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Risk Classification (risk + classification)
Selected AbstractsAdding an Alcohol-Related Risk Score to an Existing Categorical Risk Classification for Older Adults: Sensitivity to Group DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2007Sandra R. Wilson PhD OBJECTIVES: To evaluate a new alcohol-related risk score for research use. DESIGN: Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect postintervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors. SETTING: Three primary care group practices in southern California. PARTICIPANTS: Six hundred sixty-five patients aged 65 and older. MEASUREMENTS: A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score. RESULTS: Mean postintervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three-level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001). CONCLUSION: As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined. [source] Clustering technique for risk classification and prediction of claim costs in the automobile insurance industryINTELLIGENT SYSTEMS IN ACCOUNTING, FINANCE & MANAGEMENT, Issue 1 2001Ai Cheo Yeo This paper considers the problem of predicting claim costs in the automobile insurance industry. The first stage involves classifying policy holders according to their perceived risk, followed by modelling the claim costs within each risk group. Two methods are compared for the risk classification stage: a data-driven approach based on hierarchical clustering, and a previously published heuristic method that groups policy holders according to pre-defined factors. Regression is used to model the expected claim costs within a risk group. A case study is presented utilizing real data, and both risk classification methods are compared according to a variety of accuracy measures. The results of the case study show the benefits of employing a data-driven approach. © 2001 John Wiley & Sons, Ltd. [source] Adding an Alcohol-Related Risk Score to an Existing Categorical Risk Classification for Older Adults: Sensitivity to Group DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2007Sandra R. Wilson PhD OBJECTIVES: To evaluate a new alcohol-related risk score for research use. DESIGN: Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect postintervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors. SETTING: Three primary care group practices in southern California. PARTICIPANTS: Six hundred sixty-five patients aged 65 and older. MEASUREMENTS: A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score. RESULTS: Mean postintervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three-level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001). CONCLUSION: As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined. [source] Isolation and functional analysis of five HPVE6 variants with respect to p53 degradationJOURNAL OF MEDICAL VIROLOGY, Issue 3 2008Thomas Hiller Abstract Persistent infection with high risk human papillomavirus is a necessary risk factor in the etiology of invasive cervical carcinoma. With regard to molecular details, the best studied types are HPV16 and HPV18 which are found in 70% of cervical cancer worldwide, however factors associated with the progression of individual cervical intraepithelial neoplasias into cancer are still poorly understood. Intratype amino acid variations in the immortalizing and transforming early proteins E6 and E7 were described to be associated with progressive disease and linked to increased viral persistence or progression. One of the key actions of high risk HPVE6 proteins is the inhibition of the function of p53, a tumor suppressor protein, by enhancing its degradation through the ubiquitin pathway. In this study, variants of five HPV type E6 proteins (HPV35, 53, 56, 66, and 70) isolated from patient materials are described and functional analysis of them were done with respect to p53 degradation. Interestingly the E6 protein of HPV type 53, which has no consistent risk classification in the literature showed the highest variability in our study. The analysis of all variants revealed no differences with regard to the degradation ability for p53 compared to the prototype E6 proteins, suggesting that the variants tested revealed no altered functions related to the carcinogenicity of the respective HPV types. It therefore seems more likely that variations in the E6 gene sequence may allow evasion from the hosts immune system, supporting increased viral persistence. J. Med. Virol. 80:478,483, 2008. © 2008 Wiley-Liss, Inc. [source] Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee jointsARTHRITIS & RHEUMATISM, Issue 8 2009Georg Schett Objective Osteoarthritis (OA) is a leading cause of pain and physical disability in middle-aged and older individuals. We undertook this study to determine predictors of the development of severe OA, apart from age and overweight. Methods Joint replacement surgery due to severe hip or knee OA was recorded over a 15-year period in the prospective Bruneck cohort study. Demographic characteristics and lifestyle and biochemical variables, including the level of soluble vascular cell adhesion molecule 1 (VCAM-1), were assessed at the 1990 baseline visit and tested as predictors of joint replacement surgery. Results Between 1990 and 2005, hip or knee joint replacement due to OA was performed in 60 subjects. VCAM-1 level emerged as a highly significant predictor of the risk of joint replacement surgery. Intervention rates were 1.9, 4.2, and 10.1 per 1,000 person-years in the first, second, and third tertiles, of the VCAM-1 level, respectively. In multivariable logistic regression analysis, the adjusted relative risk of joint replacement surgery in the highest versus the lowest tertile group of VCAM-1 level was 3.9 (95% confidence interval 1.7,8.7) (P < 0.001). Findings were robust in various sensitivity analyses and were consistent in subgroups. Addition of the VCAM-1 level to a risk model already including age, sex, and body mass index resulted in significant gains in model discrimination (C statistic) and calibration and in more accurate risk classification of individual participants. Conclusion The level of soluble VCAM-1 emerged as a strong and independent predictor of the risk of hip and knee joint replacement due to severe OA. If our findings can be reproduced in other epidemiologic cohorts, they will assist in routine risk classification and will contribute to a better understanding of the etiology of OA. [source] |