scholarly journals Evaluation of diagnostic accuracy of biomarkers of inborn errors of metabolism in sick neonates: A prospective observational study

2021 ◽  
Vol 10 ◽  
pp. 100707
Author(s):  
N.B. Mathur ◽  
Kaushaki Shankar ◽  
Seema Kapoor ◽  
Bijo Varughese
Keyword(s):  
Observational Study ◽  
Diagnostic Accuracy ◽  
Inborn Errors Of Metabolism ◽  
Prospective Observational Study ◽  
Inborn Errors

scholarly journals Comparing lung ultrasound: extensive versus short in COVID-19 (CLUES): a multicentre, observational study at the emergency department

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048795
Author(s):  
Bram Kok ◽  
Frederik Schuit ◽  
Arthur Lieveld ◽  
Kaoutar Azijli ◽  
Prabath WB Nanayakkara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Lung Ultrasound ◽  
Final Diagnosis ◽  
Likelihood Ratios ◽  
Reverse Transcription Pcr ◽  
Registration Number ◽  
Sensitivity Specificity

BackgroundBedside lung ultrasound (LUS) is an affordable diagnostic tool that could contribute to identifying COVID-19 pneumonia. Different LUS protocols are currently used at the emergency department (ED) and there is a need to know their diagnostic accuracy.DesignA multicentre, prospective, observational study, to compare the diagnostic accuracy of three commonly used LUS protocols in identifying COVID-19 pneumonia at the ED.Setting/patientsAdult patients with suspected COVID-19 at the ED, in whom we prospectively performed 12-zone LUS and SARS-CoV-2 reverse transcription PCR.MeasurementsWe assessed diagnostic accuracy for three different ultrasound protocols using both PCR and final diagnosis as a reference standard.ResultsBetween 19 March 2020 and 4 May 2020, 202 patients were included. Sensitivity, specificity and negative predictive value compared with PCR for 12-zone LUS were 91.4% (95% CI 84.4 to 96.0), 83.5% (95% CI 74.6 to 90.3) and 90.0% (95% CI 82.7 to 94.4). For 8-zone and 6-zone protocols, these results were 79.7 (95% CI 69.9 to 87.6), 69.0% (95% CI 59.6 to 77.4) and 81.3% (95% CI 73.8 to 87.0) versus 89.9% (95% CI 81.7 to 95.3), 57.5% (95% CI 47.9 to 66.8) and 87.8% (95% CI 79.2 to 93.2). Negative likelihood ratios for 12, 8 and 6 zones were 0.1, 0.3 and 0.2, respectively. Compared with the final diagnosis specificity increased to 83.5% (95% CI 74.6 to 90.3), 78.4% (95% CI 68.8 to 86.1) and 65.0% (95% CI 54.6 to 74.4), respectively, while the negative likelihood ratios were 0.1, 0.2 and 0.16.ConclusionIdentifying COVID-19 pneumonia at the ED can be aided by bedside LUS. The more efficient 6-zone protocol is an excellent screening tool, while the 12-zone protocol is more specific and gives a general impression on lung involvement.Trial registration numberNL8497.

scholarly journals Prospective observational study evaluating the predictive value of ankle branchial pressure index on the outcomes of diabetic foot ulcers

2020 ◽  
Vol 7 (7) ◽  
pp. 2352
Author(s):  
Vishnu S. Ravidas ◽  
Samadarsi P. ◽  
Ajayan G.
Keyword(s):  
Wound Healing ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Diabetic Foot ◽  
Prospective Observational Study ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Pressure Index ◽  
Study Participants

Background: The study was conducted to determine the diagnostic accuracy of ankle branchial pressure index (ABPI) in predicting major amputation and duration of wound healing in diabetic foot ulcers.Methods: 105 participants (30-85 years) admitted in general surgery inpatient with diabetic foot ulcers during 18 months were enrolled in the present prospective observational study. Institutional ethics committee approved the study and written informed consent was obtained from all study participants. Data was analyzed using R and the tests of significance were chi square test and ANOVA. Area under curve (AUC) of receiver operator characteristic (ROC) was used to describe the diagnostic accuracy of ABPI. P<0.05 was considered statistically significant.Results: The mean ABPI of study participants was 0.7 with 23.8% participants having normal ABPI. Lower ABPI was associated with longer duration of ulcer healing (p=0.003). All participants with ABPI <0.3 required more than 120 days for wound healing (p<0.001) and required above knee amputation (p<0.001). AUC ROC of ABPI and major amputation is 0.987 with 92.9% sensitivity and 98.9% specificity. Significantly higher proportion of participants with ABPI ≤0.48 underwent major amputation. The AUC of ROC of ABPI on duration of wound healing was 0.953 with 84.9% sensitivity and 98.1% specificity.    Conclusions: ABPI can be used as a routine tool in all patients with diabetic foot ulcers for screening peripheral arterial disease so that the decision for amputation can be made early during diabetic foot ulcers.

scholarly journals Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: A prospective observational study in a primary care setting in Japan

2019 ◽  
Author(s):  
Takashi Akimoto ◽  
Tadashi Kobayashi ◽  
Hiroki Maita ◽  
Hiroshi Osawa ◽  
Hiroyuki Kato
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Fluid Retention ◽  
Hip Pain ◽  
Joint Fluid ◽  
Initial Assessment ◽  
Hip Arthritis ◽  
Imaging Results

Abstract Background Acute hip pain caused by femoral proximal fractures or acute hip arthritis requires imaging for accurate diagnosis. Although pocket-sized ultrasound (PsUS) offers several advantages over other imaging modalities, there is limited information regarding its use in diagnosing femoral proximal fractures or acute hip arthritis. Thus, we aimed to validate the diagnostic accuracy of PsUS for both disorders. Methods In this prospective observational study, outpatients with acute hip pain were diagnosed according to a fixed procedure of the PsUS probe handling. We verified the diagnostic accuracy of PsUS findings (cortical discontinuity and joint fluid retention) and compared it with that of radiography, computed tomography, and magnetic resonance imaging. Results Our study included 52 outpatients (mean age, 78.0 years; female, 88.5%). Of 26 patients diagnosed with femoral proximal fractures, 14 had femoral neck fractures and 12 had femoral trochanteric fractures. Six patients had arthritis. The sensitivity and specificity for identifying cortical discontinuity in femoral proximal fractures were 0.96 and 0.92, respectively, and those for identifying joint fluid retention in acute hip arthritis were 1.00 and 0.65, respectively. The sensitivity for identifying either cortical discontinuity or joint fluid retention in femoral proximal fractures or acute hip arthritis was 0.97. Conclusions Negative PsUS findings of cortical discontinuity and joint fluid retention in the hip are useful for ruling out femoral proximal fractures and acute hip arthritis. PsUS and radiography have comparable diagnostic accuracies, and PsUS could aid in the initial assessment of acute hip pain among the elderly in primary care settings.

scholarly journals Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: A prospective observational study in a primary care setting in Japan

2020 ◽  
Author(s):  
Takashi Akimoto ◽  
Tadashi Kobayashi ◽  
Hiroki Maita ◽  
Hiroshi Osawa ◽  
Hiroyuki Kato
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Fluid Retention ◽  
Hip Pain ◽  
Joint Fluid ◽  
Initial Assessment ◽  
Hip Arthritis ◽  
Imaging Results

Abstract Background Acute hip pain caused by femoral proximal fractures or acute hip arthritis requires imaging for accurate diagnosis. Although pocket-sized ultrasound (PsUS) offers several advantages over other imaging modalities, there is limited information regarding its use in diagnosing femoral proximal fractures or acute hip arthritis. Thus, we aimed to validate the diagnostic accuracy of PsUS for both disorders. Methods In this prospective observational study, outpatients with acute hip pain were diagnosed according to a fixed procedure of the PsUS probe handling. We verified the diagnostic accuracy of PsUS findings (cortical discontinuity and joint fluid retention) and compared it with that of radiography, computed tomography, and magnetic resonance imaging. Results Our study included 52 outpatients (mean age, 78.0 years; female, 88.5%). Of 26 patients diagnosed with femoral proximal fractures, 14 had femoral neck fractures and 12 had femoral trochanteric fractures. The sensitivity and specificity for identifying cortical discontinuity in femoral proximal fractures were 0.96 and 0.92, respectively. The sensitivity for identifying either cortical discontinuity or joint fluid retention in femoral proximal fractures or acute hip arthritis was 0.97. Conclusions Negative PsUS findings of cortical discontinuity and joint fluid retention in the hip are useful for ruling out femoral proximal fractures and acute hip arthritis. PsUS and radiography have comparable diagnostic accuracies, and PsUS could aid in the initial assessment of acute hip pain among the elderly in primary care settings.

Diagnostic accuracy of lateral neck radiography in ruling out supraglottitis: a prospective observational study

2014 ◽  
Vol 32 (5) ◽  
pp. 348-352 ◽  
Author(s):  
Takashi Fujiwara ◽  
Hiroshi Okamoto ◽  
Yasuhiro Ohnishi ◽  
Toshio Fukuoka ◽  
Kazuyuki Ichimaru
Keyword(s):  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Lateral Neck

Diagnostic accuracy of Alvarado, RIPASA and Tzanakis scoring system in acute appendicitis: A prospective observational study

2021 ◽  
pp. 004947552110301
Author(s):  
Pushkar Sharma ◽  
Ankit Jain ◽  
Gomathi Shankar ◽  
Sreerekha Jinkala ◽  
Uday S Kumbhar ◽  
...  
Keyword(s):  
Observational Study ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Prospective Observational Study ◽  
Alvarado Score ◽  
Low Sensitivity ◽  
The Cost ◽  
Diagnostic Scores

Our prospective observational study, enrolling 167 patients undergoing emergency appendicectomy, served to evaluate the Alvarado, Tzanakis and RIPASA diagnostic scores. The latter was found to be a better scoring system because of its higher diagnostic accuracy. At centres with limited expertise in ultrasonography, RIPASA outperforms the Tzanakis score. Although easy to use, the Alvarado score was useful only to ‘rule in’ cases with AA with significant accuracy but at the cost of low sensitivity. It cannot be effectively used in triaging.

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