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- Flint, AC, et al.
(author)
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Improved ischemic stroke outcome prediction using model estimation of outcome probability: the THRIVE-c calculation
- 2015
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In: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 10:6, s. 815-821
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Journal article (peer-reviewed)abstract
- The Totaled Health Risks in Vascular Events (THRIVE) score is a previously validated ischemic stroke outcome prediction tool. Although simplified scoring systems like the THRIVE score facilitate ease-of-use, when computers or devices are available at the point of care, a more accurate and patient-specific estimation of outcome probability should be possible by computing the logistic equation with patient-specific continuous variables. Methods We used data from 12 207 subjects from the Virtual International Stroke Trials Archive and the Safe Implementation of Thrombolysis in Stroke – Monitoring Study to develop and validate the performance of a model-derived estimation of outcome probability, the THRIVE-c calculation. Models were built with logistic regression using the underlying predictors from the THRIVE score: age, National Institutes of Health Stroke Scale score, and the Chronic Disease Scale (presence of hypertension, diabetes mellitus, or atrial fibrillation). Receiver operator characteristics analysis was used to assess model performance and compare the THRIVE-c model to the traditional THRIVE score, using a two-tailed Chi-squared test. Results The THRIVE-c model performed similarly in the randomly chosen development cohort ( n = 6194, area under the curve = 0·786, 95% confidence interval 0·774–0·798) and validation cohort ( n = 6013, area under the curve = 0·784, 95% confidence interval 0·772–0·796) ( P = 0·79). Similar performance was also seen in two separate external validation cohorts. The THRIVE-c model (area under the curve = 0·785, 95% confidence interval 0·777–0·793) had superior performance when compared with the traditional THRIVE score (area under the curve = 0·746, 95% confidence interval 0·737–0·755) ( P < 0·001). Conclusion By computing the logistic equation with patientspecific continuous variables in the THRIVE-c calculation, outcomes at the individual patient level are more accurately estimated. Given the widespread availability of computers and devices at the point of care, such calculations can be easily performed with a simple user interface.
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- Selroos, O, et al.
(author)
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National and regional asthma programmes in Europe
- 2015
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In: European respiratory review : an official journal of the European Respiratory Society. - : European Respiratory Society (ERS). - 1600-0617. ; 24:137, s. 474-83
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Journal article (peer-reviewed)abstract
- This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.
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- Selroos, O, et al.
(author)
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"National and regional asthma programmes in Europe." Olof Selroos, Maciej Kupczyk, Piotr Kuna, Piotr Łacwik, Jean Bousquet, David Brennan, Susanna Palkonen, Javier Contreras, Mark FitzGerald, Gunilla Hedlin, Sebastian L. Johnston, Renaud Louis, Leanne Metcalf, Samantha Walker, Antonio Moreno-Galdó, Nikolaos G. Papadopoulos, José Rosado-Pinto, Pippa Powell and Tari Haahtela. Eur Respir Rev 2015; 24: 474-483
- 2019
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In: European respiratory review : an official journal of the European Respiratory Society. - : European Respiratory Society (ERS). - 1600-0617. ; 28:154
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Journal article (peer-reviewed)
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