Derivation and Validation of a 4-Level Clinical Pretest Probability Score for Suspected Pulmonary Embolism to Safely Decrease Imaging Testing

Roy, Pierre‐Marie; Friou, Emilie; Germeau, Boris; Douillet, Delphine; Kline, Jeffrey A.; Righini, Marc; Gal, Grégoire Le; Moumneh, Thomas; Penaloza, Andréa

doi:10.1001/jamacardio.2021.0064

Cited by 32 publications

(45 citation statements)

References 40 publications

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“…The ROC analysis was employed to evaluate the specificity and sensitivity of the 12 hub ATGs for the diagnosis of endometriosis. The accuracy of the score was assessed by calculating the ROC curve and analyzing the area under the receiver operating characteristic curve (AUC) following previous strategies ( Yamamoto et al, 2013 ; Roy et al, 2021 ). As shown in Figure 6A , the area under the curve (AUC) values of all 12 hub ATGs were more than 60% in GSE7305.…”

Section: Resultsmentioning

confidence: 99%

Identification and Analysis of Potential Autophagy-Related Biomarkers in Endometriosis by WGCNA

Wang

Cong

et al. 2021

Front. Mol. Biosci.

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Background: Endometriosis is a serious gynecological disorder characterized by debilitating pain, infertility and the establishment of innervated endometriosis lesions outside the uterus. Early detection and accurate diagnosis are pivotal in endometriosis. The work screened autophagy-related genes (ATGs) as potential biomarkers to reveal new molecular subgroups for the early diagnosis of endometriosis.Materials and Methods: The gene lists of ATGs from five databases were integrated. Then, weighted gene co-expression network analysis (WGCNA) was used to map the genes to the gene profile of endometriosis samples in GSE51981 to obtain functional modules. GO and KEGG analyses were performed on the ATGs from the key modules. Differentially expressed ATGs were identified by the limma R package and further validated in the external datasets of GSE7305 and GSE135485. The DESeq2 R package was utilized to establish multifactorial network. Subsequently, one-way analysis of variance (ANOVA) was performed to identify new molecular subgroups. Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting were used to confirm the differential expression of hub ATGs, and the receiver operating characteristic (ROC) curve analysis and Spearman correlation analysis were applied to assess the diagnostic value of hub ATGs in 40 clinical samples and human primary endometrial stromal cells (ESCs).Results: We screened 4 key modules and 12 hub ATGs and found the key genes to be strongly correlated with endometriosis. The pathways of ATGs were mainly enriched in autophagy, apoptosis, ubiquitin-protein ligase binding, and MAPK signaling pathway. The expression levels of EZH2 (Enhancer of Zeste homolog 2) and RND3 (also known as RhoE) had statistically significant changes with higher values in the endometriosis group compared with the controls, both in the tissue samples and primary ESCs. Besides, they also showed higher specificity and sensitivity by the receiver operating characteristic analysis and Spearman correlation analysis for the diagnosis of endometriosis. The TF-mRNA-miRNA-lncRNA multifactorial network was successfully constructed. Four new molecular subgroups were identified, and we preliminarily showed the ability of IQCG to independently differentiate subgroups.Conclusion: EZH2 and RND3 could be candidate biomarkers for endometriosis, which would contribute to the early diagnosis and intervention in endometriosis.

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Section: Resultsmentioning

confidence: 99%

Identification and Analysis of Potential Autophagy-Related Biomarkers in Endometriosis by WGCNA

Wang

Cong

et al. 2021

Front. Mol. Biosci.

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“…The total study population was divided into 2 cohorts using a random number generator: a referral cohort that included 60% of the subjects and a validation cohort, comprising the remaining 40%. 14,15 The characteristics of both cohorts were compared using the χ 2 or Fisher’s exact tests for categorical variables and Student’s t test or the nonparametric Wilcoxon signed rank test for continuous variables.…”

Section: Methodsmentioning

confidence: 99%

Development of an Emergency Revisit Score for Patients With Drug-Related Problems

Ruiz-Ramos

Gras-Martin

Borrego

et al. 2021

Journal of Pharmacy Technology

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Background: Drug-related problems (DRPs) are a frequent reason for emergency departments (EDs) visits. However, data about the risk factors associated with EDs revisits are limited. Objective: To develop and validate a predictive model indicating the risk factors associated with EDs revisit within 30 days of the first visit. Methods: A retrospective cohort study was conducted involving patients who attended an ED for DRPs related to cardiovascular drugs. A 30-day prediction model was created in a derivation cohort by logistic regression. An integer score proportional to the regression coefficient was assigned to the variables with P < .100 in the multivariate analysis. Results: 581 patients (mean age: 80.0 [12.6] years) were included, 133 (22.9%) revisited the ED within 30 days from discharge. Six factors (chronic kidney disease, chronic heart failure, visit to an ED in the preceding 3 months, high anticholinergic burden, DRPs associated with heparin, and safety-related DRPs) were identified as risk factors and combined into a final score, termed the DREAMER score. The model reached an area under the receiver operating curve values of 0.72 (95% confidence interval [CI] = 0.67-0.77) in the referral cohort and 0.71 (95% CI = 0.65-0.74) in the validation cohort ( P = .273). Three risk categories were generated, with the following scores and estimated risks: low risk (0-8 points): 11.6%; intermediate risk (9-14 points): 21.3%; and high risk (>14 points): 41.2%. Conclusion and Relevance: The DREAMER score identifies patients at high risk for ED revisit within 30 days from the first visit for a DRPs, being a useful tool to prioritize interventions on discharge.

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“…It is still interesting to notice that in the PERC-negative sample, 0.4% of patients received a diagnosis of PE vs 2.2% of PERC-positive patients. 27 Several strategies have been proposed to reduce PE overtesting 28 and avoid CTPA, which exposes patients to the risk of allergies, kidney failure and cumulative radiation-induced cancer. Of these, the most frequently used prediction rules are the revised Geneva rule and the Wells rule (Table 2) that divide patients into different groups according to their likelihood of having DVT/PE.…”

Section: Role Of Clinical Prediction Rules and D-dimer In The Diagnostic Assessmentmentioning

confidence: 99%

“…Other strategies have therefore been proposed to reduce PE overtesting and overdiagnosis. 28 Two main novelties characterize the new tools: the use of one only prediction score and the adoption of different cut-offs for the D-dimer based on the probability of PE. Roy and coll.…”

Section: Role Of D-dimer In the Evaluation Of Patients With Suspect Pulmonary Embolismmentioning

confidence: 99%

D-Dimer Tests in the Emergency Department: Current Insights

Innocenti

Ricci

et al. 2021

OAEM

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Derivation and Validation of a 4-Level Clinical Pretest Probability Score for Suspected Pulmonary Embolism to Safely Decrease Imaging Testing

Cited by 32 publications

References 40 publications

Identification and Analysis of Potential Autophagy-Related Biomarkers in Endometriosis by WGCNA

Identification and Analysis of Potential Autophagy-Related Biomarkers in Endometriosis by WGCNA

Development of an Emergency Revisit Score for Patients With Drug-Related Problems

D-Dimer Tests in the Emergency Department: Current Insights

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