2024
Validation of an Electronic Health Record–Based Machine Learning Model Compared With Clinical Risk Scores for Gastrointestinal Bleeding
Shung D, Chan C, You K, Nakamura S, Saarinen T, Zheng N, Simonov M, Li D, Tsay C, Kawamura Y, Shen M, Hsiao A, Sekhon J, Laine L. Validation of an Electronic Health Record–Based Machine Learning Model Compared With Clinical Risk Scores for Gastrointestinal Bleeding. Gastroenterology 2024, 167: 1198-1212. PMID: 38971198, PMCID: PMC11493512, DOI: 10.1053/j.gastro.2024.06.030.Peer-Reviewed Original ResearchElectronic health recordsGlasgow-Blatchford scoreEmergency departmentVery-low-risk patientsRisk scoreOakland scoreMachine learning modelsStructured data fieldsClinical risk scoreGastrointestinal bleedingAll-cause mortalityHealth recordsLearning modelsManual data entrySecondary analysisRisk stratification scoresAssess proportionRed blood-cell transfusionPrimary outcomeProportion of patientsData entryOvert gastrointestinal bleedingPrimary analysisReceiver-operating-characteristic curveVery-low-risk
2019
The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding
Saffouri E, Blackwell C, Laursen SB, Laine L, Dalton HR, Ngu J, Shultz M, Norton R, Stanley AJ. The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2019, 51: 253-260. PMID: 31642558, DOI: 10.1111/apt.15541.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArea Under CurveBlood TransfusionCohort StudiesEndoscopy, GastrointestinalFemaleGastrointestinal HemorrhageHospitalizationHumansMaleMiddle AgedMortalityPredictive Value of TestsPrognosisProspective StudiesReproducibility of ResultsRisk AssessmentSeverity of Illness IndexShockSurvival AnalysisUpper Gastrointestinal TractYoung AdultConceptsUpper gastrointestinal bleedingGlasgow-Blatchford scoreShock indexGastrointestinal bleedingABC scoreMajor transfusionAcute upper gastrointestinal bleedingUK National Confidential EnquiryAdmission Rockall scoreSevere gastrointestinal bleedingMajor clinical endpointsPredictors of outcomeNational Confidential EnquiryRockall scoreBlatchford scoreEndoscopic therapyConsecutive patientsHospital admissionConfidential EnquiryProspective studyClinical endpointsPatient outcomesRisk scoreDeath reportsBleedingManagement of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group.
Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F, Leontiadis GI, Abraham NS, Calvet X, Chan FKL, Douketis J, Enns R, Gralnek IM, Jairath V, Jensen D, Lau J, Lip GYH, Loffroy R, Maluf-Filho F, Meltzer AC, Reddy N, Saltzman JR, Marshall JK, Bardou M. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Annals Of Internal Medicine 2019, 171: 805-822. PMID: 31634917, PMCID: PMC7233308, DOI: 10.7326/m19-1795.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsUpper gastrointestinal bleedingNonvariceal upper gastrointestinal bleedingHigh-risk stigmataPPI therapyGastrointestinal bleedingEndoscopic therapyCardiovascular diseaseHigh-dose proton pump inhibitor therapyEvidence profilesProton pump inhibitor therapyGlasgow-Blatchford scoreOral PPI therapyPrevious ulcer bleedingHigh-risk patientsHours of presentationManagement of patientsSuccessful endoscopic therapyStrength of recommendationsQuality of evidenceInternational consensus recommendationsInternational multidisciplinary groupInternational Consensus GroupElectronic bibliographic databasesTC-325Blatchford scoreMAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding
Redondo‐Cerezo E, Vadillo‐Calles F, Stanley AJ, Laursen S, Laine L, Dalton HR, Ngu JH, Schultz M, Jiménez‐Rosales R. MAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding. Journal Of Gastroenterology And Hepatology 2019, 35: 82-89. PMID: 31359521, DOI: 10.1111/jgh.14811.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingGastrointestinal bleedingEndoscopic interventionGlasgow-Blatchford scoreSystolic blood pressureNew scoring systemBlatchford scoreProspective databaseBlood pressureRisk stratificationValidation cohortDevelopment cohortOriginal cohortEmergency roomMental statusRisk scoreClinical practiceFair discriminationScoring systemPatientsMortalityCohortNew scoreInterventionBleeding
2018
Previous Use of Antithrombotic Agents Reduces Mortality and Length of Hospital Stay in Patients With High-risk Upper Gastrointestinal Bleeding
Dunne P, Laursen SB, Laine L, Dalton HR, Ngu JH, Schultz M, Rahman A, Anderloni A, Murray IA, Stanley AJ. Previous Use of Antithrombotic Agents Reduces Mortality and Length of Hospital Stay in Patients With High-risk Upper Gastrointestinal Bleeding. Clinical Gastroenterology And Hepatology 2018, 17: 440-447.e2. PMID: 29705263, DOI: 10.1016/j.cgh.2018.04.046.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingAnti-thrombotic agentsAnti-thrombotic drugsGlasgow-Blatchford scoreRockall scoreHospital stayGastrointestinal bleedingEndoscopic therapyAcute upper gastrointestinal bleedingAnesthesiologists classification scoreBleeding-related mortalityFull Rockall scoreMean hospital stayOutcomes of patientsHigher American SocietyLength of hospitalShorter hospital staySystolic blood pressureMean American SocietyFrequency of malignancyLevels of hemoglobinHigher mean American SocietyAmerican SocietyAIMS65 scoreAnesthesiologists classification
2017
Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study
Stanley AJ, Laine L, Dalton HR, Ngu JH, Schultz M, Abazi R, Zakko L, Thornton S, Wilkinson K, Khor CJ, Murray IA, Laursen SB. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. The BMJ 2017, 356: i6432. PMID: 28053181, PMCID: PMC5217768, DOI: 10.1136/bmj.i6432.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingRockall scoreGastrointestinal bleedingInternational multicentre prospective studyAdmission Rockall scoreFull Rockall scoreGlasgow-Blatchford scoreHigh-risk patientsMulticentre prospective studyAssessment of patientsPNED scoreHospital stayBlatchford scoreDay mortalityConsecutive patientsRisk patientsComposite endpointEndoscopic treatmentProspective studyClinical endpointsClinical utilityLower riskPatientsLarge hospitalsBleeding