Diagnostic performance of the bronchial aspirate collected before and after the bronchial biopsy in patients with pulmonary neoplasia with endobronchial lesion

2020 ◽  
Vol 154 (1) ◽  
pp. 13-15
Author(s):  
Roser Costa ◽  
Mireia Martínez-Palau ◽  
Lluís Esteban ◽  
Francisco Pérez-Ochoa ◽  
Xavier Tarroch ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Bronchial Biopsy ◽  
Before And After ◽  
Bronchial Aspirate ◽  
Endobronchial Lesion ◽  
Pulmonary Neoplasia

Single-site sampling versus multi-site sampling for blood cultures; A retrospective clinical study

2021 ◽  
Author(s):  
Anna Larsson ◽  
David Yu ◽  
Patrik Dinnétz ◽  
Hampus Nordqvist ◽  
Volkan Özenci
Keyword(s):  
Clinical Study ◽  
Diagnostic Performance ◽  
Sample Volume ◽  
Blood Cultures ◽  
Single Site ◽  
Optimal Sampling ◽  
Sampling Protocol ◽  
Anaerobic Bottle ◽  
Retrospective Clinical Study ◽  
Before And After

Objectives The performance of blood cultures (BC) relies on optimal sampling. Sepsis guidelines do not specify which sampling protocol to use, but recommend two sets of BC bottles, each set containing one aerobic and one anaerobic bottle. For the single-site sampling (SSS) protocol, only one venipuncture is performed for all four bottles. The predominating multi-site sampling (MSS) protocol implies that BC bottles are collected from two separate venipuncture sites. The aim of this study was to compare SSS and MSS. Primary outcomes were number of BC sets collected, sample volume and diagnostic performance. Methods This was a retrospective clinical study comparing BC results in an emergency department before and after changing the sampling protocol to SSS from MSS. All BC samples were incubated in the BacT/ALERT BC system. Results The analysis included 5,248 patients before and 5,364 patients after the implementation of SSS. There was a significantly higher proportion of positive BCs sampled with SSS compared to MSS, 1,049/5,364 (19.56%) and 932/5,248 (17.76%) respectively ( P =0.018). This difference was due to a higher proportion of solitary BC sets (two BC bottles) in MSS. Analyzing only patients with the recommended four BC bottles, there was no difference in positivity. SSS had a higher proportion of BC bottles with the recommended sample volumes of 8-12 ml than MSS ( P <0.001). Conclusions Changing the sampling protocol to SSS from MSS resulted in higher positivity rates, higher sample volume and fewer solitary BC sets. These advantages of SSS should be considered in future sepsis guidelines.

scholarly journals Automated Radiology Alert System for Pneumothorax Detection on Chest Radiographs Improves Efficiency and Diagnostic Performance

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1182
Author(s):  
Cheng-Yi Kao ◽  
Chiao-Yun Lin ◽  
Cheng-Chen Chao ◽  
Han-Sheng Huang ◽  
Hsing-Yu Lee ◽  
...  
Keyword(s):  
Deep Learning ◽  
Diagnostic Performance ◽  
Medical Center ◽  
Characteristic Curve ◽  
Learning Model ◽  
Chest Radiographs ◽  
Alert System ◽  
Before And After ◽  
Set Up ◽  
Deep Learning Model

We aimed to set up an Automated Radiology Alert System (ARAS) for the detection of pneumothorax in chest radiographs by a deep learning model, and to compare its efficiency and diagnostic performance with the existing Manual Radiology Alert System (MRAS) at the tertiary medical center. This study retrospectively collected 1235 chest radiographs with pneumothorax labeling from 2013 to 2019, and 337 chest radiographs with negative findings in 2019 were separated into training and validation datasets for the deep learning model of ARAS. The efficiency before and after using the model was compared in terms of alert time and report time. During parallel running of the two systems from September to October 2020, chest radiographs prospectively acquired in the emergency department with age more than 6 years served as the testing dataset for comparison of diagnostic performance. The efficiency was improved after using the model, with mean alert time improving from 8.45 min to 0.69 min and the mean report time from 2.81 days to 1.59 days. The comparison of the diagnostic performance of both systems using 3739 chest radiographs acquired during parallel running showed that the ARAS was better than the MRAS as assessed in terms of sensitivity (recall), area under receiver operating characteristic curve, and F1 score (0.837 vs. 0.256, 0.914 vs. 0.628, and 0.754 vs. 0.407, respectively), but worse in terms of positive predictive value (PPV) (precision) (0.686 vs. 1.000). This study had successfully designed a deep learning model for pneumothorax detection on chest radiographs and set up an ARAS with improved efficiency and overall diagnostic performance.

scholarly journals The value of S-Detect in improving the diagnostic performance of radiologists for the differential diagnosis of thyroid nodules

2020 ◽  
Vol 22 (4) ◽  
pp. 415
Author(s):  
Qi Wei ◽  
Shu-E Zeng ◽  
Li-Ping Wang ◽  
Yu-Jing Yan ◽  
Ting Wang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Ultrasound Images ◽  
Experienced Radiologist ◽  
Before And After ◽  
Sensitivity Specificity

Aims: To compare the diagnostic value of S-Detect (a computer aided diagnosis system using deep learning) in differentiating thyroid nodules in radiologists with different experience and to assess if S-Detect can improve the diagnostic performance of radiologists.Materials and methods: Between February 2018 and October 2019, 204 thyroid nodules in 181 patients were included. An experienced radiologist performed ultrasound for thyroid nodules and obtained the result of S-Detect. Four radiologists with different experience on thyroid ultrasound (Radiologist 1, 2, 3, 4 with 1, 4, 9, 20 years, respectively) analyzed the conventional ultrasound images of each thyroid nodule and made a diagnosis of “benign” or “malignant” based on the TI-RADS category. After referring to S-Detect results, they re-evaluated the diagnoses. The diagnostic performance of radiologists was analyzed before and after referring to the results of S-Detect.Results: The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of S-Detect were 77.0, 91.3, 65.2, 68.3 and 90.1%, respectively. In comparison with the less experienced radiologists (radiologist 1 and 2), S-Detect had a higher area under receiver operating characteristic curve (AUC), accuracy and specificity (p <0.05). In comparison with the most experienced radiologist, the diagnostic accuracy and AUC were lower (p<0.05). In the less experienced radiologists, the diagnostic accuracy, specificity and AUC were significantly improved when combined with S-Detect (p<0.05), but not for experienced radiologists (radiologist 3 and 4) (p>0.05).Conclusions: S-Detect may become an additional diagnostic method for the diagnosis of thyroid nodules and improve the diagnostic performance of less experienced radiologists. 

scholarly journals Use of the new Lake Louise Criteria improves CMR detection of atypical forms of acute myocarditis

2020 ◽  
Author(s):  
Giulia Cundari ◽  
Nicola Galea ◽  
Gianluca De Rubeis ◽  
Andrea Frustaci ◽  
Francesco Cilia ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
T1 Mapping ◽  
Clinical Presentation ◽  
Acute Myocarditis ◽  
T2 Mapping ◽  
Cine Ssfp ◽  
Gadolinium Administration ◽  
Clinical Presentations ◽  
Atypical Clinical Presentation ◽  
Before And After

AbstractThe purpose of our study was to compare diagnostic performance of old and new Lake Louise Criteria (oLLC and nLLC) among different clinical presentations: infarct-like (IL), cardiomyopathic (CM) and arrhythmic (AR). 102 patients with clinical suspicion of acute myocarditis underwent cardiac magnetic resonance (CMR) on a 1.5 T scanner. Protocol included cine-SSFP, T2-weighted STIR, T2 mapping, early and late gadolinium enhancement and T1 mapping acquired before and after gadolinium administration. The degree of agreement has been calculated with Cohen’s K test. 42 patients also underwent endomyocardial biopsy (EMB). IL onset was present in 54/102 patients, CM in 28/102 and AR in 20/102. nLLC were positive in 58.3% of the patients, while oLLC in 37.9%, k = 0.57 (IC: 0.428–0.713). The degree of agreement between nLLC and oLLC was 0.49 (IC: 0.111–0.876) for AR onset (nLLC positive in 35% vs oLLC in 15%), 0.25 (IC: 0.035–0.459) for CM pattern (nLLC positive in 60.7% vs oLLC 17.9%) and 0.73 (IC: 0.543–0.912) for IL presentation (nLLC positive in 66.7% vs oLLC in 57.4%). Diagnostic accuracy was 75% for both nLLC and oLLC among IL onset, and 41.6% for oLLC vs 66.7% for nLLC, as regards CM clinical presentation. nLLC have improved diagnostic performance of CMR for the diagnosis of acute myocarditis, in particular for atypical clinical presentation.

scholarly journals A Beneficial Role of Computer-aided Diagnosis System for Less Experienced Physicians in the Diagnosis of Thyroid Nodule on Ultrasound

2021 ◽  
Author(s):  
Sunyoung Kang ◽  
Eunjung Lee ◽  
Chae Won Chung ◽  
Han Na Jang ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Computer Aided Diagnosis ◽  
Ultrasound Images ◽  
Cad System ◽  
Computer Aided ◽  
Before And After ◽  
Needle Aspiration Cytology ◽  
Aided Diagnosis

Abstract Ultrasonography is the primary diagnostic tool for thyroid nodules, while the accuracy is highly operator-dependent. The aim of this study was to investigate whether ultrasonography with computer-aided diagnosis (CAD) has assisting roles to physicians in the diagnosis of thyroid nodules. 451 thyroid nodules (³ 1 cm) evaluated by fine-needle aspiration cytology following surgery were included. 300 (66.5%) of them were diagnosed as malignancy. Thirteen physicians who had 0 months (E0, n=8), 1 year (E1, n=2), or more than 5 years (E5, n=3) of experience in ultrasonography reviewed the prepared ultrasound images of thyroid nodules before and after CAD assistance. The diagnostic performance of CAD was comparable to that of the E5 group, and better than those of the E0 and E1 groups. The AUC of the CAD for conventional PTC was higher than that for FTC and follicular variant PTC (0.925 vs. 0.499), independent of tumor size. CAD assistance significantly improved diagnostic performance in E0 group, but not in the E1 and E5 groups. In conclusion, the CAD system showed good performance in the diagnosis of conventional PTC. CAD assistance improved the diagnostic performance of physicians with less experience in ultrasonography, especially in the diagnosis of conventional PTC.

Influence of training on dorsal tangential radiographic view to detect screw protrusion after anterior plating of the distal radius: a cadaveric study

2020 ◽  
Vol 45 (8) ◽  
pp. 864-870
Author(s):  
Minke Bergsma ◽  
Miryam C. Obdeijn ◽  
Stein J. Janssen ◽  
Gregory I. Bain ◽  
Ruurd L. Jaarsma ◽  
...  
Keyword(s):  
Distal Radius ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Cadaveric Study ◽  
Specific Training ◽  
Training Video ◽  
Self Confidence ◽  
Clinical Series ◽  
Before And After ◽  
Anterior Plating

In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally protruding screws using the dorsal tangential radiographic view before and after specific training. Without prior instruction, 13 observers interpreted the dorsal tangential view of cadaveric specimens, in which anterior radial plates were placed. After seeing a training video on the dorsal tangential view, they repeated the task. Though we found that accuracy and interobserver agreement was lower than described in some other clinical series, training led to statistically significant improvements of (1) the interobserver agreement on the decision to exchange screws, (2) the self-confidence of the surgeon in obtaining adequate views, and (3) the number of fluoroscopic images required to obtain these views. After training, the number of protruding screws missed was reduced by 36%, but 7% of dorsally protruding screws was still missed.

Crohn's disease evaluated with magnetic resonance enteroclysis: diagnostic performance of experienced and inexperienced readers before and after training

2008 ◽  
Vol 49 (9) ◽  
pp. 967-974 ◽  
Author(s):  
A. Negaard ◽  
A. Mulahasanovic ◽  
L. A. Reisaeter ◽  
K. Aasekjaer ◽  
L. Sandvik ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Magnetic Resonance ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Training Evaluation ◽  
Before And After ◽  
Magnetic Resonance Enteroclysis

Background: Magnetic resonance enteroclysis (MRE) is suggested to become the preferred radiological method in small-bowel Crohn's disease (CD). However, the performance of inexperienced readers may influence the diagnostic value of the method and has not been previously investigated. Purpose: To compare readings of MRE in small-bowel CD performed by experienced and inexperienced readers before and after training. Material and Methods: One experienced radiologist (observer 1) and two trainees (observers 2 and 3) reviewed 60 MRE examinations. A second reading was performed after training. Bowel wall thickness (BWT), ulcers (BWU), stenosis (BWS), fistulas (FIS), and abscesses (ABS) were evaluated. A reference standard based on clinical records was established. Results: BWT in the terminal ileum was evaluated with high diagnostic performance (sensitivity: observer 1, 83%; observer 2, 72%; observer 3, 78%). Only BWU was diagnosed with a higher sensitivity by observer 1 (78% vs. 33% and 39%, respectively; P=0.02). False-positive findings for BWT in the jejunum (observer 2: 7; observer 3: 4) and fistulas and abscesses (observer 2: 11/5; observer 3: 5/4) were made by the trainees. Interobserver agreement in the jejunum was poor (observer 1/observer 2: κ=0.23; observer 1/observer 3: κ=−0.03) and in the ileum good (observer 1/observer 2: κ=0.78; observer 1/observer 3: κ=0.73). After training, evaluation of BWU (observer 2: 56%, P=0.22; observer 3: 44%, P=0.03), BWT (observer 2: 2; observer 3: 2), and interobserver agreement in the jejunum improved (observer 1/observer 2: κ=0.66; observer 1/observer 3: κ=0.66). However, the number of diagnosed fistulas and abscesses remained high. Conclusion: Before training, most findings of Crohn's disease in the terminal ileum were evaluated with high diagnostic performance by all readers. However, the inexperienced readers evaluated BWU with a low sensitivity and overestimated the number of FIS, number of ABS, and increased BWT in the jejunum. After training, evaluation by inexperienced readers of BWU and increased BWT in the jejunum improved.

scholarly journals Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 606 ◽  
Author(s):  
Sergio Harari ◽  
Francesca Cereda ◽  
Federico Pane ◽  
Alberto Cavazza ◽  
Nikolaos Papanikolaou ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Diseases ◽  
Diagnostic Performance ◽  
Diagnostic Yield ◽  
Bleeding Event ◽  
Interstitial Lung Diseases ◽  
Bleeding Events ◽  
Surgical Biopsy ◽  
Before And After

Introduction: Transbronchial cryobiopsy is an alternative to surgical biopsy for the diagnosis of fibrosing interstitial lung diseases, although the role of this relatively new method is rather controversial. Aim of this study is to evaluate the diagnostic performance and the safety of transbronchial cryobiopsy in patients with fibrosing interstitial lung disease. Materials and methods: The population in this study included patients with interstitial lung diseases who underwent cryobiopsy from May 2015 to May 2018 at the Division of Pneumology of San Giuseppe Hospital in Milan and who were retrospectively studied. All cryobiopsy procedures were performed under fluoroscopic guidance using a flexible video bronchoscope and an endobronchial blocking system in the operating room with patients under general anaesthesia. The diagnostic performance and safety of the procedure were assessed. The main complications evaluated were endobronchial bleeding and pneumothorax. All cases were studied with a multidisciplinary approach, before and after cryobiopsy. Results: Seventy-three patients were admitted to this study. A specific diagnosis was reached in 64 cases, with a diagnostic sensitivity of 88%; 5 cases (7%) were considered inadequate, 4 cases (5%) were found to be non-diagnostic. Only one major bleeding event occurred (1.4%), while 14 patients (19%) experienced mild/moderate bleeding events while undergoing bronchoscopy; 8 cases of pneumothorax (10.9%) were reported, of which 2 (2.7%) required surgical drainage. Conclusions: When performed under safe conditions and in an experienced center, cryobiopsy is a procedure with limited complications having a high diagnostic yield in fibrotic interstitial lung disease.

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