Search results for "decision"
showing 10 items of 2091 documents
Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)
2020
The potential impact of direct-acting antivirals (DAAs) in patients with Barcelona Clinic Liver Cancer (BCLC)-B/C stage hepatocellular carcinoma (HCC) is understudied. Patients with HCC have been systematically excluded from randomised controlled trials evaluating the effectiveness of DAAs. Thus, the benefits of DAAs in patients with HCC are less well defined. The presence of active HCC before the initiation of DAA treatment is reported to be a predictor of DAA failure, and studies in patients without HCC have demonstrated that improvements in cirrhosis complications were lower or absent after DAA failure. Even if viral eradication is achieved using DAAs, reversal of liver function impairme…
The Unsolved Conundrum of Optimal Blood Pressure Target During Acute Haemorrhagic Stroke: A Comprehensive Analysis
2019
Intracerebral haemorrhage (ICH) is a devastating cerebrovascular disease, which accounts to 15% of all strokes. Among modifiable risk factors for ICH, hypertension is the most frequent. High blood pressure (BP) is detected in more than 75–80% of patients with ICH. Extremely elevated BP has been associated with early hematoma growth, a relatively frequent occur-rence and powerful predictor of poor outcome in patients with spontaneous ICH. On the other hand, excessively low BP might cause cerebral hypoperfusion and ultimately lead to poor outcome. This review will analyse the most important trials that have tried to establish how far should BP be lowered during acute ICH. These trials have de…
Liquid Biopsy in Gastrointestinal Stromal Tumor
2017
Over the past 15 years, gastrointestinal stromal tumors (GISTs) have emerged from a poorly understood neoplasm to a well-defined tumor entity. Starting from 2000, the discovery of gain-of-function mutations involving KIT or PDGFRα (platelet-derived growth factor-α) genes and the development of tyrosine kinase inhibitors (TKIs), such as imatinib, revolutionized dramatically the management of GISTs. Due to the almost continual emergence of new data about biological complexity of GISTs and more sophisticated whole-genome technologies, to date, the role of molecular biology is clinically important to drive therapeutic decision making.
Clinical Decision-Making when Treating Diabetic Macular Edema Patients with Dexamethasone Intravitreal Implants.
2017
Diabetes mellitus (DM) is a metabolic disease frequently associated with comorbidities that include diabetic macular edema (DME). The current medical approach to treating DME involves intravitreal injections with either anti-vascular endothelial growth factors or steroids. However, the burden associated with intravitreal injections and DM-derived complications is high, underlining the need to find optimal treatment regimens. In this article we describe the considerations we apply when treating DME patients with dexamethasone intravitreal implants (Ozurdex®), particularly those that influence the clinical decision-making process during the follow-up period. These considerations are based bot…
The VIRSTA score, a prediction score to estimate risk of infective endocarditis and determine priority for echocardiography in patients with Staphylo…
2016
International audience; Objectives - To develop and validate a prediction score, to quantify, within 48 h of Staphylococcus aureus bacteremia (SAB) diagnosis, the risk of IE, and therefore determine priority for urgent echocardiography. Methods - Consecutive adult patients with SAB in 8 French university hospitals between 2009 and 2011 were prospectively enrolled and followed-up 3 months. A predictive model was developed and internally validated using bootstrap procedures. Results - Among the 2008 patients enrolled, 221 (11.0%) had definite IE of whom 39 (17.6%) underwent valve surgery, 25% of them within 6 days of SAB diagnosis. Ten predictors independently associated with IE were used to …
Requirements Analysis and Specification for a Molecular Tumor Board Platform Based on cBioPortal
2020
Clinicians in molecular tumor boards (MTB) are confronted with a growing amount of genetic high-throughput sequencing data. Today, at German university hospitals, these data are usually handled in complex spreadsheets from which clinicians have to obtain the necessary information. The aim of this work was to gather a comprehensive list of requirements to be met by cBioPortal to support processes in MTBs according to clinical needs. Therefore, oncology experts at nine German university hospitals were surveyed in two rounds of interviews. To generate an interview guideline a scoping review was conducted. For visual support in the second round, screenshot mockups illustrating the requirements …
Improving the Translational Medicine Process: Moving Patients From "End-Users" to "Engaged Collaborators".
2019
Translational medicine works through the definition of unmet medical needs, their understanding and final resolution. In this complex and multi-disciplinary process patients have always been regarded as "end-users" or no more than "data provider." Considering that the translational practice is nowadays highly inefficient (i.e., large intellectual and economical resources are wasted with limited impact on people health) here we propose to reverse the process: start from patients, engage them, and keep them at the center. A new partnership needs to be formed between the patients and the health care professionals, as well as the treating physicians, to make the most out of the current "health …
The Impact of Artificial Intelligence on Traditional Chinese Medicine
2021
Traditional Chinese Medicine (TCM) is a well-established medical system with a long history. Currently, artificial intelligence (AI) is rapidly expanding in many fields including TCM. AI will significantly improve the reliability and accuracy of diagnostics, thus increasing the use of effective therapeutic methods for patients. This systematic review provides an updated overview on the major breakthroughs in the field of AI-assisted TCM four diagnostic methods, syndrome differentiation, and treatment. AI-assisted TCM diagnosis is mainly based on digital data collected by modern electronic instruments, which makes TCM diagnosis more quantitative, objective, and standardized. As a result, th…
Defining classifier regions for WSD ensembles using word space features
2006
Based on recent evaluation of word sense disambiguation (WSD) systems [10], disambiguation methods have reached a standstill. In [10] we showed that it is possible to predict the best system for target word using word features and that using this 'optimal ensembling method' more accurate WSD ensembles can be built (3-5% over Senseval state of the art systems with the same amount of possible potential remaining). In the interest of developing if more accurate ensembles, w e here define the strong regions for three popular and effective classifiers used for WSD task (Naive Bayes – NB, Support Vector Machine – SVM, Decision Rules – D) using word features (word grain, amount of positive and neg…
Loss of habitats, naturalness and species diversity in Eurasian forest landscapes
2010
Abstract Man has exploited land and forests in Western and Central Europe longer and more intensively than in Northern Europe and further east in Eurasia. We estimated forest naturalness and modelled expected biodiversity loss in seven different landscapes (2500 km2 each) in the Netherlands, Sweden, Finland, Poland, St. Petersburg (Western European Russia), Perm (Eastern European Russia), and Irkutsk (Central Siberia) across the distribution of Pinus sylvestris L. in Eurasia. Field inventories showed that the mean living tree volumes were relatively similar in the studied sites, but the volumes of dead wood differed greatly. In Irkutsk and Perm the volume of dead trees per ha was about 5–10…