Articles producció científica> Medicina i Cirurgia

Predicting serious complications in patients with cancer and pulmonary embolism using decision tree modelling: the EPIPHANY Index

  • Datos identificativos

    Identificador: imarina:2828969
    Autores:
    Carmona-Bayonas, A.Jimenez-Fonseca, P.Font, C.Fenoy, F.Otero, R.Beato, C.Plasencia, J. M.Biosca, M.Sanchez, M.Benegas, M.Calvo-Temprano, D.Varona, D.Faez, L.de la Haba, I.Antonio, M.Madridano, O.Solis, M. P.Ramchandani, A.Castanon, E.Marchena, P. J.Martin, M.de la Pena, F. AyalaVicente, V.Asociacion Invest Enfermedad
    Resumen:
    Our objective was to develop a prognostic stratification tool that enables patients with cancer and pulmonary embolism (PE), whether incidental or symptomatic, to be classified according to the risk of serious complications within 15 days.The sample comprised cases from a national registry of pulmonary thromboembolism in patients with cancer (1075 patients from 14 Spanish centres). Diagnosis was incidental in 53.5% of the events in this registry. The Exhaustive CHAID analysis was applied with 10-fold cross-validation to predict development of serious complications following PE diagnosis.About 208 patients (19.3%, 95% confidence interval (CI), 17.1-21.8%) developed a serious complication after PE diagnosis. The 15-day mortality rate was 10.1%, (95% CI, 8.4-12.1%). The decision tree detected six explanatory covariates: Hestia-like clinical decision rule (any risk criterion present vs none), Eastern Cooperative Group performance scale (ECOG-PS; <2 vs ?2), O2 saturation (<90 vs ?90%), presence of PE-specific symptoms, tumour response (progression, unknown, or not evaluated vs others), and primary tumour resection. Three risk classes were created (low, intermediate, and high risk). The risk of serious complications within 15 days increases according to the group: 1.6, 9.4, 30.6%; P<0.0001. Fifteen-day mortality rates also rise progressively in low-, intermediate-, and high-risk patients: 0.3, 6.1, and 17.1%; P<0.0001. The cross-validated risk estimate is 0.191 (s.e.=0.012). The optimism-corrected area under the receiver operating characteristic curve is 0.779 (95% CI, 0.717-0.840).We have developed and internally validated a prognostic index to predict serious complications with the potential to impact decision-making in patients with cancer and PE.
  • Otros:

    Autor según el artículo: Carmona-Bayonas, A.; Jimenez-Fonseca, P.; Font, C.; Fenoy, F.; Otero, R.; Beato, C.; Plasencia, J. M.; Biosca, M.; Sanchez, M.; Benegas, M.; Calvo-Temprano, D.; Varona, D.; Faez, L.; de la Haba, I.; Antonio, M.; Madridano, O.; Solis, M. P.; Ramchandani, A.; Castanon, E.; Marchena, P. J.; Martin, M.; de la Pena, F. Ayala; Vicente, V.;Asociacion Invest Enfermedad
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Porras Ledantes, Jose Antonio
    Palabras clave: Thromboembolism Therapy Rule Risk Pulmonary embolism Prognostic scales Prevalence Oncology Mortality Metaanalysis Low-risk patients Incidental Epiphany index Criteria Clinical decision rule Cancer
    Resumen: Our objective was to develop a prognostic stratification tool that enables patients with cancer and pulmonary embolism (PE), whether incidental or symptomatic, to be classified according to the risk of serious complications within 15 days.The sample comprised cases from a national registry of pulmonary thromboembolism in patients with cancer (1075 patients from 14 Spanish centres). Diagnosis was incidental in 53.5% of the events in this registry. The Exhaustive CHAID analysis was applied with 10-fold cross-validation to predict development of serious complications following PE diagnosis.About 208 patients (19.3%, 95% confidence interval (CI), 17.1-21.8%) developed a serious complication after PE diagnosis. The 15-day mortality rate was 10.1%, (95% CI, 8.4-12.1%). The decision tree detected six explanatory covariates: Hestia-like clinical decision rule (any risk criterion present vs none), Eastern Cooperative Group performance scale (ECOG-PS; <2 vs ?2), O2 saturation (<90 vs ?90%), presence of PE-specific symptoms, tumour response (progression, unknown, or not evaluated vs others), and primary tumour resection. Three risk classes were created (low, intermediate, and high risk). The risk of serious complications within 15 days increases according to the group: 1.6, 9.4, 30.6%; P<0.0001. Fifteen-day mortality rates also rise progressively in low-, intermediate-, and high-risk patients: 0.3, 6.1, and 17.1%; P<0.0001. The cross-validated risk estimate is 0.191 (s.e.=0.012). The optimism-corrected area under the receiver operating characteristic curve is 0.779 (95% CI, 0.717-0.840).We have developed and internally validated a prognostic index to predict serious complications with the potential to impact decision-making in patients with cancer and PE.
    Áreas temáticas: Saúde coletiva Química Oncology Odontología Medicina veterinaria Medicina iii Medicina ii Medicina i Materiais General medicine Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Cancer research Biotecnología
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 00070920
    Direcció de correo del autor: joseantonio.porras@urv.cat
    Identificador del autor: 0000-0001-6418-1822
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://www.nature.com/articles/bjc201748
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: British Journal Of Cancer. 116 (8): 994-1001
    Referencia de l'ítem segons les normes APA: Carmona-Bayonas, A.; Jimenez-Fonseca, P.; Font, C.; Fenoy, F.; Otero, R.; Beato, C.; Plasencia, J. M.; Biosca, M.; Sanchez, M.; Benegas, M.; Calvo-Tem (2017). Predicting serious complications in patients with cancer and pulmonary embolism using decision tree modelling: the EPIPHANY Index. British Journal Of Cancer, 116(8), 994-1001. DOI: 10.1038/bjc.2017.48
    DOI del artículo: 10.1038/bjc.2017.48
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2017
    Tipo de publicación: Journal Publications
  • Palabras clave:

    Cancer Research,Oncology
    Thromboembolism
    Therapy
    Rule
    Risk
    Pulmonary embolism
    Prognostic scales
    Prevalence
    Oncology
    Mortality
    Metaanalysis
    Low-risk patients
    Incidental
    Epiphany index
    Criteria
    Clinical decision rule
    Cancer
    Saúde coletiva
    Química
    Oncology
    Odontología
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Materiais
    General medicine
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Cancer research
    Biotecnología
  • Documentos:

  • Cerca a google

    Search to google scholar