scholarly journals Prognosemodelle für Beckenbodenschäden im Vergleich von Vaginalgeburt und Sectio

2020 ◽  
Vol 53 (12) ◽  
pp. 800-805
Author(s):  
Cornelia Betschart ◽  
Roland Zimmermann
Keyword(s):  
Body Mass Index ◽  
Receiver Operating Characteristic ◽  
Body Mass ◽  
Operating Characteristic ◽  
Levator Ani ◽  
Mütterliches Alter ◽  
Receiver Operating

ZusammenfassungMehr als die Hälfte der Primiparae berichten ein Jahr nach der Geburt über Veränderungen am Beckenboden. Symptome sind Harn- oder Stuhlinkontinenz, Missempfindungen, Laxität oder Senkungsgefühl am Beckenboden. Zugrunde liegende Schädigungen können muskulärer Art (M. levator ani oder M. sphincter ani) oder ligamentärer Art sein. Risikofaktoren für Beckenbodentraumata sind höheres mütterliches Alter, eine protrahierte Austreibungsphase, Forzepsgeburt, okzipitoposteriore Einstellung und ein Dammriss III und IV°. Abgesehen vom mütterlichen Alter sind die Risikofaktoren jedoch präpartal nicht bekannt, und diese Lücke wollen Prädiktionsmodelle schließen. Das erste Prädiktionsmodell trägt den Namen UR-CHOICE. Basierend auf epidemiologischen Langzeitdaten aus den Datenbanken ProLong (UK und Neuseeland) und SWEPOP (Schweden) werden für verschiedene Parameter wie dem mütterlichen Alter, dem Body-Mass-Index (BMI), der Anzahl gewünschter Kinder und der Familienanamnese für Inkontinenz Risikogewichte etabliert, welche in der Kombination eine Prozentzahl für Urin‑, Stuhlinkontinenz und Genitaldeszensus liefern. Das zweite Modell, das „Capacity-Demand-Modell“, integriert objektive Daten aus der Bildgebung, nämlich den kindlichen Kopfumfang und den Umfang des M. levator ani, um mit einer Zuverlässigkeit von 0,8 in der Receiver-Operating-Characteristic(ROC)-Kurve ein schweres Levator-ani-Muskeltrauma vorauszusagen.

scholarly journals Preoperative Ultrasonography Is Unreliable in Predicting Hamstring Tendon Graft Diameter for ACL Reconstruction

2018 ◽  
Vol 6 (1) ◽  
pp. 232596711774614 ◽  
Author(s):  
Amit M. Momaya ◽  
Clint Beicker ◽  
Paul Siffri ◽  
Michael J. Kissenberth ◽  
Jeffrey Backes ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Receiver Operating Characteristic ◽  
Acl Reconstruction ◽  
Body Mass ◽  
Operating Characteristic ◽  
Hamstring Tendons ◽  
Graft Size ◽  
The Mean ◽  
Graft Diameter ◽  
Receiver Operating

Background: Hamstring autograft size <8 mm has been shown to be a predictor for failure after anterior cruciate ligament (ACL) reconstruction. The ability to predict graft size preoperatively is helpful in counseling patients about the possible need for graft augmentation. Purpose: To determine whether preoperative ultrasound (US) measurements of hamstring tendons can predict intraoperative graft diameter during ACL reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Twenty patients undergoing unilateral isolated ACL reconstruction were prospectively enrolled in the study (10 males, 10 females; mean ± SD age, 22.8 ± 6.6 years; height, 175.1 ± 7.1 cm; weight, 81.4 ± 14.2 kg; body mass index, 26.5 ± 4.1 kg/m2). Hamstrings were assessed by US, and double-looped semitendinosus-gracilis hamstring size was independently calculated with a freehand selection method on a nonmagnified US image by 2 orthopaedic surgeons. Intraoperative autograft size was determined with a standard graft-sizing tool. Intra- and interrater reliability was measured with intraclass correlation coefficients (ICCs) and standard error of the measure (SEM). A receiver operating characteristic curve was calculated to assess the ability of the US measurement to predict intraoperative measurements. Results: The mean autograft diameter by US was 8.9 ± 0.98 mm, while the mean intraoperative hamstring graft size was 8.1 ± 0.89 mm. There was excellent intrarater (ICC2,1 = 0.95, SEM = 0.32 mm) and interrater (ICC2,1 = 0.88, SEM = 0.55 mm) reliability for US measurements. Receiver operating characteristic analysis showed that US did not consistently quantify graft size. Graft size did not significantly correlate with height, weight, or body mass index in our sample ( P > .05). Conclusion: These results suggest that preoperative US imaging of the hamstring tendons is unreliable in predicting intraoperative graft diameter.

scholarly journals Targeting Hypertension Screening in Low‐ and Middle‐Income Countries: A Cross‐Sectional Analysis of 1.2 Million Adults in 56 Countries

2021 ◽  
Author(s):  
Tabea K. Kirschbaum ◽  
Michaela Theilmann ◽  
Nikkil Sudharsanan ◽  
Jennifer Manne‐Goehler ◽  
Julia M. Lemp ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Body Mass ◽  
Operating Characteristic ◽  
Smoking Status ◽  
Characteristic Curve ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Background As screening programs in low‐ and middle‐income countries (LMICs) often do not have the resources to screen the entire population, there is frequently a need to target such efforts to easily identifiable priority groups. This study aimed to determine (1) how hypertension prevalence in LMICs varies by age, sex, body mass index, and smoking status, and (2) the ability of different combinations of these variables to accurately predict hypertension. Methods and Results We analyzed individual‐level, nationally representative data from 1 170 629 participants in 56 LMICs, of whom 220 636 (18.8%) had hypertension. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or reporting to be taking blood pressure–lowering medication. The shape of the positive association of hypertension with age and body mass index varied across world regions. We used logistic regression and random forest models to compute the area under the receiver operating characteristic curve in each country for different combinations of age, body mass index, sex, and smoking status. The area under the receiver operating characteristic curve for the model with all 4 predictors ranged from 0.64 to 0.85 between countries, with a country‐level mean of 0.76 across LMICs globally. The mean absolute increase in the area under the receiver operating characteristic curve from the model including only age to the model including all 4 predictors was 0.05. Conclusions Adding body mass index, sex, and smoking status to age led to only a minor increase in the ability to distinguish between adults with and without hypertension compared with using age alone. Hypertension screening programs in LMICs could use age as the primary variable to target their efforts.

scholarly journals Visceral adiposity index performed better than traditional adiposity indicators in predicting unhealthy metabolic phenotype among Chinese children and adolescents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yangyang Dong ◽  
Ling Bai ◽  
Rongrong Cai ◽  
Jinyu Zhou ◽  
Wenqing Ding
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Receiver Operating Characteristic ◽  
Body Mass ◽  
Operating Characteristic ◽  
Normal Weight ◽  
Visceral Adiposity ◽  
Metabolic Phenotype ◽  
Visceral Adiposity Index ◽  
Adiposity Index

AbstractThe relationship between visceral adiposity index (VAI) and unhealthy metabolic phenotype remained unclear in children and adolescents. This study aimed to investigate their association and compared the ability of VAI and traditional adiposity indicators (body mass index, waist circumference and waist-to-height ratio) to predict metabolically unhealthy phenotype among normal-weight, overweight and obese children and adolescents. In this cross-sectional study, 1722 children and adolescents aged 12–18 years were selected by cluster random sampling, underwent a questionnaire survey, physical examination and biochemical tests. Participants were divided into four phenotypes according to the combination of the weight status determined by body mass index (BMI) and metabolic syndrome components. Receiver operating characteristic (ROC) analysis and multivariate logistic regression were used to compare the predictive capacity between VAI and traditional adiposity indicators and their relationship with metabolically unhealthy phenotype. We found that VAI had better performance in predicting metabolically unhealthy phenotype than traditional adiposity indicators, the area under the receiver-operating characteristic curve (AUC) were 0.808 and 0.763 for boys and girls with normal-weight, 0.829 and 0.816 for boys and girls with overweight and obese (all P < 0.001). VAI was most strongly related to metabolically unhealthy phenotype whether or not to adjust the age, the adjusted OR and 95%CI was 6.15 (4.13–9.14) in boys with normal weight, and 5.90 (3.06–11.36), 4.95 (2.35–10.41) in boys and girls with overweight and obese, respectively (all P < 0.001). Our findings suggested VAI could be used as a comprehensive predictor to identify unhealthy metabolic phenotype in children and adolescents.

Übereinstimmung von klinischer Diagnose, strukturierten Interviews und Selbstbeurteilungsfragebögen bei Depression im Kindes- und Jugendalter

2012 ◽  
Vol 40 (6) ◽  
pp. 405-414 ◽  
Author(s):  
Kathrin Dolle ◽  
Gerd Schulte-Körne ◽  
Nikolaus von Hofacker ◽  
Yonca Izat ◽  
Antje-Kathrin Allgaier
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Kinder Und Jugendliche ◽  
Prädiktive Werte ◽  
Receiver Operating

Fragestellung: Die vorliegende Studie untersucht die Übereinstimmung von strukturierten Kind- und Elterninterviews sowie dem klinischen Urteil bei der Diagnostik depressiver Episoden im Kindes- und Jugendalter. Zudem prüft sie, ob sich die Treffsicherheit und die optimalen Cut-off-Werte von Selbstbeurteilungsfragebögen in Referenz zu diesen verschiedenen Beurteilerperspektiven unterscheiden. Methodik: Mit 81 Kindern (9–12 Jahre) und 88 Jugendlichen (13–16 Jahre), die sich in kinder- und jugendpsychiatrischen Kliniken oder Praxen vorstellten, und ihren Eltern wurden strukturierte Kinder-DIPS-Interviews durchgeführt. Die Kinder füllten das Depressions-Inventar für Kinder und Jugendliche (DIKJ) aus, die Jugendlichen die Allgemeine Depressions-Skala in der Kurzform (ADS-K). Übereinstimmungen wurden mittels Kappa-Koeffizienten ermittelt. Optimale Cut-off-Werte, Sensitivität, Spezifität sowie positive und negative prädiktive Werte wurden anhand von Receiver operating characteristic (ROC) Kurven bestimmt. Ergebnisse: Die Interviews stimmten untereinander sowie mit dem klinischen Urteil niedrig bis mäßig überein. Depressive Episoden wurden häufiger nach klinischem Urteil als in den Interviews festgestellt. Cut-off-Werte und Validitätsmaße der Selbstbeurteilungsfragebögen variierten je nach Referenzstandard mit den schlechtesten Ergebnissen für das klinische Urteil. Schlussfolgerungen: Klinische Beurteiler könnten durch den Einsatz von strukturierten Interviews profitieren. Strategien für den Umgang mit diskrepanten Kind- und Elternangaben sollten empirisch geprüft und detailliert beschrieben werden.

Sign in / Sign up

Export Citation Format

Share Document