Abstract #1168: Systematic Review of the Positive Predictive Value of RAS Mutations in Cytologically Indeterminate Thyroid Nodules

Thyroid malignancies are found in 7% to 15% of all thyroid nodules. Immunohistochemical markers, including CK19, HBME-1and TROP2, have shown an effective role in identifying these malignancies. Hence, due to the lack of appropriate diagnostic tests for the identification of thyroid neoplasms, in this study, we aimed to determine the diagnostic value of these biomarkers in the identification of different types of follicular thyroid neoplasms. In this cross-sectional study, paraffin-embedded tissue blocks from the surgical resection of patients with thyroid nodules, referring to Imam Reza and Razavi Hospitals of Mashhad in 2017, were studied. Sensitivity, specificity, and positive and negative predictive values of these biomarkers for the identification of different types of follicular thyroid neoplasms were also studied. 129 patients with a mean age of 44.65±12.59 years participated in this study, of whom 101 (78.29%) were women. The most common type of follicular thyroid neoplasm was papillary carcinoma (60.47%). The highest sensitivity (94.87%) and positive predictive value (68.51%) in the detection of follicular neoplasms was observed by CK19 in papillary carcinoma. The sensitivity and positive predictive value of TROP2 in the detection of papillary neoplasms was 93.58% and 75.25%, respectively. In addition, HBME-1 had the highest specificity (72.54 %) and positive predictive value (81.57%) in identifying this neoplasm. The results of this study showed that CK19, HBME-1, and TROP2 had high diagnostic value in the detection of papillary thyroid neoplasms. Although these biomarkers had low diagnostic value in identifying follicular adenoma and carcinoma, given the high negative predictive value, they can be considered as powerful markers in identifying negative cases.

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Utility of the methylated SEPT9 test for the early detection of colorectal cancer: a systematic review and meta-analysis of diagnostic test accuracy

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2019-000355 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000355 ◽

Cited By ~ 5

Author(s):

Rohit Hariharan ◽

Mark Jenkins

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Early Detection ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Predictive Value ◽

Meta Analysis ◽

Test Accuracy ◽

Sensitivity Specificity

BackgroundCirculating tumour DNA from colorectal cancer (CRC) is a biomarker for early detection of the disease and therefore potentially useful for screening. One such biomarker is the methylated SEPT9 (mSEPT9) gene, which occurs during CRC tumourigenesis. This systematic review and meta-analysis aims to establish the sensitivity, specificity and accuracy of mSEPT9 tests for the early diagnosis of CRC.MethodsA systematic search of the relevant literature was conducted using Medline and Embase databases. Data were extracted from the eligible studies and analysed to estimate pooled sensitivity, specificity and diagnostic test accuracy.ResultsBased on 19 studies, the pooled estimates (and 95% CIs) for mSEPT9 to detect CRC were: sensitivity 69% (62–75); specificity 92% (89–95); positive likelihood ratio 9.1 (6.1–13.8); negative likelihood ratio 0.34 (0.27–0.42); diagnostic OR 27 (15–48) and area under the curve 0.89 (0.86–0.91). The test has a positive predictive value of 2.6% and negative predictive value of 99.9% in an average risk population (0.3% CRC prevalence), and 9.5% (positive predictive value) and 99.6% (negative predictive value) in a high-risk population (1.2% CRC prevalence).ConclusionThe mSEPT9 test has high specificity and moderate sensitivity for CRC and is therefore a potential alternative screening method for those declining faecal immunochemical test for occult blood (FIT) or other screening modalities. However, it is limited by its poor diagnostic performance for precancerous lesions (advanced adenomas and polyps) and its relatively high costs, and little is known about its acceptability to those declining to use the FIT.

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THE RISK OF THYROID CANCER IN PATIENTS WITH THYROID NODULE 3 CM OR LARGER

Endocrine Practice ◽

10.4158/ep-2020-0136 ◽

2020 ◽

Vol 26 (11) ◽

pp. 1286-1290

Author(s):

Edy Kornelius ◽

Shih-Chang Lo ◽

Chien-Ning Huang ◽

Yi-Sun Yang

Keyword(s):

Thyroid Cancer ◽

Positive Predictive Value ◽

Thyroid Carcinoma ◽

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Predictive Value ◽

Thyroid Nodules ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Fine Needle

Objective: There are conflicting data on the risk of thyroid cancer in thyroid nodules 3 cm or larger, and few such studies on this issue have been conducted in Asia. This study aimed to examine the risk of thyroid cancer in patients with thyroid nodules 3 cm or larger. Methods: This was a 7-year retrospective study conducted in a tertiary referral hospital in Taiwan. All patients with a thyroid nodule measuring ≥3 cm who underwent thyroid operation with or without fine-needle aspiration biopsy (FNAB) were included. The prevalence rate of thyroid cancer, as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false-negative rate of FNAB for thyroid nodule ≥3 cm were also examined. Results: A total of 132 patients were included in this study. Thyroid cancer was detected in 19 of 132 (14.4%) thyroid nodules measuring ≥3 cm. The performance of FNAB for detecting cancer in nodules 3 cm or larger without considering other ultrasonography parameters was relatively poor with a sensitivity of 50%, but the specificity (100%), PPV (100 %), and NPV (93.4 %) were excellent. Conclusion: The risk of thyroid cancer for thyroid nodules ≥3 cm in this study was low. The PPV and NPV of FNAB were high for the detection of cancer in large nodules. The decision to perform thyroidectomy should not be solely based on nodule size and should include other factors, such as ultrasound characteristics and surgical risk. Abbreviations: ATA = American Thyroid Association; FNAB = fine-needle aspiration biopsy; mPTC = micropapillary thyroid carcinoma; NPV = negative predictive value; PPV = positive predictive value; PTC = papillary thyroid carcinoma

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Reliability of administrative data to identify sexually transmitted infections for population health: a systematic review

BMJ Health & Care Informatics ◽

10.1136/bmjhci-2019-100074 ◽

2019 ◽

Vol 26 (1) ◽

pp. e100074

Author(s):

Brian E Dixon ◽

Saurabh Rahurkar ◽

Yenling Ho ◽

Janet N Arno

Keyword(s):

Systematic Review ◽

Positive Predictive Value ◽

Sexually Transmitted Infections ◽

Population Health ◽

Health Research ◽

Predictive Value ◽

International Classification Of Diseases ◽

Public Health Research ◽

Sexually Transmitted ◽

Icd Codes

IntroductionInternational Classification of Diseases (ICD) codes in administrative health data are used to identify cases of disease, including sexually transmitted infections (STIs), for population health research. The purpose of this review is to examine the extant literature on the reliability of ICD codes to correctly identify STIs.MethodsWe conducted a systematic review of empirical articles in which ICD codes were validated with respect to their ability to identify cases of chlamydia, gonorrhoea, syphilis or pelvic inflammatory disease (PID). Articles that included sensitivity, specificity and positive predictive value of ICD codes were the target. In addition to keyword searches in PubMed and Scopus databases, we further examined bibliographies of articles selected for full review to maximise yield.ResultsFrom a total of 1779 articles identified, only two studies measured the reliability of ICD codes to identify cases of STIs. Both articles targeted PID, a serious complication of chlamydia and gonorrhoea. Neither article directly assessed the validity of ICD codes to identify cases of chlamydia, gonorrhoea or syphilis independent of PID. Using ICD codes alone, the positive predictive value for PID was mixed (range: 18%–79%).Discussion and conclusionWhile existing studies have used ICD codes to identify STI cases, their reliability is unclear. Further, available evidence from studies of PID suggests potentially large variation in the accuracy of ICD codes indicating the need for primary studies to evaluate ICD codes for use in STI-related public health research.

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Does the clinical assessment help in predicting malignancy in thyroid swell

Nepalese Journal of ENT Head and Neck Surgery ◽

10.3126/njenthns.v5i1.16853 ◽

2017 ◽

Vol 5 (1) ◽

pp. 12-13

Author(s):

Ishwor Raj Devkota ◽

S. Bhandary ◽

S. Karki

Keyword(s):

Positive Predictive Value ◽

Clinical Assessment ◽

Thyroid Surgery ◽

Predictive Value ◽

False Positive ◽

Thyroid Nodules ◽

False Negative ◽

Male Ratio ◽

The Mean ◽

One Year

Objectives: To predict malignant nodules in solitary thyroid nodules on clinical assessment.Materials and methods: A total of 48 cases with thyroid nodule were clinically assessed in detail and underwent the standard thyroid surgery at BPKIHS, Dharan during the period of one year (April 2012 to march 2013).Results: The mean age was 41.42 years with female to male ratio of 15:1. Most of the patients were euthyroid (73%). Majority of the thyroid nodules were malignant (85.4%) and only 14.6% were benign on clinical assessment. The sensitivity of clinical evaluation was 84.6%, specificity 13.6%, positive predictive value 53.6%, negative predictive value 42.8%. Percentage of the false negative, false positive and overall accuracy was 57.1%, 46.3% and 52% respectively.Conclusion: Even though the sensitivity is high, clinical assessment has low specificity. So we cannot rely on clinical assessment in predicting malignancy in the thyroid nodules.

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AIBx, artificial intelligence model to risk stratify thyroid nodules

10.1101/2021.02.13.21251688 ◽

2021 ◽

Author(s):

Johnson Thomas ◽

Tracy Haertling

Keyword(s):

Artificial Intelligence ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Thyroid Nodules ◽

Classification Systems ◽

Image Similarity ◽

Ultrasound Images ◽

Similarity Model ◽

Sensitivity Specificity

AbstractBackgroundCurrent classification systems for thyroid nodules are very subjective. Artificial intelligence (AI) algorithms have been used to decrease subjectivity in medical image interpretation. 1 out of 2 women over the age of 50 may have a thyroid nodule and at present the only way to exclude malignancy is through invasive procedures. Hence, there exists a need for noninvasive objective classification of thyroid nodules. Some cancers have benign appearance on ultrasonogram. Hence, we decided to create an image similarity algorithm rather than image classification algorithm.MethodsUltrasound images of thyroid nodules from patients who underwent either biopsy or thyroid surgery from February of 2012 through February of 2017 in our institution were used to create AI models. Nodules were excluded if there was no definitive diagnosis of benignity or malignancy. 482 nodules met the inclusion criteria and all available images from these nodules were used to create the AI models. Later, these AI models were used to test 103 thyroid nodules which underwent biopsy or surgery from March of 2017 through July of 2018.ResultsNegative predictive value of the image similarity model was 93.2%. Sensitivity, specificity, positive predictive value and accuracy of the model was 87.8%, 78.5%, 65.9% and 81.5% respectively.ConclusionWhen compared to published results of ACR TIRADS and ATA classification system, our image similarity model had comparable negative predictive value with better sensitivity specificity and positive predictive value. By using image similarity AI models, we can eliminate subjectivity and decrease the number of unnecessary biopsies. Using image similarity AI model, we were able to create an explainable AI model which increases physician’s confidence in the predictions.

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Comparative Analysis of Diagnostic Value for Shear Wave Elastography and Real-Time Elastographic Imaging for Thyroid Nodules

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2019.2594 ◽

2019 ◽

Vol 9 (2) ◽

pp. 334-338

Author(s):

Qing Yang ◽

Wenhong Zhou ◽

Jiyu Li ◽

Guojun Wu ◽

Feng Ding ◽

...

Keyword(s):

Differential Diagnosis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Shear Wave ◽

Predictive Value ◽

Thyroid Nodules ◽

Shear Wave Elastography ◽

Roc Curves ◽

Diagnostic Value ◽

Sensitivity Specificity

Objective: To compare the diagnostic value of shear wave elastography (SWE) and real-time elastography (RTE) in the diagnosis of benign and malignant thyroid nodules. Methods: A total of 34 patients who ever received thyroidectomy in our hospital from January 2016 to January 2018 were identified. Meanwhile, all the patients received SWE and RTE before surgery, and all the diagnoses were confirmed by pathological examinations. With respect to SWE technique, the Subject Operating Characteristics (ROC) curves were drawn, in order to obtain the optimal threshold and then make differential diagnoses of benign and malignant thyroid nodules. In terms of RTE, the Rago 5 scoring method was utilized to make differential diagnoses of benign and malignant thyroid nodules. Besides, the pathological examinations after surgery could be considered as the golden standard. At last, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE and RTE were calculated, respectively. Results: A total of 51 thyroid nodules were identified, and 41 nodules were benign, 10 nodules were malignant. On the basis of ROC curves, with respect to SWE, the best threshold for differential diagnosis of benign and malignant thyroid nodules is 38.3 kPa. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE were 72.7% (8/11), 85% (34/40), 82.4% (42/51), 68.4% (13/19), and 87.5% (35/40), respectively. And the diagnostic indicators of RTE were 81.8% (9/11), 87.5% (35/40), 84.3% (43/51), 73.7% (14/19), and 90.0% (36/40). The sensitivity of quasi-static elastography in differential diagnosis of benign and malignant thyroid nodules with diameter ≤1 cm was 87.5% (7/8), and the sensitivity of SWE was 50.0% (5/10). In addition, the accuracy of SWE in differential diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm was 100% (6/6), and the accuracy of RTE for this kind of thyroid nodules was 66.7% (4/6). Conclusion: Both SWE and RTE technology have good application value in differential diagnosis of benign and malignant thyroid nodules. But, SWE is preferable when making diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm, and RTE was superior in detecting benign and malignant thyroid nodules with diameter ≤1 cm.

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