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PubMed2003

[Classification of periodontal diseases].

During the past centuries the basic understanding of periodontal disease and the concepts of etiopathogenesis have evolved and substantially changed. The changes in paradigm has always been followed by the conceptual changes in the classification of periodontal disease. The earliest entirely descriptive classifications were based on the clinical signs and symptoms of periodontal disease. These were followed by a classification system based on the classical pathology paradigm established by Orban and Gottlieb. This was replaced by the next classification reflecting the infection/host response paradigm during the late '60s started with the pioneering works by Loe and coworkers. It is because many data indicated that the host response (determined by genetics, immunology and behavioral factors) was at least as important in the clinical manifestation of periodontal destruction than the bacterial biofilm this classification had been also updated. The AAP published its latest official classification system in 1999. Nevertheless this new system is far from perfect and should evolve as soon as enough data are collected by periodontal research to answer many controversy still existing to day.

Atrophy↗
PubMed2003

Weight status classification of patients on continuous peritoneal dialysis.

We tested the agreement between classifications of the weight status of patients on peritoneal dialysis (PD) by body mass index (BMI) and by body fat (BF) content (BF/W, where W = actual weight), when BF was computed as BF = W - V/0.73 from the Sahlgrenska, Watson, or Hume anthropometric formulas estimating body water (V) in 933 patients on PD and 7,737 outpatients without hydration disorders. We used currently accepted cut-off values for classifying subjects as underweight, normal-weight, overweight, and obese by BMI and BF/W. We obtained these values: BMI: men on PD (n = 555), 25.5 +/- 4.3; men with normal renal function [NRF (n = 5,906)], 27.7 +/- 5.1; women on PD (n = 378), 25.9 +/- 6.1; women with NRF (n = 1,831), 28.3 +/- 6.5; BFSahlgrenska/W--men on PD, 0.238 +/- 0.063; men with NRF, 0.274 +/- 0.052; women on PD, 0.342 +/- 0.89; women with NRF, 0.366 +/- 0.075. We obtained these regressions: Women on PD BMI = 12.0832 + 38.9550 (BFSahlgrenska/W) -92.9252 (BFSahlgrenska/W)2 +254.0675 (BFSahlgrenska/W)3, r2 = 0.917; Men on PD BMI = 19.4729 - 29.1310 (BFSahlgrenska/W) +213.7045 (BFSahlgrenska/W)2, r2 = 0.888. From those regressions, the BMI value corresponding to the BFSahlgrenska/W cut-off for underweight was similar to the National Institutes of Health (NIH) BMI cut-off for underweight. The BMI value corresponding to the BFSahlgrenska/W cut-off for obesity was substantially lower than the NIH BMI cut-off for obesity. The kappa ratios of the classifications of weight status by BMI and BFSahlgrenska/W varied between 0.142 and 0.304 (poor agreement), with more than 50% of the subjects classified in a more obese weight category by BFSahlgrenska/W than by BMI. Classification of the subjects by BMI and by BFSahlgrenska/W in quintiles or quartiles led to much higher kappa ratios, particularly in women. The results were similar in subjects with NRF and with the use of the Watson and Hume formulas to estimate BF. The use of arbitrary cut-off values of BMI or anthropometric BF/W to classify PD patients or patients without edematous states as underweight, normal-weight, overweight, or obese leads to substantial disagreement between the two classifications. Classification of weight status by BMI or BF/W in quintiles or quartiles improves substantially the agreement between the two classifications and should be preferred.

Adipose Tissue↗
PubMed2004

[Classification of epileptic seizures and syndromes: new proposals].

In the decade of 1980 the International League Against Epilepsy (ILAE) developed a classification system of epileptic seizures and syndromes. These classifications were established progressively and are presently used in all the world. In the following years, video-EEG monitoring became widely available and provided direct information about seizure semiology and ictal EEG that had not been so well understood during the development of the ILAE classifications. This new information demonstrated certain limitations of the old classification of epileptic seizures. In addition, improvements in brain imaging techniques and research in genetics added further information on the pathophysiology of epilepsies and epileptic syndromes. In order to integrate these advances into the practical management of epilepsies, new classification proposals have been developed. This article reviews the clinical implications of these new classifications.

Humans↗
PubMed1992

[Development of diagnostic classification systems in psychiatry].

The author presents a historical account of classifications of mental disorders. He follows the development from simple classifications at the onset of the 19th century via Morel's, Kraepelin's, Kuffner's and Bleuler's classification to the new diagnostic classification of North American psychiatrists (DSM-III), International classification of diseases (ICD 10) to the contemporary multiaxial classification of mental disorders.

Humans↗
PubMed2004

[International classification of epileptic seizures, epilepsies, and epileptic syndromes].

Epilepsy is one of the common diseases in neurology. Its correct diagnosis and classification are important for choosing the most appropriate treatment. Currently, Classification of Epileptic Seizures in 1981 and Classification of Epilepsies and Epileptic Syndromes in 1989, both were proposed by International League Against Epilepsy (ILAE), are available. As for Classification of Epilepsies and Epileptic Syndromes, two divisions continue to be widely used to shape the major classes: The first separates epilepsies with generalized seizures (generalized epilepsy) from epilepsies with partial or focal seizures (localization-related, partial or focal epilepsies). The other separates epilepsies of known etiology (symptomatic or secondary epilepsies) from those that are idiopathic (primary) and those that are cryptogenic. In 2001, ILAE Task Force proposed a new classification. However, its daily use has yet been limited. Simple and useful classification will lead to better understanding and more appropriate management of epilepsy.

Epilepsy↗
PubMed2002

Simultaneous classification and feature clustering using discriminant vector quantization with applications to microarray data analysis.

In many applications of supervised learning, automatic feature clustering is often desirable for a better understanding of the interaction among the various features as well as the interplay between the features and the class labels. In addition, for high dimensional data sets, feature clustering has the potential for improvement in classification accuracy and reduction in computational complexity. In this paper, a method is developed for simultaneous classification and feature clustering by extending discriminant vector quantization (DVQ), a prototype classification method derived from the principle of minimum description length using source coding techniques. The method incorporates feature clustering with classification performed by fusing features in the same clusters. To illustrate its effectiveness, the method has been applied to microarray gene expression data for human lymphoma classification. It is demonstrated that incorporating feature clustering improves classification accuracy, and the clusters generated match well with biological meaningful gene expression signature groups.

Algorithms↗
PubMed2005

Lenke classification system of adolescent idiopathic scoliosis: treatment recommendations.

The Lenke and associates classification system of adolescent idiopathic scoliosis (AIS) was developed to provide a comprehensive and reliable means to categorize all surgical AIS curves. This classification system requires analysis of the upright coronal and sagittal radiographs along with the supine side bending radiographic views. The triad classification system consists of a curve type (1-6), a lumbar spine modifier (A, B, C), and a sagittal thoracic modifier (-, N, +). All three regions of the radiographic coronal and sagittal planes, the proximal thoracic, main thoracic, and thoracolumbar/lumbar are designated as either the major curve (largest Cobb measurement) or minor curves with the minor curves separated into structural and nonstructural types. The recommendations are that the major and structural minor curves are included in the instrumentation and fusion and the nonstructural minor curves are excluded. Overall, the classification system is treatment directed; however, there are other aspects of the radiographic and clinical deformity that may suggest deviation from the recommendations of the classification system. The ultimate goal of this classification system is to allow organization of similar curve patterns to provide comparisons of various treatment methods to provide optimal treatment for each AIS surgical patient.

Adolescent↗
PubMed2005

Clinical usefulness of the WHO histological classification of thymoma.

PURPOSE: Rosai et al. published the World Health Organization (WHO) classification of thymic epithelial tumors in 1999, and its clinical usefulness seems to be established. It is our purpose to find the clinically relevant diagnostic points in the WHO Histological Classification of Thymoma. METHODS: Thymomas surgically removed from 100 consecutive patients at Juntendo University Hospital between October 1983 and February 2002 were classified according to the WHO histological classification. We assessed overall survival and recurrence-free rate calculated for each tumor type in the WHO classification compared with those of tumors classified by the Masaoka system. RESULTS: The thymic epithelial tumors in this series comprised 10 type A, 15 type AB, 18 type B1, 21 type B2, 33 type B3, and 3 type C tumors according to the WHO classification. Based on the Masaoka system, the disease was stage I in 53 patients, stage II in 30, stage III in 15, and stage IV in 2. The 15-year recurrence-free rate was 100% for type A, AB and B1, while the rates for types B2 and B3 were 66.7% and 54.5%, respectively. The 10-year recurrence-free rate was 66.7% for type C. The 15-year recurrence-free rate of the 64 patients with type A, AB, B1, and B2 thymomas was significantly higher from that of the 33 patients with type B3 thymoma (p=0.0026). CONCLUSION: When using the WHO classification, it is critical to distinguish type B3 thymoma from other tumor types.

Adult↗
PubMed2006

[Evaluation of the course of chronic obstructive lung diseases according to the classifications of the European Respiratory Society and the Global Initiative on Chronic Obstructive Lung Disease].

In 91 patients with chronic obstructive lung disease (COLD), the severity of this disease according to the Classifications of the European Respiratory Society (ERS) and the Global Initiative on Chronic Obstructive Lung Disease (GOLD) was compared with that of pulmonary dysfunction according to the data of a comprehensive study, involving the determination of bronchial patency, lung volumes, capacities, and gas-exchange function. This follows that the ERS and GOLD classifications are to be positively appraised as they provide an eligible group of patients for clinical practice in terms of the severity of pulmonary dysfunction and that of COLD. However, the concomitant clinical use of both classifications cannot be regarded as justifiable due to that there are differences in the number of detectable grades (stages) of COLD and borderline (COLD differentiating grades (stages) values of EFV1). In this connection, both classifications have approximately equally significant merits and shortcomings and it is practically impossible to give preference to one of them as the best one. The optimal way out of the established situation is to develop a new (improved) classification of the severity of COLD on the bases of these two existing classifications.

Europe↗
PubMed2006

Optimizing the classification of acute lymphoblastic leukemia and acute myeloid leukemia samples using artificial neural networks.

Accurate classification of human blood cells plays a decisive role in the diagnosis and treatment of diseases. Artificial Neural Networks (ANN) have been consistently used as a trusted classification tool for this type of analysis. In this study, a new Artificial Neural Network approach is proposed for the multidimensional classification of two of the most common forms of leukemia: Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML), also sometimes called Acute Myelogenous Leukemia. Beckman-Coulter Corporation supplied flow cytometry data of 120 patients that were used in the training and testing phases. The ANN algorithm was thus developed to exploit the different features of the different blood cells provided in an optimized fashion. The goal was to establish a programming tool, supported through this new ANN development, for the identification of normal and abnormal blood samples and provide information to medical doctors in the form of diagnostic references for the specific disease state that is considered for this study. The application of the ANN algorithm produced remarkable classification accuracy results that show a 95% classification accuracy for the normal blood samples and 90% classification accuracy for the abnormal samples even under the ubiquitous problem of overlap.

Blood Cell Count↗
PubMed1991

[Why do people contact physicians? The development of the core classification of primary health care].

The Norwegian study on reasons for contacting physicians comprised part of a large international project. The aim of this project was to develop an international classification of the different reasons why patients contact the health services. In 1978 the World Health Organization appointed an expert working party and outlined the principles for the new classification, based mainly on other WHO classifications. A trial version of the classification was tested by general practitioners in nine countries. The Norwegian study involved 11 general practionners. It comprised 8,337 consecutive encounters and 11,865 reasons for these encounters. 65% of the reason were symptoms or observational diagnosis, 13% were specific diagnoses. 16% of the reasons were preventive, diagnostic or therapeutic procedures. 6% contacted the physician for administrative reasons. The International Classification of Primary Care is simple, logical and easy to use. It is based on extensive research carried out in general practice. It represents the bio-psycho-social "whole person" concept of primary care. ICPC includes WHO-approved cross-codes for the International Classification of Diseases, ICD.

Family Practice↗
PubMed1991

[The validity of the perinatal classification by the Health Department].

On the basis of 273 perinatal and neonatal deaths in three Danish counties in 1985 and 1986, the validity of the abbreviated classification of perinatal deaths by the National Board of Health which comprises six categories was assessed. The classification is relatively robust regarding incorrect classification of International Classification of Diseases (ICD) as 87% of the deaths were classified in the relevant categories. This may be because the classification is relatively rough but also because the classification, as regards ICD diagnoses, is based on information from the register of births.

Cause of Death↗
PubMed1990

[A case of the right subclavian artery as the last branch of the aortic arch in the human fetus and a new classification on these variations].

An anomalous case of the right subclavian artery arising from the aortic arch as the last branch, in which the first branch was the right common carotid, the second the left common carotid and the third the left subclavian artery, was found in a 10 months human fetus among 173 fetuses. The right subclavian artery arose from the posterior wall of the aortic arch at the level of the Th4 and passed obliquely between the esophagus and the thoracic vertebrae. The right and the left vertebral arteries arising from the subclavian arteries on the same side entered the transverse foramen of the C6 of each side. This case belonged to type G of Adachi's classification and as well type 5 of Holzapfel's. The present authors wish to offer a new trial classification on these variations, including the origins and numbers of the vertebral arteries, by investigating many original reports in Japanese, as follows: 1) A new classification is fixed on the basis of the type G and H of Adachi-Williams et al.-Nakagawa in the classification of the branching types of the aortic arch. The type G represents that the right common carotid, the left common carotid, the left subclavian and the right subclavian arteries arise from the aortic arch in this order. The type H represents that the bicarotid trunk, the left subclavian and the right subclavian arteries arise from the aortic arch. 2) When the left vertebral artery arising from the aortic arch is found in the type G and H, "C" is prefixed G or H, as type CG, type CH. 3) When the right vertebral artery arising from the right common carotid artery is found, a prime mark, ""', is put on G or H, as type G', type H'. 4) In order to represent a compound type of the above 2) and 3), both "C" and ""' are put, as type CG', type CH'. 5) When the bilateral vertebral arteries arising from the respective subclavian artery are found in the above 2), 3) and 4) "2" postfixed "C" and the prime mark ""', as type G'2, type C2G, type CG'2, type C2G', type C2G'2, type H'2, type C2H, type CH'2, type C2H', type C2H'2. According to the above new classification, Adachi's type G can be arranged into 18 branching types. This classification may be helpful and sufficient to provide more than 100 cases of the type G and H reported on Japanese.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

A proposed clinical classification of pelvic endometriosis.

Two hundred and forty-four cases of pelvic endometriosis were diagnosed by laparoscopy between Jan. 1979 and Dec. 1986. Consulting the principles designated by the American Fertility Society (AFS) and Revised American Fertility Society (RAFS) classification, diseases were staged as mild, moderate and severe. The results of clinical classification were compared with those of laparoscopic classification. The conformance rate between clinical and RAFS classification was 74.2%. The pregnancy rates after operation were 69.2%, 42.9% and 38.5% among 94 patients clinically classified as mild, moderate and severe, respectively, as compared with 65.2%, 41.4% and 35.7% in terms of RAFS classification. The authors point out that laparoscopy is an excellent procedure for diagnosing and staging endometriosis. In hospitals where laparoscopic equipment is not available, clinical classification can be used as a substitute for staging those highly suspected of having endometriosis.

Endometriosis↗
PubMed1989

[3 classifications of gestosis].

Three classifications: of the American College of Obstetricians and Gynecologists (ACOG), of the Organization of Gestosis (OG) and of the International Society for Study of Hypertension in Pregnancy (ISSHP) differ among one another in some essential points. According to ACOG the term "preeclampsia" means a state with hypertension and albuminuria or edema, according to ISSHP--hypertension and albuminuria. This may lead to serious misunderstanding as many obstetricians use this term to identify a directly threatening eclampsia attack. But the two classifications do not provide a term for such a condition whereas according to OG this state is identified as threatening eclampsia. The OG and ACOG classifications give a classifications according to the progression of the disease, the ISSHP does not give such a classification. ISSHP does not consider edema as a symptom, ACOG takes it into consideration if it is accompanied by hypertension according to OG the very edema not subsiding after relaxation is enough to diagnose gestosis E. ISSHP has introduced the term "hypertension in pregnancy", but also includes one-symptom form "pregnancy albuminuria" not accompanied by hypertension. Such terms suggest lack of etiological relation between those forms, which has not however been proved. The names of one-symptom forms according to OG "gestosis H" and "gestosis P" do not impose such a relation (it is a classification according to symptoms), but they do not exclude it. Contrary to ACOG and OG, ISSHP gives the level of diastolic blood pressure only.

Congresses as Topic↗
PubMed1989

[Tumor classification--present status and further developments].

Characterization of the individuality of a malignant tumor is needed for planning treatment and evaluating its results. The present classification of tumors is the result of long years of international effort, and is published as the WHO International Histological Classification of Tumors and the UICC TNM Classification of Malignant Tumors, 4th edition. For a number of tumor entities TNM classification is not yet available. A classification of liver and lung metastases is the aim of UICC studies, some of which have been initiated. The further development of tumor classification is focused on the identification of independent prognostic factors (prognostic indices and prognostic grouping), which apart from the TNM defined stage, have separate influence on the prognosis.

Humans↗
PubMed1989

[Clinical epidemiology using an electronic value-added tabulator. Application to cancer of the prostate in TNM classification and in calculating Kaplan-Meier curves].

The authors have been using the WHO-TNM 1977 classified, modified in 1982, for prostatic cancer for more than ten years. This classification has been considered to be insufficient to allow precise choice of therapeutic determinants and to accurately evaluate the results of treatments. A new WHO TNM 88 classification has been recently published and has raised many controversies in the urological literature which complicates the development of this classification. The authors have developed a value added system of TNM scoring using the Excel programme on a personal computer, which tries to integrate the various classifications 78-82-88. Very precise rules must be determined for information collection, the most reproducible medical indicators must be selected and they must be made as objective and as pertinent as possible. The rules of the WHO classification must then be formalized and introduced into the expert system as rules of production. The system allows optimal transcription of the scores from one classification to another, depending on the political orientations of the necessity of translation. Lastly, the system calculates, in real time, the actuarial survival and/or Kaplan-Meier curves for all of the events identified by an indicator for the patient files entered into the system.

Electronic Data Processing↗
PubMed1987

The pathological classification of colorectal cancer.

The reporting and staging of large bowel cancer needs to be improved and refined. To achieve this end, the following steps should be adopted: All useful information should be utilised. Useful information has an independent bearing upon any clinically important end point, whether this be survival, local recurrence or response to treatment. Classifications should be based upon research that is carried out with meticulous care. It must be accepted that classifications may alter as new information comes to light. Different clinical settings will require different classifications. A classification only succeeds if it is applied correctly. Clinicians and pathologists require instruction on what to record and how to derive data with minimum effort and maximum accuracy. It is important that all terms are defined clearly and unambiguously. Finally classifications should be simple so that symbols can be readily equated with particular clinical endpoints. We have recently identified four pathological variables which influence long-term survival independently in patients undergoing curative surgery for rectal cancer. A new prognostic classification has been developed that is based on a simple scoring system for these variables. It is superior to staging by the method of Dukes because it places twice as many patients into groups that provide a confident prediction of clinical outcome.

Adenocarcinoma↗