Lower spatial QRS-T angle rules out sustained ventricular arrhythmias in children with hypertrophic cardiomyopathy

2016 ◽  
Vol 27 (2) ◽  
pp. 354-358 ◽  
Author(s):  
Daniel Cortez ◽  
Nandita Sharma ◽  
Jean Cavanaugh ◽  
Froilan Tuozo ◽  
Gwendolyn Derk ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Odds Ratio ◽  
Qt Interval ◽  
Ventricular Arrhythmias ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Values ◽  
Corrected Qt Interval ◽  
High Negative Predictive Value ◽  
Operating Characteristic Curve

AbstractIntroductionThe spatial peaks QRS-T angle accurately distinguishes children with hypertrophic cardiomyopathy from their healthy counterparts. The spatial peaks QRS-T angle is also useful in risk stratification for ventricular arrhythmias. We hypothesised that the spatial peaks QRS-T angle would be useful for the prediction of ventricular arrhythmias in hypertrophic cardiomyopathy patients under 23 years of age.MethodsCorrected QT interval and spatial peaks QRS-T angles were retrospectively assessed in 133 paediatric hypertrophic cardiomyopathy patients (12.4±6.6 years) with versus without ventricular arrhythmias of 30 seconds or longer. Significance, positive/negative predictive values, and odds ratios were calculated based on receiver operating characteristic curve cut-off values.ResultsIn total, 10 patients with ventricular arrhythmias were identified. Although the corrected QT interval did not differentiate those with versus without ventricular arrhythmias, the spatial peaks QRS-T angle did (151.4±19.0 versus 116.8±42.6 degrees, respectively, p<0.001). At an optimal cut-off value (124.1 degrees), the positive and negative predictive values of the spatial peaks QRS-T angle were 15.4 and 100.0%, respectively, with an odds ratio of 25.9 (95% CI 1.5–452.2).ConclusionIn children with hypertrophic cardiomyopathy, the spatial peaks QRS-T angle is associated with ventricular arrhythmia burden with high negative predictive value and odds ratio.

scholarly journals SAA (Serum Amyloid A)

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3523-3530
Author(s):  
Juliane Schweizer ◽  
Alejandro Bustamante ◽  
Vanessa Lapierre-Fétaud ◽  
Júlia Faura ◽  
Natalie Scherrer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Receiver Operating Characteristic Curve ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Serum Amyloid A ◽  
Operating Characteristic ◽  
Independent Predictor ◽  
Characteristic Curve ◽  
Amyloid A ◽  
Operating Characteristic Curve

Background and Purpose: The aim of this study was to evaluate and independently validate SAA (serum amyloid A)—a recently discovered blood biomarker—to predict poststroke infections. Methods: The derivation cohort (A) was composed of 283 acute ischemic stroke patients and the independent validation cohort (B), of 367 patients. The primary outcome measure was any stroke-associated infection, defined by the criteria of the US Centers for Disease Control and Prevention, occurring during hospitalization. To determine the association of SAA levels on admission with the development of infections, logistic regression models were calculated. The discriminatory ability of SAA was assessed, by calculating the area under the receiver operating characteristic curve. Results: After adjusting for all predictors that were significantly associated with any infection in the univariate analysis, SAA remained an independent predictor in study A (adjusted odds ratio, 1.44 [95% CI, 1.16–1.79]; P =0.001) and in study B (adjusted odds ratio, 1.52 [1.05–2.22]; P =0.028). Adding SAA to the best regression model without the biomarker, the discriminatory accuracy improved from 0.76 (0.69–0.83) to 0.79 (0.72–0.86; P <0.001; likelihood ratio test) in study A. These results were externally validated in study B with an improvement in the area under the receiver operating characteristic curve, from 0.75 (0.70–0.81) to 0.76 (0.71–0.82; P <0.038). Conclusions: Among patients with ischemic stroke, blood SAA measured on admission is a novel independent predictor of infection after stroke. SAA improved the discrimination between patients who developed an infection compared with those who did not in both derivation and validation cohorts. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00390962.

Carboplatin dosing in the treatment of epithelial ovarian cancer (EOC): A Gynecologic Oncology Group (GOG) study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5041-5041
Author(s):  
Roisin Eilish O'Cearbhaill ◽  
Austin Miller ◽  
Franco Muggia ◽  
Judith A. Smith ◽  
Michael A. Bookman ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Gynecologic Oncology ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Predictive Values ◽  
Phase Iii Trial ◽  
Operating Characteristic Curve ◽  
Grade 3 ◽  
The Relationship

5041 Background: Optimal carboplatin dosing (CPRx) for patients (pts) with renal dysfunction or low creatinine (Cr) values in the setting of malnutrition and ascites is unknown. Multiple methods have been utilized to estimate Cr clearance (CrCl) but these perform differently in pts with abnormal Cr values. We sought to determine 1) the relationship between adverse events (AE) and baseline CrCl used for CPRx; 2) the effect on CPRx of using Cockcroft-Gault (CG) +/- the NCI/CTEP recommended limits (CGL), Modification of diet in renal disease (MDRD) or Jelliffe Formula (J) renal function estimates. Methods: Retrospective data were drawn from pts treated on GOG 182, a phase III trial of carboplatin doublet vs triplet or sequential doublet combinations in stage III/IV EOC. For patient safety, the protocol was amended to assign the lower limit of Cr at 0.6mg/dl for CPRx. Area under the receiver operating characteristic curve (AUC) was used to describe associations between CrClJ and various AE. Sensitivity and positive predictive values (PPV) described the AE rate in pts with CrClJ <60ml/min. CPRx for each pt was calculated using J, CG, CGL and MDRD. Results: 3830 evaluable pts had a mean age 58.7yrs, mean BMI 26.8kg/m2 and mean baseline CrClJ 81.9ml/min (range 23.4-239). The AUC statistics (range 0.52-0.64) show that the log(CrClJ) was not a good predictor of grade ≥3 AE (anemia, thrombocytopenia, febrile neutropenia, auditory, renal, metabolic, neurologic). A cutoff value of CrClJ <60 ml/min would have deemed 15% of pts treated on GOG182 ineligible. The range of PPV for the above AEs in pts with CrClJ <60 ml/min was 1.8-15%. Using CG, CGL, MDRD instead of J for CPRx would have resulted in >10% decrease in CPRx in 21%, 32% and 12% of pts, respectively. Using CG, CGL, MDRD instead of J for CPRx would have resulted in >10% increase in CPRx in 45%, 9.6% and 5.2% of pts, respectively. Conclusions: Our data do not support excluding patients with CrClJ <60ml/min from clinical trials. The new GOG guidelines replacing J with CGL affect CPRx. The clinical significance of this change with regards to toxicity, particularly in pts with abnormally low Cr values, is yet to be determined.

scholarly journals Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110161
Author(s):  
Jiajia Song ◽  
Xianping Huang ◽  
Shenzhi Zhao ◽  
Jiajia Chen ◽  
Ruiheng Chen ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cardiac Auscultation ◽  
Relative Operating Characteristic ◽  
Operating Characteristic Curve ◽  
Sensitivity Specificity

Objective This study aimed to investigate the feasibility and reliability of pulse oximetry combined with cardiac auscultation in screening neonatal congenital heart disease (CHD). Methods This was a retrospective, observational, screening study. All newborns included in the study were at the Second Affiliated Hospital of Wenzhou Medical University from July 2019 to January 2020. Primary screening of CHD was conducted by pulse oximetry combined with cardiac auscultation assays. Indices, including sensitivity, specificity, the positive/negative predictive value, the positive/negative likelihood ratio, and the diagnostic odds ratio, were calculated. The area under the relative operating characteristic curve of the subjects was measured. Results A total of 3327 neonates were enrolled, among whom 139 were diagnosed with CHD and the incidence of CHD was 4.2%. The sensitivity, specificity, diagnostic odds ratio, and area under the relative operating characteristic curve of pulse oximetry combined with cardiac auscultation were 89.9%, 94.7%, 169.0, and 0.923, respectively. Conclusions Pulse oximetry combined with cardiac auscultation is a novel screening method with acceptable accuracy and feasibility for neonatal CHD. This combination method is worth promoting widely.

scholarly journals Externe Validierung einer Single-Item Skala zur Erfassung der Motivation zum Rauchstopp

2021 ◽  
Vol 67 (4) ◽  
pp. 171-180
Author(s):  
Yekaterina Pashutina ◽  
Sabrina Kastaun ◽  
Elena Ratschen ◽  
Lion Shahab ◽  
Daniel Kotz
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Odds Ratio ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Single Item ◽  
Logistische Regression ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Zusammenfassung. Zielsetzung: Die Motivation to Stop Scale (MTSS) ist eine englischsprachige Single-Item Skala zur Vorhersage von Rauchstoppversuchen. Ziel dieser Arbeit war die externe Validierung der deutschsprachigen Version der MTSS (Motivation zum Rauchstopp Skala, MRS) an einer Stichprobe von aktuell Tabakrauchenden in Deutschland. Methodik: Datenbasis war die Deutsche Befragung zum Rauchverhalten (DEBRA), eine deutschlandweite, persönlich-mündliche Haushaltsbefragung von Personen ab 14 Jahren mit telefonischer Nachbefragung nach 6 Monaten. Analysiert wurden Daten aus den ersten 18 Wellen (Juni 2016–Mai 2019) von 767 aktuell Tabakrauchenden. Die MRS (Stufe 1–7 = keine bis höchste Motivation) wurde bei der Erstbefragung eingesetzt. Bei der Nachbefragung wurde die Anzahl der Rauchstoppversuche seit Erstbefragung erfasst. Logistische Regression wurde durchgeführt und die diskriminative Genauigkeit der MRS mittels Area Under the Receiver Operating Characteristic Curve (ROC-AUC) berechnet. Ergebnisse: Bei Erstbefragung waren 61,1 % ( n = 469; 95 % Konfidenzintervall (KI) = 57.7–64.6) der 767 Rauchenden nicht zum Rauchstopp motiviert (MRS-Stufe 1–2). Insgesamt unternahmen 185 der 767 Rauchenden (24,1 %; 95 % KI = 21.1–27.1) zwischen der Erst- und Nachbefragung mindestens einen Rauchstoppversuch. Mit steigender Motivationsstufe auf der MRS nahm die Wahrscheinlichkeit für einen Rauchstoppversuch zu: Odds Ratio = 1.37, 95 % KI = 1.25–1.51, bei einer diskriminativen Genauigkeit von ROC-AUC = 0.64. Schlussfolgerung: Die MRS ist ein kurzes und valides Messinstrument zur Erfassung der Rauchstoppmotivation im deutschen Sprachraum.

Serum miR-21 and miR-26a Levels Negatively Correlate with Severity of Cirrhosis in Patients with Chronic Hepatitis B

MicroRNA ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Shili Jiang ◽  
Wei Jiang ◽  
Ying Xu ◽  
Xiaoning Wang ◽  
Yongping Mu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Pugh Class ◽  
Operating Characteristic Curve ◽  
Class C ◽  
Circulating Levels

Background and Objective: Accurately evaluating the severity of liver cirrhosis is essential for clinical decision making and disease management. This study aimed to evaluate the value of circulating levels of microRNA (miR)-26a and miR-21 as novel noninvasive biomarkers in detecting severity of cirrhosis in patients with chronic hepatitis B. </P><P> Methods: Thirty patients with clinically diagnosed chronic hepatitis B-related cirrhosis and 30 healthy individuals were selected. The serum levels of miR-26a and miR-21 were quantified by qRT-PCR. Receiver operating characteristic curve analysis was performed to evaluate the sensitivity and specificity of the miRNAs for detecting the severity of cirrhosis. Results: Serum miR-26a and miR-21 levels were found to be significantly downregulated in patients with severe cirrhosis scored at Child-Pugh class C in comparison to healthy controls (miR-26a p<0.01, and miR-21 p<0.001, respectively). The circulating miR-26a and miR-21 levels in patients were positively correlated with serum albumin concentration but negatively correlated with serum total bilirubin concentration and prothrombin time. Receiver operating characteristic curve analysis revealed that both serum miR-26a and miR-21 levels were associated with a high diagnostic accuracy for patients with cirrhosis scored at Child-Pugh class C (miR-26a Cut-off fold change at ≤0.4, Sensitivity: 84.62%, Specificity: 89.36%, P<0.0001; miR-21 Cut-off fold change at ≤0.6, Sensitivity: 84.62%, Specificity: 78.72%, P<0.0001). Our results indicate that the circulating levels of miR-26a and miR-21 are closely related to the extent of liver decompensation, and the decreased levels are capable of discriminating patients with cirrhosis at Child-Pugh class C from the whole cirrhosis cases.

A validated novel preoperative index to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology: A cohort study

2019 ◽  
Vol 30 (7-8) ◽  
pp. 221-228
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh ◽  
Nicholas Hobbs ◽  
Jigar Shah ◽  
Matthew Harris ◽  
...  
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Emergency Laparotomy ◽  
Contamination Index ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Aims To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology. Methods Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination. Results Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively. Conclusions As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.

scholarly journals Evaluation of factors that predict the success rate of trial of labor after the cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Mi ◽  
Pengfei Qu ◽  
Na Guo ◽  
Ruimiao Bai ◽  
Jiayi Gao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cesarean Section ◽  
Receiver Operating Characteristic Curve ◽  
Success Rate ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Training Set ◽  
History Of ◽  
Operating Characteristic Curve

Abstract Background For most women who have had a previous cesarean section, vaginal birth after cesarean section (VBAC) is a reasonable and safe choice, but which will increase the risk of adverse outcomes such as uterine rupture. In order to reduce the risk, we evaluated the factors that may affect VBAC and and established a model for predicting the success rate of trial of the labor after cesarean section (TOLAC). Methods All patients who gave birth at Northwest Women’s and Children’s Hospital from January 2016 to December 2018, had a history of cesarean section and voluntarily chose the TOLAC were recruited. Among them, 80% of the population was randomly assigned to the training set, while the remaining 20% were assigned to the external validation set. In the training set, univariate and multivariate logistic regression models were used to identify indicators related to successful TOLAC. A nomogram was constructed based on the results of multiple logistic regression analysis, and the selected variables included in the nomogram were used to predict the probability of successfully obtaining TOLAC. The area under the receiver operating characteristic curve was used to judge the predictive ability of the model. Results A total of 778 pregnant women were included in this study. Among them, 595 (76.48%) successfully underwent TOLAC, whereas 183 (23.52%) failed and switched to cesarean section. In multi-factor logistic regression, parity = 1, pre-pregnancy BMI < 24 kg/m2, cervical score ≥ 5, a history of previous vaginal delivery and neonatal birthweight < 3300 g were associated with the success of TOLAC. The area under the receiver operating characteristic curve in the prediction and validation models was 0.815 (95% CI: 0.762–0.854) and 0.730 (95% CI: 0.652–0.808), respectively, indicating that the nomogram prediction model had medium discriminative power. Conclusion The TOLAC was useful to reducing the cesarean section rate. Being primiparous, not overweight or obese, having a cervical score ≥ 5, a history of previous vaginal delivery or neonatal birthweight < 3300 g were protective indicators. In this study, the validated model had an approving predictive ability.

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