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PubMed2004

Prevalence of adult binge drinking: a comparison of two national surveys.

BACKGROUND: Binge drinking (defined as five or more drinks on an occasion) causes approximately half of the estimated 85,000 alcohol-related deaths in the United States each year. The Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey, and the National Survey on Drug Use and Health (NSDUH), an in-person survey, provide population-based estimates of binge drinking. Evaluating the concordance of binge drinking estimates from the BRFSS and the NSDUH is important for surveillance and for planning prevention programs. METHODS: In 2003, combined data on binge drinking for 1999 and 2001 from the BRFSS (n =355,371) and the NSDUH (n =87,145) were analyzed for respondents aged >or=18 years. RESULTS: National binge drinking estimates were 14.7% (95% confidence interval [CI]=14.5-15.2) for BRFSS and 21.6% (CI=21.2-22.0) for NSDUH. Although there was good correlation between state-specific binge drinking estimates from the two surveys (Pearson's r =0.82), the BRFSS state estimates were significantly lower (p <0.05) than the NSDUH estimates in 46 states and the District of Columbia. The demographic characteristics of binge drinkers and the wording of the binge question were similar in the two surveys. However, in 1999, NSDUH changed from paper interviews to computer-administered interviews, and incorporated an internal validity check with feedback questions to resolve inconsistent responses. CONCLUSIONS: Estimates of binge drinking from the NSDUH were consistently higher than those from the BRFSS, probably due to differences in survey methodology. Continued efforts to improve binge drinking surveillance are important for preventing this public health problem.

Adult↗

PubMed2005

Prediction of complications following nonemergency percutaneous coronary interventions.

Previous models for prediction of complications after percutaneous coronary interventions (PCIs) have included in-hospital mortality and major in-hospital complications. In general, these models have excluded elevated cardiac biomarkers as a complication. We sought to determine whether a risk model could predict complications, including biomarker elevation, in patients undergoing nonemergency PCI. We examined the outcomes of nonemergency PCI performed on patients at Mayo Clinic from 2000 to 2003. The primary end point was in-hospital complications of death, myocardial infarction (MI) (Q-wave MI, or post-PCI creatine kinase-MB elevation >or=3 times the upper limit of normal), emergency coronary artery bypass grafting, or stroke. We used the Hosmer-Lemeshow test to demonstrate the adequacy of the model fit, and the c-index for discriminatory ability of the model. Of 2,894 nonemergency PCIs, the end point was noted in 232 (8%). The final prediction model included vein graft intervention (odds ratio [OR] 2.19), angiographic thrombus (OR 2.12), preprocedure stenosis of a minor (OR 1.98) or major (OR 1.62) side branch, and type C lesion (OR 1.48). The model had modest ability to discriminate between event and nonevent patients (c = 0.641). In the 500 bootstrap samples for internal validation, the c-index was 0.642 +/- 0.020, indicating only fair discriminatory ability. The average number of observed events was 232.0 +/- 14.7 compared with 232.1 +/- 2.5 expected events (average difference -0.06 +/- 14.5). In conclusion, the 5 risk variables associated with an increased risk of complications in patients undergoing elective PCI included vein graft intervention, presence of angiographic thrombus, stenosis of a major or minor side branch, and type C lesion; however, the discriminatory ability of the model derived from the variables was only modest.

Aged↗

PubMed2006

Prediction of mortality risk in the elderly.

PURPOSE: Ways to predict the risk of cardiovascular (CV) events or all-cause mortality have largely been derived from populations in which old and very old subjects were underrepresented. We set out to estimate the incremental prognostic utility of inflammation and atherosclerosis markers in the prediction of all-cause and CV mortality in elderly men. METHODS: In a prospective population-based cohort study, conventional CV risk factors were documented in 403 independently living elderly men. C-reactive protein (CRP) and interleukin (IL)-6 levels were measured. Carotid plaques were assessed by ultrasound. Analyses were performed with proportional hazards analyses, and bootstrapping was used for internal validation. Main outcome was CV and all-cause mortality occurring during 4 years of follow-up. RESULTS: Increasing tertiles of CRP, IL-6, and number of plaques were independently associated with all-cause and CV mortality. With information on age, carotid plaques, IL-6, and CRP yielded good discriminatory power for all-cause and CV mortality: area under the receiver operating characteristic curve (95% confidence interval), 0.76 (0.70-0.82) and 0.74 (0.68-0.80), respectively. Combined use of only IL-6 and plaque burden allowed identification of subjects with low and high mortality risk. The Framingham PROCAM and a Dutch Risk Function poorly predicted mortality risk, similar or worse than a model using age alone. CONCLUSION: In the old and very old, IL-6 and number of carotid plaques are powerful predictors of mortality risk in the years to come. Conventional risk scores seem to perform unsatisfactorily.

Aged↗

PubMed2005

The post-stroke rehabilitation outcomes project.

Jette AM. The Post-Stroke Rehabilitation Outcomes Project. The Post-Stroke Rehabilitation Outcomes Project (PSROP) provides an important example of the value of observational study designs in rehabilitation. The strength of the PSROP lies in the extensive, in-depth data collected on the specific rehabilitation interventions provided to patients and their relationship to short-term outcomes as well as the wide generalizability of the study's findings. Although providing valuable insights, one has to be extremely cautious in drawing direct practice recommendations from the PSROP given several internal validity threats inherent in the PSROP design.

Health Services Research↗

PubMed2006

Predicting survival in patients requiring renal replacement therapy after cardiac surgery.

BACKGROUND: We sought to develop and internally validate a prediction score for all-cause in-hospital mortality in patients who have acute renal failure and require renal replacement therapy after cardiac surgery. METHODS: From January 1992 to July 2001, 136 of 14,000 patients (0.9%) had acute renal failure requiring renal replacement therapy after cardiac surgery. Multivariate logistic regression analysis, based on pre-renal replacement therapy variables, was used to construct a predictive score for all causes of in-hospital mortality. Subsequently, the score was validated in 27 patients who underwent surgery between August 2001 and March 2003. RESULTS: In-hospital mortality was 58% (79 of 136). From the logistic regression model, we assigned a score (range, 0 to 6) based on the presence of independent predictors of operative mortality (preoperative creatinine < or = 1.5 mg/dL [odds ratio (OR) = 5.0], hypertension [OR = 4.4], predialysis coma [OR = 9.6], sepsis [OR = 6.4], and total bilirubin > or = 2 mg/dL [OR = 5.6]). Higher scores strongly predicted mortality: patients who scored 3 or higher before the initiation dialysis (n = 54), had a mortality rate of 94% (51 of 54). In contrast, patients who scored 1 or less on this scale (n = 36), had a mortality of 16% (6 of 36). In the validation cohort, the sensitivity of the new score at the cutoff of 2 or fewer points versus 3 or more points was 0.71, the specificity was 0.90, the positive predictive value was 0.92, and the negative predictive value was 0.64. CONCLUSIONS: The prediction score represents a simple and accurate tool for predicting in-hospital mortality associated with renal replacement therapy for cardiac surgery patients before the institution of this resource-intensive treatment.

Acute Kidney Injury↗

PubMed2005

Binding studies and GRIND/ALMOND-based 3D QSAR analysis of benzothiazine type K(ATP)-channel openers.

For seventeen 1,4-benzothiazine potassium channel openers, we performed binding studies in rat aortic smooth muscle cells and cardiomyocytes, compared their binding affinities with published relaxation data, and derived 3D-QSAR models using GRIND/ALMOND descriptors. Binding affinities in smooth muscle cells range from a pK(D) of 4.76 for compound 3e to 9.10 for compound 4c. Comparison of data for smooth muscle relaxation and binding shows preferentially higher pEC(50)s for the former. In cardiomyocytes, pK(D) values range from 4.21 for 3e to 8.16 for 4c. 3D-QSAR analysis resulted in PLS models of two latent variables for all three activities with determination coefficients of 0.97 (smooth muscle relaxation) and 0.94 (smooth muscle cells- and cardiomyocytes-binding). Internal validation yielded q(2) values of 0.69, 0.66, and 0.64. The carbonyl on the N-4 substituent, the hydrogen bond acceptor at C-6, the five-membered ring at N-4, and the gem-dimethyls mainly guide strong binding and strong smooth muscle relaxation.

Adenosine Triphosphate↗

PubMed2006

Antimalarial activity: a QSAR modeling using CODESSA PRO software.

A quantitative structure-activity relationship (QSAR) modeling of the antimalarial activity of two diverse sets of compounds for each of two strains D6 and NF54 of Plasmodium falciparum is presented. The molecular structural features of compounds are presented by molecular descriptors (geometrical, topological, quantum mechanical, and electronic) calculated using the CODESSA PRO software. Satisfactory multilinear regression models were obtained for data sets of the D6 and NF54 strains, with R2 = 0.84 and 0.89, respectively. The models were also satisfactorily validated internally. The descriptors involved in these equations were related to the mechanism of antimalarial protection.

Animals↗

PubMed2005

Classification and evaluation of prolapse.

Pelvic organ prolapse is prevalent among older women. Milder stages of prolapse, cranial to the hymen, are common and usually symptomless. A specific symptom is a bulge outside the vagina. Functional symptoms from the bladder, bowel and sexual life frequently coexist without a known cause/effect relationship to prolapse. Prolapse should be measured by the validated internationally approved pelvic organ prolapse quantification (POPQ) system that can measure prolapse in the three compartments and three levels of the vagina. We should work on a common classification system and agreement in which symptoms should be recorded as related to prolapse and expected to improve by prolapse surgery.

Coitus↗

PubMed2006

Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a prevalent, chronic and disabling anxiety disorder. Despite the efficacy and strength of pharmacologic interventions for OCD, medications are not always well accepted or effective, making an efficacious psychosocial alternative especially attractive. Cognitive-behavioral therapy (CBT) has been established as an effective treatment for adult OCD, yet access to such treatment is limited, especially in rural areas. Technological advances allow for therapy to be provided in a real-time format over a videoconferencing network. This method allows therapists to provide state-of-the-art treatment to patients who would not otherwise have access to it. This paper presents three cases of OCD successfully treated via videoconferencing CBT. The presence of OCD was established via structured clinical interview and clinician-rated outcome measures were completed by evaluators blinded to the method of treatment. A multiple baseline across individuals design was used to support the internal validity of the CBT outcome data. Patient ratings of therapeutic alliance were high across all three cases. Information gathered from qualitative interviews post-treatment confirmed quantitative measures finding high levels of patient satisfaction. This pilot study suggests that videoconferencing-based CBT is a promising method to bring appropriate treatment to thousands who live far distances from well-trained therapists.

Adult↗

PubMed2005

Toxicity of surfactants to green microalgae Pseudokirchneriella subcapitata and Scenedesmus subspicatus and to marine diatoms Phaeodactylum tricornutum and Skeletonema costatum.

Ecotoxicity of different commercial surfactants (six anionic, two amphoteric and one nonionic), essential constituents of cleansing hair products (shampoos), as well as ecotoxicity of eight shampoos containing different combinations of these surfactants, were tested in order to evaluate their possible toxic effects on microalgae. Specific objective of this research was to compare the sensitivity of selected freshwater and marine microalgae to these widely used surfactants and well-known pollutants in surface waters. Internationally validated methods (ISO standards) for the determination of toxic effects on the growth of planktonic freshwater green algae Pseudokirchneriella subcapitata and Scenedesmus subspicatus and marine diatoms Skeletonema costatum and Phaeodactylum tricornutum, were used. The obtained results showed that the concentrations of tested surfactants and shampoos, which resulted in 50% growth reduction of planktonic freshwater green algae, when compared to the controls without test substances (EC50), were in the range from 0.32 to 4.4 mg l(-1) for surfactants and from 2.1 to 8.5 mg l(-1) for shampoos expressed as active substance. Marine diatoms were significantly more sensitive to the tested surfactants than freshwater green algae (EC50 0.14-1.7 mg l(-1) for surfactants and 0.35-1.25 mg l(-1) for shampoos). According to the classification on the basis of environmental effects, the obtained results suggested that all tested surfactants can be classified as having toxic effects on freshwater green alga Pseudokirchneriella subcapitata. Some of them indicated that they have a very toxic effect on Scenedesmus subspicatus and marine diatoms Skeletonema costatum and Phaeodactylum tricornutum.

Chlorophyta↗

PubMed2006

The Cochrane Fertility Regulation Group: synthesizing the best evidence about family planning.

The Fertility Regulation Group of the Cochrane Collaboration has been assessing the best available evidence on fertility regulation, family size and birth spacing. By the end of 2005, this group had published 32 systematic reviews and 12 protocols; most reviews were on contraception. Because of suboptimal trial quality, firm conclusions could be made in only five reviews. Threats to internal validity in published trials include the absence of description of allocation concealment, intentional exclusion of participants after randomization, failure to use intention-to-treat analyses and lack of treatment blinding. The precision of results has been limited by small sample sizes. The finding that most trials of oral contraceptives were conducted by pharmaceutical companies raises concerns about potential commercial bias. Of necessity, most information about fertility regulation effectiveness and adverse effects comes from observational studies, which vary widely in quality. Systematic reviews of evidence, with an emphasis on randomized controlled trials when available, will continue to improve fertility regulation in the years ahead.

Clinical Trials as Topic↗

PubMedDate not supplied

The value of videotape in mock oral board examinations.

OBJECTIVE: To determine the impact on self-perception, of having residents view their own performance (taped) on mock oral board examinations. DESIGN: Self-evaluation-intervention-self-evaluation design. Third-, fourth-, and fifth-year residents evaluated themselves after each examination(room) during mock oral examinations. Residents reviewed the examination on videotape and re-evaluated themselves. SETTING: University Medical Center. PARTICIPANTS: Twenty surgical residents from the third, fourth, and fifth years of training. MAIN OUTCOME MEASURES: Mean scores in 6 categories based on a 5-point Likert scale. Scores by examiners plus pre- and post-video viewing self-scores were compared. RESULTS: We found that residents consistently underestimated their performance on the examination. Viewing their videotapes resulted in revised self-scores, which were more consistent with scores of the examiners. All scores will be presented in sequence as follows: Mean score by examiners, mean self-score pre-tape viewing and mean self-score post-tape viewing. For professionalism, scores were 4.63, 4.15, and 4.43, p = 0.047. For organization, 3.91, 3.27, and 3.63, p = 0.007. For decision making, 4.02, 3.42, and 3.72, p = 0.033. P-values reflect the comparison of resident self-scores pre- and post-tape viewing. Analysis of variance comparison of scores in various rooms (different examiners) revealed no significant difference in scores based on rooms (different examiners). Evaluations according to rooms (different examiners) were not statistically different, supporting inter-rater reliability. There was consistent improvement in knowledge and decision making with advanced years of training, supporting internal validity of the examination. CONCLUSIONS: Videotape viewing results in revised resident self-scores, which are more consistent with scores given by the examiners. Tape viewing significantly affected resident self-scores in professionalism, organization, and decision-making.

Analysis of Variance↗

PubMed2006

Respiratory symptoms in patients with inflammatory bowel disease and the impact of dietary salicylates.

BACKGROUND: Respiratory symptoms are over-represented in inflammatory bowel disease. There are similarities between the epidemiology of inflammatory bowel disease and that of respiratory conditions for which an adverse influence of salicylate has been identified. Natural salicylates exist within our diet. AIMS: To determine whether a lower intake of dietary salicylates is associated with less active inflammatory bowel disease and fewer concurrent respiratory symptoms. PATIENTS AND METHODS: Respiratory status, inflammatory bowel disease activity, quality of life, and dietary habits were established in 73 patients with Crohn's disease and 69 with ulcerative colitis, using a self-administered questionnaire and peak expiratory flow rate readings. Harvey-Bradshaw and Simple Birmingham/Royal Free Colitis indices, an internally validated respiratory score, and estimated weekly dietary salicylate intake, were calculated for each patient. RESULTS: There was at least one respiratory symptom in 63.4% of patients. The commonest underlying respiratory diagnosis was asthma. Respiratory impairment was similar in ulcerative colitis and Crohn's disease; 56.3% of Crohn's disease patients with an active respiratory diagnosis had other extra-intestinal manifestations. The dietary salicylate intake was independent of respiratory status, but inversely correlated with ulcerative colitis activity (dietary salicylate intake 37.0mg versus 21.4mg for low and higher Simple Birmingham/Royal Free Colitis index, respectively; p<0.02). A similar association was not seen in Crohn's disease. CONCLUSIONS: Respiratory impairment is common in inflammatory bowel disease. Higher intake of dietary salicylates is associated with less active colitis and possibly causally so.

Adolescent↗

PubMed2026

Redefining the real problem in psychedelic trials: Why fighting the Lessebo matters more than blinding integrity.

Imperfect blinding is not specific to psychedelic trials. In randomized trials, treatment allocation is frequently correctly guessed, yet blinding integrity is rarely assessed outside of psychedelic research and is generally not considered a barrier in regulatory evaluation. The intense debate in psychedelics may reflect a broader double standard affecting mental health research, when uncertainties arising from imperfect blinding are confounded by those linked to patient-reported outcome measures. Indeed, people living with mental disorders are often viewed as unreliable reporters, despite well-documented limitations of clinician-rated scales and the absence of robust biological markers of symptomatic change. Importantly, it is the maintenance of reasonable doubt of treatment allocation that sustains internal validity and ethical feasibility of placebo-controlled designs, rather than perfect blinding. Concerns about expectancy bias in psychedelic trials are closely tied to blinding debates. When allocation is inferred, expectations may cluster in the arm perceived as active or in stereotyped experiences and influence outcomes differently in active and control arms, leading to a risk of lessebo, a negative placebo effect due to the negative expectation related to receiving a placebo. However, we argue that an underrecognized mechanism of lessebo is disappointment. This risk may reflect insufficient clinical management of disappointment rather than pre-treatment expectation alone. We therefore propose shifting the emphasis from preserving inevitably imperfect blinding towards mitigating disappointment in both arms. Establishing non-stereotyped expectations prior to treatment through structured psychoeducation, strengthened therapeutic alliance, and realistic preparation would help avoid lessebo effects. Such strategies would enhance ethical rigor, interpretability, and the clinical usefulness of psychedelic trials.

Humans↗

PubMed2006

Prognostic factors for progression of childhood optic pathway glioma: a systematic review.

A systematic literature review was carried out to evaluate best existing evidence on prognostic factors for progression of childhood optic pathway glioma. Databases were searched for relevant articles and articles selected independently by two authors. Information about study design, population, treatment, outcome and prognostic analysis were abstracted and the quality of each article was assessed. A total of 23 articles met the inclusion criteria. Many studies had important methodological limitations, regarding external and internal validity. Eleven studies evaluated possible prognostic factors in a multivariate analysis. Three high-quality studies indicated age<1 year as an independent prognostic factor for a worse progression-free survival. Three studies with multivariate analysis, including one high-quality study, found that children with neurofibromatosis type 1 (NF-1) have a better progression-free survival than those without NF-1. Two studies with multivariate analysis found tumour site to be a prognostic factor, both with some methodological limitations. In conclusion, this systematic review demonstrates that only a few of the prognostic factors proposed have been proven to be clinically relevant. Age<1 year is a clear and independent prognostic factor for progression-free survival. Other prognostic factors, such as NF-1, tumour site and others, are suggested, but are still without solid evidence and need further high-quality studies to be clearly proven.

Disease Progression↗

PubMed2006

Modelling chronic exposure to contaminated soil: a toxicokinetic approach with the terrestrial snail Helix aspersa.

To enlarge the possibilities of using organisms of the soil fauna to assess the bioaccumulative potential of chemicals, the kinetic of soil cadmium (Cd) transfer to the terrestrial gastropod Helix aspersa was investigated under laboratory conditions during a long-term experiment (6 months). During the exposure phase (3 months), juvenile snails were subjected to three different concentrations of Cd spiked in artificial ISO soil (ISO 0, 20 and 100 mg Cd kg(-1)) and to a field soil (ME4) industrially contaminated by 20 mg Cd kg (-1). For both soils, internal steady-state Cd concentrations were reached in the viscera of the snails, the main storage organ for Cd, after 2 weeks of exposure whatever the Cd concentration in soil. The equilibrium concentrations in the viscera were 0.7 (+/-0.1), 11.3 (+/-2.4), 73.3 (+/-4.8) and 6.3 (+/-1.3) mg Cd kg(-1) dry mass for ISO 0, ISO 20, ISO 100 and ME4, respectively. During the depuration phase (3 months), from 0 to 52% of the accumulated Cd in the viscera were removed by excretion or relocation in the foot. However, the snails were not able to depurate down to initial concentrations. Data were modelled by integrating a specific growth rate constant into one-compartment toxicokinetic models. This allowed the calculation of Cd uptake rates that can be used as indicators of metal bioavailability. Since this parameter was found to be lower for snails exposed to the field soil ME4, we concluded that lower Cd bioavailability in this field soil was responsible of the lower transfer to the snails compared to the ISO 20 soil, even though they were polluted to similar extents. Internal validation showed that the toxicokinetic models could be applied for predictive purposes, promising for the development of a bioaccumulation directive for terrestrial environment.

Animals↗

PubMed2026

Multiregion profiling of genomic and transcriptional heterogeneity in head and neck squamous-cell carcinoma.

BACKGROUND: Intratumoral heterogeneity (ITH) is thought to contribute to tumour evolution and treatment resistance but its biological and clinical significance in localised head and neck squamous-cell carcinoma (HNSCC) remains incompletely understood. PATIENTS AND METHODS: In the prospective SCANDARE study, we analysed 87 patients with resectable HNSCC treated with upfront surgery. Two to five spatially distinct tumour regions per patient underwent pathological evaluation, targeted DNA sequencing, and bulk RNA sequencing. Genomic ITH (gITH) was quantified using clonal deconvolution and Shannon diversity indices, whereas transcriptional heterogeneity (tITH) was assessed using the intratumour expression distance metric. Associations between ITH, molecular features, tumour microenvironment composition, and clinical outcomes were explored using multivariable statistical models. RESULTS: Pathology-based spatial heterogeneity showed limited prognostic value. gITH was common, with 37% of tumours displaying regionally heterogeneous pathogenic variants, including spatially actionable alterations in 10% of patients. In an initial multivariable Cox model, higher gITH was associated with shorter disease-free survival. However, after Ridge-penalised modelling and bootstrap internal validation, the effect size was attenuated [corrected hazard ratio 1.42, 95% confidence interval (CI) 0.91-2.75]. The overall model retained moderate discriminative performance (optimism-corrected C-index 0.69, 95% CI 0.59-0.79). gITH was associated with tumour cellularity, reduced estimated endothelial cell infiltration, and alterations in KMT2C and PIK3CA. tITH differed according to human papillomavirus (HPV) status, with lower tITH in HPV-positive tumours, and was associated with distinct biological pathways and genomic alterations. Genomic and tITH were not correlated. CONCLUSIONS: This prospective multiregion study provides a comprehensive characterisation of genomic and tITH in localised HNSCC. Our findings highlight substantial spatial molecular diversity within primary tumours and suggest potential associations between heterogeneity, tumour biology, and clinical outcome that warrant validation in independent cohorts.

head and neck squamous-cell carcinoma (HNSCC)↗

PubMed2006

Pre-treatment nomogram for disease-specific survival of patients with chemotherapy-naive androgen independent prostate cancer.

OBJECTIVE: Our objective was to develop a nomogram that predicts the probability of cancer-specific survival in men with untreated androgen-independent prostate cancer (AIPC). METHODS: AIPC was diagnosed in 129 consecutive patients between 1989 and 2002. No patient received cytotoxic chemotherapy. Univariate and multivariate Cox regression models were used to test the association between prostate-specific antigen (PSA) level at initiation of androgen deprivation, PSA doubling time (PSADT), PSA nadir on androgen deprivation therapy (ADT), time from ADT to AIPC, and AIPC-specific mortality. Multivariate regression coefficients were then used to develop a nomogram predicting AIPC-specific survival at 12-60 mo after AIPC diagnosis. Two-hundred bootstrap resamples were used to internally validate the nomogram. RESULTS: AIPC-specific mortality was recorded in 74 of 129 patients (57.4%). Other-cause mortality was recorded in 7 men (5.4%). Median overall survival was 52.0 mo (mean, 36.0 mo) and median AIPC-specific survival was 54.0 mo (mean, 35.0 mo). In univariate regression models, all variables were significant predictors of AIPC-specific survival (p < or = 0.02). In multivariate models, PSADT and time from androgen deprivation to AIPC remained statistically significant (p < or = 0.004). Bootstrap-corrected predictive accuracy of the nomogram was 80.9% versus 74.9% for our previous model. CONCLUSIONS: A nomogram predicting AIPC-specific survival is between 13% and 14% more accurate than previous nomograms and 6% more accurate than tree regression-based predictions obtained from the same data. Moreover, a nomogram approach combines several advantages, such as user-friendly interface and precise estimation of individual recurrence probability at several time points after AIPC diagnosis, which all patients deserve to know and all treating physicians need to know.

Aged↗