scholarly journals Monitoring the Burden of Seizures and Highly Epileptiform Patterns in Critical Care with a Novel Machine Learning Method

2020 ◽  
Author(s):  
Baharan Kamousi ◽  
Suganya Karunakaran ◽  
Kapil Gururangan ◽  
Matthew Markert ◽  
Barbara Decker ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Seizure Activity ◽  
Epileptiform Activity ◽  
High Sensitivity ◽  
Machine Learning Method ◽  
High Negative Predictive Value ◽  
Majority Consensus ◽  
Eeg Recordings

Abstract Introduction Current electroencephalography (EEG) practice relies on interpretation by expert neurologists, which introduces diagnostic and therapeutic delays that can impact patients’ clinical outcomes. As EEG practice expands, these experts are becoming increasingly limited resources. A highly sensitive and specific automated seizure detection system would streamline practice and expedite appropriate management for patients with possible nonconvulsive seizures. We aimed to test the performance of a recently FDA-cleared machine learning method (Claritγ, Ceribell Inc.) that measures the burden of seizure activity in real time and generates bedside alerts for possible status epilepticus (SE). Methods We retrospectively identified adult patients (n = 353) who underwent evaluation of possible seizures with Rapid Response EEG system (Rapid-EEG, Ceribell Inc.). Automated detection of seizure activity and seizure burden throughout a recording (calculated as the percentage of ten-second epochs with seizure activity in any 5-min EEG segment) was performed with Claritγ, and various thresholds of seizure burden were tested (≥ 10% indicating ≥ 30 s of seizure activity in the last 5 min, ≥ 50% indicating ≥ 2.5 min of seizure activity, and ≥ 90% indicating ≥ 4.5 min of seizure activity and triggering a SE alert). The sensitivity and specificity of Claritγ’s real-time seizure burden measurements and SE alerts were compared to the majority consensus of at least two expert neurologists. Results Majority consensus of neurologists labeled the 353 EEGs as normal or slow activity (n = 249), highly epileptiform patterns (HEP, n = 87), or seizures [n = 17, nine longer than 5 min (e.g., SE), and eight shorter than 5 min]. The algorithm generated a SE alert (≥ 90% seizure burden) with 100% sensitivity and 93% specificity. The sensitivity and specificity of various thresholds for seizure burden during EEG recordings for detecting patients with seizures were 100% and 82% for ≥ 50% seizure burden and 88% and 60% for ≥ 10% seizure burden. Of the 179 EEG recordings in which the algorithm detected no seizures, seizures were identified by the expert reviewers in only two cases, indicating a negative predictive value of 99%. Discussion Claritγ detected SE events with high sensitivity and specificity, and it demonstrated a high negative predictive value for distinguishing nonepileptiform activity from seizure and highly epileptiform activity. Conclusions Ruling out seizures accurately in a large proportion of cases can help prevent unnecessary or aggressive over-treatment in critical care settings, where empiric treatment with antiseizure medications is currently prevalent. Claritγ’s high sensitivity for SE and high negative predictive value for cases without epileptiform activity make it a useful tool for triaging treatment and the need for urgent neurological consultation.

Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Oligoclonal Bands ◽  
High Negative Predictive Value ◽  
Csf Oligoclonal Bands ◽  
Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

scholarly journals CHRONIC VULVAL SYMPTOMS: COMPARISON OF VARIOUS DIAGNOSTIC METHODS

2021 ◽  
Vol 9 (02) ◽  
pp. 310-314
Author(s):  
Akanksha Sharma ◽  
◽  
Saritha Shamsunder ◽  
Niti Khunger ◽  
Geetika Khanna ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Predictive Value ◽  
Diagnostic Methods ◽  
Neoplastic Lesions ◽  
High Negative Predictive Value ◽  
Diagnostic Modalities ◽  
Scrape Cytology

The aim of our study was to compare the various diagnostic modalities for evaluation of chronic vulval symptoms. We studied 100 women presenting with chronic vulval symptoms who underwent examination of vulva with low magnification, scrape cytology, colposcopy & directed biopsy. The overall sensitivity and specificity for detecting vulvar lesions was 29.87% and 100% with low magnification 58.44% and 13.04% with cytology 77.92 % and 17.39 % with colposcopy. We concluded that clinical examination with or without magnification can detect most of the neoplastic lesions. Colposcopy and cytology have high negative predictive value and provide reassurance in absence of disease.

scholarly journals Sensitivity and Specificity of Sheard and Percival’s Criteria for the Diagnosis of Young People with Near-heterophoria

2021 ◽  
Vol 9 (B) ◽  
pp. 1128-1134
Author(s):  
Saif Hassan Alrasheed ◽  
Amel Mohamed Yousif ◽  
Majid A. Moafa ◽  
Abd Elaziz Mohamed Elmadina ◽  
Mohammad Alobaid
Keyword(s):  
Young People ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Binocular Vision ◽  
Predictive Value ◽  
High Sensitivity ◽  
The Other ◽  
Cross Sectional ◽  
Predictive Values ◽  
Low Sensitivity

BACKGROUND: Sheard and Percival assumed that symptoms from latent strabismus can be avoided if the relevant fusional vergence is adequate to support the heterophoria. AIM: The aim of the study was to determine the sensitivity and specificity of Sheard’s and Percival’s criterion for the diagnosis of heterophoria. METHODS: A cross-sectional hospital-based study was performed at Al-Neelain Eye Hospital Khartoum, Sudan from February to October 2019. Heterophoria was measured using Maddox Wing and fusional vergence using a prism bar. Thereafter, Sheard’s and Percival’s criteria were used for the diagnosis of heterophoria. RESULTS: A total of 230 participants (age = 15–30 years; mean age = 19.34 ± 3.325 years) were recruited for this study. The Sheard’s criteria showed a high sensitivity of 87.2% and a low specificity of 8.0% for the diagnosing of exophoria, with positive and negative predictive values of 65.5% and 26%, respectively. The criteria showed a relatively low sensitivity of 77.8% and a specificity of 9.0% in the diagnosis of esophoria, with a positive and negative predictive values of 56% and 20%, respectively. Percival criteria showed high sensitivity 84.2% and low specificity 9.1% in diagnosing esophoria, with a positive and negative predictive value of 61.5% and 25%, respectively. On the other hand, the criteria showed low sensitivity 67.4% and specificity 13.8% in diagnosing exophoria, with positive and negative predictive value 61.9% and 17%, respectively. CONCLUSION: Sheard’s and Percival’s criteria are useful in diagnosing binocular vision problems. Sheard’s criteria are accurate in diagnosing near exophoria and Percival’s criteria are more accurate in diagnosing near esophoria. Therefore, these criteria provide good clues and predictions for the diagnosis of binocular vision problems.

scholarly journals Sensitivity and Specificity of Gene Xpert in the Diagnosis of Spinal Tuberculosis: A Prospective Controlled Clinical Study

2019 ◽  
Vol 10 (5) ◽  
pp. 553-558
Author(s):  
Anil M. Solanki ◽  
Saumyajit Basu ◽  
Amitava Biswas ◽  
Subhendu Roy ◽  
Aditya Banta
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Spinal Tuberculosis ◽  
False Negative ◽  
High Sensitivity ◽  
Control Group ◽  
Surgical Biopsy ◽  
True Negative

Study Design: Prospective matched cohort study Objective: To evaluate the sensitivity and specificity of Gene Xpert in the diagnosis of spinal tuberculosis. Methods: From January 2016 to August 2018, Gene Xpert results were prospectively studied in 68 patients of clinicoradiologically suspected spinal tuberculosis (STB) and a control group (CG) of 92 patients, all of whom underwent computed tomography–guided/C-arm-guided/open surgical biopsy. Sensitivity, specificity, positive predictive value, and negative predictive value are obtained using standard equations. Results: Out of 68 cases of STB, Gene Xpert was positive in 62 (true positive: 62/68) and negative in 6 (false negative: 6/68). Gene Xpert was negative for all 92 cases of CG (true negative: 92/92, false positive 0/92). Thus, in our series, sensitivity of Gene Xpert is 91.18%, specificity is 100%, positive predictive value is 100%, and negative predictive value is 93.88%. Out of all cases of STB, 62/68 (91.18%) were Gene Xpert positive, but only 35/64 (54.69%) was acid-fast bacilli (AFB) culture positive and 53/60(88.33%) was histopathologically conclusive of TB. Also, Gene Xpert was positive in 7/7 (100%) cases of STB in which histopathology were inconclusive and 25/29 (86.21%) cases of STB in which AFB culture was negative. Conclusion: In STB, Gene Xpert clearly outperforms AFB culture and histopathology due to its high sensitivity and specificity apart from being rapid in diagnosis. Hence it is justified to diagnose spinal tuberculosis by Gene Xpert though histopathology is confirmative and AFB culture remains the gold standard.

scholarly journals The sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard

10.17158/522 ◽  
2016 ◽  
Vol 19 (2) ◽  
Author(s):  
John Mark De Real
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Malaria Parasite ◽  
High Sensitivity ◽  
Significant Difference

<p>The main objective of this study was to test the sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard. Data were acquired from blood mass survey of malaria infection conducted in the community of Paquibato district, Davao City. There were 377 total participants examined through Rapid Diagnostic Test (RDT) and slide microscopy. Of the 377 participants tested, 16 (4.24%) of them were positive to Plasmodium falciparum and 68 (18.04%) were positive to Plasmodium vivax using slide microscopy. Of the 16 participants’ positive for P. faciparum, PfRDT (HRP-2) correctly identified 13 expressing 81.25% (low) sensitivity of the tool. Of the 68 participants’ positive for P. vivax, PvRDT (pLDH) correctly identified 65 expressing 95.59% (high) sensitivity. Both of the RDTs (HRP-2 and pLDH), however, attained 100% specificity. PfRDT (HRP-2) has a positive predictive value of 100% and a negative predictive value of 99.2%, likewise PvRDT (pLDH) has a positive predictive value of 100% and a negative predictive value of 99.04%, all in all, suggesting a high degree of reliability of SD BIOLINE Malaria Antigen P.f/P.v. the data showed no significant difference on the performance level of RDT, albeit less sensitive, compared to slide microscopy.</p><p><strong>Keywords:</strong> Health, malaria, sensitivity, specificity, HRP-2, pLDH, descriptive Davao City, Philippines.</p><div> </div>

scholarly journals Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

2021 ◽  
Vol 10 (4) ◽  
pp. 729 ◽  
Author(s):  
Giuseppe Boriani ◽  
Pietro Palmisano ◽  
Vincenzo Livio Malavasi ◽  
Elisa Fantecchi ◽  
Marco Vitolo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Lower Sensitivity ◽  
Single Time ◽  
High Negative Predictive Value ◽  
Low Sensitivity ◽  
Single Time Point ◽  
Time Point

Our aim was to assess the prevalence of unknown atrial fibrillation (AF) among adults during single-time point rhythm screening performed during meetings or social recreational activities organized by patient groups or volunteers. A total of 2814 subjects (median age 68 years) underwent AF screening by a handheld single-lead ECG device (MyDiagnostick). Overall, 56 subjects (2.0%) were diagnosed with AF, as a result of 12-lead ECG following a positive/suspected recording. Screening identified AF in 2.9% of the subjects ≥ 65 years. None of the 265 subjects aged below 50 years was found positive at AF screening. Risk stratification for unknown AF based on a CHA2DS2VASc > 0 in males and >1 in females (or CHA2DS2VA > 0) had a high sensitivity (98.2%) and a high negative predictive value (99.8%) for AF detection. A slightly lower sensitivity (96.4%) was achieved by using age ≥ 65 years as a risk stratifier. Conversely, raising the threshold at ≥75 years showed a low sensitivity. Within the subset of subjects aged ≥ 65 a CHA2DS2VASc > 1 in males and >2 in females, or a CHA2DS2VA > 1 had a high sensitivity (94.4%) and negative predictive value (99.3%), while age ≥ 75 was associated with a marked drop in sensitivity for AF detection.

FDG-PET in Hodgkin lymphoma

2008 ◽  
Vol 47 (06) ◽  
pp. 235-238 ◽  
Author(s):  
M. Dietlein ◽  
C. Mauz-Körholz ◽  
A. Engert ◽  
P. Borchmann ◽  
O. Sabri ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Study Groups ◽  
Therapy Control ◽  
German Study ◽  
High Negative Predictive Value ◽  
Consolidation Radiotherapy

SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.

scholarly journals Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

2021 ◽  
Vol 18 (12) ◽  
pp. 6606
Author(s):  
Jolanta Nawrocka-Rutkowska ◽  
Iwona Szydłowska ◽  
Aleksandra Rył ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Pelvic Pain ◽  
Predictive Value ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
History Of Surgery ◽  
Previous Surgery ◽  
History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

scholarly journals Screening for aneurysms of the abdominal aorta using a simple screening device

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
J. W. Brakel ◽  
T. A. Berendsen ◽  
P. M. C. Callenbach ◽  
J. van der Burgh ◽  
R. J. Hissink ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Abdominal Aorta ◽  
Predictive Value ◽  
Cost Effective ◽  
Abdominal Ultrasound ◽  
Predictive Values ◽  
Bladder Scan ◽  
Health Council ◽  
Screening Device

Abstract Introduction Several countries advocate screening for aneurysms of the abdominal aorta (AAA) in selected patients. In the Netherlands, routine screening is currently under review by the National Health Council. In any screening programme, cost-efficiency and accuracy are key. In this study, we evaluate the Aorta Scan (Verathon, Amsterdam, Netherlands), a cost-effective and easy-to-use screening device based on bladder scan technology, which enables untrained personnel to screen for AAA. Methods We subjected 117 patients to an Aorta Scan and compared the results to the gold standard (abdominal ultrasound). We used statistical analysis to determine sensitivity and specificity of the Aorta Scan, as well as the positive and negative predictive values, accuracy, and inter-test agreement (Kappa). Results Sensitivity and specificity were 0.86 and 0.98, respectively. Positive predictive value was 0.98 and negative predictive value was 0.88. Accuracy was determined at 0.92 and the Kappa value was 0.85. When waist–hip circumferences (WHC) of > 115 cm were excluded, sensitivity raised to 0.96, specificity stayed 0.98, positive and negative predictive value were 0.98 and 0.96, respectively, accuracy to 0.97, and Kappa to 0.94. Conclusion Herein, we show that the Aorta Scan is a cost-effective and very accurate screening tool, especially in patients with WHC below 115 cm, which makes it a suitable candidate for implementation into clinical practice, specifically in the setting of screening selected populations for the presence of AAA.

Sign in / Sign up

Export Citation Format

Share Document