The Genetic Sonogram

Zhong, Yan; Longman, Ryan E.; Bradshaw, Rachael; Odibo, Anthony O.

doi:10.7863/jum.2011.30.4.463

Cited by 11 publications

(3 citation statements)

References 14 publications

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“…Another example is showed by Moreno-Cid et al, who performed a systematic review of the clinical prediction rules for the risk of Down syndrome based on ultrasound findings in pregnancy [31]. These authors showed that only 3 of the rules were validated (2 internally and 1 externally) and 4 of them were incorporated into a software application [32-35]. Moreover, a recent systematic review evaluated Web-based cardiovascular disease risk calculators in terms of clinical validity, understandability, and actionability [36].…”

Section: Discussionmentioning

confidence: 99%

A Computer Application to Predict Adverse Events in the Short-Term Evolution of Patients With Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2019

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Background Chronic obstructive pulmonary disease (COPD) is a common chronic disease. Exacerbations of COPD (eCOPD) contribute to the worsening of the disease and the patient’s evolution. There are some clinical prediction rules that may help to stratify patients with eCOPD by their risk of poor evolution or adverse events. The translation of these clinical prediction rules into computer applications would allow their implementation in clinical practice. Objective The goal of this study was to create a computer application to predict various outcomes related to adverse events of short-term evolution in eCOPD patients attending an emergency department (ED) based on valid and reliable clinical prediction rules. Methods A computer application, Prediction of Evolution of patients with eCOPD (PrEveCOPD), was created to predict 2 outcomes related to adverse events: (1) mortality during hospital admission or within a week after an ED visit and (2) admission to an intensive care unit (ICU) or an intermediate respiratory care unit (IRCU) during the eCOPD episode. The algorithms included in the computer tool were based on clinical prediction rules previously developed and validated within the Investigación en Resultados y Servicios de Salud COPD study. The app was developed for Windows and Android systems, using Visual Studio 2008 and Eclipse, respectively. Results The PrEveCOPD computer application implements the prediction models previously developed and validated for 2 relevant adverse events in the short-term evolution of patients with eCOPD. The application runs under Windows and Android systems and it can be used locally or remotely as a Web application. Full description of the clinical prediction rules as well as the original references is included on the screen. Input of the predictive variables is controlled for out-of-range and missing values. Language can be switched between English and Spanish. The application is available for downloading and installing on a computer, as a mobile app, or to be used remotely via internet. Conclusions The PrEveCOPD app shows how clinical prediction rules can be summarized into simple and easy to use tools, which allow for the estimation of the risk of short-term mortality and ICU or IRCU admission for patients with eCOPD. The app can be used on any computer device, including mobile phones or tablets, and it can guide the clinicians to a valid stratification of patients attending the ED with eCOPD. Trial Registration ClinicalTrials.gov NCT00102401; https://clinicaltrials.gov/ct2/show/results/NCT02434536 (Archived by WebCite at http://www.webcitation.org/76iwTxYuA) International Registered Report Identifier (IRRID) RR2-10.1186/1472-6963-11-322

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Section: Discussionmentioning

confidence: 99%

A Computer Application to Predict Adverse Events in the Short-Term Evolution of Patients With Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2019

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“…The present study by Verlohren and colleagues nicely demonstrates that an increase in this ratio before thirty-four weeks of gestation has high sensitivity and specificity to predict the occurrence of preeclampsia in their European cohort; 95% and 94% respectively for a cut-off of 33. However, sFlt-1/PlGF ratios after 34 weeks in preeclamptic pregnancies are not as informative because of the increase in these ratios during uncomplicated pregnancy (4,5,7). Moreover, the similarities of values in late onset preeclampsia to those in uncomplicated pregnancies suggest that alternative or parallel pathways other than angiogenic balance may contribute to hypertension in late-onset preeclampsia.…”

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confidence: 99%

“…In discussion of limitations, Verlohren et al note that they did not calculate positive or negative predictive values directly from their data set due to the study design. However, one can combine an overall PE rate of 2–5% and the distributions of sFlt-1/PlGF for preeclampsia and non- preeclamptic pregnancies to derive risks of preeclampsia for given gestational ages as well as positive or negative predictive values (7). In addition, other risk factors or recently identified biomarkers in blood or urine such as complement products C3a, C5a, C5b-9, angiotensin type 1 receptor auto-antibodies, or the insulin like growth factor acid labile subunit should also be tested in models to refine this approach (3;8;9).…”

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confidence: 99%

Of Risks and Ratios

et al. 2014

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First trimester serum tests for Down's syndrome screening

Alldred

Takwoingi

Guo

et al. 2015

Cochrane Database of Systematic Reviews

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Tests involving two markers in combination with maternal age, specifically PAPP-A, free βhCG and maternal age are significantly better than those involving single markers with and without age. They detect seven out of 10 Down's affected pregnancies for a fixed 5% FPR. The addition of further markers (triple tests) has not been shown to be statistically superior; the studies included are small with limited power to detect a difference.The screening blood tests themselves have no adverse effects for the woman, over and above the risks of a routine blood test. However some women who have a 'high risk' screening test result, and are given amniocentesis or chorionic villus sampling (CVS) have a risk of miscarrying a baby unaffected by Down's. Parents will need to weigh up this risk when deciding whether or not to have an amniocentesis or CVS following a 'high risk' screening test result.

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The Genetic Sonogram

Abstract: With a slight reduction in the Down syndrome detection rate, the use of the likelihood ratio approach was associated with a significantly lower false-positive rate compared with the logistic regression approach.

Cited by 11 publications

References 14 publications

A Computer Application to Predict Adverse Events in the Short-Term Evolution of Patients With Exacerbation of Chronic Obstructive Pulmonary Disease

A Computer Application to Predict Adverse Events in the Short-Term Evolution of Patients With Exacerbation of Chronic Obstructive Pulmonary Disease

Of Risks and Ratios

First trimester serum tests for Down's syndrome screening

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