The Sensitivity and Specificity of Radiology and Histopathology in the Diagnosis of Posttraumatic Osteomyelitis

1989 ◽  
Vol 02 (03) ◽  
pp. 98-103 ◽  
Author(s):  
H. W. Tvedten ◽  
U. V. Mostosky ◽  
M. Thomas ◽  
R. L. Stickle ◽  
J. B. Kaneene ◽  
...  
Keyword(s):  
Body Weight ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Post Inoculation ◽  
Posttraumatic Osteomyelitis ◽  
Post Traumatic ◽  
Receive Treatment

SummaryThe sensitivity and specificity of radiology and histopathology in the diagnosis of post-traumatic osteomyelitis was determined. Post-traumatic osteomyelitis was created in one tibia of each of 31 dogs. Fifteen dogs did not receive treatment and sixteen dogs were treated with clindamycin (11 mg/kg body weight q 12 h, PO) for 28 days. At 8 wks post-inoculation week, S. aureus was isolated from nine of 31 dogs. Bacteriological reculture was the standard diagnostic test for osteomyelitis and was used as the standard for comparison in the calculations of the sensitivity and specificity of both radiology and histopathology. The sensitivity of radiology (radiological consensus of three radiologists) in the diagnosis of post-traumatic osteomyelitis at 8 weeks post-inoculation was 62.5% with a range among individual radiologists from 37.5% to 62.5%. The specificity of radiology (consensus) in the diagnosis of posttraumatic osteomyelitis at 8 weeks post-inoculation was 57.1% with a range among individual radiologists from 28.5% to 95.2%. The sensitivity of histopathology in the diagnosis of post-traumatic osteomyelitis at 8 weeks post-inoculation was 33.3%. The specificity of histopathology in the diagnosis of post-traumatic osteomyelitis at 8 weeks post-inoculation was 86.3%.

Cardiopulmonary Exercise Testing in Combined Pulmonary Fibrosis and Emphysema

Respiration ◽  
2021 ◽  
pp. 369-377
Author(s):  
Michael Westhoff ◽  
Patric Litterst ◽  
Ralf Ewert
Keyword(s):  
Body Weight ◽  
Pulmonary Fibrosis ◽  
Sensitivity And Specificity ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Arterial Oxygen ◽  
Peak Exercise ◽  
Cutoff Value ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2

Background: Combined pulmonary fibrosis and emphysema (CPFE) is a distinct entity among fibrosing lung diseases with a high risk for lung cancer and pulmonary hypertension (PH). Notably, concomitant PH was identified as a negative prognostic indicator that could help with early diagnosis to provide important information regarding prognosis. Objectives: The current study aimed to determine whether cardiopulmonary exercise testing (CPET) can be helpful in differentiating patients having CPFE with and without PH. Methods: Patients diagnosed with CPFE in 2 German cities (Hemer and Greifswald) over a period of 10 years were included herein. CPET parameters, such as peak oxygen uptake (peak VO2), functional dead space ventilation (VDf/VT), alveolar-arterial oxygen difference (AaDO2), arterial-end-tidal CO2 difference [P(a-ET)CO2] at peak exercise, and the minute ventilation-carbon dioxide production relationship (VE/VCO2 slope), were compared between patients with and without PH. Results: A total of 41 patients with CPET (22 with PH, 19 without PH) were analyzed. Right heart catheterization was performed in 15 of 41 patients without clinically relevant complications. Significant differences in peak VO2 (861 ± 190 vs. 1,397 ± 439 mL), VO2/kg body weight/min (10.8 ± 2.6 vs. 17.4 ± 5.2 mL), peak AaDO2 (72.3 ± 7.3 vs. 46.3 ± 14.2 mm Hg), VE/VCO2 slope (70.1 ± 31.5 vs. 39.6 ± 9.6), and peak P(a-ET)tCO2 (13.9 ± 3.5 vs. 8.1 ± 3.6 mm Hg) were observed between patients with and without PH (p < 0.001). Patients with PH had significantly higher VDf/VT at rest, VT1, and at peak exercise (65.6 ± 16.8% vs. 47.2 ± 11.6%; p < 0.001) than those without PH. A cutoff value of 44 for VE/VCO2 slope had a sensitivity and specificity of 94.7 and 72.7%, while a cutoff value of 11 mm Hg for P(a-ET)CO2 in combination with peak AaDO2 >60 mm Hg had a specificity and sensitivity of 95.5 and 84.2%, respectively. Combining peak AaDO2 >60 mm Hg with peak VO2/body weight/min <16.5 mL/kg/min provided a sensitivity and specificity of 100 and 95.5%, respectively. Conclusion: This study provided initial data on CPET among patients having CPFE with and without PH. CPET can help noninvasively detect PH and identify patients at risk. AaDO2 at peak exercise, VE/VCO2 slope, peak P(a-ET)CO2, and peak VO2 were parameters that had high sensitivity and, when combined, high specificity.

scholarly journals A new highly sensitive and specific overnight combined screening and diagnostic test for primary aldosteronism

2016 ◽  
Vol 175 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Vaios Tsiavos ◽  
Athina Markou ◽  
Labrini Papanastasiou ◽  
Theodora Kounadi ◽  
Ioannis I Androulakis ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Primary Aldosteronism ◽  
Low Cost ◽  
Confirmatory Test ◽  
Outpatient Basis ◽  
Endocrine Hypertension ◽  
Serum Aldosterone ◽  
Highly Sensitive ◽  
Aldosterone To Renin Ratio

Context Primary aldosteronism (PA) is the most common cause of endocrine hypertension that is diagnosed following a two-step process: an initial screening test, based on the serum aldosterone-to-renin ratio (ARR), followed by a relatively laborious and time-consuming confirmatory test to document autonomous aldosterone (ALD) secretion. Objective The aim of this study is to develop a simple overnight test for the early and definite diagnosis of PA. Patients and methods Totally, 148 hypertensive patients underwent a fludrocortisone–dexamethasone suppression test (FDST) and the new overnight diagnostic test (DCVT) using pharmaceutical RAAS (renin–angiotensin–aldosterone system) blockade with dexamethasone, captopril and valsartan. Results Of the 148 patients, 45 were diagnosed as having PA and they all normalized their elevated blood pressure (BP) after administration of spironolactone or eplerenone. The remaining 103 patients were considered as having essential hypertension and served as controls. Using ROC analysis, the estimated sensitivity and specificity were 91 and 100%, respectively, for the post-FDST ARR, whereas 98% and 89% and 100% and 82% for the post-DCVT ARR and post-DCVT ALD, respectively, with selected cutoffs of 0.32ng/dL/μU/mL and 3ng/dL respectively. However, considering these cutoffs simultaneously, the estimated sensitivity and specificity were 98 and 100% respectively. Applying these cutoffs, the diagnosis of PA was confirmed in 44 (98%) of the 45 patients who were considered to have the disease. Conclusions In this study, a highly sensitive and specific, low-cost, rapid, safe, and easy-to-perform diagnostic test (DCVT) for PA is described, which could be utilized on an outpatient basis potentially substituting conventional laborious testing.

scholarly journals Observed Differences in Diagnostic Test Accuracy between Patient Subgroups: Is It Real or Due to Reference Standard Misclassification?

2007 ◽  
Vol 53 (10) ◽  
pp. 1725-1729 ◽  
Author(s):  
Corné Biesheuvel ◽  
Les Irwig ◽  
Patrick Bossuyt
Keyword(s):  
Clinical Practice ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Reference Standard ◽  
Target Condition ◽  
Test Sensitivity ◽  
The Past ◽  
Patient Subgroups

Abstract Before a new test is introduced in clinical practice, its accuracy should be assessed. In the past decade, researchers have put an increased emphasis on exploring differences in test sensitivity and specificity between patient subgroups. If the reference standard is imperfect and the prevalence of the target condition differs among subgroups, apparent differences in test sensitivity and specificity between subgroups may be caused by reference standard misclassification. We provide guidance on how to determine whether observed differences may be explained by reference standard misclassification. Such misclassification may be ascertained by examining how the apparent sensitivity and specificity change with the prevalence of the target condition in the subgroups.

scholarly journals Utility of Glycated Hemoglobin in Diagnosing Type 2 Diabetes Mellitus: A Community-Based Study

2010 ◽  
Vol 95 (6) ◽  
pp. 2832-2835 ◽  
Author(s):  
Padala Ravi Kumar ◽  
Anil Bhansali ◽  
Muthuswamy Ravikiran ◽  
Shobhit Bhansali ◽  
Pinaki Dutta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Hba1c Level ◽  
Glycated Hemoglobin ◽  
World Health ◽  
Oral Glucose ◽  
Community Based ◽  
Cut Point

Abstract Context: Although glycated hemoglobin (HbA1c) has recently been incorporated as a diagnostic test by the American Diabetes Association, its validity needs to be established in Asian Indians in a community setting. Objective: The objective of the study was to assess the validity of HbA1c as a screening and diagnostic test in individuals with newly detected diabetes mellitus. Design and Setting: Community based randomized cross sectional study in urban Chandigarh, a city in north India, from April 2008 to August 2009. Subjects: Subjects included 1972 subjects aged 20 yr or older. Intervention: Intervention included an oral glucose tolerance test and glycated hemoglobin in all the subjects. Main Outcome Measures: Utility of HbA1c as a diagnostic method in newly detected diabetes mellitus subjects was evaluated. Results: Using World Health Organization criteria for diagnosis of diabetes mellitus, 134 (6.7%) had newly detected diabetes mellitus, 192 (9.7%) known diabetes mellitus, 329 (16.6%) prediabetes, and 1317 (69.4%) were normal of 1972 people screened. Using only the ADA criteria, 38% people were underdiagnosed. An HbA1c level of 6.1% had an optimal sensitivity and specificity of 81% for diagnosing diabetes. A HbA1c level of 6.5% (±2 sd) and 7% (±2.7 sd) had sensitivity and specificity of 65 and 88% and 42 and 92%, respectively, with corresponding positive predictive value and negative predictive value of 75.2 and 96.5% and 90.4and 94.4%, respectively, for diagnosis of newly detected diabetes mellitus. Conclusion: A HbA1c cut point of 6.1% has an optimal sensitivity and specificity of 81% and can be used as a screening test, and a cut point of 6.5% has optimal specificity of 88% for diagnosis of diabetes.

COMPARISON OF FOURTH GENERATION ELISA AND RAPID DIAGNOSTIC TEST FOR DIAGNOSIS OF HEPATITIS C VIRUS(HCV) INFECTION IN A TERTIARY CARE HOSPITAL.

2021 ◽  
pp. 15-17
Author(s):  
Stuti Kansra Arora ◽  
Mala Chhabra ◽  
Anuradha Anuradha ◽  
Arvind Achra ◽  
Nandini Duggal
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Treatment Initiation ◽  
Tertiary Care ◽  
Hcv Infection ◽  
Fourth Generation ◽  
World Population ◽  
Test Results ◽  
Blood Samples

Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.

scholarly journals Sensitivity and specificity of a rapid diagnostic test for chronic Chagas disease at a referral center in Brazil - can it be included as a standard serological diagnostic test in the clinical practice of a referral center?

2021 ◽  
Vol 1 ◽  
pp. e1236
Author(s):  
Alejandro M. Hasslocher-Moreno ◽  
Ingebourg Georg ◽  
Luiz H. C. Sangenis ◽  
Mauro F. F. Mediano
Keyword(s):  
Clinical Practice ◽  
Diagnostic Test ◽  
Chagas Disease ◽  
Sensitivity And Specificity ◽  
Diagnostic Testing ◽  
Chronic Phase ◽  
Neglected Tropical Disease ◽  
Rapid Diagnostic Testing ◽  
Referral Center ◽  
Chronic Chagas Disease

Introduction: Chagas disease (CD) is a neglected tropical disease. In the chronic phase of CD, the diagnosis is essentially serologic. Conventional reactions are currently in use. More recently, the use of rapid diagnostic testing (RDT) is indicated when conventional techniques are not available. Objective: To evaluate the sensitivity and specificity of RDTs for chronic CD diagnosis. Methodology: Individuals under suspicion of CD were evaluated using ELISA, Chemiluminescence (ChLIA) and RDT tests. Results: The RDT showed 95.1% sensitivity and 96.7% specificity, respectively. Conclusion: The findings of the present study showed that RDT used in the diagnosis of CD at a referral center in Brazil were not able to detect all CD cases when compared to Elisa and ChLIA.

scholarly journals Enabling animal rabies diagnostic in low-access areas: Sensitivity and specificity of a molecular diagnostic test from cerebral tissue dried on filter paper

2020 ◽  
Vol 14 (3) ◽  
pp. e0008116
Author(s):  
Felana Suzah Rasolonjatovo ◽  
Hélène Guis ◽  
Malavika Rajeev ◽  
Laurent Dacheux ◽  
Lalaina Arivony Nomenjanahary ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Filter Paper ◽  
Molecular Diagnostic ◽  
Cerebral Tissue ◽  
Molecular Diagnostic Test

scholarly journals The sensitivity and specificity of platelet autoantibody testing in immune thrombocytopenia: a systematic review and meta‐analysis of a diagnostic test

2019 ◽  
Vol 17 (5) ◽  
pp. 787-794 ◽  
Author(s):  
John R. Vrbensky ◽  
Joyce E. Moore ◽  
Donald M. Arnold ◽  
James W. Smith ◽  
John G. Kelton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Immune Thrombocytopenia ◽  
Meta Analysis

scholarly journals 659. Evaluation of a Rapid Diagnostic Assay for Early Detection of Bacteriuria

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S302-S302
Author(s):  
Robbie Lee Anne Christian ◽  
Curtis Donskey ◽  
Maria Navas
Keyword(s):  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Medical Center ◽  
Traditional Culture ◽  
Urine Samples ◽  
Microbiology Laboratory ◽  
Viridans Streptococci ◽  
Colony Forming Units ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment

Abstract Background Patients with suspected urinary tract infection (UTI) are often prescribed an empiric antibiotic treatment due to delays in obtaining results of urine cultures. The BacterioScan System measures the turbidity of incubating urine specimens to provide a qualitative determination of bacteriuria at a density of >5 × 104 colony-forming units (CFU)/mL within approximately 3 hours. We examined the utility of the BacterioScan assay in predicting bacteriuria and assessed the potential impact of this test to reduce the number of urine cultures processed. Methods Urine samples received for culture in the microbiology laboratory of the Cleveland VA Medical Center were collected daily between September 2018 and December 2018. For each specimen, we performed a bacterioscan diagnostic test and compared it with the result of the traditional culture and urinalysis if available. Urinary cultures were categorized into 4 groups as defined in Figure 1. We compared the sensitivity and specificity of the bacterioscan vs. urinalysis (leukocyte esterase and/or pyuria) results. Results 120 urine samples were tested. As shown in Table 1, the BacterioScan had better sensitivity and specificity than the urinalysis for detection of positive urine cultures. The use of the BacterioScan to rule out UTI could have accurately spared 69 of 120 (57.5%) samples from traditional culture and prevented 26 of 120 (21.6%) from possible misinterpretation as infection due to reporting of growth. BacterioScan resulted in 4 of 31 (12.9%) false negatives, but all occurred when positive cultures were due to viridans streptococci or uropathogens in numbers below 100,000 CFU.ml. Conclusion The BacterioScan system is a rapid diagnostic test that provides early information on urine culture results that could help to avoid overuse of empirical antimicrobials in patients with suspected UTI and decrease the workload of the Microbiology Laboratory. Disclosures All authors: No reported disclosures.

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