Aspiration Screening in Motor Neuron Disease: Preliminary Results From Utilization of the Yale Swallow Protocol

Purpose Dysphagia is a common symptom experienced by patients with motor neuron disease (MND). The Yale Swallow Protocol (YSP) is a validated screening instrument for identifying patients at risk for aspiration. The purpose of this exploratory cross-sectional, multicenter study was to investigate how the YSP results in identifying aspiration risk in patients with MND in comparison with aspiration observed during a videofluoroscopic swallow study (VFSS). Method Participants referred for VFSS as part of clinical management were recruited from four specialized MND clinics. All participants were administered the YSP immediately prior to the VFSS by a speech-language pathologist, with results recorded as pass or fail. Aspiration on VFSS was determined using the Penetration–Aspiration Scale (scores 6–8). A 2 × 2 contingency table was constructed to compare results of YSP with those on VFSS. Results Thirty-one patients with MND (13 males, 18 females; M age = 64 ± 12 years) referred for VFSS participated in this study. Of the 22 patients who failed the YSP, interrupted drinking was the most frequent reason (65%). Compared to the VFSS, the YSP yielded a sensitivity of 80%, a specificity of 33%, positive predictive value of 36%, and negative predictive value of 78%. Conclusions The YSP is a simple tool and easy to utilize and has a high sensitivity in identifying aspiration risk in amyotrophic lateral sclerosis. A future investigation with a larger sample size is needed to better investigate the utility of YSP as a screening tool for this population.

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Detecting proteinuria: A comparison of diagnostic tests

Paediatrica Indonesiana ◽

10.14238/pi51.1.2011.17-21 ◽

2011 ◽

Vol 51 (1) ◽

pp. 17

Author(s):

Jeanida Mauliddina ◽

Rosmayanti Siregar ◽

Oke Rina Ramayani ◽

Rafita Ramayati ◽

Rusdidjas Rusdidjas

Keyword(s):

Sensitivity And Specificity ◽

Predictive Value ◽

High Sensitivity ◽

Cross Sectional Study ◽

Common Symptom ◽

Sulfosalicylic Acid ◽

Cross Sectional ◽

Renal Disorders ◽

Acid Test ◽

Urine Specimens

Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.

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Ex Vivo assessment of competent strut coverage after coronary stenting by optical coherence tomography

European Heart Journal ◽

10.1093/ehjci/ehaa946.2471 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Bhoite ◽

H Jinnouchi ◽

F Otsuka ◽

Y Sato ◽

A Sakamoto ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Predictive Value ◽

Ex Vivo ◽

High Sensitivity ◽

Optical Coherence ◽

Cross Sectional ◽

Neointimal Thickness ◽

Stent Strut ◽

Oct Imaging ◽

Definition Of

Abstract Background In many studies, struts coverage is defined as >0 mm of tissue overlying the stent struts by optical coherence tomography (OCT). However, this definition has never been validated using histology as the “gold standard”. The present study sought to assess the appropriate cut-off value of neointimal thickness of stent strut coverage by OCT using histology. Methods OCT imaging was performed on 39 human coronary arteries with stents from 25 patients at autopsy. A total of 165 cross-sectional images from 46 stents were co-registered with histology. The optimal cut-off value of strut coverage by OCT was determined. Strut coverage by histology was defined as endothelial cells with at least underlying two layers of smooth muscle cells. Considering the resolution of OCT is 10–20 μm, 3 different cut-off values (i.e. at ≥20, ≥40, and ≥60 μm) were assessed. Results A total of 2235 struts were evaluated by histology. Eventually, 1216 struts which were well-matched struts were analyzed in this study. By histology, uncovered struts were observed in 160 struts and covered struts were observed in 1056 struts. The broadly used definition of OCT-coverage which does not consider neointimal thickness yielded a poor specificity of 37.5% and high sensitivity 100%. Of 3 cut-off values, the cut-off value of >40 μm was more accurate as compared to >20 and >60 mm [sensitivity (99.3%), specificity (91.0%), positive predictive value (98.6%), and negative predictive value (95.6%)] Conclusion The most accurate cut-off value was ≥40 μm neointimal thickness by OCT in order to identify stent strut coverage validated by histology. Funding Acknowledgement Type of funding source: None

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Evaluating Specivity, Sensitivity, Positive and Negative Predictive Values of CA125 for Diagnosing Ovarian Cancer

Journal of Arak University of Medical Sciences ◽

10.32598/jams.24.2.6002.1 ◽

2021 ◽

Vol 24 (2) ◽

pp. 196-203

Author(s):

Elahe Fini ◽

◽

Neda Nasirian ◽

Bahram Hosein Beigy ◽

◽

...

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Tumor Marker ◽

Negative Predictive Value ◽

Predictive Value ◽

Screening Test ◽

High Sensitivity ◽

Medical Community ◽

Cross Sectional ◽

Predictive Values

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.

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Development of the Brief Bedside Dysphagia Screening Test – Revised: a Cross-Sectional Czech Study

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2015.93 ◽

2015 ◽

Vol 58 (2) ◽

pp. 49-55 ◽

Cited By ~ 7

Author(s):

Petra Mandysová ◽

Edvard Ehler ◽

Jana Škvrňáková ◽

Michal Černý ◽

Iva Bártová ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Screening Test ◽

High Sensitivity ◽

Endoscopic Examination ◽

Swallowing Function ◽

Cross Sectional ◽

Neurological Conditions ◽

Nose And Throat

Aim: The purpose of this study was to develop a revised version of the Brief Bedside Dysphagia Screening Test for determining penetration/aspiration risk in patients prone to dysphagia. The priority was to achieve high sensitivity and negative predictive value. Methods: The study screeners conducted bedside assessment of the swallowing function in 157 patients with a neurological (mainly stroke) or an ear, nose, and throat diagnosis (mainly head and neck cancer). The results were compared with a gold standard, flexible endoscopic examination of swallowing. Results: For the neurological subgroup (N = 106), eight statistically significant bedside assessment items were combined into the Brief Bedside Dysphagia Screening Test-Revised (BBDST-R). Cut-off score 1 produced the highest sensitivity (95.5%; 95% confidence interval CI [CI]: 84.9–98.7%) and negative predictive value (88.9%; 95% CI 67.2–96.9%). Conclusion: The BBDST-R is suitable for dysphagia screening in departments caring for patients with neurological conditions.

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Transvaginal Ultrasonography and Hysteroscopy in Evaluation of Abnormal Uterine Bleeding- A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46163.15095 ◽

2021 ◽

Author(s):

G Sindhujha Sekar ◽

A Esther Ruby ◽

P Lalitha

Keyword(s):

Predictive Value ◽

Gold Standard ◽

Endometrial Hyperplasia ◽

Abnormal Uterine Bleeding ◽

High Sensitivity ◽

Cross Sectional Study ◽

Uterine Bleeding ◽

Age Group ◽

Sectional Study ◽

Cross Sectional

Introduction: In perimenopausal age group particularly, 70% of all gynaecological consultations are for Abnormal Uterine Bleeding (AUB). About 30% of women seek medical assistance for AUB during their reproductive age group and about one third of hysterectomies are carried out for AUB alone. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of Transvaginal Ultrasonography (TVS) versus hysteroscopy in detecting uterine abnormalities Materials and Methods: A cross-sectional study in patients with AUB, admitted to the Department of Obstetrics and Gynaecology at RGGWCH, Puducherry between February 2016 and February 2017 who met the inclusion criteria were included. Sample size was 85 cases. After taking detailed history and physical examination the patient was investigated to rule out organic causes of AUB and then TVS and hysteroscopy were done. Any intrauterine pathology was looked for and endometrial sampling was taken from the abnormal sites for Histopathological Examination (HPE). Both TVS and hysteroscopy results were compared with histopathology which is the gold standard. Results: The sensitivity of TVS in diagnosis of uterine fibroid in comparison to hysteroscopy was 94.74% and the specificity was 71.21%. The sensitivity of hysteroscopy in diagnosis of endometrial hyperplasia in comparison to HPE was 75% and the specificity was 87.01%. The sensitivity of TVS in diagnosis of endometrial hyperplasia in comparison to HPE was 37.5% and the specificity was 90.91%. The sensitivity of hysteroscopy in diagnosis of polyp in comparison to HPE was 100% and the specificity was 97.3%. The sensitivity and specificity of TVS in diagnosis of polyp in comparison to HPE were 9.09% and 93.24%, respectively. Conclusion: TVS had a high sensitivity to detect fibroids but its value in detecting hyperplasia and polyps was in question in this study. But hysteroscopy had a maximum sensitivity to detect polyps and high sensitivity to detect endometrial hyperplasia compared to histopathology which is a gold standard investigation.

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Assessment of nutritional status of children aged 34-92 months using various nutritional status indices and validity of age independent indices

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20194740 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2593

Author(s):

Nayantara R. Gandra ◽

Kalavathy Jasmine Masillamoni

Keyword(s):

Nutritional Status ◽

Predictive Value ◽

Gold Standard ◽

High Sensitivity ◽

Cross Sectional Study ◽

Cross Sectional ◽

Nutritional Status Of Children ◽

Sensitivity Specificity ◽

Age Independent ◽

Weight For Age

Background: Even though there are many programs run by Government to tackle the problem of malnutrition in India, problem of malnutrition is still there. Malnutrition leads to infections and even can lead to death of child in severe cases. The mortality rate is very high compared to other countries. The objective of the study to study validity of age independent various nutritional status indices in comparison to gold standard of weight for ageMethods: Present study was institution based cross sectional study carried out at SDA high school, from January 2019 to July 2019 among 58 school children aged 34-92 months of age. Anthropometric measurements like weight, height, head circumference, chest circumference, mid arm circumference were recorded as per the standard guidelines. Weight for height, weight of age, Kanawati Index, Jeliffe’s ratio, Rao index, and Dugdales index was calculated. Gold standard used was weight for age. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for these indices.Results: Majority of the children belonged to 48-60 months and 61-72 months i.e. 29.3% each. Males were more than females. Prevalence of malnutrition was 60.3%, 48.3%, 51.7%, 91.4%, and 56.8% based on weight for age, Kanawati index, Rao index, Jeliffe’s ratio and Dugdale’s index respectively. Dugdale’s index was found to have high sensitivity (85.7%) and specificity (86.9%) compared to all other indices.Conclusions: Among age independent indices of nutritional status available, Dugdales index can be used as it has been found that it has remarkably higher sensitivity and specificity compared to other age independent indices of nutritional status.

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Giá trị của siêu âm sử dụng bảng phân loại ACR - TIRADS 2017 trong chẩn đoán nhân giáp

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.76.1 ◽

2022 ◽

Author(s):

Quang Huy Huynh

Keyword(s):

Roc Curve ◽

Predictive Value ◽

Thyroid Nodules ◽

Imaging Modality ◽

High Sensitivity ◽

The Elderly ◽

Thyroid Ultrasound ◽

Cross Sectional ◽

Non Invasive ◽

Classification Score

TÓM TẮT Đặt vấn đề: Bệnh lý nhân giáp là một bệnh lý phổ biến, đặc biệt là ở phụ nữ và người lớn tuổi. Siêu âm tuyến giáp, được xem như là một phương tiện đầu tay, là phương pháp chẩn đoán hình ảnh có những khả năng vượt trội như tương đối đơn giản, rẻ tiền, không xâm lấn, có thể lặp lại nhiều lần để chẩn đoán bệnh, và có khả năng phát hiện được những tổn thương rất nhỏ. Nghiên cứu này nhằm xác định xác giá trị của siêu âm sử dụng bảng phân loại ACR-TIRADS 2017 trong chẩn đoán nhân giáp. Phương pháp: Thiết kế nghiên cứu mô tả cắt ngang, với cỡ mẫu 169 bệnh nhân được phẫu thuật nhân giáp. Trước phẫu thuật, bệnh nhân được siêu âm tuyến giáp bằng máy GE (LOGIQ S7 Pro, LOGIQ E9 …) với đầu dò linear tần số 7,5 - 12 MHz. Kết quả siêu âm bảng phân loại TI-RADS theo ACR 2017 so sánh với tiêu chuẩn vàng là kết quả giải phẫu bệnh. Kết quả: Siêu âm áp dụng bảng phân loại ACR-TIRADS 2017 trong phân biệt nhân giáp lành tính và ác tính: Độ nhạy 97,9%, độ đặc hiệu 82,6%, giá trị tiên đoán dương 95,8%, giá trị tiên đoán âm 90,5%, và độ chính xác 94,9%. Diện tích dưới đường cong ROC (AUC) của phân loại ACR-TIRADS trong chẩn đoán nhân giáp ác tính là bằng 0,953 (p < 0,001). Điểm cắt (cut - off) được chọn là TIRADS 4. Diện tích dưới đường cong ROC (AUC) của điểm số của hạt giáp theo phân loại ACR- là 0,967 (p < 0,001). Điểm cắt (cut - off) được chọn là 5 điểm. Kết luận: Siêu âm áp dụng bảng phân loại ACR-TIRADS 2017 có giá trị trong chẩn đoán phân biệt nhân giáp lành tính và ác tính với độ nhạy và độ đặc hiệu cao. ABSTRACT THE USE OF THYROIDULTRASOUND WITH ACR - TIRADS 2017 CLASSIFICATION IN THE DIAGNOSIS OF THYROID NODULES Backgrounds: Thyroid disease is very common, especially in women and the elderly. Thyroid ultrasound, as a first - line tool, is an imaging modality with outstanding capabilities such as being relatively simple, inexpensive, non - invasive, and repeatable for diagnosis of thyroid diseases, and can detect very small lesions. This study aims to determine the use of thyroid ultrasound with ACR-TIRADS 2017 classification in the diagnosis of thyroid nodules. Methods: A cross - sectional descriptive study was conducted in 169 patients undergoing thyroidectomy. All patients had been preoperatively performed thyroid ultrasound using a GE machine (LOGIQ S7 Pro, LOGIQ E9 ...) with a linear transducer frequency of 7.5 - 12 MHz. The ultrasound results using the 2017 ACR-TIRADS classification compared with pathological findings as the gold standard diagnostics. Results: Thyroid ultrasound using the 2017 ACR-TIRADS classification could distinguish benign and malignant thyroid nodules with the sensitivity of 97.9%, specificity 82.6%, positive predictive value 95.8%, negative predictive value 90.5%, and accuracy of 94.9%. The area under the ROC curve (AUC) of the ACRTIRADS classification in the diagnosis of malignant thyroid nodules was 0.953 (p < 0.001). The cut - off point was selected as TIRADS 4. The area under the ROC curve (AUC) of the ACR - classification score of the armor particles was 0.967 (p < 0.001). The cut - off point is selected as 5 points. Conclusion: Thyroid ultrasound using the 2017 ACR-TIRADS classification is valuable in the differential diagnosis of benign and malignant thyroid nodules with high sensitivity and specificity. Keywords: Ultrasound, thyroid nodules, ACR-TIRADS 2017, benign, malignant.

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ROLE OF 3D CT SCAN IN QUANTIFYING GLENOID BONE LOSS IN RECURRENT UNILATERAL SHOULDER DISLOCATION

10.36106/gjra/1713747 ◽

2021 ◽

pp. 173-177

Author(s):

Shivprasad Jaybhay ◽

Madhuri Misal

Keyword(s):

Bone Loss ◽

Predictive Value ◽

Shoulder Dislocation ◽

False Negative ◽

Three Dimensional ◽

High Sensitivity ◽

Cross Sectional Study ◽

Glenoid Bone Loss ◽

Cross Sectional ◽

Recurrent Shoulder Dislocation

Purpose: Patients with recurrent shoulder instability often present with osseous injury to the glenoid and humeral head. Glenoid bone loss can easily be quantied on a three-dimensional computed tomography scan by modeling the inferior portion of the glenoid contour as a true circle on an en face view. This study investigated the accuracy of CT in determining the presence and severity of glenoid bone loss in patients with unilateral recurrent shoulder dislocation. Methodology: This prospective cross-sectional study was done among patients with unilateral recurrent shoulder dislocation. Forty patients with anterior shoulder dislocation underwent shoulder CT examination before arthroscopy. Results: Glenoid bone loss was evident in 38 (95%) of the 40 patients at arthroscopy. Compared with arthroscopy, CT had sensitivity in detecting glenoid bone loss of 92.1%; specicity, 100%; positive predictive value, 100%; and negative predictive value, 40.0%. Three false-negative CT assessments had 5%, 5%, and 20% glenoid bone loss, respectively, at arthroscopy. There was a strong correlation between CT and arthroscopy with respect to the severity of glenoid bone loss (r = 0.73). Conclusion: CT has both a high sensitivity and a high specicity for detecting glenoid bone loss, and agreement with arthroscopy regarding the severity of glenoid bone loss is good. CT can be used to assess glenoid bone loss and the need for bone augmentation surgery.

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Evaluation of the Alere Pima™ for CD4+ T lymphocytes counts in HIV-positive outpatients in Southern Brazil

International Journal of STD & AIDS ◽

10.1177/0956462414526862 ◽

2014 ◽

Vol 25 (13) ◽

pp. 956-959 ◽

Cited By ~ 9

Author(s):

L Rathunde ◽

GMB Kussen ◽

MP Beltrame ◽

LM Dalla Costa ◽

SM Raboni

Keyword(s):

Flow Cytometry ◽

T Lymphocytes ◽

T Lymphocyte ◽

Predictive Value ◽

Opportunistic Infections ◽

Point Of Care ◽

High Sensitivity ◽

Hiv Positive ◽

Point Of Care Test ◽

Patients At Risk

CD4 + lymphocyte counts are routinely ordered during the early phases of antiretroviral therapy and for prophylaxis of opportunistic infections in HIV-positive patients. Flow cytometry is the standard methodology for CD4 counts in Brazilian reference laboratories. However, these laboratories are located in large cities, frequently distant from patients, thus limiting patient access and delaying results. We compared a point-of-care test with flow cytometry determination of CD4+ T lymphocyte counts in HIV patients. We analysed 107 consecutive samples by both methods. Overall, the point-of-care test performed well, with excellent agreement between it and the standard method. Test results were concordant for patients with CD4+ T lymphocyte values above and below 200 cells/mm 3. The performance characteristics obtained were sensitivity 94% (95% CI 89.5–98.5%), specificity 93% (95% CI 88.2–97.8%), positive predictive value 86% (95% CI 79.4–92.6%), and negative predictive value 97% (95% CI 94–100%). The high sensitivity and specificity of the point-of-care test methodology suggest its utility as an alternative method for rapid measurement of CD4+ T lymphocytes in patients with limited access to reference laboratories, enabling prompt therapeutic intervention for patients at risk of progression to AIDS.

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