Metabolomics for discovery of biomarkers for cystic fibrosis: Towards MS-based primary screening methods with improved positive predictive value

2014 ◽  
Vol 47 (15) ◽  
pp. 143 ◽  
Author(s):  
Alicia DiBattista ◽  
Adriana N. Macedo ◽  
Osama Y. Al-Dirbashi ◽  
Pranesh Chakraborty ◽  
Philip Britz-McKibbin
Keyword(s):  
Cystic Fibrosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Methods ◽  
Primary Screening

Attended With and Head-Turning Sign can be clinical markers of cognitive impairment in older adults

2017 ◽  
Vol 29 (11) ◽  
pp. 1763-1769 ◽  
Author(s):  
Pinar Soysal ◽  
Cansu Usarel ◽  
Gul Ispirli ◽  
Ahmet Turan Isik
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cognitive Assessment ◽  
Screening Methods ◽  
Operating Characteristics ◽  
Head Turning ◽  
Sensitivity Specificity

ABSTRACTBackground:Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI).Methods:Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all.Results:Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (−) patients (p < 0.001). Similar significant findings were obtained in the patients with positive and negative HTS (p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting CI were 92%, 37%, 31.4%, and 93.7%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of HTS were 80%, 64%, 41.8%, and 91.5%, respectively. The area under the receiver-operating characteristics curve was 0.90 for AW and 0.82 for HTS.Conclusion:AW and HTS are fast, simple, effective, and sensitive methods for detecting CI. Therefore, they can be used for older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment.

scholarly journals Comparison Between Normobaric Hypoxia Altitude Simulation Test and Altitude Hypoxia Predictive Equations in Cystic Fibrosis Patients

2019 ◽  
Author(s):  
Christine Costa ◽  
André Barros ◽  
João Valença Rodrigues ◽  
Richard Staats ◽  
Mariana Alves ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Individual Differences ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Healthy Controls ◽  
Simulation Test ◽  
Oxygen Supplementation ◽  
Predictive Equations ◽  
The Individual

AbstractBackground:The Hypoxia Altitude Simulation Test (HAST) is the Gold Standard to evaluate hypoxia in response to altitude and to decide on in-flight requirements for oxygen supplementation. Several equations are available to predict PaO2 in altitude (PaO2alt), but it remains unclear whether their predictive value is equivalent. We aimed to compare the results obtained by the available methods in a population of cystic fibrosis (CF) adults.Methods:Eighty-eight adults (58 healthy controls and 30 CF patients) performed a spirometry followed by an HAST. HAST results were compared with the predicted PaO2alt made by five equations: 1st: PaO2alt= 0,410 x PaO2ground + 1,7652; 2nd: PaO2alt= 0,519 x PaO2ground + 11,855 x FEV1 (L) − 1,760; 3rd: PaO2alt= 0,453 x PaO2ground + 0,386 x FEV1 (%) + 2,44; 4th: PaO2alt= 0,88 + 0,68 x PaO2ground; 5th: PaO2alt= PaO2ground − 26,6.Results:None of the controls required in-flight oxygen neither by HAST or by the five predictive equations. Eleven CF-patients had PaO2alt < 50 mmHg, accessed by HAST. The positive predictive value was 50% (1st), 87.5% (2nd and 3rd), 77.78% (4th) and 58.33% (5th). Areas under the curve were 78.95% (1st), 84.69% (2nd), 88.04% (3rd) and 78.95% (4th and 5th). FEV1 and PaO2ground were correlated with HAST results.Conclusions:The 3rd equation gave the best predictions in comparison with results obtained by HAST. However, because the individual differences found were substantial for all equations, we still recommend performing a HAST whenever possible to confidently access in-flight hypoxia and the need for oxygen.

scholarly journals Optimization of the French cystic fibrosis newborn screening programme by a centralized tracking process

2017 ◽  
Vol 25 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Anne Munck ◽  
Dominique Delmas ◽  
Marie-Pierre Audrézet ◽  
Lydie Lemonnier ◽  
David Cheillan ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Positive Predictive Value ◽  
Newborn Screening ◽  
Predictive Value ◽  
Screening Strategy ◽  
Sweat Test ◽  
Initial Visit ◽  
Tracking Process ◽  
Monitoring Process ◽  
European Standards

Objectives To evaluate the French cystic fibrosis newborn screening algorithm, based on data tracked by a centralized monitoring process, from 2002 to 2014. The programme aimed to attain European Standards in terms of positive predictive value, sensitivity, the ratio of screen positive patients diagnosed with cystic fibrosis to infants who screen positive but with inconclusive diagnosis (CFSPID), and time to diagnosis. Methods Retrospective analysis of programme performance, compliance with the algorithm, and changes in screening strategy. Results Modifications in the flow chart protocol improved the positive predictive value to 0.31 while maintaining the sensitivity at 0.95. Among infants diagnosed with cystic fibrosis, or identified as CFSPID, sweat test results were obtained for 94%, and two mutations were identified after exhaustive screening for the gene, when applicable, in 99.6%. The rate of pending diagnosis was very low (0.5%). The ratio of infants with cystic fibrosis:CFSPID was 6.3:1. Age at initial visit at the CF centre was ≤ 35 days, respectively, in 53%/26%. Conclusion Performances were in agreement with European standards, but timeliness of initial visit needed improvement. Our data complement an accumulating body of evidence demonstrating that attention must be paid to such ethical considerations as limiting carrier detection and inconclusive diagnosis. Newborn screening programmes should have a rigorous centralized monitoring process to warrant adjustments for improving performance to attain consensus guidelines.

Positive Predictive Value Surfaces as a Complementary Tool to Assess the Performance of Virtual Screening Methods

2020 ◽  
Vol 20 (14) ◽  
pp. 1447-1460
Author(s):  
Juan F. Morales ◽  
Sara Chuguransky ◽  
Lucas N. Alberca ◽  
Juan I. Alice ◽  
Sofía Goicoechea ◽  
...  
Keyword(s):  
Virtual Screening ◽  
Positive Predictive Value ◽  
Ensemble Learning ◽  
Predictive Value ◽  
Experimental Testing ◽  
Screening Tools ◽  
Screening Methods ◽  
Learning Approaches ◽  
Classification Problems ◽  
Screening Experiments

Background: Since their introduction in the virtual screening field, Receiver Operating Characteristic (ROC) curve-derived metrics have been widely used for benchmarking of computational methods and algorithms intended for virtual screening applications. Whereas in classification problems, the ratio between sensitivity and specificity for a given score value is very informative, a practical concern in virtual screening campaigns is to predict the actual probability that a predicted hit will prove truly active when submitted to experimental testing (in other words, the Positive Predictive Value - PPV). Estimation of such probability is however, obstructed due to its dependency on the yield of actives of the screened library, which cannot be known a priori. Objective: To explore the use of PPV surfaces derived from simulated ranking experiments (retrospective virtual screening) as a complementary tool to ROC curves, for both benchmarking and optimization of score cutoff values. Methods: The utility of the proposed approach is assessed in retrospective virtual screening experiments with four datasets used to infer QSAR classifiers: inhibitors of Trypanosoma cruzi trypanothione synthetase; inhibitors of Trypanosoma brucei N-myristoyltransferase; inhibitors of GABA transaminase and anticonvulsant activity in the 6 Hz seizure model. Results: Besides illustrating the utility of PPV surfaces to compare the performance of machine learning models for virtual screening applications and to select an adequate score threshold, our results also suggest that ensemble learning provides models with better predictivity and more robust behavior. Conclusion: PPV surfaces are valuable tools to assess virtual screening tools and choose score thresholds to be applied in prospective in silico screens. Ensemble learning approaches seem to consistently lead to improved predictivity and robustness.

Testing Cervicography and Cervicoscopy as Screening Tests for Cervical Cancer

1993 ◽  
Vol 79 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Silvia Cecchini ◽  
Rita Bonardi ◽  
Antonia Mazzotta ◽  
Grazia Grazzini ◽  
Anna Iossa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Test ◽  
Detection Rate ◽  
Pap Test ◽  
Cost Effective ◽  
Screening Tests ◽  
Screening Methods ◽  
Abnormal Cytology

Aims and Background Suboptimal sensitivity is currently reported for Pap test in screening for cervical cancer. Colposcopy is known to be more sensitive than cytology but its use as a screening test is not possible due to costs and complexity. Screening by cervicography has been suggested as a compromise being less costly and feasible. The present study evaluates the feasibility of screening by cervicography and cervicoscopy (naked eye examination of the cervix after acetic acid lavage) on a consecutive screening series. Methods Cervicography and cervicoscopy were performed by the smear taker in subjects consecutively attending a screening clinic. Women with abnormal cytology (atypia or more severe lesion) and/or abnormal cervicography or cervicoscopy (acetowhite lesion) underwent colposcopic assessment. The three screening methods were compared according to positivity rate, CIN 2-3 detection rate and positive predictive value. Results 2105 consecutive subjects were screened. Positivity rate was 3.8 %, 15.3 % or 25.4 % for cytology, cervicography or cervicoscopy, respectively, 486 of 555 women attended the assessment phase, 281 directed biopsies were performed and 8 CIN 2-3 lesions were detected. Cytology, cervicography and cervicoscopy, detected 5.5, or 7 of 8 CIN 2-3 lesions, respectively. The positive predictive value was 0% for cytologic atypia, 25 % for cytologic SIL, 1.75 % for cervicography and 2.05% for cervicoscopy. Detecting one CIN 2-3 lesion at cytology cost $ 5,543. The cost per each additional cytologically negative CIN 2-3 lesion detected at cervicography or cervicoscopy was $ 12,947 or $ 3,916, respectively. Conclusions The study confirms the limited sensitivity of cytology for CIN 2-3. The association of cervicography was not cost effective. Cervicoscopy was poorly specific but increased the detection rate of CIN 2-3 at relatively low costs. Cervicoscopy is worth further evaluation as a screening test.

Diagnosis of cerebral hemorrhage before the era of computed tomography

2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Hemorrhagic Stroke ◽  
Cranial Computed Tomography ◽  
Cerebral Stroke ◽  
Daily Routine ◽  
Stroke Patients ◽  
The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

VALUE OF COMBINATION OF HAP SCORE AND BISAP SCORE IN PREDICTING SEVERITY IN PATIENTS OF ACUTE PANCREATITIS

2019 ◽  
pp. 96-100
Author(s):  
Thi Ngoc Suong Le ◽  
Pham Chi Tran ◽  
Van Huy Tran
Keyword(s):  
Acute Pancreatitis ◽  
Positive Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Prognostic Value ◽  
Acute Inflammation ◽  
Clinical Symptoms ◽  
Mortality Rates ◽  
Multiple Organ ◽  
Central Hospital

Acute pancreatitis (AP) is an acute inflammation of the pancreas, usually occurs suddenly with a variety of clinical symptoms, complications of multiple organ failure and high mortality rates. Objectives: To determine the value of combination of HAP score and BISAP score in predicting the severity of acute pancreatitis of the Atlanta 2012 Classification. Patients and Methods: 75 patients of acute pancreatitis hospitalized at Hue Central Hospital between March 2017 and July 2018; HAP and BISHAP score is calculated within the first 24 hours. The severity of AP was classified by the revised Atlanta criteria 2012. Results: When combining the HAP and BISAP scores in predicting the severity of acute pancreatitis, the area under the ROC curve was 0,923 with sensitivity value was 66.7%, specificity value was 97.1%; positive predictive value was 66.7%, negative predictive value was 97.1%. Conclusion: The combination of HAP and BISAP scores increased the sensitivity, predictive value, and prognostic value in predicting the severity of acute pancreatitis of the revised Atlanta 2012 classification in compare to each single scores. Key words: HAPscore, BiSAP score, acute pancreatitis, predicting severity

scholarly journals Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

2010 ◽  
Vol 4 ◽  
pp. CMC.S3864 ◽  
Author(s):  
M. Wehrschuetz ◽  
E. Wehrschuetz ◽  
H. Schuchlenz ◽  
G. Schaffler
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Potential ◽  
Coronary Artery Stenoses ◽  
Artery Disease ◽  
Msct Angiography

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.

Sign in / Sign up

Export Citation Format

Share Document