Obesity and the outcome of young breast cancer patients in the UK: the POSH study.

Background: Obese breast cancer patients have a poorer prognosis than non-obese patients. We examined data from a large prospective cohort study to explore the associations of obesity with tumour pathology, treatment and outcome in young British breast cancer patients receiving modern oncological treatments.

Patients And Methods: A total of 2956 patients aged ≤40 at breast cancer diagnosis were recruited from 126 UK hospitals from 2001 to 2007.

Improving the transparency of prognosis research: the role of reporting, data sharing, registration, and protocols.

George Peat and colleagues review and discuss current approaches to transparency and published debates and concerns about efforts to standardize prognosis research practice, and make five recommendations.

Irish public opinion on assisted human reproduction services: Contemporary assessments from a national sample.

Objective: To measure Irish opinion on a range of assisted human reproduction (AHR) treatments.

Methods: A nationally representative sample of Irish adults (n=1,003) were anonymously sampled by telephone survey.

Results: Most participants (77%) agreed that any fertility services offered internationally should also be available in Ireland, although only a small minority of the general Irish population had personal familiarity with AHR or infertility.

WITHDRAWN: Benzodiazepines and related drugs for insomnia in palliative care.

This review is out of date, and the original authors are no longer available to update it. The editorial group responsible for this previously published document have withdrawn it from publication.

Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study.

Background: Black ethnic groups have a higher breast cancer mortality than Whites. American studies have identified variations in tumour biology and unequal health-care access as causative factors. We compared tumour pathology, treatment and outcomes in three ethnic groups in young breast cancer patients treated in the United Kingdom.

Statistical considerations for the development of prescriptive fetal and newborn growth standards in the INTERGROWTH-21st Project.

The INTERGROWTH-21(st) Project has in its mandate to develop prescriptive standards for fetal, neonatal and preterm post-neonatal growth. The project comprises three components: the Fetal Growth Longitudinal Study (FGLS), the Preterm Postnatal Follow-up Study (PPFS), and the Newborn Cross-Sectional Study (NCSS). We consider here the statistical aspects of the three components as they relate to the construction of these standards, in particular the sample size, and outline the principles that will guide the planned main analyses.

Managing data for the international, multicentre INTERGROWTH-21st Project.

The INTERGROWTH-21(st) Project data management was structured incorporating both a centralised and decentralised system for the eight study centres, which all used the same database and standardised data collection instruments, manuals and processes. Each centre was responsible for the entry and validation of their country-specific data, which were entered onto a centralised system maintained by the Data Coordinating Unit in Oxford. A comprehensive data management system was designed to handle the very large volumes of data.

Identifying patients with undetected renal tract cancer in primary care: an independent and external validation of QCancer® (Renal) prediction model.

Introduction: To evaluate the performance of QCancer® (Renal) for predicting the absolute risk of renal tract cancer in a large independent UK cohort of patients from general practice records.

Materials And Methods: Open cohort study to validate QCancer® (Renal) prediction model. Record from 365 practices from United Kingdom contributing to The Health Improvement Network (THIN) database.

Building a metaphor: another brick in the wall?

The metaphor of studies being bricks from which a wall is being built leads to new ideas about accumulating knowledge, explains

Identifying patients with undetected gastro-oesophageal cancer in primary care: External validation of QCancer® (Gastro-Oesophageal).

Objective: To evaluate the performance of QCancer® (Gastro-Oesophageal) for predicting the risk of undiagnosed gastro-oesophageal cancer in an independent UK cohort of patients from general practice records.

Design: Open cohort study to validate QCancer® (Gastro-Oesophageal) prediction model. Three hundred sixty-five practices from the United Kingdom contributing to The Health Improvement Network database.

Identifying women with undetected ovarian cancer: independent and external validation of QCancer(®) (Ovarian) prediction model.

Early identification of ovarian cancer is an unresolved challenge and the predictive value of single symptoms is limited. We evaluated the performance of QCancer(®) (Ovarian) prediction model for predicting the risk of ovarian cancer in a UK cohort of general practice patients. A total of 1.

A systematic review finds prediction models for chronic kidney disease were poorly reported and often developed using inappropriate methods.

Background: Chronic kidney disease (CKD) is a global health concern that is increasing mainly as the result of increasing incidences of diabetes and hypertension. Furthermore, if left untreated, individuals with CKD may progress to end-stage kidney failure. Identifying individuals with undiagnosed CKD or those who are at an increased risk of developing CKD or progressing to end-stage kidney disease (ESKD) is therefore an important challenge.

Predicting the 10 year risk of cardiovascular disease in the United Kingdom: independent and external validation of an updated version of QRISK2.

Objective: To evaluate the performance of the QRISK2-2011 score for predicting the 10 year risk of cardiovascular disease in an independent UK cohort of patients from general practice and to compare it with earlier versions of the model and a National Institute for Health and Clinical Excellence version of the Framingham equation.

Design: Prospective cohort study to validate a cardiovascular risk score with routinely collected data between June 1994 and June 2008.

Setting: 364 practices from the United Kingdom contributing to The Health Improvement Network (THIN) database.

Identifying patients with undetected colorectal cancer: an independent validation of QCancer (Colorectal).

Background: Early identification of colorectal cancer is an unresolved challenge and the predictive value of single symptoms is limited. We evaluated the performance of QCancer (Colorectal) prediction model for predicting the absolute risk of colorectal cancer in an independent UK cohort of patients from general practice records.

Methods: A total of 2.

Predicting the adverse risk of statin treatment: an independent and external validation of Qstatin risk scores in the UK.

Objective: To evaluate the performance of the QStatin scores for predicting the 5-year risk of developing acute renal failure, cataract, liver dysfunction and myopathy in men and women in England and Wales receiving statins.

Design: Prospective cohort study to evaluate the performance of four statin risk prediction models.

Setting: 364 practices in the UK contributing to The Health Improvement Network database.

Fracture risk assessment: state of the art, methodologically unsound, or poorly reported?

Osteoporotic fractures, including hip fractures, are a global health concern associated with significant morbidity and mortality as well as a major economic burden. Identifying individuals who are at an increased risk of osteoporotic fracture is an important challenge to be resolved. Recently, multivariable prediction tools have been developed to assist clinicians in the management of their patients by calculating their 10-year risk of fracture (FRAX, QFracture, Garvan) using a combination of known risk factors.

Developing risk prediction models for type 2 diabetes: a systematic review of methodology and reporting.

Background: The World Health Organisation estimates that by 2030 there will be approximately 350 million people with type 2 diabetes. Associated with renal complications, heart disease, stroke and peripheral vascular disease, early identification of patients with undiagnosed type 2 diabetes or those at an increased risk of developing type 2 diabetes is an important challenge. We sought to systematically review and critically assess the conduct and reporting of methods used to develop risk prediction models for predicting the risk of having undiagnosed (prevalent) or future risk of developing (incident) type 2 diabetes in adults.

Predicting risk of osteoporotic and hip fracture in the United Kingdom: prospective independent and external validation of QFractureScores.

Objective: To evaluate the performance of the QFractureScores for predicting the 10 year risk of osteoporotic and hip fractures in an independent UK cohort of patients from general practice records.

Design: Prospective cohort study.

Setting: 364 UK general practices contributing to The Health Improvement Network (THIN) database.

Procalcitonin: a key marker in children with urinary tract infection.

Urinary tract infections (UTIs) are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesicoureteral reflux (VUR) is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar) or cystography (for VUR) and present limitations (feasibility, pain, cost, etc.

Control chart methods for monitoring surgical performance: a case study from gastro-oesophageal surgery.

Graphical methods are becoming increasingly used to monitor adverse outcomes from surgical interventions. However, uptake of such methods has largely been in the area of cardiothoracic surgery or in transplants with relatively little impact made in surgical oncology. A number of the more commonly used graphical methods including the Cumulative Mortality plot, Variable Life-Adjusted Display, Cumulative Sum (CUSUM) and funnel plots will be described.

Reporting on covariate adjustment in randomised controlled trials before and after revision of the 2001 CONSORT statement: a literature review.

Objectives: To evaluate the use and reporting of adjusted analysis in randomised controlled trials (RCTs) and compare the quality of reporting before and after the revision of the CONSORT Statement in 2001.

Design: Comparison of two cross sectional samples of published articles.

Data Sources: Journal articles indexed on PubMed in December 2000 and December 2006.

An independent and external validation of QRISK2 cardiovascular disease risk score: a prospective open cohort study.

Objective: To evaluate the performance of the QRISK2 score for predicting 10-year cardiovascular disease in an independent UK cohort of patients from general practice records and to compare it with the NICE version of the Framingham equation and QRISK1.

Design: Prospective cohort study to validate a cardiovascular risk score.

Setting: 365 practices from United Kingdom contributing to The Health Improvement Network (THIN) database.

Reporting performance of prognostic models in cancer: a review.

Background: Appropriate choice and use of prognostic models in clinical practice require the use of good methods for both model development, and for developing prognostic indices and risk groups from the models. In order to assess reliability and generalizability for use, models need to have been validated and measures of model performance reported. We reviewed published articles to assess the methods and reporting used to develop and evaluate performance of prognostic indices and risk groups from prognostic models.

An independent external validation and evaluation of QRISK cardiovascular risk prediction: a prospective open cohort study.

Objective: To independently evaluate the performance of the QRISK score for predicting 10 year risk of cardiovascular disease in an independent UK cohort of patients from general practice and compare the performance with Framingham equations.

Design: Prospective open cohort study.

Setting: 274 practices from England and Wales contributing to the THIN database.