Real-time tool to display the predicted disease course and treatment response for children with Crohn's disease.
Real-time tool to display the predicted disease course and treatment response for children with Crohn's disease.
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DOI：
10.1002/ibd.21386
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发表时间：
2011-01
影响因子：
4.9
通讯作者：
Dubinsky, Marla C.
中科院分区：
文献类型：
--
作者：
Siegel, Corey A.;Siegel, Lori S.;Hyams, Jeffrey S.;Kugathasan, Subra;Markowitz, James;Rosh, Joel R.;Leleiko, Neal;Mack, David R.;Crandall, Wallace;Evans, Jonathan;Keljo, David J.;Otley, Anthony R.;Oliva-Hemker, Maria;Farrior, Sharmayne;Langton, Christine R.;Wrobel, Iwona T.;Wahbeh, Ghassan;Quiros, J. Antonio;Silber, Gary;Bahar, Ron J.;Sands, Bruce E.;Dubinsky, Marla C.
Immunomodulators and biologics are effective treatments for children with Crohn’s disease (CD). The challenge of communicating the anticipated disease course with and without therapy to patients and parents is a barrier to the timely use of these agents. The aim of this project was to develop a tool to graphically display the predicted risks of CD and expected benefits of therapy. Using prospectively collected data from 796 pediatric CD patients we developed a model using system dynamics analysis (SDA). The primary model outcome is the probability of developing a CD related complication. Input variables include patient and disease characteristics, magnitude of serologic immune responses expressed as the quartile sum score (QSS), and exposure to medical treatments. Multivariate Cox proportional analyses show variables contributing a significant increase in the hazard ratio (HR) for a disease complication include female gender, older age at diagnosis, small bowel or perianal disease, and a higher QSS. As QSS increases, the HR for early use of corticosteroids increases, in contrast to a decreasing HR with early use of immunomodulators, early or late biologics, and early combination therapy. The concordance index for the model is 0.81. Using SDA, results of the Cox analyses are transformed into a simple graph displaying a real-time individualized probability of disease complication and treatment response. We have developed a tool to predict and communicate individualized risks of CD complications and how this is modified by treatment. Once validated, it can be used at the bedside to facilitate patient decision making.
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DOI：
10.1016/j.cgh.2008.04.032
发表时间：
2008-10
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Dubinsky MC;Kugathasan S;Mei L;Picornell Y;Nebel J;Wrobel I;Quiros A;Silber G;Wahbeh G;Katzir L;Vasiliauskas E;Bahar R;Otley A;Mack D;Evans J;Rosh J;Hemker MO;Leleiko N;Crandall W;Langton C;Landers C;Taylor KD;Targan SR;Rotter JI;Markowitz J;Hyams J;Western Regional Pediatric IBD Research Alliance;Pediatric IBD Collaborative Research Group;Wisconsin Pediatric IBD Alliance
通讯作者：
Wisconsin Pediatric IBD Alliance
DOI：
10.1111/j.1539-6924.2008.01135.x
发表时间：
2009-01
期刊：
Risk analysis : an official publication of the Society for Risk Analysis
影响因子：
--
作者：
Johnson FR;Ozdemir S;Mansfield C;Hass S;Siegel CA;Sands BE
通讯作者：
Sands BE
影响因子：
29.4
作者：
Hyams, Jeffrey;Crandall, Wallace;Baldassano, Robert
通讯作者：
Baldassano, Robert
影响因子：
29.4
作者：
Beaugerie, L;Seksik, P;Cosnes, J
通讯作者：
Cosnes, J
影响因子：
3.6
作者：
Lipkus, Isaac M.
通讯作者：
Lipkus, Isaac M.