A Clinical Model To Estimate the Pretest Probability of Lung Cancer in Patients With Solitary Pulmonary Nodules

Gould, Michael K.; Ananth, Lakshmi; Barnett, Paul G.

doi:10.1378/chest.06-1261

Cited by 374 publications

(414 citation statements)

References 19 publications

(17 reference statements)

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“…The area under the curve (AUC) estimates were consistently higher for Risk Score than for Pain Days, indicating improved prediction: 0.77 vs. 0.73 for back pain; 0.74 vs. 0.64 for headache; and 0.78 vs. 0.69 for orofacial pain. The AUC estimates for the chronic pain Risk Score are higher than some other prognostic indicators evaluated for back pain (14), comparable to other screening and prognostic tests used in clinical medicine (1,3,12,28), but lower than highly specific diagnostic tests (22,29). This is consistent with viewing chronic pain as a prognostic evaluation associated with uncertainty regarding long-term outcome (32).…”

Section: Prevalence Of Chronic Painsupporting

confidence: 69%

Chronic pain reconsidered

Korff¹,

Dunn²

2008

Pain

167

142

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Chronic pain has been traditionally defined by pain duration, but this approach has limited empirical support; and does not account for chronic pain's multidimensionality. This study compared durationbased and prospective approaches to defining chronic pain in terms of their ability to predict future pain course and outcomes for primary care patients with three common pain conditions: back pain (n = 971), headache (n = 1078), or orofacial pain (n = 455). At baseline, their chronic pain was classified retrospectively based on Pain Days in the prior six months and prospectively with a prognostic Risk Score identifying patients with "possible" or "probable" chronic pain. The 0-28 Risk Score was based on pain intensity, pain-related activity limitations, depressive symptoms, number of pain sites, and Pain Days. Pain and behavioral outcomes were assessed at six-month follow-up, and long-term opioid use was assessed two to five years after baseline. Risk Score consistently predicted clinically significant pain at six months better than did Pain Days alone (Area under the Curve of 0.74-0.78 for Risk Score vs. 0.63-0.73 for Pain Days). Risk Score was a stronger predictor of future SF-36 Physical Function, pain-related worry, unemployment, and long-term opioid use than Pain Days alone. Thus, for these three common pain conditions, a prognostic Risk Score had better predictive validity for pain outcomes than did pain duration alone. However, chronic pain appears to be a continuum rather than a distinct class, because long-term pain outcomes are highly variable and inherently uncertain.

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Section: Prevalence Of Chronic Painsupporting

confidence: 69%

Chronic pain reconsidered

Korff¹,

Dunn²

2008

Pain

167

142

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“…11,12 14 To ensure that our model was not overfitting, we internally validated our robust Poisson regression models using 10-fold cross-validation. 35 We took all the predicted probabilities from the 10 models and generated a single ROC curve for each model. SPSS version 17.0 (SPSS Inc., Chicago, IL) and Stata version 10.0 (Stata Corp., College Station, TX) were used for statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

A comparison of charlson and elixhauser comorbidity measures to predict colorectal cancer survival using administrative health data

MSc

Baracos

Winget

et al. 2010

Cancer

137

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BACKGROUND: Cancer survival is related to features of the primary malignancy and concurrent presence of nonmalignant diseases (comorbidities), including weight-related conditions (obesity, weight loss). The Charlson and Elixhauser methods are 2 well-known methods that take comorbidities into account when explaining survival. They differ in both the number and categorization of comorbidities. METHODS: Cancer, comorbidity, and survival data were acquired from inpatient administrative hospital records in 574 colorectal cancer patients. Robust Poisson regression was used to analyze 2-and 3-year survival according to cancer features and comorbidities classified by the Charlson and Elixhauser methods. Data for weight-related conditions (body mass index, weight loss) and performance status were acquired upon a new patient visit to the regional cancer center. Discrimination was assessed with the concordance Overall, the Elixhauser comorbidities outperformed the Charlson comorbidities (P < .05). The use of self-reported weight and performance status data significantly increased discrimination by the Elixhauser method in 2-year but not 3-year survival. CONCLUSIONS: The Elixhauser method is a superior comorbidity risk-adjustment model for colorectal cancer survival prediction.

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“…We then calculated the AUC (c-statistic) for the predicted probabilities that were generated by this cross validation. 26,27 …”

Section: Study Variablesmentioning

confidence: 99%

Predictors of Senior Center Use among Older Adults in New York City Public Housing

et al. 2014

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Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and Englishspeaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts.

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A Clinical Model To Estimate the Pretest Probability of Lung Cancer in Patients With Solitary Pulmonary Nodules

Abstract: Background-Estimating the clinical probability of malignancy in patients with a solitary pulmonary nodule (SPN) can facilitate the selection and interpretation of subsequent diagnostic tests.

Cited by 374 publications

References 19 publications

Chronic pain reconsidered

Chronic pain reconsidered

A comparison of charlson and elixhauser comorbidity measures to predict colorectal cancer survival using administrative health data

Predictors of Senior Center Use among Older Adults in New York City Public Housing

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