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At least 1,333 records · Page 74Linked to original sources
PubMed2005

Indexation criteria of ventricular mass and predictive role of blood pressure and body composition.

BACKGROUND: There is no definite consensus on which indexation of left ventricular mass (LVM) should be used to better identify left ventricular hypertrophy (LVH). Left ventricular mass has been adjusted to height, to height2.7(h2.7) and to body surface area (BSA). The aims of the present study were to evaluate the prevalence of LVH according to different indexations and different cut-offs and to identify the most useful indexation of LVM to detect hypertension-related LVH. METHODS: Echocardiographic LVH was defined as LVM to h2.7, LVM to BSA, LVM to height, LVM values in the upper 5th percentile of our gender-related LVM distribution, using different partition values suggested in previous population-based studies. RESULTS: Prevalence of LVH in the general population was 32% using the less restrictive criterion (LVH 49.2/46.7 g/m2.7), 15% with the criterion of LVH 116/104 g/m2, and 3.8% with the most restrictive one (LVH 134/110 g/m2). Prevalence of LVH in hypertensive subjects was almost twice than in normotensive subjects with all criteria. Only 20 subjects out of the 707 evaluated were found to have LVH with all six criteria. In multiple regression analysis SBP was independently associated with nonindexed LVM and was indexed to both BSA and h2.7. On the other hand, fat-free mass was a powerful predictor of nonindexed LVM or of LVM to BSA, whereas body mass index was the strongest predictor of LVM to h2.7. CONCLUSIONS: The indexation of LVM to BSA, possibly with the cut-off of LVH 116/104, is probably the best criterion for identifying blood pressure-related LVH.

Adolescent↗
PubMed2005

Quantification of index tapping regularity after stroke with tri-axial accelerometry.

OBJECTIVE: Quantifying intrinsic components of movement may help to better understand the nature of motor deficits after stroke. Here we quantify the ability of stroke patients to finger tap in rhythm with auditory cues given at physiological rate. METHODS: Using tri-axial accelerometry, we measured tapping regularity (Regularity Index) during auditory-cued index-to-thumb tapping at 1.25 Hz in 20 prospectively selected right-handed chronic stroke patients (mean age 61 yrs) and 20 right-handed healthy subjects (7 young and 13 age matched; mean age 24 and 58 yrs, respectively). With the aim to validate our method, two measures of clinical deficit, the European Stroke Scale (ESS) and the maximum number of index-thumb taps in 15s (IT-Max) were recorded on the same day. RESULTS: There was no effect of age or hand used on the Regularity Index in the control subjects. In patients, the Regularity Index of their affected hand was significantly worse compared to their unaffected hand and to age-matched controls (p<0.05 and p<0.01, respectively). The Regularity Index significantly correlated with the ESS and IT-Max in the clinically expected direction (p=0.025 and 0.001, respectively). CONCLUSION: These data indicate that our method has validity to quantify finger-tapping regularity. After stroke, there is a deficit in the ability to keep pace with auditory cues that correlates, but does not equate, with other indices of motor function. Quantifying tapping regularity may provide novel insights into the mechanisms underlying recovery of finger dexterity after stroke.

Acoustic Stimulation↗
PubMed2004

Effect of body mass index on nonalcoholic fatty liver disease in patients undergoing minimally invasive bariatric surgery.

The risk factors for nonalcoholic fatty liver disease in patients undergoing bariatric surgery are under study. We wanted to determine the correlation between nonalcoholic fatty liver disease and patient factors such as obesity and liver function tests. A retrospective analysis was performed on 177 nonalcoholic morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass with liver biopsy, to identify risk factors for nonalcoholic fatty liver disease. The histologic grade of liver disease was compared with preoperative body mass index, age, and liver function tests. Simple steatosis and steatohepatitis were present in 90% and 42% of patients, respectively. Elevated transaminase levels were an independent risk for liver disease. Body mass index and liver disease were not correlated with univariate analysis. Regression analysis performed on age, body mass index, and liver disease demonstrated that the risk for liver disease increased with body mass index in the younger (<35 years old) age group and decreased with body mass index in the older (>45 years old) age group. There was a high incidence of steatosis and steatohepatitis in these nonalcoholic bariatric patients, and elevated transaminase level was indicative of disease. Body mass index was a positive risk factor for liver disease in younger patients but a negative risk factor in the older patients.

Adult↗
PubMed2005

Glycemic index of potatoes commonly consumed in North America.

OBJECTIVE: To determine the effect of variety and cooking method on glycemic response and glycemic index of common North American potatoes. DESIGN: Study 1: subjects consumed 200 g Russet or white potatoes that were either (a) precooked, refrigerated, and reheated (precooked) or (b) cooked and consumed immediately (day-cooked). Incremental area under the curve was determined. Study 2: subjects consumed 50 g carbohydrate portions of white bread or potatoes (six different varieties and two different cooking methods). Glycemic index values were calculated. In both studies meals were consumed after a 10- to 12-hour overnight fast and finger-prick capillary-blood glucose was measured before and at intervals for 2 hours after consumption. SUBJECTS: The study groups were as follows: Study 1 comprised four men and six women, aged 20 to 44 and Study 2 comprised 11 men and one woman, aged 18 to 50. STATISTICAL ANALYSES: Repeated measures analysis of variance with Newman-Kuels to protect for multiple comparisons (criterion of significance two-tailed P <.05). RESULTS: Study 1: Precooked Russet potatoes elicited lower area under the curve than day-cooked (P <.05), while precooking had no effect on boiled white potatoes. Study 2: The glycemic index values of potatoes varied significantly, depending on the variety and cooking method used (P =.003) ranging from intermediate (boiled red potatoes consumed cold: 56) to moderately high (roasted California white potatoes: 72; baked US Russet potatoes: 77) to high (instant mashed potatoes: 88; boiled red potatoes: 89). CONCLUSIONS: The glycemic index of potatoes is influenced by variety and method of cooking and US Russet potatoes have only a moderately high glycemic index. Individuals who wish to minimize dietary glycemic index can be advised to precook potatoes and consume them cold or reheated.

Adolescent↗
PubMed2006

US honeys varying in glucose and fructose content elicit similar glycemic indexes.

The glycemic index of honey may vary, depending upon its floral variety and fructose-to-glucose ratio. We determined the glycemic index of four US honey varieties in 12 healthy adult men and women with a mean (+/-standard error) age of 24.5+/-1.5 years. The glycemic index of 250-mL solution servings of clover, buckwheat, cotton, and tupelo honeys providing 50 g carbohydrate were assessed relative to triplicate feedings of 50 g carbohydrate as a glucose solution. Fructose-to-glucose ratios were 1.09, 1.12, 1.03, 1.54, for clover, buckwheat, cotton, and tupelo, respectively. Blood was collected after an overnight fast and 15, 30, 45, 60, 90, and 120 minutes after intake. Ten minutes were allowed for food consumption. Areas under the glycemic response curves for each honey were expressed as percent means of each participant's average response to glucose feedings. The means (+/-standard error) of the glycemic index were 69.2+/-8.1, 73.4+/-6.4, 73.6+/-6.6, 74.1+/-8.2 for clover, buckwheat, cotton, and tupelo honeys, respectively. No statistically significant differences between the honeys were apparent, nor was a relationship between glycemic index and the fructose-to-glucose ratio detected, indicating that small differences in fructose-to-glucose ratios do not substantially impact honey glycemic index.

Adult↗
PubMed2005

A multipurpose comorbidity scoring system performed better than the Charlson index.

BACKGROUND AND OBJECTIVES: To develop a comorbidity scoring system that out-performs the Charlson index. METHODS: Population-based cohorts of medical (n=326,456), procedural (n=349,686), and psychiatric (n=16,895) inpatients in Western Australia were followed for 1-year mortality, 30-day readmissions, and length of stay (LOS) using data linkage. Conditions were identified at index admission and over the preceding 12 months. A Multipurpose Australian Comorbidity Scoring System (MACSS) was developed, based on the most frequent 102 comorbid conditions associated with a rate ratio (RR) > or = 1.1 of death or readmission or a LOS difference > or =0.5 days. The performance of MACSS and the Charlson index in predicting mortality, readmission, and LOS, and in controlling confounding by comorbidity, was compared in five test scenarios involving asthma, myocardial infarction, mastectomy, transurethral prostatectomy, and major depressive illness. RESULTS: MACSS performed better than the Charlson index on all three outcomes in all five clinical groups. It reduced the failure of the Charlson index to discriminate on mortality and readmission outcomes by 5-40%, improved R(2) in LOS models by up to fourfold and often doubled the correction of originally confounded effect measures. CONCLUSION: The use of the MACSS and similar alternatives to the Charlson index are a new methodologic standard for adjustment of comorbidity risk.

Adolescent↗
PubMed2006

Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in Asians with knee osteoarthritis in Singapore.

OBJECTIVE: To cross-culturally adapt and validate Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in patients with knee osteoarthritis (OA) in Singapore. METHODS: Singapore English and Chinese versions were cross-culturally adapted from the source English version following standard guideline (including cognitive debriefing). Patients were asked to complete an identical, pretested questionnaire containing the Lequesne index, Short Form 36 Health Survey (SF-36), and EQ-5D twice within 6 days. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICC). Dimensionality was assessed by principal component factor analysis. Construct validity was tested by item-to-scale correlations and 12 and six a priori hypotheses for convergent and divergent construct validities, respectively. RESULTS: Singapore English and Chinese Lequesne indices were well accepted by patients in pilot testing and were therefore administered to a consecutive sample of 127 English- and 131 Chinese-speaking Singaporeans with knee OA. Acceptable internal consistency was observed for activities of daily living and the global index (alpha=0.72-0.82), and the good test-retest reliability for all scales in both versions (ICC=0.66-0.94). Expected item-to-scale correlations were presented only in activities of daily living in both versions. Factor analysis yielded two factors for both versions. Convergent and divergent construct validities were supported by the presence of hypothesized correlations between the Lequesne index and SF-36 and EQ-5D scales. CONCLUSION: Both versions of the Lequesne index demonstrated acceptable reliability and validity among multiethnic Asian patients with knee OA, which suggests that it could be used as a global index in the health-related quality of life (HRQoL) measurements in Singapore and possibly other Asian countries.

Activities of Daily Living↗
PubMed2005

The pulse transit time arousal index in obstructive sleep apnea before and after CPAP.

BACKGROUND AND PURPOSE: Pulse transit time (PTT) is a non-invasive index which reflects changes in peripheral vascular resistance and intrathoracic pressure. PTT arousal index (PTT Ar/I) is defined as the frequency (number/hour) of a defined decrease in PTT which may serve as a marker for respiratory events, and associated arousals which occur in patients with obstructive sleep apnea (OSA). This study was designed to evaluate the PTT Ar/I before and after patients with OSA were treated with continuous positive airway pressure (CPAP). PATIENTS AND METHODS: Individuals referred for evaluation of possible OSA underwent split-night polysomnography (PSG). The findings from 144 consecutive patients with a respiratory disturbance index (RDI)>/=20, who demonstrated at least a 50% drop in RDI with CPAP, provide the basis for this analysis. The PTT Ar/I measured before and after CPAP were compared to other measures of severity for OSA, including RDI and arousal index. RESULTS: The PTT Ar/I correlates with the RDI (r=0.43, P</=0.0001) and with the arousal index (r=0.43, P<0.0001). Moreover, the decrease in RDI and arousal index that occurs with CPAP treatment correlates with a similar decrease in the PTT Ar/I (r=0.54, P<0.0001). CONCLUSIONS: The PTT Ar/I correlates well with other standard measures of severity in patients with OSA and is potentially a non-invasive marker with which to measure the frequency of disruptive events that occur during sleep.

Arousal↗
PubMedDate not supplied

Validity of the new Backache Index (BAI) in patients with low back pain.

BACKGROUND CONTEXT: The Backache Index (BAI) is applied to patients with low back pain (LBP) in order to help therapists, doctors, and surgeons perform physical examinations easily. It is carried out within a short space of time (<2 min) without using inclinometric instruments. PURPOSE: To explore the reliability, validity, and responsiveness of this new Backache Index in patients with LBP, which can fulfil the existing need for a reliable routine examination in the clinical environment. STUDY DESIGN/SETTING: Patients with LBP filled in disability questionnaires; pain rating scales and physical impairment tests were completed in function of construct validity and correlation studies. A subgroup was evaluated for interobserver and test-retest reliability, and a second group was reassessed after two active treatment sessions to verify the responsiveness compared with other examined variables. PATIENT SAMPLE: In total, 75 patients with subacute LBP (3-12 weeks) participated in a randomized controlled study. OUTCOME MEASURES: The validity of the BAI was explored through a correlation with the standard Oswestry LBP Disability Index (ODI), the McGill LBP Questionnaire Index (MPQ), and the Visual Analogue Scale (VAS). METHODS: The BAI consisted of a scoring system that includes pain factors and stiffness estimation at the end of a series of five different lumbar movements of a patient standing in an erect position. RESULTS: The correlations between the separate outcomes and the BAI ranged from 0.61 to 0.76 (p<.001). The interobserver reliability between two experienced observers for the five outcome scores was good (intraclass correlation coefficient [ICC]>0.86) and even perfect for the BAI (ICC=0.96). A BAI change of one unit is able to exclude a measurement error. A significantly good correlation (p<.001) was found between the BAI at baseline, the ODI (R=0.62), and the total degree of pain rating index (MPQ-PRI-T) (R=0.57), a moderate correlation with the total number of chosen adjectives from the whole list of adjectives (MPQ-NWC-T) (R=0.48), and the VAS (R=0.47), but a lower correlation was found with the MPQ-Quality of life index (R=0.43). The effect size and discriminative ability of the measures were explored after two treatment sessions of deep transverse friction myotherapy by means of study of the receiver operating characteristics curve (ROC) and the greatest area under the curve (AUC). The greatest level of distinction was found for the MPQ-PRI-T and the BAI (AUC>0.93), followed by the ODI (AUC=0.92). A lower level of distinction was found for the MPQ-NWC-T and the VAS (AUC>0.82). CONCLUSIONS: The BAI appears to be a reliable and valid assessment of overall restricted spinal movements in case of LBP and discriminates between successful and unsuccessful treatment outcome.

Adult↗
PubMed2004

An index to measure the association between dietary patterns and coronary heart disease risk factors: findings from two Italian studies.

BACKGROUND: To examine the association between established coronary heart disease (CHD) risk factors and eating patterns by creating a dietary index utilizing a limited amount of food frequency questionnaire data on specified indicator foods. METHODS: Selected data from the Italian Risk Factors and Life Expectancy (RIFLE) project collected between 1978-1979 and 1983-1984 on 7665 men and women, aged 20-59 years, were used to compute a dietary index summarizing the relative proportion of fatty to non-fatty foods. The association between this index and systolic and diastolic blood pressure (SBP, DBP), body mass index, total serum cholesterol (TC), and blood glucose, controlling for potential confounders was then tested using multiple linear regression. RESULTS: Among men, a positive association was found between the index and all five CHD risk factors (P < 0.01). Among women, the associations were weaker, becoming statistically significant only for TC and glucose. CONCLUSIONS: Our food index was able to detect relationships between diet and traditional CHD risk factors. A tool such as this, which requires only a limited number of key indicator food items, might enhance the use of existing food frequency questionnaires and also streamline the process of collecting new dietary information.

Adult↗
PubMed1995

Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease.

Left ventricular (LV) mass has been established as an independent risk factor for cardiovascular disease morbidity and mortality. To account for differences in body size, a variety of factors have been proposed for indexing LV mass. Dual energy x-ray absorptiometry provides a measure of lean body mass which can be used as a comparison with other more clinically applicable methods of standardization. The study included 192 subjects (100 male, 103 white) aged 6 to 17 years. Lean body mass was determined by dual energy x-ray absorptiometry and LV mass was calculated from M-mode echocardiographic measurements. There were significant differences by gender (males 98.7 g, females 80.3g, p < 0.001), but not race, for unindexed LV mass. Indexing LV mass by lean body mass eliminated the difference by gender. Log-log regression analysis revealed that the optimal height exponent for indexing LV mass was height3 (95% confidence interval, 2.8 to 3.1). LV mass/height3 provided the most consistently high intraclass correlation with LV mass/lean body mass versus indexing with body surface area, height, height2, and height2.7 across the 4 race/gender groups. LV mass indexed by height3 eliminated differences in LV mass by gender (males 26.1 +/- 4.72 g/m3, females 25.5 +/- 4.8 g/m3, p = NS). The proposed method for indexing LV mass by height3 should be useful in the clinical setting. The 90th and 95th percentiles of LV mass/height3 provide cutpoints for determining the presence of LV hypertrophy in children and adolescents.

Absorptiometry, Photon↗
PubMed1997

The Preterm Prediction Study: association of cesarean delivery with increases in maternal weight and body mass index.

OBJECTIVE: Our purpose was to evaluate whether maternal weight and body mass index measured either before or during pregnancy are associated with an increased risk of cesarean delivery. STUDY DESIGN: Maternal weight and height were prospectively collected on 2929 women in the National Institutes of Health Maternal-Fetal Medicine Units Network Preterm Prediction Study. Prepregnancy and 27- to 31-week maternal weight and height were used to calculate the body mass index, and its contribution to the risk of cesarean delivery was determined. Women with prenatally diagnosed congenital anomalies (n = 89) and pregestational diabetes (n = 31) were excluded from analysis. RESULTS: Univariate analysis of risk factors for cesarean delivery in the 2809 eligible women revealed a decreased risk of cesarean delivery with maternal age < 18 years and multiparity; increased risk of cesarean delivery was noted with maternal age > 35 years and a male fetus. Increases in either prepregnancy or 27- to 31-week maternal weight (5-pound units) or body mass index (1.0 kg/m2 units) were significantly associated with an increased odds of cesarean delivery (p = 0.0001). Each unit increase in prepregnancy or 27- to 31-week body mass index resulted in a parallel increase in the odds of cesarean delivery of 7.0% and 7.8%, respectively. Multivariable stepwise logistic regression analysis confirmed the association of male fetus, age, nulliparity, and body mass index as significant variables contributing to cesarean delivery risk. CONCLUSIONS: The risk of cesarean delivery is associated with incremental changes in maternal weight and body mass index before and during pregnancy after adjustment for potential confounding factors. Prepregnancy counseling about optimizing maternal weight and monitoring weight gain during pregnancy to decrease the risk of cesarean delivery are supported by this study.

Adolescent↗
PubMed1996

Endocrine tumors of the pancreas: Ki-67 immunoreactivity on paraffin sections is an independent predictor for malignancy: a comparative study with proliferating-cell nuclear antigen and progesterone receptor protein immunostaining, mitotic index, and other clinicopathologic variables.

Prediction for malignancy of pancreatic endocrine tumors (PET) is often a formidable challenge for the pathologist. The authors evaluated the role of the proliferative activity and progesterone receptor protein (PgRP) in predicting prognosis and survival of PET. Twenty-three functioning (FT) and 31 nonfunctioning tumors (NFT) were evaluated for mitotic activity and immunostaining for Ki-67 antigen, proliferating cell nuclear antigen (PCNA), and progesterone receptor protein (PgRP) on paraffin sections. The results were expressed as a percentage (index) of immunoreactive or mitosing cells. All 54 cases showed immunostaining for Ki-67 and PCNA, and valuable mitotic index, whereas only a fraction of tumors (25 of 54 cases) exhibited PgRP expression. Ki-67 and PCNA indexes correlated strongly between themselves and to mitotic index, whereas an inverse relationship was observed between cell proliferation and PgRP status in both FT and NFT. Although univariate analysis showed that Ki-67, PCNA, mitotic and PgRP indexes, stage, immunoreactivity for hormones other than insulin, diameter, and nonfunctioning type of tumor were statistically correlated to survival, Cox's regression method let only Ki-67 index emerge as an independent predictor of survival using a cutoff value of 5% in both FT and NFT.

Adenoma, Islet Cell↗
PubMed1998

Transition zone index as a risk factor for acute urinary retention in benign prostatic hyperplasia.

OBJECTIVES: To examine the efficacy of various parameters obtained by transrectal ultrasonography (TRUS) as predictors of the onset of acute urinary retention in patients with benign prostatic hyperplasia (BPH). METHODS: From April 1993 to March 1997, 331 men aged 51 to 84 years with symptoms of BPH were enrolled in this study. Among them, 64 patients presented to our clinic because of acute urinary retention. TRUS was used to calculate the transition zone (TZ) volume, the transition zone index (TZ index = TZ volume/total prostate volume), the total prostate volume, and presumed circle area ratio (PCAR). To compare the usefulness of the various indices, the area under the receiver-operator characteristic (ROC) curve was calculated for each index. RESULTS: There were significant differences in the American Urological Association (AUA) symptom score, total prostate volume, TZ volume, TZ index, and PCAR between patients with and without acute urinary retention, but no significant differences in age and quality of life score. In patients with acute urinary retention, the area under the ROC curve was 0.924 for the TZ index, 0.834 for the TZ volume, 0.753 for the PCAR, 0.684 for the total prostate volume, and 0.628 for the AUA symptom score. CONCLUSIONS: The TZ index is an accurate predictor of acute urinary retention in patients with BPH and may be a useful method for deciding between surgical intervention and antiandrogen treatment.

Acute Disease↗
PubMed2001

Relationship between plasma level of cardiotrophin-1 and left ventricular mass index in patients with dilated cardiomyopathy.

OBJECTIVES: The study evaluated the relationship between plasma cardiotrophin-1 (CT-1) concentration and left ventricular (LV) mass in dilated cardiomyopathy (DCM) patients with congestive heart failure (CHF). BACKGROUND: Cardiotrophin-1 is a newly identified member of the interleukin-6 (IL-6) family of cytokines and one of the endogenous ligands for gp130 signaling pathways in the heart, and it has potent hypertrophic and survival effects on cardiac myocytes. However, the clinical significance of CT-1 is poorly understood. METHODS: We measured the plasma CT-1 level in 51 consecutive patients with DCM. Patients were classified into two groups: small LV mass index group and large LV mass index group, based on the median level of LV mass index. RESULTS: The plasma CT-1 level was increased in DCM patients with the severity of CHF and was significantly higher in the large LV mass group than in the small LV mass group, despite the absence of a difference in LV ejection fraction between the two groups. In addition, there was a significant positive correlation between the plasma CT-1 level and the LV mass index (r = 0.627, p < 0.0001). According to stepwise multivariate analyses among hemodynamic and neurohumoral factors, a high plasma CT-1 level showed an independent and significant positive relationship with a large LV mass index in patients with DCM. CONCLUSIONS: These results indicate that the plasma CT-1 level is increased in patients with DCM and is significantly correlated with the LV mass index, suggesting that CT-1 plays an important role in structural LV remodeling in patients with DCM.

Adolescent↗
PubMed1997

A new index for early prediction of hospitalization in patients with acute asthma.

Data from studies using the factor analysis technique have shown that asthma appears to be multidimensional and that most of the subjective and objective measures utilized in the assessment of asthma patients represent a much smaller number of underlying dimensions. Additionally, several investigators have emphasized that evaluation of acute asthma is an ongoing process, as the degree and time course of the response to therapy vary considerably between patients. The aim of this study was to examine the usefulness of the most common clinical and objective measures in the evaluation of acute asthma in the emergency department (ED) for predicting the outcome of acute episodes in adults. In an effort to identify variables that can predict the outcome of patients with acute asthma, 184 adults (age 32.4 +/- 11.6 [mean +/- SD]) (analysis sample) who presented to an ED were studied. The inclusion criteria were: (1) age between 18 and 50 years; (2) a peak expiratory flow rate (PEFR) or forced expiratory volume in the first second (FEV1) below 50% of predicted; and (3) no history of chronic cough or cardiac, hepatic, renal, or other medical disease. All patients were treated with salbutamol delivered with metered-dose inhaler (MDI) into a spacer device in 4 puffs actuated at 10-minute intervals and 500 mg of intravenous hydrocortisone. The multivariate statistical technique of discriminant analysis was utilized to develop the index, and after this, a new sample (n = 91), the validation sample, was studied to validate the index. In the analysis sample 163 patients (89%) were discharged (relapse rate within 7 days = 10%) and 21 (11%) were hospitalized (mean duration of hospital stay = 5.75 +/- 2.81 days). The discriminant analysis identified three independent variables that make the greatest contribution in discriminating between the two groups studied: PEFR variation over baseline, PEFR as percent of predicted, and accessory muscle use, all measured at 30 minutes after the beginning of treatment. A multifactorial index using these three variables presented a sensitivity of 0.86, a specificity of 0.96, a positive predictive value of 0.75, and a negative predictive value of 0.98. The validation sample index sensitivity, specificity, and positive and negative predictive values were 0.83, 0.97, 0.83, and 0.97, respectively. In conclusion, a predictive index has been developed for evaluating patients with asthma who present to an ED. This simple and brief three-item index can facilitate an early decision (30 minutes of treatment) to hospitalize patients with severe asthma.

Acute Disease↗
PubMed1995

The validation of the Peer Assessment Rating index for malocclusion severity and treatment difficulty.

The Peer Assessment Rating (PAR) index is a British occlusal index that measures the severity of dental malocclusion and has been used in several investigations that have evaluated the effectiveness of orthodontic treatment provision in Europe. As part of its development, the PAR index was validated for malocclusion severity, by using the opinions of a panel of 74 dentists and orthodontists. The present investigation was carried out to validate the PAR index, by using the opinion of an American panel of orthodontists. Eleven orthodontists examined a sample of 200 sets of study casts and rated them for malocclusion severity and perceived treatment difficulty. Multiple regression techniques were used to evaluate the predictive power of the components of malocclusion on the panel's scores. Weightings were calculated from the partial regression coefficients and, when these weightings were applied to the PAR index, the association between the panel's opinion and the PAR index scores was increased.

Analysis of Variance↗
PubMed2001

Development and validation of a self-completed HIV symptom index.

Traditional, open-ended provider questions regarding patient symptoms are insensitive. Better methods are needed to measure symptoms for clinical management, patient-oriented research, and adverse drug-event reporting. Our objective was to develop and initially validate a brief, self-reported HIV symptom index tailored to patients exposed to multidrug antiretroviral therapies and protease inhibitors, and to compare the new index to existing symptom measures. The research design was a multistage design including quantitative review of existing literature, qualitative and quantitative analyses of pilot data, and quantitative analyses of a prospective sample. Statistical analyses include frequencies, chi-square tests for significance, linear and logistic regression. The subjects were from a multisite convenience sample (n = 73) within the AIDS Clinical Trials Group and a prospective sample from the Cleveland Veterans Affairs Medical Center (n = 115). Measures were patient-reported symptoms and health-related quality of life, physician-assessed disease severity, CD4 cell count, and HIV-1 RNA viral quantification. A 20-item, self-completed HIV symptom index was developed based upon prior reports of symptom frequency and bother and expert opinion. When compared with prior measures the index included more frequent and bothersome symptoms, yet was easier to use (self-report rather than provider interview). The index required less than 5 minutes to complete, achieved excellent completion rates, and was thought comprehensive and comprehensible in a convenience sample. It was further tested in a prospective sample of patients and demonstrated strong associations with physical and mental health summary scores and with disease severity. These associations were independent of CD4 cell count and HIV-1 RNA viral quantification. This 20-item HIV symptom index has demonstrated construct validity, and offers a simple and rational approach to measuring HIV symptoms for clinical management, patient-oriented research, and adverse drug reporting.

Antiretroviral Therapy, Highly Active↗