ABSTRACT
AIM: to assess effectiveness of the use of modern methods of prognostication for assessment of risk of development of ischemic heart disease (IHD). MATERIAL AND METHODS: We examined 131 patients with diagnosis of IHD verified by coronary angiography and 159 subjects of control group. Initial information on each patient included the following parameters: traditional risk factors, laboratory parameters, results of instrumental examination, genetic markers. We studied 29 polymorphisms in 27 genes which according to international databases were associated with IHD. Genotype was assessed as 2 models: dominant and recessive. For each patient we calculated individual genetic index as sum of present polymorphic markers with addition of data of familial anamnesis. The data obtained were analyzed with the "RECOGNITION" system which used for solution of prognostication problems main approaches and algorithms of the theory of recognition by precedents. RESULTS: Accuracy of recognition varied from 70 to 75% with small number of traits and up to 90% on informative trait subsystems. The method "linear machine" showed the highest accuracy. The voting algorithm showed maximal accuracy of prognosis relative to some algorithms. In IHD prognostication most information systems comprised genetic markers, most significant of which was the genetic index representing sum of available polymorphic markers with addition of data of familial anamnesis. CONCLUSION: Analysis with the use of methods of recognition by precedents is a perspective technique for stratification of IHD risk and support of optimal decision making on prevention. The use of collectives of different methods of prognostication allows to increase accuracy of prognosis.
Subject(s)
Diagnosis, Computer-Assisted/methods , Genetic Markers/genetics , Genetic Techniques , Myocardial Ischemia/diagnosis , Risk Assessment/methods , Adult , Aged , Diagnosis, Differential , Female , Follow-Up Studies , Genotype , Humans , Incidence , Male , Middle Aged , Myocardial Ischemia/epidemiology , Myocardial Ischemia/genetics , Polymorphism, Genetic , Prognosis , Reproducibility of Results , Risk Factors , Russia/epidemiologyABSTRACT
The paper focuses on algorithms of outcomes assessment of surgical treatment of the patients with degenerative lumbar disk disease. From 1997 to 2006 389 patients with discogenic lumbar pain were operated in the Medical Center of Central Bank of Russia. 185 patients underwent radiofrequency destruction of facet nerves, laser percutaneous lumbar discectomy was performed in 39 patients, microdiscectomy -- in 131, and decompression combined with lumbar spine stabilization -- in 31 cases. Clinical and radiological data of each patient were recorded in the database using 3-point scale according to intensity of the feature. Assessment of patients' condition was performed pre- and postoperatively (after discharge and after 6, 12 and 24 months interval). Postoperative outcome was recorded for the current period in compliance with modified criteria of Kawabata et al. Obtained data were mathematically and statistically processed. Developed algorithms allowed assessment of postoperative outcome in the patients with degenerative lumbar disk disease. Outcome data can be used for evaluation of feasibility of surgical treatment as well as for selection of surgical technique.
