Background: For evidence-based medical practice, well-defined risk scoring systems are essential to identify patients with a poor prognosis. The objective of this study was to develop a prognostic score, the Montreal prognostic score (MPS), to improve prognostication of patients with incurable non-small cell lung cancer (NSCLC) in everyday practice.
Methods: A training cohort (TC) and a confirmatory cohort (CC) of newly diagnosed patients with NSCLC planning to receive chemotherapy were used to develop the MPS. Stage and clinically available biomarkers were entered into a Cox model and risk weights were estimated. C-statistics were used to test the accuracy.
Results: The TC consisted of 258 patients and the CC consisted of 433 patients. Montreal prognostic score classified patients into three distinct groups with median survivals of 2.5 months (95% confidence interval (CI): 1.8, 4.2), 8.2 months (95% CI: 7.0, 9.4) and 18.2 months (95% CI: 14.0, 27.5), respectively (log-rank, P<0.001). Overall, the C-statistics were 0.691 (95% CI: 0.685, 0.697) for the TC and 0.665 (95% CI: 0.661, 0.670) for the CC.
Conclusion: The MPS, by classifying patients into three well-defined prognostic groups, provides valuable information, which physicians could use to better inform their patients about treatment options, especially the best timing to involve palliative care teams.
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http://dx.doi.org/10.1038/bjc.2013.515 | DOI Listing |
J Am Acad Orthop Surg
January 2025
From the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Schultz), Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA (Zhuang), Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA (Shapiro), Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University, Stanford, CA (Kamal).
Background: Social drivers of health (SDOH) are area-level, nonmedical factors that affect health outcomes. By contrast, health-related social needs (HRSNs) are individual patient reported and are being deployed in some payment models. SDOH are often used to broadly represent health disparities of communities through metrics, such as the Social Vulnerability Index (SVI); however, the association of area-level SVI to individual HRSNs has not been well studied in hand surgery, which has implications for addressing social risks to improve health and in quality measurement.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Department of Orthopaedic Oncology, Learning Cancer Outcome Research Program, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Background: Comorbidity indices are used to help to estimate patients' length of hospital stay, care costs, outcomes, and mortality. Increasingly, they are considered in reimbursement models. The applicability of comorbidity indices to patients undergoing orthopaedic oncology surgery has not been studied.
View Article and Find Full Text PDFArq Bras Cir Dig
January 2025
Universidade de São Paulo, Faculty of Medicine - São Paulo (SP), Brazil.
Background: Pancreatic neuroendocrine tumors (PNETs) are uncommon and heterogeneous neoplasms, often exhibiting indolent biological behavior. Their incidence is rising, largely due to the widespread use of high-resolution imaging techniques, particularly influencing the diagnosis of sporadic non-functioning tumors, which account for up to 80% of cases. While surgical resection remains the only curative option, the impact of factors such as tumor grade, size, and type on prognosis and recurrence is still unclear.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China.
Background: Recent research has revealed the potential value of machine learning (ML) models in improving prognostic prediction for patients with trauma. ML can enhance predictions and identify which factors contribute the most to posttraumatic mortality. However, no studies have explored the risk factors, complications, and risk prediction of preoperative and postoperative traumatic coagulopathy (PPTIC) in patients with trauma.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Geriatrics, School of Medicine, University of California San Francisco.
Importance: The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear.
Objective: To evaluate the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.
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