Objective: The aim of this study was to establish and validate a clinical prediction model for assessing the risk of metastasis and patient survival in Ewing's sarcoma (ES).
Methods: Patients diagnosed with ES from the Surveillance, Epidemiology and End Results (SEER) database for the period 2010-2016 were extracted, and the data after exclusion of vacant terms was used as the training set (n=767). Prediction models predicting patients' overall survival (OS) at 1 and 3 years were created by cox regression analysis and visualized using Nomogram and web calculator. Multicenter data from four medical institutions were used as the validation set (n=51), and the model consistency was verified using calibration plots, and receiver operating characteristic (ROC) verified the predictive ability of the model. Finally, a clinical decision curve was used to demonstrate the clinical utility of the model.
Results: The results of multivariate cox regression showed that age, , bone metastasis, tumor size, and chemotherapy were independent prognostic factors of ES patients. Internal and external validation results: calibration plots showed that the model had a good agreement for patient survival at 1 and 3 years; ROC showed that it possessed a good predictive ability and clinical decision curve proved that it possessed good clinical utility.
Conclusions: The tool built in this paper to predict 1- and 3-year survival in ES patients ( https://drwenleli0910.shinyapps.io/EwingApp/ ) has a good identification and predictive power.
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http://dx.doi.org/10.1186/s12885-022-09796-7 | DOI Listing |
Telemed J E Health
December 2024
Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil.
: To explore the potential of gatekeeping for specialized consultations and patient care via remote interactions with family physicians. This cross-sectional study was conducted at a tertiary hospital between November 2020 and December 2021, when specialized consultations were canceled due to the COVID-19 pandemic. Patients who were evaluated for remote consultation with family physicians were included.
View Article and Find Full Text PDFJAMA Surg
December 2024
Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University, Baltimore, Maryland.
Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).
Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.
JAMA Netw Open
December 2024
School of Pharmacy, University of Maryland, Baltimore.
Importance: Initiating effective therapy early is associated with improved survival among patients hospitalized with gram-negative bloodstream infections; furthermore, providing early phenotype-desirable antimicrobial therapy (PDAT; defined as receipt of a β-lactam antibiotic with the narrowest spectrum of activity to effectively treat the pathogen's phenotype) is crucial for antimicrobial stewardship. However, the timing of targeted therapy among patients hospitalized with gram-negative bloodstream infections is not well understood.
Objective: To compare the clinical outcomes between patients who were hospitalized with Enterobacterales bloodstream infections receiving early vs delayed PDAT.
JAMA Netw Open
December 2024
Center for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St Louis, Missouri.
Importance: Hospital participation in the Bundled Payments for Care Improvement-Advanced (BPCI-A) initiative has been associated with modest savings and stable clinical outcomes overall, but it is unknown whether the program performs differently for medical and surgical or procedural (henceforth, surgical) episodes.
Objective: To assess the association of BPCI-A participation with Medicare spending and clinical outcomes for medical and surgical episodes.
Design, Setting, And Participants: This retrospective difference-in-differences cohort study utilized 100% Medicare fee-for-service inpatient claims for episodes initiated between January 1, 2017, and September 30, 2019, and included 90 days of follow-up.
JAMA Neurol
December 2024
Department of Health Sciences, University of Genoa, Genoa, Italy.
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