scholarly journals Screening for Major Depression in the Early Stages of Multiple Sclerosis

1995 ◽  
Vol 22 (3) ◽  
pp. 228-231 ◽  
Author(s):  
Michael J.L. Sullivan ◽  
Brian Weinshenker ◽  
Samuel Mikail ◽  
Scott R. Bishop
Keyword(s):  
Multiple Sclerosis ◽  
Major Depression ◽  
Clinical Utility ◽  
False Negative ◽  
False Negative Rate ◽  
Adjustment Disorder ◽  
Structured Interview ◽  
Newly Diagnosed ◽  
Predictive Values ◽  
Screening Measure

AbstractBackgroundMultiple Sclerosis (MS) is associated with a high risk of developing major depression, but depression in MS patients frequently goes undetected and untreated. The current study examined the clinical utility of the Beck Depression Inventory (BDI) as a screening measure for major depression in newly diagnosed MS patients.MethodsForty-six new referrals to an MS clinic completed the BDI and participated in a structured interview for major depression, within 2 months of the diagnosis of MS.ResultsAccording to DSM-III-R criteria, 40% of patients were diagnosed with major depression, 22% had adjustment disorder with depressed mood, and 37% showed no evidence of mood disorder. Sensitivity and specificity values, and positive and negative predictive values are reported for every BDI cut-off score between 9 and 21.ConclusionsA BDI cut-off score of 13 (sensitivity = .71, specificity = .79) is recommended as optimal for use in screening for major depression in newly diagnosed MS patients. The use of the BDI as a screening measure for major depression must proceed with caution given that a cut-off score of 13 still yielded a false-negative rate of 30%.

scholarly journals Reducing the Number of Unnecessary Thyroid Biopsies While Improving Diagnostic Accuracy: Toward the “Right” TIRADS

2018 ◽  
Vol 104 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Giorgio Grani ◽  
Livia Lamartina ◽  
Valeria Ascoli ◽  
Daniela Bosco ◽  
Marco Biffoni ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Thyroid Nodules ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Classification Systems ◽  
American Thyroid Association ◽  
Predictive Values ◽  
Korean Society ◽  
The Right

Abstract Context The prevalence of thyroid nodules in the general population is increasingly high, and at least half of those biopsied prove to be benign. Sonographic risk-stratification systems are being proposed as “rule-out” tests that can identify nodules that do not require fine-needle aspiration (FNA) cytology. Objective To comparatively assess the performances of five internationally endorsed sonographic classification systems [those of the American Thyroid Association, the American Association of Clinical Endocrinologists, the American College of Radiology (ACR), the European Thyroid Association, and the Korean Society of Thyroid Radiology] in identifying nodules whose FNAs can be safely deferred and to estimate their negative predictive values (NPVs). Design Prospective study of thyroid nodules referred for FNA. Setting Single academic referral center. Patients Four hundred seventy-seven patients (358 females, 75.2%); mean (SD) age, 55.9 (13.9) years. Main Outcome Measures Number of biopsies classified as unnecessary, false-negative rate (FNR), sensitivity, specificity, predictive values, and diagnostic ORs for each system. Results Application of the systems’ FNA criteria would have reduced the number of biopsies performed by 17.1% to 53.4%. The ACR Thyroid Imaging Reporting and Data System (TIRADS) allowed the largest reduction (268 of 502) with the lowest FNR (NPV, 97.8%; 95% CI, 95.2% to 99.2%). Except for the Korean Society of Thyroid Radiology TIRADS, all other systems exhibited significant discriminatory performance but produced significantly smaller reductions in the number of procedures. Conclusions Internationally endorsed sonographic risk stratification systems vary widely in their ability to reduce the number of unnecessary thyroid nodule FNAs. The ACR TIRADS outperformed the others, classifying more than half the biopsies as unnecessary with a FNR of 2.2%.

scholarly journals An assessment of the accuracy of contrast enema for the diagnosis of Hirschsprung disease at a South African tertiary hospital

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica S. Msomi ◽  
Hansraj Mangray ◽  
Vicci Du Plessis
Keyword(s):  
Diagnostic Accuracy ◽  
South African ◽  
False Negative ◽  
False Negative Rate ◽  
Hirschsprung Disease ◽  
Contrast Enema ◽  
Initial Screening ◽  
Tertiary Referral Hospital ◽  
Predictive Values ◽  
Picture Archiving And Communication

Objectives: To compare radiological findings with the histological diagnosis of Hirschsprung disease (HD) to establish the usefulness of contrast enema as an initial screening and diagnostic tool. To correlate accuracy of radiological diagnosis at Grey’s Hospital with international standards.Materials and methods: Systematic searches were conducted through the Picture Archiving and Communication System and the National Health Laboratory Service records for patients aged 0–12 years, with clinically suspected HD, for whom both contrast enemas and rectal biopsies were performed between 01 January 2011 and 31 August 2015 in a tertiary-level hospital. A total of 54 such patients were identified. Diagnostic accuracy levels were calculated by comparing radiological results with histology results, which is the gold standard.Results: Diagnostic accuracy of contrast enema was 78%, sensitivity was 94.4% and the negative predictive value was 95.7%. Specificity (68.8%) and positive predictive values (63%) were considerably lower. A lower false-negative rate of 5.6% was obtained at Grey’s Hospital as compared with the international reports of up to 30%.Conclusion: Contrast enema remains useful as an initial screening and diagnostic test for HD. Results of this South African tertiary referral hospital were consistent with the best international results for sensitivity of the contrast enema (approximately 80% – 88% in excluding the disease).

Secondary Complete Cytoreduction in Recurrent Ovarian Cancer: Benefit of Optimal Patient Selection Using Scoring System

2014 ◽  
Vol 24 (2) ◽  
pp. 238-246 ◽  
Author(s):  
Enora Laas ◽  
Mathieu Luyckx ◽  
Marjolein De Cuypere ◽  
Frederic Selle ◽  
Emile Daraï ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Patient Selection ◽  
Positive Impact ◽  
False Negative ◽  
False Negative Rate ◽  
Recurrent Ovarian Cancer ◽  
Complete Resection ◽  
Predictive Values ◽  
Independent Population ◽  
The Impact

ObjectiveComplete tumor cytoreduction seems to be beneficial for patients with recurrent epithelial ovarian cancer (REOC). The challenge is to identify patients eligible for such surgery. Several scores based on simple clinical parameters have attempted to predict resectability and help in patient selection for surgery in REOC.The aims of this study were to assess the performance of these models in an independent population and to evaluate the impact of complete resection.Materials and MethodsA total of 194 patients with REOC between January 2000 and December 2010 were included in 2 French centers. Two scores were used: the AGO DESKTOP OVAR trial score and a score from Tian et al.The performance (sensitivity, specificity, and predictive values) of these scores was evaluated in our population. Survival curves were constructed to evaluate the survival impact of surgery on recurrence.ResultsPositive predictive values for complete resection were 80.6% and 74.0% for the DESKTOP trial score and the Tian score, respectively. The false-negative rate was high for both models (65.4% and 71.4%, respectively). We found a significantly higher survival in the patients with complete resection (59.4 vs 17.9 months,P< 0.01) even after adjustment for the confounding variables (hazard ratio [HR], 2.53; 95% confidence interval, 1.01–6.3;P= 0.04).ConclusionsIn REOC, surgery seems to have a positive impact on survival, if complete surgery can be achieved. However, factors predicting complete resection are not yet clearly defined. Recurrence-free interval and initial resection seem to be the most relevant factors. Laparoscopic evaluation could help to clarify the indications for surgery.

scholarly journals False negativity rate of ultrasonography with mammography in women with palpable breast lumps

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1800-1804
Author(s):  
Sudha M ◽  
Prashant Moorthy
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Imaging ◽  
False Negative ◽  
False Negative Rate ◽  
Predictive Values ◽  
High Negative Predictive Value ◽  
Study Population ◽  
Palpable Breast ◽  
Breast Lumps

This study was performed to determine the false negativity rates of ultrasonography with mammography in the assessment of women with palpable breast lumps. The relevant data on 202 female patients aged above 14 years of age, who had presented to our institution with a breast lump, had been retrospectively reviewed from our hospital database. Out of these, 155 patients for whom mammography with sonography imaging (MSI) was done were included in the study population. It consisted of tissue-positive cases, tissue-negative cases, and false-negative MSI confirmed on pathology. All cancer cases and false-negative cases using MSI were identified. Cancer rates, false-negative rates, and negative predictive values were calculated based on MSI breast imaging reporting and BI-RADS categories. Among patients who had undergone MSI, 73.55 % (114/155) of patients had BI-RADS 1–2. Despite a benign result, 10.5% (12/114) of them had gone ahead with a tissue diagnosis, whereas BI-RADS 4 and 5 had a 100% biopsy rate (28/28, 4/4, respectively). Out of the seventeen cancers detected in toto, only one belonged to BI-RADS 1–2. The false-negative rate of MSI (i.e., BI-RADS 1–2) was found to be 1.75% (1/114). As none of the remaining cases had progressed into malignancy post-follow-up (Median: 9 months, Range: 2 – 13 months), The negative predictive value (NPV) and cancer rate were estimated to be 99.12% and 0.88% respectively. Therefore, low false negativity and high negative predictive value of mammography with ultrasonography imaging for breast lumps were established.

Computerized prediction system for the route of delivery (vaginal birth versus cesarean section)

2018 ◽  
Vol 46 (8) ◽  
pp. 881-884 ◽  
Author(s):  
Mehmet Sinan Beksac ◽  
Atakan Tanacan ◽  
Hikmet Ozge Bacak ◽  
Kemal Leblebicioglu
Keyword(s):  
Cesarean Section ◽  
Learning Algorithm ◽  
False Negative ◽  
False Negative Rate ◽  
Prediction System ◽  
Predictive Values ◽  
Specificity And Sensitivity ◽  
Delivery Route ◽  
Computerized System ◽  
Route Of Delivery

Abstract Aim To develop a supportive computerized prediction system for the route of delivery. Materials and methods This study consisted of 2127, 3548 and 1723 deliveries for the years 1976, 1986 and 1996, respectively. We have developed a supervised artificial neural network (ANN) for predicting the delivery route. We have used a back-propagation learning algorithm for this purpose. The data used for the computerized system were obtained during the admission of the patients to the delivery room at the beginning of the first stage of labor after pelvic examination and examination/evaluation of the mother and fetus. The input variables for the ANN were maternal age, gravida, parity, gestational age at birth, necessity and type of labor induction, presentation of the baby at birth, and maternal disorders and/or risk factors. The outputs of the algorithm were vaginal delivery or cesarean section (CS). Results The CS rates in 1976, 1986 and 1996 were 9.1%, 18.5% and 44.5%, respectively. We have demonstrated that the system’s specificity and sensitivity were 97.5% and 60.9%, respectively. The false positive rate was 2.5%, whereas the false negative rate was 39.1%. The positive and negative predictive values were 81.8% and 93.1%, respectively. Conclusion Our computerized system, heretofore named as the “Adana System,” can be used as a supportive decision-making system for predicting the delivery route. The Adana System might be a useful tool to protect physicians against adverse medicolegal issues.

scholarly journals Predictive values, uncertainty, and interpretation of serology tests for the novel coronavirus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naomi C. Brownstein ◽  
Yian Ann Chen
Keyword(s):  
Disease Burden ◽  
False Negative ◽  
False Negative Rate ◽  
Supplementary Information ◽  
The Novel ◽  
Positive Serology ◽  
Predictive Values ◽  
Infected People ◽  
Novel Coronavirus ◽  
Different Levels

AbstractAntibodies testing in the coronavirus era is frequently promoted, but the underlying statistics behind their validation has come under more scrutiny in recent weeks. We provide calculations, interpretations, and plots of positive and negative predictive values under a variety of scenarios. Prevalence, sensitivity, and specificity are estimated within ranges of values from researchers and antibodies manufacturers. Illustrative examples are highlighted, and interactive plots are provided in the Supplementary Information. Implications are discussed for society overall and across diverse locations with different levels of disease burden. Specifically, the proportion of positive serology tests that are false can differ drastically from up to 3%–88% for people from different places with different proportions of infected people in the populations while the false negative rate is typically under 10%.

Assessing the Clinical Utility of the Eating Beliefs Questionnaire

2020 ◽  
Vol 36 (2) ◽  
pp. 421-426 ◽  
Author(s):  
Amy L. Burton ◽  
Evelyn Smith ◽  
Maree J. Abbott
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Clinical Utility ◽  
Structured Interview ◽  
Self Report ◽  
Predictive Values ◽  
Negative Beliefs ◽  
Cutoff Scores ◽  
Eating Disorders Examination ◽  
Sensitivity Specificity

Abstract. The Eating Beliefs Questionnaire (EBQ) is a valid and reliable self-report tool measuring positive and negative beliefs about binge eating. This study sought to further investigate the clinical utility of the EBQ using a clinical binge eating sample and a healthy control comparison group. Clinical participants were 74 individuals seeking treatment for eating disorders: 38 with bulimia nervosa and 36 with binge eating disorder. Healthy controls were 114 individuals recruited from the general community. Participants all completed a test battery that included the EBQ. Diagnoses of clinical participants were confirmed using the semi-structured interview, the Eating Disorders Examination, administered by a trained clinician. The EBQ and its subscales showed good internal consistency, and significant differences between the clinical and nonclinical groups were observed for EBQ total and subscales scores, but not between the two clinical groups. Receiver operating characteristic (ROC) curve analyses revealed optimal cutoff scores for the EBQ, which demonstrated excellent sensitivity, specificity, and positive and negative predictive values. Results from this study provide further evidence in support of the EBQ’s psychometric properties. Clinical cutoff scores can be used to assess severity of binge eating-related cognitions in both research and clinical settings.

Comparative assessment of Yale Single Q uestion and Beck Depression Inventory Scale in screening for depression in multiple sclerosis

2003 ◽  
Vol 9 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Jagannadha R Avasarala ◽  
Anne H Cross ◽  
Kathryn Trinkaus
Keyword(s):  
Multiple Sclerosis ◽  
Beck Depression Inventory ◽  
Predictive Value ◽  
Rating Scale ◽  
False Negative ◽  
False Negative Rate ◽  
Outpatient Setting ◽  
Self Report ◽  
Study Results ◽  
Antidepressant Use

Objectives: To examine if depression in multiple sclerosis (MS) can be accurately recognized using the Yale Single Q uestion (YSQ) screen as compared with the Beck Depression Inventory (BDI), a 21-item self-report rating scale for depression. In addition, we sought to assess the sensitivity, specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of the YSQ. Background:Depression associated with MS is a major contributo r to morbidity. Screening for depression in patients with MS currently includes the BD1, which measures characteristic attitudes and symptoms of depression. However, in a busy outpatient clinic, the BDI might not be the most appro priate instrument, particularly if depression screening can be assessed accurately using simpler techniques that are easy to administer and consume less time. We compared the accuracy of the YSQ screen response against the BDI to screen for depression in MS patients, in an outpatient setting. Methods: This is a comparative outcome study of two ‘instruments’ used for screening depression in MS patients in an academic outpatient setting. A ll patients were initially screened for depression by asking patients the YSQ - ‘Do you frequently feel sad or depressed?’, followed by BDI administration. Depression was defined as a score of]-13 on the BDI. O ne hundred and twenty successive patients who presented to the MS clinic at Washington University School of Medicine and met the criteria for diagnosis of MS were screened for depression. A ll patients diagnosed as having MS, regardless of type, were included in the study. Results: O f the 120 patients studied, a total of 49 of 120 were clinically depressed as defined by a BDI cut-o ff of]-13; 71 of 120 were not. The sensitivity of the YSQ was 32 of 49=65.3% with a 95% confidence interval (0.50, 0.78), specificity was 62 of 71=87.3% (0.77, 0.94), PPV was 32 of 41=78.0% (0.62, 0.89) and NPV was 62 of 79=78.5% (0.68, 0.87). O f the 49 patients depressed by BDI criteria, 17 responded ‘no’ to the YSQ, yielding a false-negative rate of 34.7% (0.22, 0.50). The Wilcoxon -Mann -Whitney test for difference in age among those on antidepressants compared with those who were not showed no statistical difference (P =0.35). For patients on antidepressants, the mean BDI score was 16.09-8.9 (mean9-SD) and 9.59-8.7 for those not on antidepressants. Differences in BDI scores among patients on antidepressants versus those who were not were statistically significant (P B-0.0001). Patients on antidepressants had significantly higher BDI scores. Conclusions: O ur results show that the YSQ cannot replace the BDI as a screening instrument for depression in MS. The YSQ could not identify 34.7% of patients who were depressed by BDI criteria. However, as reported in a published study, BDI missed 30% of cases with early depression in MS when a cut-o ff of]-13 was used. The YSQ appears to be specific in ruling out depression when a patient is not depressed. MS is a chronic disease and since prevalence of depression varies, it is important to screen patients repeatedly over time so as not to miss the diagnosis. That BDI scores were higher among those taking antidepressants underscores the fact that this subset of patients need to be on medicatio n, but the higher scores could also represent a sampling error since the duration of antidepressant use was not studied.

scholarly journals Are antibodies tests accurate? Understanding predictive values and uncertainty of serology tests for the novel coronavirus

2020 ◽  
Author(s):  
Naomi C Brownstein ◽  
Yian Ann Chen
Keyword(s):  
Disease Burden ◽  
False Negative ◽  
False Negative Rate ◽  
The Novel ◽  
Positive Serology ◽  
Predictive Values ◽  
Infected People ◽  
Supplementary Material ◽  
Novel Coronavirus ◽  
Different Levels

ABSTRACTAntibodies testing in the coronavirus era is frequently promoted, but the underlying statistics behind their validation has come under more scrutiny in recent weeks. We provide calculations, interpretations, and plots of positive and negative predictive values under a variety of scenarios. Prevalence, sensitivity, and specificity are estimated within ranges of values from researchers and antibodies manufacturers. Illustrative examples are highlighted, and interactive plots are provided in the Supplementary Material. Implications are discussed for society overall and across diverse locations with different levels of disease burden. Specifically, the proportion of positive serology tests that are false can differ drastically from up to 3% to 88% for people from different places with different proportions of infected people in the populations while the false negative rate is typically under 10%.

Diagnostic Accuracy and Clinical Utility of Endoscopic Bile Duct Brushing in the Evaluation of Biliary Strictures

1999 ◽  
Vol 123 (8) ◽  
pp. 712-715 ◽  
Author(s):  
Vincent Trent ◽  
Kamal K. Khurana ◽  
Latha R. Pisharodi
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
False Positive ◽  
Clinical Utility ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Atypical Hyperplasia ◽  
Biliary Strictures

Abstract Pathologic evidence of malignancy in biliary strictures is useful in the preoperative setting because it helps define therapeutic planning and prognosis. The purpose of this study was to assess the diagnostic accuracy and clinical utility of endoscopic bile duct brushings in the evaluation of bile duct strictures. We retrospectively evaluated 34 endoscopic biliary brushings derived from 31 patients with bile duct strictures. Relevant clinical and follow-up data were collected. Histologic specimens were reviewed in patients undergoing subsequent biopsies. Patients included 18 men and 13 women with an age range of 25 to 79 years (mean, 52 years). All patients had histologic and/or clinical follow-up. Cytologic diagnosis included cholangiocarcinoma (14.7%), suspicious for cholangiocarcinoma (5.9%), atypical hyperplasia (17.6%), and negative for malignancy (61.7%). All positive diagnoses were confirmed by histologic testing (false-positive rate, 0%). The cases that were suspicious for cholangiocarcinoma and the 5 atypical hyperplasia cases were also subsequently diagnosed as cholangiocarcinoma by biopsy. One atypical case was diagnosed as pancreatic carcinoma. All 21 negative cases were confirmed by biopsies (15) and clinical follow-up (6) (false-negative rate, 20%). Endoscopic bile duct brushing is diagnostically accurate and hence clinically useful in the management of patients with bile duct strictures. Atypical hyperplasias may contribute to diagnostic pitfalls leading to false-positive and false-negative diagnoses.

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