Ultrasonographic fetal nomograms of anterior ventricular hemisphere ratio (AVHR) and posterior ventricular hemisphere ratio (PVHR) for early prenatal diagnosis of hydrocephalus

Serial ultrasound scans were done in 150 fetuses between 14th to 22nd week of gestation to establish the nomograms of anterior ventricular hemisphere ratio (AVHR) and posterior ventricular hemisphere ratio (PVHR). Of 150 fetuses, 100 were in the high risk group for neural tube defect and 50 were in the control group. The study indicates that the value of AVHR decreases from 0.62 to 0.50 and PVHR from 0.60 to 0.50 between 14th to 22nd week of gestation. No statistical difference was observed in the values of AVHR and PVHR in high risk and low risk (control) cases (p>.001). The value of AVHR or PVHR greater than 0.5 after 18 weeks of gestation or more was considered pathological for hydrocephalus. In 2, out of 3 cases of hydrocephalus detected in our series, the value of AVHR and PVHR was 0.7 at 20 weeks and in the third case it was 0.6 at 18 weeks. All of these values were 3 SD above the normal for the period of gestation.     

Extent of pelvic lymph node dissection and the impact of standard template dissection on nomogram prediction of lymph node involvement

Background

Our current lymph node involvement (LNI) nomogram was created using patients receiving both limited and standard lymph node dissection (LND). Over time, refinements in technique could affect the diagnostic yield from LND.

Objective

Our aim was to validate our existing LNI nomogram or develop a new nomogram with updated prediction coefficients that reflect the current standard LND template during radical prostatectomy (RP). We hypothesized that the existing nomogram would demonstrate good discrimination but poor calibration in a contemporary series of standard LND.

Design, setting, and participants

A retrospective analysis of 4176 consecutive primary RP patients was performed, including open procedures (3097 patients from 2000 to 2008) and laparoscopic procedures (1079 patients from 2005 to 2008). After excluding 127 patients (3%) with limited LND, 10 (0.2%) with pretreatment prostate-specific antigen (PSA) >50 ng/ml, and 318 (8%) with incomplete data, the final cohort totaled 3721 patients. The nomograms were evaluated using receiver operating characteristic analysis, calibration plots, and decision-curve analysis.

Interventions

Patients received open or laparoscopic (conventional and robot-assisted) RP and standard LND in our center.

Measurements

Assessments were obtained using preoperative PSA, biopsy Gleason score, and clinical stage.

Results and limitations

The median number of nodes removed was 11, with ∼60% of patients having at least 10 nodes removed (n = 2224). Overall, 5.2% of patients (n = 194) had positive lymph nodes. The new nomogram had very high discriminative accuracy (area under the curve: 0.862). The decision-curve analysis showed that the new nomogram had the highest clinical net benefit for all reasonable threshold probabilities.

Conclusions

The new nomogram shows improved calibration when predicting lymph node invasion in a contemporary cohort of patients with prostate cancer exclusively treated with RP and standard LND. This nomogram will be used as the preferred predictive model for counseling patients and developing studies at our institution.     

Nomograms for prediction of disease recurrence in patients with primary Ta, T1 transitional cell carcinoma of the bladder

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.     

普通外科恶性肿瘤患者术后下肢深静脉血栓形成预测模型的构建

背景与目的：下肢深静脉血栓形成（LDVT）是普通外科恶性肿瘤患者术后常见的并发症之一,严重影响患者的术后康复。目前的评估工具无法对LDVT患者进行更加细致的风险分层。因此,本研究探讨普通外科恶性肿瘤患者术后发生LDVT的影响因素,并建立可靠的预测工具,从而为LDVT的诊断和防治提供帮助。方法：回顾性分析2021年1月1日—2022年10月31日中南大学湘雅医院普通外科手术治疗恶性肿瘤患者的临床资料,根据良好设计的纳入、排除标准对病例进行严格的质量控制。使用已经较明确的LDVT的影响因素和一些重要临床特征作为分析变量,单变量分析和多变量分析用以评估LDVT的影响因素以及筛选模型的预测因子。应用编程软件制作基于Logistic回归的列线图并通过受试者工作特征曲线（ROC）评估列线图的预测性能,校准曲线用以评估预测模型与数据的拟合程度。使用决策曲线分析（DCA）比较预测模型与其他单一指标临床应用价值的差异。结果：本研究共纳入342例患者,其中LDVT组167例,对照组175例。单变量分析显示,1个月内有手术创伤史、高血压史、吸烟史、饮酒史、放疗史、ICU住院时间、红细胞（RBC）、血红蛋白（...     

社区老年人认知衰弱风险预测模型的构建及验证

目的 构建并验证社区老年人认知衰弱风险预测模型.方法 2020年8月—2021年7月便利选取广州市某社区卫生服务中心526名体检老年人,分为建模集368名和验证集158名,采用一般状况调查表及认知衰弱评定工具收集资料.采用Logistic回归确定影响因素,应用R软件建立预测认知衰弱发生风险的列线图模型;采用加强Boot...     

皮革胃患者术后生存情况预测的列线图模型研究

目的:构建皮革胃患者术后预后的列线图预测模型,并验证其准确性。方法:收集2008年12月—2014年9月共203例在福建医科大学附属协和医院胃外科行R_0切除的皮革胃患者的临床病理资料。根据Cox逻辑回归分析确定的独立预后因素,用R软件建立列线图预测模型,并分析所建模型对皮革胃患者预后预测的准确度。结果:全组患者中,男152例,女51例,其平均年龄为60.3(21～89)岁;II期患者25例(12.3%),III期患者178例(87.7%);中位随访时间38(2～111)个月;3、5年总体生存率分别为31.2%、18.7%。多因素分析结果示,BMI(P=0.006)、肿瘤细胞分化程度(P=0.042)、T分期(P=0.032)、N分期(P=0.032)、ASA评分(P=0.016)是预后的独立危险因素。根据以上独立危险因素建立列线图,并根据列线图的得分将患者进行危险分组分析发现,高危组(16分)、中危组(8～16分)和低危组(≤8分)患者的生存差异有统计学意义(P0.001)。列线图的线性χ~2、阳性似然比、赤池信息量值准则均优于第七版AJCC-TNM分期系统(68.99 vs. 58.58、70.18 vs. 58.36、1 473.38 vs. 1 485.04)。结论:所建立的列线图模型能有效预测皮革胃患者的术后总体生存率,其预测准确度优于第7版AJCC-TNM分期系统,但该结果仍需进一步通过大宗的病例和多中心研究验证。     

浆液性卵巢癌治疗后远期生存列线图预测模型的构建和验证

目的:构建并验证浆液性卵巢癌远期生存概率的列线图,为卵巢癌患者提供个性化的治疗建议和随访策略.方法:共有6957例来自SEER数据库的患者被纳入训练组;外部验证组数据来自于1244例患者的临床资料.基于Cox回归模型构建列线图,使用一致性指数、受试者操作特征曲线、校准图进行验证.绘制Kaplan-Meier曲线比较不同...     

Pediatric echocardiographic nomograms: What has been done and what still needs to be done

Nomograms are essential tools for quantification in pediatric echocardiography. In the last few years, multiple sources highlight that nomograms employed for decades presented significant numerical and methodological limitations. As a result, widely different ranges of normality were generated, thus creating confusion in estimation of several cardiac diseases. New nomograms have recently been generated, overcoming some of the gaps of previous research: wider sample sizes (including neonates/infants), solid statistical/methodological plan, and availability of new data (chamber dimensions, many functional parameters). In particular, robust two-dimensional nomograms covering a wide spectrum of cardiac measurements have recently become available. Significant advances have been made for functional data (i.e. diastolic and deformation indexes) but a few limitations still exist. These include numerical issues (sample size of below 400 subjects) and methodological pitfalls (heterogeneous data normalization/expression). Despite these limitations, however, actual nomograms for functional data present quite reproducible intervals of normality with the exception of neonates and infants.In conclusion, great advances have been made during the last years. A few basic rules for the building of nomograms have been established (i.e. inclusion/exclusion criteria, measurement standardization), while others (i.e. the sample size, the way to express/normalize data, statistical requirements) are basically defined but still require standardization. New pediatric echocardiographic nomograms of good quality are easily accessible due to new electronic tools (online calculators, apps for smart-phone/tablets). Studies are ongoing to generate wider, comprehensive and multi-ethnic nomograms and to evaluate new parameters (e.g. three-dimensional parameters).