Validation of the IMPEDE VTE score for prediction of venous thromboembolism in Chinese patients with multiple myeloma: A single-center retrospective cohort study.

Multiple myeloma (MM) significantly increases the risk of venous thromboembolism (VTE) within 6 months of treatment initiation. The IMPEDE VTE score is a VTE risk prediction model which is recently incorporated into the National Comprehensive Cancer Network (NCCN) guidelines, but it lacks validation among Asians, including Chinese MM patients. We performed a retrospective chart review of 405 Chinese with newly diagnosed MM who started therapy at Beijing Jishuitan Hospital between April 2013 to October 2022. The 6-month cumulative incidence of VTE was 3.8 % (95 % CI:1.6-7.6), 8.6 % (95 % CI: 5.3-21.9) and 40.5 % (95 % CI: 24.9-55.7) in the low-, intermediate- and high-risk groups (P < 0.001), respectively. The C-statistic of the IMPEDE VTE scores for predicting VTE within 6 months of treatment initiation was 0.74 (95 % CI: 0.65-0.83). Of note, in this single-center cohort study, we propose that the anticoagulant LMWH may be more effective than the antiplatelet aspirin in potentially preventing VTE in newly diagnosed MM patients. Our findings suggest that the IMPEDE VTE score is a valid evidence-based risk stratification tool in Chinese patients with newly diagnosed MM.

Framework and Approach of Diagnosis and Rehabilitation Intervention for Children with Communication Disorders Using WHO Family International Classifications / 中国康复理论与实践

Results and Conclusion:The core diagnostical terms of communication disorder for children include Primary Pragmatic Language Impairment of Developmental Language Disorder, Communication, Communicating-Receiving, and Communicating-Production, etc. Communication disorder is a typical disorder of limited social interaction and a typical manifestation of developmental retardation for children, named Developmental Language Disorder Main Companion Pragmatic Language Impairment (6A01.22), subclass of Developmental Language Disorder (6A01). Communication disorders involve in speech-related body structures and functions, activity and participation, environmental factors and personal factors; such as communication (d3), including communicating-receiving (d310-d329), communicating-production (d330-d349), conversation and use of communication devices and techniques (d350-d369), and health-related behaviors. The structured framework of rehabilitation intervention involves in body function and structure, activity and participation, environmental factors and personal factors; includes assessment, training and treatment, educational counseling, and psychological and social support. Objective:To explore the definition and core terminology of communication disorders for children, establish the diagnostic criteria and functional assessment criteria of communication disorder, and develop a holistic rehabilitation solution for it based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (Children and Youth version) (ICF-CY) and International Classification of Health Interventions (ICHI). Methods:Core definition and terminology of communication disorder were analysed with ICD-11, American Speech-Language-Hearing Association (ASHA) and Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V). The diagnostical criteria of communication disorders for children were analyzed using the ICD-11. The functioning diagnostical criteria of communication disorders for children were explored using ICF-CY. A holistic rehabilitation solution was developed based on ICF-CY and ICHI.