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Articoli di riviste sul tema "Multicenter validation"

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Autore: Grafiati

Pubblicato: 1 giugno 2024

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1

Koehler, John J., Stuart A. Malafa, Jeffrey Hillesland, Lawrence J. Baer, Ralph N. Rogers, Nancy R. Navitskas, Deborah Briggs et al. "A multicenter validation of the prehospital index". Annals of Emergency Medicine 16, n. 4 (aprile 1987): 380–85. http://dx.doi.org/10.1016/s0196-0644(87)80354-2.

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Pelletier-Galarneau, M., O. O. Sogbein, X. Pham, J. Hao, J. Le, M. D. Strober, M. L. Middleton, J. Kikut, L. M. Freeman e L. S. Zuckier. "Multicenter Validation of a Shortened Gastric-Emptying Protocol". Journal of Nuclear Medicine 56, n. 6 (16 aprile 2015): 873–76. http://dx.doi.org/10.2967/jnumed.115.155366.

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Bergeron, David, Kelsey Flynn, Louis Verret, Stéphane Poulin, Rémi W. Bouchard, Christian Bocti, Tamàs Fülöp et al. "Multicenter Validation of an MMSE-MoCA Conversion Table". Journal of the American Geriatrics Society 65, n. 5 (15 febbraio 2017): 1067–72. http://dx.doi.org/10.1111/jgs.14779.

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Staartjes, Victor E., Carlo Serra, Matteo Zoli, Diego Mazzatenta, Fabio Pozzi, Davide Locatelli, Elena D’Avella, Domenico Solari, Luigi Maria Cavallo e Luca Regli. "Multicenter external validation of the Zurich Pituitary Score". Acta Neurochirurgica 162, n. 6 (14 marzo 2020): 1287–95. http://dx.doi.org/10.1007/s00701-020-04286-w.

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Barry, Jeremy A., Rima Ait-Belkacem, William M. Hardesty, Lydia Benakli, Clara Andonian, Hermes Licea-Perez, Jonathan Stauber e Stephen Castellino. "Multicenter Validation Study of Quantitative Imaging Mass Spectrometry". Analytical Chemistry 91, n. 9 (2 aprile 2019): 6266–74. http://dx.doi.org/10.1021/acs.analchem.9b01016.

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Chen, Xiaolin. "313 Development and Validation of a Scoring System for Hemorrhage Risk in Brain Arteriovenous Malformations". Neurosurgery 70, Supplement_1 (aprile 2024): 91. http://dx.doi.org/10.1227/neu.0000000000002809_313.

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INTRODUCTION: The dilemma between natural rupture risk and adverse outcomes of intervention is of major concern for patients with unruptured arteriovenous malformations (AVMs). The existing risk score for AVM rupture includes factors that are controversial and lacks prospective validation. METHODS: This prognostic study developed a prediction model derived from a single-center cohort (derivation cohort) and validated in a multicenter external validation cohort and a conservative treatment validation cohort. Patients were recruited from a nationwide multicenter prospective collaboration registry in China. A total of 4135 patients were enrolled. 3962 patients were included (3585 in the derivation cohort and 377 in the multicenter external validation cohort); 1028 patients from the derivation cohort who had time-to-event data and prerupture imaging results were included in the conservative treatment validation cohort. RESULTS: Four risk factors were used to develop the scoring system: ventricular system involvement, venous aneurysm, deep location, and exclusively deep drainage (VALE). The VALE scoring system performed well in all 3 cohorts, with areas under the receiver operating characteristic curve of 0.77 (95% CI, 0.75-0.78) in the derivation cohort, 0.85 (95% CI, 0.81-0.89) in the multicenter external validation cohort, and 0.73 (95% CI, 0.65-0.81) in the conservative treatment validation cohort. The 10-year hemorrhage-free rate was 95.5% (95% CI, 87.1%-100%) in the low-risk group, 92.8% (95% CI, 88.8%-97.0%) in the moderate-risk group, and 75.8% (95% CI, 65.1%-88.3%) in the high-risk group; the model discrimination was significant when comparing these rates between the high-risk group and the low- and moderate-risk groups (p < .001 for both comparisons). CONCLUSIONS: In this prognostic study, the VALE scoring system was developed to distinguish rupture risk among patients with AVMs. The stratification of unruptured AVMs may enable patients with low risk of rupture to avoid unnecessary interventions.

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Lafage, Virginie, Neil J. Bharucha, Frank Schwab, Robert A. Hart, Douglas Burton, Oheneba Boachie-Adjei, Justin S. Smith et al. "Multicenter validation of a formula predicting postoperative spinopelvic alignment". Journal of Neurosurgery: Spine 16, n. 1 (gennaio 2012): 15–21. http://dx.doi.org/10.3171/2011.8.spine11272.

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Object Sagittal spinopelvic imbalance is a major contributor to pain and disability for patients with adult spinal deformity (ASD). Preoperative planning is essential for pedicle subtraction osteotomy (PSO) candidates; however, current methods are often inaccurate because no formula to date predicts both postoperative sagittal balance and pelvic alignment. The authors of this study aimed to evaluate the accuracy of 2 novel formulas in predicting postoperative spinopelvic alignment after PSO. Methods This study is a multicenter retrospective consecutive PSO case series. Adults with spinal deformity (> 21 years old) who were treated with a single-level lumbar PSO for sagittal imbalance were evaluated. All patients underwent preoperative and a minimum of 6-month postoperative radiography. Two novel formulas were used to predict the postoperative spinopelvic alignment. The results predicted by the formulas were then compared with the actual postoperative radiographic values, and the formulas' ability to identify successful (sagittal vertical axis [SVA] ≤ 50 mm and pelvic tilt [PT] ≤ 25°) and unsuccessful (SVA > 50 mm or PT > 25°) outcomes was evaluated. Results Ninety-nine patients met inclusion criteria. The median absolute error between the predicted and actual PT was 4.1° (interquartile range 2.0°–6.4°). The median absolute error between the predicted and actual SVA was 27 mm (interquartile range 11–47 mm). Forty-one of 54 patients with a formula that predicted a successful outcome had a successful outcome as shown by radiography (positive predictive value = 0.76). Forty-four of 45 patients with a formula that predicted an unsuccessful outcome had an unsuccessful outcome as shown by radiography (negative predictive value = 0.98). Conclusions The spinopelvic alignment formulas were accurate when predicting unsuccessful outcomes but less reliable when predicting successful outcomes. The preoperative surgical plan should be altered if an unsuccessful result is predicted. However, even after obtaining a predicted successful outcome, surgeons should ensure that the predicted values are not too close to unsuccessful values and should identify other variables that may affect alignment. In the near future, it is anticipated that the use of these formulas will lead to better surgical planning and improved outcomes for patients with complex ASD.

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Stiell, I. G. "Multicenter Prospective Validation of the Canadian CT Head Rule". Academic Emergency Medicine 10, n. 5 (1 maggio 2003): 539—a—539. http://dx.doi.org/10.1197/aemj.10.5.539-a.

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Stiell, I. G. "Multicenter Prospective Validation of the Canadian C-Spine Rule". Academic Emergency Medicine 9, n. 5 (1 maggio 2002): 359—b—360. http://dx.doi.org/10.1197/aemj.9.5.359-b.

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Domeier, Robert M., Robert A. Swor, Rawden W. Evans, J. Brian Hancock, William Fales, Jon Krohmer, Shirley M. Frederiksen, Edgardo J. Rivera-Rivera e M. Anthony Schork. "Multicenter Prospective Validation of Prehospital Clinical Spinal Clearance Criteria". Journal of Trauma: Injury, Infection, and Critical Care 53, n. 4 (ottobre 2002): 744–50. http://dx.doi.org/10.1097/00005373-200210000-00021.

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Cook, Allyson C., Bellal Joseph, Kenji Inaba, Paul A. Nakonezny, Brandon R. Bruns, Jeff D. Kerby, Karen J. Brasel et al. "Multicenter external validation of the Geriatric Trauma Outcome Score". Journal of Trauma and Acute Care Surgery 80, n. 2 (febbraio 2016): 204–9. http://dx.doi.org/10.1097/ta.0000000000000926.

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Howard, George, Lloyd E. Chambless, William H. Baker, John J. Ricotta, Anne M. Jones, Daniel O'Leary, Virginia J. Howard, Thomas J. Elliott, David S. Lefkowitz e James F. Toole. "A multicenter validation study of Doppler ultrasound versus angiography". Journal of Stroke and Cerebrovascular Diseases 1, n. 4 (gennaio 1991): 166–73. http://dx.doi.org/10.1016/s1052-3057(10)80013-8.

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Kobashigawa, Jon A., Jonathan M. Tobis, Randall C. Starling, E. Murat Tuzcu, Andrew L. Smith, Hannah A. Valantine, Alan C. Yeung et al. "Multicenter Intravascular Ultrasound Validation Study Among Heart Transplant Recipients". Journal of the American College of Cardiology 45, n. 9 (maggio 2005): 1532–37. http://dx.doi.org/10.1016/j.jacc.2005.02.035.

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14

Vakharia, Vejay N., Rachel E. Sparks, Kuo Li, Aidan G. O'Keeffe, Fernando Pérez‐García, Lucas G. S. França, Andrew L. Ko et al. "Multicenter validation of automated trajectories for selective laser amygdalohippocampectomy". Epilepsia 60, n. 9 (7 agosto 2019): 1949–59. http://dx.doi.org/10.1111/epi.16307.

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Oeckl, Patrick, Claude Jardel, François Salachas, Foudil Lamari, Peter M. Andersen, Robert Bowser, Mamede de Carvalho et al. "Multicenter validation of CSF neurofilaments as diagnostic biomarkers for ALS". Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration 17, n. 5-6 (11 aprile 2016): 404–13. http://dx.doi.org/10.3109/21678421.2016.1167913.

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Newsome, Andrea Sikora, Susan E. Smith, William J. Olney e Timothy W. Jones. "Multicenter validation of a novel medication-regimen complexity scoring tool". American Journal of Health-System Pharmacy 77, n. 6 (5 marzo 2020): 474–78. http://dx.doi.org/10.1093/ajhp/zxz330.

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Abstract Background The MRC-ICU, a novel regimen complexity scoring tool, provides an objective measure of medication regimen complexity in critically ill patients. The MRC-ICU may have the ability to evaluate the impact of critical care pharmacists on patient outcomes but requires further validation. The objective of this study was to confirm the external validity of the MRC-ICU scoring tool at multiple institutions and intensive care unit (ICU) settings. Methods This was a multicenter, prospective, observational study. The electronic medical record was reviewed to collect patient demographics and patient outcomes, and the medication administration record was reviewed to collect MRC-ICU scores at 24 hours, 48 hours, and ICU discharge. Validation was performed by assessing convergent and divergent validity of the score. Spearman rank-order correlation was used to determine correlation. Results A total of 230 patients were evaluated across both centers in both medical ICUs and surgical ICUs. Differences between the original center and the new site included that total number of orders (29 vs 126; P < 0.001) and total number of medication orders (17 vs 36; P < 0.001) were higher at the new site, whereas the original site had higher overall MRC-ICU scores (14 vs 11; P = 0.004). The MRC-ICU showed appropriate convergent validity with number of orders and medication orders (all P < 0.001) and appropriate divergent validity with no significant correlation found between age, weight, or gender (all P > 0.05). Conclusions External validity of the MRC-ICU has been confirmed through evaluation at an external site and in the surgical ICU population. The MRC-ICU scoring tool requires prospective evaluation to provide objective data regarding optimal pharmacist use.

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Shapiro, N. I. "A Standardized Conjunctiva Pallor Tool Predicts Anemia: A Multicenter Validation". Academic Emergency Medicine 13, n. 5Supplement 1 (1 maggio 2006): S78—S79. http://dx.doi.org/10.1197/j.aem.2006.03.185.

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van der Straaten, Saskia, Alexander Springer, Aleksandra Zecic, Doris Hebenstreit, Ursula Tonnhofer, Aneta Gawlik, Malgorzata Baumert et al. "The External Genitalia Score (EGS): A European Multicenter Validation Study". Journal of Clinical Endocrinology & Metabolism 105, n. 3 (29 ottobre 2019): e222-e230. http://dx.doi.org/10.1210/clinem/dgz142.

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Abstract Context Standardized description of external genitalia is needed in the assessment of children with atypical genitalia. Objectives To validate the External Genitalia Score (EGS), to present reference values for preterm and term babies up to 24 months and correlate obtained scores with anogenital distances (AGDs). Design, Setting A European multicenter (n = 8) validation study was conducted from July 2016 to July 2018. Patients and Methods EGS is based on the external masculinization score but uses a gradual scale from female to male (range, 0–12) and terminology appropriate for both sexes. The reliability of EGS and AGDs was determined by the interclass correlation coefficient (ICC). Cross-sectional data were obtained in 686 term babies (0–24 months) and 181 preterm babies, and 111 babies with atypical genitalia. Results The ICC of EGS in typical and atypical genitalia is excellent and good, respectively. Median EGS (10th to 90th centile) in males < 28 weeks gestation is 10 (8.6–11.5); in males 28–32 weeks 11.5 (9.2–12); in males 33–36 weeks 11.5 (10.5–12) and in full-term males 12 (10.5–12). In all female babies, EGS is 0 (0-0). The mean (SD) lower/upper AGD ratio (AGDl/u) is 0.45 (0.1), with significant difference between AGDl/u in males 0.49 (0.1) and females 0.39 (0.1) and intermediate values in differences of sex development (DSDs) 0.43 (0.1). The AGDl/u correlates with EGS in males with typical genitalia and in atypical genitalia. Conclusions EGS is a reliable and valid tool to describe external genitalia in premature and term babies up to 24 months. EGS correlates with AGDl/u in males. It facilitates standardized assessment, clinical decision-making and multicenter research.

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Krag, David, Donald Weaver, Takamaru Ashikaga, Frederick Moffat, V. Suzanne Klimberg, Craig Shriver, Sheldon Feldman et al. "The Sentinel Node in Breast Cancer — A Multicenter Validation Study". New England Journal of Medicine 339, n. 14 (ottobre 1998): 941–46. http://dx.doi.org/10.1056/nejm199810013391401.

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Vonesh, Edward F., John Burkart, Stephen D. McMurray e Paul F. Williams. "Peritoneal Dialysis Kinetic Modeling: Validation in a Multicenter Clinical Study". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 16, n. 5 (settembre 1996): 471–81. http://dx.doi.org/10.1177/089686089601600509.

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Objective To clinically validate the use of a computer-based kinetic model for peritoneal dialysis (PD) by assessing the level of agreement between measured and modeled values of urea and creatinine clearances and ultrafiltration (UF). Design An open multicenter observational study. Patients There were 111 adult continuous ambulatory peritoneal dialysis (CAPD) patients (47 female, 64 male) in four centers. All patients underwent a four-hour peritoneal equilibration test (PET) using 2.5% dextrose but with variable fill volumes (range: 1 -3 L). Patients with a residual renal function greater than 10 mL/min were excluded. Main Outcome Measures Correlations and limits of agreement between measured and modeled values of total weekly urea KTN, total weekly normalized creatinine clearance (L/week/1.73 m2), daily drain volume (L), net ultrafiltration (L), daily peritoneal urea clearance (L/day), and daily peritoneal creatinine clearance (L/day). Measured values were obtained from 24-hour urine and dialysate collections while modeled values were based on results from the PET in combination with the PD ADEQUEST® kinetic program. Results The results show there is excellent agreement between measured and modeled urea KTN and creatinine clearances, with concordance correlations of 0.94 and 0.92, respectively. Given the excessive variation and limited range in ultrafiltration values, the concordance correlation between measured and modeled UF was only 0.50. In terms of daily peritoneal clearances and ultrafiltration, the level of precision (i.e., standard deviation) in the differences between modeled and measured values is ±1.05 L/ day for urea clearance, ±1.03 L/day for creatinine clearance, and ±0.919 L/day for ultrafiltration. By contrast, the level of precision (i.e., standard deviation) in the differences between two measured values is estimated to be ±0.979 L/day for urea clearance, ±0.802 L/day for creatinine clearance, and ±0.707 L/day for ultrafiltration. Defining the limits of clinical agreement to be ±2 standard deviations of the differences between two clinically measured 24-hour clearances (or ultrafiltration), we find that 94% of the modeled urea clearances, 87% of the modeled creatinine clearances, and 86% of the modeled ultrafiltration values fall within the limits of clinical agreement. Conclusion Data from a carefully performed PET and overnight exchange can, in combination with a scientifically validated kinetic model, provide clinicians with a powerful mathematical tool for use in CAPD dialysis prescription management. Although not intended to replace actual measurements, kinetic modeling can prove useful as a means for predicting clearances for various alternative prescriptions and perhaps also as a means for checking certain types of noncompliance.

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Kline, J., D. Courtney, C. Moore, C. Kabrhel, H. Smithline, T. McCubbin, P. Richman et al. "Prospective, Multicenter Validation of the Pulmonary Embolism Rule-out Criteria". Academic Emergency Medicine 14, n. 5 Supplement 1 (1 maggio 2007): S7—S8. http://dx.doi.org/10.1197/j.aem.2007.03.705.

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Werline, Laura, e Amanda Young. "Multicenter Emergency Department Validation of the Canadian Syncope Risk Score". Journal of Emergency Medicine 58, n. 6 (giugno 2020): 981. http://dx.doi.org/10.1016/j.jemermed.2020.05.028.

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Rodríguez-Rey, Rocío, Helena García-Llana, María Paz Ruiz-Álvarez, Alicia Gómez-Gómez, Gloria del Peso e Rafael Selgas. "Multicenter Validation of the Emotional State Instrument for Dialysis Patients". Nursing Research 68, n. 1 (2019): 39–47. http://dx.doi.org/10.1097/nnr.0000000000000321.

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Ranallo, Courtney, Madhuradhar Chegondi, Nori Minich, Xinge Ji, Michael Kattan e Steven Shein. "721: MULTICENTER VALIDATION AND REFINEMENT OF THE CRITICAL BRONCHIOLITIS SCORE". Critical Care Medicine 51, n. 1 (15 dicembre 2022): 351. http://dx.doi.org/10.1097/01.ccm.0000908616.02573.8a.

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Eskicorapci, Saadettin Yilmaz, Erdem Karabulut, Levent Türkeri, Sümer Baltacı, Cag Cal, Gokhan Toktas, Haluk Akpınar et al. "Validation of 2001 Partin Tables in Turkey: A Multicenter Study". European Urology 47, n. 2 (febbraio 2005): 185–89. http://dx.doi.org/10.1016/j.eururo.2004.08.002.

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Bergeron, David, Louis Verret, Stephane Poulin, Michèle Houde, Marie-Pierre Fortin, Remi W. Bouchard, Christian Bocti, Serge Gauthier, Ziad Nasreddine e Robert Laforce. "P1-227: Multicenter Validation of an Mmse-Moca Conversion Table". Alzheimer's & Dementia 12 (luglio 2016): P494. http://dx.doi.org/10.1016/j.jalz.2016.06.976.

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Thiruganasambandamoorthy, Venkatesh, Marco L. A. Sivilotti, Natalie Le Sage, Justin W. Yan, Paul Huang, Mona Hegdekar, Eric Mercier et al. "Multicenter Emergency Department Validation of the Canadian Syncope Risk Score". JAMA Internal Medicine 180, n. 5 (1 maggio 2020): 737. http://dx.doi.org/10.1001/jamainternmed.2020.0288.

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Rocha-de-Lossada, Carlos, Cosimo Mazzotta, Federico Gabrielli, Filomena Tiziana Papa, Carmen Gómez-Huertas, Celia García-López, Facundo Urbinati et al. "Ocular Surface Microbiota in Naïve Keratoconus: A Multicenter Validation Study". Journal of Clinical Medicine 12, n. 19 (4 ottobre 2023): 6354. http://dx.doi.org/10.3390/jcm12196354.

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In the field of Ophthalmology, the mNGS 16S rRNA sequencing method of studying the microbiota and ocular microbiome is gaining more and more weight in the scientific community. This study aims to characterize the ocular microbiota of patients diagnosed with keratoconus who have not undergone any prior surgical treatment using the mNGS 16S rRNA sequencing method. Samples of naïve keratoconus patients were collected with an eNAT with 1 mL of Liquid Amies Medium (Copan Brescia, Italy), and DNA was extracted and analyzed with 16S NGS. The microbiota analysis showed a relative abundance of microorganisms at the phylum level in each sample collected from 38 patients with KC and 167 healthy controls. A comparison between healthy control and keratoconus samples identified two genera unique to keratoconus, Pelomonas and Ralstonia. Our findings suggest that alterations in the microbiota may play a role in the complex scenario of KC development.

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Kao, Yuan, Wei-Jing Lee, Kang-Ting Tsai, Chung-Feng Liu, Chien-Chin Hsu, Hung-Jung Lin, Chien-Cheng Huang e How-Ran Guo. "External validation of geriatric influenza death score: A multicenter study". PLOS ONE 18, n. 3 (24 marzo 2023): e0283475. http://dx.doi.org/10.1371/journal.pone.0283475.

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The Geriatric Influenza Death (GID) score was developed to help decision making in older patients with influenza in the emergency department (ED), but external validation is unavailable. Thus, we conducted a study was to fill the data gap. We recruited all older patients (≥65 years) who visited the ED of three hospitals between 2009 and 2018. Demographic data and clinical characteristics were retrospectively collected. Discrimination, goodness of fit, and performance of the GID score were evaluated. Of the 5,508 patients (121 died) with influenza, the mean age was 76.6±7.4 (standard deviation) years, and 49.3% were males. The GID score was higher in the mortality group (1.7±1.1 vs. 0.8±0.8, p <0.01). With 0 as the reference, the odds ratio for morality with score of 1, 2 and ≥3 was 3.08 (95% confidence interval [CI]: 1.66–5.71), 6.69 (95% CI: 3.52–12.71), and 23.68 (95% CI: 11.95–46.93), respectively. The area under the curve was 0.722 (95% CI: 0.677–0.766), and the Hosmer–Lemeshow goodness of fit test was 1.000. The GID score had excellent negative predictive values with different cut-offs. The GID score had good external validity, and further studies are warranted for wider application.

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Chen, Yu, Heze Han, Xiangyu Meng, Hengwei Jin, Dezhi Gao, Li Ma, Ruinan Li et al. "Development and Validation of a Scoring System for Hemorrhage Risk in Brain Arteriovenous Malformations". JAMA Network Open 6, n. 3 (1 marzo 2023): e231070. http://dx.doi.org/10.1001/jamanetworkopen.2023.1070.

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ImportanceThe dilemma between natural rupture risk and adverse outcomes of intervention is of major concern for patients with unruptured arteriovenous malformations (AVMs). The existing risk score for AVM rupture includes factors that are controversial and lacks prospective validation.ObjectiveTo develop and robustly validate a reliable scoring system to predict the rupture risk of AVMs.Design, Setting, and ParticipantsThis prognostic study developed a prediction model derived from a single-center cohort (derivation cohort) and validated in a multicenter external cohort (multicenter external validation cohort) and a cohort of patients receiving conservative treatment management (conservative treatment validation cohort). Patients were recruited from a nationwide multicenter prospective collaboration registry in China. A total of 4135 patients were enrolled in the registry between August 1, 2011, and September 1, 2021. Of those, 3962 patients were included in the study (3585 in the derivation cohort and 377 in the multicenter external validation cohort); 1028 patients from the derivation cohort who had time-to-event data and prerupture imaging results were included in the conservative treatment validation cohort. Data were analyzed from March 10 to June 21, 2022.Main Outcomes and MeasuresA scoring system was developed based on risk factors identified from a literature review and a robust selection process. Patients were stratified into different risk groups based on scores to calculate hemorrhage-free probability in future years, and Kaplan-Meier curves were plotted to visualize risk stratification. Receiver operating characteristic curves were used to assess the discrimination of models. Univariable analyses (logistic regression analysis for descriptive data and Cox regression analysis for survival data) were used to compare baseline information and assess bias.ResultsAmong 3962 patients (2311 men [58.3%]; median [IQR] age, 26.1 [14.6-35.5] years), 3585 patients (2100 men [58.6%]; median [IQR] age, 25.9 [14.6-35.0] years) were included in the derivation cohort, and 377 patients (211 men [56.0%]; median [IQR] age, 26.4 [14.5-39.2] years) were included in the multicenter external validation cohort. Thirty-six hemorrhages occurred over a median (IQR) follow-up of 4.2 (0.3-6.0) years among 1028 patients in the conservative treatment validation cohort. Four risk factors were used to develop the scoring system: ventricular system involvement, venous aneurysm, deep location, and exclusively deep drainage (VALE). The VALE scoring system performed well in all 3 cohorts, with areas under the receiver operating characteristic curve of 0.77 (95% CI, 0.75-0.78) in the derivation cohort, 0.85 (95% CI, 0.81-0.89) in the multicenter external validation cohort, and 0.73 (95% CI, 0.65-0.81) in the conservative treatment validation cohort. The 10-year hemorrhage-free rate was 95.5% (95% CI, 87.1%-100%) in the low-risk group, 92.8% (95% CI, 88.8%-97.0%) in the moderate-risk group, and 75.8% (95% CI, 65.1%-88.3%) in the high-risk group; the model discrimination was significant when comparing these rates between the high-risk group and the low- and moderate-risk groups (P &lt; .001 for both comparisons).Conclusions and RelevanceIn this prognostic study, the VALE scoring system was developed to distinguish rupture risk among patients with AVMs. The stratification of unruptured AVMs may enable patients with low risk of rupture to avoid unnecessary interventions. These findings suggest that the scoring system is a reliable and applicable tool that can be used to facilitate patient and physician decision-making and reduce unnecessary interventions or unexpected AVM ruptures.

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Quesada López, Miguel, Laura Amaya Pascasio, Sara Blanco Madera, Jorge Pagola, Diana Vidal de Francisco, Elena de Celis Ruiz, Inmaculada Villegas Rodríguez et al. "External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study". Stroke Research and Treatment 2023 (7 dicembre 2023): 1–8. http://dx.doi.org/10.1155/2023/6655772.

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Introduction. The screening for atrial fibrillation (AF) scale (SAFE score) was recently developed to provide a prediction of the diagnosis of AF after an ischemic stroke. It includes 7 items: a g e ≥ 65 years, bronchopathy, thyroid disease, cortical location of stroke, intracranial large vessel occlusion, NT-ProBNP ≥250 pg/mL, and left atrial enlargement. In the internal validation, a good performance was obtained, with an A U C = 0.88 (95% CI 0.84-0.91) and sensitivity and specificity of 83% and 80%, respectively, for s c o r e s ≥ 5 . The aim of this study is the external validation of the SAFE score in a multicenter cohort. Methods. A retrospective multicenter study, including consecutive patients with ischemic stroke or transient ischemic attack between 2020 and 2022 with at least 24 hours of cardiac monitoring. Patients with previous AF or AF diagnosed on admission ECG were excluded. Results. Overall, 395 patients were recruited for analysis. The SAFE score obtained an A U C = 0.822 (95% CI 0.778-0.866) with a sensitivity of 87.2%, a specificity of 65.4%, a positive predictive value of 44.1%, and a negative predictive value of 94.3% for a SAFE s c o r e ≥ 5 , with no significant gender differences. Calibration analysis in the external cohort showed an absence of significant differences between the observed values and those predicted by the model (Hosmer-Lemeshow’s test 0.089). Conclusions. The SAFE score showed adequate discriminative ability and calibration, so its external validation is justified. Further validations in other external cohorts or specific subpopulations of stroke patients might be required.

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Witteveen, Esther, Luuk Wieske, Juultje Sommers, Jan-Jaap Spijkstra, Monique C. de Waard, Henrik Endeman, Saskia Rijkenberg et al. "Early Prediction of Intensive Care Unit–Acquired Weakness: A Multicenter External Validation Study". Journal of Intensive Care Medicine 35, n. 6 (1 maggio 2018): 595–605. http://dx.doi.org/10.1177/0885066618771001.

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Objectives: An early diagnosis of intensive care unit–acquired weakness (ICU-AW) is often not possible due to impaired consciousness. To avoid a diagnostic delay, we previously developed a prediction model, based on single-center data from 212 patients (development cohort), to predict ICU-AW at 2 days after ICU admission. The objective of this study was to investigate the external validity of the original prediction model in a new, multicenter cohort and, if necessary, to update the model. Methods: Newly admitted ICU patients who were mechanically ventilated at 48 hours after ICU admission were included. Predictors were prospectively recorded, and the outcome ICU-AW was defined by an average Medical Research Council score <4. In the validation cohort, consisting of 349 patients, we analyzed performance of the original prediction model by assessment of calibration and discrimination. Additionally, we updated the model in this validation cohort. Finally, we evaluated a new prediction model based on all patients of the development and validation cohort. Results: Of 349 analyzed patients in the validation cohort, 190 (54%) developed ICU-AW. Both model calibration and discrimination of the original model were poor in the validation cohort. The area under the receiver operating characteristics curve (AUC-ROC) was 0.60 (95% confidence interval [CI]: 0.54-0.66). Model updating methods improved calibration but not discrimination. The new prediction model, based on all patients of the development and validation cohort (total of 536 patients) had a fair discrimination, AUC-ROC: 0.70 (95% CI: 0.66-0.75). Conclusions: The previously developed prediction model for ICU-AW showed poor performance in a new independent multicenter validation cohort. Model updating methods improved calibration but not discrimination. The newly derived prediction model showed fair discrimination. This indicates that early prediction of ICU-AW is still challenging and needs further attention.

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Qi, Jing, Guangcong Ruan, Yi Ping, Zhifeng Xiao, Kaijun Liu, Yi Cheng, Rongbei Liu et al. "Development and validation of a deep learning-based approach to predict the Mayo endoscopic score of ulcerative colitis". Therapeutic Advances in Gastroenterology 16 (gennaio 2023): 175628482311709. http://dx.doi.org/10.1177/17562848231170945.

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Background: The ulcerative colitis (UC) Mayo endoscopy score is a useful tool for evaluating the severity of UC in patients in clinical practice. Objectives: We aimed to develop and validate a deep learning-based approach to automatically predict the Mayo endoscopic score using UC endoscopic images. Design: A multicenter, diagnostic retrospective study. Methods: We collected 15120 colonoscopy images of 768 UC patients from two hospitals in China and developed a deep model based on a vision transformer named the UC-former. The performance of the UC-former was compared with that of six endoscopists on the internal test set. Furthermore, multicenter validation from three hospitals was also carried out to evaluate UC-former’s generalization performance. Results: On the internal test set, the areas under the curve of Mayo 0, Mayo 1, Mayo 2, and Mayo 3 achieved by the UC-former were 0.998, 0.984, 0.973, and 0.990, respectively. The accuracy (ACC) achieved by the UC-former was 90.8%, which is higher than that achieved by the best senior endoscopist. For three multicenter external validations, the ACC was 82.4%, 85.0%, and 83.6%, respectively. Conclusions: The developed UC-former could achieve high ACC, fidelity, and stability to evaluate the severity of UC, which may provide potential application in clinical practice. Registration: This clinical trial was registered at the ClinicalTrials.gov (trial registration number: NCT05336773)

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Liu, Jin, Tao Lian, Haimei Chen, Xiaohong Wang, Xianyue Quan, Yu Deng, Juan Yao et al. "Pretreatment Prediction of Relapse Risk in Patients with Osteosarcoma Using Radiomics Nomogram Based on CT: A Retrospective Multicenter Study". BioMed Research International 2021 (4 febbraio 2021): 1–13. http://dx.doi.org/10.1155/2021/6674471.

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Objective. To develop and externally validate a CT-based radiomics nomogram for pretreatment prediction of relapse in osteosarcoma patients within one year. Materials and Methods. In this multicenter retrospective study, a total of 80 patients (training cohort: 63 patients from three hospitals; validation cohort: 17 patients from three other hospitals) with osteosarcoma, undergoing pretreatment CT between August 2010 and December 2018, were identified from multicenter databases. Radiomics features were extracted and selected from tumor regions on CT image, and then, the radiomics signature was constructed. The radiomics nomogram that incorporated the radiomics signature and clinical-based risk factors was developed to predict relapse risk with a multivariate Cox regression model using the training cohort and validated using the external validation cohort. The performance of the nomogram was assessed concerning discrimination, calibration, reclassification, and clinical usefulness. Results. Kaplan-Meier curves based on the radiomics signature showed a significant difference between the high-risk and the low-risk groups in both training and validation cohorts ( P < 0.001 and P = 0.015 , respectively). The radiomics nomogram achieved good discriminant results in the training cohort ( C -index: 0.779) and the validation cohort ( C -index: 0.710) as well as good calibration. Decision curve analysis revealed that the proposed model significantly improved the clinical benefit compared with the clinical-based nomogram ( P < 0.001 ). Conclusions. This multicenter study demonstrates that a radiomics nomogram incorporated the radiomics signature and clinical-based risk factors can increase the predictive value of the osteosarcoma relapse risk, which supports the clinical application in different institutions.

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Lu, Sz-Wei, Kuang-Yu Niu, Chu-Pin Pai, Shih-Hua Lin, Chen-Bin Chen, Yu-Tai Lo, Yi-Chih Lee, Chen-June Seak e Chieh-Ching Yen. "Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study". Cancers 16, n. 4 (16 febbraio 2024): 804. http://dx.doi.org/10.3390/cancers16040804.

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Purpose: To develop and internally validate a novel prediction score to predict the occurrence of arterial–esophageal fistula (AEF) in esophageal cancer bleeding. Methods: This retrospective cohort study enrolled patients with esophageal cancer bleeding in the emergency department. The primary outcome was the diagnosis of AEF. The patients were randomly divided into a derivation group and a validation group. In the derivation stage, a predictive model was developed using logistic regression analysis. Subsequently, internal validation of the model was conducted in the validation cohort during the validation stage to assess its discrimination ability. Results: A total of 257 patients were enrolled in this study. All participants were randomized to a derivation cohort (n = 155) and a validation cohort (n = 102). AEF occurred in 22 patients (14.2%) in the derivation group and 14 patients (13.7%) in the validation group. A predictive model (HEARTS-Score) comprising five variables (hematemesis, active bleeding, serum creatinine level >1.2 mg/dL, prothrombin time >13 s, and previous stent implantation) was established. The HEARTS-Score demonstrated a high discriminative ability in both the derivation and validation cohorts, with c-statistics of 0.90 (95% CI 0.82–0.98) and 0.82 (95% CI 0.72–0.92), respectively. Conclusions: By employing this novel prediction score, clinicians can make more objective risk assessments, optimizing diagnostic strategies and tailoring treatment approaches.

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Walker, Katie J., Jirayus Jiarpakdee, Anne Loupis, Chakkrit Tantithamthavorn, Keith Joe, Michael Ben-Meir, Hamed Akhlaghi et al. "Predicting Ambulance Patient Wait Times: A Multicenter Derivation and Validation Study". Annals of Emergency Medicine 78, n. 1 (luglio 2021): 113–22. http://dx.doi.org/10.1016/j.annemergmed.2021.02.010.

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Depner, T. A., P. R. Keshaviah, J. P. Ebben, P. F. Emerson, A. J. Collins, K. K. Jindal, A. R. Nissenson, J. M. Lazarus e K. Pu. "Multicenter clinical validation of an on-line monitor of dialysis adequacy." Journal of the American Society of Nephrology 7, n. 3 (marzo 1996): 464–71. http://dx.doi.org/10.1681/asn.v73464.

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Quantitation of hemodialysis by measuring changes in blood solute concentration requires careful timing when taking the postdialysis blood sample to avoid errors from postdialysis rebound and from recirculation of blood through the access device. It also requires complex mathematical interpretation to account for solute disequilibrium in the patient. To circumvent these problems, hemodialysis can be quantified and its adequacy assessed by direct measurement of the urea removed in the dialysate. Because total dialysate collection is impractical, an automated method was developed for measuring dialysate urea-nitrogen concentrations at frequent intervals during treatment. A multicenter clinical trial of the dialysate monitoring device, the Biostat 1000 (Baxter Healthcare Corporation, McGaw Park, IL) was conducted to validate the measurements of urea removed, the delivered dialysis dose (Kt/V), and net protein catabolism (PCR). The results were compared with a total dialysate collection in each patient. During 29 dialyses in 29 patients from three centers, the paired analysis of urea removed, as estimated by the dialysate monitor compared with the total dialysate collection, showed no significant difference (14.7 +/- 4.7 g versus 14.8 +/- 5.1 g). Similarly, measurements of Kt/V and PCR showed no significant difference (1.30 +/- 0.18 versus 1.28 +/- 0.19, respectively, for Kt/V and 42.3 +/- 15.7 g/day versus 52.2 +/- 17.4 g/day for PCR). When blood-side measurements during the same dialyses were analyzed with a single-compartment, variable-volume model of urea kinetics, Kt/V was consistently overestimated (1.49 +/- 0.29/dialysis, P < 0.001), most likely because of failure to consider urea disequilibrium. Because urea disequilibrium is difficult to quantitate during each treatment, dialysate measurements have obvious advantages. The dialysate monitor eliminated errors from dialysate bacterial contamination, simplified dialysate measurements, and proved to be a reliable method for quantifying and assuring dialysis adequacy.

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Bergmann, R. L., J. Forster, J. Schulz, K. E. Bergmann, C. P. Bauer e U. Wahn. "Atopic family history. Validation of instruments in a multicenter cohort study". Pediatric Allergy and Immunology 4, n. 3 (agosto 1993): 130–35. http://dx.doi.org/10.1111/j.1399-3038.1993.tb00081.x.

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Esposito, Gianluca, Pedro Pimentel-Nunes, Stefano Angeletti, Rui Castro, Diogo Libânio, Gloria Galli, Edith Lahner, Emilio Di Giulio, Bruno Annibale e Mario Dinis-Ribeiro. "Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study". Endoscopy 51, n. 06 (21 dicembre 2018): 515–21. http://dx.doi.org/10.1055/a-0808-3186.

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Abstract Background Random biopsies are recommended to identify individuals at risk of gastric adenocarcinoma. Cumulative evidence suggests that narrow-band imaging (NBI) can be used to grade gastric intestinal metaplasia (GIM). We aimed to externally validate a classification of endoscopic grading of gastric intestinal metaplasia (EGGIM). Methods Consecutive patients in two centers were submitted to high resolution white-light gastroscopy followed by NBI to estimate EGGIM – a score (0 – 10) resulting from the sum of endoscopic assessments of GIM, scored as 0, 1, or 2 for no GIM, ≤ 30 %, or > 30 % of the mucosa, respectively, in five areas (lesser and greater curvature of both antrum and corpus, and incisura). If GIM was endoscopically suspected, targeted biopsies were performed; if GIM was not noticeable, random biopsies were performed according to the Sydney system to estimate the operative link on gastric intestinal metaplasia (OLGIM; the gold standard). Results 250 patients (62 % female; median age 55 years) were included. GIM was staged as OLGIM 0, I, II, III, IV in 136 (54 %), 15 (6 %), 52 (21 %), 34 (14 %), and 13 (5 %) patients, respectively. All patients with GIM except three were identifiable with targeted biopsies. For the diagnosis of OLGIM III/IV, the area under the ROC curve was 0.96 (95 % confidence interval [CI] 0.93 – 0.98) and by using the cutoff > 4, sensitivity, specificity, and positive likelihood ratio were 89 %, 95 %, and 16.5, respectively; results were similar (91 %, 95 %, and 18.1) when excluding patients with foveolar hyperplasia. Conclusions For the first time, an endoscopic approach was externally validated to determine the risk of gastric cancer without the need for biopsies. This can be used to simplify and individualize the management of patients with gastric precancerous conditions.

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De Ost, B., B. Schaeken, S. Vynckier, E. Sterpin e D. Van den Weyngaert. "Reference dosimetry for helical tomotherapy: Practical implementation and a multicenter validation". Medical Physics 38, n. 11 (20 ottobre 2011): 6020–26. http://dx.doi.org/10.1118/1.3651496.

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Munschauer, Frederick E., Margaret M. Hens, Roger L. Priore, Elaine Stolarski, Sherry Buffamonte, Ann Carlin, Larry Wechsler et al. "Screening for atrial fibrillation in the community: A multicenter validation trial". Journal of Stroke and Cerebrovascular Diseases 8, n. 2 (marzo 1999): 99–103. http://dx.doi.org/10.1016/s1052-3057(99)80063-9.

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Puehringer, H., M. Macek, A. Stambergova, L. Dvorakova, M. Dunø, B. Tuemmler, S. Hedtfeld, M. Tzetis, M. Poulou e C. Oberkanins. "24 Multicenter validation study of a novel StripAssay for cystic fibrosis". Journal of Cystic Fibrosis 10 (giugno 2011): S7. http://dx.doi.org/10.1016/s1569-1993(11)60046-5.

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de Medeiros, Heydrich Lopes Virgulino, Selene Cordeiro Vasconcelos, Helio Elkis, Diana Rocha Martins, Raissa Miranda de Alexandria Leite, Ana Carla Leite de Albuquerque, Rosana Ramos Freitas et al. "The Brief Negative Symptom Scale: Validation in a multicenter Brazilian study". Comprehensive Psychiatry 85 (agosto 2018): 42–47. http://dx.doi.org/10.1016/j.comppsych.2018.06.007.

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Groch, Mark W., William D. Erwin, Paul H. Murphy, Amjad Ali, Warren Moore, Patrick Ford, Jianzhong Qian, Charles A. Barnett e Jean Lette. "Validation of a knowledge-based boundary detection algorithm: a multicenter study". European Journal of Nuclear Medicine 23, n. 6 (giugno 1996): 662–68. http://dx.doi.org/10.1007/bf00834528.

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Bulloch, Blake, Gina Neto, Amy Plint, Rodrick Lim, Per Lidman, Martin Reed, Cheri Nijssen-Jordan, Milton Tenenbein e Terry P. Klassen. "Validation of the Ottawa Knee Rule in children: A multicenter study". Annals of Emergency Medicine 42, n. 1 (luglio 2003): 48–55. http://dx.doi.org/10.1067/mem.2003.196.

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Tsivgoulis, G., E. Stamboulis, V. K. Sharma, I. Heliopoulos, K. Voumvourakis, H. L. Teoh, A. Patousi et al. "Multicenter external validation of the ABCD2 score in triaging TIA patients". Neurology 74, n. 17 (26 aprile 2010): 1351–57. http://dx.doi.org/10.1212/wnl.0b013e3181dad63e.

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Gatti, Arianna, Luigi Del Vecchio, Massimo Geuna, Matteo G. Della Porta e Bruno Brando. "Multicenter validation of a simplified method for paroxysmal nocturnal hemoglobinuria screening". European Journal of Haematology 99, n. 1 (17 aprile 2017): 27–35. http://dx.doi.org/10.1111/ejh.12885.

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Orlhac, Fanny, Frédérique Frouin, Christophe Nioche, Nicholas Ayache e Irène Buvat. "Validation of A Method to Compensate Multicenter Effects Affecting CT Radiomics". Radiology 291, n. 1 (aprile 2019): 53–59. http://dx.doi.org/10.1148/radiol.2019182023.

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Li, Marilyn M., Federico A. Monzon, Jaclyn A. Biegel, Vaidehi Jobanputra, Jennifer J. Laffin, Brynn Levy, Annette Leon et al. "A multicenter, cross-platform clinical validation study of cancer cytogenomic arrays". Cancer Genetics 208, n. 11 (novembre 2015): 525–36. http://dx.doi.org/10.1016/j.cancergen.2015.08.002.

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Tan, King L., David W. Scott, Fangxin Hong, Brad S. Kahl, Richard I. Fisher, Nancy L. Bartlett, Ranjana H. Advani et al. "Tumor-associated macrophages predict inferior outcomes in classic Hodgkin lymphoma: a correlative study from the E2496 Intergroup trial". Blood 120, n. 16 (18 ottobre 2012): 3280–87. http://dx.doi.org/10.1182/blood-2012-04-421057.

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Abstract Increased tumor-associated macrophages (TAMs) are reported to be associated with poor prognosis in classic Hodgkin lymphoma (CHL). We investigated the prognostic significance of TAMs in the E2496 Intergroup trial, a multicenter phase 3 randomized controlled trial comparing ABVD and Stanford V chemotherapy in locally extensive and advanced stage CHL. Tissue microarrays were constructed from formalin-fixed, paraffin-embedded tumor tissue and included 287 patients. Patients were randomly assigned into training (n = 143) and validation (n = 144) cohorts. Immunohistochemistry for CD68 and CD163, and in situ hybridization for EBV-encoded RNA were performed. CD68 and CD163 IHC were analyzed by computer image analysis; optimum thresholds for overall survival (OS) were determined in the training cohort and tested in the independent validation cohort. Increased CD68 and CD163 expression was significantly associated with inferior failure-free survival and OS in the validation cohort. Increased CD68 and CD163 expression was associated with increased age, EBV-encoded RNA positivity, and mixed cellularity subtype of CHL. Multivariate analysis in the validation cohort showed increased CD68 or CD163 expression to be significant independent predictors of inferior failure-free survival and OS. We demonstrate the prognostic significance of TAMs in locally extensive and advanced-stage CHL in a multicenter phase 3 randomized controlled clinical trial.