PrognostiCheck®

Prognosis; it is a matter of life and death, How effective is that treatment?

Imagine a technology that reports the presence-severity-progression of any disease, the effectiveness of any treatment and the timing of non-acute death (we can’t tell you about oncoming buses). Well PrognostiCheck is it; we measure the phase angle which is an illustration of the vitality of cell membranes. Disease begins and ends on a cellular level. This level of the hierarchy of physiology occurs prior to where lab studies, imaging techniques and physicial examination come from so it takes (a little) work to understand it. However the results are a simple measured value; higher in health, lower in sickness, effective treatment stops it from lowering and causes it to rise. If your value goes below two degrees you die. hen you are diagnosed with a serious disese what your value is tells you if you will survive. The test is simple, inepxensive and noninvasive. It is precise (test, re-test reliabilit .99 out of 1) sensitive, specific and accurate (.98 out of 1).

If you are healthy it tells you how healthy you really are, did you recover from that injury or overcome your genetic heritage (the gift that keeps on giving). If you have one or more chronic diseases it tells you how frail you are, what the cumulative burden of the conditions that you have have done to you, if the treatment is working or do you (will you) have to do more. When you have a terminal condition it tells you about your death and enables you to make better end-of-life decisions.

The test is simple the implication enormous, let’s talk more!

Thank you,

Cheers!

Michaeal
IPGDx

Tags: Cancer Prognosis, cancer treatment, effectiveness of treatment, end of life decisions, If Sick How Sick, Prognosis, Treatment and Prognosis

Prognostic Role of Phase Angle in advanced Non-Small Cell Lung Cancer(NSCLC)

Non-small cell lung cancer (NSCLC) accounts for about 80% of all lung cancers. Malnutrition is a frequent manifestation in patients with advanced NSCLC and is a major contributor to morbidity and mortality. Malnutrition is characterized by changes in cellular membrane integrity and alterations in fluid balance. As a result, measurement of body composition is an important component of overall nutritional evaluation in cancer patients.

A frequent manifestation of advanced lung cancer is malnutrition, timely identification and treatment of which can lead to improved patient outcomes. Bioelectrical impedance analysis (BIA) is an easy-to-use and non-invasive technique to evaluate changes in body composition and nutritional status.

Here is an excerpt from the study that was conducted by D.Gupta and Team to investigate the prognostic role of BIA-derived phase angle in advanced non-small cell lung cancer (NSCLC).

A case series of 165 stages IIIB and IV NSCLC patients treated at our center. The Kaplan Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of phase angle, independent of stage at diagnosis and prior treatment history.

93 were males and 72 females. 61 had stage IIIB disease at diagnosis while 104 had stage IV. The median phase angle was 5.3 degrees (range = 2.9 – 8). Patients with phase angle <= 5.3 had a median survival of 7.6 months (95% CI: 4.7 to 9.5; n = 81), while those with > 5.3 had 12.4 months (95% CI: 10.5 to 18.7; n = 84); (p = 0.02). After adjusting for age, stage at diagnosis and prior treatment history we found that every one degree increase in phase angle was associated with a relative risk of 0.79 (95% CI: 0.64 to 0.97, P = 0.02).

It was concluded from the study that phase angle acts as an independent prognostic indicator in patients with stage IIIB and IV NSCLC. Nutritional interventions targeted at improving phase angle could potentially lead to an improved survival in patients with advanced NSCLC.

PrognostiCheck® is a scoring system that interprets a measured electrical value i.e Phase angle , that illustrates the health of the cell membrane. It can be used to provide critically important information to patients, their families and physicians on survival in cancer and all other diseases.

By seeing what is happening in the cell-wall-membrane the results provide better information sooner that supports, compliments and increases the value of the physicians decision dataset.

Tags: Burden of Disease, effectiveness of treatment, Non-Small Cell Lung Cancer, Phase Angle, Prognosis, Treatment and Prognosis

Phase Angle as a Prognostic Factor for Post-Operative Complications

Bioelectric Impedance Analysis (BIA), and its parameter, phase angle, have been described as a prognostic tool in several clinical situations, but they have never been studied in surgical population

Here is an abstract from the study conducted by M.Barbosa-Silva, A.Barros to assess the importance of nutritional variables and parameters from BIA as predictors of post-operative complications in a multi variable regression model.

The nutritional status of 225 adult patients scheduled to undergo gastrointestinal surgery was assessed by several methods, including bioelectric impedance analysis and subjective global assessment. Potential confounding factors were also studied. Patients were screened for post-operative complications until hospital discharge.

Weight loss greater than 10%, subjective global assessment, nutritional risk assessment, ECM/BCM ratio and phase angle (from BIA) were the prognostic factors significantly associated with post-operative complications in the crude analysis. After adjusting for sex, age, marital status, tumors and pre-operative infections, only phase angle remained as a prognostic factor (RR=4.3; CI95% 1.6–11.8 for phase angle <−0.8 sd), while the other nutritional variables lost their association with post-operative complications.

From the study it was concluded that Phase angle remains an important prognostic factor for postoperative complications, even after adjusting for other individual predictors and confounders.

PrognostiCheck® device measures Phase Angle and the values derived from Phase Angle are associated with improvement, disease progression and treatment efficacy and the timing of non-acute death.

Tags: Bioelectrical impedance Analysis, phase angle values, post-operative complications

Bioelectrical Impedance Phase Angle Changes During Hydration and Prognosis in Advanced Cancer

Here is an abstract from the study that was conducted to determine whether bioelectrical impedance (BIA) correlates before hydration or changes during hydration and determine if these changes were prognostically important.

Fifty eligible patients underwent BIA measurements 3 consecutive days. Laboratory studies (electrolytes, creatinine, and hemoglobin) on day 1; weights and vital signs were recorded. Kaplan-Meier survival estimates were made at 30 and 60 days. Hazard ratios (HRs) based on Cox proportional hazards model were calculated.

Results. Weight loss was associated with shorter survival. A higher phase angle (PA) on day 1 predicted longer survival. Increased PA during hydration predicted shorter survival: increased weight during hydration predicted longer survival.

Discussion. Higher phase angle before hydration predicts poorer survival and, paradoxically, an increase in phase angle during hydration predicted poorer survival and preexisting intracellular dehydration, cachexia, or poor membrane function.

Conclusions. Phase angle and weight during hydration predict survival in cancer.

PrognostiCheck® illustrates the timing of death to support end-of-life discussions,treatment options and the transition to palliative and hospice care.

Phase angle determined by PrognostiCheck® detects changes in tissue electrical properties and is a reliable and objective prognostic indicator in several chronic conditions.

Tags: Advanced Cancer Prognosis, effectiveness of treatment, Phase Angle, Treatment and Prognosis

Phase Angle predicts survival in haemodialysis patients

Phase angle is clearly associated with prognosis and survival as a powerful independent variable.

The higher the value of phase angle generally the healthier the subject indicating the ratio of cells and water is balanced and that the ability of the plasma cell membrane to hold the electrical signal is good.

PrognostiCheck® device measures Phase Angle and the values derived from Phase Angle are associated with improvement, disease progression and treatment efficacy and the timing of non-acute death.

Here is an abstract from the study that was conducted by Chertow GM, to determine the relation between phase angle by bioelectrical impedance analysis (BIA) and survival in haemodialysis patients.

The study was conducted on Three thousand nine adult patients on thrice weekly hemodialysis. Patients with amputations above the transmetatarsal site were excluded from participation.

Mean phase angle was 4.8 ± 1.8 degrees. Patients with narrow (low) phase angle experienced an increased relative risk (RR) of death (<3 degrees; RR 4.3; 95% confidence interval [Cl], 2.9–6.2; and 3 to 4 degrees); RR 2.2; 95% Cl, 1.6–3.2; compared with the ≥6 degrees reference). There were no significant differences in risk among patients with phase angle 4 to 5 degrees (RR 1.2; 95% Cl, 0.8–1.8), 5 to 6 degress (RR 1.1; 95% Cl, 0.7–1.7), and ≥6 degrees, suggesting a nonlinear relation between phase angle and survival. The RRs for phase angle <4 degrees remained statistically significant after adjusting for age, gender, race, serum albumin and creatinine concentrations, and dialysis intensity (<3 degrees, RR 2.2; 95% Cl, 1.6–3.1, and 3 to 4 degrees, RR 1.3; 95% Cl, 1.0–1.7, compared with all patients ≥4 degrees).

From the study it was concluded that In patients on hemodialysis, BIA-derived phase angle <4 degrees was associated with an increased RR of death, even after adjustment for case mix and several nutritional indicators.

Tags: disease progression, Disease severity, effectiveness of treatment, phase angle values, survival in haemodialysis patients

Bioelectrical phase angle values in a clinical sample of ambulatory rehabilitation patients

Phase angle is derived from the resistance(R) and reactance(Xc) measurements obtained from bioelectric impedance analysis (BIA) and is considered indicative of cellular health and membrane integrity.

PrognostiCheck® is a noninvasive measurement that uses a well-established vascular diagnostic technique to measure the values of resistance (R) and Reactance (Xc) and calculate phase angle . Phase angle is clearly associated with prognosis and survival as a powerful independent variable.

Here is an Abstract from a study conducted by Simon M Gunn that measured phase angle values of rehabilitation patients and compared them to reference values, measures of functional ability and serum C-reactive protein (CRP) levels to explore their utility as a clinical tool to monitor disease progression and treatment efficacy.

The study was conducted on 215 ambulatory rehabilitation patients aged 20 – 94 years. All participants had been hospitalized for a stroke, orthopedic or other condition resulting in a functional limitation. PhA was derived from BIA analysis and functional ability characterized using the Functional Independence Measure (FIM), timed up and go (TUG) and maximal quadriceps strength (MQS). Serum levels of CRP were also collected.

Stroke patients had the highest PhA (5.3°) followed by elective orthopedic surgery (5.0°) with the other group (4.3°) significantly lower than both previous categories (p < 0.001). Ambulatory rehabilitation patients' PhA values were dependent on age and sex (p < 0.001), lower than published age matched healthy reference values (p ≤ 0.05) and similar to other hospitalized or sick groups, but also higher than values reported in critically ill patients. Patients with CRP values less than 10 mg.L-1 had significantly (p = 0.005) higher mean PhA values. Furthermore, the highest functional status quartiles had significantly higher PhAs (p ≤ 0.04) for the FIM, MQS and TUG measures.

The results suggest that the phase angles of rehabilitation patients are between those of healthy individuals and seriously ill patients, thereby supporting claims that phase angle is indicative of general health status.

Phase angles are a potentially useful indicator of functional status in patients commencing an ambulatory rehabilitation program with a normal hydration status.

Tags: ambulatory rehabilitation patients, BIA Analysis, Phase Angle