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Four Year Prognostic Index


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181. Portable Normothermic Cardiac Perfusion System in Donation After Cardiocirculatory Death

the next 5 years would cost about $5.6 million. Although the people we spoke with had no direct experience with a perfusion system, people waiting for a heart transplant expressed hope that the technology could increase the potential donor pool. Family members of organ donors believed the technology could increase the likelihood of a successful heart transplant. February 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 3, pp. 1–90, March 2020 2 ACKNOWLEDGMENTS This report was developed (...) transplantation. We assessed the risk of bias of each included study and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also reviewed the economic evidence published during the same time period for the cost-effectiveness of a portable normothermic cardiac perfusion system for DCD hearts compared with cold storage for NDD hearts. We further estimated the 5-year net budget impact of publicly funding

2020 Health Quality Ontario

182. 10-kHz High-Frequency Spinal Cord Stimulation for Adults With Chronic Noncancer Pain

types of spinal cord stimulation would save about $0.73 million over the next 5 years in Ontario. People with chronic noncancer pain said that their pain affected their ability to do daily activities and affected their emotional well-being. They said that spinal cord stimulation reduced their pain, allowing them to function better. March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 6, pp. 1–109, March 2020 2 ACKNOWLEDGMENTS This report was developed by a multidisciplinary team from (...) . Methods We performed a systematic literature search of the clinical evidence. We assessed the risk of bias of each included study using the Cochrane Risk of Bias and ROBINS-I tools and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We performed a systematic economic literature search. We analyzed the 5-year budget impact of publicly funding 10-kHz high-frequency SCS in Ontario for adults

2020 Health Quality Ontario

183. 5-Aminolevulinic Acid Hydrochloride (5-ALA)–Guided Surgical Resection of High-Grade Gliomas

of disease. The incidence of high-grade gliomas is approximately 3 to 5 per 100,000 March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 9, pp. 1–92, March 2020 11 people, with incidence increasing with age. The median age of onset for glioblastomas is 64 years, peaking between 75 and 85 years. 10 Grade III gliomas occur in a younger population than glioblastoma, with a mean age of diagnosis in the fourth or fifth decade of life. 11 Prognosis Despite improvements in both the diagnosis (...) survival. There is uncertainty regarding the impact of 5-ALA on adverse events after surgical resection. We estimate that publicly funding 5-ALA–guided surgical resection in Ontario over the next 5 years would result in a budget impact of about $930,000 in year 1 to about $1,765,000 in year 5, yielding a total 5-year budget impact of about $7,500,000. A participant with high-grade glioma reported a positive experience with 5-ALA and felt more satisfied with the 5-ALA–guided resection compared

2020 Health Quality Ontario

184. Routine Human Papilloma Virus (HPV) Testing in Squamous Cell Head and Neck Cancer

) or DSS was seen in HPV-positive versus negative patients with non-oropharyngeal tumours. Justification for Recommendation 1 There is evidence from a meta-analysis of randomized trials that HPV-positivity is a strong predictor of prognosis in patients with oropharyngeal squamous cell carcinoma. In addition, it is likely that HPV status will influence management decisions in the near future and is now regarded as a mandatory stratification factor for clinical trials. Therefore, even though at this time (...) no recommendation can be made to base clinical management decisions on HPV status, the valuable prognostic benefits of HPV testing are sufficient to warrant routine testing. Qualifying Statements for Recommendation 1 ? The above recommendation only applies to patients with squamous cell carcinoma of the oropharynx, which includes tonsil, base of tongue, soft palate and associated pharyngeal walls. The data and recommendation do not apply to patients with non- oropharyngeal cancers. ? Altering management

2020 Cancer Care Ontario

185. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China (Full text)

. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. Conclusion Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart. Introduction During the past two decades, the outbreak and prevalence of severe acute (...) susceptible to poor prognosis. Given the rapid spread of 2019-nCoV, an updated meta-analysis with significantly larger sample sizes by integrating the published studies is urgently warranted. Accordingly, the present analysis will not only identify the cardiovascular epidemiological and clinical characteristics of 2019-nCoV infection with greater precision but also unravel the impact of the infection on the cardiac injury. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses

2020 Covid-19 Ad hoc papers PubMed abstract

186. Regional Therapies for Colorectal Cancer Liver Metastases

of resectable CRC liver metastases. These interventions are not recommended outside of a clinical trial. Recommendation 2 There is insufficient evidence to recommend the addition of cTACE to systemic therapy in the first-line treatment of those with unresectable CRC liver metastases outside of a clinical trial. Key Evidence for Recommendation 2 ? One retrospective four-arm study [1] was identified. This study had a moderate risk of bias as measured by ROBINS-I. Median OS, five-year PFS, and conversion (...) of the addition of cTACE to systemic therapy in first-line treatment of those with unresectable CRC liver metastases? One study [1] was retained. This was a retrospective four-arm study of 154 participants with KRAS wild-type metachronous liver metastases comparing chemotherapy ± cetuximab to chemotherapy ± cetuximab plus cTACE. The chemotherapy regimen used was most often mFOLFOX6 or FOLFIRI. Median survival was significantly different between the study arms (see Table 4-4, p<0.0001) as was the five-year PFS

2020 Cancer Care Ontario

187. Minimal Residual Disease Testing in Acute Leukemia

, and decisions about these practical aspects of MRD testing will require constant review. 1 Clinical utility refers to the ability of the test to provide information that is useful to direct treatment and ultimately improve patient outcome. This is in contrast to prognostic utility (or prognosis), which gives information about likely survival time but does not address whether or not a treatment would be beneficial. Guideline MOTAC-6 Section 1: Recommendations Page 2 RECOMMENDATIONS Recommendation 1 MRD (...) be discordance between the two measurements, potentially underestimating the disease burden if only blood is monitored. ? While the prognostic information from MRD testing is accepted in clinical practice and used to inform patients of their prognosis, the ability of MRD testing results to be predictive of adult ALL patient response to different treatment options (escalation or de- escalation) is not yet established ? While the adjustment of treatment intensity based on MRD testing results has been tested

2020 Cancer Care Ontario

188. Clinical care of severe acute respiratory infections – Tool kit

enteral nutrition ESBL extended spectrum beta-lactamase ESI emergency severity index ETAT emergency triage assessment and treatment Clinical Care for Severe Acute Respiratory Infection—Toolkit xETT endotracheal tube FiO 2 fraction of inspired oxygen FLACC face, legs, activity, cry, consolability Hb haemoglobin HFNC high-flow nasal cannula HR heart rate ICP intracranial pressure ICRC International Committee of the Red Cross ICU intensive care unit ILI influenza-like illness IM intramuscular IMAI (...) fatality ratios (CFR) of 1–6% have been reported from some countries. • According to data from China, approximately 80% of people will have mild (40%) to moderate (40%) disease and recover. Moderate disease will include a mild form of pneumonia. • More severe disease and higher CFRs have been seen in the elderly (over 60 years old) and those with chronic medical conditions, with clinical deterioration occurring at around day 7 of illness. Children appear to mainly have mild disease. • The most common

2020 WHO Coronavirus disease (COVID-19) Pandemic

189. Factors Informing Clinical Decisions about Ventilator Use during Ventilator Shortages in an Infectious Disease Pandemic

. - SOFA, APACHE II, Simplified Acute Physiology Score (SAPS II), Morbidity Probability Model II (MPM II), Charlson Comorbidity Index (CCI), CURB-65 (confusion, urea, respiratory rate, blood pressure, and age =65 years), A-DROP, Logistic Organ Dysfunction Score (LODS), STSS, and the Modified Early Warning (MEW). Guidelines and Triage Frameworks: We identified 14 global guidelines, regional guidelines, and disaster plans and 4 triage frameworks published between January 1, 2010, and April 2, 2020 (...) ASSESSMENT Factors Informing Clinical Decision about Ventilator Use during Ventilator Shortages in an Infectious Disease Pandemic © April 15, 2020 ECRI | 13 Author/Year Title Summary Michigan Department of Community Health. Office of Public Health Preparedness 2012 Guidelines for Ethical Allocation of Scarce Medical Resources and Services During Public Health Emergencies in Michigan These guidelines contain “two general criteria considered acceptable for guiding allocation decisions: medical prognosis

2020 Covid-19 Ad hoc papers

190. What clinical features or scoring system, if any, might best predict a benefit from hospital admission for patients with COVID-19?

”[All Fields] OR ICU[All Fields] OR ITU[All Fields] OR CCU[All Fields] OR “intensive treatment unit*”[All Fields] OR “intensive therapy unit*”[All Fields])))) AND ((((“Prognosis”[Mesh]) OR “Severity of Illness Index”[Mesh]) OR “Signs and Symptoms”[Mesh]) OR (presentation OR signs OR symptoms OR manifestations OR markers OR determinants OR features OR prognosis OR prognostic))) Filters: English, from 2019 – 2020 ((Algorithm OR Pathway OR Protocol OR Formula OR Criteria OR Standardization OR triage (...) 2020. We found five clinical guidelines and four systematic reviews that included either guidance for primary care clinicians on either identifying or referring patients with suspected or confirmed COVID-19, or that linked clinical features to patient outcomes in a way that could define prognostic factors. We also found 60+ potentially relevant studies of other designs, including but not limited to: cohort, case-control, case series, modelling, editorials. We chose to focus our analysis

2020 Oxford COVID-19 Evidence Service

191. Are there risk factors and preventative interventions for acute respiratory distress syndrome (ARDS) in COVID-19?

Hg and a chest radiograph showing patchy shadows Zhu 2020 (16) WHO interim guidance Inciardi 2020 (17) Not stated SUMMARY OF FINDINGS FROM MOST USEFUL PAPERS DEMOGRAPHICS Older age Four studies reported older age was associated with an increased risk of ARDS. In a retrospective cohort study of 201 hospitalised patients with confirmed COVID-19 pneumonia(3), 84 (41.8%) developed ARDS. Wu(3) noted that the median age of ARDS patients was 58.5 years, compared with 48 years for non-ARDS patients (...) features (23), which may mean the existing evidence on prognostic factors for ARDS is not directly applicable. For this reason, this review focuses on COVID-19 specific knowledge and aims to determine if there are any known risk factors for ARDS in this infection and whether there are any interventions to prevent ARDS developing. SEARCH STRATEGY Search terms: The were combined with relevant text words and MeSH terms for risk or prevention (including risk*, predict*, prevent*, probab*, control

2020 Oxford COVID-19 Evidence Service

192. COVID-19 rapid evidence summary: vitamin D for COVID-19

Government advises that everyone needs vitamin D equivalent to an average daily intake of 10 micrograms (400 international units). They advise that all people should consider taking a daily supplement containing 10 micrograms vitamin D during autumn and winter months. They also advise that people whose skin has little to no exposure to sunlight and ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, should consider taking a vitamin D supplement all year round (...) , people with vitamin D deficiency may also be prescribed higher therapeutic doses of vitamin D. Factors for decision making Factors for decision making Effectiveness and safety Effectiveness and safety Evidence was from 5 published studies in peer-reviewed journals. One observational cohort study (D'Avolio et al. 2020), 3 observational prognostic studies involving published data sets using correlation or regression (Hastie et al. 2020, Ilie et al. 2020 and Laird et al. 2020) and 1 case- control survey

2020 NICE COVID-19 rapid evidence summary

193. Evidence Report for Investigating symptoms of lung cancer: a guide for all health professionals

cancers are diagnosed at an advanced stage, contributing to the low five-year relative survival rate of 17%. 1 We know that diagnosis at an earlier stage of lung cancer leads to better survival outcomes for patients. However, diagnosing lung cancer can be challenging. Symptoms are often non- specific, which can impact on both patient and health professional awareness. Furthermore, the association of lung cancer with smoking can cause patients to feel stigmatised, contributing to delays in help-seeking (...) are diagnosed at an early stage and 53% at an advanced stage. 1 The five-year survival for lung cancers diagnosed an early stage (stage 1 and stage 2) are 68% and 32% respectively compared to 17% and 3% for those diagnosed at an advanced stage (stage 3 and stage 4). 1 Non-specific lung cancer symptoms can make both patient awareness and primary care diagnosis difficult. 3 Many of the symptoms of lung cancer are commonly encountered in primary care but are often non-specific, such as cough and chest pain

2020 Cancer Australia

194. Allogeneic stem cell transplantation in aggressive B-cell non-Hodgkin lymphoma and in T-cell non-Hodgkin lymphoma

developed Lugano classification additionally recommends performing imaging – fluorodeoxyglucose positron emission tomography or computed tomography – for staging purposes and does away with the suffixes A and B [8, 9]. No conclusions regarding the patient’s prognosis can be drawn based on anatomic staging using the Ann Arbor system. The International Prognostic Index (IPI), which was designed to allow a prognosis, was developed on patients with aggressive B-NHL [7, 10]. On the basis of the factors (...) Society for Medical Oncology FL Follicular lymphoma G-BA Gemeinsamer Bundesausschuss (Federal Joint Committee) GvHD Graft-versus-host disease GvL Graft-versus-lymphoma effect HLA Human leukocyte antigen HSTCL Hepatosplenic T-cell lymphoma IPI International prognostic index ITT Intention to treat IQWiG Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (Institute for Quality and Efficiency in Health Care) Extract of final report N17-02 Version 1.0 Allogeneic stem cell transplantation

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

195. British guideline on the management of asthma

wheezing or asthma through childhood. 76, 85 The presence of these factors increases the probability that a child with respiratory symptoms will have asthma. These factors include: Age at presentation The natural history of wheeze is dependent on age at first presentation. In general, the earlier the onset of wheeze, the better the prognosis. Cohort studies show a break point at around two years; most children who present before this age become asymptomatic by mid-childhood. 86-89 Coexistent atopy (...) , respectively, and in section 4.3 on predicting future risk of asthma attacks, each recommendation has been graded and the supporting evidence assessed for adults and adolescents over 12 years old, children 5–12 years, and children under 5 years. Further information on managing asthma in adolescents (10–19 years of age as defined by the World Health Organization) 3 is given in section 11.2 British guideline on the management of asthma The guideline considers diagnosis of asthma and management in all

2019 SIGN

196. Search strategies to identify observational studies in MEDLINE and Embase. (Abstract)

. The first study used one surgical intervention-focused systematic review thus limiting the generalizability of findings. The second study used four systematic reviews but with less than 100 studies. The external validation was performed only on Specificity Terms Filter from the first study Both studies were published 10 years ago and labelling and indexing of observational studies has changed since then.We found 18 methodological filters across two eligible studies. Search strategies from the first (...) Search strategies to identify observational studies in MEDLINE and Embase. Systematic reviews are essential for decision-making. Systematic reviews on observational studies help answer research questions on aetiology, risk, prognosis, and frequency of rare outcomes or complications. However, identifying observational studies as part of systematic reviews efficiently is challenging due to poor and inconsistent indexing in literature databases. Search strategies that include a methodological

2019 Cochrane

197. Benefit assessment of biotechnologically produced drugs for the treatment of rheumatoid arthritis

of the disease was usually between 6 and 12 years. Only in 2 studies was it markedly shorter with Extract of final report A16-70 Version 1.0 Biologics for rheumatoid arthritis 23 July 2019 Institute for Quality and Efficiency in Health Care (IQWiG) - 29 - about 2 years. On the basis of the available information on disease-specific characteristics (e.g. DAS 28, existing erosions and immunological as well as prognostic factors), severe rheumatoid arthritis with an unfavourable prognosis could be assumed (...) less than half a year. Based on available information on disease-specific characteristics (e.g. DAS 28, existing erosions and immunological as well as prognostic factors), severe rheumatoid arthritis could be assumed for the population of all studies at baseline. The populations of 4 studies showed on average a slightly less severe disease compared with the other studies in Study Pool 1.1. For a further study, there was little information to estimate the severity of the disease. Explicit

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

198. Optimisation of RIZIV – INAMI lump sums for incontinence

in the general population suffer with UI. Daily UI estimated prevalence is 5% to 15%, rising over 15% for women above 70 years who are in residential care. The UI prevalence in men (11-34%) is less than half as common compared to women but prevalence increases more steadily with age. Among young and middle-aged women, only age, body mass index, parity and mode of delivery are unambiguously associated with incontinence, and for all of these, the association with stress UI is greater than with urgency UI (UUI (...) and age at admission for faecal and urinary incontinence (2014) 107 Figure 26 – Distribution of sex and age at admission for faecal and urinary incontinence (2014): patients aged 0 – 20 years 107 Figure 27 – Evolution of number of patients benefiting from a small or large incontinence lump sum, or from reimbursements for self-catheterisation material or incontinence material covered by article 27 (extrapolated from EPS 2008 – 2015) 113 Figure 28 – Age distribution of patients receiving an incontinence

2020 Belgian Health Care Knowledge Centre

199. Usefulness of Ki67 Index in Hormone Receptor-positive Breast Cancer

cancers but is variable within ER-positive cancer, the greatest practical prognostic value of proliferative index seems to be within ER-positive disease. Decisions regarding the use of adjuvant therapy in early operable breast cancer depend on an array of factors that predict prognosis and therapeutic efficacy. Multigene signatures related to cell proliferation show consistent accuracy in the clinical characterization of hormone receptor (HR)-positive BC, hence interest in biologic factors (...) Usefulness of Ki67 Index in Hormone Receptor-positive Breast Cancer Usefulness of Ki67 Index in Hormone Receptor-positive Breast Cancer - Full Text View - 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. Usefulness of Ki67

2011 Clinical Trials

200. Impact of body mass index on compliance and persistence to adjuvant breast cancer therapy. (Full text)

Impact of body mass index on compliance and persistence to adjuvant breast cancer therapy. Several authors found that the prognosis of overweight and obese breast cancer (BC) patients was lower than that of normal weight patients. We present the first study which evaluates the impact of body mass index (BMI) on compliance (i.e. to start a recommended therapy) and persistence to adjuvant BC therapy. An unselected cohort of 766 patients (≤75 years) diagnosed from 1997 to 2009 was analyzed (...) in relevance to the four adjuvant therapy modalities: (A) radiation, (B) chemotherapy, (C) therapy with trastuzumab, and (D) endocrine therapy. With respect to compliance, multivariate analyses calculated Odds ratios (ORs) >1 for increased BMI in all four therapy modalities, i.e. increased BMI had a positive influence on compliance. The results were significant for radiotherapy (OR,2.37;95%CI,1.45-3.88;p < 0.001) and endocrine therapy (OR,1.92;95%CI,1.21-3.04;p = 0.002) and showed a trend in chemotherapy

2011 Breast PubMed abstract

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