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Clinical Decision Rule

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141. Trustworthy or flawed clinical prediction rule? Full Text available with Trip Pro

Trustworthy or flawed clinical prediction rule? 29415758 2018 05 14 2018 12 02 1466-609X 22 1 2018 02 08 Critical care (London, England) Crit Care Trustworthy or flawed clinical prediction rule? 31 10.1186/s13054-018-1961-9 Granholm Anders A Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Perner Anders A Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen (...) in Intensive Care, Blegdamsvej 9, 2100, Copenhagen, Denmark. mortenhylander@gmail.com. eng Letter Comment 2018 02 08 England Crit Care 9801902 1364-8535 IM Crit Care. 2017 Dec 12;21(1):301 29233160 Decision Support Techniques Emergency Service, Hospital Humans Predictive Value of Tests 2017 12 23 2018 01 18 2018 2 9 6 0 2018 2 9 6 0 2018 5 15 6 0 epublish 29415758 10.1186/s13054-018-1961-9 10.1186/s13054-018-1961-9 PMC5804002 J Clin Epidemiol. 2011 Sep;64(9):993-1000 21411281 Intensive Care Med. 2014 Apr

2018 Critical Care

142. "Rule of Spence" and Dickman's Classification of Transverse Atlantal Ligament Injury Revisited: Discrepancy of Prediction on Atlantoaxial Stability Based on Clinical Outcome of Non-Operative Treatment for Atlas Fractures. (Abstract)

"Rule of Spence" and Dickman's Classification of Transverse Atlantal Ligament Injury Revisited: Discrepancy of Prediction on Atlantoaxial Stability Based on Clinical Outcome of Non-Operative Treatment for Atlas Fractures. Detailed clinical information of 13 adult patients with acute atlantal fractures underwent nonoperative treatment was retrospectively studied. "Rule of Spence" was found inaccurate in predicting either integrity of transverse atlantal ligament (TAL) or atlantoaxial stability (...) , whereas Dickman's classification of TAL injury was more superior to "rule of Spence" on both prediction.A retrospective study.To evaluate the prediction accuracy of "Rule of Spence" and Dickman's classification of the transverse atlantal ligament (TAL) injury on clinical outcomes (mainly focused on atlantoaxial stability) of atlas fractures treated nonoperatively.TAL is regarded as primary stabilizer of the atlantoaxial complex. Atlas fractures are categorized as unstable and stable according to TAL

2018 Spine

143. Psychiatric Medications and Reproductive Safety: Scientific and Clinical Perspectives Pertaining to the US FDA Pregnancy and Lactation Labeling Rule. Full Text available with Trip Pro

Psychiatric Medications and Reproductive Safety: Scientific and Clinical Perspectives Pertaining to the US FDA Pregnancy and Lactation Labeling Rule. Pregnancy labeling of prescription medications in the US is in the midst of a major transformation. The FDA's previous system, which used letter ratings to convey drug safety, was simple but led to misunderstandings-both faulty assurances and undue concerns. The new system, established under the Pregnancy and Lactation Labeling Rule, aims for more (...) descriptive and up-to-date explanations of risk as well as context needed for informed decision-making based on available data. In April 2017, a conference titled "Pharmacovigilance, Reproductive Safety, and the Pregnancy and Lactation Labeling Rule" brought together clinicians and researchers, FDA officials, and representatives of the public and industry to discuss a host of questions relating to the new system. This Academic Highlights article summarizes their discussions, which included topics

2018 Journal of Clinical Psychiatry

144. Query-constraint-based mining of association rules for exploratory analysis of clinical datasets in the National Sleep Research Resource. Full Text available with Trip Pro

literature-based evidence may serve as the candidates for new hypotheses to explore and investigate. Together with literature-based evidence, the association rules mined over the NSRR clinical datasets may be used to support clinical decisions for sleep-related problems. (...) Query-constraint-based mining of association rules for exploratory analysis of clinical datasets in the National Sleep Research Resource. Association Rule Mining (ARM) has been widely used by biomedical researchers to perform exploratory data analysis and uncover potential relationships among variables in biomedical datasets. However, when biomedical datasets are high-dimensional, performing ARM on such datasets will yield a large number of rules, many of which may be uninteresting. Especially

2018 Medical Informatics and Decision Making

145. The Development and Validation of a Clinical Prediction Rule to Predict Transmission of Methicillin-Resistant Staphylococcus aureus in Nursing Homes. Full Text available with Trip Pro

, resident dependency on HCWs for care, the presence of any medical device, diabetes mellitus, and chronic skin breakdown, showed good performance (C statistic = 0.70; sensitivity = 76%, specificity = 49%) in the development set. The decision curve analysis indicated that this model has greater clinical utility than use of a nares surveillance culture for MRSA colonization, which is current clinical practice for placing hospital inpatients on Contact Precautions. The prediction rule demonstrated less (...) The Development and Validation of a Clinical Prediction Rule to Predict Transmission of Methicillin-Resistant Staphylococcus aureus in Nursing Homes. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among nursing home residents is high. Health-care workers (HCWs) often serve as a vector in MRSA transmission. The ability to identify residents who are likely to transmit MRSA to HCWs' hands and clothing during clinical care is important so that infection control

2018 American Journal of Epidemiology

146. Effectiveness and Safety of a Clinical Assessment and 0h/1h Troponin Rule-Out Protocol

Effectiveness and Safety of a Clinical Assessment and 0h/1h Troponin Rule-Out Protocol Effectiveness and Safety of a Clinical Assessment and 0h/1h Troponin Rule-Out Protocol - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Effectiveness and Safety of a Clinical Assessment and 0h/1h Troponin Rule-Out Protocol (ESC-TROP) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03421873 Recruitment Status : Recruiting First Posted

2018 Clinical Trials

147. Development of a clinical prediction rule to diagnose Pneumocystis jirovecii pneumonia in the World Health Organization’s algorithm for seriously ill HIV-infected patients Full Text available with Trip Pro

. The area under the receiver operating characteristic curve of the clinical prediction rule models was 0.761 (95% CI 0.683-0.840) for the respiratory rate model and 0.797 (95% CI 0.725-0.868) for the oxygen saturation model. Both models had zero probability for PJP for scores of zero, and positive likelihood ratios exceeded 10 for high scores.We developed simple clinical prediction rules for PJP, which, if externally validated, could assist decision-making in the WHO seriously ill algorithm. (...) Development of a clinical prediction rule to diagnose Pneumocystis jirovecii pneumonia in the World Health Organization’s algorithm for seriously ill HIV-infected patients The World Health Organization (WHO) algorithm for the diagnosis of tuberculosis in seriously ill HIV-infected patients recommends that treatment for Pneumocystis jirovecii pneumonia (PJP) should be considered without giving clear guidance on selecting patients for empiric PJP therapy. PJP is a common cause

2018 Southern African journal of HIV medicine

148. Development of Clinical Prediction Rules and Health Services Research in Patients With Heart Failure

Development of Clinical Prediction Rules and Health Services Research in Patients With Heart Failure Development of Clinical Prediction Rules and Health Services Research in Patients With Heart Failure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Development of Clinical Prediction Rules and Health Services Research in Patients With Heart Failure (ESSIC) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03512704 Recruitment Status : Completed First Posted : May 1, 2018 Last Update Posted : February 5

2018 Clinical Trials

149. Predicting mortality in severe COVID-19: a systematic review of the literature and external validation of clinical prediction rules for mortality from SARS-CoV-2 infection

Predicting mortality in severe COVID-19: a systematic review of the literature and external validation of clinical prediction rules for mortality from SARS-CoV-2 infection Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability (...) -abstract screening: 1. Not an original full research paper (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from

2020 PROSPERO

150. Response: Re: Signs and Symptoms That Rule Out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis Full Text available with Trip Pro

Adults: A Systematic Review and Meta-Analysis.” Not only is lung ultrasonography a possible alternative to chest radiography (CXR) for the diagnosis of community-acquired pneumonia (CAP) , but also they can be useful for the differential diagnosis of chest pain and dyspnea in the emergency department. , We agree that point-of-care ultrasound (POCUS) should be explored in future studies on clinical decision rules for CAP, in addition to other point-of-care (POC) tests such as c-reactive protein (...) that accuracy with lower volume requires further study. In addition, because pneumonia is relatively rare in primary care patients (about 3% to 4% of patients with lower respiratory tract symptoms), even a fairly accurate test can have a poor positive predictive value, leading to antibiotic overuse. We, therefore, advocate that future studies focus on the integration of simple heuristics, the overall clinical impression, validated clinical decision rules, and validated POC tests (eg, c-reactive protein

2019 The Journal of the American Board of Family Medicine

151. The One-hour High Sensitivity Troponin to Rule-Out MI

of the serial high-sensitivity cardiac troponin assays themselves, raising the specter of . Most importantly, the current evidence is limited to providing negative and positive predictive values for the various algorithms. Future studies will need to assess the clinical impact of using the algorithms on decision-making, disposition times, and patient outcomes in order to demonstrate efficacy and safety. It likely the lack of such studies that has kept these algorithms out of our practice in the US, and out (...) The One-hour High Sensitivity Troponin to Rule-Out MI Emergency Medicine > Journal Club > Archive > July 2016 Toggle navigation July 2016 The One-hour High Sensitivity Troponin to Rule-Out MI Vignette You are working your 0irst ever shift as an intern in the Barnes-Jewish Emergency Department on July 1st when you encounter Mrs. P, a forty-year old woman whose chief complaint is chest pain. She reports that 1 hour prior to arrival, while sitting at her desk at work, she developed a sharp

2017 Washington University Emergency Medicine Journal Club

152. Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. Full Text available with Trip Pro

Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. Drug prescription errors are made, worldwide, on a daily basis, resulting in a high burden of morbidity and mortality. Existing rule-based systems for prevention of such errors are unsuccessful and associated with substantial burden of false alerts.In this prospective study, we evaluated the accuracy, validity, and clinical (...) in subsequent medical orders.A clinical decision support system that used a probabilistic, machine-learning approach based on statistically derived outliers to detect medication errors generated clinically useful alerts. The system had high accuracy, low alert burden and low false-positive rate, and led to changes in subsequent orders.© The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email

2019 Journal of the American Medical Informatics Association

153. Teetering on a liver's edge: a case report highlighting clinical decision-making in thrombocytopenia. Full Text available with Trip Pro

Teetering on a liver's edge: a case report highlighting clinical decision-making in thrombocytopenia. This report illustrates the importance of a detailed history and physical exam and careful analysis of hematologic parameters when diagnosing ITP. This case demonstrates that even with subtle deviations from typical ITP findings one must promptly reevaluate the diagnosis. This case also highlights the importance of peripheral smear review by an expert in pediatric hematopathology.A previously (...) was historically performed on all patients with presumed ITP to rule out leukemia. In 2011, the American Society of Hematology (ASH) stopped recommending routine BMA in patients suspected of having ITP. ASH advises in cases with unusual findings on history, physical examination or CBC, it is reasonable to perform a BMA. Our patient had mild hepatomegaly, which may have qualified him for a BMA. He also had an elevated LDH and urate, which are not listed as criteria for BMA by ASH but were considered atypical

2019 BMC Cancer

154. Developing a framework for evidence-based grading and assessment of predictive tools for clinical decision support. Full Text available with Trip Pro

Developing a framework for evidence-based grading and assessment of predictive tools for clinical decision support. Clinical predictive tools quantify contributions of relevant patient characteristics to derive likelihood of diseases or predict clinical outcomes. When selecting predictive tools for implementation at clinical practice or for recommendation in clinical guidelines, clinicians are challenged with an overwhelming and ever-growing number of tools, most of which have never been (...) Score, Well's Criteria, Modified Early Warning Score, and Ottawa knee rule. After peer review, by six expert clinicians and healthcare researchers, the framework and the grading of the tools were updated.GRASP framework grades predictive tools based on published evidence across three dimensions: 1) Phase of evaluation; 2) Level of evidence; and 3) Direction of evidence. The final grade of a tool is based on the highest phase of evaluation, supported by the highest level of positive evidence

2019 BMC Medical Informatics and Decision Making

155. Clinical Evaluation of the "NICU Clinical Decision Support Dashboard"

access to other resources at their fingertips. Other Name: Lotus Dashboard No Intervention: Standard Care: Parent The Parental Control group will receive standard of care without any study devices. Experimental: NICU Dashboard: Clinician The Clinician group will have access to the NICU Dashboard, which presents information from the EHR, bedside monitoring, and other systems of record through a pre-released FDA Class 2 clinical decision support rule-based system, to assist the appropriate evidence (...) Clinical Evaluation of the "NICU Clinical Decision Support Dashboard" Clinical Evaluation of the "NICU Clinical Decision Support Dashboard" - MHSB - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Clinical

2018 Clinical Trials

156. Clinical Evaluation of the "NICU Clinical Decision Support Dashboard"

of record through a pre-released FDA Class 2 clinical decision support rule-based system, to assist the appropriate evidence-based guidelines be integrated with team workflows. Caregivers educate and coach parents to facilitate integrating them into their infant's care. NICU clinicians will be asked to complete questionnaires 1) prior to clinical go-live of the intervention (baseline), 2) at the study mid-way point, and 3) upon completion of parent recruitment. Device: NICU Dashboard The NICU Dashboard (...) Clinical Evaluation of the "NICU Clinical Decision Support Dashboard" Clinical Evaluation of the "NICU Clinical Decision Support Dashboard" - CHMCO - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Clinical

2018 Clinical Trials

157. Nexus Chest CT Decision Rule in Blunt Trauma

rules have poor and is useful only when negative Use clinical judgment to determine CT indications VI. References Lin and Rodriguez in Herbert (2016) EM:Rap 16(2): 10-11 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Nexus Chest CT Decision Rule in Blunt Trauma." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Radiology About (...) Nexus Chest CT Decision Rule in Blunt Trauma Nexus Chest CT Decision Rule in Blunt Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer

2018 FP Notebook

158. Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound?

, however, were much lower (85–89% with wide CI), which seems clinically unacceptable when a diagnosis with such possible dismal consequences is suspected. Both studies were based on relatively small size resulting in large CI making the final decision difficult. Editor Comment ED, emergency department; EP, emergency physician; LR, likelihood ratio; NPV, negative predictive value; PPV, positive predictive value; USS, ultrasound scan. Clinical Bottom Line ED bedside ultrasound could possibly be used (...) Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? BestBets: Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? Report By: Éliane Raymond-Dufresne - PGY-3, Emergency Medicine Search checked by Hisham

2013 BestBETS

159. Evaluation of clinical rules in a standalone pharmacy based clinical decision support system for hospitalized and nursing home patients. (Abstract)

Evaluation of clinical rules in a standalone pharmacy based clinical decision support system for hospitalized and nursing home patients. To improve the current standalone pharmacy clinical decision support system (CDSS) by identifying and quantifying the benefits and limitations of the system.Alerts and handling of the executed clinical rules were extracted from the CDSS from the period September 2011 to December 2011. The number of executed clinical rule alerts, number of actions on alerts (...) , and the reason why alerts were classified as not relevant were analyzed. The alerts where considered clinically relevant when the pharmacist needed to contact the physician.The 4065 alerts have been separated into: 1137 (28.0%) new alerts, 2797 (68.8%) repeat alerts and 131 (3.2%) double alerts. When the alerts were analyzed, only 3.6% were considered clinically relevant. Reasons why alerts were considered as not to be relevant were: (a) the dosage was correct or already adjusted, (b) the drug

2015 International journal of medical informatics

160. Effectiveness and safety of a clinical decision rule for guiding the management of children with pneumonia vaccinated against pneumococcal disease: A controlled clinical trial. (Abstract)

Effectiveness and safety of a clinical decision rule for guiding the management of children with pneumonia vaccinated against pneumococcal disease: A controlled clinical trial. Although most cases of pneumonia in children younger than 5 years old have a viral nature, in everyday practice, they are frequently treated with antibiotics. A clinical decision rule (BPS:Bacterial Pneumonia Score) proved to be effective for identifying which children with pneumonia required antibiotics, but its (...) performance has not been assessed in the population vaccinated against pneumococcal disease. Our objective was to assess whether using the BPS would allow to reduce antibiotic use compared to routine management of children with community acquired pneumonia vaccinated against pneumococcal disease.Randomized, controlled, partially-blinded clinical trial with parallel groups comparing two approaches in the management of children aged 3-60 months old in an outpatient setting because of pneumonia, who had been

2015 Archivos argentinos de pediatria Controlled trial quality: uncertain

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