MP89-04 DOES GRADE MATTER? A SYSTEMATIC REVIEW OF THE IMPACT OF VARICOCELE GRADE ON RESPONSE TO TREATMENT.
Notice bibliographique
Résumé
You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-04 DOES GRADE MATTER? A SYSTEMATIC REVIEW OF THE IMPACT OF VARICOCELE GRADE ON RESPONSE TO TREATMENT. Clark Judge, Christopher Deibert, Doron Stember, and Peter Stahl Clark JudgeClark Judge More articles by this author , Christopher DeibertChristopher Deibert More articles by this author , Doron StemberDoron Stember More articles by this author , and Peter StahlPeter Stahl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2802AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The treatment options for couples affected by varicocele-associated subfertility include varicocelectomy and assisted reproduction. Our goal was to investigate varicocele grade as a prognostic factor that could be potentially incorporated into shared decision making with affected patients. METHODS Pubmed, Embase, and MEDLINE databases were searched for studies evaluating the impact of varicocele grade on response to treatment through May 1, 2016. We analyzed all studies of varicocelectomy in infertile men with palpable varicoceles that reported outcomes stratified by varicocele grade. Heterogeneity of semen quality reporting precluded data compilation and meta-analysis. Therefore the impact of varicocele grade on post-treatment semen quality was analyzed by structured data synthesis. The impact of varicocele grade on pregnancy rates was studied by data extraction and meta-analysis using a binary random effects model. Quality assessment was conducted using the Newcastle-Ottawa Scale (NOS). RESULTS One randomized controlled trial and 11 cohort studies described outcomes of varicocelectomy stratified by varicocele grade in 1,394 infertile men with palpable varicocele. For men with only grade 1 varicocele, only 1 of 5 studies reported improved concentration and just 1 of 6 showed improved motility. In contrast, 5 of 5 studies that evaluated concentration and 4 of 5 studies that evaluated motility after repair of grade 2/3 varicoceles reported positive treatment responses. Four of 6 studies that directly compared concentration response to varicocelectomy in men with grade 1 and grade 2/3 varicoceles reported greater improvements in men with larger varicoceles. Three of 6 studies that directly compared motility response to varicocelectomy in men with grade 1 and grade 2/3 varicoceles reported greater improvements in men with larger varicoceles. Morphology changes were less consistently related to varicocele grade. Meta-analyses of the included studies did not reveal improved pregnancy rates after treatment of either grade 1 or grade 2/3 varicoceles. Quality assessment determined that 4 of the 11 non-randomized studies were of high quality. CONCLUSIONS Improved semen quality after varicocelectomy has been consistently reported for men with grade 2/3 varicoceles. In contrast, improvement is uncommon for men with grade 1 varicoceles. Incorporation of varicocele grade into patient counseling may improve our ability to select patients for varicocelectomy that are most likely to benefit from surgery. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1203 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Clark Judge More articles by this author Christopher Deibert More articles by this author Doron Stember More articles by this author Peter Stahl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,066 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,008 | 0,011 |
| Bibliométrie | 0,007 | 0,009 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».