Evaluation of the Discrimination Ability of the Decision Rule Allowing to Predict the Probability of Death in Oncosurgical Patients with Comorbid Pathology.

At the moment, there are many decision rules and mathematical models that reduce the risk of postoperative mortality and complications. A small part of such medical mathematical models (scales) is successfully used in practice, but there is also a part that eventually remains on the shelves and becomes morally obsolete. The purpose of this work is to evaluate the discrimination ability of the prognostic model underlying the decision rule that allows ranking patients into groups with favorable and unfavorable outcomes and into a group of patients subject to preoperative preparation to maintain the performance of the mathematical model Oncoprognosis 1.0. The discrimination ability carried out by constructing an area under the Receiver Operating Characteristic (ROC) curve. The investigation allowed conduct that any decision rule requires revision over time, its clarification and, if necessary, adjustments and updates.

16S rRNA gene sequencing data of the upper respiratory tract microbiome in the SARS-CoV-2 infected patients.

The SARS-CoV-2 pandemic is a big challenge for humanity. The COVID-19 severity differs significantly from patient to patient, and it is important to study the factors protecting from severe forms of the disease. Respiratory microbiota may influence the patient's susceptibility to infection and disease severity due to its ability to modulate the immune system response of the host organism. This data article describes the microbiome dataset from the upper respiratory tract of SARS-CoV-2 positive patients from Russia. This dataset reports the microbial community profile of 335 human nasopharyngeal swabs collected between 2020-05 and 2021-03 during the first and the second epidemic waves. Samples were collected from both inpatients and outpatients in 4 cities of the Russian Federation (Moscow, Kazan, Irkutsk, Nizhny Novgorod) and sequenced using the 16S rRNA gene amplicon sequencing of V3-V4 region. Data contains information about the patient such as age, sex, hospitalization status, percent of damaged lung tissue, oxygen saturation (SpO2), respiratory rate, need for supplemental oxygen, chest computer tomography severity score, SARS-CoV-2 lineage, and also information about smoking and comorbidities. The amplicon sequencing data were deposited at NCBI SRA as BioProject PRJNA751478.

Assessment of the Prognostic Accuracy of Scores in Different Ways on the Example of Assessing the Validity of the Prognostic Model ISS-RTS-TRISS.

The aim of the present study was a comparison of prognostic accuracy assessment results for scores in different ways on the example of validity analysis of the prognostic model ISS-RTS-TRISS for assessing the severity of the condition in children with trauma. The prospective study was conducted using clinical and physiological data collected at the admission and during the first 24 hours of hospitalization from 414 children with trauma. We had three groups of patients, common group children with traumatic brain injuries, and two groups of patients were divided into the two following ways: 141 (34%) patients with isolated traumatic brain injuries and 273 (66%) patients with combined injuries with traumatic brain injuries The validity and prognostic accuracy of prognostic scores were assessed by determining there discrimination and calibration ability. Analysis of the discrimination ability of score was carried out by assessment the areas under the ROC curves. For analysis of the calibration ability of score was used three methods of the Hosmer-Lemeshow test (H-criterion, C-criterion in two variants). The ISS-RTS-TRISS score showed significantly outstanding predictive accuracy in studied groups (AUROC >=0.9) .However, estimation the calibration ability of score using the C-criterion, by dividing into groups with the same number of cases of patients (recommended for abnormal distribution) did not show an unambiguous results. It was shown that to obtain an unambiguous correct result, it was necessary to use the C-criterion method using the division of cases into groups with the same number of patients with the lethal outcome. When using this method, satisfactory results of study of calibration ability were shown for all the studied groups (p<0.05).

Model of Decision Making Support for a Doctor in the Treatment of an Oncosurgical Patient in a Hospital.

At the present moment, there is no uniform approach to the decision to conduct a planned surgical intervention in case of oncosurgical pathology, with appropriate recommendations in different sources. Consequently, in modern medicine, there is a particular problem of an objective assessment of the patient's physical condition and a risk assessment of an upcoming surgical intervention for developing an individualized tactic of preparation for surgical treatment for each particular patient. The need for introduction of new approaches and technologies, as well as treatment regimens, that allow us to take a fresh look at the possibilities of solving the problems of predicting critical outcomes of planned operations, determined the purpose of our study. The result of our study was the design of a decision rule in the form of the Microsoft Access software, which allows to rank patients with oncological diseases by the probability of lethal outcome in surgery.

Estimation of the Accuracy of Prognostic Scores for the Treatment of Children with Severe Trauma in a Specialized Trauma Hospital.

The aim of the present work was to study the validity and prognostic accuracy of scores for assessing the severity of the condition in children with severe trauma, located in the Department of Anesthesiology and Resuscitation in the Clinical and Research Institute of Urgent Pediatric Surgery and Trauma. The prospective study was conducted using clinical and physiological data collected at the admission and during the first 24 hours of hospitalization from 474 patients. The validity and prognostic accuracy of prognostic scores were assessed by determining their discrimination and calibration ability. A comparison of the discriminatory ability of scores was carried out by comparing the areas under the ROC curves with the z-criterion. Four prognostic scores were included into the study: PRISM, APACHE II, ISS-RTS-TRISS, which were used for calculating the severity of injury and for prognosis of death. Score PTS was used for evaluating the severity index only. Our results indicate that only score ISS-RTS-TRISS may be useful in practice (has excellent discrimination ability and significant calibration ability). The other lack either discrimination ability (PRISM) or calibration ability (PTS, APACHE II). The result of the study has shown that only one of the four prognostic scores, ISS-RTS-TRISS, can be successfully used in everyday practice in the department of anesthesiology and resuscitation in the specialized hospital of children's traumatology to assess the severity of the condition, with the possibility of predicting the likelihood of a lethal outcome.