E W Steyerberg

..Performing a D-dimer test is hence essential in all patients in the selection for a CT scan. Improvements in the prediction rules are necessary to make these meaningful in the diagnostic work-up for pulmonary embolism...

..Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably with age...

..New markers may improve prediction of diagnostic and prognostic outcomes. We review various measures to quantify the incremental value of markers over standard, readily available characteristics...

..The risk is dependent of the affected mismatch repair gene. The aim of the present study was to calculate the cumulative risk of LS related cancers in proven MLH1, MSH2 and MSH6 mutation carriers...

..The objective of this study is to quantify the benefits of ordinal analysis in the real-life situation of a large TBI trial...

..To improve planning, we constructed, validated and tested three models designed to predict length of stay (LOS) in the ICU in individual patients...

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..The concept that this neoadjuvant chemoradiotherapy regimen improves overall survival has, however, to be proven in a randomized phase III trial...

..This study aims to evaluate the cost-effectiveness of a multicomponent implementation strategy aimed at the reduction of healthcare associated infections in Dutch hospital care, by promotion of hand hygiene...

..Logistic random effects models are a popular tool to analyze multilevel also called hierarchical data with a binary or ordinal outcome. Here, we aim to compare different statistical software implementations of these models...

..The aim of this study is to compare standard methods for ranking with a novel method that takes into account natural variation...

..Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with a frequently disabling outcome. Our aim was to develop a prognostic model to predict an ordinal clinical outcome at two months in patients with aSAH...

..We conducted a labelled discrete choice experiment with realistic choices to investigate patients' trade-offs between the expected health gains and the burden of testing in surveillance of Barrett esophagus (BE)...

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..An accurate, practical laboratory test is needed to confirm clinical diagnosis of pertussis in adults during the first 3 symptomatic weeks, when treatment is effective and transmission can be interrupted...

..To provide a framework for local healthcare organisations considering the effectiveness of clinical pathways as a patient management strategy...

..To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk...

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..Recently, stent placement has been introduced as an alternative treatment. We reviewed the available literature on stent placement and GJJ for gastric outlet obstruction, with regard to medical effects and costs...

..Statistical models have been proposed to predict indolent cancer. We validated and updated model predictions for a screening setting...

..We aimed to develop and validate a simple risk score for surgical mortality that could be applied to administrative data...

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..Updating to local circumstances may be required to make such models better applicable. We aimed to compare traditional and empirical Bayes (EB) methods to perform such updating...

..Referring physicians and treating specialists must ensure that elderly patients are not deprived of the opportunity to consider all of their treatment options...

..A reliable prediction of outcome on admission is of great clinical relevance. We aimed to develop prognostic models with readily available traditional and novel predictors...

..For external validation, substantial sample sizes should be used for sufficient power to detect clinically important changes in performance as compared with the internally validated estimate...

..Models that predict mortality after acute myocardial infarction (AMI) contain different predictors and are based on different populations. We studied the agreement and validity of predictions for individual patients...

..We investigated racial disparities in access to surgical evaluation, receipt of surgery, and survival among elderly patients with locoregional esophageal cancer...

..Parsimonious updating methods were found preferable to more extensive model revisions, which should only be attempted with relatively large validation samples in combination with shrinkage...

..Such robust coding may especially be relevant for modeling in relatively small data sets...

..Other measures of performance may be warranted in specific applications, such as reclassification metrics to gain insight into the value of adding a novel predictor to an established model...

..This study investigates whether alternative modelling techniques might improve the applicability and simplicity of such prediction rules...

..To determine the relative importance of computed tomographic (CT) measurements for the prediction of histologic findings in residual masses in patients with nonseminomatous testicular cancer...

..This type of care is very likely to be more cost effective than physician-led follow-up...

..As health economic aspects have only been studied in general terms, we estimated the cost of GJJ and that of stent placement in such patients...

..In conclusion, in patients with critical lower limb ischemia, the presence of ischemic skin lesions and the described radiological arterial disease score can be used to estimate amputation risk...

..The variation in essential assumptions of previous decision analyses directly affected the indication for prophylactic replacement. This study shows how detailed statistical analyses may guide modeling choices in a decision analysis...

..Placement should be considered at an early stage in these conditions...

..Both gastrojejunostomy (GJJ) and stent placement are commonly used palliative treatments of obstructive symptoms caused by malignant gastric outlet obstruction (GOO)...

..In many countries uptake of colorectal cancer (CRC) screening remains low...

..If further validated, this score can provide an evidence-based tool for the selection of palliative treatment in esophageal cancer patients...

..These estimated costs can be used for economic analyses of preventive strategies for severe RSV disease...

..We therefore recommend shrinkage methods in full models including prespecified predictors and incorporation of external information, when prognostic models are constructed in small data sets...

..The aim of the study was to assess the clinical severity of undertriaged patients in the MTS and to define the determinants of undertriage...

..Moreover, the correlations between SES and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with oesophageal cancer...

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..We conclude that prognostic models may benefit substantially from explicit incorporation of literature data...

..83 and 0.82). This study illustrates that a careful modelling strategy may result in an adequate predictive model. Further study of model validity may stimulate application in clinical practice...

..This information will be useful for patient counseling and clinical decision making. It also could serve as a baseline for the evaluation of newer valve types...

..This may improve CHD risk prediction. The aim of the present simulation study was to investigate to what degree CHD risk can be predicted by testing multiple genetic variants (genetic profiling)...

..In conclusion, a sensible strategy in small data sets is to apply shrinkage methods in full models that include well-coded predictors that are selected based on external information...

..The aim of this study was to investigate the cost-effectiveness of HEMS assistance compared with emergency medical services (EMS)...

..In patients with presumed Barrett esophagus we evaluated clinical risk factors that could predict the presence of intestinal metaplasia and dysplasia in biopsies of columnar-lined esophagus (CLE), independently of histological results...

..It remains to be determined whether the application of positron emission tomography will further increase sensitivities and specificities of metastases detection without jeopardising costs and QALYs...

..Incisional hernia develops in the majority of patients after wound dehiscence repair, regardless of suture material or technique. Aneurysm of the abdominal aorta and severe dehiscence with evisceration predispose to incisional hernia...

..We conducted a study to determine the preferences of individuals and to predict uptake for colorectal cancer (CRC) screening programmes using various screening tests...

..The aim of this study was to investigate the association between patient characteristics, resection rates and survival among patients with oesophageal or gastric cancer...

..Risk factors for adenocarcinoma of the oesophagus (OAC) and gastric cardia (GCA) are not yet established...

..Renal artery stenosis is a rare cause of hypertension. The gold standard for diagnosing renal artery stenosis, renal angiography, is invasive and costly...

..In this study, we assessed whether publication bias was also present in the reporting of EUS staging results in upper gastrointestinal cancer...

..To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand...

..To assess the cost effectiveness of antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease...

..In this retrospective study, we compared GJJ and stent placement with regard to medical effects...

..The high incidence of both outcomes in patients primarily referred support direct admission of more and particularly older patients with severe or moderate brain trauma to level I trauma centers...

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..Although some factors provide prognostic information as to the risk of amputation in patients with CLI, there are no data supporting a more favorable treatment effect in any group...

..Therefore, we suggest that staging procedures for esophageal and gastric cardia cancer should preferably be performed in centers with technically advanced equipment and experienced radiologists...

..The probability-based policies could refine the selection without such an increase in the number of resections. Prediction models for the residual histology therefore merit wider application in clinical practice...

..We conclude that a simple statistical model, based on a limited number of patient characteristics, provides better guidelines for patient selection than those currently used in clinical practice...

..As intestinal metaplasia and cardiac-type mucosa are endoscopically indiscernible, it is difficult to take targeted samples from columnar-lined oesophagus with consequently a risk of having undetected intestinal metaplasia...

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..The aim of this study was to identify such predictors of progression to high-grade dysplasia (HGD) and EAC in patients with BE after 4 years of surveillance and to develop a prediction model based on these factors...

..Meta-analysis and microsimulation were used to calculate age-specific long-term prognosis after allograft aortic root replacement based on current evidence...

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..We aimed to investigate the potential benefits of different approaches for dealing with heterogeneity in a case study on traumatic brain injury (TBI)...

..Screening for prostate cancer (PC) may save lives, but overdiagnosis and overtreatment are serious drawbacks. We aimed to determine men's preferences for PC screening, and to elicit the trade-offs they make...

..The benefits of endoscopic surveillance for patients with Barrett's esophagus should be weighed against its drawbacks, including the short-term burden for patients...

..Measuring quality of care and ranking hospitals with outcome measures poses two major methodological challenges: case-mix adjustment and variation that exists by chance...

..Psychosocial problems are also present, but care is less commonly expected. Nurses' involvement during follow-up could be a way to optimize patients' management after oesophageal cancer surgery...

..We conclude that split-sample validation is inefficient, and recommend bootstrapping for estimation of internal validity of a predictive logistic regression model...

..We developed a clinical prognostic model for early prediction of outcome in GBS, applicable for clinical practice and future therapeutic trials...

..These patients might profit most from more intensive treatment strategies. For this purpose, a regression tree was previously developed on 332 patients. We aimed to evaluate the performance and structure of this tree...

..Should the decision to perform esophagectomy have only been based on metastasis detection in these regional centers, over 1 in 20 patients would have undergone resection in the presence of metastases...

..We conclude that outcome following TBI is dependent on age, race, to a lesser extent on education, but not on gender...

..57, 95% CI 1.13-2.18; p=0.01) and CHD (RR 1.72, 95% CI 1.23-2.41; p=0.002). In conclusion, our data suggest that genetic variation in the ABCG8 gene may influence the burden of atherosclerosis...

..As these risk factors are common in Western countries, they are probably not helpful in individualization of surveillance intervals...

..We analyzed data from the 2 largest global trials of hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B to determine which are most likely to respond to PEG-IFN-alfa therapy...

..The risk of developing esophageal adenocarcinoma (EAC) for patients with Barrett's esophagus (BE) is approximately 0.5% per year...

..The authors aimed to assess the repeatability of the Manchester Triage System (MTS) in children...

..In both techniques, progression of aortic regurgitation over time is small but accelerated in young adults...

..The purpose of this article is to compare displays for the influence of random variation on the apparent differences in the quality of care between the Dutch hospitals...

..We therefore performed a systematic review to assess cancer risks in PJS patients and used these data to develop a surveillance recommendation...

..Application of this protocol will allow early diagnosis, and therefore prevent any adverse anti-cancer treatment sequelae including gonadectomy, and requiring life long androgen supplementation in some patients...

..Cox regression was the most promising tool to define a more refined classification. British Journal of Cancer (2004) 90, 1176-1183. doi:10.1038/sj.bjc.6601665 www.bjcancer.com Published online 24 February 2004..

..It has been demonstrated that 40% of patients admitted to pulmonary medicine wards use proton pump inhibitors (PPIs) without a registered indication...

..Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation...

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..This rule should be validated before it can be used reliably to select hypertensive patients for renal angiography. We determined the validity of the prediction rule in recent patients and in other settings...

..Therefore, the goal of treatment should be the complete elimination of Barrett's mucosa...

..Persistent Barrett's oesophagus may still harbour molecular aberrations and must therefore be considered still to be at risk of progression to adenocarcinoma...