| 1. |
- Pennells, Lisa, et al.
(författare)
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Equalization of four cardiovascular risk algorithms after systematic recalibration : individual-participant meta-analysis of 86 prospective studies
- 2019
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 40:7, s. 621-
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Tidskriftsartikel (refereegranskat)abstract
- Aims: There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after ‘recalibration’, a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied.Methods and results: Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at ‘high’ 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29–39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22–24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44–51 such individuals using original algorithms, in contrast to 37–39 individuals with recalibrated algorithms.Conclusion: Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need.
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| 2. |
- Dicks, Lynn V., et al.
(författare)
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Farmland conservation
- 2015
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Ingår i: What works in conservation. - 9781783741571 - 9781783741588 - 9781783741595 - 9781783741601 - 9781783741618 ; , s. 245-284
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This book is meant as a guide to the evidence available for different conservation interventions and as a starting point in assessing their effectiveness. The assessments are based on the available evidence for the target group of species for each intervention. The assessment may therefore refer to different species or habitat to the one(s) you are considering. Before making any decisions about implementing interventions it is vital that you read the more detailed accounts of the evidence in order to assess their relevance for your study species or system.Full details of the evidence are available at www.conservationevidence.comThere may also be significant negative side-effects on the target groups or other species or communities that have not been identified in this assessment.A lack of evidence means that we have been unable to assess whether or not an intervention is effective or has any harmful impacts.
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| 3. |
- Ball, Emily L., et al.
(författare)
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Predicting post-stroke cognitive impairment using acute CT neuroimaging : A systematic review and meta-analysis
- 2022
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Ingår i: International Journal of Stroke. - : Sage Publications. - 1747-4930 .- 1747-4949. ; 17:6, s. 618-627
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Forskningsöversikt (refereegranskat)abstract
- Background Identifying whether acute stroke patients are at risk of cognitive decline could improve prognostic discussions and management. Structural computed tomography neuroimaging is routine in acute stroke, and may identify those at risk of post-stroke dementia or post-stroke cognitive impairment (PSCI).Aim To systematically review the literature to identify which stroke or pre-stroke features on brain computed tomography scans, performed at the time of stroke, are associated with post-stroke dementia or PSCI.Summary of review We searched electronic databases to December 2020. We included studies reporting acute stroke brain computed tomography, and later diagnosis of a cognitive syndrome. We created summary estimates of size of unadjusted association between computed tomography features and cognition. Of 9536 citations, 28 studies (41 papers) were eligible (N = 7078, mean age 59.8-78.6 years). Cognitive outcomes were post-stroke dementia (10 studies), PSCI (17 studies), and one study analyzed both. Fifteen studies (N = 2952) reported data suitable for meta-analyses. White matter lesions (WML) (six studies, N = 1054, OR = 2.46, 95% CI = 1.25-4.84), cerebral atrophy (four studies, N = 558, OR = 2.80, 95% CI = 1.21-6.51), and pre-existing stroke lesions (three studies, N = 352, OR = 2.38, 95% CI = 1.06-5.32) were associated with post-stroke dementia. WML (four studies, N = 473, OR = 3.46, 95% CI = 2.17-5.52) were associated with PSCI. Other computed tomography features were either not associated with cognitive outcome, or there were insufficient data.Conclusions Cognitive impairment following stroke is of great concern to patients and carers. Features seen on visual assessment of acute stroke computed tomography brain scans are strongly associated with cognitive outcomes. Clinicians should consider when and how this information should be discussed with stroke survivors.
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| 4. |
- Dicks, Lynn V., et al.
(författare)
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Farmland Conservation : Evidence for the effects of interventions in northern and western Europe
- 2014
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- This synopsis covers evidence for the effects of conservation interventions for native farmland wildlife. It is restricted to evidence captured on the website www.conservationevidence.com. It includes papers published in the journal Conservation Evidence, evidence summarized on our database and systematic reviews collated by the Collaboration for Environmental Evidence. It is the thrid volume in the series Synopses of Conservation Evidence. Evidence was collected from all European countries west of Russia, but not those south of France, Switzerland, Austria, Hungary and Romania. A list of interventions to conserve wildlife on farmland was developed collaboratively by a team of thirteen experts. A number of interventions that are not currently agri-environment options were added during this process, such as 'Provide nest boxes for bees (solitary or bumblebees)' and 'Implement food labelling schemes relating to biodiversity-friendly farming'. Interventions relating to the creation or management of habitats not considered commercial farmland (such as lowland heath, salt marsh and farm woodland) were removed. The list of interventions was organized into categories based on the International Union for the Conservation of Nature (IUCN) classifications of direct threats and conservation actions. Interventions that fall under the threat category 'Agriculture' are grouped by farming system, with separate sections for interventions that apply to arable or livestock farms, or across all farming types.
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| 5. |
- Hudson, Thomas J., et al.
(författare)
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International network of cancer genome projects
- 2010
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 464:7291, s. 993-998
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Tidskriftsartikel (refereegranskat)abstract
- The International Cancer Genome Consortium (ICGC) was launched to coordinate large-scale cancer genome studies in tumours from 50 different cancer types and/or subtypes that are of clinical and societal importance across the globe. Systematic studies of more than 25,000 cancer genomes at the genomic, epigenomic and transcriptomic levels will reveal the repertoire of oncogenic mutations, uncover traces of the mutagenic influences, define clinically relevant subtypes for prognosis and therapeutic management, and enable the development of new cancer therapies.
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