Journal of evaluation in clinical practice
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Venous thromboembolism (VTE) is a fatal complication and the most common preventable cause of death in hospitals. The risk-to-benefit ratio of thromboprophylaxis depends on the performance of the risk assessment model. A linear model, the Padua model, is recommended for medical inpatients in the United States but is not suitable for Chinese inpatients due to differences in race and disease spectrum. Currently, machine learning (ML) methods show advantages in modeling complex data patterns and have been applied to clinical data analysis. This study aimed to build VTE risk assessment ML models among Chinese inpatients and compare the predictive validity of the ML models with that of the Padua model. ⋯ Advances in ML technology provide powerful tools for medical data analysis, and choosing models conforming to the disease pattern would achieve good performance. Popular ML models do not surpass the Padua model on all indicators of validity, and the drawback of low sensitivity should be improved upon in the future.
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Meta Analysis
Effects of eradicating Helicobacter pylori on metachronous gastric cancer prevention: A systematic review and meta-analysis.
Helicobacter pylori (H pylori) infection is closely associated with the incidence of gastric cancer. However, whether H pylori eradication prevents metachronous gastric cancer remains uncertain. The aim of our study is to assess how eradicating H pylori influences metachronous gastric cancer onset following treatment of early stage gastric cancer via endoscopic resective surgery. ⋯ Eradicating H pylori via therapeutic treatment can effectively reduce rates of metachronous gastric cancer, and as such, it should be implemented in H pylori-infected individuals recently treated for early stage gastric cancers via endoscopic resection.
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Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity-related diseases. Our aim was to compare these two procedures. ⋯ Both LSG and LRYGB can be performed with very low conversion to open rate and mortality rate. The readmission rate and re-operation rate are comparable between these two surgeries. The efficacy of these two surgeries on EWL and T2DM is equivalent, but LSG has an advantage over LRYGB in operation time and early complications rate.
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Current meta-analysis was conducted aiming to assess the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treatment of acute leukaemia (AL) patients with chemotherapy-induced thrombocytopenia (CIT). ⋯ Our findings suggest that rhIL-11 is effective and safe in the treatment of CIT in patients with AL.
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Review Meta Analysis
Comparison of four heterogeneity measures for meta-analysis.
Heterogeneity is a critical issue in meta-analysis, because it implies the appropriateness of combining the collected studies and impacts the reliability of the synthesized results. The Q test is a traditional method to assess heterogeneity; however, because it does not have an intuitive interpretation for clinicians and often has low statistical power, many meta-analysts alter to use some measures, such as the I2 statistic, to quantify the extent of heterogeneity. This article aims at providing a summary of available tools to assess heterogeneity and comparing their performance. ⋯ The I2 and R ̂ I statistics are recommended for measuring heterogeneity. Meta-analysts should use the heterogeneity measures as descriptive statistics which have intuitive interpretations from the clinical perspective, instead of determining the significance of heterogeneity simply based on their magnitudes.