88 research outputs found
Hernioplasty without discomfort. can subcutaneous drainage be effective to reduce local complications?
No full textIl trattamento endovascolare laser della vena piccola safena: esperienza personale e confronto dei risultati con altre tecniche ablative endovascolari e chirurgiche tradizionali
No full textIL TRATTAMENTO DELLA IVC RECIDIVA MEDIANTE SCLEROMOUSSE: ANALISI DELLA LETTERATURA ED ESPERIENZA PERSONALE
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La Standardizzazione nel trattamento laser endovenoso: revisione della letteratura ed esperienza personale
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Predicting a prolonged air leak after video assisted thoracic surgery, is it really possible?
No full textValidation of predictive risk models for prolonged air leak (PAL) is essential to
understand if they can help to reduce its incidence and complications. This
study aimed to evaluate both the clinical and statistical performances of 4
existing models. We selected 4 predictive PAL risk models based on their
scientific relevance. We referred to these models as Chicago, Bordeaux,
Leeds and Pittsburgh model, respectively, according to the affiliation place
of the first author. These predicting risk models were retrospectively applied
to patients recorded on the second edition of the Italian Video-Assisted
Thoracoscopic Surgery Group registry. Predictions for each patient were
calculated based on the logistic regression coefficient values provided in the
original manuscripts. All models were tested for their overall performance,
discrimination, and calibration. We recalibrated the original models with the
re-estimation of the model intercept and slope. We used curve decision
analysis to describe and compare the clinical effects of the studied risk mod
els.
Better statistical metrics characterize the models developed on larger
populations (Chicago and Bordeaux models). However, no model has a valid
benefit for threshold probability greater than 0.30. The Net benefit of the
most performing model (Bordeaux model) at the threshold probability of
0.11 is 23 of 1000 patients, burdened by 333 false positive cases. One of
1000 is the Net benefit at the threshold probability of 0.3. The use of PAL
scores based on preoperative predictive factors cannot be currently used in
a clinical setting because of a high false positive rate and low positive pre
dictive valu
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