scholarly journals Clinimetrics: The Central Sensitisation Inventory: a useful screening tool for clinicians, but not the gold standard

2021 ◽  
Author(s):  
Jo Nijs ◽  
Eva Huysmans
Keyword(s):  
Gold Standard ◽  
Screening Tool ◽  
Central Sensitisation

scholarly journals Development of a Tetrazolium-Derived Paper-Based Diagnostic Device as an Early, Alternative Bacteria Screening Tool

Micromachines ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 44
Author(s):  
Michael Muljadi ◽  
Chao-Min Cheng ◽  
Ching-Ju Shen
Keyword(s):  
Gold Standard ◽  
Rapid Detection ◽  
Screening Tool ◽  
Analytical Tool ◽  
Environmental Applications ◽  
Sufficient Evidence ◽  
Diagnostic Device ◽  
Analytical Methodology ◽  
Bacteria Culture

(1) Background: The complexity, amount of time, and the large amount of resource required to perform gold-standard bacteria culture procedures makes it difficult to perform timely pathogenic analyses, especially in areas where such resources are not readily available. A paper-based biochemical analytical tool can potentially tackle problems economically in terms of time and convenience, potentially finding utility in applications where simple and timely detection of bacteria is necessary; (2) Methods: The utility of paper-based MTT-PMS strips was tested using a simple colorimetric analytical methodology; (3) Results: Sufficient evidence was obtained to suggest that the strips can potentially be used as a rapid and convenient early, alternative bacteria screening tool for a variety of applications; (4) Conclusions: The potential of strips for the rapid detection of bacteria compared to standard bacteria culture is a key advantage in certain clinical, agricultural, and environmental applications.

Use of an online questionnaire as a follow-up tool for a cohort of health personnel and patients attending a chemoradiotherapy unit in Mexico.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13518-e13518
Author(s):  
Jorge Humberto Hernandez-Felix ◽  
Mónica Isabel Meneses Medina ◽  
Luis Guillermo Anaya Sánchez ◽  
Ana Karen Valenzuela ◽  
Vanessa Rosas Rosas Camargo ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Screening Test ◽  
Screening Tool ◽  
Healthcare Personnel ◽  
Rt Pcr ◽  
Anticancer Treatment ◽  
Definition Of ◽  
Suspicious Case

e13518 Background: COVID-19 detection in a timely manner in patients (pts) undergoing anticancer treatment is essential. RT-PCR test for SARS-CoV2 is the diagnostic gold standard, however it is a potentially limited resource in our setting. As an alternative, clinicians have developed symptom-based questionnaires as a screening tool for the detection of COVID-19 to optimize resources. The predictive efficacy of these tools in pts with cancer and healthcare personnel (HCP) who treat them has not been evaluated. Our objective was to describe the findings of the follow-up through an online clinical tool in our cohort, and determine its predictive performance compared against the gold standard. Methods: Data was obtained from a follow-up cohort of HCP and pts attending the chemoradiotherapy unit of a tertiary hospital designated as a COVID-19 priority facility in Mexico City . The follow-up period was from June 12 to September 30, 2020, and consisted of a 10-item clinical questionnaire (CQ) on respiratory symptoms and contact with patients diagnosed with COVID-19, collected daily electronically or by telephone . In addition, RT-PCR for SARS-CoV2 was performed every two weeks. The CQ was considered as a positive screening test if in the period between the biweekly RT-PCRs the participants had reported symptoms or contact. Results: We included 130 asymptomatic participants. 44.6% (n = 58) were HCP and 55.3 % (n = 72) were pts. Within a median follow-up of 85 days (IQR 48-103) a total of 8970 CQ were completed, 48.3% (n = 4335) were answered by HCP and 51.6% (n = 4635) by pts. 4.03% (n = 175) of CQ returned positive in HCP and 0.77% (n = 36) in pts. 634 nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed, 13.5% (n = 18) of the participants tested positive for SARS-CoV2 infection. When we evaluate within the biweekly period, the CQ for symptoms or contact was found to be a positive screening test in 12% (n = 78). If we applied the standardized definition of COVID-19 suspicious case used at our center, the CQ was found to be positive just in 3.9% (n = 25). The CQ as a general screening tool gave a sensitivity (SN) of 33.3%, specificity (SP) of 88.3%, a positive predictive value (PPV) of 7.6% and a negative predictive value (NPV) of 97.8%. Using the standardized definition, CQ gave a SN of 38.8% and a SP of 97.07%, a PPV of 28% and a NPV of 98.1%. Conclusions: Screening based on self-reporting of symptoms and contact through a questionnaire demonstrated low sensivity but high specificity in our cohort. When we applied a standardized definition of COVID-19 suspicious case, the clinical performance improved. RT-PCR testing remains as the gold standard to detect COVID-19 and should be preferred in patients undergoing anticancer treatment. Nevertheless, clinical questionnaires are an accessible tool for follow-up.

O003. Validity and acceptability of the Swahili pGALS screening tool at a tertiary referral hospital in Kenya

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Kawishe Jacqueline ◽  
Ngugi Anthony ◽  
Migowa Angela
Keyword(s):  
Median Time ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Screening Tool ◽  
Clinical Skills ◽  
Lower Sensitivity ◽  
African Countries ◽  
Tertiary Referral Hospital ◽  
Paediatric Rheumatologist

Abstract Background A common reason implicated in the severity of presentation and mortality caused by most rheumatic conditions among children is the delay of presentation to a paediatric rheumatologist. Evidence suggests poor practice of paediatric musculoskeletal clinical skills could be a cause for delay and that history suggestive of musculoskeletal disease alone has poor sensitivity in detecting rheumatological conditions. The paediatrics gait, arms, legs and spine (pGALS) musculoskeletal screening tool was therefore developed to encourage early detection of paediatric rheumatological conditions. It has been validated and translated successfully in other countries. Swahili is well understood and spoken in Kenya and other East African countries and for the pGALS to be incorporated in our setting, we needed to translate and asses its validity in Swahili. The objective is todetermine the sensitivity and specificity of the translated Swahili pGALS screening tool in detecting abnormal joints among children aged 5-16 years. To measure the acceptability of the Swahili pGALS screening tool with reference to time taken performing the examination and the discomfort as perceived by the children and their guardians. Methods We conducted a diagnostic utility study. The three English pGALS screening questions were translated into Swahili according to the WHO standard of translation of a tool and the manoeuvres were performed by a ‘copy me’ approach. The ‘copy me’ approach entailed asking the participants to imitate the research assistants as various manoeuvres were done. Children between the ages of 5–16 years seen at the Aga Khan University Accident and emergency department and family medicine clinic who spoke Swahili and had symptoms suggestive of musculoskeletal conditions were enrolled using systematic random sampling. Children who were already on follow up with the Aga Khan paediatric rheumatologist were excluded. Children had the Swahili pGALS and gold standard review (with the paediatric rheumatologist) on the same day. Guardians were asked to answer questions on acceptability with regards to time taken to perform the tool and level of discomfort. Those with possible rheumatological condition as per the gold standard were offered follow up. Results We enrolled one hundred children with a median age of the children was nine years (IQR 7–11). The sensitivity and specificity of the Swahili pGALS screening tool were 76.8% (CI 63.6–87.0%) and 40.0% (CI 23.9–57.9%). The diagnostic accuracy was 62.7% (CI 52.1–72.1%) and the ROC area was 0.58 (CI 0.48–0.68). The median time taken to perform the Swahili pGALS was 5.0 minutes (IQR 3.5-6.0 minutes). Ninety percent of the guardians found the practice of pGALS to have ‘no’ to ‘some’ discomfort. Conclusions This study had a lower sensitivity and specificity than what was seen with similar studies. Although the sensitivity seen was low, it was still within acceptable range for a screening tool and may still be applicable in Kenya and other Swahili speaking countries if used in conjunction with good rheumatological history to refer early the 76% of children picked up by the screening tool. However, the low specificity implies that relatively large number of false positives would still need to be reviewed by a rheumatologist if the tool is adapted for use. The median time taken to perform the tool was also longer than observed in previous studies but the tool was overall deemed acceptable by majority of the guardians/ parents. Keywords pGALS, Kenya, Swahili, Paediatric, Rheumatology

scholarly journals Diagnostic accuracy of the iCare rebound tonometer compared to the Perkins applanation tonometer in assessing intraocular pressure in rural patients

Diagnosis ◽  
2015 ◽  
Vol 2 (4) ◽  
pp. 227-234 ◽  
Author(s):  
Yifan Li ◽  
Christopher R. Carpenter ◽  
Kathryn Nicholson ◽  
William Ken Milne
Keyword(s):  
Intraocular Pressure ◽  
Rural Communities ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Screening Tool ◽  
Unmet Need ◽  
Negative Likelihood Ratio ◽  
Rebound Tonometer ◽  
Applanation Tonometer ◽  
Icare Rebound Tonometer

AbstractVision health is recognized as a critical unmet need in North America. The ocular morbidity associated with glaucoma results from increased intraocular pressure (IOP) and early detection is crucial for the management of glaucoma. Our objective was to find a diagnostically accurate screening tool for intraocular hypertension that can be used in rural communities. We sought to validate the diagnostic accuracy of the iCare rebound tonometer against the gold standard Perkins applanation tonometer (PAT) in measuring IOP.Patients from two rural communities in Ontario, Canada visiting their optometrists for routine appointments had their IOP measured by a non-contact tonometer (NCT), an iCare rebound tonometer, and a Perkins applanation tonometer (PAT). Values of sensitivity, specificity, and likelihood ratios for a positive and negative result were calculated for the iCare and the NCT.Complete data was collected from 209 patients. Overall, the iCare tonometer had high levels of validity, as compared to the gold standard PAT. The iCare tonometer displayed excellent sensitivity of 98.3% (90–99%, 95% CI) and excellent negative likelihood ratio of 0.024 (0.0088–0.066, 95% CI) which is useful for ruling out intraocular hypertension.The iCare tonometer is a reasonably valid tool for detecting elevated IOP. Its ease of use, simplicity, and accessibility makes it a good screening tool to improve eye health in rural areas.

Validating the Neurodevelopmental Domain of Neurodevelopmental Ecological Screening Tool: An Ecological Screener for Use With 3-5 Year-Old Children Impacted by Poverty and Homelessness

2021 ◽  
pp. 073428292110055
Author(s):  
Carmela J. DeCandia ◽  
George J. Unick ◽  
Katherine T. Volk
Keyword(s):  
Factor Analysis ◽  
Gold Standard ◽  
Screening Tool ◽  
Rating Scale ◽  
Dimensional Structure ◽  
Developmental Risk ◽  
New Instrument ◽  
Scale Models ◽  
Confirmatory Factor ◽  
Test Retest Reliability

The Neurodevelopmental Ecological Screening Tool (NEST) is a new instrument to screen children for developmental challenges. This article describes the validation of the NEST neurodevelopmental domain. Data were collected from a nationwide purposely restricted sample of caregivers of children aged 3–5 years ( n = 231) living in poverty and experiencing homelessness. We used Rasch-based Rating Scale Models to select items with good fit. Cronbach’s alpha was used to measure the internal consistency validity of the entire neurodevelopmental domain. Construct validity and dimensional structure were obtained using confirmatory factor analysis. Interclass correlations were used to measure the test–retest reliability of the subdomains. Neurodevelopmental Ecological Screening Tool scores were compared to results on clinician-administered gold standard measures for a subsample ( n = 48). The neurodevelopmental domain score represents a single overarching risk construct with some variance attributable to distinct developmental constructs and validly and reliably identifies a child’s level of developmental risk.

scholarly journals Evaluation of the Pediatric Symptom Checklist as a screening tool for the identification of emotional and psychosocial problems

2013 ◽  
Vol 31 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Sandra Regina B. Muzzolon ◽  
Mônica Nunes L. Cat ◽  
Lúcia Helena C. dos Santos
Keyword(s):  
Gold Standard ◽  
Child Behavior Checklist ◽  
Screening Tool ◽  
Emotional Problems ◽  
Psychosocial Problems ◽  
Cutoff Score ◽  
Symptom Checklist ◽  
Southern Brazil ◽  
Pediatric Symptom Checklist ◽  
Brazilian Version

OBJECTIVE To investigate the Brazilian version of Pediatric Symptom Checklist (PSC) as a screening tool to identify psychosocial and emotional problems in schoolchildren from six to 12 years old. METHODS Diagnostic test conducted in a public school of Curitiba, Paraná (Southern Brazil), to evaluate the PSC accuracy and consistency, considering the Child Behavior Checklist (CBCL) as the gold standard. Among 415 parents invited for the study, 145 responded to both PSC and CBCL. The results of the two instruments were compared. PSC and CBCL were considered positive if scores ≥28 and >70 respectively. RESULTS Among the 145 cases, 49 (33.8%) were positive for both PSC and CBCL. The ROC curve showed the PSC score of 21 as the best cutoff point for screening psychosocial and emotional problems, with a sensitivity of 96.8% and a specificity of 86.7%. Regarding the reference cutoff (score ≥28 points), the sensitivity was 64.5% and the specificity, 100.0%, similar to those found in the original version of the tool. CONCLUSIONS The Portuguese version of PSC was effective for early identification of emotional and/or psychosocial problems in a schoolchildren group and may be useful for pediatricians.

scholarly journals Evaluation of The Pink Luminous Breast LED-Based Technology Device as a Screening Tool for the Early Detection of Breast Abnormalities

2021 ◽  
Author(s):  
Fernando Ocasio-Villa ◽  
Luisa Morales-Torres ◽  
Norma Velez-Medina ◽  
Juan C Orengo ◽  
Edu B. Suarez-Martinez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Gold Standard ◽  
Breast Screening ◽  
Screening Tool ◽  
Red Light ◽  
High Sensitivity ◽  
The United States

Breast cancer is the leading cause of sex-specific female cancer death in the United States. Detection at earlier stages contributes to decrease the mortality rate. The mammography is considered the gold standard for breast cancer screening with an estimate sensitivity of 86.9% and a specificity 88.9%. However, these values are negatively affected by the breast, which is consider a risk factor for developing breast cancer. Herein, we validate the novel LED-based FDA Class I medical device Pink Luminous Breast (PLB) by the comparison of two breast screening imaging-based tests using a double blinded approach. The PLB works by emitting a LED red light with a harmless spectrum of 640-800 nanometers, the trans-illuminated breast tissue allows the observation of abnormalities represented by darker or shadowing areas. In this study, we evaluated the sensitivity and specificity of the PLB device as a screening tool for the early detection of breast abnormalities when compared with the mammography as the gold standard. Our results showed that PLB device has a high sensitivity (89.6%) and specificity (96.4%) for detecting breast abnormalities comparable to the adjusted mammography values: 86.3% and 68.9% respectively. Importantly, the percentage of positive dense tissue findings from a total of 340 events was 266 (78.2%) using PLB vs. 248 (72.9%) detected by the mammography. A 100% of the participants responded in a survey that they feel comfortable using the device and visualizing their breast without feeling pain or discomfort during the examination. The PLB positive validation vs the mammography brings the potential to be recommended for routinely breast screening at non-clinical settings. The PLB provides a rapid, non-invasive, portable, and easy-to-use tool for breast screening that can complement the home-based BSE technique or the CBE. In addition, the PLB can be conveniently used for screening breasts with surgical implants. PLB provides an accessible and painless breast cancer screening tool. The use of this device is not intended to replace the mammography as the gold standard for breast screening but rather to use it as an adjunct or complement tool as part of more efficient earlier detection strategies and contribute to decrease this health disparity.

scholarly journals Validation of the PHQ-9 depression scale in Ethiopian cancer patients attending the oncology clinic at Tikur Anbessa specialized hospital

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mikyas Degefa ◽  
Benyam Dubale ◽  
Fikirte Bayouh ◽  
Biniyam Ayele ◽  
Yared Zewde
Keyword(s):  
Cancer Patients ◽  
Internal Consistency ◽  
Gold Standard ◽  
Screening Tool ◽  
Depression Scale ◽  
Area Under The Curve ◽  
Diagnostic Interview ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract Background Although depression is highly prevalent among cancer patients, it is often underdiagnosed and poorly managed particularly in developing nations. These shortcomings can have substantial adverse effects not only on the disease prognosis but also on patients’ quality of life. The Patient Health Questionnaire-9 is a widely used depression screening tool but it has not been validated among patients with chronic illnesses such as cancer in Ethiopia. We aim to validate the PHQ-9 among Ethiopian cancer patients in an outpatient setting. Methods A cross-sectional study was conducted among cancer patients attending the oncology clinic at Tikur Anbessa Specialized Hospital (TASH). We assessed criterion validity and performance of the PHQ-9 test against the gold standard Mini-International Neuropsychiatric Interview (MINI) diagnostic tool among patients with cancer. The MINI was administered by psychiatric nurses who were blind to the initial PHQ-9 screening tool. Results A total of 163 patients completed the 2 stages of a diagnostic interview in the study. The majority (64%) of the participants were women, the mean age was 46 (13.5) years. Using the gold standard MINI test the prevalence of Major Depressive Episode (MDE) was 15%. The internal consistency (Cronbach’s α) for PHQ-9 was 0.78 suggesting good (acceptable) internal consistency for the reliability of the test scores. When the total PHQ-9 score was used to identify cases of MDE, the Area under the Curve (AUC) was 0.93 (95% confidence interval [CI], 0.88–0.97) on Receiver Operating Characteristic (ROC) analysis. This shows evidence for the excellent discriminating power of the PHQ-9 between cases and non-cases of MDE. At cutoff point ≥4, the PHQ-9 had a sensitivity of 88% and specificity of 78.1% on the ROC curve to detect MDE. Conclusion PHQ-9 is a reliable and valid instrument to detect MDE among individuals with chronic conditions such as cancer patients in outpatient settings and it can be used in resource-limited settings for early diagnosis and proper therapy of such patients.

Abstract P134: Cardiac Screening in Adolescent and Young Athletes: A 3 year Cross Sectional Study Assessing the Diagnostic Accuracy of the History Questionnaire, Physical Examination, and Electrocardiogram

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Monica L Zigman ◽  
Kimberly G Harmon ◽  
David S Owens ◽  
Jordan M Prutkin ◽  
Jack C Salerno ◽  
...  
Keyword(s):  
Physical Examination ◽  
False Positive ◽  
Gold Standard ◽  
Student Athletes ◽  
Screening Tool ◽  
Physical Exam ◽  
Young Athletes ◽  
Cardiac Screening ◽  
Cardiovascular Screening ◽  
Qt Syndrome

Background & Aim: The accuracy of each cardiac screening tool for young athletes needs further investigation. The aim of this study is to evaluate the Preparticipation Physical Evaluation Monograph 4 th Edition (PPE-4), which is the current recommendation for cardiovascular screening in young athletes, and the 12-lead electrocardiogram (ECG). Methods: During October 2010 to June 2013 student athletes from high schools around the greater Seattle area received a one-time cardiac screen including history and physical examination as recommended in the PPE-4, and a resting 12-lead ECG. Those with abnormal findings received a focused echocardiogram. Student athletes were defined as participating in at least one high school level sport or higher per year. A true positive was defined as the identification of a cardiac disorder associated with sudden cardiac death. Sensitivity (Sn), specificity (Sp), false positive rate (FP), and positive and negative likelihood ratios (+LR, -LR), were calculated for each screening tool. Results: Screening events were held at 23 high schools; 4,743 student athletes ranged in age from 13-19 (mean 15.8), 54% male, 65% Caucasian, 13% mixed race, 10% Asian/Pacific Islander, 6% African-American. A total of 1065 (23%) students had at least one positive history response after physician review, 408 (9%) had an abnormal finding on physical exam, and 185 (4%) had an abnormal ECG. Echocardiography was performed on 1417 students who presented a positive finding on history, physical, or ECG or were a male basketball player. There were 21 cardiac disorders identified that could potentially lead to SCD (0.4%). Wolff-Parkinson-White (9) was most common, followed by 4 cases of coronary artery abnormalities, 3 cases of Long QT Syndrome, 3 dilated aortic roots or aneurysm, and 1 case each of hypertrophic cardiomyopathy and Short QT Syndrome. ECG identified 14 cases of those 21, Echo identified 9 cases of those 21. The history questionnaire had a Sn of 52%, Sp 78%, +LR 2.4, and FP 22%. Physical Exam had a Sn 19%, Sp 91%, +LR 2.2, and FP 9%. ECG had a Sn 67%, Sp 96%, +LR 18.4, and FP 4%. Conclusion: ECG had the highest Sn, Sp, and +LR of the screening tools evaluated. History and physical exam had lower Sn and +LRs and higher false positive rates. A limitation to this study is that there is no gold standard for this screening protocol. ECG may miss structural abnormalities and Echo may miss conduction disorders. A combination of the two tests was considered the gold standard, meaning sensitivity of all tests may be overestimated. More research is needed to improve the performance of cardiovascular screening methods especially through the history questionnaire and physical exam. Out of the three tools evaluated the best tool to detect underlying cardiovascular conditions associated with SCD is ECG.

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