Deborah Jael Herrera, W. van de Veerdonk, Daiane Maria Seibert, M. Boke, Claudia Gutiérrez-Ortiz, N. Yimer, Karen Feyen, Allegra Ferrari, G. Van Hal
Individualized risk prediction models for colorectal cancer (CRC) play a pivotal role in shaping risk-based screening approaches, garnering attention for use in informed decision making by patients and clinicians. While the incorporation of new predictors and the development of advanced yet complex prediction models can enhance model performance, their practical implementation in clinical settings remains challenging. This systematic review assessed individualized CRC risk prediction models for their validity and potential clinical utility. Utilizing the Cochrane Collaboration methods and PROBAST tool, we conducted comprehensive searches across key databases and risk of bias assessment, respectively. Out of 41 studies included evaluating 44 risk prediction models, 12 conventional and 3 composite models underwent external validation. All risk models exhibited varying discriminatory accuracy, with the area under the curve (AUCs) ranging from 0.57 to 0.90. However, most studies showed an unclear or high risk of bias, with concerns about applicability. Of the five models with promising clinical utility, only two underwent external validation and one employed a decision curve analysis. These models demonstrated a discriminating and well-calibrated performance. While high-performing CRC risk prediction models exist, a need for transparent reporting of performance metrics and their clinical utility persists. Further research on this area is needed to facilitate the integration of these models into clinical practice, particularly in CRC screening.
{"title":"From Algorithms to Clinical Utility: A Systematic Review of Individualized Risk Prediction Models for Colorectal Cancer","authors":"Deborah Jael Herrera, W. van de Veerdonk, Daiane Maria Seibert, M. Boke, Claudia Gutiérrez-Ortiz, N. Yimer, Karen Feyen, Allegra Ferrari, G. Van Hal","doi":"10.3390/gidisord5040045","DOIUrl":"https://doi.org/10.3390/gidisord5040045","url":null,"abstract":"Individualized risk prediction models for colorectal cancer (CRC) play a pivotal role in shaping risk-based screening approaches, garnering attention for use in informed decision making by patients and clinicians. While the incorporation of new predictors and the development of advanced yet complex prediction models can enhance model performance, their practical implementation in clinical settings remains challenging. This systematic review assessed individualized CRC risk prediction models for their validity and potential clinical utility. Utilizing the Cochrane Collaboration methods and PROBAST tool, we conducted comprehensive searches across key databases and risk of bias assessment, respectively. Out of 41 studies included evaluating 44 risk prediction models, 12 conventional and 3 composite models underwent external validation. All risk models exhibited varying discriminatory accuracy, with the area under the curve (AUCs) ranging from 0.57 to 0.90. However, most studies showed an unclear or high risk of bias, with concerns about applicability. Of the five models with promising clinical utility, only two underwent external validation and one employed a decision curve analysis. These models demonstrated a discriminating and well-calibrated performance. While high-performing CRC risk prediction models exist, a need for transparent reporting of performance metrics and their clinical utility persists. Further research on this area is needed to facilitate the integration of these models into clinical practice, particularly in CRC screening.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139183815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Marginean, M. Popescu, A. Drocaș, S. Cazacu, R. Mitrut, I. Mărginean, George Alexandru Iacob, Marian-Sorin Popescu, A. Docea, P. Mitruț
Irritable bowel syndrome (IBS) is a common digestive disorder with a significant impact on both individuals and society in terms of quality of life and healthcare costs. A growing body of research has identified various communication pathways between the microbiota and the brain in relation to motility disorders, with the gut–brain axis being key to the pathogenesis of IBS. Multiple factors contribute to the pathogenetic pathways in IBS, including immune mechanisms, psychosocial factors, increased oxidative stress and pro-inflammatory cytokine release, as well as genetic and hormonal factors. Increased permeability of the normal intestinal barrier allows bacterial products to access the lamina propria, providing a mechanism for perpetuating chronic inflammation and characteristic symptoms. The microbiota influences inflammatory processes in IBS by altering the balance between pro-inflammatory factors and host defence. Probiotics modulate the pathophysiological mechanisms involved in IBS by influencing the composition of the microbiota and improving intestinal motility disorders, visceral hypersensitivity, immune function of the intestinal epithelium, metabolic processes in the intestinal lumen, dysfunction of the microbiota-GBA, and are recognised as effective and safe in IBS therapy. Our study aimed to provide a comprehensive overview of the relationship between the gut–brain axis, microbiota, and IBS, based on current information.
{"title":"Gut–Brain Axis, Microbiota and Probiotics—Current Knowledge on Their Role in Irritable Bowel Syndrome: A Review","authors":"C. Marginean, M. Popescu, A. Drocaș, S. Cazacu, R. Mitrut, I. Mărginean, George Alexandru Iacob, Marian-Sorin Popescu, A. Docea, P. Mitruț","doi":"10.3390/gidisord5040043","DOIUrl":"https://doi.org/10.3390/gidisord5040043","url":null,"abstract":"Irritable bowel syndrome (IBS) is a common digestive disorder with a significant impact on both individuals and society in terms of quality of life and healthcare costs. A growing body of research has identified various communication pathways between the microbiota and the brain in relation to motility disorders, with the gut–brain axis being key to the pathogenesis of IBS. Multiple factors contribute to the pathogenetic pathways in IBS, including immune mechanisms, psychosocial factors, increased oxidative stress and pro-inflammatory cytokine release, as well as genetic and hormonal factors. Increased permeability of the normal intestinal barrier allows bacterial products to access the lamina propria, providing a mechanism for perpetuating chronic inflammation and characteristic symptoms. The microbiota influences inflammatory processes in IBS by altering the balance between pro-inflammatory factors and host defence. Probiotics modulate the pathophysiological mechanisms involved in IBS by influencing the composition of the microbiota and improving intestinal motility disorders, visceral hypersensitivity, immune function of the intestinal epithelium, metabolic processes in the intestinal lumen, dysfunction of the microbiota-GBA, and are recognised as effective and safe in IBS therapy. Our study aimed to provide a comprehensive overview of the relationship between the gut–brain axis, microbiota, and IBS, based on current information.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139239838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Toms, C. Sandroussi, D. Yeo, James Morkaya, C. Pulitano, Daniel Steffens
The aims of this study were to assess patient-reported outcomes and the survival of patients following curative resection for pancreas cancer. Adult patients undergoing curative pancreatic resection between April 2014 and April 2019 across six major hospitals in Sydney were invited to complete the Short-Form 36 (SF-36v2) and the Functional Assessment Cancer Therapy—Hepatobiliary (FACT-Hep) questionnaires. Time from surgery was categorised into four different time points: 3–11, 12–23, 24–35, and 36–62 months. Survival analyses were performed using Kaplan–Meier and log-rank tests. A total of 278 patients underwent curative resection. Mean (SD) age was 65.0 (13.2), and 50.7% (n = 141) were males. Out of the 205 (74%) alive patients, 128 (62%) completed the study surveys. The physical component score and total FACT-Hep scores showed no significant changes over time. The mental component score improved from 3–11 months to 12–23 months (p = 0.009) and from 3–11 months to 36–62 months (p = 0.007). Survivorship showed a significant difference between malignancy, pre-malignancy, and benign disease groups, with 45.8 months (95%CI: 42.4–49.1), 40.3 months (95%CI: 36.4–44.2), and 41.3 months (95%CI: 37.9–44.9), respectively. For patients undergoing curative resection for pancreatic cancer, mental component scores improved over time, whereas overall survival outcomes seem to be influenced according to cancer pathology.
{"title":"Patient-Reported Outcomes and Survival Following Pancreatic Cancer Resection—Results from a Cross-Section Study","authors":"C. Toms, C. Sandroussi, D. Yeo, James Morkaya, C. Pulitano, Daniel Steffens","doi":"10.3390/gidisord5040042","DOIUrl":"https://doi.org/10.3390/gidisord5040042","url":null,"abstract":"The aims of this study were to assess patient-reported outcomes and the survival of patients following curative resection for pancreas cancer. Adult patients undergoing curative pancreatic resection between April 2014 and April 2019 across six major hospitals in Sydney were invited to complete the Short-Form 36 (SF-36v2) and the Functional Assessment Cancer Therapy—Hepatobiliary (FACT-Hep) questionnaires. Time from surgery was categorised into four different time points: 3–11, 12–23, 24–35, and 36–62 months. Survival analyses were performed using Kaplan–Meier and log-rank tests. A total of 278 patients underwent curative resection. Mean (SD) age was 65.0 (13.2), and 50.7% (n = 141) were males. Out of the 205 (74%) alive patients, 128 (62%) completed the study surveys. The physical component score and total FACT-Hep scores showed no significant changes over time. The mental component score improved from 3–11 months to 12–23 months (p = 0.009) and from 3–11 months to 36–62 months (p = 0.007). Survivorship showed a significant difference between malignancy, pre-malignancy, and benign disease groups, with 45.8 months (95%CI: 42.4–49.1), 40.3 months (95%CI: 36.4–44.2), and 41.3 months (95%CI: 37.9–44.9), respectively. For patients undergoing curative resection for pancreatic cancer, mental component scores improved over time, whereas overall survival outcomes seem to be influenced according to cancer pathology.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139253061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This review article will address the frequently encountered functional gastrointestinal disorders (FGIDs) occurring in infancy. The clinical features and management of infant regurgitation, infant colic, infant dyschezia, and functional constipation are discussed with reference to the most recent literature and evidence. Management should be focused on ruling out organic causes with careful history and examination, and then reassurance for the caregiver in this often very stressful period of parenting. There is often no or minimal pharmacological treatment necessary for FGIDs and treatment should be individualised for each patient and family.
{"title":"An Overview of the Management of Functional Gastrointestinal Disorders in Infancy","authors":"Laura Rishanghan, Rupert Hinds","doi":"10.3390/gidisord5040041","DOIUrl":"https://doi.org/10.3390/gidisord5040041","url":null,"abstract":"This review article will address the frequently encountered functional gastrointestinal disorders (FGIDs) occurring in infancy. The clinical features and management of infant regurgitation, infant colic, infant dyschezia, and functional constipation are discussed with reference to the most recent literature and evidence. Management should be focused on ruling out organic causes with careful history and examination, and then reassurance for the caregiver in this often very stressful period of parenting. There is often no or minimal pharmacological treatment necessary for FGIDs and treatment should be individualised for each patient and family.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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