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Predicting Risk (predicting + risk)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Perspective: Assessing the Clinical Utility of Serum CTX in Postmenopausal Osteoporosis and Its Use in Predicting Risk of Osteonecrosis of the Jaw,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2009
Sanford Baim
Abstract Bone turnover markers (BTMs) have become increasingly important in the management of postmenopausal osteoporosis (PMO). In bisphosphonate-treated women with PMO, BTMs can provide early indications of treatment efficacy, are predictors of BMD response and fracture risk reduction, and are potentially useful for monitoring patient compliance. The bone resorption marker serum C-telopeptide cross-link of type 1 collagen (sCTX) has shown high sensitivity and specificity for the detection of increased bone resorption. Recently, sCTX has been singled out as a potential indicator of risk of osteonecrosis of the jaw (ONJ) in patients receiving oral bisphosphonates who require oral surgery. However, whether BTMs are capable of predicting ONJ risk and whether sCTX is usable for this purpose are controversial questions. This article presents an overview of the current literature regarding critical issues affecting the clinical utility of BTMs (including variability and reference ranges) and the current applications of BTMs in PMO management, with a focus on sCTX. Last, the appropriateness of using sCTX to predict ONJ risk in women receiving oral bisphosphonates for PMO is evaluated. [source]

Predicting risk for early infantile atopic dermatitis by hereditary and environmental factors

BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2009
H-J. Wen
Summary Background, Hereditary and environmental factors contribute to the occurrence of atopic dermatitis (AD). However, the interaction of these two factors is not totally understood. Objectives, To evaluate the early risk factors for infantile AD at the age of 6 months and to develop a predictive model for the development of AD. Methods, In 2005, a representative sample of mother and newborn pairs was obtained by multistage, stratified systematic sampling from the Taiwan national birth register. Information on hereditary and environmental risk factors was collected by home interview when babies were 6 months old. Multivariate regression analysis was applied to determine the risk factors for AD in the infants. Results, A total of 20 687 pairs completed the study satisfactorily. AD was diagnosed in 7·0% of 6-month-old infants by physicians. Parental asthma, atopic dermatitis and allergic rhinitis, and maternal education levels were risk factors for AD in infants. Among environmental factors, fungus on walls at home and renovation/painting in the house during pregnancy were significantly associated with early infantile AD. Using these factors, the probability of having infantile AD was estimated and grouped into low, high and very high. With five runs of tests in mutually exclusive subsets of this population, the likelihood of AD for 6-month-old infants was consistent in all the groups with the predictive model. The highest predicted probability of AD was 70·1%, among boys with maternal education levels > 12 years, both parents with AD, renovation and painting of the house during pregnancy and fungus on walls at home. The lowest probability was 3·1%, among girls with none of the above factors. Conclusions, This investigation provides a technique for predicting the risk of infantile AD based on hereditary and environmental factors, which could be used for developing a preventive strategy against AD, especially among those children with a family history of atopy. [source]

Sequential analysis of lines of evidence,an advanced weight-of-evidence approach for ecological risk assessment

INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 4 2006
Ruth N Hull
Abstract Weight-of-evidence (WOE) approaches have been used in ecological risk assessment (ERA) for many years. The approaches integrate various types of data (e.g., from chemistry, bioassay, and field studies) to make an overall conclusion of risk. However, the current practice of WOE has several important difficulties, including a lack of transparency related to how each line of evidence is weighted or integrated into the overall weight-of-evidence conclusion. Therefore, a sequential analysis of lines of evidence (SALE) approach has been developed that advances the practice of WOE. It was developed for an ERA of chemical stressors but also can be used for nonchemical stressors and is equally applicable to the aquatic and terrestrial environments. The sequential aspect of the SALE process is a significant advancement and is based on 2 primary ideas. First, risks can be ruled out with the use of certain lines of evidence, including modeled hazard quotients (HQs) and comparisons of soil, water, or sediment quality with conservative soil, water or sediment quality guidelines. Thus, the SALE process recognizes that HQs are most useful in ruling out risk rather than predicting risk to ecological populations or communities. Second, the SALE process provides several opportunities to exit the risk assessment process, not only when risks are ruled out, but also when magnitude of effect is acceptable or when little or no evidence exists that associations between stressors and effects may be causal. Thus, the SALE approach explicitly includes interaction between assessors and managers. It illustrates to risk managers how risk management can go beyond the simple derivation of risk-based concentrations of chemicals of concern to risk management goals based on ecological metrics (e.g., species diversity). It also can be used to stimulate discussion of the limitations of the ERA science, and how scientists deal with uncertainty. It should assist risk managers by allowing their decisions to be based on a sequential, flexible, and transparent process that includes direct toxicity risks, indirect risks (via changes in habitat suitability), and the spatial and temporal factors that can influence the risk assessment. [source]

Risk Stratification in Women Enrolled in the Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM)

ACADEMIC EMERGENCY MEDICINE, Issue 2 2008
Deborah B. Diercks MD
Abstract Objectives:, It has been reported that the mortality risk for heart failure differs between men and women. It has been postulated that this is due to differences in comorbid features. Variation in risk profiles by gender may limit the performance of stratification algorithms available for heart failure in women. This analysis examined the ability of a published risk stratification model to predict outcomes in women. Methods:, The Acute Decompensated Heart Failure National Registry Emergency Module (ADHERE-EM) database was used. Characteristics, treatments, and outcomes for men and women were compared. The ADHERE registry classification and regression tree (CART) analysis was used for the risk stratification evaluation. Results:, Of 10,984 ADHERE-EM patients, 5,736 (52.2%) were women. In-hospital mortality was similar between men and women (p = 0.727). Significant differences (p < 0.0002) were noted by gender in all three variables in the CART model (blood urea nitrogen [BUN] , 43 mg/dL, systolic blood pressure < 115 mm Hg, and serum creatinine , 2.75 mg/dL). However, the CART model effectively stratified both genders into distinct risk groups with no significant difference in mortality by gender within stratified groups. Conclusions:, The ADHERE Registry CART tool is effective at predicting risk in ED patients, regardless of gender. [source]