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Québec, Canada

Makosso-Kallyth S.,CRCHUQ | Diday E.,University of Paris Dauphine
Advances in Data Analysis and Classification | Year: 2012

This paper is an adaptation of symbolic interval Principal Component Analysis (PCA) to histogram data. We proposed two methodologies. The first one involved three steps: the coding of bins of histogram, the ordinary PCA of means of variables and the representation of dispersion of symbolic observations we call concepts. For the representation of dispersion of these concepts we proposed the transformation of histograms into intervals. Then, we suggest the projection of the hypercubes or the interval lengths associated to each concept on the principal axes of the ordinary PCA of means. In the second methodology, we proposed the use of the three previous steps with the angular transformation. © 2012 Springer-Verlag.

Lamers R.E.D.,St Elisabeth Hospital | Cuypers M.,University of Tilburg | Garvelink M.M.,CRCHUQ | de Vries M.,University of Tilburg | And 3 more authors.
Patient Education and Counseling | Year: 2016

Objective To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods From February–September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients’ needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients. Results 1 (N = 15): Dutch urologists reached consensus on 61% of the statements concerning users’ criteria, decision options, structure, and medical content. 2 (N = 24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients’ preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N = 10): Pros of the DA were clear information provision, systematic design and easy to read and re-read. Conclusion A LUTS/BPH DA containing VCEs** was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted. Practice Implications This method can be adopted for the development of DAs to support other medical decision issues. © 2016 Elsevier Ireland Ltd

Giguere Y.,CRCHUQ | Giguere Y.,Laval University | Charland M.,CRCHUQ | Theriault S.,CRCHUQ | And 7 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012

Preeclampsia (PE), which is defined as new onset hypertension after 20 weeks of pregnancy accompanied by protein-uria, is characterized by inadequate placentation, oxidative stress, inflammation and widespread endothelial dysfunction. A link between PE and long-term risk of cardiovascular disease (CVD) was suggested by retrospective studies, which found that PE was associated with a 2-3-fold risk of CVD later in life, with a 5-7-fold risk in the case of severe and/or early-onset PE. Recently, meta-analyses and prospective studies have confirmed the association between PE and the emergence of an unfavorable CVD risk profile, in particular a 3-5-fold increased prevalence of the metabolic syndrome only 8 years after the index pregnancy. PE and CVD share many risk factors, including obesity, hypertension, dyslipi-demia, hypercoagulability, insulin resistance and both entities are characterized by endothelial dysfunction. PE and CVD are complex traits sharing common risk factors and pathophysiological processes, but the genetic link between both remains to be elucidated. However, recent evidence suggests that genetic determinants associated with the metabolic syndrome, inflammation and subsequent endothelial dysfunction are involved. As the evidence now supports that PE represents a risk factor for the emergence of the metabolic syndrome and CVD later in life, the importance of long-term follow-up assessment of CVD risk beginning early in women with a history of PE must be considered and translated into new preventive measures. © 2012 by Walter de Gruyter •Berlin • Boston.

Forest J.-C.,CRCHUQ | Forest J.-C.,Laval University | Charland M.,CRCHUQ | Masse J.,Laval University | And 8 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012

Pre-eclampsia (PE) and other hypertensive disorders of pregnancy (HDP) are a leading cause of adverse outcomes. Their pathophysiology remains elusive, hampering the development of efficient prevention. The onset of HDP and PE and the severity of their clinical manifestations are heterogeneous. The advent of preventive measures, such as low-dose aspirin that targets high-risk women, emphasizes the need of better prediction. Until recently, only environmental information and maternal risk factors were considered, with equivocal predictive value. No validated screening procedures were available to identify at-risk women despite the emergence of Doppler ultrasonography parameters for the uterine artery (e.g., pulsatility index and bilateral notching) and pathophysi-ological biochemical markers (e.g., angiogenesis, inflamma-tion, and endothelial dysfunction). Owing to its heterogeneity and lack of specific, sensitive markers among those studied so far (>200), PE is unlikely to be detected early by a single predictive parameter. Systematic reviews have concluded that no single test fulfilling World Health Organization criteria for biomarker selection can diagnose/predict a disease. However, by combining antenatal risk factors, clinical parameters, as well as biophysical and biochemical markers into multivariate algorithms, the risk of PE can be estimated with performance levels that could reach clinical utility. Performance characteristics of selected algorithms will be presented and discussed with respect to transferability to different geographic and healthcare environments. © 2012 by Walter de Gruyter •Berlin • Boston.

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