scholarly journals SP3.2.9 The concordance between emergency CT reporting in non-traumatic abdominal pain with surgical findings at laparotomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Claire Edwin ◽  
Alice Bradley ◽  
Filomena Liccardo ◽  
Georgina Bowman ◽  
Sophie Crisford ◽  
...  
Keyword(s):  
False Positive ◽  
False Negative ◽  
Ct Imaging ◽  
Patient Treatment ◽  
Emergency Laparotomy ◽  
Abdominal Ct ◽  
Out Of Hours ◽  
Clinical Episode ◽  
The Impact ◽  
Audit Standards

Abstract Aims Abdominal CT imaging is commonly used to assess the acute abdomen, and is relied upon by clinicians in decision making, often influencing the timeliness of intervention. Increased demand for CT imaging has led to departments out-sourcing reporting out of hours. The aim of this audit was to evaluate the concordance between emergency laparotomy findings and pre-operative CT reports. Methods 115 patients underwent emergency laparotomy with a pre-operative CT scan pertinent to the clinical episode (May 2019-October 2020). 2 surgical assessors independently assessed the CT reports and laparotomy findings to determine discrepancies. Using published audit standards, discrepancies were defined as major-felt to affect patient treatment- and further classified as false positive, false negative, misdiagnosis, indeterminate; or minor and unlikely to change course of patient care. Results 32/115 had discrepancies, 28/32 major (16/28 misdiagnosis, 4/28 false negative, 3/28 false positive, and 5/28 indeterminate). 71/115 reported by in house radiology. 19/71 discrepancies reported in house (16 major, 3 minor), 13/32 discrepancies reported by out of hours service (12 major, 1 minor). Relative risk of major discrepancies between in house radiology and out of hours service was 1.2 (p = 0.5). Conclusions Published audit standards are that CT reports should have >90% concordance with laparotomy findings; this audit found concordance in 76%. Further analysis comparing gastrointestinal vs. non-gastrointestinal specialist radiologist to assess the impact on concordance will be performed. We aim to explore the discrepancies, and seek to identify if our imaging and operating practices can be improved.

Multivariate interpretation of laboratory tests used in monitoring patients

1990 ◽  
Vol 36 (5) ◽  
pp. 748-751 ◽  
Author(s):  
H B Slotnick ◽  
P Etzell
Keyword(s):  
Small Groups ◽  
False Positive ◽  
Laboratory Tests ◽  
False Negative ◽  
Test Results ◽  
Laboratory Findings ◽  
Bonferroni Inequality ◽  
The Impact

Abstract This study demonstrates an approach to the problem of minimizing false-negative and false-positive laboratory findings. In this approach, we consider the fact that results of laboratory tests are correlated, utilize within-person test results to interpret current results, and minimize the impact of multivariate conservatism by examining test results in small groups. The procedure requires panels of tests to be divided into related subpanels, testing each subpanel independently, and using the Bonferroni inequality to determine whether any of the observed values for a given subpanel is "out-of-range." The procedure is demonstrated, and its limitations are observed and discussed.

scholarly journals Factors associated with false negative and false positive results of prostate-specific antigen (PSA) and the impact on patient health

Medicine ◽  
2019 ◽  
Vol 98 (40) ◽  
pp. e17451 ◽  
Author(s):  
Mari Carmen Bernal-Soriano ◽  
Lucy A. Parker ◽  
Maite López-Garrigos ◽  
Ildefonso Hernández-Aguado ◽  
Juan P. Caballero-Romeu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
False Positive ◽  
False Negative ◽  
Specific Antigen ◽  
Factors Associated ◽  
Patient Health ◽  
The Impact ◽  
Positive Results

scholarly journals Determining the impact of psychosis on rates of false-positive and false-negative diagnosis in Alzheimer's disease

2017 ◽  
Vol 3 (3) ◽  
pp. 385-392 ◽  
Author(s):  
Corinne E. Fischer ◽  
Winnie Qian ◽  
Tom A. Schweizer ◽  
Zahinoor Ismail ◽  
Eric E. Smith ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
False Positive ◽  
False Negative ◽  
The Impact

Selective Use of Intraoperative Touch Prep Analysis of Sentinel Nodes in Breast Cancer

2005 ◽  
Vol 71 (11) ◽  
pp. 955-962 ◽  
Author(s):  
Rachel C. Forbes ◽  
Clovis Pitchford ◽  
Jean F. Simpson ◽  
Glen C. Balch ◽  
Mark C. Kelley
Keyword(s):  
Breast Cancer ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Nodal Metastasis ◽  
Axillary Lymph ◽  
Sentinel Nodes ◽  
Number Of Patients ◽  
The Impact ◽  
Positive Results

Imprint cytology (touch prep) is often used for intraoperative examination of sentinel nodes in breast cancer. This allows axillary lymph node dissection (ALND) to be performed immediately for tumor-positive nodes. We evaluated the accuracy of touch prep examination of sentinel nodes and its role in the surgical treatment of breast cancer. We analyzed 169 breast cancer patients who underwent 170 lymphatic mapping procedures with intraoperative touch prep examination. Results from the touch prep were correlated with histopathology and clinical variables. There were 115 true-negative, 35 true-positive, 15 false-negative, and 5 false-positive results. Touch prep had a sensitivity of 70 per cent and specificity of 96 per cent. Positive predictive value, negative predictive value, and diagnostic accuracy were all 88 per cent. The false-negative rate was 30 per cent and correlated with the size of the nodal metastasis and number of involved nodes, but not other patient factors. Touch prep is useful for the evaluation of sentinel nodes in breast cancer, but it has a lower sensitivity than initially reported, particularly in patients with micrometastases. False positive results occur, although they may be reduced after experience with the technique. We recommend that suspicious findings on touch prep should be confirmed by frozen section and that ALND only be performed for histologically documented metastases. We currently perform touch prep only in patients who are at high risk of nodal metastasis or will undergo mastectomy. This improves operative efficiency and limits the impact of false positive and negative results without dramatically increasing the number of patients who require a second surgical procedure.

The lifetime economic burden of inaccurate HER2 testing: Comparing false positive and false negative HER2+ early breast cancer patients in the United States.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6626-6626
Author(s):  
Louis Garrison ◽  
Joseph Babigumira ◽  
Anthony Masaquel ◽  
Bruce Wang ◽  
Deepa Lalla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Economic Burden ◽  
False Positive ◽  
False Negative ◽  
The United States ◽  
Test Accuracy ◽  
Her2 Testing ◽  
Life Years ◽  
The Impact

6626 Background: Trastuzumab is administered to patients with early breast cancer (EBC) whose tumors test positive for HER2 using IHC or FISH diagnostic tests. However, due to test characteristics and testing heterogeneity, patients may be misdiagnosed as false positive (FP) or false negative (FN). This analysis estimates the lifetime economic burden of inaccurate HER2 testing in the US. Methods: We developed a national-level economic model to estimate the impact on healthcare costs and quality-adjusted life years (QALYs) in both groups in 2012. The model estimates the expected number of FP and FN patients using literature-derived estimates of each test’s sensitivity, specificity, and utilization. Based on estimates from the literature, a FP patient would generate unneeded trastuzumab costs of about $56,000 and experience a chance (2.9%) of related cardiotoxicity; an FN patient would save $56,000 in trastuzumab costs, but lose 1.7 QALYs of life expectancy and face a greater likelihood of recurrence and associated costs ($42,000) to treat metastatic disease. A net monetary benefit approach (valuing healthy life years at $100,000) is used to compare the lifetime economic burden for FP and FN. Results: The estimated overall proportions of FP and FN are 2.8% and 2.2% of 227,000 EBC patients, resulting in about 6,400 and 5,000 women in each group, respectively. Overall, approximately 8600 QALYs would be lost among FN patients who do not receive trastuzumab. We estimate the incremental per-patient lifetime burden of an FP to be about $57,000, and for an FN to be about $118,000. The implied incremental loss to society for FPs is $362 million and for FNs is $596 million. Conclusions: Current testing practices and treatment patterns for HER2+ EBC patients result in misdiagnosis and non-optimal treatment in approximately 11,500 patients each year: the combined total economic loss to society is nearly $1 billion. The greater share of the loss is among FN patients who would have benefited from trastuzumab, but did not receive it. The significant annual burden of HER2 misdiagnosis suggests that substantial societal investments to improve HER2 test accuracy should be considered.

scholarly journals Analyzing and predicting spear-phishing using machine learning methods

2020 ◽  
Vol 10 (4) ◽  
pp. 262-273
Author(s):  
Samad Dadvandipour ◽  
Aadil Gani Ganie
Keyword(s):  
False Positive ◽  
Credit Card ◽  
Latent Dirichlet Allocation ◽  
Topic Model ◽  
False Negative ◽  
Svm Classifier ◽  
Critical Material ◽  
Coherence Score ◽  
Percent Accuracy ◽  
The Impact

Phishing implies misdirecting the client by masking himself/herself as a reliable individual, to take the Critical material, for example, bank account number, credit card numbers, and so on; one of the noticeably utilized Phishing these days is spear phishing, and it is one of the effective phishing assaults given its social, mental boundaries. In this paper, we will mitigate the impact of spear phishing by utilizing the multi-layer approach. The multi-layer approach is the best method of managing the web interruption, as the intruder needs to experience shift levels. Practically all the scientists are dealing with the content of the email; however, this paper picks a novel method to counter the phishing messages by utilizing both the attachment and content of an email. We applied sentimental analysis on emails, including both content of the email and the attachment, to check whether they are spam or not using SVM classifier and Randomforest Classifier; the former showed 96 percent accuracy while, as later offers 97.66 percent accuracy. SVM showed false-positive 0 percent and false-negative 4 percent, while RandomForest showed 0 percent false-positive and 2.33 percent false-negative ratios. We also performed topic modeling using LDA(Latent Dirichlet Allocation)) from Gensim package to get the dominant topics in our dataset. We visualized the results of our topic model using pyLDvis. The perplexity and coherence score of our topic model is -12.897670565510511 and 0.44700287476452394, respectively.

scholarly journals The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them

2021 ◽  
pp. 61-67
Author(s):  
O.A. Burka ◽  
N.F. Lygyrda ◽  
V.V. Kutsovol ◽  
A.V. Svintsitska
Keyword(s):  
Cervical Cancer ◽  
Differential Diagnosis ◽  
False Positive ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Clinical Results ◽  
Cervical Epithelium ◽  
Reactive Changes ◽  
The Impact

Cervical cancer (CC) screening is a major component of secondary prevention of CC and involves screening all women at risk of developing this disease, most of whom are asymptomatic. Cytology remains an important component of CC screening in the era of primary screening by genotyping the human papillomavirus. Papanikolaou staining is the method of choice for CC screening. This review highlights the causes of false negative results for various methods of Pap tests and how they can be prevented. A detailed analysis of conditions accompanied by a high probability of false positive abnormal results of the Pap test, an explanation of the pathophysiological basis of this phenomenon, clinical and cytological criteria for differential diagnosis is also presented.Pap test is a screening test. The aim of the cytological examination in CC screening is to assign the patient to a group with absent neoplastic changes in the cervical epithelium, a group with neoplastic changes in the cervical epithelium present, or a group when it is impossible to make an accurate differential diagnosis between benign reactive changes and neoplasia. The Bethesda Cytology Reporting System is used to unify and standardize these categories in most countries of the world. Benign conditions are a common cause of false positive reports of cellular atypia on cervical screening, as evidenced by a large number of studies. This fact should be taken into account both in the interpretation of the results and, if possible, in the planning of cervical screening. The most common conditions that are accompanied by reactive changes in the cervical epithelium, which can be incorrectly assessed as atypia, are: reactive and reparative inflammatory changes, atrophy, metaplasia, reactive changes caused by intrauterine devices. In this regard, when working with the cytological component of cervical screening, it is important for the clinician to understand the basic principles of assessing the cervical epithelium, which will allow using the descriptive part of the report to determine tactics if a false negative or false positive screening result is suspected.Thus, understanding the impact of common benign conditions on the cervical epithelium makes it possible to rationally plan cytological cervical screening and correctly interpret its results in order to achieve the best clinical results that are not limited to the detection of precancerous conditions.

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