scholarly journals Accuracy of new Corvis ST parameters for detecting subclinical and clinical keratoconus eyes in a Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shengwei Ren ◽  
Liyan Xu ◽  
Qi Fan ◽  
Yuwei Gu ◽  
Kaili Yang
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Chinese Population ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Youden Index ◽  
Diagnostic Efficiency ◽  
Stiffness Parameter ◽  
Diagnostic Ability ◽  
Corvis St ◽  
Operating Characteristic Curve

AbstractThis study aimed to compare the values of new corneal visualization Scheimpflug technology (Corvis ST) parameters in normal, subclinical keratoconus (SKC) and keratoconus (KC) eyes, and evaluate the diagnostic ability to distinguish SKC and KC eyes from normal eyes. One-hundred normal, 100 SKC and 100 KC eyes were included in the study. Corvis ST parameters containing dynamic corneal response parameters were measured by one ophthalmologist. The receiver operating characteristic curve was used to evaluate the diagnostic ability of new Corvis ST parameters. The new Corvis ST parameters in KC eyes were different from those in the control and SKC eyes after adjusting for IOP and CCT, and stiffness parameter at the first applanation (SP-A1) and Corvis biomechanical index (CBI) were significantly different between the control and SKC eyes (all P < 0.05). The parameter with the highest diagnostic efficiency was SP-A1 (Youden index = 0.40, AUC = 0.753), followed by CBI (Youden index = 0.38, AUC = 0.703), and Integrated Radius (Youden index = 0.33, AUC = 0.668) in diagnosing SKC from control eyes. New Corvis ST parameters in SKC eyes were significantly different from normal control and KC eyes, and could be considered to distinguish SKC and KC eyes from normal eyes.

Preoperative skeletal muscle density is associated with postoperative mortality in patients with cardiovascular disease

2019 ◽  
Vol 30 (4) ◽  
pp. 515-522 ◽  
Author(s):  
Masashi Yamashita ◽  
Kentaro Kamiya ◽  
Atsuhiko Matsunaga ◽  
Tadashi Kitamura ◽  
Nobuaki Hamazaki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Skeletal Muscle ◽  
Receiver Operating Characteristic Curve ◽  
Prognostic Model ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Postoperative Mortality ◽  
Youden Index ◽  
Muscle Density ◽  
Operating Characteristic Curve

Abstract OBJECTIVES Although skeletal muscle density (SMD) is useful for predicting mortality, the cut-off in an acute clinical setting is unclear, especially in patients with cardiovascular disease (CVD). This study was performed to determine the preoperative SMD cut-off using the psoas muscle and to investigate the effect on postoperative outcomes, including sarcopaenia, in CVD patients. METHODS Preoperative psoas SMD was measured by abdominal computed tomography in CVD patients. Postoperative sarcopaenia was defined according to the criteria of the Asia Working Group for Sarcopaenia. The Youden index was used to test the predictive accuracy of survival models. The prognostic capability was evaluated using multivariable survival and receiver operating characteristic curve analyses. RESULTS Continuous data were available for 1068 patients (mean age 65.5 years; 63.6% male). A total of 105 (9.8%) deaths occurred during the 1.99-year median follow-up period (interquartile range 0.71–4.15). The psoas SMD cut-off estimated by the Youden index was 45 Hounsfield units with high sensitivity and moderate specificity for all-cause mortality and was consistent in various stratified analyses. After adjusting for the existing prognostic model, EuroSCORE II, preoperative and postoperative physical status, psoas SMD cut-off was predicted for mortality (hazard ratio 2.42, 95% confidence interval 1.32–4.45). The psoas SMD cut-off was also significantly associated with postoperative sarcopaenia and provided additional prognostic information to EuroSCORE II on receiver operating characteristic curve analysis (area under the curve 0.627 vs 0.678, P = 0.011). CONCLUSIONS Reduced psoas SMD was associated with postoperative mortality and added information prognostic for mortality to the existing prognostic model in CVD patients.

scholarly journals Handgrip Strength Could Be an Early Predictor of Cognitive Impairment in the Chinese Population

2021 ◽  
Author(s):  
Hang Su ◽  
Xiaokang Sun ◽  
Fang Li ◽  
Qihao Guo
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Receiver Operating Characteristic Curve ◽  
Chinese Population ◽  
Operating Characteristic ◽  
Handgrip Strength ◽  
Characteristic Curve ◽  
Normal Individuals ◽  
Operating Characteristic Curve ◽  
Early Predictor

Abstract BackgroundThis study aimed to explore the level and changes of handgrip strength in pre-clinical Alzheimer’s disease (AD) and AD participates, and to evaluate the association between handgrip strength and cognitive function.Methods1431 participants from the memory clinic of Shanghai JiaoTong University Affiliated Sixth People’s Hospital and community were enrolled into the final analysis, included 596 AD, 288 mild cognitive impairment (MCI), and 547 normal individuals (NC). All participants received a comprehensive neuropsychological assessment. Mini-mental state examination (MMSE), montreal cognitive assessment-Basic (MoCA-BC), and the Chinese version of the Addenbrooke’s cognitive examination (ACE-III-CV) were used as cognitive tests. The receiver operating characteristic curve (ROC) was plotted to assess the power of the handgrip strength as a screening measure to discriminate AD and MCI.ResultsThe results showed that participants with lower handgrip strength had lower MMSE, MoCA-BC, and ACE-III-CV scores (P <0.05). Handgrip strength in the mild cognitive impairment (MCI) group was significantly lower than that of normal individuals (NC), and the AD group had a further decline (both P<0.01). Multivariate logistic regression was performed with the handgrip strength quartiles, the results showed ORs of AD for increasing levels of handgrip strength were 1.00, 0.58 (0.46–0.78), 0.51 (0.36–0.73), and 0.50 (0.35–0.68), showing a decreasing trend (Pfor trend < 0.001). The receiver operating characteristic curve demonstrated that the handgrip strength cut-off points for identification of AD were16.8 kg and 20.7 kg among the female participates above and under 70 yrs, 24.4 kg and 33.3 kg for the male participates above and under 70 yrs, respectively.ConclusionsStronger handgrip strength was associated with better performances on cognitive function, handgrip strength could be an early predictor of cognitive impairment in the Chinese population. The current study provides a foundation for non-cognitive features as early predictors of cognitive impairment, researches on the association between frailty and cognition will be further developed in the future.

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.

The gut hormone GLP-2 predicts cardiovascular risk in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Kahles ◽  
R.W Mertens ◽  
M.V Rueckbeil ◽  
M.C Arrivas ◽  
J Moellmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Funding Source ◽  
Cardiovascular Prognosis ◽  
Operating Characteristic Curve ◽  
Hs Crp

Abstract Background GLP-1 and GLP-2 (glucagon-like peptide-1/2) are gut derived hormones that are co-secreted from intestinal L-cells in response to food intake. While GLP-1 is known to induce postprandial insulin secretion, GLP-2 enhances intestinal nutrient absorption and is clinically used for the treatment of patients with short bowel syndrome. The relevance of the GLP-2 system for cardiovascular disease is unknown. Purpose The aim of this study was to assess the predictive capacity of GLP-2 for cardiovascular prognosis in patients with myocardial infarction. Methods Total GLP-2 levels, NT-proBNP concentrations and the Global Registry of Acute Coronary Events (GRACE) score were assessed at time of admission in 918 patients with myocardial infarction, among them 597 patients with NSTEMI and 321 with STEMI. The primary composite outcome of the study was the first occurrence of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (3-P-MACE) with a median follow-up of 311 days. Results Kaplan-Meier survival plots (separated by the median of GLP-2 with a cut-off value of 4.4 ng/mL) and univariable cox regression analyses found GLP-2 values to be associated with adverse outcome (logarithmized GLP-2 values HR: 2.87; 95% CI: 1.75–4.68; p&lt;0.0001). Further adjustment for age, sex, smoking, hypertension, hypercholesterolemia, diabetes mellitus, family history of cardiovascular disease, hs-Troponin T, NT-proBNP and hs-CRP levels did not affect the association of GLP-2 with poor prognosis (logarithmized GLP-2 values HR: 2.96; 95% CI: 1.38–6.34; p=0.0053). Receiver operating characteristic curve (ROC) analyses illustrated that GLP-2 is a strong indicator for cardiovascular events and proved to be comparable to other established risk markers (area under the curve of the combined endpoint at 6 months; GLP-2: 0.72; hs-Troponin: 0.56; NT-proBNP: 0.70; hs-CRP: 0.62). Adjustment of the GRACE risk estimate by GLP-2 increased the area under the receiver-operating characteristic curve for the combined triple endpoint after 6 months from 0.70 (GRACE) to 0.75 (GRACE + GLP-2) in NSTEMI patients. Addition of GLP-2 to a model containing GRACE and NT-proBNP led to a further improvement in model performance (increase in AUC from 0.72 for GRACE + NT-proBNP to 0.77 for GRACE + NT-proBNP + GLP-2). Conclusions In patients admitted with acute myocardial infarction, GLP-2 levels are associated with adverse cardiovascular prognosis. This demonstrates a strong yet not appreciated crosstalk between the heart and the gut with relevance for cardiovascular outcome. Future studies are needed to further explore this crosstalk with the possibility of new treatment avenues for cardiovascular disease. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German Society of Cardiology (DGK), German Research Foundation (DFG)

A conditional approach for the receiver operating characteristic curve construction to evaluate diagnostic test performance in a family-matched case–control design

2021 ◽  
pp. 096228022199595
Author(s):  
Yalda Zarnegarnia ◽  
Shari Messinger
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Control ◽  
Paired Data ◽  
Characteristic Curves ◽  
Receiver Operating Characteristic Curves ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Receiver operating characteristic curves are widely used in medical research to illustrate biomarker performance in binary classification, particularly with respect to disease or health status. Study designs that include related subjects, such as siblings, usually have common environmental or genetic factors giving rise to correlated biomarker data. The design could be used to improve detection of biomarkers informative of increased risk, allowing initiation of treatment to stop or slow disease progression. Available methods for receiver operating characteristic construction do not take advantage of correlation inherent in this design to improve biomarker performance. This paper will briefly review some developed methods for receiver operating characteristic curve estimation in settings with correlated data from case–control designs and will discuss the limitations of current methods for analyzing correlated familial paired data. An alternative approach using conditional receiver operating characteristic curves will be demonstrated. The proposed approach will use information about correlation among biomarker values, producing conditional receiver operating characteristic curves that evaluate the ability of a biomarker to discriminate between affected and unaffected subjects in a familial paired design.

Receiver operating characteristic curve estimation for time to event with semicompeting risks and interval censoring

2016 ◽  
Vol 25 (6) ◽  
pp. 2750-2766 ◽  
Author(s):  
Hélène Jacqmin-Gadda ◽  
Paul Blanche ◽  
Emilie Chary ◽  
Célia Touraine ◽  
Jean-François Dartigues
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Censored Data ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Disease Onset ◽  
Interval Censoring ◽  
Inverse Probability ◽  
Operating Characteristic Curve ◽  
Semicompeting Risks

Semicompeting risks and interval censoring are frequent in medical studies, for instance when a disease may be diagnosed only at times of visit and disease onset is in competition with death. To evaluate the ability of markers to predict disease onset in this context, estimators of discrimination measures must account for these two issues. In recent years, methods for estimating the time-dependent receiver operating characteristic curve and the associated area under the ROC curve have been extended to account for right censored data and competing risks. In this paper, we show how an approximation allows to use the inverse probability of censoring weighting estimator for semicompeting events with interval censored data. Then, using an illness-death model, we propose two model-based estimators allowing to rigorously handle these issues. The first estimator is fully model based whereas the second one only uses the model to impute missing observations due to censoring. A simulation study shows that the bias for inverse probability of censoring weighting remains modest and may be less than the one of the two parametric estimators when the model is misspecified. We finally recommend the nonparametric inverse probability of censoring weighting estimator as main analysis and the imputation estimator based on the illness-death model as sensitivity analysis.

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