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Results for “Nomogram”

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At least 217 records · Page 12Linked to original sources

PubMed1996

Evaluation of detrusor activity during micturition in patients with benign prostatic enlargement with a clinical nomogram.

PURPOSE: We investigated the accuracy of analysis of detrusor contraction during micturition with a simple to use pressure-flow nomogram (linear passive urethral resistance relation). The computer derived maximum detrusor contraction parameter was used as a reference. The correlation with bladder emptying capability was used as a control. MATERIALS AND METHODS: Advanced pressure-flow analysis was performed in 224 elderly men with lower urinary tract symptoms. RESULTS: All patients with a contraction classified as normal on the nomogram had good maximum detrusor contractions. However, 50% of the patients with a weak classification on the nomogram showed good maximum detrusor contractions. CONCLUSIONS: The nomogram is useful in the selection of patients with a good detrusor contraction.

Aged↗

PubMedDate not supplied

The effectiveness of implementing the weight-based heparin nomogram as a practice guideline.

OBJECTIVE: To determine the effectiveness of the nomogram in a community hospital that implemented it as a practice guideline. DESIGN: A nonexperimental, retrospective time series. SETTING: A 600-bed community teaching hospital and regional referral center in Phoenix, Ariz. PATIENTS: The study population included 591 consecutive patients with venous thromboembolism, treated over a 5-year study period. METHODS: During this period, the weight-based heparin nomogram was adapted into a preprinted order sheet and distributed to the hospital wards. The main outcome variables were the time to achieve a therapeutic activated partial thromboplastin time and the rate of bleeding complications. RESULTS: Voluntary implementation of the nomogram steadily increased, reaching 94%. Comparison of the periods before and after 50% implementation demonstrated an increase in initial heparin dose (1185 vs 1420 U/h, P < .001), a decrease in time to achieve therapeutic activated partial thromboplastin time (19.6 vs 11.8 hours), a decrease in the variance of this parameter (25 vs 4 hours, P < .001), and no change in bleeding rates. The proportion of patients achieving a therapeutic activated partial thromboplastin time within 24 hours decreased from 97% to 86% when the results from our previous randomized controlled trial (efficacy) are compared with the present results (effectiveness). CONCLUSIONS: The weight-based heparin nomogram was well accepted by clinicians at our institution and led to more aggressive heparin dosing and improvements in intermediate outcomes, without increasing bleeding. Mitigation of benefit is likely to occur when practice guidelines are moved from the realm of efficacy research into clinical practice. Therefore, the effectiveness of such measures requires monitoring.

Drug Administration Schedule↗

PubMedDate not supplied

Exercise capacity in untrained normal adults: a nomogram for Indians.

The exercise capacity of 155 hospital-based patients (125 males and 30 females) who underwent treadmill testing and coronary angiography for investigation of chest pain was used to derive regression equations for exercise capacity (METS) against age. A regression equation [18 - 0.16 x (age)] for males and [11 - 0.84 x (age)] for females was obtained. Using these equations an exercise capacity nomogram was developed. From this nomogram the predicted exercise capacity was calculated for another set of 228 patients (209 males and 19 females) whose treadmill tests were negative. The results confirmed that the nomogram could be applied to determine the expected and actual exercise capacity of Indians within a mean difference of 0.08 METS. This nomogram is being offered for clinical, therapeutic and preventive use for Indian patients.

Adult↗

PubMed1997

[Heart rate, blood lactate concentration and subjective stress perception in submaximal running: new nomograms for assessment of endurance capacity].

Considering the protective effect of physical activity against coronary heart disease, the estimation of endurance capacity is not only recommended for sportsmen but is also useful for exercise counselling of unfit persons. Endurance capacity can be estimated with test protocols leading to complete exhaustion, or by submaximal test procedures. Submaximal tests have the advantage of putting less stress on subjects than maximal test protocols; on the other hand, they are less accurate. As a complement to traditional submaximal test protocols based on heart rate analysis, a new submaximal protocol is proposed based on measurements of capillary blood lactate concentration during exercise. Incremental tests of 319 men with wide variation of endurance capacity were used to calculate nomograms of the typical pattern of exercise-induced increase in capillary blood lactate concentration, heart rate, and rating of perceived exertion in relation to endurance capacity. The running velocity eliciting a capillary blood concentration of 4 mmol/l lactate was selected as the parameter for endurance capacity. With the help of these nomograms, the 4 mmol/l-velocity could be estimated with submaximal values of lactate, heart rate or rating of perceived exertion. The appropriateness of the nomograms was checked against the data of 100 independent maximal treadmill tests. Estimation of 4 mmol/l-velocity with submaximal lactate values showed good precision (with a small standard deviation of +/-0.17 m/s); in contrast, the estimation of endurance capacity with submaximal values for heart rate and rating of perceived exertion showed substantially larger standard deviations (approximately +/-0.56 m/s). We conclude that, for estimation of endurance capacity from submaximal running values, the nomogram for blood lactate concentrations can be recommended.

Adolescent↗

PubMed2006

Nontoxic suramin as a chemosensitizer in patients: dosing nomogram development.

PURPOSE: We reported that suramin produced chemosensitization at nontoxic doses. This benefit was lost at the approximately 10-fold higher, maximally tolerated doses (MTD). The aim of the current study was to identify in patients the chemosensitizing suramin dose that delivers 10-50 microM plasma concentrations over 48 h. METHODS: Nonsmall cell lung cancer patients were given suramin, paclitaxel, and carboplatin, every 3 weeks. The starting chemosensitizing suramin dose was estimated based on previous results on MTD suramin in patients, and adjusted by using real-time pharmacokinetic monitoring. A dosing nomogram was developed by using population-based pharmacokinetic analysis of phase I results (15 patients, 85 treatment cycles), and evaluated in phase II patients (19 females, 28 males, 196 treatment cycles). RESULTS: The chemosensitizing suramin dose showed a terminal half-life of 202 h and a total body clearance of 0.029 L h(-1) m(-2) (higher than the 0.013 L h(-1) m(-2) value for MTD of suramin). The dosing nomogram, incorporating body surface area as the major covariate of intersubject variability and the time elapsed since the previous dose (to account for the residual concentrations due to the slow elimination), delivered the target concentrations in >95% of treatments. CONCLUSIONS: The present study identified and validated a dosing nomogram and schedule to deliver low and nontoxic suramin concentrations that produce chemosensitization in preclinical models.

Algorithms↗

PubMed2007

Prediction of indolent prostate cancer: validation and updating of a prognostic nomogram.

PURPOSE: Screening with serum prostate specific antigen testing leads to the detection of many prostate cancers early in their natural history. Statistical models have been proposed to predict indolent cancer. We validated and updated model predictions for a screening setting. MATERIALS AND METHODS: We selected 247 patients with clinical stage T1C or T2A from the European Randomized Study on Screening for Prostate Cancer who were treated with radical prostatectomy. We validated a nomogram that had previously been developed in a clinical setting. Predictive characteristics were serum prostate specific antigen, ultrasound prostate volume, clinical stage, prostate biopsy Gleason grade, and total length of cancer and noncancer tissue in biopsy cores. Indolent cancer was defined as pathologically organ confined cancer 0.5 cc or less in volume without poorly differentiated elements. Logistic regression was used to update the previous model and examine the contribution of other potential predictors. RESULTS: Overall 121 of 247 patients (49%) had indolent cancer, while the average predicted probability was around 20% (p <0.001). Effects of individual variables were similar to those found before and discriminative ability was adequate (AUC 0.76). An updated model was constructed, which merely recalibrated the nomogram and did not apply additional predictors. CONCLUSIONS: Prostate cancers identified in a screening setting have a substantially higher likelihood of being indolent than those predicted by a previously proposed nomogram. However, an updated model can support patients and clinicians when the various treatment options for prostate cancer are considered.

Aged↗

PubMed2006

Development and internal validation of preoperative transition zone prostate cancer nomogram.

OBJECTIVES: Up to 20% of men may harbor a transition zone (TZ) prostate cancer (PCa) at radical prostatectomy (RP). TZ PCa may be associated with more favorable RP pathologic findings than peripheral zone (PZ) PCa. To identify these men, we developed a model capable of predicting the probability of TZ PCa at RP. METHODS: The study cohort consisted of 945 consecutive men treated with RP, with clinical stage, prostate-specific antigen (PSA) level, and detailed biopsy and RP pathology data available. The preoperative variables were used as predictors in the multivariate logistic regression models to predict the rate of TZ PCa at RP. PCa was defined as a TZ tumor when more than 50% of the planimetrically measured tumor volume was situated within the TZ. Regression coefficients were used to develop nomograms, which were subjected to 200 bootstrap resamples to reduce overfit bias. RESULTS: TZ PCa at the final pathologic examination was recorded in 110 patients (11.6%). After 200 bootstraps, the most parsimonious and most accurate nomogram was 77.3% accurate in predicting the probability of TZ PCa. CONCLUSIONS: This nomogram is ideally suited to identify patients with markedly elevated, nearly metastatic serum PSA levels who harbor a TZ tumor that is highly treatable by RP.

Adult↗

PubMed2006

Nomogram predictive of cancer specific survival in patients undergoing partial or total amputation for squamous cell carcinoma of the penis.

PURPOSE: We created the first nomograms to predict cancer specific survival probabilities of patients with squamous cell carcinoma of the penis, clustering prognostic information from the most commonly used clinical and pathological variables. MATERIALS AND METHODS: We retrospectively collected clinical and pathological data from 175 patients who had undergone surgery for squamous cell carcinoma of the penis from 1980 to 2002 at 11 urological centers in northeastern Italy. A logistic regression model was used to construct the nomogram. RESULTS: At a median followup of 24 months, 101 patients (57.7%) were alive and disease-free while 74 (42.3%) died of penile cancer. According to multivariate analyses, 2 models predictive of cancer specific survival probability were generated. The first model was based on the pathological findings of the primary tumor after penectomy and on the clinical stage of groin lymph nodes, while the second model included the pathological data of the primary tumor and groin lymph nodes. The concordance index was 0.728 for the first model and 0.747 for the second. Calibration appeared to be good in both models. CONCLUSIONS: In this article we propose 2 models to predict the 5-year cancer specific survival probabilities of patients with squamous cell carcinoma of the penis. Both models showed good discriminating power and calibration in predicting patient 5-year cancer specific survival. These nomograms could improve the quality of prognostic data provided to patients and support physicians in planning treatment.

Aged↗

PubMed2006

Significant upgrading affects a third of men diagnosed with prostate cancer: predictive nomogram and internal validation.

OBJECTIVE: To explore the rate of significant upgrading from biopsy to radical prostatectomy (RP) specimens in a contemporary cohort, and to develop a prognostic model capable of predicting the probability of significant upgrading, as previous reports indicate that up to 43% of men with low-grade prostate cancer at biopsy will be diagnosed with high-grade cancer at RP. PATIENTS AND METHODS: The study cohort comprised 4789 men (median age 63 years, range 39-82) treated with RP, with available clinical stage, prostate-specific antigen levels, biopsy and RP Gleason sum values. These variables were used as predictors in multivariate logistic regression models (LRMs) addressing the rate of significant Gleason sum upgrading, defined as a Gleason sum increase either from < or = 6 to > or = 7 or from 7 to > or = 8 between the biopsy and RP specimens. Regression coefficients were used to develop and validate (200 bootstrap re-samples) a nomogram predicting significant biopsy Gleason sum upgrading. RESULTS: Significant biopsy Gleason sum upgrading was recorded in 1349 (28.2%) patients. In multivariate LRMs, all predictors were highly significant (all P < 0.001). The bootstrap-corrected accuracy of the nomogram predicting the probability of significant Gleason sum upgrading between biopsy and RP specimens was 75.7%. CONCLUSION: Our nomogram might prove highly useful when the possibility of a more aggressive Gleason variant could change the treatment options.

Adult↗

PubMed2000

Predicting the risk of mobility difficulty in older women with screening nomograms: the Women's Health and Aging Study II.

BACKGROUND: A major obstacle to screening for early mobility disability (ie, mobility difficulty), a major public health concern, is the lack of a method that identifies those who are at high risk. The goal of this study was to develop easy-to-use clinical nomograms for estimation of the probability of incident mobility difficulty. METHODS: We conducted a population-based prospective study using data from 266 high physically and cognitively functioning older women, aged 70 to 80 years, who were free of mobility disability at the baseline evaluation of the Women's Health and Aging Study II. The outcome measure was incident mobility disability within 18 months, defined as self-reported difficulty walking 0.8 km, climbing 10 steps, or transferring from or into a car or bus. Logistic regression and receiver operating characteristic curve analyses were used for evaluation of the optimal combination of self-reported and performance-based mobility measures. Bootstrap sampling and estimation was used for validation. RESULTS: Predictive nomograms were developed based on a final model that included 3 simple-to-obtain measures of preclinical disability: self-report of modification in mobility tasks without having difficulty with them, one-leg stance balance, and time to walk 1 m at a usual pace. Final model accuracy (as estimated by the area under the receiver operating characteristic curve) was 73% (SE = 0.04). Validation analysis confirmed the high accuracy of these nomograms. CONCLUSIONS: An original tool was developed for assessment of the risk of mobility difficulty in older women that can be used to assist physicians and researchers in deciding which women to target for preventive interventions.

Aged↗

PubMed1998

Estimation of canine prostatic volume: nomogram based on prostatic cubic volume.

To estimate prostate volume in canines, we demonstrated the nomogram based on prostatic cubic volume. Transrectal ultrasonography (TRUS) was performed in twenty beagle dogs. Prostatic length (L) and height (H) were determined on sagittal image, and prostatic width (W) was determined on transaxial image. Data of one dog, which had asymmetrical shaped prostate, were excluded from the analysis. Prostate volume was estimated by the following nomogram: Gravimetric prostatic volume (g) = 0.642 x prostatic cubic volume (cm3) + 1.84 (prostatic cubic volume = L x H x W cm3, r = 0.997, p<0.001). By substituting the prostatic height to the average of height, prostatic volume of one dog showing asymmetrical shape was successfully estimated. We also showed technical points in evaluating morphology of canine prostate on TRUS. In conclusion, this nomogram is of great use for directly estimating prostatic volume.

Animals↗

PubMed1976

Nomograms relating aldosterone excretion to urinary sodium and potassium in the pediatric population: their application to the study of childhood hypertension.

The lability and diurnal variation of blood pressure in normal and hypertensive children were examined and found to be less than that described in adults. Nomograms were prepared relating urinary sodium and potassium to urinary aldosterone in children ranging in age from infancy to 22 years. These nomograms reveal that the relation of aldosterone excretion to sodium excretion is described by a hyperbolic function. Most values for normal children, children with mild essential hypertension and children with severe essential hypertension fell between two hyperbolic curves representing the 5th and 95th percentile, respectively. Hypertensive children with low and high plasma renin activity were found to have an inappropriately high level of urinary aldosterone excretion in relation to urinary sodium excretion. No relation was found between potassium and aldosterone excretion. By means of these nomograms the normal standards for aldosterone excretion in children were refined, permitting classification of hypertensive children into distinct groups. This classification may have prognostic significance.

Adolescent↗

PubMed1988

Death time estimation in case work. I. The rectal temperature time of death nomogram.

A rectal temperature time of death nomogram was developed on the basis of physical considerations, the two-exponential term of Marshall and Hoare (J. Forensic Sci., 7 (1962) 56-81), further studies of literature and our own experimental body coolings. The Nomogram Method is based on a single measurement of the rectal temperature. The result is obtained immediately at a scene of crime without any mental arithmetic. Support in the practical application of the method and data for the accuracy of estimated death time are given. Special problems and its limitations are discussed. The Nomogram Method is compared with other temperature methods of estimating the time since death.

Algorithms↗

PubMed1997

New birth weight nomograms for twin gestation on the basis of accurate gestational age.

OBJECTIVE: Our purpose was to establish new nomograms for the birth weight of twins on the basis of accurate methods to validate gestational age. STUDY DESIGN: The medical records of 1632 consecutive twin gestations delivered between 1984 and 1996 were reviewed. Only pregnancies induced by ovulation induction techniques or that were measured ultrasonographically for crown-rump length during the first trimester were included. Excluded were those whose fetuses (one or both) were stillborn, or if the mother smoked, had a significant chronic illness, or was prescribed any regular medications. The study comprised 520 twin pregnancies at 28 to 41 gestational weeks at delivery. RESULTS: The median and 10th and 90th percentile birth weight curves were calculated for the studied twins and plotted against previously reported singleton nomograms. Fetuses of twin pregnancies were found to be growth restricted in comparison with previously reported singletons throughout the third trimester. This trend became more evident after the thirty-fourth to thirty-sixth weeks. CONCLUSIONS: We recommend these novel birth weight nomograms for clinical use in the management of twin pregnancies.

Birth Weight↗

PubMed1999

Development of a nomogram that predicts the probability of a positive prostate biopsy in men with an abnormal digital rectal examination and a prostate-specific antigen between 0 and 4 ng/mL.

OBJECTIVES: Early detection of prostate cancer traditionally involves both digital rectal examination (DRE) and serum prostate-specific antigen (PSA) determination in an informed patient population. Abnormalities in either of these studies typically lead to additional evaluations, including prostate biopsy. In this study, we analyzed the operational characteristics of serum PSA between 0 and 4 ng/mL as an initial test for prostate cancer. METHODS: From January 1990 through May 1997, transrectal biopsies were obtained from 700 men with a serum PSA level less than 4.0 ng/mL but DRE suspicious for cancer. Patient age, race, and serum PSA level were reviewed for this study. RESULTS: Of the 700 men studied, 445 were white (64%) and 255 were African American (36%). In multivariate analysis of prebiopsy risk factors (age, race, serum PSA), serum PSA was the only independent predictor of a positive prostate biopsy. A nomogram was created that determines the worst-case probability of a positive prostate biopsy in men with PSA between 0 and 4 ng/mL and a DRE suspicious for cancer. The predictions from the nomogram appeared accurate and discriminating, with a bias-corrected area under the receiver operating characteristic curve (i.e., comparison of the predicted probability with the actual outcome) of 0.75. CONCLUSIONS: Although early detection of prostate cancer has traditionally used both PSA measurement and DRE, PSA testing alone could be more easily implemented and may encourage some men to seek consultation who might not otherwise have done so. By providing a nomogram which provides a worse-case scenario (assuming a positive DRE) of the probability of a positive biopsy, the patient and clinician can make an informed decision as to whether additional evaluation is warranted.

Adult↗

PubMed1980

A clinically oriented nomogram for the derivation and interpretation of alveolar-arterial oxygen gradients.

This paper is designed for those familiar with arterial blood gases, alveolar-arterial (A-a) oxygen gradients, and their application in the clinical setting. The concept of a gradient is reviewed, and several examples of clinical applications are given. A nomogram of A-a gradients is presented for two representative altitudes. Using only the PaO2 and PaCO2 available from blood gases, the corresponding A-a gradient can be found quickly. Further, the nomogram is presented in such a way as to facilitate interpretation of results. Finally, we present a computer program that will allow the production of a nomogram of A-a gradients appropriate for a specific altitude.

Adult↗

PubMed2000

A clinical nomogram for predicting long-term survival in advanced colorectal cancer.

From our prospectively accrued database of patients with gastrointestinal cancer, 1057 patients with advanced colorectal cancer were identified with the aim of determining predictive factors for survival of greater than 2 years and to use this information to develop a predictive nomogram. Patient's baseline characteristics, type and number of chemotherapy regimens received, and response to chemotherapy were assessed by univariate and multivariate logistic regression comparing those who survived greater than or less than 2 years. A total of 161 (15.2%) patients survived more than 2 years, so-called long survivors (LS). In multivariate analysis, positive predictive factors for LS were: good performance status (PS), normal serum carcinoembryonic antigen (CEA), rectal primary, Dukes' stage A-B, well or moderate differentiation, two or less disease sites, response to chemotherapy and treatment used protracted venous infusion (PVI) 5-fluorouracil (5-FU) in first-line chemotherapy, and the increasing number of chemotherapy treatments received. From these PS, CEA, number of sites and response to first-line chemotherapy were used to develop a nomogram capable of predicting the probability of survival beyond 2 years for an individual patient. This large study confirmed the relevance of known prognostic factors in metastatic colorectal cancer and demonstrated the importance of response to chemotherapy as an independent factor to predict LS. By combining these, we developed a nomogram which provides information which is likely to prove useful in the management of patients with advanced colorectal cancer.

Adolescent↗

PubMed2001

Determination of contact hip stress from nomograms based on mathematical model.

Nomograms are presented that enable determination of maximal stress on the hip joint weight bearing area if certain geometrical parameters of the hip and pelvis and the body weight are known. The nomograms are calculated by using previously developed mathematical models. It is demonstrated how the maximal stress on the hip joint weight bearing area is determined from the presented nomograms for a hip for which the geometrical parameters were obtained from a standard anteroposterior rentgenograph. This simple and noninvasive method may give insight into the biomechanical status of the hip which should be considered in routine surgical planning and as a part of the routine examination of the patient without the use of any additional tools.

Biomechanical Phenomena↗