Nomogram for predicting the probability of the positive outcome of prostate biopsies among Ghanaian men

Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to provide a basis for predicting a prostate biopsy outcome by correlating clinical indicators and diagnostic parameters among Ghanaian men.Subjects and methods: The study was a hospital-based cross-sectional prospective one which was under- taken at the Department of Surgery (Urology Unit) Komfo Anokye Teaching Hospital (KATH) from December, 2014 to March, 2016. In all a total of 241 patients suspected of having a prostate disorder due based on an abnormal digital rectal examination (DRE) findings and, or elevated prostate specific antigen (PSA) level underwent Trans-Rectal Ultrasonography (TRUS) guided biopsy of the prostate. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostatespecific antigen (PSA), digital rectal examination (DRE) status, prostate specific antigen density (PSAD), history of alcohol consumption and history of smoking findings were included in the analysis. Two nomogram models were developed that were based on these independent predictors to estimate the probability of a positive initial prostate biopsy. Receiver-operating characteristic curves (ROC) were used to assess the accuracy of using the nomograms and PSA and PSAD levels for predicting positive a prostate biopsy outcome. Results: Prostate cancer was diagnosed in 63 out of 241 patients (26.1%). Benign prostatic hyperplasia was diagnosed in 172 (71.4%) of patients and the remaining 6 patients (2.48%) had chronic inflammation. Significantly elevated levels of PSA and PSAD were observed among patients with PCa compared to patients without PCa (p < 0.05). Furthermore, it was observed that age, DRE, PSA, PSAD, history of smoking, and history of alcohol consumption were significantly independent predictors (p < 0.05) of prostate cancer. The area under the receiver operating characteristic curve (AUC) of nomogram I and II were 87.3 and 84.8 respectively which were greater than that of total PSA (AUC = 75.8) and PSAD (AUC = 77.8) alone for predicting a positive initial prostate biopsy. Conclusion: We conclude that, nomograms offer a better and accurate assessment for predicting a positive outcome of prostate biopsies than the use of traditional tools of PSA, DRE and PSAD alone

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma a

Nomogram for predicting the probability of the positive outcome of prostate biopsies among Ghanaian men

Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to provide a basis for predicting a prostate biopsy outcome by correlating clinical indicators and diagnostic parameters among Ghanaian men. Subjects and methods: The study was a hospital-based cross-sectional prospective one which was undertaken at the Department of Surgery (Urology Unit) Komfo Anokye Teaching Hospital (KATH) from December, 2014 to March, 2016. In all a total of 241 patients suspected of having a prostate disorder due based on an abnormal digital rectal examination (DRE) findings and, or elevated prostate specific antigen (PSA) level underwent Trans-Rectal Ultrasonography (TRUS) guided biopsy of the prostate. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), digital rectal examination (DRE) status, prostate specific antigen density (PSAD), history of alcohol consumption and history of smoking findings were included in the analysis. Two nomogram models were developed that were based on these independent predictors to estimate the probability of a positive initial prostate biopsy. Receiver-operating characteristic curves (ROC) were used to assess the accuracy of using the nomograms and PSA and PSAD levels for predicting positive a prostate biopsy outcome. Results: Prostate cancer was diagnosed in 63 out of 241 patients (26.1%). Benign prostatic hyperplasia was diagnosed in 172 (71.4%) of patients and the remaining 6 patients (2.48%) had chronic inflammation. Significantly elevated levels of PSA and PSAD were observed among patients with PCa compared to patients without PCa (p < 0.05). Furthermore, it was observed that age, DRE, PSA, PSAD, history of smoking, and history of alcohol consumption were significantly independent predictors (p < 0.05) of prostate cancer. The area under the receiver operating characteristic curve (AUC) of nomogram I and II were 87.3 and 84.8 respectively which were greater than that of total PSA (AUC = 75.8) and PSAD (AUC = 77.8) alone for predicting a positive initial prostate biopsy Conclusion: We conclude that, nomograms offer a better and accurate assessment for predicting a positive outcome of prostate biopsies than the use of traditional tools of PSA, DRE and PSAD alone. Keywords: Nomogram, Prostate biopsy, Prostate specific antigen (PSA), Prostate specific antigen density (PSAD

MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials. © 2016 The Author

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis)

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards

Correction to: Is diet partly responsible for differences in COVID-19 death rates between and within countries? (Clinical and Translational Allergy, (2020), 10, 1, (16), 10.1186/s13601-020-00323-0)

Following publication of the original article [1], the authors identified an error in the affiliation list. The affiliation of author G. Walter Canonica should have been split up into two affiliations: • Personalized Medicine, Asthma and Allergy – Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy • Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy The corrected affiliation list is reflected in this Correction. © 2020, The Author(s)