Journal ArticleDOI
Clinical prediction rules. Applications and methodological standards.
TLDR
Qualitative standards that can be used to decide whether a prediction rule is suitable for adoption in a clinician's practice are described and applied to 33 reports of prediction rules.Abstract:
The objective of clinical prediction rules is to reduce the uncertainty inherent in medical practice by defining how to use clinical findings to make predictions. Clinical prediction rules are derived from systematic clinical observations. They can help physicians identify patients who require diagnostic tests, treatment, or hospitalization. Before adopting a prediction rule, clinicians must evaluate its applicability to their patients. We describe methodological standards that can be used to decide whether a prediction rule is suitable for adoption in a clinician's practice. We applied these standards to 33 reports of prediction rules; 42 per cent of the reports contained an adequate description of the prediction rules, the patients, and the clinical setting. The misclassification rate of the rule was measured in only 34 per cent of reports, and the effects of the rule on patient care were described in only 6 per cent of reports. If the objectives of clinical prediction rules are to be fully achieved, authors and readers need to pay close attention to basic principles of study design.read more
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Journal ArticleDOI
ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: Executive summary and recommendations: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on the management of patients with unstable angina)
Eugene Braunwald,Elliott M. Antman,John W. Beasley,Robert M. Califf,Melvin D. Cheitlin,Judith S. Hochman,Robert H. Jones,Dean J. Kereiakes,Joel Kupersmith,Thomas N. Levin,Carl J. Pepine,John W. Schaeffer,Earl E. Smith,David E Steward,Pierre Theroux,Raymond J. Gibbons,Joseph S. Alpert,David P. Faxon,Valentin Fuster,Gabriel Gregoratos,Loren F. Hiratzka,Alice K. Jacobs,Sidney C. Smith +22 more
TL;DR: The present guidelines supersede the 1994 guidelines and summarize both the evidence and expert opinion and provide final recommendations for both patient evaluation and therapy.
Journal ArticleDOI
A prediction rule to identify low-risk patients with community-acquired pneumonia
Michael J. Fine,Thomas E. Auble,Donald M. Yealy,Barbara H. Hanusa,Lisa A. Weissfeld,Daniel E. Singer,Christopher M. Coley,Thomas J. Marrie,Wishwa N. Kapoor +8 more
TL;DR: A prediction rule that stratifies patients into five classes with respect to the risk of death within 30 days accurately identifies the patients with community-acquired pneumonia who are at low risk for death and other adverse outcomes and may help physicians make more rational decisions about hospitalization for patients with pneumonia.
Journal ArticleDOI
The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults.
William A. Knaus,Douglas P. Wagner,Elizabeth A. Draper,Jack E. Zimmerman,Marilyn Bergner,Paulo G. Bastos,Carl A. Sirio,Donaldj Murphy,Ted Lotring,Anne M. Damiano +9 more
TL;DR: The overall predictive accuracy of the first-day APACHE III equation was such that, within 24 h ofICU admission, 95 percent of ICU admissions could be given a risk estimate for hospital death that was within 3 percent of that actually observed.
Journal ArticleDOI
Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration.
Karel G.M. Moons,Douglas G. Altman,Johannes B. Reitsma,John P. A. Ioannidis,Petra Macaskill,Ewout W. Steyerberg,Andrew J. Vickers,David F. Ransohoff,Gary S. Collins +8 more
TL;DR: In virtually all medical domains, diagnostic and prognostic multivariable prediction models are being developed, validated, updated, and implemented with the aim to assist doctors and individuals in estimating probabilities and potentially influence their decision making.
Journal ArticleDOI
What is subjective global assessment of nutritional status
Allan S. Detsky,McLaughlin,Jeffrey P. Baker,Johnston N,S Whittaker,Rena A. Mendelson,K.N. Jeejeebhoy +6 more
TL;DR: It is concluded that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.
References
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