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PubMed1989

The development of a disease classification system, based on the International Classification of Diseases, for use by neurologists.

Effective planning and evaluation of medical services is only possible if appropriate and reliable information is available. Diagnoses of patients seen are essential data. The epidemiological value of standard, reliable diagnostic data could also be considerable. The International Classification of Diseases (ICD) is the only system currently available which provides a common basis of classification for general statistical use. A booklet, using ICD codes, for classifying in-patients and out-patients seen by neurologists has been developed. It is simple and easy to use, affords the necessary economy of time, and should result in uniformity of coding. Reliability studies confirm that inaccuracies occur when patients' diagnoses are coded retrospectively from their medical files, even when observers are medically trained. It is recommended that doctors should accept personal responsibility for coding patients' diagnoses at the time of consultation or discharge from hospital.

Diagnosis, Differential↗

PubMed1977

Diagnosis, definition and classification in chronic generalized respiratory disorder. A proposal to come to a manageable clinical classification system in the human being. An answer to the stimulating report of the ACCP-ATS joint committee on pulmonary nomenclature.

It appears that the definition of a syndrome is to a large extent determined by the approach of the researcher. Particular emphasis is given to the very great interest of a classification as meticulous as possible, using all relevant clinical data not only as snapshots, but also over the longest possible observation period. Such a classification of carefully followed individual cases may contribute essentially to the identification of syndromes and to the detection of pathomechanisms and pathogenesis.

Chronic Disease↗

PubMed1992

Asthma classification by pathophysiology and IgE-mediated allergic reaction: new concepts for classification of asthma.

Bronchial asthma was classified by the pathophysiology and by the mechanism of onset of the disease. Forty asthmatics who had serum IgE levels lower than 200 IU/ml were evaluated by two classification methods. 1. In asthma classified by a score based on clinical findings and examinations, the characteristics of the findings and examination results were compared among three asthma types, i.e., Ia. simple broncho-constriction type, Ib. bronchoconstriction+hypersecretion type, and II. bronchiolar obstruction type. Type Ib patients, in addition to manifesting hypersecretion, had a significantly higher proportion of eosinophils in the bronchoalveolar lavage (BAL) fluid compared to other asthma types. Significantly decreased values for ventilatory parameters and an increased proportion of BAL neutrophils were found in type II compared with other asthma types. 2. In a new classification by mechanism of onset, asthma was classified into three types according to the degree of participation of IgE-mediated reactions associated with specific IgE antibodies and serum levels of total IgE: asthma induced by definite IgE-mediated reaction (atopic asthma), possible IgE-mediated reactions (asthma), and asthma induced by non-IgE-mediated reaction (asthma syndrome).

Adolescent↗

PubMed1991

[Changes in the pleura of subjects occupationally-exposed to asbestos: radiological study technique, spectrum, etiological classification and coding according to the ILO classification].

Pleural abnormalities of 119 occupationally asbestos-exposed with prominent internal stripe of the lateral thoracic wall were radiodiagnostically analysed by plain films of the thorax in four views and by computed tomography in the course of medical expert's certification. Abnormalities were coded according to 1980 ILO international classification of pneumoconioses. Hardly half of the patients had pleural abnormalities caused by asbestos exposure: Pleural plaques, "diffuse" pleural fibrosis, pleural effusions, organized pleural effusions and pleural tumors. The other half of the patients had pleural involvement of pulmonary and chest wall abnormalities or variations of the lateral thoracic wall not related to asbestos exposure. The 1980 ILO classification of pneumoconioses proved to be inadequate for complete coding of the abnormalities, since only the postero-anterior plain film of the thorax must be used, since the normal appearance of the pleura is insufficiently defined and since the entity of organized pleural effusion is lacking.

Asbestosis↗

PubMed1979

Visual classification of banded human chromosomes. III. Classification and karyotyping of density profiles described by band transition sequences.

Band transition profiles (BT-profiles) representing extracted band pattern features of 898 density profiles of banded chromosomes were classified and karyotyped by a cytogeneticist in order to investigate how much information was lost by substituting for the original density profiles their extracted features. The results were evaluated and compared with visual classification and karyotyping of the same 898 density profiles from which the BT-profiles were derived. Six per cent errors were made in classification of isolated BT-profiles and 0.7% errors were made in karyotyping BT-profiles. These error rates were comparable to the corresponding error rates in classifying and karyotyping density profiles, which were 5% and 0.5%, respectively. It is concluded that most of the important band pattern information of the density profiles is retained in the BT-profiles, and it is supposed that the condensed BT-sequences (from which the BT-profiles are derived) constitute a sufficient and appropriate basis for automated karyotyping.

Chromosome Banding↗

PubMed1976

[Endocrine ophthalmopathy. Clinical symptoms, classification, diagnostic classification, indications for treatment (author's transl)].

The clinical aspects and classification of "endocrine ophthalmopathy" were described. The clinical picture is of importance for the physician in nuclear medicine who is involved with the diagnosis and therapy of hyperthyroidism. In vivo and in vitro investigations in nuclear medicine regarding the classification of ophthalmic findings are derived from disturbances in control of the regulatory systems of the hypothalmas-pituitary-thyroid which are parallel to the ophthalmic processes. The clinical forms of endocrine ophthalmopathy and the thyroid findings which accompany it were systematized and an appropriate therapeutic procedure for the respective anomaly was described.

Graves Disease↗

PubMed1975

The classification of depressive disorders. II. A review of historical and physiological classification studies.

A review of recent classification studies of depressive disorders based on historical data and physiological indices was made. It was found that historical variables, such as age of onset and family background, are potentially useful to distinguish depressive subgroups, although these groupings did not differentiate consistently unipolar from bipolar depressives. While the physiological indices do not support the present psychiatric nosology, single physical signs were found to differentiate subgroups within the effective disorders. The implications of these findings for a different research model were discussed.

Adjustment Disorders↗

PubMed1985

Computerized EEG pattern classification by adaptive segmentation and probability density function classification. Clinical evaluation.

A series of 63 clinical EEGs showing a variety of normal and abnormal patterns was analysed by computer with particular reference to the different types of pattern within the same EEG. Boundaries between different patterns were established by means of adaptive segmentation, so that the duration of the resulting segments was determined by the particular EEG itself (thus the term 'adaptive'). Four channels from each EEG were analysed, paired (left and right) channels were simultaneously segmented and analysed interactively. Similar segments were then clustered without supervision by estimating a probability density function in a 2-dimensional 'feature space' having dimensions of mean frequency and mean power. Individual clusters emerged as well-defined peaks of the surface, individual segments or small groups of duration insufficient to constitute a separate cluster, being identified as 'singular events' (e.g., rare sharp waves, artifacts). The autocorrelation function was used to characterize the EEG both for the segmentation and for the subsequent clustering of the resulting segments. In confirmation of our previous work, adaptive segmentation based on the autocorrelation function of the EEG was found to be quite satisfactory. Unsupervised clustering by estimation of the probability density function in feature space was found to give the correct number of clusters (usually less than 5) in a majority of the records (65%), but in the remaining minority of cases (35%), either overclustering or underclustering occurred. Further, the 'singular events' were occasionally partly included in a formal cluster. Comparison of these results of EEG clustering by unsupervised probability density function estimation with earlier results obtained by supervised hierarchical clustering suggests that there may be subtle cues used by the electroencephalographer in the classification of EEG patterns which have not been adequately approximated by the computer algorithms thus far used in this work. Hence at least some minimal degree of supervision in the clustering process may be necessary, at least for the present. On the other hand, the method recommends itself for the representation of illustrative EEG summaries which, in conjunction with a short written report, would provide the clinical neurologist with a sufficient picture of the real EEG without, in most cases, the need to inspect the original record.

Action Potentials↗

PubMed1992

[Histological classification of malignant non-Hodgkin's lymphomas and patient survival: the Kiel classification versus the working formulation].

In 163 out of 251 histologically classified malignant Non-Hodgkin's lymphomas, a comparison was made of the patient survival with respect to both histological type and malignant grade according to the Kiel Classification (KC) and the three prognostic groups of the Working Formulation (WF). As expected, the survival rate of 94 low-grade malignant lymphoma cases (KC) was significantly better than that of 69 high-grade cases (p < 0.0001). Similar results were found both for 46 low grade cases (WF) in comparison to 50 high grade cases (p < 0.001) and for 67 intermediate grade cases (WF) compared with the 50 high grade cases (p < 0.05). The survival rates of low and intermediate grade cases (WF), however, showed no statistically significant difference. The low- and high-grade malignant lymphoma entities of KC, which together constitute the intermediate grade of WF, differed significantly with respect to patient survival (p < 0.05). Therefore, it appears that an intermediate grade is not essential in the KC.

Humans↗

PubMed1991

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atheroslcerosis. Part I: Principles of classification and methods of dyslipoproteinemia determination.

This paper sums up new findings in the field of pathogenetic relations between lipid and lipoprotein metabolical disorders on the one hand and the risk of early forms of atherosclerosis on the other hand. Detail classification of disorders proceeds from precise clinical and biochemical criteria, genetic considerations and therapeutical aspects. It provides definitions of hyperlipidemia, hyperlipoproteinemia, normolipidemic (latent) dyslipoproteinemia, secondary hyperlipidemia, apolipoproteinopathia and relatively harmless (benign) hyperlipidemia. The paper provides detail tables and systematic graphs.

Adult↗

PubMedDate not supplied

Classification and prognostic evaluation in multiple myeloma. A retrospective study of relationship of survivals and responses to chemotherapy to immunological types, 20 single prognostic factors, 15 clinical staging systems, and 6 morphological classifications.

In a group of 136 completely followed up patients with multiple myeloma, the prognostic significance of the immunological myeloma types, of 20 different single prognostic factors, of 15 clinical staging systems, and of 6 morphological classifications was retrospectively investigated by means of the calculation of mean survivals, survival curves, and responses to chemotherapy. A univariate analysis was employed in order to correlate each prognostic parameter at presentation with the survival in the whole group; a multivariate analysis according to the Cox's hazards regression model was used in order to select the most powerful prognostic variables. The patients were grouped according to the myeloma immunological types, to the mean value of each single prognostic factor, and to each stage of the clinical and morphological systems. Causes of death were also related to immunological multiple myeloma types. All single variables, except age and serum calcium, presented a significant relationship with the survival, even if at different significance levels. Cox's regression model selected among them, serum levels of beta 2-microglobulin, percentage of bone marrow plasma cells, hemoglobinemia, lytic bone lesions, and Bence-Jones proteinuria as the most significant factors related to survival. Each clinical and morphological staging system divided groups of patients with significant differences in mean survivals, or in survival curves, or in response to therapy. Multiple myeloma type IgA and micromolecular, with Bence-Jones proteinuria, and type lambda were associated with a poor prognosis, with low therapeutical response, and with the development of fatal renal failure. All these parameters, together with new prognostic factors, are useful in the prognostic evaluation, and, when applied in different steps of the diagnosis and the therapy, allow of studying the clinical course of multiple myeloma under different perspectives, in order to have a more complete picture of the disease and of the single patient.

Adult↗

PubMed1990

The classification of anxiety disorders in current and future classifications.

Comments are made on the main categories by which specific states of morbid anxiety are classified in the ICD-9, ICD-10, DSM-III and DSM-III-R. The latest classifications, ICD-10 and DSM-III-R, contain many more such categories than ICD-9, and although they differ in the priority given to panic versus agoraphobia, the content is very largely similar. ICD-10 contains several categories of special interest to mental health workers in developing countries and primary health care.

Anxiety Disorders↗

PubMed1979

Classification of animal lymphomas: the implications of applying Rappaport's classification for human lymphomas to experimental tumors.

One hundred and seventy animal lymphomas (species ranging from molluses to monkeys) were reclassified histologically according to the modified Rappaport classification for human lymphomas. The results were correlated with the etiology of the lymphomas, their clinical course, and in selected cases with their immunological type. The study stresses the value of such a procedure for comparative reasons, allowing a more adequate selection of animal models for human lymphomas.

Animals↗

PubMed1978