to those with mean ICU stay of 0.13 days in patients with APACHE II score 10 or less. Conclusion: Acute generalized peritonitis being life–threatening medical emergency requires careful consideration in its management that needs to be economically viable, acceptably feasible and outcome oriented with better allocation & utilization of ICU resources that needs meticulous case analysis & prioritization. This present

  4. Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score

    PubMed Central

    Hung, Man; Hon, Shirley D.; Cheng, Christine; Franklin, Jeremy D.; Aoki, Stephen K.; Anderson, Mike B.; Kapron, Ashley L.; Peters, Christopher L.; Pelt, Christopher E.

    2014-01-01

    Background: The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. Purpose: To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. Results: All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. Conclusion: The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior

  5. Variable Selection for Propensity Score Models When Estimating Treatment Effects on Multiple Outcomes: a Simulation Study

    PubMed Central

    Wyss, Richard; Girman, Cynthia J.; LoCasale, Robert J.; Brookhart, M. Alan; Stürmer, Til

    2012-01-01

    Purpose It is often preferable to simplify the estimation of treatment effects on multiple outcomes by using a single propensity score (PS) model. Variable selection in PS models impacts the efficiency and validity of treatment effects. However, the impact of different variable selection strategies on the estimated treatment effects in settings involving multiple outcomes is not well understood. The authors use simulations to evaluate the impact of different variable selection strategies on the bias and precision of effect estimates to provide insight into the performance of various PS models in settings with multiple outcomes. Methods Simulated studies consisted of dichotomous treatment, two Poisson outcomes, and eight standard-normal covariates. Covariates were selected for the PS models based on their effects on treatment, a specific outcome, or both outcomes. The PSs were implemented using stratification, matching, and weighting (IPTW). Results PS models including only covariates affecting a specific outcome (outcome-specific models) resulted in the most efficient effect estimates. The PS model that only included covariates affecting either outcome (generic-outcome model) performed best among the models that simultaneously controlled measured confounding for both outcomes. Similar patterns were observed over the range of parameter values assessed and all PS implementation methods. Conclusions A single, generic-outcome model performed well compared with separate outcome-specific models in most scenarios considered. The results emphasize the benefit of using prior knowledge to identify covariates that affect the outcome when constructing PS models and support the potential to use a single, generic-outcome PS model when multiple outcomes are being examined. PMID:23070806

  6. The 15-item Systemic Clinical Outcome and Routine Evaluation (SCORE-15) Scale: Portuguese Validation Studies.

    PubMed

    Vilaça, Margarida; de Sousa, Bruno; Stratton, Peter; Relvas, Ana Paula

    2015-01-01

    This study reports on the validity of the 15-item Portuguese version of the Systemic Clinical Outcome Routine Evaluation (SCORE-15; Vilaça, Silva, & Relvas, 2014), a brief and comprehensive measure of family functioning. Previous studies with SCORE-15 show that this version replicates the three-factor solution found for the original English version: Family strengths, Family communication and Family difficulties. In addition to reviewing previous studies, this article analyses the discriminant, convergent and predictive validity of the Portuguese SCORE-15. To do so, the SCORE-15 was administered to family members attending systemic family or couple's therapy at the start of the first and fourth sessions and also to a group of non-clinical individuals. Overall, data are reported from 618 participants, including 136 from families attending systemic therapy and 482 community family members. Comparisons of community and clinical samples (discriminant validity) showed statistically significant differences for the total scale and subscales (p < .001), with the community participants presenting healthier family functioning than the clinical ones. Analyses using SCORE-15 and the Quality of Life - adult version, another family measure applied simultaneously (convergent validity), indicate that both scales are significantly (p < .01) and moderately (r = -.47) correlated. Mean score analysis of SCORE-15's therapeutic sensitivity to change (predictive validity) showed that only the Family communication subscale was sensitive to statistically significant improvement (p < .05) from session 1 to session 4, whereas the SCORE-15's reliability change index points to its ability to detect clinical improvements (RCI = 14%). PMID:26585316

  7. Does Year Round Schooling Affect the Outcome and Growth of California's API Scores?

    ERIC Educational Resources Information Center

    Wu, Amery D.; Stone, Jake E.

    2010-01-01

    This paper examined whether year round schooling (YRS) in California had an effect upon the outcome and growth of schools' Academic Performance Index (API) scores. While many previous studies had examined the connection between YRS and academic achievement, most had lacked the statistical rigour required to provide reliable interpretations. As a…

  8. Secondary Evaluations of MTA 36-Month Outcomes: Propensity Score and Growth Mixture Model Analyses

    ERIC Educational Resources Information Center

    Swanson, James M.; Hinshaw, Stephen P.; Arnold, L. Eugene; Gibbons, Robert D.; Marcus, Sue; Hur, Kwan; Jensen, Peter S.; Vitiello, Benedetto; Abikoff, Howard B.: Greenhill, Laurence L.; Hechtman, Lily; Pelham, William E.; Wells, Karen C.; Conners, C. Keith; March, John S.; Elliott, Glen R.; Epstein, Jeffery N.; Hoagwood, Kimberly; Hoza, Betsy; Molina, Brooke S. G.; Newcorn, Jeffrey H.; Severe, Joanne B.; Wigal, Timothy

    2007-01-01

    Objective: To evaluate two hypotheses: that self-selection bias contributed to lack of medication advantage at the 36-month assessment of the Multimodal Treatment Study of Children With ADHD (MTA) and that overall improvement over time obscured treatment effects in subgroups with different outcome trajectories. Method: Propensity score analyses,…

  9. Propensity Score Matching of Children in Kinship and Nonkinship Foster Care: Do Permanency Outcomes Still Differ?

    ERIC Educational Resources Information Center

    Koh, Eun; Testa, Mark F.

    2008-01-01

    This study compares the permanency outcomes of children in kinship foster care with a matched sample of children in nonkinship foster care in Illinois. It addresses the issue of selection bias by using propensity score matching (PSM) to balance mean differences in the characteristics of children in kinship and nonkinship foster homes. The data…

  10. A clinical risk score of myocardial fibrosis predicts adverse outcomes in aortic stenosis

    PubMed Central

    Chin, Calvin W.L.; Messika-Zeitoun, David; Shah, Anoop S.V.; Lefevre, Guillaume; Bailleul, Sophie; Yeung, Emily N.W.; Koo, Maria; Mirsadraee, Saeed; Mathieu, Tiffany; Semple, Scott I.; Mills, Nicholas L.; Vahanian, Alec; Newby, David E.; Dweck, Marc R.

    2016-01-01

    Aims Midwall myocardial fibrosis on cardiovascular magnetic resonance (CMR) is a marker of early ventricular decompensation and adverse outcomes in aortic stenosis (AS). We aimed to develop and validate a novel clinical score using variables associated with midwall fibrosis. Methods and results One hundred forty-seven patients (peak aortic velocity (Vmax) 3.9 [3.2,4.4] m/s) underwent CMR to determine midwall fibrosis (CMR cohort). Routine clinical variables that demonstrated significant association with midwall fibrosis were included in a multivariate logistic score. We validated the prognostic value of the score in two separate outcome cohorts of asymptomatic patients (internal: n = 127, follow-up 10.3 [5.7,11.2] years; external: n = 289, follow-up 2.6 [1.6,4.5] years). Primary outcome was a composite of AS-related events (cardiovascular death, heart failure, and new angina, dyspnoea, or syncope). The final score consisted of age, sex, Vmax, high-sensitivity troponin I concentration, and electrocardiographic strain pattern [c-statistic 0.85 (95% confidence interval 0.78–0.91), P < 0.001; Hosmer–Lemeshow χ2 = 7.33, P = 0.50]. Patients in the outcome cohorts were classified according to the sensitivity and specificity of this score (both at 98%): low risk (probability score <7%), intermediate risk (7–57%), and high risk (>57%). In the internal outcome cohort, AS-related event rates were >10-fold higher in high-risk patients compared with those at low risk (23.9 vs. 2.1 events/100 patient-years, respectively; log rank P < 0.001). Similar findings were observed in the external outcome cohort (31.6 vs. 4.6 events/100 patient-years, respectively; log rank P < 0.001). Conclusion We propose a clinical score that predicts adverse outcomes in asymptomatic AS patients and potentially identifies high-risk patients who may benefit from early valve replacement. PMID:26491110

  11. Correlation between microsatellite discrepancy scores and transplant outcome after haemopoietic SCT for pediatric ALL.

    PubMed

    Harvey, J; Green, A; Groves, S J; Cornish, J; Moppett, J; Cummins, M; Keen, L; Culliford, S; Poles, A; Hulme, W; Li, Y; Steward, C G

    2015-03-01

    Microsatellite analyses show that self-reported ethnicity often correlates poorly with true genetic ancestry. As unknown ancestral differences could potentially have an impact on transplant outcome, we developed an average allele length discrepancy (AALD) score to assess allele length discrepancy between donor/recipient (D/R) using microsatellites analysed routinely in post-transplant chimeric assessment. This was then compared with outcome in a homogeneously treated cohort of pediatric patients undergoing high-resolution sibling or matched unrelated donor transplantation for acute lymphoblastic leukemia (ALL). AALD scores formed a numeric continuum ranging from 0 to 1.4 (median 0.76) for sibling pairs and 0.8-2.17 (median 1.6) for high-resolution matched unrelated donor (HR-MUD) pairs. There was a trend for worse OS with increasing AALD score, which reached statistical significance above a threshold of 1.7 for OS. Patients whose transplants had an AALD score of ⩾1.8 had a risk of non-relapse mortality 4.9 times greater (P=0.025) and relapse risk three times greater (P=0.058) than those scoring <1.8. This approach will now be explored in a Centre International for Blood and Marrow Transplantation Research (CIBMTR) study of 750 D/R pairs across all disease groups; if confirmed, it has the potential to improve donor selection for patients with multiple prospective donors. PMID:25581412

  12. Evaluation of outcome change scores for patients with pneumonia or heart failure.

    PubMed

    Scherb, Cindy A; Head, Barbara J; Hertzog, Melody; Swanson, Elizabeth; Reed, David; Maas, Meridean L; Moorhead, Sue; Conley, Deborah Marks; Kozel, Marie; Clarke, Mary; Gillette, Susan; Weinberg, Barbara

    2013-01-01

    This study was conducted to describe the variance in selected Nursing Outcomes Classification (NOC) outcome change scores of hospitalized older patients with pneumonia (n = 216) or heart failure (HF; n = 67) that could be explained by age, length of stay (LOS), number of comorbid conditions, number of nursing diagnoses, and number of nursing interventions. Investigators used a descriptive correlational design to analyze data sets from three U.S. community hospitals. Study participants had at least two ratings on one of nine outcomes selected for their frequency and use across the three hospitals. A significant portion of the variance in the outcomes Knowledge: Illness Care and Fall Prevention Behavior was explained for pneumonia patients. None of the regression models for HF patients showed significance. Individual independent variables were significant in some of the models (i.e., LOS [pneumonia], number of nursing diagnoses [pneumonia and HF]). Implications for research and clinical practice are discussed. PMID:21447806

  13. Patient-Reported Outcome Measures-What Data Do We Really Need?

    PubMed

    Lyman, Stephen; Hidaka, Chisa

    2016-06-01

    The Center for Medicaid and Medicare Services has recently announced the inclusion of several patient-reported outcome measures (PROMs), including the abbreviated Hip Disability and Osteoarthritis Outcome Score and Knee Injury and Osteoarthritis Outcome Score for joint replacement (HOOS, JR and KOOS, JR) for the purpose of quality assessment in total hip and total knee replacement (THR and TKR). Historically, Center for Medicaid and Medicare Services and other agencies have used measures of process (eg, % vaccinated) or adverse events (eg, infection rates, readmission rates) for quality assessment. However, the use of PROMs has become a priority based on stated goals by the National Quality Strategy and Institute of Medicine for a more patient-centered approach. Here, we review several general health and joint-specific PROMs, which have been extensively used in research to assess treatment efficacy and discuss their relevance to the new criteria for quality assessment, particularly for THR and TKR. Although we expect HOOS, JR and KOOS, JR to yield much useful information in the near term, these surveys are likely an interim solution. In the future, we anticipate that novel measurement platforms, such as wearable technologies or patient-specific surveys, may open new and exciting avenues of research to discover which types of data-perhaps not previously available-best represent patient quality of life and satisfaction after THR, TKR, or other orthopedic procedures. PMID:27157278

  14. Angiographic Lesion Complexity Score and In-Hospital Outcomes after Percutaneous Coronary Intervention

    PubMed Central

    Endo, Ayaka; Kawamura, Akio; Miyata, Hiroaki; Noma, Shigetaka; Suzuki, Masahiro; Koyama, Takashi; Ishikawa, Shiro; Nakagawa, Susumu; Takagi, Shunsuke; Numasawa, Yohei; Fukuda, Keiichi; Kohsaka, Shun

    2015-01-01

    Objective We devised a percutaneous coronary intervention (PCI) scoring system based on angiographic lesion complexity and assessed its association with in-hospital complications. Background Although PCI is finding increasing application in patients with coronary artery disease, lesion complexity can lead to in-hospital complications. Methods Data from 3692 PCI patients were scored based on lesion complexity, defined by bifurcation, chronic total occlusion, type C, and left main lesion, along with acute thrombus in the presence of ST-segment elevation myocardial infarction (1 point assigned for each variable). Results The patients’ mean age was 67.5 +/- 10.8 years; 79.8% were male. About half of the patients (50.3%) presented with an acute coronary syndrome, and 2218 (60.1%) underwent PCI for at least one complex lesion. The patients in the higher-risk score groups were older (p < 0.001) and had present or previous heart failure (p = 0.02 and p = 0.01, respectively). Higher-risk score groups had significantly higher in-hospital event rates for death, heart failure, and cardiogenic shock (from 0 to 4 risk score; 1.7%, 4.5%, 6.3%, 7.1%, 40%, p < 0.001); bleeding with a hemoglobin decrease of >3.0 g/dL (3.1%, 11.0%, 13.1%, 10.3%, 28.6%, p < 0.001); and postoperative myocardial infarction (1.5%, 3.1%, 3.8%, 3.8%, 10%, p = 0.004), respectively. The association with adverse outcomes persisted after adjustment for known clinical predictors (odds ratio 1.72, p < 0.001). Conclusion The complexity score was cumulatively associated with in-hospital mortality and complication rate and could be used for event prediction in PCI patients. PMID:26121583

  15. The PER (Preoperative Esophagectomy Risk) Score: A Simple Risk Score to Predict Short-Term and Long-Term Outcome in Patients with Surgically Treated Esophageal Cancer

    PubMed Central

    Reeh, Matthias; Metze, Johannes; Uzunoglu, Faik G.; Nentwich, Michael; Ghadban, Tarik; Wellner, Ullrich; Bockhorn, Maximilian; Kluge, Stefan; Izbicki, Jakob R.; Vashist, Yogesh K.

    2016-01-01

    Abstract Esophageal resection in patients with esophageal cancer (EC) is still associated with high mortality and morbidity rates. We aimed to develop a simple preoperative risk score for the prediction of short-term and long-term outcomes for patients with EC treated by esophageal resection. In total, 498 patients suffering from esophageal carcinoma, who underwent esophageal resection, were included in this retrospective cohort study. Three preoperative esophagectomy risk (PER) groups were defined based on preoperative functional evaluation of different organ systems by validated tools (revised cardiac risk index, model for end-stage liver disease score, and pulmonary function test). Clinicopathological parameters, morbidity, and mortality as well as disease-free survival (DFS) and overall survival (OS) were correlated to the PER score. The PER score significantly predicted the short-term outcome of patients with EC who underwent esophageal resection. PER 2 and PER 3 patients had at least double the risk of morbidity and mortality compared to PER 1 patients. Furthermore, a higher PER score was associated with shorter DFS (P < 0.001) and OS (P < 0.001). The PER score was identified as an independent predictor of tumor recurrence (hazard ratio [HR] 2.1; P < 0.001) and OS (HR 2.2; P < 0.001). The PER score allows preoperative objective allocation of patients with EC into different risk categories for morbidity, mortality, and long-term outcomes. Thus, multicenter studies are needed for independent validation of the PER score. PMID:26886613

  16. A novel application of propensity score matching to estimate Alcoholics Anonymous’ effect on drinking outcomes

    PubMed Central

    Magura, Stephen; McKean, Joseph; Kosten, Scott; Tonigan, J. Scott

    2012-01-01

    Background Randomized controlled trials (RCTs) of mutual aid, including Alcoholics Anonymous (AA), are notoriously difficult to conduct and correlational studies are problematic to interpret due to potential confounds. Methods A secondary analysis was conducted of Project MATCH, a RCT of alcoholism treatments. Although MATCH did not randomly assign subjects to AA vs. no AA, the 12 Step Facilitation (TSF) condition did result in a higher proportion of subjects attending community AA meetings than in the other two treatment conditions. The key inference is that there exists a latent subgroup in MATCH who attended AA only because its constituents received TSF, not because of the “normal” factors leading to self-selection of AA. A novel application of propensity score matching (PSM) allowed four latent AA-related subgroups to be identified to estimate an unconfounded effect of AA on drinking outcomes. Results The study hypotheses were supported: subjects who consistently attended AA solely due to their exposure to TSF (the “Added AA” subgroup) had better drinking outcomes than equivalent subjects who did not consistently attend AA, but would have so attended, had they been exposed to TSF (the “Potential AA” subgroup); this indicates an AA effect on drinking. Conclusions The analysis presents evidence that consistent AA attendance improves drinking outcomes, independent of “normal” confounding factors that make correlations between AA attendance and outcomes difficult to interpret. PMID:23040721

  17. Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy

    PubMed Central

    2016-01-01

    Recently, several prognostic scoring systems for patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) have been published. The aim of this study was to validate the established scoring systems for outcome prediction in Korean patients. We retrospectively reviewed the data of 50 patients on ECMO therapy in our center from 2012 to 2014. A calculation of outcome prediction scoring tools was performed and the comparison across various models was conducted. In our study, the overall hospital survival was 46% and successful weaning rate was 58%. The Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) score showed good discrimination of mortality prediction for patients on ECMO with AUC of 0.80 (95% CI 0.66-0.90). The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and simplified acute physiology score (SAPS) II score also showed fair prediction ability with AUC of 0.79 (95% CI 0.65-0.89) and AUC of 0.78 (95% CI 0.64-0.88), respectively. However, the ECMOnet score failed to predict mortality with AUC of 0.51 (95% CI 0.37-0.66). When evaluating the predictive accuracy according to optimal cut-off point of each scoring system, RESP score had a best specificity of 91.3% and 66.7% of sensitivity, respectively. This study supports the clinical usefulness of the prognostic scoring tools for severe ARDS with ECMO therapy when applying to the Korean patients receiving ECMO. PMID:27247503

  18. Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy.

    PubMed

    Lee, Seunghyun; Yeo, Hye Ju; Yoon, Seong Hoon; Lee, Seung Eun; Cho, Woo Hyun; Jeon, Doo Soo; Kim, Yun Seong; Son, Bong Soo; Kim, Do Hyung

    2016-06-01

    Recently, several prognostic scoring systems for patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) have been published. The aim of this study was to validate the established scoring systems for outcome prediction in Korean patients. We retrospectively reviewed the data of 50 patients on ECMO therapy in our center from 2012 to 2014. A calculation of outcome prediction scoring tools was performed and the comparison across various models was conducted. In our study, the overall hospital survival was 46% and successful weaning rate was 58%. The Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) score showed good discrimination of mortality prediction for patients on ECMO with AUC of 0.80 (95% CI 0.66-0.90). The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and simplified acute physiology score (SAPS) II score also showed fair prediction ability with AUC of 0.79 (95% CI 0.65-0.89) and AUC of 0.78 (95% CI 0.64-0.88), respectively. However, the ECMOnet score failed to predict mortality with AUC of 0.51 (95% CI 0.37-0.66). When evaluating the predictive accuracy according to optimal cut-off point of each scoring system, RESP score had a best specificity of 91.3% and 66.7% of sensitivity, respectively. This study supports the clinical usefulness of the prognostic scoring tools for severe ARDS with ECMO therapy when applying to the Korean patients receiving ECMO. PMID:27247503

  19. Management and outcome of abdominal shotgun wounds. Trauma score and the role of exploratory laparotomy.

    PubMed Central

    Cairns, B A; Oller, D W; Meyer, A A; Napolitano, L M; Rutledge, R; Baker, C C

    1995-01-01

    OBJECTIVE: The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA: It has been proposed that exploratory laparotomy may be unnecessary and even overused in a subset of patients with abdominal shotgun wounds. METHODS: Data on shotgun wound patients from October 1987 through March 1992 from a statewide trauma registry were examined. Patients with abdominal shotgun wounds were identified and compared with patients with nonabdominal shotgun wounds. RESULTS: Of 516 shotgun wound patients, 138 (26.7%) had abdominal wounds and 88 (63.8%) had exploratory laparotomies. Abdominal shotgun wounds resulted in significantly longer number of intensive care unit days (4.3 vs. 2.5, p < 0.05), a greater number of blood units transfused (7.8 vs. 2.4, p < 0.05), and a higher mortality (15.9% vs. 4.8%, p < 0.05) when compared with nonabdominal shotgun wounds. When stratified for trauma score, the mortality for abdominal shotgun wounds always was significantly greater than for nonabdominal shotgun wounds. All abdominal shotgun wound patients with trauma scores less than ten died. The negative laparotomy rate for abdominal shotgun wound patients with normal trauma scores was 9.4%. No patient with a negative laparotomy died. CONCLUSION: Abdominal shotgun wounds are a particularly lethal subset of shotgun wounds. Although some abdominal shotgun wound patients can be managed without laparotomy, the morbidity and mortality for these injuries are substantial, even in patients with normal trauma score. Clinical judgment is an excellent predictor of the need for laparotomy. PMID:7717780

  20. Sequential organ failure assessment scoring and prediction of patient's outcome in Intensive Care Unit of a tertiary care hospital

    PubMed Central

    Jain, Aditi; Palta, Sanjeev; Saroa, Richa; Palta, Anshu; Sama, Sonu; Gombar, Satinder

    2016-01-01

    Background and Aims: The objective was to determine the accuracy of sequential organ failure assessment (SOFA) score in predicting outcome of patients in Intensive Care Unit (ICU). Material and Methods: Forty-four consecutive patients between 15 and 80 years admitted to ICU over 8 weeks period were studied prospectively. Three patients were excluded. SOFA score was determined 24 h postadmission to ICU and subsequently every 48 h for the first 10 days. Patients were followed till discharge/death/transfer from the ICU. Initial SOFA score, highest and mean SOFA scores were calculated and correlated with mortality and duration of stay in ICU. Results: The mortality rate was 39% and the mean duration of stay in the ICU was 9 days. The maximum score in survivors (3.92 ± 2.17) was significantly lower than nonsurvivors (8.9 ± 3.45). The initial SOFA score had a strong statistical correlation with mortality. Cardiovascular score on day 1 and 3, respiratory score on day 7, and coagulation profile on day 3 correlated significantly with the outcome. Duration of the stay did not correlate with the survival (P = 0.461). Conclusion: SOFA score is a simple, but effective prognostic indicator and evaluator for patient progress in ICU. Day 1 SOFA can triage the patients into risk categories. For further management, mean and maximum score help determine the severity of illness and can act as a guide for the intensity of therapy required for each patient.

  1. Apgar scores at 10 min and outcomes at 6–7 years following hypoxic-ischaemic encephalopathy

    PubMed Central

    Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

    2014-01-01

    Aim To determine the association between 10 min Apgar scores and 6–7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Methods Evaluations at 6–7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. Results In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0–3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0–3; there was no significant interaction between cooling and Apgar scores (p=0.26). Conclusions Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration. PMID:23896791

  2. Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study.

    PubMed

    Erdem, Hakan; Ozturk-Engin, Derya; Tireli, Hulya; Kilicoglu, Gamze; Defres, Sylviane; Gulsun, Serda; Sengoz, Gonul; Crisan, Alexandru; Johansen, Isik Somuncu; Inan, Asuman; Nechifor, Mihai; Al-Mahdawi, Akram; Civljak, Rok; Ozguler, Muge; Savic, Branislava; Ceran, Nurgul; Cacopardo, Bruno; Inal, Ayse Seza; Namiduru, Mustafa; Dayan, Saim; Kayabas, Uner; Parlak, Emine; Khalifa, Ahmad; Kursun, Ebru; Sipahi, Oguz Resat; Yemisen, Mucahit; Akbulut, Ayhan; Bitirgen, Mehmet; Popovic, Natasa; Kandemir, Bahar; Luca, Catalina; Parlak, Mehmet; Stahl, Jean Paul; Pehlivanoglu, Filiz; Simeon, Soline; Ulu-Kilic, Aysegul; Yasar, Kadriye; Yilmaz, Gulden; Yilmaz, Emel; Beovic, Bojana; Catroux, Melanie; Lakatos, Botond; Sunbul, Mustafa; Oncul, Oral; Alabay, Selma; Sahin-Horasan, Elif; Kose, Sukran; Shehata, Ghaydaa; Andre, Katell; Dragovac, Gorana; Gul, Hanefi Cem; Karakas, Ahmet; Chadapaud, Stéphane; Hansmann, Yves; Harxhi, Arjan; Kirova, Valerija; Masse-Chabredier, Isabelle; Oncu, Serkan; Sener, Alper; Tekin, Recep; Elaldi, Nazif; Deveci, Ozcan; Ozkaya, Hacer Deniz; Karabay, Oguz; Senbayrak, Seniha; Agalar, Canan; Vahaboglu, Haluk

    2015-01-01

    Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16%) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1%, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis. PMID:25634680

  3. Surgical Outcomes in Patients with High Spinal Instability Neoplasm Score Secondary to Spinal Giant Cell Tumors

    PubMed Central

    Elder, Benjamin D.; Sankey, Eric W.; Goodwin, C. Rory; Kosztowski, Thomas A.; Lo, Sheng-Fu L.; Bydon, Ali; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Witham, Timothy F.; Sciubba, Daniel M.

    2015-01-01

    Study Design Retrospective review. Objective To describe the surgical outcomes in patients with high preoperative Spinal Instability Neoplastic Score (SINS) secondary to spinal giant cell tumors (GCT) and evaluate the impact of en bloc versus intralesional resection and preoperative embolization on postoperative outcomes. Methods A retrospective analysis was performed on 14 patients with GCTs of the spine who underwent surgical treatment prior to the use of denosumab. A univariate analysis was performed comparing the patient demographics, perioperative characteristics, and surgical outcomes between patients who underwent en bloc marginal (n = 6) compared with those who had intralesional (n = 8) resection. Results Six patients underwent en bloc resections and eight underwent intralesional resection. Preoperative embolization was performed in eight patients. All patients were alive at last follow-up, with a mean follow-up length of 43 months. Patients who underwent en bloc resection had longer average operative times (p = 0.0251), higher rates of early (p = 0.0182) and late (p = 0.0389) complications, and a higher rate of surgical revision (p = 0.0120). There was a 25% (2/8 patients) local recurrence rate for intralesional resection and a 0% (0/6 patients) local recurrence rate for en bloc resection (p = 0.0929). Conclusions Surgical excision of spinal GCTs causing significant instability, assessed by SINS, is associated with high intraoperative blood loss despite embolization and independent of resection method. En bloc resection requires a longer operative duration and is associated with a higher risk of complications when compared with intralesional resection. However, the increased morbidity associated with en bloc resection may be justified as it may minimize the risk of local recurrence. PMID:26835198

  4. Patient reported outcomes in hip arthroplasty registries.

    PubMed

    Paulsen, Aksel

    2014-05-01

    PROs are used increasingly in orthopedics and in joint registries, but still many aspects of use in this area have not been examined in depth. To be able to introduce PROs in the DHR in a scientific fashion, my studies were warranted; the feasibility of four often used PROs (OHS, HOOS, EQ-5D and SF-12) was examined in a registry context. Having the PROs in the target language is an absolute necessity, so I translated, cross-culturally adapted and validated a Danish language version of an often used PRO (OHS), since this PRO had no properly developed Danish language version. To minimize data loss and to maximize the data quality I validated our data capture procedure, an up to date AFP system, by comparing scannable, paper-based PROs, with manual single-key- and double-key entered data. To help further registry-PRO studies, I calculated the number of patients needed to discriminate between subgroups of age, sex, diagnosis, and prosthesis type for each of four often used PROs (OHS, HOOS, EQ-5D and SF-12), and to simplify the clinical interpretation of PRO scores and PRO change scores in PRO studies, I estimated MCII and PASS for two often used PROs (EQ-5D and HOOS). The feasibility study included 5,747 THA patients registered in the DHR, and I found only minor differences between the disease-specific and the generic PROs regarding ceiling and floor effects as well as discarded items. The HOOS, the OHS, the SF-12, and the EQ-5D are all appropriate PROs for administration in a hip registry. I found that group sizes from 51 to 1,566 were needed for subgroup analysis, depending on descriptive factors and choice of PRO. The AFP study included 200 THA patients (398 PROs, 4,875 items and 21,887 data fields), and gave excellent results provided use of highly structured questionnaires. OMR performed equally as well as manual double-key entering, and better than single-key entering. The PRO translation and validation study included 2,278 patients (and 212 patients for the test

  5. In Search of a Gold Standard Scoring System for the Subjective Evaluation of Cosmetic Outcomes Following Breast-Conserving Therapy.

    PubMed

    Racz, Jennifer M; Hong, Nicole Look; Latosinsky, Steven

    2015-01-01

    The absence of a widely accepted method for aesthetic evaluation following breast-conserving surgery for breast cancer limits the ability to evaluate cosmetic outcomes. In this study, two different panel scoring approaches were compared in an attempt to identify a gold standard scoring system for subjectively assessing cosmetic outcomes following breast-conserving therapy. Standardized photographs of each participant were evaluated independently by twelve health care professionals involved in breast cancer diagnosis and treatment using the Danoff four-point scale. Individual Danoff scores were combined using two methods, a random sample "three-panel" score and an iterative "Delphi-panel" score, in order to create a final cosmetic score for each patient. Agreement between these two aggregative approaches was assessed with a weighted kappa (wk) statistic. Patient and professional recruitment occurred at two separate tertiary care multi-disciplinary breast health centers. Women with unilateral breast cancer who underwent breast-conserving therapy (segmental mastectomy or lumpectomy and radiotherapy) and were at least 2 years after radiotherapy were asked to participate. Ninety-seven women were evaluated. The Delphi approach required three rounds of evaluation to obtain greater than 50% agreement in all photographs. The wk statistic between scores generated from the "three-panel" and "Delphi-panel" approaches was 0.80 (95% CI: 0.71-0.89), thus demonstrating substantial agreement. Evaluation of cosmetic outcomes following breast-conserving therapy using a "three-panel" and "Delphi-panel" score provide similar results, confirming the reliability of either approach for subjective evaluation. Simplicity of use and interpretation favors the "three-panel" score. Future work should concentrate on the integration of the three-panel score with objective and patient-reported scales to generate a comprehensive cosmetic evaluation platform. PMID:25940058

  6. The People Next Door: Getting along with the Neighbors in "Yoo-Hoo Mrs. Goldberg" and "District 9"

    ERIC Educational Resources Information Center

    Beck, Bernard

    2010-01-01

    Two different perspectives on the immigrant struggles are found in a documentary about the radio and television program "The Goldbergs" and a science fiction thriller about the treatment of an immigrant alien community. "Yoo-Hoo Mrs. Goldberg" is optimistic and celebrates the achievements of an established ethnic community in America and the woman…

  7. Predicting Outcome in Acute Organophosphorus Poisoning with a Poison Severity Score or the Glasgow Coma Scale

    PubMed Central

    Davies, James O. J.; Eddleston, Michael; Buckley, Nick A.

    2008-01-01

    Background: Organophosphorus pesticide poisoning kills around 200,000 people each year, principally due to self poisoning in the Asia-Pacific region. Aim: We wished to assess whether patients at high risk of death could be identified accurately using clinical parameters soon after hospital admission. Design: We evaluated the usefulness of the International Program on Chemical Safety Poison Severity Score (IPCS PSS) and the Glasgow Coma Score (GCS) prospectively for predicting death in patients poisoned by organophosphorus pesticides. Methods: Data were collected as part of a multicentre cohort study in Sri Lanka. Study doctors saw all patients on admission, collecting data on pulse, blood pressure, pupil size, need for intubation, and GCS. Results: 1365 patients with a history of acute organophosphorus poisoning were included. Receiver operating characteristic (ROC) curves were calculated for the IPCS PSS and GCS on admission. The IPCS PSS and GCS had similar ROC area under the curves (AUC) and best cut points as determined by Youden's index (AUC/sensitivity/specificity 0.81/0.78/0.79 for IPCS PSS ≥ grade 2 and 0.84/0.79/0.79 for GCS ≤13). The predictive value varied with the pesticide ingested, being more accurate for dimethoate poisoning and less accurate for fenthion poisoning (GCS AUC 0.91 compared to 0.69). Conclusions: GCS and the IPCS PSS were similarly effective at predicting outcome. Patients presenting with a GCS ≤ 13 need intensive monitoring and treatment. However, the identity of the organophosphate must be taken into account since the half of all patients who died from fenthion poisoning only had mild symptoms at presentation. PMID:18319295

  8. Validation of the Spanish version of the hip outcome score: a multicenter study

    PubMed Central

    2014-01-01

    Background The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports’ items. The aim of the present study is to translate and validate HOS into Spanish. Methods A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Results Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach’s alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. Conclusion The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Level of evidence Prognostic study, Level I PMID:24884511

  9. Effects of a Rural Family Drug Treatment Court Collaborative on Child Welfare Outcomes: Comparison Using Propensity Score Analysis.

    PubMed

    Pollock, McLean D; Green, Sherri L

    2015-01-01

    Previous studies that have examined the impact of family drug treatment courts (FDTCs) on child welfare outcomes have produced mixed results. This study evaluates the impact of a rural, FDTC collaborative on child welfare outcomes using propensity score analysis. Findings from the study show that children in the treatment group had longer stays in child welfare custody but were substantially less likely to experience future incidents of maltreatment than those in families with parental substance use disorders without these services. PMID:26827480

  10. Impact of ureteric stent on outcome of extracorporeal shockwave lithotripsy: A propensity score analysis

    PubMed Central

    Gołąb, Adam; Słojewski, Marcin

    2016-01-01

    Introduction Extracorporeal shockwave lithotripsy (SWL) is one of the most frequently performed procedures in patients with urolithiasis. For ureter-localized stones, SWL is often preceded by a double J stent insertion. However, fear of serious complications, including sepsis associated with stents, is often expressed. The following study assessed the impact of stent insertions on the results of SWL in patients with ureteric stones. Material and methods The study group consisted of 411 ureteric stone patients who were treated with SWL from January 2010 to December 2014. In 60 cases, treatment was preceded by ureteric stent insertion. A propensity scoring system was used to pair non-stented patients with the stented group. Success rates were assessed and compared using the chi-squared test. Multivariate logistic regression analysis was used to evaluate the influence of particular variables on the stone-free rate. Results The overall success rate was 82.2%. After matching, the success rate of the stented group was not significantly different from the control group (85.0% vs. 83.3% respectively, p = 0.80). The mean number of sessions was higher in the stented group (1.88 per patient). Stones located in the lower part of the ureter have the greatest chance of being successfully treated. Conclusions The double J stent has no influence on the outcome of SWL treatment. In view of the greater likelihood of having additional sessions, this approach should be reserved for selected cases. PMID:27551556

  11. Outcome of total hip arthroplasty, but not of total knee arthroplasty, is related to the preoperative radiographic severity of osteoarthritis

    PubMed Central

    Tilbury, Claire; Holtslag, Maarten J; Tordoir, Rutger L; Leichtenberg, Claudia S; Verdegaal, Suzan H M; Kroon, Herman M; Fiocco, Marta; Nelissen, Rob G H H; Vliet Vlieland, Thea P M

    2016-01-01

    Background and purpose There is no consensus on the impact of radiographic severity of hip and knee osteoarthritis (OA) on the clinical outcome of total hip arthroplasty (THA) and total knee arthroplasty (TKA). We assessed whether preoperative radiographic severity of OA is related to improvements in functioning, pain, and health-related quality of life (HRQoL) 1 year after THA or TKA. Patients and methods This prospective cohort study included 302 THA patients and 271 TKA patients with hip or knee OA. In the THA patients, preoperatively 26% had mild OA and 74% had severe OA; in the TKA patients, preoperatively 27% had mild OA and 73% had severe OA. Radiographic severity was determined according to the Kellgren and Lawrence (KL) classification. Clinical assessments preoperatively and 1 year postoperatively included: sociodemographic characteristics and patient-reported outcomes (PROMs): Oxford hip/knee score, hip/knee injury and osteoarthritis outcome score (HOOS/KOOS), SF36, and EQ5D. Change scores of PROMs were compared with mild OA (KL 0–2) and severe OA (KL 3–4) using a multivariate linear regression model. Results Adjusted for sex, age, preoperative scores, BMI, and Charnley score, radiographic severity of OA in THA was associated with improvement in HOOS “Activities of daily living”, “Pain”, and “Symptoms”, and SF36 physical component summary (“PCS”) scale. In TKA, we found no such associations. Interpretation The decrease in pain and improvement in function in THA patients, but not in TKA patients, was positively associated with the preoperative radiographic severity of OA. PMID:26484651

  12. Patient-reported outcomes for US oncology labeling: review and discussion of score interpretation and analysis methods.

    PubMed

    Shields, Alan; Coon, Cheryl; Hao, Yanni; Krohe, Meaghan; Yaworsky, Andrew; Mazar, Iyar; Foley, Catherine; Globe, Denise

    2015-01-01

    This paper describes ways to approach the conceptual and practical challenges associated with interpreting the clinical meaning of scores produced by patient reported outcome (PRO) questionnaires, particularly when used to inform efficacy decisions for regulatory approval for oncology products. Score interpretation estimates are not inherent to PRO questionnaires per se, instead, vary dependent upon sample and study design characteristics. Scores from PRO measures can be interpreted at the individual and group level, and each carries its own set of statistics for evaluating differences. Oncology researchers have a variety of methods and data analytic strategies available to support their score interpretation needs, which should be considered in the context of their a priori knowledge of the target patient population, the hypothesized effects of treatment, the study design and assessment schedule, and the inferences and decisions to be made from the PRO data. PMID:26594897

  13. Outcome Predictors in Prosthetic Joint Infections--Validation of a risk stratification score for Prosthetic Joint Infections in 120 cases.

    PubMed

    Wimmer, Matthias D; Randau, Thomas M; Friedrich, Max J; Ploeger, Milena M; Schmolder, Jan; Strauss, Andreas C; Pennekamp, Peter H; Vavken, Patrick; Gravius, Sascha

    2016-03-01

    Prosthetic joint infections are a major challenge in total joint arthroplasty, especially in times of accumulating drug resistancies. Even though predictive risk classifications are a widely accepted tool to define a suitable treatment protocol a classification is still missing considering the difficulty in treating the -causative pathogen antibiotically. In this study, we present and evaluate a new predictive risk stratification for prosthetic joint infections in 120 cases, treated with a two-stage exchange. Treatment outcomes in 120 patients with proven prosthetic joint infections in hip and knee prostheses were regressed on time of infection, systemic risk factors, local risk factors and the difficulty in treating the causing pathogen. The main outcome variable was "definitely free of infection" after two years as published. Age, gender, and BMI were included as covariables and analyzed in a logistic regression model. 66 male and 54 female patients, with a mean age at surgery of 68.3 years±12.0 and a mean BMI of 26.05±6.21 were included in our survey and followed for 29.0±11.3 months. We found a significant association (p<0.001) between our score and the outcome parameters evaluated. Age, gender and BMI did not show a significant association with the outcome. These results show that our score is an independent and reliable predictor for the cure rate in prosthetic joint infections in hip and knee prostheses treated within a two-stage exchange protocol. Our score illustrates, that there is a statistically significant, sizable decrease in cure rate with an increase in score. In patients with prosthetic joint infections the validation of a risk score may help to identify patients with local and systemic risk factors or with infectious organisms identified as "difficult to treat" prior to the treatment or the decision about the treatment concept. Thus, appropriate extra care should be considered and provided. PMID:26984667

  14. [Hong Seok-hoo's translation of "New Edition of Physiology Textbook"(1906) and its meanings].

    PubMed

    Park, Jun-Hyoung; Park, Hyoung-Woo

    2012-12-01

    Hong Seok-hoo, who took charge of Jejungwon, was successful in translating Jiro Tsuboi's book titled "New Edition of Physiology Textbook (1897)" in Japanese and publishing it with a title of "New Edition of Physiology Textbook" in 1906. Jiro Tsuboi, the original author of that book, was a doctor having majored in Hygienics in Germany and was also known to have done pioneering work in Hygienics and Occupational and Environmental Medicine in Japan. At that time, he wrote that book for the purpose of teaching his students at Ordinary Middle School and Normal School. Therefore, it was not intended as a Physiology textbook for medical students, but an introductory book explaining Physiology with a wide range of subjects including hygienic matters in a broader sense. Hong Seok-hoo made an almost complete translation of the "New Edition of Physiology Textbook." While editing the book, however, he changed some of the most Japanese-style contents to meet the Korean conditions then, and made up for some insufficient contents with reference to the original author's other books. Although it was not included in an original version of that book, he also compiled a physiology dictionary in order to help Korean readers acquire medical terms in a more systematic way. Just like other textbooks of Jejungwon, the "New Edition of Physiology Textbook" was also put into Korean only. Hong Seok-hoo accepted Japanese-style medical terms, but also changed some of them or coined new words, considering the Korean circumstances then. He seemed to do so in an effort to introduce Western medicine in a more independent way while overcoming his limitations of translation. In particular, this book criticized that a long-term use of cosmetics might cause a serious lead poisoning from a Christian viewpoint, saying that a God-created human body should be kept intact as it is. In addition, in the course of reediting premodern books, the term "Lord" was changed into "God," which is considered a kind of

  15. Locally Advanced Rectal Cancer Patients Receiving Radio-Chemotherapy: A Novel Clinical-Pathologic Score Correlates With Global Outcome

    SciTech Connect

    Berardi, Rossana; Mantello, Giovanna; Scartozzi, Mario; Del Prete, Stefano; Luppi, Gabriele; Martinelli, Roberto; Fumagalli, Marco; Grillo-Ruggieri, Filippo; Bearzi, Italo; Mandolesi, Alessandra; Marmorale, Cristina; Cascinu, Stefano

    2009-12-01

    Purpose: To determine the importance of downstaging of locally advanced rectal cancer after neoadjuvant treatment. Methods and Materials: The study included all consecutive patients with locally advanced rectal cancer who underwent neoadjuvant treatment (chemotherapy and/or radiotherapy) in different Italian centers from June 1996 to December 2003. A novel score was used, calculated as the sum of numbers obtained by giving a negative or positive point, respectively, to each degree of increase or decrease in clinical to pathologic T and N status. Results: A total of 317 patients were eligible for analysis. Neoadjuvant treatments performed were as follows: radiotherapy alone in 75 of 317 patients (23.7%), radiotherapy plus chemotherapy in 242 of 317 patients (76.3%). Worse disease-free survival was observed in patients with a lower score (Score 1 = -3 to +3 vs. Score 2 = +4 to +7; p = 0.04). Conclusions: Our results suggest that a novel score, calculated from preoperative and pathologic tumor and lymph node status, could represent an important parameter to predict outcome in patients receiving neoadjuvant treatment for rectal cancer. The score could be useful to select patients for adjuvant chemotherapy after neoadjuvant treatment and surgery.

  16. Survival outcomes scores (SOFT, BAR, and Pedi-SOFT) are accurate in predicting post-liver transplant survival in adolescents.

    PubMed

    Conjeevaram Selvakumar, Praveen Kumar; Maksimak, Brian; Hanouneh, Ibrahim; Youssef, Dalia H; Lopez, Rocio; Alkhouri, Naim

    2016-09-01

    SOFT and BAR scores utilize recipient, donor, and graft factors to predict the 3-month survival after LT in adults (≥18 years). Recently, Pedi-SOFT score was developed to predict 3-month survival after LT in young children (≤12 years). These scoring systems have not been studied in adolescent patients (13-17 years). We evaluated the accuracy of these scoring systems in predicting the 3-month post-LT survival in adolescents through a retrospective analysis of data from UNOS of patients aged 13-17 years who received LT between 03/01/2002 and 12/31/2012. Recipients of combined organ transplants, donation after cardiac death, or living donor graft were excluded. A total of 711 adolescent LT recipients were included with a mean age of 15.2±1.4 years. A total of 100 patients died post-LT including 33 within 3 months. SOFT, BAR, and Pedi-SOFT scores were all found to be good predictors of 3-month post-transplant survival outcome with areas under the ROC curve of 0.81, 0.80, and 0.81, respectively. All three scores provided good accuracy for predicting 3-month survival post-LT in adolescents and may help clinical decision making to optimize survival rate and organ utilization. PMID:27478012

  17. Propensity score methods for estimating relative risks in cluster randomized trials with low-incidence binary outcomes and selection bias.

    PubMed

    Leyrat, Clémence; Caille, Agnès; Donner, Allan; Giraudeau, Bruno

    2014-09-10

    Despite randomization, selection bias may occur in cluster randomized trials. Classical multivariable regression usually allows for adjusting treatment effect estimates with unbalanced covariates. However, for binary outcomes with low incidence, such a method may fail because of separation problems. This simulation study focused on the performance of propensity score (PS)-based methods to estimate relative risks from cluster randomized trials with binary outcomes with low incidence. The results suggested that among the different approaches used (multivariable regression, direct adjustment on PS, inverse weighting on PS, and stratification on PS), only direct adjustment on the PS fully corrected the bias and moreover had the best statistical properties. PMID:24771662

  18. Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

    PubMed Central

    Dettmer, Marius; Pourmoghaddam, Amir; Kreuzer, Stefan W.

    2015-01-01

    Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS) from a young group of patients (n = 52, age 48.9 ± 6.1 years) who had received hip resurfacing (HR) with a cohort of patients (n = 73, age 48.2 ± 6.6 years) who had received neck-preserving, short-stem implant total hip arthroplasty (THA). Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year) in both groups (p < 0.0001, η2 = 0.69); there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8) than MiniHip surgery (62.5 min ± 14.8), U = 85.0, p < 0.0001, η2 = 0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs. PMID:26101669

  19. Outcomes for youth receiving intensive in-home therapy or residential care: a comparison using propensity scores.

    PubMed

    Barth, Richard P; Greeson, Johanna K P; Guo, Shenyang; Green, Rebecca L; Hurley, Sarah; Sisson, Jocelyn

    2007-10-01

    This study compares outcomes for behaviorally troubled children receiving intensive in-home therapy (IIHT) and those receiving residential care (RC). Propensity score matching is used to identify matched pairs of youth (n = 786) with equivalent propensity for IIHT. The majority of pretreatment differences between the IIHT and RC groups are eliminated following matching. Logistic regression is then conducted on outcome differences at 1 year postdischarge. Results show that IIHT recipients had a greater tendency (.615) toward living with family, making progress in school, not experiencing trouble with the law, and placement stability compared with RC youth (.558; p < .10). This suggests that IIHT is at least as effective for achieving positive outcomes. Given IIHT's reduced restrictiveness and cost, intensive in-home services should be the preferred treatment over RC in most cases. PMID:18194029

  20. The Disaggregation of Value-Added Test Scores to Assess Learning Outcomes in Economics Courses

    ERIC Educational Resources Information Center

    Walstad, William B.; Wagner, Jamie

    2016-01-01

    This study disaggregates posttest, pretest, and value-added or difference scores in economics into four types of economic learning: positive, retained, negative, and zero. The types are derived from patterns of student responses to individual items on a multiple-choice test. The micro and macro data from the "Test of Understanding in College…

  1. Impact of malnutrition on pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit

    PubMed Central

    Nangalu, Romi; Pooni, Puneet Aulakh; Bhargav, Siddharth; Bains, Harmesh Singh

    2016-01-01

    Objectives: This study was done to determine the effect of malnutrition on mortality in Pediatric Intensive Care Unit (PICU) and on the pediatric risk of mortality (PRISM) scoring. Subjects and Methods: This was a prospective study done over 1 year. There were total 400 patients (1 month 14 years), who were divided into cases with weight for age <3rd centile and controls with ≥3rd centile of WHO charts. Cases were subdivided into mild/moderate (61–80% of expected weight for age) and severe malnutrition (<60%). Results: Out of total, 38.5% patients were underweight, and malnutrition was more in infancy, 61/104, i.e. 58.5% (P - 0.003). There was no significant difference in vitals at admission. Cases needed prolonged mechanical ventilation (P - 0.0063) and hospital stay (P - 0.0332) compared to controls. Mean and median PRISM scores were comparable in both the groups, but mortality was significantly higher in severely malnourished (P value 0.027). Conclusion: Severe malnutrition is independently associated with higher mortality even with similar PRISM score. There is need to give an additional score to children with weight for age <60% of expected. PMID:27555691

  2. Estimating Geriatric Mortality after Injury Using Age, Injury Severity, and Performance of a Transfusion: The Geriatric Trauma Outcome Score

    PubMed Central

    Zhao, Frank Z.; Wolf, Steven E.; Nakonezny, Paul A.; Minhajuddin, Abu; Rhodes, Ramona L.; Paulk, M. Elizabeth

    2015-01-01

    Abstract Background: A tool to determine the probability of mortality for severely injured geriatric patients is needed. Objective: We sought to create an easily calculated geriatric trauma prognostic score based on parameters available at the bedside to aid in mortality probability determination. Methods: All patients ≥65 years of age were identified from our Level I trauma center's registry between January 1, 2000 and December 31, 2013. Measurements included age, Injury Severity score (ISS), units of packed red blood cells (PRBCs) transfused in the first 24 hours, and patients' mortality status at the end of their index hospitalization. As a first step, a logistic regression model with maximum likelihood estimation and robust standard errors was used to estimate the odds of mortality from age, ISS, and PRBCs after dichotomizing PRBCs as yes/no. We then constructed a Geriatric Trauma Outcome (GTO) score that became the sole predictor in the re-specified logistic regression model. Results: The sample (n=3841) mean age was 76.5±8.1 years and the mean ISS was 12.4±9.8. In-hospital mortality was 10.8%, and 11.9% received a transfusion by 24 hours. Based on the logistic regression model, the equation with the highest discriminatory ability to estimate probability of mortality was GTO Score=age+(2.5×ISS)+22 (if given PRBCs). The area under the receiver operating characteristic curve (AUC) for this model was 0.82. Selected GTO scores and their related probability of dying were: 205=75%, 233=90%, 252=95%, 310=99%. The range of GTO scores was 67.5 (survivor) to 275.1 (died). Conclusion: The GTO model accurately estimates the probability of dying, and can be calculated at bedside by those possessing a working knowledge of ISS calculation. PMID:25974408

  3. Assessing treatment outcomes using a single question: the net promoter score.

    PubMed

    Hamilton, D F; Lane, J V; Gaston, P; Patton, J T; Macdonald, D J; Simpson, A H R W; Howie, C R

    2014-05-01

    Satisfaction with care is important to both patients and to those who pay for it. The Net Promoter Score (NPS), widely used in the service industries, has been introduced into the NHS as the 'friends and family test'; an overarching measure of patient satisfaction. It assesses the likelihood of the patient recommending the healthcare received to another, and is seen as a discriminator of healthcare performance. We prospectively assessed 6186 individuals undergoing primary lower limb joint replacement at a single university hospital to determine the Net Promoter Score for joint replacements and to evaluate which factors contributed to the response. Achieving pain relief (odds ratio (OR) 2.13, confidence interval (CI) 1.83 to 2.49), the meeting of pre-operative expectation (OR 2.57, CI 2.24 to 2.97), and the hospital experience (OR 2.33, CI 2.03 to 2.68) are the domains that explain whether a patient would recommend joint replacement services. These three factors, combined with the type of surgery undertaken (OR 2.31, CI 1.68 to 3.17), drove a predictive model that was able to explain 95% of the variation in the patient's recommendation response. Though intuitively similar, this 'recommendation' metric was found to be materially different to satisfaction responses. The difference between THR (NPS 71) and TKR (NPS 49) suggests that no overarching score for a department should be used without an adjustment for case mix. However, the Net Promoter Score does measure a further important dimension to our existing metrics: the patient experience of healthcare delivery. PMID:24788496

  4. 3-D volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: Clinical correlations and comparison to Lund-Mackay scoring

    PubMed Central

    Pallanch, John; Yu, Lifeng; Delone, David; Robb, Rich; Holmes, David R.; Camp, Jon; Edwards, Phil; McCollough, Cynthia H.; Ponikau, Jens; Dearking, Amy; Lane, John; Primak, Andrew; Shinkle, Aaron; Hagan, John; Frigas, Evangelo; Ocel, Joseph J.; Tombers, Nicole; Siwani, Rizwan; Orme, Nicholas; Reed, Kurtis; Jerath, Nivedita; Dhillon, Robinder; Kita, Hirohito

    2014-01-01

    Background We aimed to test the hypothesis that 3-D volume-based scoring of computed tomographic (CT) images of the paranasal sinuses was superior to Lund-Mackay CT scoring of disease severity in chronic rhinosinusitis (CRS). We determined correlation between changes in CT scores (using each scoring system) with changes in other measures of disease severity (symptoms, endoscopic scoring, and quality of life) in patients with CRS treated with triamcinolone. Methods The study group comprised 48 adult subjects with CRS. Baseline symptoms and quality of life were assessed. Endoscopy and CT scans were performed. Patients received a single systemic dose of intramuscular triamcinolone and were reevaluated 1 month later. Strengths of the correlations between changes in CT scores and changes in CRS signs and symptoms and quality of life were determined. Results We observed some variability in degree of improvement for the different symptom, endoscopic, and quality-of-life parameters after treatment. Improvement of parameters was significantly correlated with improvement in CT disease score using both CT scoring methods. However, volumetric CT scoring had greater correlation with these parameters than Lund-Mackay scoring. Conclusion Volumetric scoring exhibited higher degree of correlation than Lund-Mackay scoring when comparing improvement in CT score with improvement in score for symptoms, endoscopic exam, and quality of life in this group of patients who received beneficial medical treatment for CRS. PMID:24106202

  5. Pediatric ECMO outcomes: comparison of centrifugal versus roller blood pumps using propensity score matching.

    PubMed

    Barrett, Cindy S; Jaggers, James J; Cook, E Francis; Graham, Dionne A; Yarlagadda, Vasmi V; Teele, Sarah A; Almond, Christopher S; Bratton, Susan L; Seeger, John D; Dalton, Heidi J; Rycus, Peter T; Laussen, Peter C; Thiagarajan, Ravi R

    2013-01-01

    Centrifugal blood pumps are being increasingly utilized in children supported with extracorporeal membrane oxygenation (ECMO). Our aim was to determine if survival and ECMO-related morbidities in children supported with venoarterial (VA) ECMO differed by blood pump type.Children aged less than 18 years who underwent VA ECMO support from 2007 to 2009 and reported to the Extracorporeal Life Support Organization registry were propensity score matched (Greedy 1:1 matching) using pre-ECMO characteristics.A total of 2,656 (centrifugal = 2,231, roller = 425) patients were identified and 548 patients (274 per pump type) were included in the propensity score-matched cohort. Children supported with centrifugal pumps had increased odds of hemolysis (odds ratio [OR], 4.03 95% confidence interval [CI], 2.37-6.87), hyperbilirubinemia (OR, 5.48; 95% CI, 2.62-11.49), need for inotropic support during ECMO (OR, 1.54; 95% CI, 1.09-2.17), metabolic alkalosis (blood pH > 7.6) during ECMO (OR, 3.13; 95% CI, 1.49-6.54), and acute renal failure (OR, 1.61; 95% CI, 1.10-2.39). Survival to hospital discharge did not differ by pump type.In a propensity score-matched cohort of pediatric ECMO patients, children supported with centrifugal pumps had increased odds of ECMO-related complications. There was no difference in survival between groups. PMID:23438777

  6. Improving the assessment of the outcome of nonsynonymous SNVs with a consensus deleteriousness score, Condel.

    PubMed

    González-Pérez, Abel; López-Bigas, Nuria

    2011-04-01

    Several large ongoing initiatives that profit from next-generation sequencing technologies have driven--and in coming years will continue to drive--the emergence of long catalogs of missense single-nucleotide variants (SNVs) in the human genome. As a consequence, researchers have developed various methods and their related computational tools to classify these missense SNVs as probably deleterious or probably neutral polymorphisms. The outputs produced by each of these computational tools are of different natures and thus difficult to compare and integrate. Taking advantage of the possible complementarity between different tools might allow more accurate classifications. Here we propose an effective approach to integrating the output of some of these tools into a unified classification; this approach is based on a weighted average of the normalized scores of the individual methods (WAS). (In this paper, the approach is illustrated for the integration of five tools.) We show that this WAS outperforms each individual method in the task of classifying missense SNVs as deleterious or neutral. Furthermore, we demonstrate that this WAS can be used not only for classification purposes (deleterious versus neutral mutation) but also as an indicator of the impact of the mutation on the functionality of the mutant protein. In other words, it may be used as a deleteriousness score of missense SNVs. Therefore, we recommend the use of this WAS as a consensus deleteriousness score of missense mutations (Condel). PMID:21457909

  7. Correlation of Social Science Students' Grade Outcome with Reading and Writing Scores.

    ERIC Educational Resources Information Center

    Parrott, Marietta

    A study was conducted at College of the Sequoias (COS) to examine the entry-level reading and writing skills of students and their grade outcomes in the social science courses for which they were enrolled. The study sought to identify any predictors of students' eventual success/non-success in class. The study focused on the placement test scores…

  8. Major Field Achievement Test in Business: Guidelines for Improved Outcome Scores--Part I

    ERIC Educational Resources Information Center

    McLaughlin, J. Patrick; White, Jason T.

    2007-01-01

    Outcomes measurements have always been an important part of proving to outside constituencies how you "measure up" to other schools with your business programs. A common nationally-normed exam that is used is the Major Field Achievement Test in Business from Educational Testing Services. Our paper discusses some guidelines that we are "pilot…

  9. An Outcome Measure of Functionality and Pain in Patients with Low Back Disorder: A Validation Study of the Iranian version of Low Back Outcome Score

    PubMed Central

    Nayeb Aghaei, Hossein; Azhari, Shirzad; Shazadi, Sohrab; Khayat Kashany, Hamid; Mohammadi, Hassan Reza; Montazeri, Ali

    2016-01-01

    Study Design Cross-sectional study. Purpose This study aimed to cross-culturally translate and validate the low back outcome score (LBOS) in Iran. Overview of Literature Lumbar disc hernia (LDH) is the most common diagnoses of low back pain and imposes a heavy burden on both individual and society. Instruments measuring patient reported outcomes should satisfy cetain psychometric properties. Methods The translation and cross-cultural adaptation of the original questionnaire was performed using Beaton's guideline. A total of 163 patients with LDH were asked to respond to the questionnaire at three points in time: preoperative and twice within 1-week interval after surgery assessments. The Oswestry disabilty index (ODI) was also completed. The internal consistency, test-retest, convergent validity, and responsiveness to change were assessed. Responsiveness to change also was assessed comparing patients' pre- and postoperative scores. Results The mean age of the cohort was 49.8 years (standard deviation=10.1). The Cronbach's alpha coefficients for the LBOS at preoperative and postoperative assessments ranged from 0.77 to 0.79, indicating good internal consistency. Test-retest reliability as performed by intraclass correlation coefficient was found to be 0.82 (0.62–0.91). The instrument discriminated well between sub-groups of patients who differed in the Finneson-Cooper score. The ODI correlated strongly with the LBOS score, lending support to its good convergent validity (r=––0.83; p<0.001). Further analysis also indicated that the questionnaire was responsive to change (p<0.001). Conclusions The Iranian version of LBOS performed well and the findings suggest that it is a valid measure of back pain treatment evaluation among LDH patients. PMID:27559453

  10. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty.

    PubMed

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas; Barfod, Kristoffer W; Husted, Henrik; Troelsen, Anders

    2016-06-01

    Background and purpose - When evaluating the outcome after total knee arthroplasty (TKA), increasing emphasis has been put on patient satisfaction and ability to perform activities of daily living. To address this, the forgotten joint score (FJS) for assessment of knee awareness has been developed. We investigated the validity and reliability of the FJS. Patients and methods - A Danish version of the FJS questionnaire was created according to internationally accepted standards. 360 participants who underwent primary TKA were invited to participate in the study. Of these, 315 were included in a validity study and 150 in a reliability study. Correlation between the Oxford knee score (OKS) and the FJS was examined and test-retest evaluation was performed. A ceiling effect was defined as participants reaching a score within 15% of the maximum achievable score. Results - The validity study revealed a strong correlation between the FJS and the OKS (intraclass correlation coefficient (ICC) = 0.81, 95% CI: 0.77-0.85; p < 0.001). The test-retest evaluation showed almost perfect reliability for the FJS total score (ICC = 0.91, 95% CI: 0.88-0.94) and substantial reliability or better for individual items of the FJS (ICC? 0.79). We found a high level of internal consistency (Cronbach's? = 0.96). The ceiling effect for the FJS was 16%, as compared to 37% for the OKS. Interpretation - The FJS showed good construct validity and test-retest reliability. It had a lower ceiling effect than the OKS. The FJS appears to be a promising tool for evaluation of small differences in knee performance in groups of patients with good clinical results after TKA. PMID:26937689

  11. Does adding ICU data to the POSSUM score improve the prediction of outcomes following surgery for upper gastrointestinal malignancies?

    PubMed

    Butterfield, R; Stedman, W; Herod, R; Aneman, A

    2015-07-01

    Surgery for upper gastrointestinal malignancy carries a high postoperative mortality and morbidity risk. The importance of preoperative physiological reserve and intraoperative events in determining clinical outcomes is recognised in the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) score that comprises variables relevant to both phases. Whether adding variables linked to ICU admission characteristics improves the predictive capacity of POSSUM is unclear, especially in an Australian/New Zealand healthcare context. This study aimed to evaluate the predictive capacity of the POSSUM score for 30-day mortality and in-hospital morbidity in 80 patients undergoing resection of oesophageal (28%), gastric (26%) or pancreatic (46%) malignancies and admitted to ICU. The 30-day mortality was 8.8% and 65% of patients developed some postoperative complication. Receiver operating characteristics generated an area under the curve (95% CI) to predict mortality by Portsmouth POSSUM of 0.87 (0.77 to 0.93) and morbidity by POSSUM of 0.67 (0.55 to 0.77). Multiple regression analysis including biochemical variables and vital signs on admission to ICU identified renal function parameters, fluid balance and need for cardiorespiratory support beyond the first postoperative day as independent factors associated with mortality and morbidity (in addition to the POSSUM score) but the inclusion of these variables in a logistic regression model did not significantly improve the predictive capacity for mortality (to area under the curve 0.93 [0.85 to 0.97]) or morbidity (to area under the curve 0.67 [0.55 to 0.78]). In conclusion, the POSSUM score provides clinically useful predictive capacity in patients undergoing surgery for upper gastrointestinal malignancies. The incorporation of ICU admission variables to the pre- and intraoperative POSSUM variables did not significantly enhance the precision. PMID:26099762

  12. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty

    PubMed Central

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas; Barfod, Kristoffer W; Husted, Henrik; Troelsen, Anders

    2016-01-01

    Background and purpose When evaluating the outcome after total knee arthroplasty (TKA), increasing emphasis has been put on patient satisfaction and ability to perform activities of daily living. To address this, the forgotten joint score (FJS) for assessment of knee awareness has been developed. We investigated the validity and reliability of the FJS. Patients and methods A Danish version of the FJS questionnaire was created according to internationally accepted standards. 360 participants who underwent primary TKA were invited to participate in the study. Of these, 315 were included in a validity study and 150 in a reliability study. Correlation between the Oxford knee score (OKS) and the FJS was examined and test-retest evaluation was performed. A ceiling effect was defined as participants reaching a score within 15% of the maximum achievable score. Results The validity study revealed a strong correlation between the FJS and the OKS (intraclass correlation coefficient (ICC) = 0.81, 95% CI: 0.77–0.85; p < 0.001). The test-retest evaluation showed almost perfect reliability for the FJS total score (ICC = 0.91, 95% CI: 0.88–0.94) and substantial reliability or better for individual items of the FJS (ICC? 0.79). We found a high level of internal consistency (Cronbach’s? = 0.96). The ceiling effect for the FJS was 16%, as compared to 37% for the OKS. Interpretation The FJS showed good construct validity and test-retest reliability. It had a lower ceiling effect than the OKS. The FJS appears to be a promising tool for evaluation of small differences in knee performance in groups of patients with good clinical results after TKA. PMID:26937689

  13. Treatment of Pulmonary Embolism With Rivaroxaban: Outcomes by Simplified Pulmonary Embolism Severity Index Score from a Post Hoc Analysis of the EINSTEIN PE Study

    PubMed Central

    Fermann, Gregory J; Erkens, Petra M G; Prins, Martin H; Wells, Philip S; Pap, Ákos F; Lensing, Anthonie W A; Kline, Jeffrey

    2015-01-01

    Objectives The objective was to assess adverse outcomes in relation to the simplified Pulmonary Embolism Severity Index (PESI) score in patients treated with rivaroxaban or standard therapy in the phase III EINSTEIN PE study and to evaluate the utility of the simplified PESI score to identify low-risk pulmonary embolism (PE) patients. Methods A post hoc analysis of EINSTEIN PE data was performed to assess the efficacy and safety of rivaroxaban in patients with a range of simplified PESI scores. Recurrent venous thromboembolism, fatal PE, all-cause mortality, and major bleeding were stratified by simplified PESI scores of 0, 1, or ≥2 and according to treatment period at 7, 14, 30, and 90 days and at the end of the full intended treatment period. Results Simplified PESI scores could be calculated in 4,831 of the 4,832 randomized patients; of those, 53.6, 36.7, and 9.7% had PESI scores of 0, 1, and ≥2, respectively. Among patients with simplified PESI scores of 0 or 1, fatal PE, all-cause mortality, and other adverse outcomes were uncommon within the first 7, 14, and 30 days. Patients with simplified PESI scores of ≥2 had more frequent adverse outcomes. Major bleeding was lower in the rivaroxaban group, particularly in those with simplified PESI scores of 1 or ≥2. Conclusions The findings support using risk stratification with the simplified PESI score to identify low-risk patients with PE. PMID:25716463

  14. A prospective comparison of echocardiographic wall motion score index and radionuclide ejection fraction in predicting outcome following acute myocardial infarction

    PubMed Central

    Galasko, G; Basu, S; Lahiri, A; Senior, R

    2001-01-01

    OBJECTIVE—To characterise echocardiographic wall motion score index (WMSI) as a surrogate measure of left ventricular ejection fraction (EF) following acute myocardial infarction (AMI) and to compare its prognostic value with that of EF measured by radionuclide ventriculography (RNV).
DESIGN—A prospective study to compare baseline echocardiographic WMSI with RNV EF in consecutive patients thrombolysed for AMI, both performed on the same day before discharge, and their relative prognostic values in predicting cardiac events.
SETTING—District general hospital coronary care unit and cardiology department.
PATIENTS—120 consecutive patients free of exclusion criteria thrombolysed for AMI and followed up for a mean (SD) of 13 (10) months.
INTERVENTIONS—None.
MAIN OUTCOME MEASURES—Correlation coefficients and receiver operating characteristic curve analyses plus cardiac event rates at follow up between RNV EF and echocardiographic WMSI.
RESULTS—WMSI correlated well with RNV EF. The best corresponding WMSIs for EFs 45%, 40%, and 35% were 0.6, 0.8, and 1.1, respectively. There were 42 cardiac events during follow up. Although both RNV EF and WMSI were strong univariate predictors of cardiac events, only WMSI independently predicted outcome in a multivariate model. All three WMSI cut offs significantly predicted events, while an RNV EF cut off of ⩽ 45% v > 45% failed to reach significance.
CONCLUSIONS—Although both RNV and echocardiographic WMSI strongly predicted cardiac outcome, WMSI, a cheaper and more readily available technique, is more discriminatory, especially in cases of mild left ventricular dysfunction following AMI.


Keywords: echocardiographic wall motion score index; radionuclide ventriculography; prognosis; acute myocardial infarction PMID:11514477

  15. Predicting Outcome after Traumatic Brain Injury: Development of Prognostic Scores Based on the IMPACT and the APACHE II

    PubMed Central

    Siironen, Jari; Kivisaari, Riku; Hernesniemi, Juha; Skrifvars, Markus B.

    2014-01-01

    Abstract Prediction models are important tools for heterogeneity adjustment in clinical trials and for the evaluation of quality of delivered care to patients with traumatic brain injury (TBI). We sought to improve the predictive performance of the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials) prognostic model by combining it with the APACHE II (Acute Physiology and Chronic Health Evaluation II) for 6-month outcome prediction in patients with TBI treated in the intensive care unit. A total of 890 patients with TBI admitted to a large urban level 1 trauma center in 2009–2012 comprised the study population. The IMPACT and the APACHE II scores were combined using binary logistic regression. A randomized, split-sample technique with secondary bootstrapping was used for model development and internal validation. Model performance was assessed by discrimination (by area under the curve [AUC]), calibration, precision, and net reclassification improvement (NRI). Overall 6-month mortality was 22% and unfavorable neurological outcome 47%. The predictive power of the new combined IMPACT–APACHE II models was significantly superior, compared to the original IMPACT models (AUC, 0.81–0.82 vs. 0.84–0.85; p<0.05) for 6-month mortality prediction, but not for unfavorable outcome prediction (AUC, 0.81–0.82 vs. 0.83; p>0.05). However, NRI showed a significant improvement in risk stratification of patients with unfavorable outcome by the IMPACT–APACHE II models, compared to the original models (NRI, 5.4–23.2%; p<0.05). Internal validation using split-sample and resample bootstrap techniques yielded equivalent results, indicating low grade of overestimation. Our findings show that by combining the APACHE II with the IMPACT, improved 6-month outcome predictive performance is achieved. This may be applicable for heterogeneity adjustment in forthcoming TBI studies. PMID:24836936

  16. The Dynamic International Prognostic Scoring System for myelofibrosis predicts outcomes after hematopoietic cell transplantation.

    PubMed

    Scott, Bart L; Gooley, Ted A; Sorror, Mohamed L; Rezvani, Andrew R; Linenberger, Michael L; Grim, Jonathan; Sandmaier, Brenda M; Myerson, David; Chauncey, Thomas R; Storb, Rainer; Buxhofer-Ausch, Veronika; Radich, Jerald P; Appelbaum, Frederick R; Deeg, H Joachim

    2012-03-15

    Studies by the International Working Group showed that the prognosis of myelofibrosis patients is predicted by the Dynamic International Prognostic Scoring System (DIPSS) risk categorization, which includes patient age, constitutional symptoms, hemoglobin, leukocyte count, and circulating blasts. We evaluated the prognostic usefulness of the DIPSS in 170 patients with myelofibrosis, 12 to 78 years of age (median, 51.5 years of age), who received hematopoietic cell transplantation (HCT) between 1990 and 2009 from related (n = 86) or unrelated donors (n = 84). By DIPSS, 21 patients had low-risk disease, 48 had intermediate-1, 50 had intermediate-2, and 51 had high-risk disease. Five-year incidence of relapse, relapse-free survival, overall survival, and nonrelapse mortality for all patients were 10%, 57%, 57%, and 34%, respectively. Among patients with DIPSS high-risk disease, the hazard ratio for post-HCT mortality was 4.11 (95% CI, 1.44-11.78; P = .008), and for nonrelapse mortality was 3.41 (95% CI, 1.15-10.09; P = .03) compared with low-risk patients. After a median follow-up of 5.9 years, the median survivals have not been reached for DIPSS risk groups low and intermediate-1, and were 7 and 2.5 years for intermediate-2 and high-risk patients, respectively. Thus, HCT was curative for a large proportion of patients with myelofibrosis, and post-HCT success was dependent on pre-HCT DIPSS classification. PMID:22234678

  17. Effects of Game Location, Quality of Opposition, and Starting Quarter Score in the Outcome of Elite Water Polo Quarters.

    PubMed

    Ruano, Miguel Á; Serna, Ana D; Lupo, Corrado; Sampaio, Jaime E

    2016-04-01

    Ruano, MÁ, Serna, AD, Lupo, C, and Sampaio, JE. Effects of game location, quality of opposition and starting quarter score in the outcome of elite water polo quarters. J Strength Cond Res 30(4): 1014-1020, 2016-The notational analysis is used to investigate teams' performance in water polo, especially focused on the determinants of success. Recently, a new topic has emerged "the situational variables," which includes the game conditions that may influence the performance at a behavioral level. The aim of this study was to identify the interactive effects of starting quarter score (SQS) (i.e., score difference at the beginning of each quarter and at the final score) and game location (GL) (i.e., home and away teams) in relation to quality of opposition (i.e., positions of difference between opposing teams at the end-of-season rankings) in elite men's water polo games. Data comprised 528 games (n = 2,112 quarters) from the first Spanish water polo division. A linear regression analysis was applied to show the impact of SQS and GL in relation to quality of opposition (unbalanced and balanced) for quarter (all quarters, and second, third, and fourth quarters). Results showed that SQS has an important effect for all quarters (0.16) and for the second (0.14) and third (0.14) quarters in balanced games (whereas the fourth quarter has an unpredictable outcome), and for each quarter (all quarters: 0.33; second quarter: 0.55; third quarter: 0.44; fourth quarter: 0.26) in unbalanced games. In addition, GL effects emerged for balanced (0.31) and unbalanced (0.45) games for all quarters and specifically for the second quarter of the unbalanced games. Therefore, this study showed that the elite water polo game dynamics, indirectly providing a reference for coaches (i.e., effective tactical approach) and physical trainers (i.e., high performance intensities), plans to improve their players' performance. PMID:26999289

  18. Patient-reported outcome measures in arthroplasty registries.

    PubMed

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric; Lübbeke, Anne; Denissen, Geke; Dunn, Jennifer; Lyman, Stephen; Franklin, Patricia; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Dawson, Jill

    2016-07-01

    The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and rigorous testing to ensure that it is valid, reliable, responsive, and acceptable to the intended population. A survey of the 41 ISAR member registries showed that 8 registries administered a PROMs program that covered all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the University of California at Los Angeles Activity Score (UCLA). PMID:27168175

  19. Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes

    PubMed Central

    Dexheimer Neto, Felippe Leopoldo; Rosa, Regis Goulart; Duso, Bruno Achutti; Haas, Jaqueline Sanguiogo; Savi, Augusto; Cabral, Cláudia da Rocha; Maccari, Juçara Gasparetto; de Oliveira, Roselaine Pinheiro; Antônio, Ana Carolina Peçanha; Castro, Priscylla de Souza; Teixeira, Cassiano

    2016-01-01

    Purpose. The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated. Materials and Methods. A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed. Results. In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%, P = 0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences. Conclusions. The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge. PMID:27123450

  20. Propensity Score Analysis of the Role of Initial Antifungal Therapy in the Outcome of Candida glabrata Bloodstream Infections.

    PubMed

    Puig-Asensio, M; Fernández-Ruiz, M; Aguado, J M; Merino, P; Lora-Pablos, D; Guinea, J; Martín-Dávila, P; Cuenca-Estrella, M; Almirante, B

    2016-06-01

    Candida glabrata isolates have reduced in vitro susceptibility to azoles, which raises concerns about the clinical effectiveness of fluconazole for treating bloodstream infection (BSI) by this Candida species. We aimed to evaluate whether the choice of initial antifungal treatment (fluconazole versus echinocandins or liposomal amphotericin B [L-AmB]-based regimens) has an impact on the outcome of C. glabrata BSI. We analyzed data from a prospective, multicenter, population-based surveillance program on candidemia conducted in 5 metropolitan areas of Spain (May 2010 to April 2011). Adult patients with an episode of C. glabrata BSI were included. The main outcomes were 14-day mortality and treatment failure (14-day mortality and/or persistent C. glabrata BSI for ≥48 h despite antifungal initiation). The impact of using fluconazole as initial antifungal treatment on the patients' prognosis was assessed by logistic regression analysis with the addition of a propensity score approach. A total of 94 patients with C. glabrata BSI were identified. Of these, 34 had received fluconazole and 35 had received an echinocandin/L-AmB-based regimen. Patients in the echinocandin/L-AmB group had poorer baseline clinical status than did those in the fluconazole group. Patients in the fluconazole group were more frequently (55.9% versus 28.6%) and much earlier (median time, 3 versus 7 days) switched to another antifungal regimen. Overall, 14-day mortality was 13% (9/69) and treatment failure 34.8% (24/69), with no significant differences between the groups. On multivariate analysis, after adjusting for baseline characteristics by propensity score, fluconazole use was not associated with an unfavorable evolution (adjusted odds ratio [OR] for 14-day mortality, 1.16, with 95% confidence interval [CI] of 0.22 to 6.17; adjusted OR for treatment failure, 0.83, with 95% CI of 0.27 to 2.61). In conclusion, initial fluconazole treatment was not associated with a poorer outcome than that

  1. Estimating the safety effects of lane widths on urban streets in Nebraska using the propensity scores-potential outcomes framework.

    PubMed

    Wood, Jonathan S; Gooch, Jeffrey P; Donnell, Eric T

    2015-09-01

    A sufficient understanding of the safety impact of lane widths in urban areas is necessary to produce geometric designs that optimize safety performance for all users. The overarching trend found in the research literature is that as lane widths narrow, crash frequency increases. However, this trend is inconsistent and is the result of multiple cross-sectional studies that have issues related to lack of control for potential confounding variables, unobserved heterogeneity or omitted variable bias, or endogeneity among independent variables, among others. Using ten years of mid-block crash data on urban arterials and collectors from four cities in Nebraska, crash modification factors (CMFs) were estimated for various lane widths and crash types. These CMFs were developed using the propensity scores-potential outcomes methodology. This method reduces many of the issues associated with cross-sectional regression models when estimating the safety effects of infrastructure-related design features. Generalized boosting, a non-parametric modeling technique, was used to estimate the propensity scores. Matching was performed using both Nearest Neighbor and Mahalanobis matching techniques. CMF estimation was done using mixed-effects negative binomial or Poisson regression with the matched data. Lane widths included in the analysis included 9ft, 10ft, 11ft, and 12ft. Some of the estimated CMFs were point estimates while others were functions of traffic volume (i.e., the CMF changed depending on the traffic volume). Roadways with 10ft travel lanes were found to experience the highest crash frequency relative to other lane widths. Meanwhile, roads with 9ft travel lanes were found to experience the lowest relative crash frequency. While this may be due to increased driver caution when traveling on narrow lanes, it is possible that unobserved factors influenced this result. CMFs for target crash types (sideswipe same-direction and sideswipe opposite-direction) were consistent

  2. Usefulness of the Baseline Syntax Score to Predict 3-Year Outcome After Complete Revascularization by Percutaneous Coronary Intervention.

    PubMed

    Kang, Jeehoon; Park, Kyung Woo; Han, Jung-Kyu; Yang, Han-Mo; Kang, Hyun-Jae; Koo, Bon-Kwon; Kim, Hyo-Soo

    2016-09-01

    Although we strive to achieve complete revascularization (CR) in those receiving percutaneous coronary intervention, it is uncertain which of these patients are at increased risk of clinical events. In this study, we aimed to investigate whether the baseline SYNTAX score (bSS) can predict adverse clinical events in patients receiving CR. From the Efficacy of Xience/Promus Versus Cypher in Reducing Late Loss After Stenting registry, the 3-year patient-oriented composite end point (POCE; all cause death, any myocardial infarction, and any revascularization) was compared according to bSS tertiles (1 ≤ low bSS < 6, 6 ≤ mid-bSS < 10, high bSS ≥ 10). Of the 5,088 patients, CR was achieved in 2,173 by percutaneous coronary intervention. The 3-year POCE increased significantly along with bSS tertile (7.3% vs 8.4% vs 14.8%, p <0.001). Multivariate analysis showed that, despite having the same residual SS of 0, the bSS was an independent predictor of 3-year POCE (hazard ratio 1.038, 95% confidence interval 1.018 to 1.058, p <0.001 per bSS point). In subgroup analysis, bSS was a predictor for 3-year POCE in multivessel diseases (hazard ratio 1.029, 95% confidence interval 1.004 to 1.054, p = 0.025 per bSS point), whereas in single-vessel diseases, the discriminative value of bSS was less significant. Also the clinical SYNTAX score, which added age, creatinine level, and ejection fraction to the bSS, was superior to the bSS in predicting 3-year POCE (area under the curve 0.595 vs 0.649, p = 0.008). In conclusion, the bSS was an independent predictor of long-term clinical outcomes in patients receiving CR, especially in those with multivessel coronary artery disease. Adding clinical factors to the bSS could increase the predictive power of clinical outcomes. PMID:27394412

  3. Long-term Therapeutic Outcomes of Radiofrequency Ablation for Subcapsular versus Nonsubcapsular Hepatocellular Carcinoma: A Propensity Score Matched Study.

    PubMed

    Kang, Tae Wook; Lim, Hyo Keun; Lee, Min Woo; Kim, Young-Sun; Rhim, Hyunchul; Lee, Won Jae; Paik, Yong Han; Kim, Min Ji; Ahn, Joong Hyun

    2016-07-01

    Purpose To compare the long-term therapeutic outcomes of radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) in subcapsular versus nonsubcapsular locations by using propensity score matching. Materials and Methods RF ablation for subcapsular HCC is controversial because of a high risk of incomplete ablation or major complications. This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. Between April 2006 and December 2011, 508 consecutive patients (396 men, 112 women; age range, 30-80 years) with a single HCC (Barcelona Clinic Liver Cancer stage 0 or A) underwent ultrasonography-guided percutaneous RF ablation as a first-line treatment. The patients were divided into two groups according to tumor location: subcapsular (n = 227) and nonsubcapsular (n = 281). Subcapsular HCC was defined as an index tumor located within 0.1 cm of the liver capsule. The association of subcapsular location and therapeutic outcomes of RF ablation was evaluated, including (a) local tumor progression (LTP) by using a competing risk regression model and (b) overall survival (OS) by using a Cox proportional hazards model according to propensity score matched data. The major complication rates from both overall data and matched data were assessed. Results Matching yielded 163 matched pairs of patients. In the two matched groups, cumulative LTP rates were 18.8% and 20.9% at 3 and 5 years, respectively, in the subcapsular group and 13.2% and 16.0% in the nonsubcapsular group. Corresponding OS rates were 90.7% for 3 years and 83.2% for 5 years in the subcapsular group and 91.4% and 79.1%, respectively, in the nonsubcapsular group. Hazard ratios (HRs) for LTP (HR = 1.37, P = .244) and OS (HR = 0.86, P = .604) were not significantly different between the two matched groups. Additionally, differences in major complication rates were not significant between groups for the two sets of data (P > .05). Conclusion The

  4. Hypofractionated stereotactic radiosurgery for treatment of cerebral arteriovenous malformations: outcome analysis with use of the modified arteriovenous malformation scoring system.

    PubMed

    Chen, Joseph C T; Mariscal, Luis; Girvigian, Michael R; Vanefsky, Marc A; Glousman, Brandon N; Miller, Michael J; Feng, Lei; Rahimian, Javad

    2016-07-01

    Radiosurgery has long been an accepted modality for definitive treatment of cerebral arteriovenous malformations (AVM). Efforts to improve the therapeutic ratio for this indication include use of staged volume procedures and hypofractionation. This study reviews our experience with a cohort of patients treated with hypofractionated radiosurgery. Over a 3year period, 38 patients harboring 39 cerebral AVM were treated with hypofractionated stereotactic radiotherapy. Seventeen of these patients presented due to hemorrhage, four were asymptomatic unruptured lesions and the remainder were symptomatic unruptured lesions. The median AVM volume was 11.43 cc and median modified Radiosurgery-Based Arteriovenous Malformation Score (mRBAS) was 2.02. The median follow-up was 7.32years. Four patients harboring four AVM were lost to follow-up before a result could be ascertained leaving 35 AVM for analysis. Excellent outcomes (AVM obliteration without new deficits) occurred in 17 of 34 (50%) patients and in 18 of 35 (51%) AVM treated. AVM obliteration was seen in 26 of 35 (74%) lesions treated. Two patients died during the follow-up period (6%). A poor result (major deficit without obliteration) was seen in one patient. Of 19 patients harboring AVM with mRBAS >2.0, an excellent outcome was achieved in eight (42%). Hypofractionation for cerebral AVM can result in satisfactory obliteration rates, but with risk of significant complications commensurate with mRBAS. Further study of this technique will be needed to ascertain the degree of incremental improvement, if any, over other radiosurgery treatment methods. PMID:26947340

  5. The effectiveness of providing peer benchmarked feedback to hip replacement surgeons based on patient-reported outcome measures—results from the PROFILE (Patient-Reported Outcomes: Feedback Interpretation and Learning Experiment) trial: a cluster randomised controlled study

    PubMed Central

    Boyce, Maria B; Browne, John P

    2015-01-01

    Objective To test whether providing surgeons with peer benchmarked feedback about patient-reported outcomes is effective in improving patient outcomes. Design Cluster randomised controlled trial. Setting Secondary care—Ireland. Participants Surgeons were recruited through the Irish Institute of Trauma and Orthopaedic Surgery, and patients were recruited in hospitals prior to surgery. We randomly allocated 21 surgeons and 550 patients. Intervention Surgeons in the intervention group received peer benchmarked patient-reported outcome measures (PROMs) feedback and education. Main outcome variable Postoperative Oxford Hip Score (OHS). Results Primary outcome data were available for 11 intervention surgeons with responsibility for 230 patients and 10 control surgeons with responsibility for 228 patients. The mean postoperative OHS for the intervention group was 40.8 (95% CI 39.8 to 41.7) and for the control group was 41.9 (95% CI 41.1 to 42.7). The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.2, p=0.09). Secondary outcomes were the Hip Osteoarthritis Outcome Score (HOOS), EQ-5D and the proportion of patients reporting a problem after surgery. The mean postoperative HOOS for the intervention group was 36.2 and for the control group was 37.1. The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.3, p=0.1). The mean postoperative EQ-5D for the intervention group was 0.85 and for the control group was 0.87. The adjusted effect estimate was −0.02 (95% CI −0.05 to 0.008, p=0.2). 27% of intervention patients and 24% of control patients reported at least one complication after surgery (adjusted OR=1.2, 95% CI 0.6 to 2.3, p=0.6). Conclusions Outcomes for patients operated on by surgeons who had received peer benchmarked PROMs data were not statistically different from the outcomes of patients operated on by surgeons who did not receive feedback. PROMs information alone seems to be insufficient to identify opportunities for quality improvement. Trial

  6. Outcomes of DES in Diabetic and Nondiabetic Patients with Complex Coronary Artery Disease after Risk Stratification by the SYNTAX Score

    PubMed Central

    Loutfi, Mohamed; Sadaka, Mohamed A.; Sobhy, Mohamed

    2016-01-01

    Diabetes mellitus (DM) increases the risk of adverse outcomes after coronary revascularization. Controversy persists regarding the optimal revascularization strategy for diabetic patients with multivessel coronary artery disease (MVD). AIM The aim of this study was to assess the outcomes of drug-eluting stent (DES) insertion in DM and non-DM patients with complex coronary artery disease (CAD) after risk stratification by the percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. METHODS AND RESULTS We performed multivessel percutaneous coronary intervention (PCI) for 601 lesions in 243 DM patients and 1,029 lesions in 401 non-DM patients. All included patients had MVD and one or more lesions of type B2/C. The two-year outcomes and event rates were estimated in the DM and non-DM patients using Kaplan–Meier analyses. The baseline SYNTAX score was ≤22 in 84.8% vs. 84%, P = 0.804, and 23–32 in 15.2% vs. 16%, P = 0.804, of the DM and non-DM patients, respectively. The number of diseased segments treated (2.57 ± 0.75 vs. 2.47 ± 0.72; P = 0.066) and stents implanted per patient (2.41 ± 0.63 vs. 2.32 ± 0.54; P = 0.134) were similar in both groups. After a mean follow-up of 642 ± 175 days, there were no differences in the major adverse cardiac and cerebrovascular events (MACCE; 26.7% vs. 20.9%; P = 0.091), composite end point of all-cause death/myocardial infarction (MI)/stroke (12.3% vs. 9%; P = 0.172), individual MACCE components of death (3.7% vs. 3.2%; P = 0.754), MI (6.6% vs. 4%; P = 0.142), and absence of stroke in the DM and non-DM patients. An increased need for repeat revascularization was observed in DM patients (18.5% vs. 10.2%; P = 0.003). In the multivariate analysis, DM was an independent predictor of repeat revascularization (hazard ratio: 1.818; 95% confidence interval: 1.162–2.843; P = 0.009). CONCLUSIONS DES implantation provides favorable early and mid-term results in both DM and non-DM patients undergoing PCI for

  7. How Close Is Close Enough? Testing Nonexperimental Estimates of Impact against Experimental Estimates of Impact with Education Test Scores as Outcomes. Discussion Paper No. 1242-02

    ERIC Educational Resources Information Center

    Wilde, Elizabeth Ty; Hollister, Robinson

    2002-01-01

    In this study we test the performance of some nonexperimental estimators of impacts applied to an educational intervention--reduction in class size--where achievement test scores were the outcome. We compare the nonexperimental estimates of the impacts to "true impact" estimates provided by a random-assignment design used to assess the…

  8. How Close Is Close Enough? Testing Nonexperimental Estimates of Impact against Experimental Estimates of Impact with Education Test Scores as Outcomes. Discussion Paper.

    ERIC Educational Resources Information Center

    Wilde, Elizabeth Ty; Hollister, Robinson

    This study tested the performance of nonexperimental estimators of impacts applied to a class size reduction intervention with achievement test scores as the outcome. Nonexperimental estimates of impacts were compared to "true impact" estimates provided by a random-assignment design that assessed intervention effects. Data came from Project STAR,…

  9. The Impact of Previous Schooling Experiences on a Quaker High School's Graduating Students' College Entrance Exam Scores, Parents' Expectations, and College Acceptance Outcomes

    ERIC Educational Resources Information Center

    Galusha, Debbie K.

    2010-01-01

    The purpose of the study is to determine the impact of previous private, public, home, or international schooling experiences on a Quaker high school's graduating students' college entrance composite exam scores, parents' expectations, and college attendance outcomes. The study's results suggest that regardless of previous private, public, home,…

  10. Development and Validation of the Delinquency Reduction Outcome Profile (DROP) in a Sample of Incarcerated Juveniles: A Multiconstruct/Multisituational Scoring Approach

    ERIC Educational Resources Information Center

    Barbot, Baptiste; Haeffel, Gerald J.; Macomber, Donna; Hart, Lesley; Chapman, John; Grigorenko, Elena L.

    2012-01-01

    The "Delinquency Reduction Outcome Profile" ("DROP") is a novel situational-judgment test (SJT) designed to measure social decision making in delinquent youth. The DROP includes both a typical SJT scoring method, which captures the deviation of an individual response from an "ideal" expert-based response pattern, as well as a novel…

  11. Safety evaluation of continuous green T intersections: A propensity scores-genetic matching-potential outcomes approach.

    PubMed

    Wood, Jonathan; Donnell, Eric T

    2016-08-01

    The continuous green T intersection is characterized by a channelized left-turn movement from the minor street approach onto the major street, along with a continuous through movement on the major street. The continuous flow through movement is not controlled by the three-phase traffic signal that is used to separate all other movements at the intersection. Rather, the continuous through movement typically has a green through arrow indicator to inform drivers that they do not have to stop. Past research has consistently shown that there are operational and environmental benefits to implementing this intersection form at three-leg locations, when compared to a conventional signalized intersection. These benefits include reduced delay, fuel consumption, and emissions. The safety effects of the conventional green T intersection are less clear. Past research has been limited to small sample sizes, or utilized only statistical comparisons reported crashes to evaluate the safety performance relative to similar intersection types. The present study overcomes past safety research evaluations by using a propensity scores-potential outcomes framework, with genetic matching, to compare the safety performance of the continuous green T to conventional signalized intersections, using treatment and comparison site data from Florida and South Carolina. The results show that the expected total, fatal and injury, and target crash (rear-end, angle, and sideswipe) frequencies are lower at the continuous green T intersection relative to the conventional signalized intersection (CMFs of 0.958 [95% CI=0.772-1.189], 0.846 [95% CI=0.651-1.099], and 0.920 [95% CI=0.714-1.185], respectively). PMID:27129112

  12. External Beam Radiotherapy for Prostate Cancer: Urinary Outcomes for Men With High International Prostate Symptom Scores (IPSS)

    SciTech Connect

    Malik, Renuka; Jani, Ashesh B.; Liauw, Stanley L.

    2011-07-15

    Purpose: To report the urinary outcome of men treated for prostate cancer with external beam radiotherapy (EBRT) who have pretreatment obstructive urinary symptoms (International Prostate Symptom Score [IPSS] {>=}15). Methods and Materials: We treated 368 patients with EBRT for localized prostate cancer, and pre- and post-radiotherapy (RT) IPSSs were recorded. In total, 80 men had an IPSS {>=}15, 48% of whom were taking genitourinary (GU) medications before RT. The IPSS was followed over time and analyzed as a pretreatment factor against Radiation Therapy Oncology Group acute and late GU toxicity. Results: The median follow-up was 44 months. Among men with a pre-RT IPSS {>=}15, the median IPSS at baseline, first follow-up, and last follow-up was 18 (range, 15 to 34), 17 (range, 0 to 32), and 13 (range, 0 to 34), respectively. The mean patient declines in IPSS from baseline to first and last follow-up were -3.6 points (p < 0.0004) and -6.9 points (p < 0.0001), respectively. At last follow-up, 43 men (54%) took GU medications. Pre-RT IPSS {>=}15 vs. {<=}14 was associated with a higher incidence of Grade {>=}2 acute GU toxicity (64% vs. 42%, p = 0.0005), and 4-year freedom from Grade {>=}2 late GU toxicity was 38% vs. 64% (p < 0.0001). There was no greatly increased risk of Grade {>=}3 late GU toxicity for men with IPSS {>=}15 (4-year freedom from Grade {>=}3 late GU toxicity of 90% vs. 96%, p = 0.0964). Conclusions: Although the improvement is not immediate, men with moderate to severe obstructive GU symptoms can have improvement in urinary function after EBRT, without significant risk for severe morbidity.

  13. The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes

    PubMed Central

    Yin, Huiqun; He, Ruibing; Wang, Cunli; Zhu, Jie; Li, Yang

    2016-01-01

    Objective The aim of this study was to investigate associations between the morphology score of blastocysts and blastocoele re-expansion speed after warming with clinical outcomes, which could assist in making correct and cost-effective decisions regarding the appropriate time to vitrify blastocysts and to transfer vitrified-warmed blastocysts. Methods A total of 327 vitrified-warmed two-blastocyst transfer cycles in women 38 years old and younger were included in this retrospective study. Results The clinical pregnancy rate (CPR) and implantation rate (IR) of transfers of two good-morphology grade 4 blastocysts vitrified on day 5 (64.1% and 46.8%, respectively) were significantly higher than the CPR and IR associated with the transfers of two good-morphology grade 3 blastocysts vitrified on day 5 (46.7% and 32.2%, respectively). No significant differences were found in the CPR and IR among the transfers of two good-morphology grade 4 blastocysts regardless of the day of cryopreservation. Logistic regression analysis showed that blastocoele re-expansion speed after warming was associated with the CPR. Conclusion The selection of a good-morphology grade 4 blastocyst to be vitrified could be superior to the choice of a grade 3 blastocyst. Extending the culture of grade 3 blastocysts and freezing grade 4 or higher blastocysts on day 6 could lead to a greater likelihood of pregnancy. Since re-expansion was shown to be a morphological marker of superior blastocyst viability, blastocysts that quickly re-expand after warming should be prioritized for transfer. PMID:27104155

  14. Cross-Cultural Adaptation and Validation of the Dutch Version of the Hip and Groin Outcome Score (HAGOS-NL)

    PubMed Central

    2016-01-01

    Background Valid and reliable questionnaires to assess hip and groin pain are lacking. The Hip and Groin Outcome Score (HAGOS) is a valid and reliable self-reported measure to assess symptoms, activity limitations, participation restrictions and quality of life of persons with hip and/or groin complaints. The purpose of this study was to translate and cross-culturally adapt the HAGOS into Dutch (HAGOS-NL), and to evaluate its internal consistency, validity and reliability. Methods Translation and cross-cultural adaption of the Dutch version of the HAGOS (HAGOS-NL) was performed according to international guidelines. The study population consisted of 178 adult patients who had undergone groin hernia repair surgery in the previous year. All respondents filled in the HAGOS-NL, the SF-36, and the SMFA-NL for determining construct validity of the HAGOS-NL. To determine reliability, 81 respondents filled in the HAGOS-NL after a time interval of two weeks. Results Factor analysis confirmed the original six-factor solution of the HAGOS. Internal consistency was good for all the subscales of the HAGOS-NL. High correlations were observed between the HAGOS-NL and the SF-36 and SMFA-NL, indicating good construct validity. The HAGOS-NL showed high reliability, except for the subscale Participation in Physical Activities which was moderate. Conclusions The HAGOS was successfully translated and cross-culturally adapted from English into Dutch (HAGOS-NL). This study shows that the HAGOS-NL is a valid and reliable instrument for the assessment of functional status and health-related quality of life in patients with groin complaints. PMID:26821266

  15. The intra- and inter-assessor reliability of measurement of functional outcome by lameness scoring in horses.

    PubMed

    Fuller, Catherine J; Bladon, Bruce M; Driver, Adam J; Barr, Alistair R S

    2006-03-01

    The objective of this study was to assess the reliability of lameness scoring in horses. One veterinary surgeon examined nineteen lame horses on four occasions. Gait was recorded by camcorder, and scored from 0 to 10 ranging from sound to non-weight bearing lameness. A global score of overall change in lameness during the study was also determined for each horse. To measure intra-assessor reliability of the scoring systems, one veterinary surgeon scored videotapes of the horses' gaits on two occasions. To measure inter-assessor reliability, three veterinary surgeons viewed the videotapes, assigning individual lameness scores plus global scores to each horse. Reliability of individual lameness scoring was good intra-assessor, but only just within our acceptable limit inter-assessor. However, global scoring of change in lameness throughout the study was found to be reliable overall. Since clinician scoring is commonly used to assess lameness in horses, this is an important finding, fundamental to future clinical studies. PMID:16490710

  16. Aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina

    PubMed Central

    Woo, Jong Shin; Kim, Weon; Kwon, Se Hwan; Youn, Hyo Chul; Kim, Hyun Soo; Kim, Jin Bae; Kim, Soo Joong; Kim, Woo-Shik; Kim, Kwon Sam

    2016-01-01

    Background The coronary artery calcium (CAC) and aortic arch calcification (AoAC) are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardiac death, stroke, myocardial infarction, or repeated revascularization. The extent of AoAC on chest X-ray was graded on a scale from 0 to 3. Results During the four years of follow-up, 620 patients were treated by coronary stenting and 153 (7%) adverse events occurred. A higher grade of AoAC was associated with a higher CAC score. Cox regression showed that the CAC score, but not AoAC, were associated with adverse events. In patients with CAC score < 400, AoAC showed an additive predictive value in detecting significant coronary artery disease (CAD). A gradual increases in the risk of adverse events were noted if AoAC was present in patients with similar CAC score. Conclusions As AoAC is strongly correlated with the CAC score regardless of age or gender, careful evaluation of CAD would be required in patients with AoAC on conventional chest X-rays. PMID:27103916

  17. Comparison of Risk Scoring Systems to Predict the Outcome in ASA-PS V Patients Undergoing Surgery

    PubMed Central

    Yurtlu, Derya Arslan; Aksun, Murat; Ayvat, Pınar; Karahan, Nagihan; Koroglu, Lale; Aran, Gülcin Önder

    2016-01-01

    Abstract Operative decision in American Society of Anesthesiology Physical Status (ASA-PS) V patient is difficult as this group of patients expected to have high mortality rate. Another risk scoring system in this ASA-PS V subset of patients can aid to ease this decision. Data of ASA-PS V classified patients between 2011 and 2013 years in a single hospital were analyzed in this study. Predicted mortality of these patients was determined with acute physiology and chronic health evaluations (APACHE) II, simplified acute physiology score (SAPS II), Charlson comorbidity index (CCI), Porthsmouth physiological and operative severity score for enumeration of mortality and morbidity (P-POSSUM), Surgical apgar score (SAS), and Goldman cardiac risk index (GCRI) scores. Observed and predicted mortality rates according to the risk indexes in these patients were compared at survivor and nonsurvivor group of patients. Risk stratification was made with receiver operator characteristic (ROC) curve analysis. Data of 89 patients were included in the analyses. Predicted mortality rates generated by APACHE II and SAPS II scoring systems were significantly different between survivor and nonsurvivor group of patients. Risk stratification with ROC analysis revealed that area under curve was 0.784 and 0.681 for SAPS II and APACHE II scoring systems, respectively. Highest sensitivity (77.3) is reached with SAPS II score. APACHE II and SAPS II are better predictive tools of mortality in ASA-PS V classified subset of patients. Discrimination power of SAPS II score is the best among the compared risk stratification scores. SAPS II can be suggested as an additional risk scoring system for ASA-PS V patients. PMID:27043696

  18. Long-Term Clinical Outcomes according to Initial Management and Thrombolysis In Myocardial Infarction Risk Score in Patients with Acute Non-ST-Segment Elevation Myocardial Infarction

    PubMed Central

    Jeong, Hae Chang; Jeong, Myung Ho; Chae, Shung Chull; Hur, Seung Ho; Hong, Taek Jong; Kim, Young Jo; Seong, In Whan; Chae, Jei Keon; Rhew, Jay Young; Chae, In Ho; Cho, Myeong Chan; Bae, Jang Ho; Rha, Seung Woon; Kim, Chong Jin; Choi, Donghoon; Jang, Yang Soo; Yoon, Junghan; Chung, Wook Sung; Cho, Jeong Gwan; Seung, Ki Bae; Park, Seung Jung

    2010-01-01

    Purpose There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR). Materials and Methods 2,845 patients with acute NSTEMI (65.6 ± 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 ± 12.6 years, 856 males) and late invasive treatment (65.3 ± 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score. Results There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (≥ 5 points). Conclusions The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI. PMID:20046515

  19. Science Teacher Efficacy and Outcome Expectancy as Predictors of Students' End-of-Instruction (EOI) Biology I Test Scores

    ERIC Educational Resources Information Center

    Angle, Julie; Moseley, Christine

    2009-01-01

    The purpose of this study was to compare teacher efficacy beliefs of secondary Biology I teachers whose students' mean scores on the statewide End-of-Instruction (EOI) Biology I test met or exceeded the state academic proficiency level (Proficient Group) to teacher efficacy beliefs of secondary Biology I teachers whose students' mean scores on the…

  20. Predictive Value of Combining the Ankle-Brachial Index and SYNTAX Score for the Prediction of Outcome After Percutaneous Coronary Intervention (from the SHINANO Registry).

    PubMed

    Ueki, Yasushi; Miura, Takashi; Miyashita, Yusuke; Motoki, Hirohiko; Shimada, Kentaro; Kobayashi, Masanori; Nakajima, Hiroyuki; Kimura, Hikaru; Akanuma, Hiroshi; Mawatari, Eiichiro; Sato, Toshio; Hotta, Shoji; Kamiyoshi, Yuichi; Maruyama, Takuya; Watanabe, Noboru; Eisawa, Takayuki; Aso, Shinichi; Uchikawa, Shinichiro; Hashizume, Naoto; Sekimura, Noriyuki; Morita, Takehiro; Ebisawa, Soichiro; Izawa, Atsushi; Koyama, Jun; Ikeda, Uichi

    2016-01-15

    The Synergy Between PCI With TAXUS and Cardiac Surgery (SYNTAX) score is effective in predicting clinical outcome after percutaneous coronary intervention (PCI). However, its prediction ability is low because it reflects only the coronary characterization. We assessed the predictive value of combining the ankle-brachial index (ABI) and SYNTAX score to predict clinical outcomes after PCI. The ABI-SYNTAX score was calculated for 1,197 patients recruited from the Shinshu Prospective Multi-center Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention (SHINANO) registry, a prospective, observational, multicenter cohort study in Japan. The primary end points were major adverse cardiovascular and cerebrovascular events (MACE; all-cause death, myocardial infarction, and stroke) in the first year after PCI. The ABI-SYNTAX score was calculated by categorizing and summing up the ABI and SYNTAX scores. ABI ≤ 0.49 was defined as 4, 0.5 to 0.69 as 3, 0.7 to 0.89 as 2, 0.9 to 1.09 as 1, and 1.1 to 1.5 as 0; an SYNTAX score ≤ 22 was defined as 0, 23 to 32 as 1, and ≥ 33 as 2. Patients were divided into low (0), moderate (1 to 2), and high (3 to 6) groups. The MACE rate was significantly higher in the high ABI-SYNTAX score group than in the lower 2 groups (low: 4.6% vs moderate: 7.0% vs high: 13.9%, p = 0.002). Multivariate regression analysis found that ABI-SYNTAX score independently predicted MACE (hazards ratio 1.25, 95% confidence interval 1.02 to 1.52, p = 0.029). The respective C-statistic for the ABI-SYNTAX and SYNTAX score for 1-year MACE was 0.60 and 0.55, respectively. In conclusion, combining the ABI and SYNTAX scores improved the prediction of 1-year adverse ischemic events compared with the SYNTAX score alone. PMID:26684515

  1. PROSPECTIVE VALIDATION OF THE VASOACTIVE-INOTROPIC SCORE AND CORRELATION TO SHORT TERM OUTCOMES IN NEONATES AND INFANTS AFTER CARDIOTHORACIC SURGERY

    PubMed Central

    Davidson, Jesse; Tong, Suhong; Hancock, Hayley; Hauck, Amanda; da Cruz, Eduardo; Kaufman, Jon

    2016-01-01

    Purpose Prospective validation of vasoactive-inotropic score (VIS) and inotrope score (IS) in infants after cardiovascular surgery Methods Prospective observational study of 70 infants (≤90 days of age) undergoing cardiothoracic surgery. VIS and IS were assessed at 24 (VIS24, IS24), 48 (VIS48, IS48), and 72 (VIS72, IS72) hours after surgery. Maximum VIS and IS scores in the first 48 hours were also calculated (VIS48max and IS48max). The primary outcome was length of intubation. Additional outcomes included length of intensive care (ICU) stay and hospitalization, cardiac arrest, mortality, time to negative fluid balance, peak lactate, and change in creatinine. Results Based on Receiver Operating Characteristic (ROC) analysis, area under the curve (AUC) was highest for VIS48 to identify prolonged intubation time. AUC for the primary outcome was higher for VIS than IS at all time points assessed. On multivariate analysis VIS48 was independently associated with prolonged intubation (OR 22.3, p=0.002), prolonged ICU stay (OR 8.1, p=0.017), and prolonged hospitalization (OR 11.3, p=0.011). VIS48max, IS48max, and IS48 were also associated with prolonged intubation, but not prolonged ICU or hospital stay. None of the scores were associated with time to negative fluid balance, peak lactate, or change in creatinine. Conclusion In neonates and infants, a higher VIS at 48 hours after cardiothoracic surgery is strongly associated with increased length of ventilation, and prolonged ICU and total hospital stay. At all time points assessed, VIS is more predictive of poor short term outcome than IS. VIS may be useful as an independent predictor of outcomes. PMID:22527067

  2. Comparisons of the Outcome Prediction Performance of Injury Severity Scoring Tools Using the Abbreviated Injury Scale 90 Update 98 (AIS 98) and 2005 Update 2008 (AIS 2008)

    PubMed Central

    Tohira, Hideo; Jacobs, Ian; Mountain, David; Gibson, Nick; Yeo, Allen

    2011-01-01

    The Abbreviated Injury Scale (AIS) was revised in 2005 and updated in 2008 (AIS 2008). We aimed to compare the outcome prediction performance of AIS-based injury severity scoring tools by using AIS 2008 and AIS 98. We used all major trauma patients hospitalized to the Royal Perth Hospital between 1994 and 2008. We selected five AIS-based injury severity scoring tools, including Injury Severity Score (ISS), New Injury Severity Score (NISS), modified Anatomic Profile (mAP), Trauma and Injury Severity Score (TRISS) and A Severity Characterization of Trauma (ASCOT). We selected survival after injury as a target outcome. We used the area under the Receiver Operating Characteristic curve (AUROC) as a performance measure. First, we compared the five tools using all cases whose records included all variables for the TRISS (complete dataset) using a 10-fold cross-validation. Second, we compared the ISS and NISS for AIS 98 and AIS 2008 using all subjects (whole dataset). We identified 1,269 and 4,174 cases for a complete dataset and a whole dataset, respectively. With the 10-fold cross-validation, there were no clear differences in the AUROCs between the AIS 98- and AIS 2008-based scores. With the second comparison, the AIS 98-based ISS performed significantly worse than the AIS 2008-based ISS (p<0.0001), while there was no significant difference between the AIS 98- and AIS 2008-based NISSs. Researchers should be aware of these findings when they select an injury severity scoring tool for their studies. PMID:22105401

  3. Comparison of Different Risk Scores for Predicting Contrast Induced Nephropathy and Outcomes After Primary Percutaneous Coronary Intervention in Patients With ST Elevation Myocardial Infarction.

    PubMed

    Liu, Yuan-Hui; Liu, Yong; Zhou, Ying-Ling; He, Peng-Cheng; Yu, Dan-Qing; Li, Li-Wen; Xie, Nian-Jin; Guo, Wei; Tan, Ning; Chen, Ji-Yan

    2016-06-15

    Accurate risk stratification for contrast-induced nephropathy (CIN) is important for patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We aimed to compare the prognostic value of validated risk scores for CIN. We prospectively enrolled 422 consecutive patients with STEMI undergoing PPCI. Mehran; Gao; Chen; age, serum creatinine (SCr), or glomerular filtration rate, and ejection fraction (ACEF or AGEF); and Global Registry for Acute Coronary Events risk scores were calculated for each patient. The prognostic accuracy of the 6 scores for CIN, and in-hospital and 3-year all-cause mortality and major adverse clinical events (MACEs), was assessed using the c-statistic for discrimination and the Hosmer-Lemeshow test for calibration. CIN was defined as either CIN-narrow (increase in SCr ≥0.5 mg/dl) or CIN broad (≥0.5 mg/dl and/or a ≥25% increase in baseline SCr). All risk scores had relatively high predictive values for CIN-narrow (c-statistic: 0.746 to 0.873) and performed well for prediction of in-hospital death (0.784 to 0.936), MACEs (0.685 to 0.763), and 3-year all-cause mortality (0.655 to 0.871). The ACEF and AGEF risk scores had better discrimination and calibration for CIN-narrow and in-hospital outcomes. However, all risk score exhibited low predictive accuracy for CIN-broad (0.555 to 0.643) and 3-year MACEs (0.541 to 0.619). In conclusion, risk scores for predicting CIN perform well in stratifying the risk of CIN-narrow, in-hospital death or MACEs, and 3-year all-cause mortality in patients with STEMI undergoing PPCI. The ACEF and AGEF risk scores appear to have greater prognostic value. PMID:27161818

  4. Prospective evaluation of outcome of percutaneous nephrolithotomy using the ‘STONE’ nephrolithometry score: A single-centre experience

    PubMed Central

    Farhan, Muhammad; Nazim, Syed M.; Salam, Basit; Ather, M. Hammad

    2015-01-01

    Objective To assess the prediction of stone clearance and complications of percutaneous nephrolithotomy (PCNL) using the ‘STONE’ nephrolithometry score, assessing stone size, tract length (skin-to-stone distance), degree of obstruction, number of calyces involved and stone essence (density). Patients and methods This was a prospective study of patients undergoing single-tract PCNL while prone, conducted at a university hospital. All patients had non-contrast-enhanced computed tomography within 3 weeks of the procedure. Only patients with a unilateral procedure and radio-opaque stones were included. The five variables of the STONE nephrolithometry score were calculated before the procedure. The stone-free rates were assessed with a plain abdominal film at 4 weeks and complications were graded using the modified Clavien system. Results In all, 107 patients were included in the final analysis. Overall, 80% of patients were rendered stone-free. Among the individual variables, a larger stone (P = 0.002) and the involvement of multiple calyces (P = 0.04) were associated with residual stones, while tract length (skin-to-stone distance), stone density and presence of hydronephrosis were not. Patients who were rendered stone-free had a statistically significant lower overall STONE score than those with residual stones, at 7.24 vs. 8.14 (P = 0.02). The score also correlated with operative duration, which was significantly longer with a higher STONE score (P = 0.03). The complication rate was 18% and most complications were Clavien grade 2, with bleeding requiring a blood transfusion (11 patients) being the commonest. There were no deaths within 30 days of surgery, but there was no correlation between the STONE score and complications. Conclusion The STONE nephrolithometry score is a simple and easy to apply system for predicting complexity in stone clearance with PCNL. PMID:26609445

  5. A magnetic resonance imaging-based prognostic scoring system to predict outcome in transplant-eligible patients with multiple myeloma

    PubMed Central

    Mai, Elias K.; Hielscher, Thomas; Kloth, Jost K.; Merz, Maximilian; Shah, Sofia; Raab, Marc S.; Hillengass, Michaela; Wagner, Barbara; Jauch, Anna; Hose, Dirk; Weber, Marc-André; Delorme, Stefan; Goldschmidt, Hartmut; Hillengass, Jens

    2015-01-01

    Diffuse and focal bone marrow infiltration patterns detected by magnetic resonance imaging have been shown to be of prognostic significance in all stages of monoclonal plasma cell disorders and have, therefore, been incorporated into the definition of the disease. The aim of this retrospective analysis was to develop a rapidly evaluable prognostic scoring system, incorporating the most significant information acquired from magnetic resonance imaging. Therefore, the impact of bone marrow infiltration patterns on progression-free and overall survival in 161 transplant-eligible myeloma patients was evaluated. Compared to salt and pepper/minimal diffuse infiltration, moderate/severe diffuse infiltration had a negative prognostic impact on both progression-free survival (P<0.001) and overall survival (P=0.003). More than 25 focal lesions on whole-body magnetic resonance imaging or more than seven on axial magnetic resonance imaging were associated with an adverse prognosis (progression-free survival: P=0.001/0.003 and overall survival: P=0.04/0.02). A magnetic resonance imaging-based prognostic scoring system, combining grouped diffuse and focal infiltration patterns, was formulated and is applicable to whole-body as well as axial magnetic resonance imaging. The score identified high-risk patients with median progression-free and overall survival of 23.4 and 55.9 months, respectively (whole-body-based). Multivariate analyses demonstrated that the magnetic resonance imaging-based prognostic score stage III (high-risk) and adverse cytogenetics are independent prognostic factors for both progression-free and overall survival (whole-body-based, progression-free survival: hazard ratio=3.65, P<0.001; overall survival: hazard ratio=5.19, P=0.005). In conclusion, we suggest a magnetic resonance imaging-based prognostic scoring system which is a robust, easy to assess and interpret parameter summarizing significant magnetic resonance imaging findings in transplant

  6. Posterior Circulation Acute Stroke Prognosis Early Computed Tomography Score Using Hypointense Vessels on Susceptibility Weighted Imaging Independently Predicts Outcome in Patients with Basilar Artery Occlusion

    PubMed Central

    Mundiyanapurath, S.; Möhlenbruch, M.; Ringleb, P. A.; Bösel, J.; Wick, W.; Bendszus, M.; Radbruch, A.

    2015-01-01

    Purpose Appearance of hypointense vessels on susceptibility weighted imaging (SWI) has been reported to correlate with outcome in patients with ischemia of the anterior circulation. This study investigates the correlation between the appearance of hypointense vessels on SWI after recanalization therapy and outcome in patients with basilar artery occlusion. Methods Patients with basilar artery occlusion who were treated with endovascular recanalization or intravenous alteplase and received an MRI including SWI after therapy were retrieved from the hospital database for retrospective analysis. Posterior circulation Acute Stroke Prognosis Early Computed Tomography Score (pcASPECTS) was calculated based on regions displaying hypointense vessels on SWI and compared to lesions on diffusion weighted imaging (DWI). Subsequently, SWI based pcASPECTS was correlated with outcome determined with modified Rankin Scale (mRS), categorized as favorable outcome (mRS 0-2) or unfavorable outcome (3-6). Results Twenty-two MRI of patients with basilar artery occlusion were analyzed. In seven out of eight areas of the pcASPECTS hypointense vessels on SWI were significantly correlated to areas of restricted diffusion on DWI. In univariate analysis median pcASPECTS on SWI was significantly higher in patients with favorable outcome (7.5 vs. 5, p=0.02). In a multivariate analysis pcASPECTS on SWI was an independent predictor of favorable outcome (OR 2.02; CI [1.02;3,99]; p=0.04). Conclusion pcASPECTS based on hypointense vessels on SWI after therapy predicts outcome in patients with basilar artery occlusion and might potentially be used as an additional imaging biomarker in the management of patients with stroke in the posterior circulation. This needs to be confirmed in larger prospective clinical trials. PMID:26176682

  7. Characteristics and Behavioral Outcomes for Youth in Group Care and Family-Based Care: A Propensity Score Matching Approach Using National Data

    PubMed Central

    James, Sigrid; Roesch, Scott; Zhang, Jin Jin

    2013-01-01

    This study aimed to answer two questions: (a) Given expected differences in children who are placed in group care compared to those in family-based settings, is it possible to match children on baseline characteristics? (b) Are there differences in behavioral outcomes for youth with episodes in group care versus those in family-based care? Using data from the National Survey of Child and Adolescent Well-Being, the study sample included 1,191 children with episodes in out-of-home care (n = 254 youth with group care episodes; n = 937 youth with episodes in family-based care and no group care). Conditioning variables were identified, which distinguished between the two groups of youth. Using propensity score matching, all youth placed into group care were matched on the propensity score with family-based care youth. Behavioral outcomes at 36 months, as measured by the Child Behavior Checklist, were compared for the matched sample. Of the total 254 youth with group care episodes, 157 could be matched to youth with episodes in family-based care. No significant differences remained between the two groups in the matched sample, and findings revealed no significant differences in longitudinal behavioral outcomes. PMID:24273403

  8. Cost-effectiveness of robotic surgery for rectal cancer focusing on short-term outcomes: a propensity score-matching analysis.

    PubMed

    Kim, Chang Woo; Baik, Seung Hyuk; Roh, Yun Ho; Kang, Jeonghyun; Hur, Hyuk; Min, Byung Soh; Lee, Kang Young; Kim, Nam Kyu

    2015-06-01

    Although the total cost of robotic surgery (RS) is known to be higher than that of laparoscopic surgery (LS), the cost-effectiveness of RS has not yet been verified. The aim of the study is to clarify the cost-effectiveness of RS compared with LS for rectal cancer.From January 2007 through December 2011, 311 and 560 patients underwent totally RS and conventional LS for rectal cancer, respectively. A propensity score-matching analysis was performed with a ratio of 1:1 to reduce the possibility of selection bias. Costs and perioperative short-term outcomes in both the groups were compared. Additional costs due to readmission were also analyzed.The characteristics of the patients were not different between the 2 groups. Most perioperative outcomes were not different between the groups except for the operation time. Complications within 30 days of surgery were not significantly different. Total hospital charges and patients' bill were higher in RS than in LS. The total hospital charges for patients who recovered with or without complications were higher in RS than in LS, although their short-term outcomes were similar. In patients with complications, the postoperative course after RS appeared to be milder than that of LS. Total hospital charges for patients who were readmitted due to complications were similar between the groups.RS showed similar short-term outcomes with higher costs than LS. Therefore, cost-effectiveness focusing on short-term perioperative outcomes of RS was not demonstrated. PMID:26039115

  9. Likelihood ratio and score tests to test the non-inferiority (or equivalence) of the odds ratio in a crossover study with binary outcomes.

    PubMed

    Li, Xiaochun; Li, Huilin; Jin, Man; D Goldberg, Judith

    2016-09-10

    We consider the non-inferiority (or equivalence) test of the odds ratio (OR) in a crossover study with binary outcomes to evaluate the treatment effects of two drugs. To solve this problem, Lui and Chang (2011) proposed both an asymptotic method and a conditional method based on a random effects logit model. Kenward and Jones (1987) proposed a likelihood ratio test (LRTM ) based on a log linear model. These existing methods are all subject to model misspecification. In this paper, we propose a likelihood ratio test (LRT) and a score test that are independent of model specification. Monte Carlo simulation studies show that, in scenarios considered in this paper, both the LRT and the score test have higher power than the asymptotic and conditional methods for the non-inferiority test; the LRT, score, and asymptotic methods have similar power, and they all have higher power than the conditional method for the equivalence test. When data can be well described by a log linear model, the LRTM has the highest power among all the five methods (LRTM , LRT, score, asymptotic, and conditional) for both non-inferiority and equivalence tests. However, in scenarios for which a log linear model does not describe the data well, the LRTM has the lowest power for the non-inferiority test and has inflated type I error rates for the equivalence test. We provide an example from a clinical trial that illustrates our methods. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27095359

  10. The clinical absolute and relative scoring system-a quantitative scale measuring myasthenia gravis severity and outcome used in the traditional Chinese medicine.

    PubMed

    Liu, Guo-Chao; Gao, Bu-Lang; Yang, Hong-Qi; Qi, Guo-Yan; Liu, Peng

    2014-10-01

    Myasthenia gravis (MG) is a chronic autoimmune disease caused by autoantigen against the nicotine acetylcholine receptor at the neuromuscular junction. With modern treatment facilities, the treatment effect and outcome for MG has been greatly improved with MG and non-MG patients enjoying the same life expectancy. Many classifications of disease distribution and severity have been set up and tested all over the world, mainly in the western world. However, the absolute and relative scoring system for evaluating the severity and treatment effect of MG in China where traditional Chinese medicine (TCM) has been practiced for thousands of years has not been introduced worldwide. The TCM has achieved a great success in the treatment of MG in the country with a huge population. This article serves to introduce this scoring system to the world. PMID:25440379

  11. Using Propensity Score Methods to Approximate Factorial Experimental Designs to Analyze the Relationship between Two Variables and an Outcome

    ERIC Educational Resources Information Center

    Dong, Nianbo

    2015-01-01

    Researchers have become increasingly interested in programs' main and interaction effects of two variables (A and B, e.g., two treatment variables or one treatment variable and one moderator) on outcomes. A challenge for estimating main and interaction effects is to eliminate selection bias across A-by-B groups. I introduce Rubin's…

  12. A Propensity Score Matching Study of Participation in Community Activities: A Path to Positive Outcomes for Youth in New Zealand?

    ERIC Educational Resources Information Center

    O'Connor, Seini; Jose, Paul E.

    2012-01-01

    Extracurricular activities are important in many young people's lives and have been associated with positive academic, psychological, and social outcomes. However, most previous research has been limited to school-based activities in the North American context. This study expands existing literature by analyzing longitudinal data from more than…

  13. Altering School Progression through Delayed Entry or Kindergarten Retention: Propensity Score Analysis of Long-Term Outcomes

    ERIC Educational Resources Information Center

    Raffaele Mendez, Linda M.; Kim, Eun Sook; Ferron, John; Woods, Bonnie

    2015-01-01

    The authors examined long-term outcomes for children who experienced delayed entry to kindergarten or kindergarten retention. They used a cohort of 6,841 students to compare these groups to each other and typically progressing peers. First, the authors compared the groups on demographic and early childhood variables. For the long-term school-based…

  14. Combination of liver biopsy with MELD-XI scores for post-transplant outcome prediction in patients with advanced heart failure and suspected liver dysfunction

    PubMed Central

    Farr, Maryjane; Mitchell, James; Lippel, Matthew; Kato, Tomoko S.; Jin, Zhezhen; Ippolito, Paul; Dove, Lorna; Jorde, Ulrich P.; Takayama, Hiroo; Emond, Jean; Naka, Yoshifumi; Mancini, Donna; Lefkowitch, Jay H.; Schulze, P. Christian

    2016-01-01

    BACKGROUND Functional and structural liver abnormalities may be found in patients with advanced heart failure (HF). The Model of End-Stage Liver Disease Excluding INR (MELD-XI) score allows functional risk stratification of HF patients on and off anti-coagulation awaiting heart transplantation (HTx), but these scores may improve or worsen depending on bridging therapies and during time on the waiting list. Liver biopsy is sometimes performed to assess for severity of fibrosis. Uncertainty remains whether biopsy in addition to MELD-XI improves prediction of adverse outcomes in patients evaluated for HTx. METHODS Sixty-eight patients suspected of advanced liver disease underwent liver biopsy as part of their HTx evaluation. A liver risk score (fibrosis-on-biopsy + 1) × MELD-XI was generated for each patient. RESULTS Fifty-two patients were listed, of whom 14 had mechanical circulatory support (MCS). Thirty-six patients underwent transplantation and 27 patients survived ≥1 year post-HTx (74%, as compared with 88% average 1-year survival in HTx patients without suspected liver disease; p < 0.01). Survivors had a lower liver risk score at evaluation for HTx (31.0 ± 20.4 vs 65.2 ± 28.6, p < 0.01). A cut-point of 45 for liver risk score was identified by receiver-operating-characteristic (ROC) analysis. In the analysis using Cox proportional hazards models, a liver risk score ≥45 at evaluation for HTx was associated with greater risk of death at 1 year post-HTx compared with a score of <45 in both univariable (HR 3.94, 95% CI 1.77–8.79, p < 0.001) and multivariable (HR 4.35, 95% CI 1.77–8.79, p < 0.001) analyses. Patients who died <1 year post-HTx had an increased frequency of acute graft dysfunction (44.4% vs 3.7%, p = 0.009), longer ventilation times (55.6% vs 11.1%, p = 0.013) and severe bleeding events (44.4% vs 11.1%, p = 0.049). The liver risk score at evaluation for HTx also predicted 1-year mortality after HTx listing (p < 0.001). CONCLUSIONS Patients

  15. Comparison of Maximum Vasoactive Inotropic Score and Low Cardiac Output Syndrome As Markers of Early Postoperative Outcomes After Neonatal Cardiac Surgery

    PubMed Central

    Butts, Ryan J.; Scheurer, Mark A.; Atz, Andrew M.; Zyblewski, Sinai C.; Hulsey, Thomas C.; Bradley, Scott M.; Graham, Eric M.

    2014-01-01

    Low cardiac output syndrome (LCOS) and maximum vasoactive inotropic score (VIS) have been used as surrogate markers for early postoperative outcomes in pediatric cardiac surgery. The objective of this study was to determine the associations between LCOS and maximum VIS with clinical outcomes in neonatal cardiac surgery. This was a secondary retrospective analysis of a prospective randomized trial, and the setting was a pediatric cardiac intensive care unit in a tertiary care children's hospital. Neonates (n = 76) undergoing corrective or palliative cardiac operations requiring cardiopulmonary bypass were prospectively enrolled. LCOS was defined by a standardized clinical criteria. VIS values were calculated by a standard formula during the first 36 postoperative hours, and the maximum score was recorded. Postoperative outcomes included hospital mortality, duration of mechanical ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), as well as total hospital charges. At surgery, the median age was 7 days and weight was 3.2 kg. LCOS occurred in 32 of 76 (42%) subjects. Median maximum VIS was 15 (range 5–33). LCOS was not associated with duration of mechanical ventilation, ICU LOS, hospital LOS, and hospital charges. Greater VIS was moderately associated with a longer duration of mechanical ventilation (p = 0.001, r = 0.36), longer ICU LOS (p = 0.02, r = 0.27), and greater total hospital costs (p = 0.05, r = 0.22) but not hospital LOS (p = 0.52). LCOS was not associated with early postoperative outcomes. Maximum VIS has only modest correlation with duration of mechanical ventilation, ICU LOS, and total hospital charges. PMID:22349666

  16. The Constant score and the assessment of scapula dyskinesis: Proposal and assessment of an integrated outcome measure.

    PubMed

    Cutti, Andrea Giovanni; Parel, Ilaria; Pellegrini, Andrea; Paladini, Paolo; Sacchetti, Rinaldo; Porcellini, Giuseppe; Merolla, Giovanni

    2016-08-01

    The Constant-Murley score (CMS) is a popular measure of shoulder function. However, its ability to monitor the evolution of patients during rehabilitation after rotator-cuff repair is controversial. Moreover, CMS does not account for possible alterations in the scapulo-humeral coordination (SHC, scapula dyskinesis), which are apparent in variety of shoulder pathologies. To address these issues, a new formulation of CMS was firstly proposed, which rates the "affected-to-controlateral side difference in SHC" of a patient with respect to reference values of asymptomatic controls (Scapula-Weighted CMS). Then, 32 patients (53±9year-old) were evaluated with CMS and SW-CMS at 45, 70, 90-day and >6-month after rotator-cuff repair, to test three hypotheses: (1) CMS and SW-CMS are largely responsive to change; (2) accounting (SW-CMS) or not (CMS) for scapula dyskinesis leads to statistically different scores and SW-CMS cannot be predicted from CMS without clinically relevant differences; (3) 90% of patients recover a side-to-side SHC similar to asymptomatic controls at 90days. Results supported hypotheses 1 and 2. On the contrary (hypothesis 3), only 10% of patients recovered for SHC alterations at 90days, and 50% at follow-up. These findings support the use of SW-CMS and the importance of treating scapula dyskinesis after rotator-cuff repair. PMID:26184668

  17. Distal third humeri fractures treated using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate: clinical, radiographic and patient outcome scores

    PubMed Central

    Lewis, James; Rao, Prasad; Parfitt, Dan; Mohanty, Khitish; Ghandour, Adel

    2014-01-01

    Background Conventional management protocols for distal humeral extra-articular fractures (e.g. conservative, double columnar plating) are often associated with complications. We aimed to describe our experience of using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate for treatment of extra-articular distal humeral fractures. Methods We prospectively studied 23 consecutive patients who underwent fixation, in a tertiary trauma centre, over 2 years. Data, including patient demographics, duration of follow-up, patient satisfaction, visual analogue score (VAS), Oxford Elbow Score, and final outcome on discharge, were collected and analyzed. Results Of the 23 patients (12 males, 11 females; mean age 47.5 years; range 18 years to 89 years), all fractures united radiologically and clinically after the index procedure, with a mean time to fracture union of 15.7 weeks (range 9 weeks to 34 weeks) and a mean time to discharge of 17.8 weeks (range 13 weeks to 34 weeks). Oxford Elbow Score was 36.5 (range 11 to 48) at 4.6 months postoperatively; at 20 months follow-up, it was 40 (range 14 to 48) and the VAS was 8.5 (range 5 to 10). One patient had radial nerve neuropraxia pre-operatively, and one postoperatively, and both recovered uneventfully 3 months postoperatively. Neither superficial, nor deep infections were observed in this cohort. Conclusions The present study reports satisfactory outcome with the usage of the Synthes plate for extra-articular fracture management. It has become the technique of choice in our centre because it provides excellent results.

  18. Testing for Plausibly Causal Links Between Parental Bereavement and Child Socio-Emotional and Academic Outcomes: A Propensity-Score Matching Model.

    PubMed

    Williams, Leslie D; Lawrence Aber, J

    2016-05-01

    The extant literature on parentally bereaved children has focused almost exclusively on the presence of negative mental health and socio-emotional outcomes among these children. However, findings from this literature have been equivocal. While some authors have found support for the presence of higher levels of internalizing and externalizing problems or mental health problems among this population, others have not found such a relationship. Additionally, study designs in this body of literature have limited both the internal and external validity of the research on parentally bereaved children. The present study seeks to address these issues of internal and external validity by utilizing propensity-score matching analyses to make plausibly causal inferences about the relationship between bereavement and internalizing and externalizing problems among children from a nearly nationally representative sample. This study also extends examination of the influence of parental bereavement to other domains of child development: namely, to academic outcomes. Findings suggest a lack of support for causal relationships between parental bereavement and either socio-emotional or academic outcomes among U.S. children. The plausibility of assumptions necessary to draw causal inferences is discussed. PMID:26340883

  19. Group Prenatal Care Results in Medicaid Savings with Better Outcomes: A Propensity Score Analysis of CenteringPregnancy Participation in South Carolina.

    PubMed

    Gareau, Sarah; Lòpez-De Fede, Ana; Loudermilk, Brandon L; Cummings, Tammy H; Hardin, James W; Picklesimer, Amy H; Crouch, Elizabeth; Covington-Kolb, Sarah

    2016-07-01

    Objectives This study was undertaken to determine the cost savings of prevention of adverse birth outcomes for Medicaid women participating in the CenteringPregnancy group prenatal care program at a pilot program in South Carolina. Methods A retrospective five-year cohort study of Medicaid women was assessed for differences in birth outcomes among women involved in CenteringPregnancy group prenatal care (n = 1262) and those receiving individual prenatal care (n = 5066). The study outcomes examined were premature birth and the related outcomes of low birthweight (LBW) and neonatal intensive care unit (NICU) visits. Because women were not assigned to the CenteringPregnancy group, a propensity score analysis ensured that the inference of the estimated difference in birth outcomes between the treatment groups was adjusted for nonrandom assignment based on age, race, Clinical Risk Group, and plan type. A series of generalized linear models were run to estimate the difference between the proportions of individuals with adverse birth outcomes, or the risk differences, for CenteringPregnancy group prenatal care participation. Estimated risk differences, the coefficient on the CenteringPregnancy group indicator variable from identity-link binomial variance generalized linear models, were then used to calculate potential cost savings due to participation in the CenteringPregnancy group. Results This study estimated that CenteringPregnancy participation reduced the risk of premature birth (36 %, P < 0.05). For every premature birth prevented, there was an average savings of $22,667 in health expenditures. Participation in CenteringPregnancy reduced the incidence of delivering an infant that was LBW (44 %, P < 0.05, $29,627). Additionally, infants of CenteringPregnancy participants had a reduced risk of a NICU stay (28 %, P < 0.05, $27,249). After considering the state investment of $1.7 million, there was an estimated return on investment of nearly $2.3

  20. Long- and short-term outcomes of ERCP for bile duct stones in patients over 80 years old compared to younger patients: a propensity score analysis

    PubMed Central

    Kanamori, Akira; Kiriyama, Seiki; Tanikawa, Makoto; Hisanaga, Yasuhiro; Toyoda, Hidenori; Tada, Toshifumi; Kitabatake, Syusuke; Kaneoka, Yuji; Maeda, Atsuyuki; Kumada, Takashi

    2016-01-01

    Backgrounds and study aims: Endoscopic sphincterotomy (ES) is widely accepted as first-line therapy for bile duct stones (BDS). The major long-term pancreaticobiliary complication is BDS recurrence. Whether cholecystectomy should be performed after ES, especially in elderly patients, remains controversial. The aim of this study is to investigate the short-term and long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for BDS and to analyze risk factors for pancreaticobiliary complications. We also compared long-term outcomes in patients older and younger than age 80. Patients and methods: A total of 1210 patients who underwent therapeutic ERCP for BDS were retrospectively reviewed to identify risk factors for pancreaticobiliary complications. We divided these patients into two groups: Group Y (< 80 years; 960 patients) and Group O (≥ 80 years; 250 patients). There were 192 matched pairs in the propensity score analysis. Results: The incidence of pancreaticobiliary complications was 13.1 % (126/960) in Group Y and 20.4 % (51/250) in Group O (P < 0.00001). Multivariate analysis showed that a gallbladder left in situ with stones was a significant independent risk factor (hazard ratio, 2.81; 95 % confidence interval, 1.62 – 4,89; P = 0.0002). There were no significant differences in the incidence of pancreaticobiliary complications between the propensity score-matched groups. Conclusions: A gallbladder in situ with stones was the only significant risk factor for pancreaticobiliary complications after treatment for BDS. Age per se should not be the major factor when deciding on treatment that minimizes the occurrence of pancreaticobiliary disease. PMID:26793790

  1. Comparison of two classification systems in predicting the outcome of diabetic foot ulcers: the Wagner grade and the Saint Elian Wound score systems.

    PubMed

    Huang, Yao; Xie, Ting; Cao, Yemin; Wu, MinJie; Yu, LeiLei; Lu, ShuLiang; Xu, Gang; Hu, Jiale; Ruan, Hong

    2015-01-01

    The aim of the study was to compare two systems of classification in a consecutive population with diabetic foot ulcers: the Wagner grade and the Saint Elian Wound Score System (SEWSS). Sociodemographic information, patient-related and ulcer-related data at first presentation was recorded, and the patients were followed up until wound healing or accepting major amputation or for 24 weeks. One hundred eighty-six patients were included in the study, of which 172 patients were completely followed up. Among the remaining 172 patients, 53.5% (n = 92) were healed without minor amputation, 32% (n = 55) were healed with minor amputation, 9.3% (n = 16) were not healed at study termination, 3.5% (n = 6) died and 1.7% (n = 3) underwent major amputation. The median healing time for Wagner 1, Wagner 2, Wagner 3, and Wagner 4 were 23, 50, 54, 119 days, respectively. The log-rank test showed significant differences in healing time for Wagner 1, Wagner 2, Wagner 3, and Wagner 4; The median healing time for SEWSS I, SEWSS II and SEWSS III were 12, 51, and 150 days, respectively. The log-rank test showed significant differences in healing time for SEWSS I, SEWSS II and SEWSS III. Cox regression analysis showed a decreasing probability of healing with or without minor amputation with a higher SEWSS value, an increase in the SEWSS by one score reduced the probability for healing by 24%. ROC analysis showed Wagner 3 and a cut-point 17 of SEWSS had the highest Youden's index. Both the Wagner grade and SEWSS system were associated with the ulcer healing time for the patients with active DFUs. The SEWSS score makes it a better prediction tool of DFU outcome synthetically. PMID:25817047

  2. The Apgar Score.

    PubMed

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered as evidence of, or a consequence of, asphyxia; does not predict individual neonatal mortality or neurologic outcome; and should not be used for that purpose. An Apgar score assigned during resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions. PMID:26416932

  3. Imputation by the mean score should be avoided when validating a Patient Reported Outcomes questionnaire by a Rasch model in presence of informative missing data

    PubMed Central

    2011-01-01

    Background Nowadays, more and more clinical scales consisting in responses given by the patients to some items (Patient Reported Outcomes - PRO), are validated with models based on Item Response Theory, and more specifically, with a Rasch model. In the validation sample, presence of missing data is frequent. The aim of this paper is to compare sixteen methods for handling the missing data (mainly based on simple imputation) in the context of psychometric validation of PRO by a Rasch model. The main indexes used for validation by a Rasch model are compared. Methods A simulation study was performed allowing to consider several cases, notably the possibility for the missing values to be informative or not and the rate of missing data. Results Several imputations methods produce bias on psychometrical indexes (generally, the imputation methods artificially improve the psychometric qualities of the scale). In particular, this is the case with the method based on the Personal Mean Score (PMS) which is the most commonly used imputation method in practice. Conclusions Several imputation methods should be avoided, in particular PMS imputation. From a general point of view, it is important to use an imputation method that considers both the ability of the patient (measured for example by his/her score), and the difficulty of the item (measured for example by its rate of favourable responses). Another recommendation is to always consider the addition of a random process in the imputation method, because such a process allows reducing the bias. Last, the analysis realized without imputation of the missing data (available case analyses) is an interesting alternative to the simple imputation in this context. PMID:21756330

  4. Perioperative transfusion of leukocyte depleted blood products in gastric cancer patients negatively influences oncologic outcome: A retrospective propensity score weighted analysis on 610 curatively resected gastric cancer patients.

    PubMed

    Reim, Daniel; Strobl, Andreas N; Buchner, Christian; Schirren, Rebekka; Mueller, Werner; Luppa, Peter; Ankerst, Donna Pauler; Friess, Helmut; Novotny, Alexander

    2016-07-01

    The influence of perioperative transfusion (PT) on outcome following surgery for gastric cancer (GC) remains controversial, with randomized trials lacking and observational series confounded by patient risk factors. This analysis determines the association between reception of leukocyte-depleted blood products and post-operative survival for GC.Data from 610 patients who underwent curative surgery for GC in a German tertiary care clinic from 2001 to 2013 were included. Kaplan-Meier survival curves and Cox proportional hazards regression were applied to determine the association of PT and clinical and patient risk factors for overall and relapse-free survival. Propensity score analysis was performed to adjust for observational biases in reception of PT.Higher Union International Contre le Cancer/American Joint Committee on Cancer (UICC/AJCC)-stages (P <0.001), postoperative complications and severity according to the Clavien-Dindo (CD) classification (P <0.001), PT (P = 0.02), higher age (P <0.001), and neoadjuvant chemotherapy (P <0.001) were related to increased mortality rates. Higher UICC-stages (P <0.001), neoadjuvant chemotherapy (P <0.001), and type of surgery (P = 0.02) were independently associated with increased relapse rates. Patients were more likely to receive PT with higher age (P = 0.05), surgical extension to adjacent organs/structures (P = 0.002), tumor location (P = 0.003), and female gender (P = 0.03). In the adjusted propensity score weighted analysis, PT remained associated with an increased risk of death (hazard ratio (HR): 1.31, 95% CI: 1.01-1.69, P = 0.04).Because of the association of PT with negative influence on patient survival following resection for GC, risks from application of blood products should be weighed against the potential benefits. PMID:27442682

  5. Esthetic outcome of implant-based reconstructions in augmented bone: comparison of autologous and allogeneic bone block grafting with the pink esthetic score (PES)

    PubMed Central

    2014-01-01

    Introduction To determine the esthetic outcome of implant-based reconstructions after autologous and allogeneic bone grafting. Methods From 2003 to 2009, 67 patients underwent alveolar ridge augmentation and were enrolled in the study, 41 meet the inclusion criteria and 31 agreed to take part in the study. Patients were 18-69 years old (mean: 49.3 ± 13.8 years), and predominantly female. Patients received bone block grafts either autologous (n = 48) (AUBB) or allografts (ABB) (n = 19). Implants were inserted 4-7 months (autografts) or 5-6 months (allografts) after bone grafting. The Pink Esthetic Score (PES) as well as radiographic and subjective assessments were employed for the outcome analysis. The PES was assessed twice within one month based on digital photographic images that were randomly rearranged between evaluations by three independent, experienced investigators. Results Across all observations and investigators, the average PES was 7.5 ± 2.6 without differences between implants inserted in auto- and allografted bone, respectively. Patients assessed the allograft procedures as less painful and would have repeated it more often. The intra-rater reliability was excellent (correlation coefficients 0.7-0.9). The inter-observer agreement was lower (correlation coefficients 0.6-0.8). Conclusions Bone grafting with ABB allografts yields equivalent results to autologous grafting, and patients appreciate the omission of bone harvesting. The PES is a reliable method but should be performed by the same individual. PMID:24885136

  6. Better Glasgow outcome score, cerebral perfusion pressure and focal brain oxygenation in severely traumatized brain following direct regional brain hypothermia therapy: A prospective randomized study

    PubMed Central

    Idris, Zamzuri; Zenian, Mohd Sofan; Muzaimi, Mustapha; Hamid, Wan Zuraida Wan Abdul

    2014-01-01

    Background: Induced hypothermia for treatment of traumatic brain injury is controversial. Since many pathways involved in the pathophysiology of secondary brain injury are temperature dependent, regional brain hypothermia is thought capable to mitigate those processes. The objectives of this study are to assess the therapeutic effects and complications of regional brain cooling in severe head injury with Glasgow coma scale (GCS) 6-7. Materials and Methods: A prospective randomized controlled pilot study involving patients with severe traumatic brain injury with GCS 6 and 7 who required decompressive craniectomy. Patients were randomized into two groups: Cooling and no cooling. For the cooling group, analysis was made by dividing the group into mild and deep cooling. Brain was cooled by irrigating the brain continuously with cold Hartmann solution for 24-48 h. Main outcome assessments were a dichotomized Glasgow outcome score (GOS) at 6 months posttrauma. Results: A total of 32 patients were recruited. The cooling-treated patients did better than no cooling. There were 63.2% of patients in cooling group attained good GOS at 6 months compared to only 15.4% in noncooling group (P = 0.007). Interestingly, the analysis at 6 months post-trauma disclosed mild-cooling-treated patients did better than no cooling (70% vs. 15.4% attained good GOS, P = 0.013) and apparently, the deep-cooling-treated patients failed to be better than either no cooling (P = 0.074) or mild cooling group (P = 0.650). Conclusion: Data from this pilot study imply direct regional brain hypothermia appears safe, feasible and maybe beneficial in treating severely head-injured patients. PMID:25685201

  7. Pretreatment Modified Glasgow Prognostic Score Predicts Clinical Outcomes After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer

    SciTech Connect

    Kishi, Takahiro; Matsuo, Yukinori Ueki, Nami; Iizuka, Yusuke; Nakamura, Akira; Sakanaka, Katsuyuki; Mizowaki, Takashi; Hiraoka, Masahiro

    2015-07-01

    Purpose: This study aimed to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with non-small cell lung cancer (NSCLC) who received stereotactic body radiation therapy (SBRT). Methods and Materials: Data from 165 patients who underwent SBRT for stage I NSCLC with histologic confirmation from January 1999 to September 2010 were collected retrospectively. Factors, including age, performance status, histology, Charlson comorbidity index, mGPS, and recursive partitioning analysis (RPA) class based on sex and T stage, were evaluated with regard to overall survival (OS) using the Cox proportional hazards model. The impact of the mGPS on cause of death and failure patterns was also analyzed. Results: The 3-year OS was 57.9%, with a median follow-up time of 3.5 years. A higher mGPS correlated significantly with poor OS (P<.001). The 3-year OS of lower mGPS patients was 66.4%, whereas that of higher mGPS patients was 44.5%. On multivariate analysis, mGPS and RPA class were significant factors for OS. A higher mGPS correlated significantly with lung cancer death (P=.019) and distant metastasis (P=.013). Conclusions: The mGPS was a significant predictor of clinical outcomes for SBRT in NSCLC patients.

  8. Impact of the Residual SYNTAX Score on Outcomes of Revascularization in Patients with ST-Segment Elevation Myocardial Infarction and Multivessel Disease

    PubMed Central

    Loutfi, Mohamed; Ayad, Sherif; Sobhy, Mohamed

    2016-01-01

    Primary percutaneous coronary intervention (P-PCI) has become the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI) when performed by an experienced team in a timely manner. However, no consensus exists regarding the management of multivessel coronary disease detected at the time of P-PCI. AIM The aim of this study was to evaluate the use of the residual SYNTAX score (rSS) following a complete vs. culprit-only revascularization strategy in patients with STEMI and multivessel disease (MVD) to quantify the extent and complexity of residual coronary stenoses and their impact on adverse ischemic outcomes. METHODS Between October 1, 2012, and November 30, 2013, we enrolled 120 consecutive STEMI patients with angiographic patterns of multivessel coronary artery disease (CAD) who had a clinical indication to undergo PCI. The patients were subdivided into those who underwent culprit-only PCI (60 patients) and those who underwent staged-multivessel PCI during the index admission or who were staged within 30 days of the index admission (60 patients). Both the groups were well matched with regard to clinical statuses and lesion characteristics. Clinical outcomes at one year were collected, and the baseline SYNTAX score and rSS were calculated. RESULTS The mean total stent length (31.07 ± 12.7 mm vs. 76.3 ± 14.1 mm) and the number of stents implanted per patient (1.34 ± 0.6 vs. 2.47 ± 0.72) were higher in the staged-PCI group. The rSS was higher in the culprit-only PCI group (9.7 ± 5.7 vs. 1.3 ± 1.99). The angiographic and clinical results after a mean follow-up of 343 ± 75 days demonstrated no significant difference in the occurrence of in-hospital Major Adverse Cardiac and Cerebrovascular Events (MACCE) between both the groups (6.7% vs. 5%, P = 1.000). However, patients treated with staged PCI with an rSS ≤8 had significant reductions in one-year MACCE (10.7% vs. 30.5%, P = 0.020*), death/Myocardial infarction (MI)/Cerebrovascular accident

  9. Apgar score

    MedlinePlus

    ... the baby's: Breathing effort Heart rate Muscle tone Reflexes Skin color Each category is scored with 0, ... scores 2 for muscle tone. Grimace response or reflex irritability is a term describing response to stimulation, ...

  10. The Influence of Therapist Variance on the Dependability of Therapists' Alliance Scores: A Brief Comment on "The Dependability of Alliance Assessments: The Alliance-Outcome Correlation Is Larger than You Think" (Crits-Christoph et al., 2011)

    ERIC Educational Resources Information Center

    Baldwin, Scott A.; Imel, Zac E.; Atkins, David C.

    2012-01-01

    Objective: Crits-Christoph, Connolly Gibbons, Hamilton, Ring-Kurtz, and Gallop (2011) used generalizability theory to critique the measurement of the therapeutic alliance in psychotherapy research, showing that the dependability of alliance scores may be quite low, which in turn can lead to attenuated alliance-outcome correlation estimates. Method…

  11. Use of Renal Replacement Therapy May Influence Graft Outcomes following Liver Transplantation for Acute Liver Failure: A Propensity-Score Matched Population-Based Retrospective Cohort Study

    PubMed Central

    Knight, Stephen R.; Oniscu, Gabriel C.; Devey, Luke; Simpson, Kenneth J.; Wigmore, Stephen J.; Harrison, Ewen M.

    2016-01-01

    Introduction Acute kidney injury is associated with a poor prognosis in acute liver failure but little is known of outcomes in patients undergoing transplantation for acute liver failure who require renal replacement therapy. Methods A retrospective analysis of the United Kingdom Transplant Registry was performed (1 January 2001–31 December 2011) with patient and graft survival determined using Kaplan-Meier methods. Cox proportional hazards models were used together with propensity-score based full matching on renal replacement therapy use. Results Three-year patient and graft survival for patients receiving renal replacement therapy were 77.7% and 72.6% compared with 85.1% and 79.4% for those not requiring renal replacement therapy (P<0.001 and P = 0.009 respectively, n = 725). In a Cox proportional hazards model, renal replacement therapy was a predictor of both patient death (hazard ratio (HR) 1.59, 95% CI 1.01–2.50, P = 0.044) but not graft loss (HR 1.39, 95% CI 0.92–2.10, P = 0.114). In groups fully matched on baseline covariates, those not receiving renal replacement therapy with a serum creatinine greater than 175μmol/L had a significantly worse risk of graft failure than those receiving renal replacement therapy. Conclusion In patients being transplanted for acute liver failure, use of renal replacement therapy is a strong predictor of patient death and graft loss. Those not receiving renal replacement therapy with an elevated serum creatinine may be at greater risk of early graft failure than those receiving renal replacement therapy. A low threshold for instituting renal replacement therapy may therefore be beneficial. PMID:26930637

  12. Impact of Intraluminal Brachytherapy on Survival Outcome for Radiation Therapy for Unresectable Biliary Tract Cancer: A Propensity-Score Matched-Pair Analysis

    SciTech Connect

    Yoshioka, Yasuo; Ogawa, Kazuhiko; Oikawa, Hirobumi; Onishi, Hiroshi; Kanesaka, Naoto; Tamamoto, Tetsuro; Kosugi, Takashi; Hatano, Kazuo; Kobayashi, Masao; Ito, Yoshinori; Takayama, Makoto; Takemoto, Mitsuhiro; Karasawa, Katsuyuki; Nagakura, Hisayasu; Imai, Michiko; Kosaka, Yasuhiro; Yamazaki, Hideya; Isohashi, Fumiaki; Nemoto, Kenji; Nishimura, Yasumasa

    2014-07-15

    Purpose: To determine whether adding intraluminal brachytherapy (ILBT) to definitive radiation therapy (RT) for unresectable biliary tract cancer has a positive impact on survival outcome. Methods and Materials: The original cohort comprised 209 patients, including 153 who underwent external beam RT (EBRT) alone and 56 who received both ILBT and EBRT. By matching propensity scores, 56 pairs (112 patients) consisting of 1 patient with and 1 patient without ILBT were selected. They were well balanced in terms of sex, age, performance status, clinical stage, jaundice, and addition of chemotherapy. The impact of ILBT on overall survival (OS), disease-specific survival (DSS), and local control (LC) was investigated. Results: The 2-year OS rates were 31% for the ILBT+ group and 40% for theILBT– group (P=.862). The 2-year DSS rates were 42% for the ILBT+ group and 41% for the ILBT– group (P=.288). The 2-year LC rates were 65% for the ILBT+ group and 35% for the ILBT– group (P=.094). Three of the 4 sensitivity analyses showed a significantly better LC for the ILBT+ group (P=.010, .025, .049), and another showed a marginally better LC (P=.068), and none of the sensitivity analyses showed any statistically significant differences in OS or DSS. Conclusions: In the treatment for unresectable biliary tract cancer, the addition of ILBT to RT has no impact on OS or DSS but is associated with better LC. Therefore, the role of ILBT should be addressed by other measures than survival benefit, for example, by less toxicity, prolonged biliary tract patency decreasing the need for further palliative interventions, or patient quality of life.

  13. Composite risk scores and composite endpoints in the risk prediction of outcomes in anticoagulated patients with atrial fibrillation. The Loire Valley Atrial Fibrillation Project.

    PubMed

    Banerjee, A; Fauchier, L; Bernard-Brunet, A; Clementy, N; Lip, G Y H

    2014-03-01

    Several validated risk stratification schemes for prediction of ischaemic stroke (IS)/thromboembolism (TE) and major bleeding are available for patients with non-valvular atrial fibrillation (NVAF). On the basis for multiple common risk factors for IS/TE and bleeding, it has been suggested that composite risk prediction scores may be more practical and user-friendly than separate scores for bleeding and IS/TE. In a long-term prospective hospital registry of anticoagulated patients with newly diagnosed AF, we compared the predictive value of existing risk prediction scores as well as composite risk scores, and also compared these risk scoring systems using composite endpoints. Endpoint 1 was the simple composite of IS and major bleeds. Endpoint 2 was based on a composite of IS plus intracerebral haemorrhage (ICH). Endpoint 3 was based on weighted coefficients for IS/TE and ICH. Endpoint 4 was a composite of stroke, cardiovascular death, TE and major bleeding. The incremental predictive value of these scores over CHADS2 (as reference) for composite endpoints was assessed using c-statistic, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Of 8,962 eligible individuals, 3,607 (40.2%) had NVAF and were on OAC at baseline. There were no statistically significant differences between the c-statistics of the various risk scores, compared with the CHADS2 score, regardless of the endpoint. For the various risk scores and various endpoints, NRI and IDI did not show significant improvement (≥1%), compared with the CHADS2 score. In conclusion, composite risk scores did not significantly improve risk prediction of endpoints in patients with NVAF, regardless of how endpoints were defined. This would support individualised prediction of IS/TE and bleeding separately using different separate risk prediction tools, and not the use of composite scores or endpoints for everyday 'real world' clinical practice, to guide decisions on

  14. Prediction of outcome in cancer patients with febrile neutropenia: comparison of the Multinational Association of Supportive Care in Cancer risk-index score with procalcitonin, C-reactive protein, serum amyloid A, and interleukins-1beta, -6, -8 and -10.

    PubMed

    Uys, A; Rapoport, B L; Fickl, H; Meyer, P W A; Anderson, R

    2007-11-01

    The primary objective of the study was to compare the predictive potential of procalcitonin (PCT), C-reactive protein (CRP), serum amyloid A (SAA), and interleukin (IL)-1beta, IL-6, IL-8, and IL-10, with that of the Multinational Association of Supportive Care in Cancer (MASCC) risk-index score in cancer patients on presentation with chemotherapy-induced febrile neutropenia (FN). Seventy-eight consecutive FN episodes in 63 patients were included, and MASCC scores, as well as concentrations of CRP, SAA, PCT, and IL-1beta, IL-6, IL-8 and IL-10, and haematological parameters were determined on presentation, 72 h later and at outcome. Multivariate analysis of data revealed the MASCC score, but none of the laboratory parameters, to be an accurate, independent variable (P < 0.0001) for prediction of resolution with or without complications and death. Of the various laboratory parameters, PCT had the strongest association with the MASCC score (r = -0.51; P < 0.0001). In cancer patients who present with FN, the MASCC risk-index score is a useful predictor of outcome, while measurement of PCT, CRP, SAA, or IL-1beta, IL-6, IL-8 and IL-10, is of limited value. PMID:17944761

  15. Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty: protocol for a randomized, controlled study

    PubMed Central

    Cronin, Michael D.; Gofton, Wade; Erwin, Lindsey; Chow, James

    2015-01-01

    Background Total hip arthroplasty (THA) is one of the most commonly performed and successful orthopaedic surgeries. While the long-term success of THA is well documented, there is still significant room for improving patient speed of recovery and return to activities. The surgical technique used during THA has the potential to affect these early outcomes. Methods The described design is a single center, prospective, randomized, controlled study. Subjects will be randomized to receive THA using either the supercapsular percutaneously-assisted total hip (SuperPath) or traditional posterior surgical techniques. Subjects will be evaluated using Timed Up and Go (TUG), Timed Stair Climb (TSC), Hip Dysfunction and Osteoarthritis Outcome Score (HOOS), and Visual Analog Scale (VAS) for pain level estimation preoperatively, during the hospital stay, and at 2, 6 weeks, and 100 days post-discharge. Other endpoints to be evaluated include: length of stay (LOS); discharge status; transfusion rates; readmission rates; complication rates; operative time; date returned to work; and acetabular component anteversion and inclination angles. Discussion The described study will determine the effect of a tissue-sparing surgical technique on short term subject recovery following THA in comparison to the most commonly used technique in clinical practice. PMID:26734645

  16. A SCORING SYSTEM TO IMPROVE DECISION MAKING AND OUTCOMES IN THE ADAPTATION OF RECENTLY CAPTURED WHITE RHINOCEROSES (CERATOTHERIUM SIMUM) TO CAPTIVITY.

    PubMed

    Miller, Michele; Kruger, Milandie; Kruger, Marius; Olea-Popelka, Francisco; Buss, Peter

    2016-04-01

    Ninety-four subadult and adult white rhinoceroses (Ceratotherium simum) were captured between February and October, 2009-11, in Kruger National Park and placed in holding bomas prior to translocation to other locations within South Africa. A simple three-category system was developed based on appetite, fecal consistency/volume, and behavior to assess adaptation to bomas. Individual animal and group daily median scores were used to determine trends and when rhinoceroses had successfully adapted to the boma. Seventeen rhinoceroses did not adapt to boma confinement, and 16 were released (1 mortality). No differences in boma scores were observed between rhinoceroses that adapted and those that did not, until day 8, when the first significant differences were observed (adapted score=13 versus nonadapted score=10). The time to reach a boma score determined as successful adaptation (median 19 d) matched subjective observations, which was approximately 3 wk for most rhinoceroses. Unsuccessful adaptation was indicated by an individual boma score of less than 15, typically during the first 2 wk, or a declining trend in scores within the first 7-14 d. This scoring system can be used for most locations and could also be easily adapted to other areas in which rhinoceroses are held in captivity. This tool also provides important information for assessing welfare in newly captured rhinoceroses. PMID:26845302

  17. Scoring Package

    National Institute of Standards and Technology Data Gateway

    NIST Scoring Package (PC database for purchase)   The NIST Scoring Package (Special Database 1) is a reference implementation of the draft Standard Method for Evaluating the Performance of Systems Intended to Recognize Hand-printed Characters from Image Data Scanned from Forms.

  18. Scored Discussions.

    ERIC Educational Resources Information Center

    Zola, John

    1992-01-01

    Suggests a classroom strategy to help students learn to analyze and discuss significant issues from history and current policy debates. Describes scored discussions in which small groups of students receive points for participation. Provides an example of a discussion on gold mining. Includes an agenda. Explores uses of scored discussions and…

  19. Comparison of outcome predictions by the Glasgow coma scale and the Full Outline of UnResponsiveness score in the neurological and neurosurgical patients in the Intensive Care Unit

    PubMed Central

    Khanal, Kishor; Bhandari, Sanjeeb Sudarshan; Shrestha, Ninadini; Acharya, Subhash Prasad; Marhatta, Moda Nath

    2016-01-01

    Assessment of level of consciousness is very important in predicting patient's outcome from neurological illness. Glasgow coma scale (GCS) is the most commonly used scale, and Full Outline of UnResponsiveness (FOUR) score is also recently validated as an alternative to GCS in the evaluation of the level of consciousness. We carried out a prospective study in 97 patients aged above 16 years. We measured GCS and FOUR score within 24 h of Intensive Care Unit admission. The mean GCS and the FOUR scores were lower among nonsurvivors than among the survivors and were statistically significant (P < 0.001). Discrimination for GCS and FOUR score was fair with the area under the receiver operating characteristic curve of 0.79 and 0.82, respectively. The cutoff point with best Youden index for GCS and FOUR score was 6.5 each. Below the cutoff point, mortality was higher in both models (P < 0.001). The Hosmer-Lemeshow Chi-square coefficient test showed better calibration with FOUR score than GCS. A positive correlation was seen between the models with Spearman's correlation coefficient of 0.91 (P < 0.001).

  20. Effect of Serum Growth Differentiation Factor-15 and the Syntax Score on 2-Year Outcomes in Patients With Acute Coronary Syndrome.

    PubMed

    Dominguez-Rodriguez, Alberto; Abreu-Gonzalez, Pedro; Avanzas, Pablo; Consuegra-Sanchez, Luciano

    2016-05-15

    Growth differentiation factor-15 (GDF-15) is produced by cardiomyocytes and atherosclerotic lesions under stress conditions, but little is known about its relation with severity and complexity of coronary lesions. The aim of this study was to investigate the association between GDF-15 and the syntax score for risk prediction of major adverse cardiovascular events (MACE) at 2-year follow-up in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). This is a prospective cohort study of 502 patients with NSTEACS. The syntax score was calculated from baseline coronary angiography. Blood samples were obtained at study entry for the assessment of GDF-15 and high-sensitivity C reactive protein. One hundred and three patients (20.5%) showed MACE at 2-year follow-up. Patients who developed MACE had greater GDF-15 concentrations and syntax score (p <0.001) compared to patients who did not. There was a positive, but moderate, correlation between GDF-15 and syntax score (ρ = 0.45, p <0.0001). On Cox regression analysis, only GDF-15 levels (p <0.001), body mass index (p = 0.04), and syntax score (p <0.001) remained independent predictors of the MACE. The area under the curve of GDF-15 (0.912, 95% confidence interval 0.894 to 0.944) was significantly greater compared to high-sensitivity C reactive protein and syntax score. In conclusion, in patients with NSTEACS, levels of GDF-15 at admission were correlated with the syntax score and independently associated with an increased risk of MACE during 2-year follow-up. PMID:27013387

  1. CLASSIFICATION OF IRANIAN NURSES ACCORDING TO THEIR MENTAL HEALTH OUTCOMES USING GHQ-12 QUESTIONNAIRE: A COMPARISON BETWEEN LATENT CLASS ANALYSIS AND K-MEANS CLUSTERING WITH TRADITIONAL SCORING METHOD

    PubMed Central

    Jamali, Jamshid; Ayatollahi, Seyyed Mohammad Taghi

    2015-01-01

    Background: Nurses constitute the most providers of health care systems. Their mental health can affect the quality of services and patients’ satisfaction. General Health Questionnaire (GHQ-12) is a general screening tool used to detect mental disorders. Scoring method and determining thresholds for this questionnaire are debatable and the cut-off points can vary from sample to sample. This study was conducted to estimate the prevalence of mental disorders among Iranian nurses using GHQ-12 and also compare Latent Class Analysis (LCA) and K-means clustering with traditional scoring method. Methodology: A cross-sectional study was carried out in Fars and Bushehr provinces of southern Iran in 2014. Participants were 771 Iranian nurses, who filled out the GHQ-12 questionnaire. Traditional scoring method, LCA and K-means were used to estimate the prevalence of mental disorder among Iranian nurses. Cohen’s kappa statistic was applied to assess the agreement between the LCA and K-means with traditional scoring method of GHQ-12. Results: The nurses with mental disorder by scoring method, LCA and K-mean were 36.3% (n=280), 32.2% (n=248), and 26.5% (n=204), respectively. LCA and logistic regression revealed that the prevalence of mental disorder in females was significantly higher than males. Conclusion: Mental disorder in nurses was in a medium level compared to other people living in Iran. There was a little difference between prevalence of mental disorder estimated by scoring method, K-means and LCA. According to the advantages of LCA than K-means and different results in scoring method, we suggest LCA for classification of Iranian nurses according to their mental health outcomes using GHQ-12 questionnaire PMID:26622202

  2. Scoring from Contests

    PubMed Central

    Penn, Elizabeth Maggie

    2014-01-01

    This article presents a new model for scoring alternatives from “contest” outcomes. The model is a generalization of the method of paired comparison to accommodate comparisons between arbitrarily sized sets of alternatives in which outcomes are any division of a fixed prize. Our approach is also applicable to contests between varying quantities of alternatives. We prove that under a reasonable condition on the comparability of alternatives, there exists a unique collection of scores that produces accurate estimates of the overall performance of each alternative and satisfies a well-known axiom regarding choice probabilities. We apply the method to several problems in which varying choice sets and continuous outcomes may create problems for standard scoring methods. These problems include measuring centrality in network data and the scoring of political candidates via a “feeling thermometer.” In the latter case, we also use the method to uncover and solve a potential difficulty with common methods of rescaling thermometer data to account for issues of interpersonal comparability. PMID:24748759

  3. How Performance Information Affects Human-Capital Investment Decisions: The Impact of Test-Score Labels on Educational Outcomes. NBER Working Paper No. 17120

    ERIC Educational Resources Information Center

    Papay, John P.; Murnane, Richard J.; Willett, John B.

    2011-01-01

    Students receive abundant information about their educational performance, but how this information affects future educational-investment decisions is not well understood. Increasingly common sources of information are state-mandated standardized tests. On these tests, students receive a score and a label that summarizes their performance. Using a…

  4. If I Read Better, Will I Score Higher ?: The Relationship between Oral Reading Fluency Instruction and Standardized Reading Achievement Test Outcomes

    ERIC Educational Resources Information Center

    Waldron, Chad H.

    2008-01-01

    The research study examined whether a difference existed between the reading achievement scores of an experimental group and a control group in standardized reading achievement. This difference measured the effect of systematic oral reading fluency instruction with repeated readings. Data from the 4Sight Pennsylvania Benchmark Reading Assessments…

  5. The Youth Throwing Score

    PubMed Central

    Ahmad, Christopher S.; Padaki, Ajay S.; Noticewala, Manish Suresh; Makhni, Eric Chugh; Popkin, Charles Aaron

    2016-01-01

    Objectives: Epidemic levels of shoulder and elbow injuries have been reported in youth and adolescent baseball players. Despite the concerning frequency of these injuries, no instrument has been validated to assess upper extremity injury in this patient population. The purpose of this study was to validate an upper extremity assessment tool specifically designed for youth baseball players. We hypothesize this tool will be reliable, responsive and valid. Methods: The Youth Throwing Score (YTS) was constructed by a multidisciplinary healthcare provider team in addition to baseball coaches as a tool to assess upper extremity injury in 10 to 18 year old baseball players. The instrument was comprised of a demographics section and a 14 item assessment of pain, fatigue and psychosocial health. The 14 items were scored from 1 to 5 and weighted equally, with higher scores reflecting fewer symptoms and less functional disability. The psychometric properties, including the test-retest reliability, internal consistency, and responsiveness were calculated. Additionally, the Pearson correlation coefficient to 4 validated outcomes was determined. Results: A pilot form of the instrument was administered to 25 players to assess comprehension and mean item importance. Pilot analysis resulted in none of the 14 items receiving less than a 3 out of 5 mean athlete importance rating and the final instrument read at a Flesch-Kincaid level of 4.1, appropriate for patients age 9 and older. A total of 223 players completed the Youth Throwing Score, with an average player age of 14.3 ± 2.7 years old. The players self-assigned injury status, resulting in an average survey score of 59.7 ± 8.4 for the 148 players ‘playing without pain,’ 42.0 ± 11.5 for the 60 players ‘playing with pain,’ and 40.4 ± 10.5 for the 15 players ‘not playing due to pain.’ Players playing without pain scored significantly higher than those playing with pain (p < .001). The scoring tiers of the Youth

  6. Characteristics and Behavioral Outcomes for Youth in Group Care and Family-Based Care: A Propensity Score Matching Approach Using National Data

    ERIC Educational Resources Information Center

    James, Sigrid; Roesch, Scott; Zhang, Jin Jin

    2012-01-01

    This study aimed to answer two questions: (a) Given expected differences in children who are placed in group care compared to those in family-based settings, is it possible to match children on baseline characteristics? (b) Are there differences in behavioral outcomes for youth with episodes in group care versus those in family-based care? Using…

  7. Pain scoring in endometriosis: entry criteria and outcome measures for clinical trials. Report from the Art and Science of Endometriosis meeting.

    PubMed

    Vincent, Katy; Kennedy, Stephen; Stratton, Pamela

    2010-01-01

    Standardized entry criteria and outcome measures for clinical trials in endometriosis-related pain would facilitate the comparison of trial results and the production of systematic reviews, improving evidence-based practice in this area. This report summarizes the recommendations from an international meeting for these criteria. PMID:18990378

  8. Development of a new outcome prediction model for Chinese patients with penile squamous cell carcinoma based on preoperative serum C-reactive protein, body mass index, and standard pathological risk factors: the TNCB score group system

    PubMed Central

    Li, Jing; Mi, Qi-Wu; Chen, Xiao-Feng; Zhao, Qi; Li, Yong-Hong; Chen, Jie-Ping; Deng, Chuang-Zhong; Ye, Yun-Lin; Zhong, Ming-Zhu; Liu, Zhuo-Wei; Qin, Zi-Ke; Lin, Xiang-Tian; Liang, Wei-Cong; Han, Hui; Zhou, Fang-Jian

    2016-01-01

    Purpose To determine the predictive value and feasibility of the new outcome prediction model for Chinese patients with penile squamous cell carcinoma. Results The 3-year disease-specific survival (DSS) was 92.3% in patients with < 8.70 mg/L CRP and 54.9% in those with elevated CRP (P < 0.001). The 3-year DSS was 86.5% in patients with a BMI < 22.6 Kg/m2 and 69.9% in those with a higher BMI (P = 0.025). In a multivariate analysis, pathological T stage (P < 0.001), pathological N stage (P = 0.002), BMI (P = 0.002), and CRP (P = 0.004) were independent predictors of DSS. A new scoring model was developed, consisting of BMI, CRP, and tumor T and N classification. In our study, we found that the addition of the above-mentioned parameters significantly increased the predictive accuracy of the system of the American Joint Committee on Cancer (AJCC) anatomic stage group. The accuracy of the new prediction category was verified. Methods A total of 172 Chinese patients with penile squamous cell cancer were analyzed retrospectively between November 2005 and November 2014. Statistical data analysis was conducted using the nonparametric method. Survival analysis was performed with the log-rank test and the Cox proportional hazard model. Based on regression estimates of significant parameters in multivariate analysis, a new BMI-, CRP- and pathologic factors-based scoring model was developed to predict disease-specific outcomes. The predictive accuracy of the model was evaluated using the internal and external validation. Conclusion The present study demonstrated that the TNCB score group system maybe a precise and easy to use tool for predicting outcomes in Chinese penile squamous cell carcinoma patients. PMID:26980738

  9. Screening Outcomes in Older US Women Undergoing Multiple Mammograms in Community Practice: Does Interval, Age, or Comorbidity Score Affect Tumor Characteristics or False Positive Rates?

    PubMed Central

    2013-01-01

    Background Uncertainty exists about the appropriate use of screening mammography among older women because comorbid illnesses may diminish the benefit of screening. We examined the risk of adverse tumor characteristics and false positive rates according to screening interval, age, and comorbidity. Methods From January 1999 to December 2006, data were collected prospectively on 2993 older women with breast cancer and 137 949 older women without breast cancer who underwent mammography at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. Women were aged 66 to 89 years at study entry to allow for measurement of 1 year of preexisting illnesses. We used logistic regression analyses to calculate the odds of advanced (IIb, III, IV) stage, large (>20 millimeters) tumors, and 10-year cumulative probability of false-positive mammography by screening frequency (1 vs 2 years), age, and comorbidity score. The comorbidity score was derived using the Klabunde approximation of the Charlson score. All statistical tests were two-sided. Results Adverse tumor characteristics did not differ statistically significantly by comorbidity, age, or interval. Cumulative probability of a false-positive mammography result was higher among annual screeners than biennial screeners irrespective of comorbidity: 48.0% (95% confidence interval [CI] = 46.1% to 49.9%) of annual screeners aged 66 to 74 years had a false-positive result compared with 29.0% (95% CI = 28.1% to 29.9%) of biennial screeners. Conclusion Women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity. PMID:23385442

  10. Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: A physical activity and fundamental movement skills intervention for primary schools in low-income communities

    PubMed Central

    2012-01-01

    Background Many Australian children are insufficiently active to accrue health benefits and physical activity (PA) levels are consistently lower among youth of low socio-economic position. PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills (FMS) may serve as a protective factor against this trend. Methods/design The Supporting Children’s Outcomes Using Rewards Exercise and Skills (SCORES) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities, which will be evaluated using a group randomized controlled trial. The socio-ecological model provided a framework for the 12-month intervention, which includes the following components: teacher professional learning, student leadership workshops (including leadership accreditation and rewards, e.g., stickers, water bottles), PA policy review, PA equipment packs, parental engagement via newsletters, FMS homework and a parent evening, and community partnerships with local sporting organizations. Outcomes will be assessed at baseline, 6- and 12-months. The primary outcomes are PA (accelerometers), FMS (Test of Gross Motor Development II) and cardiorespiratory fitness (multi-stage fitness test). Secondary outcomes include body mass index [using weight (kg)/height (m2)], perceived competence, physical self-esteem, and resilience. Individual and environmental mediators of behavior change (e.g. social support and enjoyment) will also be assessed. The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons. Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored. Discussion SCORES is an innovative primary school-based PA and FMS intervention designed to support students attending schools in low-income communities to be more skilled and active. The

  11. Selected items from the Charcot-Marie-Tooth (CMT) Neuropathy Score and secondary clinical outcome measures serve as sensitive clinical markers of disease severity in CMT1A patients.

    PubMed

    Mannil, Manoj; Solari, Alessandra; Leha, Andreas; Pelayo-Negro, Ana L; Berciano, José; Schlotter-Weigel, Beate; Walter, Maggie C; Rautenstrauss, Bernd; Schnizer, Tuuli J; Schenone, Angelo; Seeman, Pavel; Kadian, Chandini; Schreiber, Olivia; Angarita, Natalia G; Fabrizi, Gian Maria; Gemignani, Franco; Padua, Luca; Santoro, Lucio; Quattrone, Aldo; Vita, Giuseppe; Calabrese, Daniela; Young, Peter; Laurà, Matilde; Haberlová, Jana; Mazanec, Radim; Paulus, Walter; Beissbarth, Tim; Shy, Michael E; Reilly, Mary M; Pareyson, Davide; Sereda, Michael W

    2014-11-01

    This study evaluates primary and secondary clinical outcome measures in Charcot-Marie-Tooth disease type 1A (CMT1A) with regard to their contribution towards discrimination of disease severity. The nine components of the composite Charcot-Marie-Tooth disease Neuropathy Score and six additional secondary clinical outcome measures were assessed in 479 adult patients with genetically proven CMT1A and 126 healthy controls. Using hierarchical clustering, we identified four significant clusters of patients according to clinical severity. We then tested the impact of each of the CMTNS components and of the secondary clinical parameters with regard to their power to differentiate these four clusters. The CMTNS components ulnar sensory nerve action potential (SNAP), pin sensibility, vibration and strength of arms did not increase the discriminant value of the remaining five CMTNS components (Ulnar compound motor action potential [CMAP], leg motor symptoms, arm motor symptoms, leg strength and sensory symptoms). However, three of the six additional clinical outcome measures - the 10m-timed walking test (T10MW), 9 hole-peg test (9HPT), and foot dorsal flexion dynamometry - further improved discrimination between severely and mildly affected patients. From these findings, we identified three different composite measures as score hypotheses and compared their discriminant power with that of the CMTNS. A composite of eight components CMAP, Motor symptoms legs, Motor symptoms arms, Strength of Legs, Sensory symptoms), displayed the strongest power to discriminate between the clusters. As a conclusion, five items from the CMTNS and three secondary clinical outcome measures improve the clinical assessment of patients with CMT1A significantly and are beneficial for upcoming clinical and therapeutic trials. PMID:25085517

  12. Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI.

    PubMed

    Rinkel, Rico N; Verdonck-de Leeuw, Irma M; Doornaert, Patricia; Buter, Jan; de Bree, Remco; Langendijk, Johannes A; Aaronson, Neil K; Leemans, C René

    2016-07-01

    The objective of this study is to assess swallowing and speech outcome after chemoradiation therapy for head and neck cancer, based on the patient-reported outcome measures Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI), both provided with cut-off scores. This is a cross-sectional study. Department of Otolaryngology/Head and Neck Surgery of a University Medical Center. Sixty patients, 6 months to 5 years after chemoradiation for head and neck squamous cell carcinoma. Swallowing Quality of Life Questionnaire (SWAL-QOL) and SHI, both validated in Dutch and provided with cut-off scores. Associations were tested between the outcome measures and independent variables (age, gender, tumor stage and site, and radiotherapy technique, time since treatment, comorbidity and food intake). Fifty-two patients returned the SWAL-QOL and 47 the SHI (response rate 87 and 78 %, respectively). Swallowing and speech problems were present in 79 and 55 %, respectively. Normal food intake was noticed in 45, 35 % had a soft diet and 20 % tube feeding. Patients with soft diet and tube feeding reported more swallowing problems compared to patients with normal oral intake. Tumor subsite was significantly associated with swallowing outcome (less problems in larynx/hypopharynx compared to oral/oropharynx). Radiation technique was significantly associated with psychosocial speech problems (less problems in patients treated with IMRT). Swallowing and (to a lesser extent) speech problems in daily life are frequently present after chemoradiation therapy for head and neck cancer. Future prospective studies will give more insight into the course of speech and swallowing problems after chemoradiation and into efficacy of new radiation techniques and swallowing and speech rehabilitation programs. PMID:26071622

  13. Rasch-family models are more valuable than score-based approaches for analysing longitudinal patient-reported outcomes with missing data.

    PubMed

    de Bock, Elodie; Hardouin, Jean-Benoit; Blanchin, Myriam; Le Neel, Tanguy; Kubis, Gildas; Bonnaud-Antignac, Angélique; Dantan, Etienne; Sébille, Véronique

    2013-12-16

    The objective was to compare classical test theory and Rasch-family models derived from item response theory for the analysis of longitudinal patient-reported outcomes data with possibly informative intermittent missing items. A simulation study was performed in order to assess and compare the performance of classical test theory and Rasch model in terms of bias, control of the type I error and power of the test of time effect. The type I error was controlled for classical test theory and Rasch model whether data were complete or some items were missing. Both methods were unbiased and displayed similar power with complete data. When items were missing, Rasch model remained unbiased and displayed higher power than classical test theory. Rasch model performed better than the classical test theory approach regarding the analysis of longitudinal patient-reported outcomes with possibly informative intermittent missing items mainly for power. This study highlights the interest of Rasch-based models in clinical research and epidemiology for the analysis of incomplete patient-reported outcomes data. PMID:24346165

  14. Can the painDETECT Questionnaire score and MRI help predict treatment outcome in rheumatoid arthritis: protocol for the Frederiksberg hospital's Rheumatoid Arthritis, pain assessment and Medical Evaluation (FRAME-cohort) study

    PubMed Central

    Rifbjerg-Madsen, Signe; Christensen, Anton Wulf; Boesen, Mikael; Christensen, Robin; Danneskiold-Samsøe, Bente; Bliddal, Henning; Bartels, Else Marie; Locht, Henning; Amris, Kirstine

    2014-01-01

    Introduction Pain in rheumatoid arthritis (RA) is traditionally considered to be of inflammatory origin. Despite better control of inflammation, some patients still report pain as a significant concern, even when being in clinical remission. This suggests that RA may prompt central sensitisation—one aspect of chronic pain. In contrast, other patients report good treatment response, although imaging shows signs of inflammation, which could indicate a possible enhancement of descending pain inhibitory mechanisms. When assessing disease activity in patients with central sensitisation, the commonly used disease activity scores (eg, DAS28-CRP (C reactive protein)) will yield constant high total scores due to high tender joint count and global health assessments, whereas MRI provides an isolated estimate of inflammation. The objective of this study is, in patients with RA initiating anti-inflammatory treatment, to explore the prognostic value of a screening questionnaire for central sensitisation, hand inflammation assessed by conventional MRI, and the interaction between them regarding treatment outcome evaluated by clinical status (DAS28-CRP). For the purpose of further exploratory analyses, dynamic contrast-enhanced MRI (DCE-MRI) is performed. Method and analysis The painDETECT Questionnaire (PDQ), originally developed to screen for a neuropathic pain component, is applied to indicate the presence of central sensitisation. Adults diagnosed with RA are included when either (A) initiating disease-modifying antirheumatic drug treatment, or (B) initiating or switching to biological therapy. We anticipate that 100 patients will be enrolled, tested and reassessed after 4 months of treatment. Data collection includes Clinical data, conventional MRI, DCE-MRI, blood samples and patient-reported outcomes. Ethics and dissemination This study aims at supporting rheumatologists to define strategies to reach optimal treatment outcomes in patients with RA based on chronic pain

  15. Evaluation of Four Risk-Scoring Methods to Predict Long-Term Outcomes in Patients Undergoing Aorto-Bifemoral Bypass for Aorto-Iliac Occlusive Disease

    PubMed Central

    García, Francisca; Marchena, Joaquín; Cabrera, Vicente; Hermida, María; Sotgiu, Enrico

    2012-01-01

    This study was done to determine the usefulness of the American Society of Anesthesiologists (ASA) classification, the comorbidity Charlson index unadjusted (CCIu),the comorbidity Charlson index adjusted by age (CCIa), and the Glasgow aneurysm score (GAS) for postoperative morbimortality and survival in patients treated with aorto-bifemoral bypass (AFB) for aorto-iliac occlusive disease (AIOD). A series of 278 patients who underwent AFB were restrospectively studied. For the CCIu, CCIa, ASA, and GAS, receiver operating characteristics curve analysis for prediction of morbidity showed area under the curves of 0.61 (p = 0.004), 0.59 (p = 0.026), 0.569 (p = 0.087), and 0.63 (p = 0.001), respectively. Additionally, univariate analysis showed that CCIa (p = 0.016) and GAS (p = 0.006) were associated significantly with an increased risk of developing complications. Furthermore, CCIa (p < 0.001) and GAS (p = 0.001) showed a significant association with survival. Finally, the variable age was related to morbidity (p = 0.004), mortality (p = 0.038), and survival (p < 0.001). The comorbididity and the age should be taken in account in clinical treatment decisions for patients with AIOD. The CCIa and GAS may play a role as predictive factors for postoperative morbidity and survival after AFB. PMID:23450270

  16. Early Liver Failure after Transjugular Intrahepatic Portosystemic Shunt in Patients with Cirrhosis with Model for End-Stage Liver Disease Score of 12 or Less: Incidence, Outcome, and Prognostic Factors.

    PubMed

    Luca, Angelo; Miraglia, Roberto; Maruzzelli, Luigi; D'Amico, Mario; Tuzzolino, Fabio

    2016-08-01

    Purpose To evaluate the incidence, outcomes, and prognostic factors of early liver failure (ELF) after transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with cirrhosis with Model for End-Stage Liver Disease (MELD) score of 12 or less. Materials and Methods Institutional review board approved this retrospective study, with waiver of written informed consent. Two-hundred sixteen consecutive patients with cirrhosis (140 men, 76 women; mean age, 55.9 years; virus-related cirrhosis, 67.6% [146 of 216 patients]) with baseline MELD score of 12 or less who underwent TIPS placement between September 1999 and July 2012 were followed until last clinical evaluation, liver transplantation, or death. The Kaplan-Meier method, log-rank test, area under the receiver operating characteristic curve, and univariate and multivariate analyses were used, as appropriate. Results Twenty of 216 patients (9.2%) developed ELF within 3 months of TIPS (10 patients died, one required liver transplantation, and nine increased the MELD score to >18). ELF was associated with lower survival, 37% versus 95% at 6 months, and 24% versus 86% at 12 months (P < .001) compared with patients without ELF. ELF occurred in 16 of 95 (16.8%) patients with refractory ascites and in four of 121 (3.3%) patients with other indications for TIPS. Multivariate analysis confirmed MELD scores of 11 or 12 (odds ratio, 3.96 [95% confidence interval: 1.07, 14.67]; P = .040), decreased hemoglobin level (odds ratio, 0.68 [95% confidence interval: 0.49, 0.95]; P = .022), and decreased platelet count (odds ratio, 0.99 [95% confidence interval: 0.99, 0.99]; P = .024) as predictors for ELF in patients with refractory ascites. Conclusion ELF is not uncommon in cirrhotic patients with a MELD score of 12 or less who undergo TIPS placement for refractory ascites (especially in patients with MELD of 11 or 12) and decreased hemoglobin level and platelet count. (©) RSNA, 2016. PMID:26982564

  17. Concurrent Validity of LibQUAL+[TM] Scores: What Do LibQUAL+[TM] Scores Measure?

    ERIC Educational Resources Information Center

    Thompson, Bruce; Cook, Colleen; Kyrillidou, Martha

    2005-01-01

    The present study investigated the validity of LibQUAL+[TM] scores, and specifically how total and subscale LibQUAL+[TM] scores are associated with self-reported, library-related satisfaction and outcomes scores. Participants included 88,664 students and faculty who completed the American English (n[AE] = 69,494) or the British English (n[BE] =…

  18. Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies.

    PubMed

    Schwingshackl, Lukas; Hoffmann, Georg

    2015-05-01

    Dietary patterns consider synergistic effects compared with isolated foods or nutrients on health outcomes. The aim of this systematic review and meta-analysis was to examine the associations of diet quality as assessed by the Healthy Eating Index (HEI), the Alternate Healthy Eating Index (AHEI), and the Dietary Approaches to Stop Hypertension (DASH) score and the risk of all-cause mortality, cardiovascular mortality or incidence, cancer mortality or incidence, type 2 diabetes mellitus, and neurodegenerative diseases. A literature search was performed using the electronic databases MEDLINE, SCOPUS, and EMBASE with an end date of May 10, 2014. Study-specific risk ratios were pooled using a random effect model by the Cochrane software package Review Manager 5.2. Fifteen cohort studies (34 reports), including 1,020,642 subjects, met the criteria and were included in the meta-analysis. Diets of the highest quality, as assessed by the HEI, AHEI, and DASH score, resulted in a significant risk reduction (RR) for all-cause mortality (RR 0.78, 95% CI 0.76 to 0.80; P<0.00001; I²=61%, 95% CI 20% to 81%), cardiovascular disease (incidence or mortality) (RR 0.78, 95% CI 0.75 to 0.81; P<0.00001; I²=45%, 95% CI 13% to 66%), cancer (incidence or mortality) (RR 0.85, 95% CI 0.82 to 0.88; P<0.00001; I²=77%, 95% CI 68% to 84%), and type 2 diabetes mellitus (RR 0.78, 95% CI 0.72 to 0.85; P<0.00001; I²=74%, 95% CI 52% to 86%). Differences observed for neurodegenerative diseases were not significant. Egger regression tests provided no evidence of publication bias. Diets that score highly on the HEI, AHEI, and DASH are associated with a significant reduction in the risk of all-cause mortality, cardiovascular disease, cancer, and type 2 diabetes mellitus by 22%, 22%, 15%, and 22%, respectively, and therefore is of high public health relevance. PMID:25680825

  19. Maxillofacial trauma scoring systems.

    PubMed

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. PMID:26971084

  20. Oswestry Disability Index Scoring Made Easy

    PubMed Central

    Mehra, A; Baker, D; Disney, S; Pynsent, PB

    2008-01-01

    INTRODUCTION Low back pain effects up to 80% of the population at some time during their active life. Questionnaires are available to help measure pain and disability. The Oswestry Disability Index (ODI) is the most commonly used outcome measure for low back pain. The aim of this study was to see if training in completing the ODI forms improved the scoring accuracy. PATIENTS AND METHODS The last 100 ODI forms completed in a hospital's spinal clinic were reviewed retrospectively and errors in the scoring were identified. Staff members involved in scoring the questionnaire were made aware of the errors and the correct method of scoring explained. A chart was created with all possible scores to aid the staff with scoring. A prospective audit on 50 questionnaires was subsequently performed. RESULTS The retrospective study showed that 33 of the 100 forms had been incorrectly scored. All questionnaires where one or more sections were not completed by the patient were incorrectly scored. A scoring chart was developed and staff training was implemented. This reduced the error rate to 14% in the prospective audit. CONCLUSIONS Clinicians applying outcome measures should read the appropriate literature to ensure they understand the scoring system. Staff must then be given adequate training in the application of the questionnaires. PMID:18598595

  1. In early returns scoring scores big.

    PubMed

    Butman, Samuel M

    2016-07-01

    A scoring or cutting balloon is always useful in preventing slippage during therapy of in-stent restenosis. A drug-coated scoring balloon for in-stent restenosis may be an alternative to a drug-coated balloon Definitive comparison trials are needed and likely to help define their exact role in patients with in-stent restenosis. PMID:27400636

  2. Model feedback in Bayesian propensity score estimation.

    PubMed

    Zigler, Corwin M; Watts, Krista; Yeh, Robert W; Wang, Yun; Coull, Brent A; Dominici, Francesca

    2013-03-01

    Methods based on the propensity score comprise one set of valuable tools for comparative effectiveness research and for estimating causal effects more generally. These methods typically consist of two distinct stages: (1) a propensity score stage where a model is fit to predict the propensity to receive treatment (the propensity score), and (2) an outcome stage where responses are compared in treated and untreated units having similar values of the estimated propensity score. Traditional techniques conduct estimation in these two stages separately; estimates from the first stage are treated as fixed and known for use in the second stage. Bayesian methods have natural appeal in these settings because separate likelihoods for the two stages can be combined into a single joint likelihood, with estimation of the two stages carried out simultaneously. One key feature of joint estimation in this context is "feedback" between the outcome stage and the propensity score stage, meaning that quantities in a model for the outcome contribute information to posterior distributions of quantities in the model for the propensity score. We provide a rigorous assessment of Bayesian propensity score estimation to show that model feedback can produce poor estimates of causal effects absent strategies that augment propensity score adjustment with adjustment for individual covariates. We illustrate this phenomenon with a simulation study and with a comparative effectiveness investigation of carotid artery stenting versus carotid endarterectomy among 123,286 Medicare beneficiaries hospitlized for stroke in 2006 and 2007. PMID:23379793

  3. SBRT for the Primary Treatment of Localized Prostate Cancer: The Effect of Gleason Score, Dose and Heterogeneity of Intermediate Risk on Outcome Utilizing 2.2014 NCCN Risk Stratification Guidelines

    PubMed Central

    Bernetich, Matthew; Oliai, Caspian; Lanciano, Rachelle; Hanlon, Alexandra; Lamond, John; Arrigo, Stephen; Yang, Jun; Good, Michael; Feng, Jing; Brown, Royce; Garber, Bruce; Mooreville, Michael; Brady, Luther W.

    2014-01-01

    Purpose: To report an update of our previous experience using stereotactic body radiation therapy (SBRT) for the primary treatment of prostate cancer, risk stratified by the updated National Comprehensive Cancer Network (NCCN) version 2.2014, reporting efficacy and toxicity in a community hospital setting. Methods: From 2007 to 2012, 142 localized prostate cancer patients were treated with SBRT using CyberKnife. NCCN guidelines Version 2.2014 risk groups analyzed included very low (20%), low (23%), intermediate (35%), and high (22%) risk. To further explore group heterogeneity and to comply with new guidelines, we separated our prior intermediate risk group into favorable intermediate and unfavorable intermediate groups depending on how many intermediate risk factors were present (one vs. > one). The unfavorable intermediate group was further analyzed in combination with the high risk group as per NCCN guidelines Version 2.2014. Various dose levels were used over the years of treatment, and have been categorized into low dose (35 Gy, n = 5 or 36.25 Gy, n = 107) and high dose (37.5 Gy, n = 30). All treatments were delivered in five fractions. Toxicity was assessed using radiation therapy oncology group criteria. Results: Five-year actuarial freedom from biochemical failure (FFBF) was 100, 91.7, 95.2, 90.0, and 86.7% for very low, low, intermediate and high risk patients, respectively. A significant difference in 5 year FFBF was noted for patients with Gleason score (GS) ≥8 vs. 7 vs. 5/6 (p = 0.03) and low vs. high dose (p = 0.05). T-stage, pretreatment PSA, age, risk stratification group, and use of ADT did not affect 5-year FFBF. Multivariate analysis revealed GS and dose to be the most predictive factors for 5-year FFBF. Conclusion: Our experience with SBRT for the primary treatment of localized prostate cancer demonstrates favorable efficacy and toxicity comparable to the results reported for IMRT in literature. GS remains the

  4. Single- versus Double-Scoring of Trend Responses in Trend Score Equating with Constructed-Response Tests. Research Report. ETS RR-10-12

    ERIC Educational Resources Information Center

    Tan, Xuan; Ricker, Kathryn L.; Puhan, Gautam

    2010-01-01

    This study examines the differences in equating outcomes between two trend score equating designs resulting from two different scoring strategies for trend scoring when operational constructed-response (CR) items are double-scored--the single group (SG) design, where each trend CR item is double-scored, and the nonequivalent groups with anchor…

  5. Regression Discontinuity Designs with Multiple Rating-Score Variables

    ERIC Educational Resources Information Center

    Reardon, Sean F.; Robinson, Joseph P.

    2012-01-01

    In the absence of a randomized control trial, regression discontinuity (RD) designs can produce plausible estimates of the treatment effect on an outcome for individuals near a cutoff score. In the standard RD design, individuals with rating scores higher than some exogenously determined cutoff score are assigned to one treatment condition; those…

  6. The impact of the Oncotype DX Recurrence Score on treatment decisions and clinical outcomes in patients with early breast cancer: the Maccabi Healthcare Services experience with a unified testing policy

    PubMed Central

    Siegelmann-Danieli, Nava; Silverman, Barbara; Zick, Aviad; Beit-Or, Anat; Katzir, Itzhak; Porath, Avi

    2013-01-01

    The Oncotype DX Recurrence Score is a validated prognosticator in oestrogen receptor positive (ER+) breast cancer. Our retrospective analysis of a prospectively defined cohort summarises the clinical implications associated with Oncotype DX testing according to the Maccabi Healthcare Services (MHS) policy. The MHS eligibility criteria for testing included ER+ N0/pN1mic invasive tumours, discussion of test implications with an oncologist, ductal carcinoma 0.6–1 cm Grade 2–3, HER2 negative ductal carcinomas with 1.1–4.0 cm Grade 1–2, or lobular carcinoma. Large (> 1 cm) Grade 3 tumours could have grade reassessed. We linked Recurrence Score results with patients’ information and used chi-squared tests to assess the associations thereof. Between January 2008 and December 2011, tests were performed on 751 patients (MHS-eligible, 713); 54%, 38%, and 8% of patients had low, intermediate, and high Recurrence Score results, respectively. Recurrence Score distribution varied significantly with age (P = 0.002), with increasing Recurrence Score values with decreasing age. The proportion of patients with high Recurrence Score results varied by grade/size combination and histology, occurring in 32% of small (≤ 1 cm) Grade 3 and 3% of larger (1.1–4 cm) Grade 1 ductal tumours and only in 2% of lobular carcinomas. Chemotherapy was administered to 1%, 13%, and 61% of patients with low, intermediate, and high Recurrence Score results, respectively (P < 0.0001), but only to 2% of intermediate score patients ≥ 65 years. Luteinising-hormone-releasing hormone agonists with tamoxifen were used in 27% of low Recurrence Score patients ≤ 50 years. With a median follow-up of 26 months, no systemic recurrences were documented, whereas four patients exhibited locoregional recurrences. In summary, in this low-to-moderate risk patient population, testing identified 46% of patients as intermediate/high risk. Treatment decisions were influenced by Recurrence Score results and

  7. The UPA score and teenage pregnancy.

    PubMed

    Garlick, R; Ineichen, B; Hudson, F

    1993-03-01

    Teenage motherhood is often said to be the result of deficient contraceptive and abortion services. Using data from the Public Health Common Data Set (PH CDS) we demonstrate two important effects in a Regional Health Authority: higher rates of conception are related to a live birth rather than an abortion pregnancy outcome; District Health Authorities (DHAs) with high underprivileged area scores (UPA) are more likely to have high rates of conception in the teenage years than those districts with low scores. PMID:8480012

  8. Home Energy Score

    SciTech Connect

    2011-12-16

    The Home Energy Score allows a homeowner to compare her or his home's energy consumption to that of other homes, similar to a vehicle's mile-per-gallon rating. A home energy assessor will collect energy information during a brief home walk-through and then score that home on a scale of 1 to 10.

  9. SCORE - A DESCRIPTION.

    ERIC Educational Resources Information Center

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  10. Use of the Complete Rockall Score and the Forrest Classification to Assess Outcome in Patients with Non-variceal Upper Gastrointestinal Bleeding Subject to After-hours Endoscopy: A Retrospective Cohort Study

    PubMed Central

    Giese, A; Grunwald, C; Zieren, J; Büchner, NJ; Henning, BF

    2014-01-01

    Objectives: To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission. Methods: The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For 'high risk' situations (Forrest stage Ia–IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay ≥ 3 days). Results: During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients 'age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score ≥ 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found. Conclusion: In patients with UGI-B subject to after-hours endoscopy, a 'high-risk' Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A 'high-risk ' Forrest score is not significantly associated with the study endpoints. PMID:25303191

  11. Reporting Valid and Reliable Overall Scores and Domain Scores

    ERIC Educational Resources Information Center

    Yao, Lihua

    2010-01-01

    In educational assessment, overall scores obtained by simply averaging a number of domain scores are sometimes reported. However, simply averaging the domain scores ignores the fact that different domains have different score points, that scores from those domains are related, and that at different score points the relationship between overall…

  12. Analysis of five specific scores for cervical spondylogenic myelopathy

    PubMed Central

    Dalitz, Kristina

    2007-01-01

    The ability to compare various results that measure clinical deficits and outcome is a necessity for successful worldwide discussion about cervical spondylogenic myelopathy (CSM) and its treatment. There is hardly any information in literature how to value and compare outcome assessed by different scores. In a retrospective study we objectively evaluated the Nurick-score, Japanese-orthopaedic-association-score (JOA-Score), Cooper-myelopathy-scale (CMS), Prolo-score and European-myelopathy-score (EMS) using the data of 43 patients, all of whom showed clinical and morphological signs of CSM and underwent operative decompression. The scores were assessed pre- and postoperatively. The correlation between the score-results, anamnesis, clinical and diagnostic data was investigated. All the scores show a statistically significant correlation and measure postoperative improvement. With exception of the Prolo-score all scores reflect clinical deficits of CSM. The Prolo-score rates the severity of CSM on the state of the economic situation above clinical symptoms. The main differences of the scores are shown in the number of patients showing postoperative improvement, varying between 33% (Nurick-score) and 81% (JOA-score). The recovery-rates, as a measure of the cumulative improvement of all the symptoms, show less variation (23–37%). The differences of the recovery-rate were only statistically significant between JOA-score, Nurick-score and EMS (P < 0.05), whereas all the other scores showed no significant differences. To assess the postoperative successes, the evaluation of the recovery-rate is essential. There is no significant difference in the recovery-rate amongst the majority of the scores, which allows a good comparison of the results from different studies. Nevertheless, it is always important to differentiate the therapy results of CSM published worldwide. PMID:17922150

  13. Clinical risk scores to guide perioperative management.

    PubMed

    Barnett, Sarah; Moonesinghe, Suneetha Ramani

    2011-08-01

    Perioperative morbidity is associated with reduced long term survival. Comorbid disease, cardiovascular illness, and functional capacity can predispose patients to adverse surgical outcomes. Accurate risk stratification would facilitate informed patient consent and identify those individuals who may benefit from specific perioperative interventions. The ideal clinical risk scoring system would be objective, accurate, economical, simple to perform, based entirely on information available preoperatively, and suitable for patients undergoing both elective and emergency surgery. The POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) scoring systems are the most widely validated perioperative risk predictors currently utilised; however, their inclusion of intra- and postoperative variables precludes validation for preoperative risk prediction. The Charlson Index has the advantage of consisting exclusively of preoperative variables; however, its validity varies in different patient cohorts. Risk models predicting cardiac morbidity have been extensively studied, despite the relatively uncommon occurrence of postoperative cardiac events. Probably the most widely used cardiac risk score is the Lee Revised Cardiac Risk Index, although it has limited validity in some patient populations and for non-cardiac outcomes. Bespoke clinical scoring systems responding to dynamic changes in population characteristics over time, such as those developed by the American College of Surgeons National Surgical Quality Improvement Program, are more precise, but require considerable resources to implement. The combination of objective clinical variables with information from novel techniques such as cardiopulmonary exercise testing and biomarker assays, may improve the predictive precision of clinical risk scores used to guide perioperative management. PMID:21257993

  14. Nutrient Density Scores.

    ERIC Educational Resources Information Center

    Dickinson, Annette; Thompson, William T.

    1979-01-01

    Announces a nutrient density food scoring system called the Index of Nutritional Quality (INQ). It expresses the ratio between the percent RDA of a nutrient and the percent daily allowance of calories in a food. (Author/SA)

  15. Volleyball Scoring Systems.

    ERIC Educational Resources Information Center

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  16. Skill Scores for Probabilistic Climate and Weather Prediction

    NASA Astrophysics Data System (ADS)

    Maynard, T.; Suckling, E. B.; Smith, L. A.

    2012-04-01

    A wide variety of skill scores are in use for the evaluation of probability forecasts. While the importance of using proper scores is well recognised, researchers often face requests to present results under a variety of different scores. Is there any sense in which considering many "different" skill scores makes a case more (or less) persuasive? Which set of scores makes the most persuasive case? A number of scores are considered, and their strengths and weaknesses contrasted, including the most commonly used metrics such as the proper linear score, continous ranked probability score and logartithmic score, amongst others. The role of moving from ensembles of point forecasts to continuous probability distributions is discussed. Illustrations with meteorological forecasts are considered, as are mathematical experiments where the size of the forecast-outcome archive can be made arbitrarily large. The aim is to restrict the number of skill scores considered, reduce the use of misleading scores, identify independent evidence and ensure that the set of scores published are specified before the results are in. I J Good's logarithmic score is known to be the only local, proper score for continuous variables. Proposed criticisms of locality are considered and rejected and it is argued that proper, non-local scores tend to include a term that is independent of the probability mass associated with the outcome. Thus they reward the forecast for some other property of the distribution function itself, having for example a particular shape; it is conjectured that this may be a general result. This is depricated, except in cases where the forecaster is being rewarded for something other than the relation between the forecast and reality, or whose distribution functions are unavoidably constrained by some particular structure. Remaining challenges to the evaluation of probability forecasts are noted. In partucular the effect of small samples and the implications of uncertinaty

  17. Methods for Constructing and Assessing Propensity Scores

    PubMed Central

    Garrido, Melissa M; Kelley, Amy S; Paris, Julia; Roza, Katherine; Meier, Diane E; Morrison, R Sean; Aldridge, Melissa D

    2014-01-01

    Objectives To model the steps involved in preparing for and carrying out propensity score analyses by providing step-by-step guidance and Stata code applied to an empirical dataset. Study Design Guidance, Stata code, and empirical examples are given to illustrate (1) the process of choosing variables to include in the propensity score; (2) balance of propensity score across treatment and comparison groups; (3) balance of covariates across treatment and comparison groups within blocks of the propensity score; (4) choice of matching and weighting strategies; (5) balance of covariates after matching or weighting the sample; and (6) interpretation of treatment effect estimates. Empirical Application We use data from the Palliative Care for Cancer Patients (PC4C) study, a multisite observational study of the effect of inpatient palliative care on patient health outcomes and health services use, to illustrate the development and use of a propensity score. Conclusions Propensity scores are one useful tool for accounting for observed differences between treated and comparison groups. Careful testing of propensity scores is required before using them to estimate treatment effects. PMID:24779867

  18. Walk Score®

    PubMed Central

    Brown, Scott C.; Pantin, Hilda; Lombard, Joanna; Toro, Matthew; Huang, Shi; Plater-Zyberk, Elizabeth; Perrino, Tatiana; Perez-Gomez, Gianna; Barrera-Allen, Lloyd; Szapocznik, José

    2013-01-01

    Background Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the relationship of Walk Score to walking behavior. Purpose To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. Methods Participants were 391 recent healthy Cuban immigrants (M age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (M=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants’ addresses, walking and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant’s residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. Results For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. Conclusions Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities. PMID:23867028

  19. Developing Scoring Algorithms

    Cancer.gov

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  20. Automated Essay Scoring

    ERIC Educational Resources Information Center

    Dikli, Semire

    2006-01-01

    The impacts of computers on writing have been widely studied for three decades. Even basic computers functions, i.e. word processing, have been of great assistance to writers in modifying their essays. The research on Automated Essay Scoring (AES) has revealed that computers have the capacity to function as a more effective cognitive tool (Attali,…

  1. A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study

    ERIC Educational Resources Information Center

    Kaplan, David; Chen, Jianshen

    2012-01-01

    A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for…

  2. Syncopation and the Score

    PubMed Central

    Song, Chunyang; Simpson, Andrew J. R.; Harte, Christopher A.; Pearce, Marcus T.; Sandler, Mark B.

    2013-01-01

    The score is a symbolic encoding that describes a piece of music, written according to the conventions of music theory, which must be rendered as sound (e.g., by a performer) before it may be perceived as music by the listener. In this paper we provide a step towards unifying music theory with music perception in terms of the relationship between notated rhythm (i.e., the score) and perceived syncopation. In our experiments we evaluated this relationship by manipulating the score, rendering it as sound and eliciting subjective judgments of syncopation. We used a metronome to provide explicit cues to the prevailing rhythmic structure (as defined in the time signature). Three-bar scores with time signatures of 4/4 and 6/8 were constructed using repeated one-bar rhythm-patterns, with each pattern built from basic half-bar rhythm-components. Our manipulations gave rise to various rhythmic structures, including polyrhythms and rhythms with missing strong- and/or down-beats. Listeners (N = 10) were asked to rate the degree of syncopation they perceived in response to a rendering of each score. We observed higher degrees of syncopation in time signatures of 6/8, for polyrhythms, and for rhythms featuring a missing down-beat. We also found that the location of a rhythm-component within the bar has a significant effect on perceived syncopation. Our findings provide new insight into models of syncopation and point the way towards areas in which the models may be improved. PMID:24040323

  3. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

    SciTech Connect

    Fjetland, Lars Roy, Sumit Kurz, Kathinka D.; Solbakken, Tore; Larsen, Jan Petter Kurz, Martin W.

    2013-10-15

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged {>=}80 years.

  4. Pharmacophore-Based Similarity Scoring for DOCK

    PubMed Central

    2015-01-01

    Pharmacophore modeling incorporates geometric and chemical features of known inhibitors and/or targeted binding sites to rationally identify and design new drug leads. In this study, we have encoded a three-dimensional pharmacophore matching similarity (FMS) scoring function into the structure-based design program DOCK. Validation and characterization of the method are presented through pose reproduction, crossdocking, and enrichment studies. When used alone, FMS scoring dramatically improves pose reproduction success to 93.5% (∼20% increase) and reduces sampling failures to 3.7% (∼6% drop) compared to the standard energy score (SGE) across 1043 protein–ligand complexes. The combined FMS+SGE function further improves success to 98.3%. Crossdocking experiments using FMS and FMS+SGE scoring, for six diverse protein families, similarly showed improvements in success, provided proper pharmacophore references are employed. For enrichment, incorporating pharmacophores during sampling and scoring, in most cases, also yield improved outcomes when docking and rank-ordering libraries of known actives and decoys to 15 systems. Retrospective analyses of virtual screenings to three clinical drug targets (EGFR, IGF-1R, and HIVgp41) using X-ray structures of known inhibitors as pharmacophore references are also reported, including a customized FMS scoring protocol to bias on selected regions in the reference. Overall, the results and fundamental insights gained from this study should benefit the docking community in general, particularly researchers using the new FMS method to guide computational drug discovery with DOCK. PMID:25229837

  5. The Relation between Factor Score Estimates, Image Scores, and Principal Component Scores

    ERIC Educational Resources Information Center

    Velicer, Wayne F.

    1976-01-01

    Investigates the relation between factor score estimates, principal component scores, and image scores. The three methods compared are maximum likelihood factor analysis, principal component analysis, and a variant of rescaled image analysis. (RC)

  6. The Impact of SYNTAX Score of Non-Infarct-Related Artery on Long- Term Outcome among Patients with Acute ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

    PubMed Central

    Su, Min-I; Tsai, Cheng-Ting; Yeh, Hung-I; Chen, Chun-Yen

    2014-01-01

    Objective We investigated the impact of the severity of stenosis in a non-infarct-related artery (IRA) on the long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods Three hundred one consecutive patients (age: 59.7 ± 13.2 years, 85.5% men) underwent primary PCI during 2009–2012. Receiver operating characteristic curve analysis found the optimal cutoff for non-IRA SYNTAX score (SS) to be 2.5. We divided the patients into two groups according to this cutoff value. Results By multivariable analysis, non-IRA SS (≥2.5) was an independent predictor of major adverse cardiac events (hazard ratio [HR]: 2.15, 95% confidence interval [CI]: 1.21–3.79, P  =  0.008) and all-cause mortality (HR: 3.49, 95% CI: 1.13–10.8, P  =  0.03). However, the prediction of cardiovascular mortality had only borderline significance (HR: 3.29, 95% CI: 0.90–12.08, P  =  0.07). Conclusion STEMI patients treated with primary PCI and moderate to severe non-IRA stenosis (SS ≥2.5) have more subsequent cardiac events. Those populations should be treated with more aggressive preventive and medical management. PMID:25303079

  7. Development and validation of the Essen Intracerebral Haemorrhage Score

    PubMed Central

    Weimar, C; Benemann, J; Diener, H‐C

    2006-01-01

    Background Spontaneous intracerebral haemorrhage (ICH) accounts for the highest in‐hospital mortality of all stroke types. Nevertheless, outcome is favourable in about 30% of patients. Only one model for the prediction of favourable outcome has been validated so far. Objective To describe the development and validation of the Essen ICH score. Methods Inception cohorts were assessed on the National Institutes of Health stroke scale (NIH‐SS) on admission and after follow up of 100 days. On the basis of previously validated clinical variables, a simple clinical score was developed to predict mortality and complete recovery (Barthel index after 100 days ⩾95) in 340 patients with acute ICH. Subscores for age (<60 = 0; 60–69 = 1; 70–79 = 2; ⩾80 = 3), NIH‐SS level of consciousness (alert = 0; drowsy = 1; stuporose = 2; comatose = 3), and NIH‐SS total score (0–5 = 0; 6–10 = 1; 11–15 = 2; 16–20 = 3; >20 or coma = 4) were combined into a prognostic scale with <3 predicting complete recovery and >7 predicting death. The score was subsequently validated in an external cohort of 371 patients. Results The Essen ICH score showed a high prognostic accuracy for complete recovery and death in both the development and validation cohort. For prediction of complete recovery on the Barthel index after 100 days, the Essen ICH score was superior to the physicians' prognosis and to two previous prognostic scores developed for a slightly modified outcome. Conclusions The Essen ICH score provides an easy to use scale for outcome prediction following ICH. Its high positive predictive values for adverse outcomes and easy applicability render it useful for individual prognostic indications or the design of clinical studies. In contrast, physicians tended to predict outcome too pessimistically. PMID:16354736

  8. Automated Essay Scoring versus Human Scoring: A Comparative Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2007-01-01

    The current research was conducted to investigate the validity of automated essay scoring (AES) by comparing group mean scores assigned by an AES tool, IntelliMetric [TM] and human raters. Data collection included administering the Texas version of the WriterPlacer "Plus" test and obtaining scores assigned by IntelliMetric [TM] and by human…

  9. Fingerprinting of music scores

    NASA Astrophysics Data System (ADS)

    Irons, Jonathan; Schmucker, Martin

    2004-06-01

    Publishers of sheet music are generally reluctant in distributing their content via the Internet. Although online sheet music distribution's advantages are numerous the potential risk of Intellectual Property Rights (IPR) infringement, e.g. illegal online distributions, disables any innovation propensity. While active protection techniques only deter external risk factors, additional technology is necessary to adequately treat further risk factors. For several media types including music scores watermarking technology has been developed, which ebeds information in data by suitable data modifications. Furthermore, fingerprinting or perceptual hasing methods have been developed and are being applied especially for audio. These methods allow the identification of content without prior modifications. In this article we motivate the development of watermarking and fingerprinting technologies for sheet music. Outgoing from potential limitations of watermarking methods we explain why fingerprinting methods are important for sheet music and address potential applications. Finally we introduce a condept for fingerprinting of sheet music.

  10. Olympic Scoring of English Compositions

    ERIC Educational Resources Information Center

    Follman, John; Panther, Edward

    1974-01-01

    Examines empirically the efficacy of utilizing Olympic diving and gymnastic scoring systems for grading graduate students' English compositions. Results indicated that such scoring rules do not produce ratings different in reliability or in level from conventional letter grades. (ED)

  11. Line Lengths and Starch Scores.

    ERIC Educational Resources Information Center

    Moriarty, Sandra E.

    1986-01-01

    Investigates readability of different line lengths in advertising body copy, hypothesizing a normal curve with lower scores for shorter and longer lines, and scores above the mean for lines in the middle of the distribution. Finds support for lower scores for short lines and some evidence of two optimum line lengths rather than one. (SKC)

  12. Validity and reliability of the SPORTS score for shoulder instability

    PubMed Central

    BLONNA, DAVIDE; BELLATO, ENRICO; CARANZANO, FRANCESCO; BONASIA, DAVIDE E.; MARMOTTI, ANTONGIULIO; ROSSI, ROBERTO; CASTOLDI, FILIPPO

    2014-01-01

    Purpose athletes affected by shoulder instability cannot be judged solely according to the criteria used for non-athletes. In order to improve the assessment of shoulder instability surgery outcomes, the SPORTS score was tested in a cohort of athletes. Methods ninety-eight athletes at an average follow-up of 4.6 years (range 1–9.2) after open or arthroscopic surgery for recurrent anterior shoulder instability were included in this study. The patients were asked to complete the SPORTS score questionnaire twice, with an interval of 2–3 weeks between the two assessments. The Bland-Altman method and the intra-class correlation coefficient were used to measure reliability. Criterion validity was assessed by calculating the Spearman correlation coefficient between the SPORTS score and the Western Ontario Shoulder Instability Index (WOSI) score, the Rowe score, the Oxford Shoulder Instability Score (OSIS), and the Subjective Shoulder Value (SSV). Results the SPORTS score showed excellent test-retest reliability. The systematic error between the first and the second assessment was 0.3 points (95% upper limit of agreement = 2.3 points). The criterion validity was found to be strong for the SPORTS score, which correlated best with the SSV and the “sport, recreation, and work” component of the WOSI score. The SPORTS score had an acceptable floor effect (8%). The ceiling effect was 46%, which was better than the ceiling effects seen with the Rowe, OSIS and WOSI scores. Conclusions this study suggests that the SPORTS score is a valid score in the assessment of athletes after surgery for shoulder instability and that it adds important information to the currently available scores. Level of evidence Level III, diagnostic study of nonconsecutive patients. PMID:25606544

  13. Computer scoring of the Levels of Emotional Awareness Scale.

    PubMed

    Barchard, Kimberly A; Bajgar, Jane; Leaf, Duncan Ermini; Lane, Richard D

    2010-05-01

    The Levels of Emotional Awareness Scale (LEAS; Lane, Quinlan, Schwartz, Walker, & Zeitlan, 1990) is the most commonly used measure of differentiation and complexity in the use of emotion words and is associated with important clinical outcomes. Hand scoring the LEAS is time consuming. Existing programs for scoring open-ended responses cannot mimic LEAS hand scoring. Therefore, Leaf and Barchard (2006) developed the Program for Open-Ended Scoring (POES) to score the LEAS. In this article, we report a study in which the reliability and validity of POES scoring were examined. In the study, we used three participant types (adult community members, university students, children), three LEAS versions (paper based, computer based, and the LEAS for children), and a diverse set of criterion variables. Across this variety of conditions, the four POES scoring methods had internal consistencies and validities that were comparable to hand scoring, indicating that POES scoring can be used in clinical practice and other applied settings in which hand scoring is impractical. PMID:20479190

  14. Knee instability scores for ACL reconstruction.

    PubMed

    Rahnemai-Azar, Ata A; Naendrup, Jan-Hendrik; Soni, Ashish; Olsen, Adam; Zlotnicki, Jason; Musahl, Volker

    2016-06-01

    Despite abundant biological, biomechanical, and clinical research, return to sport after anterior cruciate ligament (ACL) injury remains a significant challenge. Residual rotatory knee laxity has been identified as one of the factors responsible for poor functional outcome. To improve and standardize the assessment of knee instability, a variety of instability scoring systems is available. Recently, devices to objectively quantify static and dynamic clinical exams have been developed to complement traditional subjective grading systems. These devices enable an improved evaluation of knee instability and possible associated injuries. This additional information may promote the development of new treatment algorithms and allow for individualized treatment. In this review, the different subjective laxity scores as well as complementary objective measuring systems are discussed, along with an introduction of injury to an individualized treatment algorithm. PMID:26980119

  15. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation

    PubMed Central

    O'Brien, Emily C.; Simon, DaJuanicia N.; Thomas, Laine E.; Hylek, Elaine M.; Gersh, Bernard J.; Ansell, Jack E.; Kowey, Peter R.; Mahaffey, Kenneth W.; Chang, Paul; Fonarow, Gregg C.; Pencina, Michael J.; Piccini, Jonathan P.; Peterson, Eric D.

    2015-01-01

    Background Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. Objectives We sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based AF population. Methods We analysed data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), a prospective registry that enrolled incident and prevalent AF patients at 176 US sites. Using Cox proportional hazards regression, we identified factors independently associated with major bleeding among patients taking oral anticoagulation (OAC) over a median follow-up of 2 years (interquartile range = 1.6–2.5). We also created a numerical bedside risk score that included the five most predictive risk factors weighted according to their strength of association with major bleeding. The predictive performance of the full model, the simple five-item score, and two existing risk scores (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile INR, elderly, drugs/alcohol concomitantly, HAS-BLED, and anticoagulation and risk factors in atrial fibrillation, ATRIA) were then assessed in both the ORBIT-AF cohort and a separate clinical trial population, Rivaroxaban Once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET-AF). Results Among 7411 ORBIT-AF patients taking OAC, the rate of major bleeding was 4.0/100 person-years. The full continuous model (12 variables) and five-factor ORBIT risk score (older age [75+ years], reduced haemoglobin/haematocrit/history of anaemia, bleeding history, insufficient kidney function, and treatment with antiplatelet) both had good ability to identify those who bled vs. not (C-index 0.69 and 0.67, respectively). These scores both had

  16. Flow and diffusion of high-stakes test scores

    PubMed Central

    Marder, M.; Bansal, D.

    2009-01-01

    We apply visualization and modeling methods for convective and diffusive flows to public school mathematics test scores from Texas. We obtain plots that show the most likely future and past scores of students, the effects of random processes such as guessing, and the rate at which students appear in and disappear from schools. We show that student outcomes depend strongly upon economic class, and identify the grade levels where flows of different groups diverge most strongly. Changing the effectiveness of instruction in one grade naturally leads to strongly nonlinear effects on student outcomes in subsequent grades. PMID:19805049

  17. Automated Essay Scoring versus Human Scoring: A Correlational Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2008-01-01

    The purpose of the current study was to analyze the relationship between automated essay scoring (AES) and human scoring in order to determine the validity and usefulness of AES for large-scale placement tests. Specifically, a correlational research design was used to examine the correlations between AES performance and human raters' performance.…

  18. Interpreting Linked Psychomotor Performance Scores

    ERIC Educational Resources Information Center

    Looney, Marilyn A.

    2013-01-01

    Given that equating/linking applications are now appearing in kinesiology literature, this article provides an overview of the different types of linked test scores: equated, concordant, and predicted. It also addresses the different types of evidence required to determine whether the scores from two different field tests (measuring the same…

  19. The Machine Scoring of Writing

    ERIC Educational Resources Information Center

    McCurry, Doug

    2010-01-01

    This article provides an introduction to the kind of computer software that is used to score student writing in some high stakes testing programs, and that is being promoted as a teaching and learning tool to schools. It sketches the state of play with machines for the scoring of writing, and describes how these machines work and what they do.…

  20. More than Just Test Scores

    ERIC Educational Resources Information Center

    Levin, Henry M.

    2012-01-01

    Around the world we hear considerable talk about creating world-class schools. Usually the term refers to schools whose students get very high scores on the international comparisons of student achievement such as PISA or TIMSS. The practice of restricting the meaning of exemplary schools to the narrow criterion of achievement scores is usually…

  1. Classification of current scoring functions.

    PubMed

    Liu, Jie; Wang, Renxiao

    2015-03-23

    Scoring functions are a class of computational methods widely applied in structure-based drug design for evaluating protein-ligand interactions. Dozens of scoring functions have been published since the early 1990s. In literature, scoring functions are typically classified as force-field-based, empirical, and knowledge-based. This classification scheme has been quoted for more than a decade and is still repeatedly quoted by some recent publications. Unfortunately, it does not reflect the recent progress in this field. Besides, the naming convention used for describing different types of scoring functions has been somewhat jumbled in literature, which could be confusing for newcomers to this field. Here, we express our viewpoint on an up-to-date classification scheme and appropriate naming convention for current scoring functions. We propose that they can be classified into physics-based methods, empirical scoring functions, knowledge-based potentials, and descriptor-based scoring functions. We also outline the major difference and connections between different categories of scoring functions. PMID:25647463

  2. Skyrocketing Scores: An Urban Legend

    ERIC Educational Resources Information Center

    Krashen, Stephen

    2005-01-01

    A new urban legend claims, "As a result of the state dropping bilingual education, test scores in California skyrocketed." Krashen disputes this theory, pointing out that other factors offer more logical explanations of California's recent improvements in SAT-9 scores. He discusses research on the effects of California's Proposition 227, which…

  3. High Scores but Low Skills

    ERIC Educational Resources Information Center

    Liu, Liqun; Neilson, William S.

    2011-01-01

    In this paper college admissions are based on test scores and students can exert two types of effort: real learning and exam preparation. The former improves skills but the latter is more effective in raising test scores. In this setting the students with the lowest skills are no longer the ones with the lowest aptitude, but instead are the ones…

  4. Improving Test Scores. Research Brief

    ERIC Educational Resources Information Center

    Walker, Karen

    2003-01-01

    What strategies can improve test scores? According to research done by Amrein and Berliner, who studied 18 states with high stakes testing, their conclusion was that students did not necessarily score higher and often remained at the same level prior to the introduction of the high stakes testing. In other research done by Carnoy and Loeb, their…

  5. Trends in Classroom Observation Scores

    ERIC Educational Resources Information Center

    Casabianca, Jodi M.; Lockwood, J. R.; McCaffrey, Daniel F.

    2015-01-01

    Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from…

  6. Prognosis Predicting Score for Endovascular Treatment of Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    Duan, Guoli; Yang, Pengfei; Li, Qiang; Zuo, Qiao; Zhang, Lei; Hong, Bo; Xu, Yi; Zhao, Wenyuan; Liu, Jianmin; Huang, Qinghai

    2016-01-01

    Abstract The elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) have a greater risk of poor clinical outcome after endovascular treatment (EVT) than younger patients do. Hence, it is necessary to explore which factors are associated with poor outcome and develop a predictive score specifically for elderly patients with aSAH receiving EVT. The aim of this study was to develop and validate a predictive score for 1-year outcomes in individual elderly patients with aSAH underwent EVT. In this 10-year prospective study, 520 consecutive aSAH elderly (age ≥ 60 years) patients underwent EVT in a single center were included. The risk factors, periprocedural, and 1-year follow-up data of all patients were entered in a specific prospective database. The modified Rankin scale was used for evaluating clinical outcome. To optimize the model's predictive capacity, the original matrix was randomly divided in 2 submatrices (learning and testing). The predictive score was developed using Arabic numerals for all variables based on the variable coefficients (β) of multivariable logistic regression analysis in the learning set and the predictive performance evaluation was assessed in the testing set. The risk classes were constructed using classification criteria based on sensitivity and specificity. The poor outcome rate at 1 year was 26.15%. Six risk factors, including age, hypertension, Hunt–Hess scale, Fisher scale, aneurysm location, and periprocedural complications, were independently associated with poor outcome and assembled the Changhai score. The discriminative power analysis with the area under the receiver operating characteristic curve (AUC) of the Changhai score was statistically significant (0.864, 0.824–0.904, P < 0.001). The sensitivity and specificity of the Changhai score were 82.07% and 78.06%, respectively. Our study indicated that age, hypertension, Hunt–Hess scale, Fisher scale, aneurysm location, and periprocedural complications were

  7. The Consumer Reports Effectiveness Score: What Did Consumers Report?

    ERIC Educational Resources Information Center

    Nielsen, Stevan Lars; Smart, David W.; Isakson, Richard L.; Worthen, Vaughn E.; Gregersen, Ann T.; Lambert, Michael J.

    2004-01-01

    From readers' ratings of satisfaction, problem resolution, and perceived emotional change during treatment, Consumer Reports magazine (CR, 1995) concluded both that psychotherapy is effective and that longer, more intensive therapy is more effective. The authors compared prospectively gathered 45-Item Outcome Questionnaire scores (OQ-45; M. J.…

  8. Engineering Student Self-Assessment through Confidence-Based Scoring

    ERIC Educational Resources Information Center

    Yuen-Reed, Gigi; Reed, Kyle B.

    2015-01-01

    A vital aspect of an answer is the confidence that goes along with it. Misstating the level of confidence one has in the answer can have devastating outcomes. However, confidence assessment is rarely emphasized during typical engineering education. The confidence-based scoring method described in this study encourages students to both think about…

  9. Housing Costs, Zoning, and Access to High-Scoring Schools

    ERIC Educational Resources Information Center

    Rothwell, Jonathan

    2012-01-01

    The first section of this paper surveys academic research on educational achievement with an emphasis on the relative effects of schools and families in shaping educational outcomes. A methodology section provides a summary of data sources and defines the main variables measured. The paper then examines differences in school test score performance…

  10. Formulas for Image Factor Scores

    ERIC Educational Resources Information Center

    Hakstian, A. Ralph

    1973-01-01

    Formulas are presented in this paper for computing scores associated with factors of G, the image covariance matrix, under three conditions. The subject of the paper is restricted to "pure" image analysis. (Author/NE)

  11. Reading Ages and Standardized Scores

    ERIC Educational Resources Information Center

    Bookbinder, G. E.

    1976-01-01

    Discusses the advantages of and objections to testing children's reading ages and recommends that test results be given for both reading age and percentile levels (rather than standardized scores). (JM)

  12. On the complexity of scoring acute respiratory distress syndrome: do not forget hemodynamics!

    PubMed Central

    Repessé, Xavier; Aubry, Alix

    2016-01-01

    Acute respiratory distress syndrome (ARDS) remains associated with a poor outcome despite recent major therapeutic advances. Forecasting the outcome of patients suffering from such a syndrome is of a crucial interest and many scores have been proposed, all suffering from limits responsible for important discrepancies. Authors try to elaborate simple, routine and reliable scores but most of them do not consider hemodynamics yet acknowledged as a major determinant of outcome. This article aims at reminding the approach of scoring in ARDS and at deeply describing the most recently published one in order to highlight their main pitfall, which is to forget the hemodynamics. PMID:27618840

  13. A prognostic scoring system for arm exercise stress testing

    PubMed Central

    Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, Wade H

    2016-01-01

    Objective Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. Methods In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI). Results Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all p<0.01). A score based on the relation HRR (bpm)+7.3×METs−10.5×ST depression (0=no; 1=yes) prognosticated 5-year cardiovascular mortality with a C-statistic of 0.81 before and 0.88 after adjustment for significant demographic and clinical covariates. Arm exercise scores for the other outcome end points yielded C-statistic values of 0.77–0.79 before and 0.82–0.86 after adjustment for significant covariates versus 0.64–0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period. Conclusions Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise. PMID:26835142

  14. A correlation study of the American Shoulder and Elbow Society Score and the Oxford Shoulder Score with the use of regression analysis to predict one score from the other in patients undergoing reverse shoulder joint arthroplasty for cuff tear arthropathy

    PubMed Central

    Poon, Peter C

    2014-01-01

    Background More than 30 different scoring systems are available for evaluating outcomes of shoulder surgery. Unfortunately, given the multitude of scoring systems, there is no objective method to compare results between studies when different scoring systems are utilized. Methods We compared the American Shoulder and Elbow Society score (ASES) and the Oxford Shoulder Score (OSS) in patients undergoing reverse shoulder arthroplasty for cuff tear arthropathy. Twenty-nine patients had the ASES and OSS recorded pre-operatively, and at 6 and 12 months follow-up. The paired scores were assessed for their degree of correlation and sensitivity to change over time. Linear regression analysis was used to formulate a regression equation to predict one score from the other. Results The ASES and OSS correlated well with a Pearson’s correlation coefficient of 0.91 (p < 0.0001, n = 87). Both scores were sensitive to change. Regression analysis yielded a formula to predict the ASES from the OSS and vice versa with good accuracy (r2 = 0.83, F1,85 = 422.6, p < 0.0001). Conclusions Where good correlation exists, regression formulae can be used to accurately predict one score from the other in a specific population that it has been validated for. This can be of benefit when objectively comparing outcomes between studies using these two scoring systems.

  15. Scoring systems of severity in patients with multiple trauma.

    PubMed

    Rapsang, Amy Grace; Shyam, Devajit Chowlek

    2015-04-01

    Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. PMID:25015031

  16. Rockall score for risk stratification in adult patients with non-variceal upper gastrointestinal hemorrhage.

    PubMed

    Rahman, M W; Sumon, S M; Amin, M R; Kahhar, M A

    2013-10-01

    The Rockall risk score is a simple, validated predictive index that may serve as a useful clinical decision for assessing the risk of subsequent adverse outcomes in patients with non-variceal upper gastrointestinal hemorrhage (UGIH). The observational study was carried out over a period of 6 months from 10th July, 2012 to 09th January, 2013 in Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 60 patients with non-variceal UGIH were taken for the study during study period to see risk stratification by Rockall score and short term hospital outcome in non-variceal upper GI hemorrhage patients. Categorical variables were reported as percentage and Means and proportions were carried out using the Chi-square test of different variables. Among study population age distribution were 42(70%) <60 years, 16(26.7%) from 60-79 years and 02(3.3%) 80 years or above and sex distribution were 39(65%) male and 21(35%) were female patients. Rockall score of patients 11(18.3%) had score 1, 6(10%) had score 2, 13(21.7%) had score 3, 10(16.7%) had score 4, 6(10%) had score 5, 6(10%) had score 6, 4(6.7%) had score 7, 3(5.0%) had score 8 and 1(1.7%) had score 9. Risk stratification showed 30(50%) had low risk (score 3 or <3), 26(43.3%) had moderate risk (score 4-7) and 4(6.7%) had high risk (score 8 or >8). Outcome after initial Rockall scoring and endoscopy were found that 7(11.7%) died, 46(76.6%) survived and 7(11.7%) patients survived with complication. This study showed that Rockall score of ≤3 was predictive of low risk of adverse outcomes, and a score of ≥8 was predictive of high mortality and was useful in identifying patients with non-variceal UGIH who had low-risk scores in order to triage appropriately, without affecting patient outcomes. PMID:24292298

  17. Evaluation of Student Factors Associated with Pre-NAPLEX Scores

    PubMed Central

    Spivey, Christina A.; McDonough, Sharon; Phelps, Stephanie; Byrd, Debbie

    2014-01-01

    Objective: To examine relationships among students’ Pre-NAPLEX scores and prepharmacy, pharmacy school, and demographic variables to better understand factors that may contribute to Pre-NAPLEX performance. Methods: A retrospective review of pharmacy students’ Pre-NAPLEX scores, demographics, prepharmacy factors, and pharmacy school factors was performed. Bivariate (eg, ANOVA) and correlational analyses and stepwise linear regression were conducted to examine the significance of various factors and their relationship to Pre-NAPLEX score. Results: 168 students were included, with the majority being female (60.7%) and White (72%). Mean Pre-NAPLEX score was 68.95 ± 14.5. Non-Hispanic White students had significantly higher Pre-NAPLEX scores compared to minority students (p<0.001). Pre-NAPLEX score was correlated (p<0.001) to race/ethnicity (r=-0.341), PCAT score (r=0.272), and pharmacy school GPA (r=0.346). The regression model (adjusted R2=0.216; p<0.001) included pharmacy school GPA, academic probation, academic remediation, and PCAT composite. Conclusion: This study highlighted that select demographic, prepharmacy, and pharmacy school factors were associated with Pre-NAPLEX outcomes. Such factors may assist colleges/schools of pharmacy in identifying students who may be at risk for poorer NAPLEX performance and may need greater preparation. PMID:25657368

  18. Upper gastrointestinal bleeding risk scores: Who, when and why?

    PubMed Central

    Monteiro, Sara; Gonçalves, Tiago Cúrdia; Magalhães, Joana; Cotter, José

    2016-01-01

    Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of the complications, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. The use of risk scoring systems in early assessment of patients suffering from UGIB may be useful to distinguish high-risks patients, who may need clinical intervention and hospitalization, from low risk patients with a lower chance of developing complications, in which management as outpatients can be considered. Although several scores have been published and validated for predicting different outcomes, the most frequently cited ones are the Rockall score and the Glasgow Blatchford score (GBS). While Rockall score, which incorporates clinical and endoscopic variables, has been validated to predict mortality, the GBS, which is based on clinical and laboratorial parameters, has been studied to predict the need of clinical intervention. Despite the advantages previously reported, their use in clinical decisions is still limited. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact. PMID:26909231

  19. Can Score Databanks Help Teaching?

    PubMed Central

    Almeida, Alessandro; Barral-Netto, Manoel

    2011-01-01

    Background Basic courses in most medical schools assess students' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students' grades. Methodology/Principal Findings We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378–4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495–3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern. Conclusion/Significance An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student's performance. PMID:21246033

  20. Ligand Identification Scoring Algorithm (LISA)

    PubMed Central

    Zheng, Zheng; Merz, Kenneth M.

    2011-01-01

    A central problem in de novo drug design is determining the binding affinity of a ligand with a receptor. A new scoring algorithm is presented that estimates the binding affinity of a protein-ligand complex given a three-dimensional structure. The method, LISA (Ligand Identification Scoring Algorithm), uses an empirical scoring function to describe the binding free energy. Interaction terms have been designed to account for van der Waals (VDW) contacts, hydrogen bonding, desolvation effects and metal chelation to model the dissociation equilibrium constants using a linear model. Atom types have been introduced to differentiate the parameters for VDW, H-bonding interactions and metal chelation between different atom pairs. A training set of 492 protein-ligand complexes was selected for the fitting process. Different test sets have been examined to evaluate its ability to predict experimentally measured binding affinities. By comparing with other well known scoring functions, the results show that LISA has advantages over many existing scoring functions in simulating protein-ligand binding affinity, especially metalloprotein-ligand binding affinity. Artificial Neural Network (ANN) was also used in order to demonstrate that the energy terms in LISA are well designed and do not require extra cross terms. PMID:21561101

  1. [Trauma scores: reproducibility and reliability].

    PubMed

    Waydhas, C; Nast-Kolb, D; Trupka, A; Kerim-Sade, C; Kanz, G; Zoller, J; Schweiberer, L

    1992-02-01

    The inter-rater reliability of the Injury Severity Score (ISS) and the Polytraumaschlüssel (PTS) [multiple trauma code] was studied using diagnosis sheets filled in for 107 multiple injured patients. The scoring was performed by eight physicians with different levels of qualification. The scores for individual patients varied widely depending on the scorer, with extremes differing from the mean by about 80% and 70% for the ISS and PTS, respectively. The mean ISS and PTS for the whole study population also varied significantly between the scorers (P less than 0.0001, one-way analysis of variance). Raters with experience in trauma scoring calculated significantly higher scores (P less than 0.01, t-test) Neither the ISS nor the PTS seem reliable enough to describe injury severity in an individual patient. Treatment decisions must not be based on such grounds. Even for larger groups, caution must be exercised in comparison of different populations of multiple traumatized patients. PMID:1570531

  2. Does the Surgical Apgar Score Measure Intraoperative Performance?

    PubMed Central

    Regenbogen, Scott E.; Lancaster, R. Todd; Lipsitz, Stuart R.; Greenberg, Caprice C.; Hutter, Matthew M.; Gawande, Atul A.

    2008-01-01

    Objective To evaluate whether Surgical Apgar Scores measure the relationship between intraoperative care and surgical outcomes. Summary Background Data With preoperative risk-adjustment now well-developed, the role of intraoperative performance in surgical outcomes may be considered. We previously derived and validated a ten-point Surgical Apgar Score—based on intraoperative blood loss, heart rate, and blood pressure—that effectively predicts major postoperative complications within 30 days of general and vascular surgery. This study evaluates whether the predictive value of this score comes solely from patients’ preoperative risk, or also measures care in the operating room. Methods Among a systematic sample of 4,119 general and vascular surgery patients at a major academic hospital, we constructed a detailed risk-prediction model including 27 patient-comorbidity and procedure-complexity variables, and computed patients’ propensity to suffer a major postoperative complication. We evaluated the prognostic value of patients’ Surgical Apgar Scores before and after adjustment for this preoperative risk. Results After risk-adjustment, the Surgical Apgar Score remained strongly correlated with postoperative outcomes (p<0.0001). Odds of major complications among average-scoring patients (scores 7–8) were equivalent to preoperative predictions (likelihood ratio (LR) 1.05, 95%CI 0.78–1.41), significantly decreased for those who achieved the best scores of 9–10 (LR 0.52, 95%CI 0.35–0.78), and were significantly poorer for those with low scores—LRs 1.60 (1.12–2.28) for scores 5–6, and 2.80 (1.50–5.21) for scores 0–4. Conclusions Even after accounting for fixed preoperative risk—due to patients’ acute condition, comorbidities and/or operative complexity—the Surgical Apgar Score appears to detect differences in intraoperative management that reduce odds of major complications by half, or increase them by nearly three-fold. PMID:18650644

  3. Interpreting Force Concept Inventory Scores: Normalized Gain and SAT Scores

    ERIC Educational Resources Information Center

    Coletta, Vincent P.; Phillips, Jeffrey A.; Steinert, Jeffrey J.

    2007-01-01

    Preinstruction SAT scores and normalized gains (G) on the force concept inventory (FCI) were examined for individual students in interactive engagement (IE) courses in introductory mechanics at one high school (N=335) and one university (N=292), and strong, positive correlations were found for both populations (r=0.57 and r=0.46, respectively).…

  4. A Bootstrap Procedure of Propensity Score Estimation

    ERIC Educational Resources Information Center

    Bai, Haiyan

    2013-01-01

    Propensity score estimation plays a fundamental role in propensity score matching for reducing group selection bias in observational data. To increase the accuracy of propensity score estimation, the author developed a bootstrap propensity score. The commonly used propensity score matching methods: nearest neighbor matching, caliper matching, and…

  5. Electronic Scoring of Essays: Does Topic Matter?

    ERIC Educational Resources Information Center

    James, Cindy L.

    2008-01-01

    The scoring of student essays by computer has generated much debate and subsequent research. The majority of the research thus far has focused on validating the automated scoring tools by comparing the electronic scores to human scores of writing or other measures of writing skills, and exploring the predictive validity of the automated scores.…

  6. Estimating Decision Indices Based on Composite Scores

    ERIC Educational Resources Information Center

    Knupp, Tawnya Lee

    2009-01-01

    The purpose of this study was to develop an IRT model that would enable the estimation of decision indices based on composite scores. The composite scores, defined as a combination of unidimensional test scores, were either a total raw score or an average scale score. Additionally, estimation methods for the normal and compound multinomial models…

  7. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991.

    PubMed

    Campbell, N N; Tooley, M A; Willatts, S M

    1994-02-01

    In this paper we present a detailed analysis of the use of the APACHE II (acute physiological and chronic health evaluation) scoring system on all of the patients admitted to the general intensive care unit at the Bristol Royal Infirmary over a 20-month period. The 6-month survival of 691 adult medical and surgical patients following intensive care was recorded and this data was analysed with admission and daily APACHE II scores using a relational database. Our data confirms the relationship between admission APACHE II scores and outcome, with mean scores decreasing as duration of survival increases. We also demonstrate that the best day one scores are approximately 50% less than the admission score, irrespective of outcome, indicating the benefit of intensive care. By contrast, however, the scores on day one have either not improved or have worsened since admission, reflecting the importance of the pre-morbid health status of the patient in determining outcome from intensive care. PMID:8196033

  8. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991.

    PubMed Central

    Campbell, N N; Tooley, M A; Willatts, S M

    1994-01-01

    In this paper we present a detailed analysis of the use of the APACHE II (acute physiological and chronic health evaluation) scoring system on all of the patients admitted to the general intensive care unit at the Bristol Royal Infirmary over a 20-month period. The 6-month survival of 691 adult medical and surgical patients following intensive care was recorded and this data was analysed with admission and daily APACHE II scores using a relational database. Our data confirms the relationship between admission APACHE II scores and outcome, with mean scores decreasing as duration of survival increases. We also demonstrate that the best day one scores are approximately 50% less than the admission score, irrespective of outcome, indicating the benefit of intensive care. By contrast, however, the scores on day one have either not improved or have worsened since admission, reflecting the importance of the pre-morbid health status of the patient in determining outcome from intensive care. PMID:8196033

  9. Risk models and scores for type 2 diabetes: systematic review

    PubMed Central

    Mathur, Rohini; Dent, Tom; Meads, Catherine; Greenhalgh, Trisha

    2011-01-01

    Objective To evaluate current risk models and scores for type 2 diabetes and inform selection and implementation of these in practice. Design Systematic review using standard (quantitative) and realist (mainly qualitative) methodology. Inclusion criteria Papers in any language describing the development or external validation, or both, of models and scores to predict the risk of an adult developing type 2 diabetes. Data sources Medline, PreMedline, Embase, and Cochrane databases were searched. Included studies were citation tracked in Google Scholar to identify follow-on studies of usability or impact. Data extraction Data were extracted on statistical properties of models, details of internal or external validation, and use of risk scores beyond the studies that developed them. Quantitative data were tabulated to compare model components and statistical properties. Qualitative data were analysed thematically to identify mechanisms by which use of the risk model or score might improve patient outcomes. Results 8864 titles were scanned, 115 full text papers considered, and 43 papers included in the final sample. These described the prospective development or validation, or both, of 145 risk prediction models and scores, 94 of which were studied in detail here. They had been tested on 6.88 million participants followed for up to 28 years. Heterogeneity of primary studies precluded meta-analysis. Some but not all risk models or scores had robust statistical properties (for example, good discrimination and calibration) and had been externally validated on a different population. Genetic markers added nothing to models over clinical and sociodemographic factors. Most authors described their score as “simple” or “easily implemented,” although few were specific about the intended users and under what circumstances. Ten mechanisms were identified by which measuring diabetes risk might improve outcomes. Follow-on studies that applied a risk score as part of an

  10. Does weight affect children's test scores and teacher assessments differently?

    PubMed

    Zavodny, Madeline

    2013-06-01

    The prevalence of childhood overweight and obesity increased dramatically in the United States during the past three decades. This increase has adverse public health implications, but its implication for children's academic outcomes is less clear. This paper uses data from five waves of the Early Childhood Longitudinal Study-Kindergarten to examine how children's weight is related to their scores on standardized tests and to their teachers' assessments of their academic ability. The results indicate that children's weight is more negatively related to teacher assessments of their academic performance than to test scores. PMID:24014932

  11. LSAT Scores of Economics Majors.

    ERIC Educational Resources Information Center

    Nieswiadomy, Michael

    1998-01-01

    Argues that economics education provides many benefits to students, including preparation for law school. Examines the ranking of economics majors on the Law School Admission Test (LSAT). Finds that among the 14 majors having more than 2,000 students take the LSAT, economics students received the highest average score. (DSK)

  12. An international study to increase concordance in Ki67 scoring.

    PubMed

    Polley, Mei-Yin C; Leung, Samuel C Y; Gao, Dongxia; Mastropasqua, Mauro G; Zabaglo, Lila A; Bartlett, John M S; McShane, Lisa M; Enos, Rebecca A; Badve, Sunil S; Bane, Anita L; Borgquist, Signe; Fineberg, Susan; Lin, Ming-Gang; Gown, Allen M; Grabau, Dorthe; Gutierrez, Carolina; Hugh, Judith C; Moriya, Takuya; Ohi, Yasuyo; Osborne, C Kent; Penault-Llorca, Frédérique M; Piper, Tammy; Porter, Peggy L; Sakatani, Takashi; Salgado, Roberto; Starczynski, Jane; Lænkholm, Anne-Vibeke; Viale, Giuseppe; Dowsett, Mitch; Hayes, Daniel F; Nielsen, Torsten O

    2015-06-01

    Although an important biomarker in breast cancer, Ki67 lacks scoring standardization, which has limited its clinical use. Our previous study found variability when laboratories used their own scoring methods on centrally stained tissue microarray slides. In this current study, 16 laboratories from eight countries calibrated to a specific Ki67 scoring method and then scored 50 centrally MIB-1 stained tissue microarray cases. Simple instructions prescribed scoring pattern and staining thresholds for determination of the percentage of stained tumor cells. To calibrate, laboratories scored 18 'training' and 'test' web-based images. Software tracked object selection and scoring. Success for the calibration was prespecified as Root Mean Square Error of scores compared with reference <0.6 and Maximum Absolute Deviation from reference <1.0 (log2-transformed data). Prespecified success criteria for tissue microarray scoring required intraclass correlation significantly >0.70 but aiming for observed intraclass correlation ≥0.90. Laboratory performance showed non-significant but promising trends of improvement through the calibration exercise (mean Root Mean Square Error decreased from 0.6 to 0.4, Maximum Absolute Deviation from 1.6 to 0.9; paired t-test: P=0.07 for Root Mean Square Error, 0.06 for Maximum Absolute Deviation). For tissue microarray scoring, the intraclass correlation estimate was 0.94 (95% credible interval: 0.90-0.97), markedly and significantly >0.70, the prespecified minimum target for success. Some discrepancies persisted, including around clinically relevant cutoffs. After calibrating to a common scoring method via a web-based tool, laboratories can achieve high inter-laboratory reproducibility in Ki67 scoring on centrally stained tissue microarray slides. Although these data are potentially encouraging, suggesting that it may be possible to standardize scoring of Ki67 among pathology laboratories, clinically important discrepancies persist. Before

  13. Correcting for Test Score Measurement Error in ANCOVA Models for Estimating Treatment Effects

    ERIC Educational Resources Information Center

    Lockwood, J. R.; McCaffrey, Daniel F.

    2014-01-01

    A common strategy for estimating treatment effects in observational studies using individual student-level data is analysis of covariance (ANCOVA) or hierarchical variants of it, in which outcomes (often standardized test scores) are regressed on pretreatment test scores, other student characteristics, and treatment group indicators. Measurement…

  14. Neurodevelopmental Outcome in Preterm Infants

    ERIC Educational Resources Information Center

    Bos, Arend F.; Roze, Elise

    2011-01-01

    Aim: To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. Method: One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6wk; birthweight 480-2275g) were assessed for cognition and motor outcome at 6…

  15. THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS

    PubMed Central

    BEDUSCHI, Murilo Gamba; MELLO, André Luiz Parizi; VON-MÜHLEN, Bruno; FRANZON, Orli

    2016-01-01

    Background : About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. Objective : To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Methods : Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Results : Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. Conclusion : The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis. PMID:27120730

  16. Therapist Perception of Treatment Outcome: Evaluating Treatment Outcomes among Youth with Antisocial Behavior Problems

    PubMed Central

    Crandal, Brent R.; Foster, Sharon L.; Chapman, Jason E.; Cunningham, Phillippe B.; Brennan, Patricia A.; Whitmore, Elizabeth A.

    2014-01-01

    Effective evaluation of treatment requires the use of measurement tools producing reliable scores that can be used to make valid decisions about the outcomes of interest. Therapist-rated treatment outcome scores that are obtained within the context of empirically supported treatments (EST) could provide clinicians and researchers with data that are easily accessible and complimentary to existing instrumentation. We examined the psychometric properties of scores from the Therapist Perception of Treatment Outcome: Youth Antisocial Behavior (TPTO:YAB), an instrument developed to assess therapist judgments of treatment success among families participating in an EST, Multsystemic Therapy (MST), for youth with antisocial behavior problems. Data were drawn from a longitudinal study of MST. The initial 20-item TPTO was completed by therapists of 111 families at mid-treatment and 163 families at treatment termination. Rasch model dimensionality analyses provided evidence for two dimensions reflecting youth- and caregiver-related aspects of treatment outcome, although a bifactor analyses suggested that these dimensions reflected a single more general construct. Rasch analyses were also used to assess item and rating scale characteristics and refine the number of items. These analyses suggested items performed similarly across time and that scores reflect treatment outcome in similar ways at mid and post-treatment. Multilevel and zero-order analyses provided evidence for the validity of TPTO scores. TPTO scores were moderately correlated with scores of youth and caregiver behaviors targeted in treatment, adding support to its use as a treatment outcome measurement instrument. PMID:25642936

  17. Multiple comparisons for survival data with propensity score adjustment

    PubMed Central

    Zhu, Hong; Lu, Bo

    2015-01-01

    This article considers the practical problem in clinical and observational studies where multiple treatment or prognostic groups are compared and the observed survival data are subject to right censoring. Two possible formulations of multiple comparisons are suggested. Multiple Comparisons with a Control (MCC) compare every other group to a control group with respect to survival outcomes, for determining which groups are associated with lower risk than the control. Multiple Comparisons with the Best (MCB) compare each group to the truly minimum risk group and identify the groups that are either with the minimum risk or the practically minimum risk. To make a causal statement, potential confounding effects need to be adjusted in the comparisons. Propensity score based adjustment is popular in causal inference and can effectively reduce the confounding bias. Based on a propensity-score-stratified Cox proportional hazards model, the approaches of MCC test and MCB simultaneous confidence intervals for general linear models with normal error outcome are extended to survival outcome. This paper specifies the assumptions for causal inference on survival outcomes within a potential outcome framework, develops testing procedures for multiple comparisons and provides simultaneous confidence intervals. The proposed methods are applied to two real data sets from cancer studies for illustration, and a simulation study is also presented. PMID:25663729

  18. Do Examinees Understand Score Reports for Alternate Methods of Scoring Computer Based Tests?

    ERIC Educational Resources Information Center

    Whittaker, Tiffany A.; Williams, Natasha J.; Dodd, Barbara G.

    2011-01-01

    This study assessed the interpretability of scaled scores based on either number correct (NC) scoring for a paper-and-pencil test or one of two methods of scoring computer-based tests: an item pattern (IP) scoring method and a method based on equated NC scoring. The equated NC scoring method for computer-based tests was proposed as an alternative…

  19. scoringRules - A software package for probabilistic model evaluation

    NASA Astrophysics Data System (ADS)

    Lerch, Sebastian; Jordan, Alexander; Krüger, Fabian

    2016-04-01

    Models in the geosciences are generally surrounded by uncertainty, and being able to quantify this uncertainty is key to good decision making. Accordingly, probabilistic forecasts in the form of predictive distributions have become popular over the last decades. With the proliferation of probabilistic models arises the need for decision theoretically principled tools to evaluate the appropriateness of models and forecasts in a generalized way. Various scoring rules have been developed over the past decades to address this demand. Proper scoring rules are functions S(F,y) which evaluate the accuracy of a forecast distribution F , given that an outcome y was observed. As such, they allow to compare alternative models, a crucial ability given the variety of theories, data sources and statistical specifications that is available in many situations. This poster presents the software package scoringRules for the statistical programming language R, which contains functions to compute popular scoring rules such as the continuous ranked probability score for a variety of distributions F that come up in applied work. Two main classes are parametric distributions like normal, t, or gamma distributions, and distributions that are not known analytically, but are indirectly described through a sample of simulation draws. For example, Bayesian forecasts produced via Markov Chain Monte Carlo take this form. Thereby, the scoringRules package provides a framework for generalized model evaluation that both includes Bayesian as well as classical parametric models. The scoringRules package aims to be a convenient dictionary-like reference for computing scoring rules. We offer state of the art implementations of several known (but not routinely applied) formulas, and implement closed-form expressions that were previously unavailable. Whenever more than one implementation variant exists, we offer statistically principled default choices.

  20. Scores and scales used in emergency medicine. Practicability in toxicology.

    PubMed

    Oprita, B; Aignatoaie, B; Gabor-Postole, D A

    2014-01-01

    Medical scores, criteria and classification systems support clinical decision-making and management. They enable the clinician to predict the outcome, stratify risk, assess conditions and diagnose diseases accurately. In the emergency medicine, it is very important to ascertain safety criteria to discharge patients, time to remain in the E.R., and also ascertain the time intervals for discharge/admission. The use of the scores in the emergency medicine, toxicology and other areas of intensive medicine have become increasingly efficient. Creating a prognostic score for the acute intoxications to be used by the personnel from the Emergency Departments may have positive effects in the management of the poisoned patients (e.g. the admission in a certain treatment space: cases expected to have a trend towards worsening will be directed to the resuscitation space and after a short period of time admitted in the appropriate facility; this way, the bed occupancy time in the Emergency Department will be shortened). PMID:25870686

  1. Creating and Assessing Student Perception of an Examination Mastery Score Report for a Pharmacotherapy Course

    PubMed Central

    Nuzum, Donald S.; Pegram, Angela; Harris, John Brock

    2015-01-01

    Objective. To compare student-perceived utility of two types of score reports. Methods. Assessment standards were followed to create a new examination score report for pharmacotherapy coursework. Student examination scores were returned using the traditional score report, the utility of which students rated along 9 dimensions. A mastery score report was also distributed, and students rated it on the same 9 dimensions. The ratings were compared to determine which the students perceived as more useful. Results. The students rated the mastery score report significantly better on each of the 9 dimensions and in aggregate. Conclusion. Pharmacy students perceived the mastery score report as more useful in helping them improve their achievement of educational outcomes. PMID:26889064

  2. Interpreting force concept inventory scores: Normalized gain and SAT scores

    NASA Astrophysics Data System (ADS)

    Coletta, Vincent P.; Phillips, Jeffrey A.; Steinert, Jeffrey J.

    2007-06-01

    Preinstruction SAT scores and normalized gains (G) on the force concept inventory (FCI) were examined for individual students in interactive engagement (IE) courses in introductory mechanics at one high school (N=335) and one university (N=292) , and strong, positive correlations were found for both populations ( r=0.57 and r=0.46 , respectively). These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  3. Item Response Modeling with Sum Scores

    ERIC Educational Resources Information Center

    Johnson, Timothy R.

    2013-01-01

    One of the distinctions between classical test theory and item response theory is that the former focuses on sum scores and their relationship to true scores, whereas the latter concerns item responses and their relationship to latent scores. Although item response theory is often viewed as the richer of the two theories, sum scores are still…

  4. An Optimizing Weight For Wrong Scores.

    ERIC Educational Resources Information Center

    Donlon, Thomas F.

    This study empirically determined the optimizing weight to be applied to the Wrongs Total Score in scoring rubrics of the general form = R - kW, where S is the Score, R the Rights Total, k the weight and W the Wrongs Total, if reliability is to be maximized. As is well known, the traditional formula score rests on a theoretical framework which is…

  5. Comparison of Calipers for Matching on the Disease Risk Score.

    PubMed

    Connolly, John G; Gagne, Joshua J

    2016-05-15

    Previous studies have compared calipers for propensity score (PS) matching, but none have considered calipers for matching on the disease risk score (DRS). We used Medicare claims data to perform 3 cohort studies of medication initiators: a study of raloxifene versus alendronate in 1-year nonvertebral fracture risk, a study of cyclooxygenase 2 inhibitors versus nonselective nonsteroidal antiinflammatory medications in 6-month gastrointestinal bleeding, and a study of simvastatin + ezetimibe versus simvastatin alone in 6-month cardiovascular outcomes. The study periods for each cohort were 1998 through 2005, 1999 through 2002, and 2004 through 2005, respectively. In each cohort, we calculated 1) a DRS, 2) a prognostic PS which included the DRS as the independent variable in a PS model, and 3) the PS for each patient. We then nearest-neighbor matched on each score in a variable ratio and a fixed ratio within 8 calipers based on the standard deviation of the logit and the natural score scale. When variable ratio matching on the DRS, a caliper of 0.05 on the natural scale performed poorly when the outcome was rare. The prognostic PS did not appear to offer any consistent practical benefits over matching on the DRS directly. In general, logit-based calipers or calipers smaller than 0.05 on the natural scale performed well when DRS matching in all examples. PMID:27037270

  6. The Matter of Assessor Variance in Early Childhood Education--Or Whose Score Is It Anyway?

    ERIC Educational Resources Information Center

    Waterman, Clare; McDermott, Paul A.; Fantuzzo, John W.; Gadsden, Vivian L.

    2012-01-01

    Useful assessment outcomes (as manifest through assigned scores) must show reasonable variation across children because it is that variation that presumably defines children's individual differences. Alternatively it is conceivable that some portion of the variability in assessment outcomes does not reflect child differences but rather differences…

  7. Validation of the Pittsburgh Cardiac Arrest Category illness severity score

    PubMed Central

    Coppler, Patrick J.; Elmer, Jonathan; Calderon, Luis; Sabedra, Alexa; Doshi, Ankur A.; Callaway, Clifton W.; Rittenberger, Jon C.; Dezfulian, Cameron

    2015-01-01

    Background The purpose of this study was to validate the ability of an early post-cardiac arrest illness severity classification to predict patient outcomes. Methods The Pittsburgh Cardiac Arrest Category (PCAC) is a 4-level illness severity score that was found to be strongly predictive of outcomes in the initial derivation study. We assigned PCAC scores to consecutive in and out-of-hospital cardiac arrest subjects treated at two tertiary care centers between January 2011 and September 2013. We made assignments prospectively at Site 1 and retrospectively at Site 2. Our primary outcome was survival to hospital discharge. Inter-rater reliability of retrospective PCAC assessments was assessed. Secondary outcomes were favorable discharge disposition (home or acute rehabilitation), Cerebral Performance Category (CPC) and modified Rankin Scale (mRS) at hospital discharge. We tested the association of PCAC with each outcome using unadjusted and multivariable logistic regression. Results We included 607 cardiac arrest patients during the study (393 at Site 1 and 214 at Site 2). Site populations differed in age, arrest location, rhythm, use of hypothermia and distribution of PCAC. Inter-rater reliability of retrospective PCAC assignments was excellent (κ=0.81). PCAC was associated with survival (unadjusted odds ratio (OR) for Site 1: 0.33 (95% confidence interval (CI) 0.27–0.41)) Site 2: 0.32 (95%CI 0.24–0.43)) even after adjustment for other clinical variables (adjusted OR Site 1: 0.32 (95%CI 0.25–0.41)) Site 2: 0.31 (95%CI 0.22–0.44)). PCAC was predictive of secondary outcomes. Conclusions Our results confirm that PCAC is strongly predictive of survival and good functional outcome after cardiac arrest. PMID:25636896

  8. The Thoracolumbar AOSpine Injury Score

    PubMed Central

    Kepler, Christopher K.; Vaccaro, Alexander R.; Schroeder, Gregory D.; Koerner, John D.; Vialle, Luiz R.; Aarabi, Bizhan; Rajasekaran, Shanmuganathan; Bellabarba, Carlo; Chapman, Jens R.; Kandziora, Frank; Schnake, Klaus J.; Dvorak, Marcel F.; Reinhold, Max; Oner, F. Cumhur

    2015-01-01

    Study Design Survey of 100 worldwide spine surgeons. Objective To develop a spine injury score for the AOSpine Thoracolumbar Spine Injury Classification System. Methods Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System. Using the results, as well as limited input from the AOSpine Trauma Knowledge Forum, the Thoracolumbar AOSpine Injury Score was developed. Results Beginning with 1 point for A1, groups A, B, and C were consecutively awarded an additional point (A1, 1 point; A2, 2 points; A3, 3 points); however, because of a significant increase in the severity between A3 and A4 and because the severity of A4 and B1 was similar, both A4 and B1 were awarded 5 points. An uneven stepwise increase in severity moving from N0 to N4, with a substantial increase in severity between N2 (nerve root injury with radicular symptoms) and N3 (incomplete spinal cord injury) injuries, was identified. Hence, each grade of neurologic injury was progressively given an additional point starting with 0 points for N0, and the substantial difference in severity between N2 and N3 injuries was recognized by elevating N3 to 4 points. Finally, 1 point was awarded to the M1 modifier (indeterminate posterolateral ligamentous complex injury). Conclusion The Thoracolumbar AOSpine Injury Score is an easy-to-use, data-driven metric that will allow for the development of a surgical algorithm to accompany the AOSpine Thoracolumbar Spine Injury Classification System. PMID:27190734

  9. The Thoracolumbar AOSpine Injury Score.

    PubMed

    Kepler, Christopher K; Vaccaro, Alexander R; Schroeder, Gregory D; Koerner, John D; Vialle, Luiz R; Aarabi, Bizhan; Rajasekaran, Shanmuganathan; Bellabarba, Carlo; Chapman, Jens R; Kandziora, Frank; Schnake, Klaus J; Dvorak, Marcel F; Reinhold, Max; Oner, F Cumhur

    2016-06-01

    Study Design Survey of 100 worldwide spine surgeons. Objective To develop a spine injury score for the AOSpine Thoracolumbar Spine Injury Classification System. Methods Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System. Using the results, as well as limited input from the AOSpine Trauma Knowledge Forum, the Thoracolumbar AOSpine Injury Score was developed. Results Beginning with 1 point for A1, groups A, B, and C were consecutively awarded an additional point (A1, 1 point; A2, 2 points; A3, 3 points); however, because of a significant increase in the severity between A3 and A4 and because the severity of A4 and B1 was similar, both A4 and B1 were awarded 5 points. An uneven stepwise increase in severity moving from N0 to N4, with a substantial increase in severity between N2 (nerve root injury with radicular symptoms) and N3 (incomplete spinal cord injury) injuries, was identified. Hence, each grade of neurologic injury was progressively given an additional point starting with 0 points for N0, and the substantial difference in severity between N2 and N3 injuries was recognized by elevating N3 to 4 points. Finally, 1 point was awarded to the M1 modifier (indeterminate posterolateral ligamentous complex injury). Conclusion The Thoracolumbar AOSpine Injury Score is an easy-to-use, data-driven metric that will allow for the development of a surgical algorithm to accompany the AOSpine Thoracolumbar Spine Injury Classification System. PMID:27190734

  10. Outcomes evaluation of the athletic elbow.

    PubMed

    Freehill, Michael T; Mannava, Sandeep; Safran, Marc R

    2014-09-01

    The high-level athletic population poses difficulty when evaluating outcomes in orthopedic surgery, given generally good overall health and high function at baseline. Subtle differences in performance following injury or orthopedic surgery are hard to detect in high-performance athletes using standard outcome metrics; however, attaining these subtle improvements after injury or surgery are key to an athletes' livelihood. Outcome measures serve as the cornerstone for critical evaluation of clinical outcomes following orthopedic surgery or injury. In the age of "evidence-based medicine" and "pay-for-performance" accountability for surgical intervention, understanding clinically relevant outcome measures is essential for careful review of the published literature, as well as one's own critical review of surgical performance. The purpose of this manuscript is to evaluate clinical outcome measures in the context of the athletic elbow. An emphasis will be placed on evaluation of the 5 most clinically relevant outcome measures for sports-related elbow outcomes: (1) American Shoulder and Elbow Committee; (2) Mayo Elbow Performance Index; (3) Andrews-Timmerman [and its precursor the (4) Andrews-Carson]; and (5) Kerlan-Jobe Orthopaedic Clinic overhead athlete score. A final outcome measure that will be analyzed is "return to play" statistics, which has been published in various studies of athletes' recovery from elbow surgery, as well as, the outcomes metric known as the "Conway-Jobe scale." Although there is no perfect outcomes score for the athletic elbow, the Kerlan-Jobe Orthopaedic Clinic score is the only outcomes tool developed and validated for outcomes for elbow injuries in the overhead athlete, as compared with the Andrew-Timmerman and Conway-Jobe metrics, which were not validated outcome measures for the elbow in this patient population. Despite the Disabilities of Arm, Shoulder, Hand (DASH) (and DASH-Sport module) being validated in the general population, this