2476

OBJECTIVES/SPECIFIC AIMS: Historically, logistic regression algorithms (LRAs) have failed to differentiate strangulated small bowel obstructions (SBOs) from nonstrangulated SBOs. Our hypothesis is that a machine learning algorithm (MLA) can differentiate strangulated from simple SBOs better than an LRA can. METHODS/STUDY POPULATION: We used records of patients presenting with acute SBO and managed with exploratory laparotomy to test and train algorithms. We compared MLA to LRA via area under the receiver operating characteristic curve (AUROC) and cut-off points maximizing sensitivity and specificity. RESULTS/ANTICIPATED RESULTS: With 192 patient records, the AUROC of the MLA was 0.85. At the sensitivity cutoff, the MLA had 100% sensitivity and 55% specificity. At the specificity cutoff, the MLA had 45% sensitivity and 100% specificity. We anticipate improvements as more records are incorporated, and that LRA will underperform MLA across all measures. DISCUSSION/SIGNIFICANCE OF IMPACT: Our MLA represents a significant improvement over past LRAs, and may provide decision assistance to surgeons managing SBO. If this MLA maintains its high sensitivity, it may be used in the future to prevent unnecessary surgeries.

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Are Body Composition Parameters Better than Conventional Anthropometric Measures in Predicting Pediatric Hypertension?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165771 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5771

Author(s):

Chih-Yu Hsu ◽

Rong-Ho Lin ◽

Yu-Ching Lin ◽

Jau-Yuan Chen ◽

Wen-Cheng Li ◽

...

Keyword(s):

Body Composition ◽

Receiver Operating Characteristic Curve ◽

Operating Characteristic ◽

Characteristic Curve ◽

Fat Free Mass ◽

Z Score ◽

Pediatric Hypertension ◽

Anthropometric Measures ◽

Operating Characteristic Curve ◽

Better Than

Body composition (BC) parameters are associated with cardiometabolic diseases in children; however, the importance of BC parameters for predicting pediatric hypertension is inconclusive. This cross-sectional study aimed to compare the difference in predictive values of BC parameters and conventional anthropometric measures for pediatric hypertension in school-aged children. A total of 340 children (177 girls and 163 boys) with a mean age of 8.8 ± 1.7 years and mean body mass index (BMI) z-score of 0.50 ± 1.24 were enrolled (102 hypertensive children and 238 normotensive children). Significantly higher values of anthropometric measures (BMI, BMI z-score, BMI percentile, waist-to-height ratio) and BC parameters (body-fat percentage, muscle weight, fat mass, fat-free mass) were observed among the hypertensive subgroup compared to their normotensive counterparts. A prediction model combining fat mass ≥ 3.65 kg and fat-free mass ≥ 34.65 kg (area under the receiver operating characteristic curve = 0.688; sensitivity = 66.7%; specificity = 89.9%) performed better than BMI alone (area under the receiver operating characteristic curve = 0.649; sensitivity = 55.9%; specificity = 73.9%) in predicting hypertension. In conclusion, BC parameters are better than anthropometric measures in predicting pediatric hypertension. BC measuring is a reasonable approach for risk stratification in pediatric hypertension.

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Conventional Laboratory Blood Indicators Are Valuable for Early Diagnosis of Colorectal Cancer

10.21203/rs.3.rs-758680/v1 ◽

2021 ◽

Author(s):

Xia Gan ◽

Zhi-Yong Chen ◽

Zi-Hua Li ◽

Jian-Ming Zhou ◽

Ying Sun ◽

...

Keyword(s):

Colorectal Cancer ◽

Early Diagnosis ◽

Receiver Operating Characteristic Curve ◽

Operating Characteristic ◽

Clinical Laboratory ◽

Characteristic Curve ◽

Diagnostic Value ◽

Imaging Data ◽

Operating Characteristic Curve ◽

Better Than

Abstract Objective: Some conventional laboratory indicators have been found to be of value for the diagnosis of colorectal cancer (CRC). The present study aimed to systematically analyze the diagnostic value of conventional laboratory blood indicators for CRC, especially for early CRC. Methods: A total of 505 patients with CRC (n=210), colorectal adenoma (CRA) (n=167) or polyp (CRP) (n=128) were retrospectively collected. Clinical, laboratory and imaging data available before treatment were extracted. The diagnostic performances of laboratory blood indicators for discriminating total and early CRCs from CRA and CRP (CRA&P) were evaluated.Results: Fifty-three of 76 (69.7%) laboratory blood indicators were significant for discriminating CRC from CRA&P with areas under the receiver operating characteristic curve (AUC) ranging within 0.554-0.819, of these indicators, 17 had AUC > 0.7, three had AUC > 0.8, and five had AUCs greater than that for carcinoembryonic antigen (CEA). Fifteen indicators had overall sensitivities comparable to CEA for the diagnosis of CRC (35.7-55.4% vs. 47.7%, all P>0.05) at a specificity of 90%, and they were not or weakly correlated with CEA (absolute r = 0.058-0.333). For differentiating early CRC (TNM stage I+II, n=102) from CRA&P, the sensitivities for the 15 indicators ranged within 30.4%-55.5% at a specificity of 90% and similar to stage III+IV CRC.Conclusion: Conventional laboratory blood indicators are valuable for early CRC diagnosis, and are comparable to or better than CEA.

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Identification of risk factors for the severity of coronavirus disease 2019: a retrospective study of 163 hospitalized patients

10.21203/rs.3.rs-29825/v1 ◽

2020 ◽

Author(s):

Ye Tu ◽

Ping Yang ◽

Jingjing Wang ◽

Xuebi Tian ◽

Kai Wang ◽

...

Keyword(s):

Operating Characteristic ◽

Characteristic Curve ◽

High Sensitivity ◽

Curve Analysis ◽

Severe Illness ◽

Dynamic Changes ◽

Factors Associated ◽

Multivariable Regression ◽

Operating Characteristic Curve ◽

D Dimer

Abstract Background: To compare clinical features between moderate and severe cases with COVID-19, and screen factors associated with disease severity.Methods: Demographic and clinical data were compared between moderate and severe cases. Logistic regression was performed for prognostic factors.Results: 163 patients (median age 65.0 (56.8-71.0) years, 78 (47.9%) females) were enrolled, including 87 (53.4%) severe and 76 (46.6%) moderate cases. 79 (90.8%) severe and 59 (77.6%) moderate cases had comorbidities, with hypertension and diabetes commonly presented. The most common symptoms were fever. Severe cases had higher lactate dehydrogenase (LDH), inflammatory cytokines and lymphopenia, eosinopenia on admission, and lower eosinophil and higher neutrophil counts from admission to day 13 and 19. Multivariable regression showed that neutrophilia, eosinopenia, high LDH and D-dimer were associated with severe COVID-19. In receiver operating characteristic curve analysis, LDH, eosinophil and neutrophil + eosinophil + LDH + D-dimer combination, with area under curve of 0.86, 0.76 and 0.93, predicted severe illness with high sensitivity (82.8%, 83.3%, 88.0%) and specificity (68.4%, 84.2%, 81.3%).Conclusions: Eosinopenia, higher LDH and neutrophil + eosinophil + LDH + D-dimer combination on admission were powerful indicators of severe COVID-19. Dynamic changes of neutrophils and eosinophils may be used to evaluate disease progression.

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Cerebellar Arteriovenous Malformations

Neurosurgery ◽

10.1227/neu.0b013e318271c081 ◽

2012 ◽

Vol 71 (6) ◽

pp. 1111-1124 ◽

Cited By ~ 52

Author(s):

◽

Ana Rodríguez-Hernández ◽

Helen Kim ◽

Tony Pourmohamad ◽

William L. Young ◽

...

Keyword(s):

Arteriovenous Malformations ◽

Operating Characteristic ◽

Predictive Accuracy ◽

Characteristic Curve ◽

Venous Drainage ◽

Martin Grade ◽

Operating Characteristic Curve ◽

Cerebral Avms ◽

Cerebellar Anatomy ◽

Better Than

ABSTRACT BACKGROUND: Anatomic diversity among cerebellar arteriovenous malformations (AVMs) calls for a classification that is intuitive and surgically informative. Selection tools like the Spetzler-Martin grading system are designed to work best with cerebral AVMs but have shortcomings with cerebellar AVMs. OBJECTIVE: To define subtypes of cerebellar AVMs that clarify anatomy and surgical management, to determine results according to subtypes, and to compare predictive accuracies of the Spetzler-Martin and supplementary systems. METHODS: From a consecutive surgical series of 500 patients, 60 had cerebellar AVMs, 39 had brainstem AVMs and were excluded, and 401 had cerebral AVMs. RESULTS: Cerebellar AVM subtypes were as follows: 18 vermian, 13 suboccipital, 12 tentorial, 12 petrosal, and 5 tonsillar. Patients with tonsillar and tentorial AVMs fared best. Cerebellar AVMs presented with hemorrhage more than cerebral AVMs (P < .001). Cerebellar AVMs were more likely to drain deep (P = .04) and less likely to be eloquent (P < .001). The predictive accuracy of the supplementary grade was better than that of the Spetzler-Martin grade with cerebellar AVMs (areas under the receiver-operating characteristic curve, 0.74 and 0.59, respectively). The predictive accuracy of the supplementary system was consistent for cerebral and cerebellar AVMs, whereas that of the Spetzler-Martin system was greater with cerebral AVMs. CONCLUSION: Patients with cerebellar AVMs present with hemorrhage more often than patients with cerebral AVMs, justifying an aggressive treatment posture. The supplementary system is better than the Spetzler-Martin system at predicting outcomes after cerebellar AVM resection. Key components of the Spetzler-Martin system such as venous drainage and eloquence are distorted by cerebellar anatomy in ways that components of the supplementary system are not.

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Machine Learning Based Prediction versus Human-as-a-Security-Sensor

International Journal of Artificial Intelligence Research ◽

10.29099/ijair.v3i1.83 ◽

2018 ◽

Vol 3 (1) ◽

Author(s):

Safwana Haque ◽

George Loukas

Keyword(s):

Machine Learning ◽

Operating Characteristic ◽

Learning Algorithm ◽

Characteristic Curve ◽

Confusion Matrix ◽

Social Engineering ◽

Sensitive Information ◽

The World ◽

Operating Characteristic Curve ◽

Client System

Phishing is one of the most common cyber threats in the world today. It is a type of social engineering attack where the attacker lures unsuspecting victims into carrying out certain tasks mostly to steal personal and sensitive information. These stolen information are exploited to commit further crimes e.g. blackmails, data theft, financial theft, malware installation etc. This study was carried out to tackle this problem by designing an anti-phishing learning algorithm to detect phishing emails and also to study the accuracies of human phishing prediction to machine prediction. A graphical user interface was designed to emulate an email-client system that popped-up a warning on detecting a phishing mail successfully and collection of predictions made by expert and non-expert users on anti-phishing techniques. These predictions were compared to the predictions made by the machine learning algorithm to compare the efficiencies of all predictions considered in this research. The performance of the classifier used was measured with metrics such as confusion matrix, accuracy, receiver operating characteristic curve and area under graph

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Identification of risk factors for the severity of coronavirus disease 2019: a retrospective study of 163 hospitalized patients

10.21203/rs.3.rs-23867/v1 ◽

2020 ◽

Author(s):

Ye Tu ◽

Ping Yang ◽

Jingjing Wang ◽

Xuebi Tian ◽

Kai Wang ◽

...

Keyword(s):

Operating Characteristic ◽

Characteristic Curve ◽

High Sensitivity ◽

Curve Analysis ◽

Severe Illness ◽

Dynamic Changes ◽

Factors Associated ◽

Multivariable Regression ◽

Operating Characteristic Curve ◽

D Dimer

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Value of image-pro plus for assisting virtual touch tissue imaging in the diagnosis of thyroid nodules

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200983 ◽

2020 ◽

pp. 1-9

Author(s):

Kai-Mei Lian ◽

Teng Lin

Keyword(s):

Gold Standard ◽

Diagnostic Performance ◽

Operating Characteristic ◽

Thyroid Nodules ◽

Characteristic Curve ◽

Diagnostic Value ◽

Tissue Imaging ◽

Operating Characteristic Curve ◽

Virtual Touch Tissue Imaging ◽

Better Than

Purpose: The value of virtual touch tissue imaging (VTI) with support of Image-Pro Plus (IPP) for diagnosing malignant thyroid tumors was assessed in the present study. Methods: In this retrospective study, we enrolled 160 patients with 198 thyroid nodules. TI-RADS, VTI grade, and VTI with support of IPP (VTI-IPP) were underwent for each nodule. With the pathological diagnosis as the gold standard, the receiver-operating characteristic curve (ROC) was drawn to evaluate the diagnostic performance of VTI-IPP, VTI, TI-RADS, VTI-IPP combinate with TI-RADS in thyroid carcinoma. Results: VTI-IPP score >2, VTI score >3, TI-RADS score >1, and VTI-IPP combine with TI-RADS score >4 expressed the highest diagnostic value for malignant thyroid nodules, the areas under the curve (AUC) were 0.939, 0.905, 0.925, and 0.967, respectively. The combination indicated the largest AUC, compared with VTI-IPP and TI-RADS, respectively (P = 0.0054 and 0.0009). The performance of VTI-IPP in diagnosing thyroid carcinomas was better than VTI (P = 0.0321). Conclusion: Compare with VTI, VTI-IPP exhibited more excellent value in distinguishing between benign and malignant thyroid nodules. The value of malignant thyroid nodules diagnosis can be improved when VTI-IPP combines with TI-RADS.

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P.2.36 Assessment of serum and urinary biomarkers for pneumoconiosis in a cohort of stone workers exposed to asbestos-contaminated minerals

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.263 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A96.2-A96

Author(s):

Hsiao-Yu Yang ◽

Pau-Chung Chen

Keyword(s):

Machine Learning ◽

Operating Characteristic ◽

Prediction Models ◽

Learning Algorithm ◽

Characteristic Curve ◽

Screening Method ◽

Urinary Biomarkers ◽

Machine Learning Algorithm ◽

Dose Response Relationship

BackgroundPneumoconiosis is still a problem in workers process non-asbestiform asbestos minerals and serpentinite rocks, such as nephrite, antigorite or talc that may contaminate with paragenetic asbestos minerals. An effective screening method is still lacking. The objective of this study was to assess the diagnostic accuracy using the serum and urinary biomarkers for pneumoconiosis in workers exposed to asbestos-contaminated minerals.MethodsPrediction models of pneumoconiosis were constructed from 140 stone workers (48 cases of pneumoconiosis and 118 controls) exposed to asbestos-contaminated minerals. We measured serum soluble mesothelin-related peptide (SMRP), fibulin-3, carcinoembryonic antigen, and urinary 8-Oxo-2’-deoxyguanosine (8-OHdG)/creatinine levels. Using the ILO international classification of radiographs of pneumoconiosis profusion subcategory ≥1/0 as the reference standard, we established a prediction model by machine learning algorithm. We assessed the accuracy by the area under the receiver operating characteristic curve (AUROC).ResultsThe SMRP level increased in workers exposed to nephrite. A dose-response relationship was found between the SMRP level and the severity of pneumoconiosis in workers exposed to asbestos-contaminated minerals. Machine learning algorithm composed of sex, age, and 4 serum and urinary biomarkers is able to predict pneumoconiosis with high accuracy (AUROC ranged from 0.76 to 1.00).ConclusionOur finding highlight the use of serum and urinary biomarkers can be developed as a screening tool for pneumoconiosis in workers exposed to potential asbestos contaminated minerals.

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Beta-D-Glucan for Diagnosing Pneumocystis Pneumonia: a Direct Comparison between the Wako β-Glucan Assay and the Fungitell Assay

Journal of Clinical Microbiology ◽

10.1128/jcm.00322-19 ◽

2019 ◽

Vol 57 (6) ◽

Cited By ~ 7

Author(s):

Toine Mercier ◽

Ellen Guldentops ◽

Sofie Patteet ◽

Kurt Beuselinck ◽

Katrien Lagrou ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Diagnostic Performance ◽

Operating Characteristic ◽

Characteristic Curve ◽

Pneumocystis Pneumonia ◽

Radiological Findings ◽

Sample Testing ◽

Overall Performance ◽

Operating Characteristic Curve ◽

Better Than

ABSTRACT Measuring serum beta-d-glucan (BDG) is a useful tool for supporting a quantitative PCR (qPCR)-based diagnosis of suspected Pneumocystis pneumonia (PCP) with bronchoalveolar lavage (BAL) fluid. Since the 2000s, the Fungitell assay was the only BDG assay which was FDA cleared and Conformité Européenne (CE) marked. However, the Wako β-glucan test was also recently CE marked and commercialized. We analyzed archived sera from 116 PCP cases (who were considered to have PCP based on compatible clinical and radiological findings plus a BAL fluid qPCR threshold cycle value of ≤28) and 114 controls (those with a BAL fluid qPCR threshold cycle value of >45 and no invasive fungal infection) using the Fungitell and Wako assays in parallel and assessed their diagnostic performance using the manufacturer’s proposed cutoffs of 80 pg/ml and 11 pg/ml, respectively. We found the Wako assay to be more specific (0.98 versus 0.87, P < 0.001) and the Fungitell assay to be more sensitive (0.78 versus 0.85, P = 0.039) at the proposed cutoffs. Overall performance, as determined by the area under the receiver operating characteristic curve, was similar for both assays. We determined a new Wako assay cutoff (3.616 pg/ml) to match the sensitivity of the Fungitell assay (0.88 at a cutoff of ≥60 pg/ml). Using this newly proposed cutoff, the specificity of the Wako assay was significantly better than that of the Fungitell assay (0.89 versus 0.82, P = 0.011). In conclusion, the Wako assay performed excellently compared to the Fungitell assay for the diagnosis of presumed PCP based on qPCR. In addition, contrary to the Fungitell assay, the Wako assay allows for single-sample testing with lower inter- and intrarun variability. Finally, we propose an optimized cutoff for the Wako assay to reliably exclude PCP.

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Prediction of Death After Noncardiac Surgery: Potential Advantage of Using High‐Sensitivity Troponin T as a Continuous Variable

Journal of the American Heart Association ◽

10.1161/jaha.120.018008 ◽

2021 ◽

Author(s):

Mauricio N. Machado ◽

Fernando B. Rodrigues ◽

Marcelo A. Nakazone ◽

Danilo F. Martin ◽

Amália T. R. Sabbag ◽

...

Keyword(s):

Receiver Operating Characteristic Curve ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Troponin T ◽

Characteristic Curve ◽

High Sensitivity ◽

Continuous Variable ◽

Noncardiac Surgery ◽

Operating Characteristic Curve ◽

Age And Sex

Background Increased high‐sensitivity cardiac troponin T (hs‐cTnT) above the upper reference limit (URL) after noncardiac surgery identifies patients at risk for mortality. Prior studies have not analyzed hs‐cTnT as a continuous variable or probed age‐ and sex‐specific URLs. This study compared the prediction of 30‐day mortality using continuous postoperative hs‐cTnT levels to the use of the overall URL and age‐ and sex‐specific URLs. Methods and Results Patients (876) >40 years of age who underwent noncardiac surgery were included. Hs‐cTnT was measured on postoperative day 1. Cox proportional hazards models were used to compare associations between 30‐day mortality and using hs‐cTnT as a continuous variable, or above the overall or age‐ and sex‐specific URLs. Comparisons were performed by the area under the receiver operating characteristic curve analysis. Mortality was 4.2%. For each 1 ng/L increase in postoperative hs‐cTnT, there was a 0.3% increase in mortality ( P <0.001). Patients with postoperative hs‐cTnT >14 ng/L were 37% of the cohort, while those above age‐ and sex‐specific URLs were 25.3%. Both manifested higher mortality (hazard ratio [HR], 3.19; 95% CI, 1.20–8.49; P =0.020) and (HR, 2.76; P =0.009) than those with normal levels. The area under receiver operating characteristic curve was 0.89 using hs‐cTnT as a continuous variable, 0.87 for age‐ and sex‐specific URLs, and 0.86 for the overall URL. Conclusions Hs‐cTnT as a continuous variable was independently associated with 30‐day mortality and had the highest accuracy. Hs‐cTnT elevations using overall and/or age‐ and sex‐specific URLs were also associated with higher mortality.

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