Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?
Background Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks. Objective Using data from both studies we assessed the predictive value of 3 early predictors for hea...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2016-12, Vol.75 (6), p.1216-1220.e2 |
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| creator | Wilkes, Sally R., PhD Williams, Hywel C., DSc Ormerod, Anthony D., MD Craig, Fiona E., MBBS Greenlaw, Nicola, MSc Norrie, John, MSc Mitchell, Eleanor J., BA (Hons) Mason, James M., PhD Thomas, Kim S., PhD |
| description | Background Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks. Objective Using data from both studies we assessed the predictive value of 3 early predictors for healing at 6 months: speed of healing, Investigator Global Assessment (IGA), and resolution of inflammation, recorded at 2 and 6 weeks. Methods Logistic regression models were applied and the effectiveness of the 3 measures was assessed through estimating the positive and negative predictive values and the area under the receiver operating characteristic curve. Results The positive and negative predictive value at 6 weeks were, respectively, 63.5% (95% confidence interval [CI] 52.4%-73.7%) and 74.6% (95% CI 62.5%-84.5%) for speed of healing; 80% (95% CI 68.7%-88.6%) and 74.2% (95% CI 64.1%-82.7%) for IGA; and 72.1% (95% CI 59.9%-82.3%) and 68.1% (95% CI 57.7%-77.3%) for resolution of inflammation. IGA had the best combined positive predictive value, negative predictive value, and area under the receiver operating characteristic curve at 2 and 6 weeks. Limitations We were limited by data available from existing datasets. Conclusion Speed of healing, IGA, and resolution of inflammation were all shown to be good predictors of eventual healing of pyoderma gangrenosum. |
| doi_str_mv | 10.1016/j.jaad.2016.07.049 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835409887</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0190962216306016</els_id><sourcerecordid>1835409887</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-9eb58c9c9626d2d385047c665d50f5cc3f2cd3a7ef7a1464a1566ef893caecca3</originalsourceid><addsrcrecordid>eNp9kV9r1TAYh4Mo7mz6BbyQXnrTmj9N0oAoY-gcDGRMr0P25u2xtW1q0g7OtzflzF3sYlcJyfP7kTwvIe8YrRhl6mNf9c75iud9RXVFa_OC7Bg1ulS60S_JjjJDS6M4PyGnKfWUUlML_ZqccK1rzlSzIzdXqUgzoi9CW_xGN3TTvnDFPgRfzBF9B0uI2x3e47SsbniE8tl8CB7jmHE37SNOIa3jlzfkVeuGhG8f1jPy69vXnxffy-sfl1cX59cl1FIupcE72YCB_DzluReNpLUGpaSXtJUAouXghdPYasdqVTsmlcK2MQIcAjhxRj4ce-cY_q6YFjt2CXAY3IRhTZY1QtbUNI3OKD-iEENKEVs7x2508WAZtZtK29tNpd1UWqptVplD7x_617sR_WPkv7sMfDoCmH9532G0CTqcIEuLCIv1oXu-__OTOGSvHbjhDx4w9WGNU_ZnmU3cUnu7DXObJVOCqtwj_gG3k5nr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835409887</pqid></control><display><type>article</type><title>Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Wilkes, Sally R., PhD ; Williams, Hywel C., DSc ; Ormerod, Anthony D., MD ; Craig, Fiona E., MBBS ; Greenlaw, Nicola, MSc ; Norrie, John, MSc ; Mitchell, Eleanor J., BA (Hons) ; Mason, James M., PhD ; Thomas, Kim S., PhD</creator><creatorcontrib>Wilkes, Sally R., PhD ; Williams, Hywel C., DSc ; Ormerod, Anthony D., MD ; Craig, Fiona E., MBBS ; Greenlaw, Nicola, MSc ; Norrie, John, MSc ; Mitchell, Eleanor J., BA (Hons) ; Mason, James M., PhD ; Thomas, Kim S., PhD ; United Kingdom Dermatology Clinical Trials Network STOP GAP team</creatorcontrib><description>Background Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks. Objective Using data from both studies we assessed the predictive value of 3 early predictors for healing at 6 months: speed of healing, Investigator Global Assessment (IGA), and resolution of inflammation, recorded at 2 and 6 weeks. Methods Logistic regression models were applied and the effectiveness of the 3 measures was assessed through estimating the positive and negative predictive values and the area under the receiver operating characteristic curve. Results The positive and negative predictive value at 6 weeks were, respectively, 63.5% (95% confidence interval [CI] 52.4%-73.7%) and 74.6% (95% CI 62.5%-84.5%) for speed of healing; 80% (95% CI 68.7%-88.6%) and 74.2% (95% CI 64.1%-82.7%) for IGA; and 72.1% (95% CI 59.9%-82.3%) and 68.1% (95% CI 57.7%-77.3%) for resolution of inflammation. IGA had the best combined positive predictive value, negative predictive value, and area under the receiver operating characteristic curve at 2 and 6 weeks. Limitations We were limited by data available from existing datasets. Conclusion Speed of healing, IGA, and resolution of inflammation were all shown to be good predictors of eventual healing of pyoderma gangrenosum.</description><identifier>ISSN: 0190-9622</identifier><identifier>EISSN: 1097-6787</identifier><identifier>DOI: 10.1016/j.jaad.2016.07.049</identifier><identifier>PMID: 27742168</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Area Under Curve ; clinical practice ; clinical trials ; Dermatology ; Endpoint Determination ; Female ; Humans ; Inflammation - drug therapy ; Inflammation - etiology ; lesion improvement ; Male ; Middle Aged ; Predictive Value of Tests ; predictors ; pyoderma gangrenosum ; Pyoderma Gangrenosum - complications ; Pyoderma Gangrenosum - drug therapy ; Randomized Controlled Trials as Topic ; resolution of inflammation ; ROC Curve ; Severity of Illness Index ; speed of healing ; Time Factors ; Treatment Outcome ; Wound Healing</subject><ispartof>Journal of the American Academy of Dermatology, 2016-12, Vol.75 (6), p.1216-1220.e2</ispartof><rights>American Academy of Dermatology, Inc.</rights><rights>2016 American Academy of Dermatology, Inc.</rights><rights>Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-9eb58c9c9626d2d385047c665d50f5cc3f2cd3a7ef7a1464a1566ef893caecca3</citedby><cites>FETCH-LOGICAL-c455t-9eb58c9c9626d2d385047c665d50f5cc3f2cd3a7ef7a1464a1566ef893caecca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0190962216306016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27742168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilkes, Sally R., PhD</creatorcontrib><creatorcontrib>Williams, Hywel C., DSc</creatorcontrib><creatorcontrib>Ormerod, Anthony D., MD</creatorcontrib><creatorcontrib>Craig, Fiona E., MBBS</creatorcontrib><creatorcontrib>Greenlaw, Nicola, MSc</creatorcontrib><creatorcontrib>Norrie, John, MSc</creatorcontrib><creatorcontrib>Mitchell, Eleanor J., BA (Hons)</creatorcontrib><creatorcontrib>Mason, James M., PhD</creatorcontrib><creatorcontrib>Thomas, Kim S., PhD</creatorcontrib><creatorcontrib>United Kingdom Dermatology Clinical Trials Network STOP GAP team</creatorcontrib><title>Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?</title><title>Journal of the American Academy of Dermatology</title><addtitle>J Am Acad Dermatol</addtitle><description>Background Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks. Objective Using data from both studies we assessed the predictive value of 3 early predictors for healing at 6 months: speed of healing, Investigator Global Assessment (IGA), and resolution of inflammation, recorded at 2 and 6 weeks. Methods Logistic regression models were applied and the effectiveness of the 3 measures was assessed through estimating the positive and negative predictive values and the area under the receiver operating characteristic curve. Results The positive and negative predictive value at 6 weeks were, respectively, 63.5% (95% confidence interval [CI] 52.4%-73.7%) and 74.6% (95% CI 62.5%-84.5%) for speed of healing; 80% (95% CI 68.7%-88.6%) and 74.2% (95% CI 64.1%-82.7%) for IGA; and 72.1% (95% CI 59.9%-82.3%) and 68.1% (95% CI 57.7%-77.3%) for resolution of inflammation. IGA had the best combined positive predictive value, negative predictive value, and area under the receiver operating characteristic curve at 2 and 6 weeks. Limitations We were limited by data available from existing datasets. Conclusion Speed of healing, IGA, and resolution of inflammation were all shown to be good predictors of eventual healing of pyoderma gangrenosum.</description><subject>Adult</subject><subject>Aged</subject><subject>Area Under Curve</subject><subject>clinical practice</subject><subject>clinical trials</subject><subject>Dermatology</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammation - drug therapy</subject><subject>Inflammation - etiology</subject><subject>lesion improvement</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>predictors</subject><subject>pyoderma gangrenosum</subject><subject>Pyoderma Gangrenosum - complications</subject><subject>Pyoderma Gangrenosum - drug therapy</subject><subject>Randomized Controlled Trials as Topic</subject><subject>resolution of inflammation</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>speed of healing</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Wound Healing</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV9r1TAYh4Mo7mz6BbyQXnrTmj9N0oAoY-gcDGRMr0P25u2xtW1q0g7OtzflzF3sYlcJyfP7kTwvIe8YrRhl6mNf9c75iud9RXVFa_OC7Bg1ulS60S_JjjJDS6M4PyGnKfWUUlML_ZqccK1rzlSzIzdXqUgzoi9CW_xGN3TTvnDFPgRfzBF9B0uI2x3e47SsbniE8tl8CB7jmHE37SNOIa3jlzfkVeuGhG8f1jPy69vXnxffy-sfl1cX59cl1FIupcE72YCB_DzluReNpLUGpaSXtJUAouXghdPYasdqVTsmlcK2MQIcAjhxRj4ce-cY_q6YFjt2CXAY3IRhTZY1QtbUNI3OKD-iEENKEVs7x2508WAZtZtK29tNpd1UWqptVplD7x_617sR_WPkv7sMfDoCmH9532G0CTqcIEuLCIv1oXu-__OTOGSvHbjhDx4w9WGNU_ZnmU3cUnu7DXObJVOCqtwj_gG3k5nr</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Wilkes, Sally R., PhD</creator><creator>Williams, Hywel C., DSc</creator><creator>Ormerod, Anthony D., MD</creator><creator>Craig, Fiona E., MBBS</creator><creator>Greenlaw, Nicola, MSc</creator><creator>Norrie, John, MSc</creator><creator>Mitchell, Eleanor J., BA (Hons)</creator><creator>Mason, James M., PhD</creator><creator>Thomas, Kim S., PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161201</creationdate><title>Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?</title><author>Wilkes, Sally R., PhD ; Williams, Hywel C., DSc ; Ormerod, Anthony D., MD ; Craig, Fiona E., MBBS ; Greenlaw, Nicola, MSc ; Norrie, John, MSc ; Mitchell, Eleanor J., BA (Hons) ; Mason, James M., PhD ; Thomas, Kim S., PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-9eb58c9c9626d2d385047c665d50f5cc3f2cd3a7ef7a1464a1566ef893caecca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Area Under Curve</topic><topic>clinical practice</topic><topic>clinical trials</topic><topic>Dermatology</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Humans</topic><topic>Inflammation - drug therapy</topic><topic>Inflammation - etiology</topic><topic>lesion improvement</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>predictors</topic><topic>pyoderma gangrenosum</topic><topic>Pyoderma Gangrenosum - complications</topic><topic>Pyoderma Gangrenosum - drug therapy</topic><topic>Randomized Controlled Trials as Topic</topic><topic>resolution of inflammation</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>speed of healing</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilkes, Sally R., PhD</creatorcontrib><creatorcontrib>Williams, Hywel C., DSc</creatorcontrib><creatorcontrib>Ormerod, Anthony D., MD</creatorcontrib><creatorcontrib>Craig, Fiona E., MBBS</creatorcontrib><creatorcontrib>Greenlaw, Nicola, MSc</creatorcontrib><creatorcontrib>Norrie, John, MSc</creatorcontrib><creatorcontrib>Mitchell, Eleanor J., BA (Hons)</creatorcontrib><creatorcontrib>Mason, James M., PhD</creatorcontrib><creatorcontrib>Thomas, Kim S., PhD</creatorcontrib><creatorcontrib>United Kingdom Dermatology Clinical Trials Network STOP GAP team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilkes, Sally R., PhD</au><au>Williams, Hywel C., DSc</au><au>Ormerod, Anthony D., MD</au><au>Craig, Fiona E., MBBS</au><au>Greenlaw, Nicola, MSc</au><au>Norrie, John, MSc</au><au>Mitchell, Eleanor J., BA (Hons)</au><au>Mason, James M., PhD</au><au>Thomas, Kim S., PhD</au><aucorp>United Kingdom Dermatology Clinical Trials Network STOP GAP team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?</atitle><jtitle>Journal of the American Academy of Dermatology</jtitle><addtitle>J Am Acad Dermatol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>75</volume><issue>6</issue><spage>1216</spage><epage>1220.e2</epage><pages>1216-1220.e2</pages><issn>0190-9622</issn><eissn>1097-6787</eissn><abstract>Background Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks. Objective Using data from both studies we assessed the predictive value of 3 early predictors for healing at 6 months: speed of healing, Investigator Global Assessment (IGA), and resolution of inflammation, recorded at 2 and 6 weeks. Methods Logistic regression models were applied and the effectiveness of the 3 measures was assessed through estimating the positive and negative predictive values and the area under the receiver operating characteristic curve. Results The positive and negative predictive value at 6 weeks were, respectively, 63.5% (95% confidence interval [CI] 52.4%-73.7%) and 74.6% (95% CI 62.5%-84.5%) for speed of healing; 80% (95% CI 68.7%-88.6%) and 74.2% (95% CI 64.1%-82.7%) for IGA; and 72.1% (95% CI 59.9%-82.3%) and 68.1% (95% CI 57.7%-77.3%) for resolution of inflammation. IGA had the best combined positive predictive value, negative predictive value, and area under the receiver operating characteristic curve at 2 and 6 weeks. Limitations We were limited by data available from existing datasets. Conclusion Speed of healing, IGA, and resolution of inflammation were all shown to be good predictors of eventual healing of pyoderma gangrenosum.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27742168</pmid><doi>10.1016/j.jaad.2016.07.049</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Area Under Curve clinical practice clinical trials Dermatology Endpoint Determination Female Humans Inflammation - drug therapy Inflammation - etiology lesion improvement Male Middle Aged Predictive Value of Tests predictors pyoderma gangrenosum Pyoderma Gangrenosum - complications Pyoderma Gangrenosum - drug therapy Randomized Controlled Trials as Topic resolution of inflammation ROC Curve Severity of Illness Index speed of healing Time Factors Treatment Outcome Wound Healing |
| title | Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum? |
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