An Objective Method to Evaluate the Risk of Recurrence and Extension of Dupuytren’s Disease

This study was undertaken to assess the influence of the factors related to Dupuytren’s diathesis on the rates of recurrence and extension of Dupuytren’s disease after surgery. The records of 65 patients who underwent surgery for Dupuytren’s disease were retrospectively studied and the presence of factors related to diathesis were recorded. The sensitivity and specificity of each factor for predicting recurrence and extension were calculated. Odds ratios and 95% confidence intervals were also calculated and a discriminant analysis was performed to explore correlations between recurrence and extension and the significant variables. Our results confirmed the prognostic value of diathesis. The results have been used to develop a new scoring system for evaluating the risk of recurrence and extension.

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The Sensitivity and Specificity of a new Scoring System Using High Resolution Computed Tomography to Diagnose Lung Cancer

Medical Journal of Indonesia ◽

10.13181/mji.v18i3.360 ◽

2009 ◽

pp. 181

Author(s):

Arman A. Abdullah ◽

Nurlela Bujang ◽

Cholid Badril ◽

Chairil Hamdani ◽

Purnawan Junadi ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

High Resolution ◽

Sensitivity And Specificity ◽

Scoring System ◽

High Resolution Computed Tomography ◽

Diagnose Lung Cancer ◽

New Scoring

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Linear discriminant analysis of symptoms in patients with chronic constipation: Validation of a new scoring system (KESS)

Gastroenterology ◽

10.1016/s0016-5085(00)80553-3 ◽

2000 ◽

Vol 118 (4) ◽

pp. A1181 ◽

Cited By ~ 2

Author(s):

Charles H. Knowles ◽

James Eccersley ◽

Mark Scott ◽

Sharon M. Walker ◽

Barnaby Reeves ◽

...

Keyword(s):

Discriminant Analysis ◽

Linear Discriminant Analysis ◽

Chronic Constipation ◽

Scoring System ◽

Linear Discriminant ◽

New Scoring

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Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis

Emergency Medicine International ◽

10.1155/2018/4810730 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9

Author(s):

Zafer Dokumcu ◽

Bade Toker Kurtmen ◽

Emre Divarci ◽

Petek Bayindir Tamay ◽

Timur Kose ◽

...

Keyword(s):

Multivariate Analysis ◽

Sensitivity And Specificity ◽

Scoring System ◽

Scoring Systems ◽

Negative Appendectomy ◽

Duration Of Symptoms ◽

Suspected Appendicitis ◽

Radiological Data ◽

Negative Appendectomy Rate ◽

New Scoring

Background.Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed.Methods.Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed. All data were compared between patients with and without appendicitis. The multivariate analysis was performed to define significant variables and to examine the sensitivity and specificity of each group of predictors including radiological data. A new scoring system (NSS) was formed and was compared with two existing scoring systems: pediatric appendicitis score (PAS) and Alvarado scoring system (ASS) by using reclassification method.Results.Negative appendectomy rate was 11.3%. Statistical analysis identified 21 independently significant variables. The heel drop test had the highest odds ratio. Sensitivity and specificity rates of clinical predictors were 84.6% and 94.8%, respectively. Radiological predictors increased the sensitivity rate to 86.9%. Sensitivity and specificity rates for PAS, ASS, and NSS were 86.8% and 83.9%, 84.7% and 81.6%, and 96.8% and 95.6%, respectively. The “re-assessed negative appendectomy rate” was 6.2% and false positive results were remarkably more common in patients with duration of symptoms less than 24 hours.Conclusion.Radiological data improves the accuracy of diagnosis. Containing detailed clinical and radiological data, NSS performs superiorly to PAS and ASS, regarding sensitivity and specificity without any age limitation. The efficiency of NSS may be enhanced by determining different predictors for different phases of the inflammatory process.

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Using collagenase to treat Dupuytren’s disease: a hypothetical cost benefit analysis

Australasian Journal of Plastic Surgery ◽

10.34239/ajops.v2i1.42 ◽

2019 ◽

Vol 2 (1) ◽

pp. 23-30 ◽

Cited By ~ 1

Author(s):

Ryan Livingston ◽

Michael Wagels ◽

Alicia Heald

Keyword(s):

Cost Effectiveness ◽

Cost Saving ◽

Cost Benefit Analysis ◽

Full Range ◽

Dupuytren’S Disease ◽

Cost Difference ◽

Substantial Cost Saving ◽

Dupuytren's Disease ◽

Risk Of Recurrence

Background: Collagenase, an enzyme produced by clostridium histolyticum (CCH), is a relatively new injection able to cleave collagen strands in vitro. While not yet available on the PBS, the side effect profile and risk of recurrence of collegenase injections are comparable to fasciectomy in appropriately selected patients. In this study, we aimed to demonstrate the safety and cost-effectiveness of collagenase for the treatment of Dupuytren’s disease. Method: Twenty-five patients at our hospital received collagenase injections for treatment of their Dupuytren’s disease. Data from this cohort was compared to a hypothetical group extrapolated from the literature. Results: Surgical treatment, excluding outpatient visits, costs on average AU$5852 per patient and collagenase costs AU$1176 per patient (gross cost difference AU$4676). Moderating this cost difference by the effect of complications using the incremental cost effectiveness ratio, the cost saving is AU$1137.71 per unit decrease in complications with collagenase treatment. Surgical fasciectomy has a lower risk of recurrence than collagenase but costs up to AU$543 more for patients for whom the condition does not recur within five years of treatment. In our cohort, 25 patients had 31 cords injected with collagenase. All but two patients achieved full range of motion of their affected joint and 20 per cent sustained minor skin tears requiring dressings. Conclusion: This analysis suggests that the investment of public health funds in the treatment of suitable patients with collagenase should produce a substantial cost saving without increasing the risk of complications.

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