scholarly journals TP8.1.12 Diagnostic Utility of MRI in the Evaluation of Potential Malignancy in Patients Presented with Nipple Discharge

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nixon Phua Cher Yang ◽  
Muhammad Adeel Javed Butt ◽  
Parmvir Singh Nijjar ◽  
Saung Phyu ◽  
Musa Barkeji
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Imaging Tool ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Abstract Aims Nipple discharge is a presentation commonly seen at breast clinics. It is conventionally evaluated with physical examination and sonography( or mammography). The aim of this study is to investigate the diagnostic value of magnetic resonance imaging (MRI) as an additional imaging tool in the evaluation of potential malignancy in patients presented with nipple discharge. Methods A retrospective evaluation of 85 patients with nipple discharge who underwent breast ultrasound (USS) and MRI between 04/06/2008 and 25/10/2019 was conducted. Clinical notes, radiographic reports and biopsy results were reviewed. Sensitivity, specificity, positive predictive value and negative predictive value of USS and MRI were calculated. Results Out of the 85 patients (all female; mean age 45.33 +/- 12.93 years old) with nipple discharge, 11 were found to have biopsy-proven malignancy (invasive ductal carcinoma/ ductal carcinoma in situ; 12.94% risk). USS failed to identify seven malignancies (27.27% sensitivity) while MRI missed three malignancies (72.72% sensitivity). USS falsely identified four malignancies from 74 patients with no malignancy (94.59% specificity) while MRI only falsely identified one case (98.65% specificity). For patients with negative USS results (U1/U2/U3) or negative MRI results (BI-RADS category 1,2 or 3), the negative predictive values of USS is 89.74% while that of MRI is 96.05%. The positive predictive values of USS and MRI are 42.86% and 88.88% respectively. Conclusion Compared to USS, MRI has a higher sensitivity, specificity, positive predictive value and predictive value. It will be a valuable addition to the standard nipple discharge evaluation workup to help rule out malignancy.

scholarly journals Diagnostic value of self-report compared with Beck Depression Inventory (BDI-II) in screening of depression

2020 ◽  
Author(s):  
Mehran zarghami ◽  
Fatemeh Taghizadeh ◽  
Mahmood mousazadeh
Keyword(s):  
Positive Predictive Value ◽  
Beck Depression Inventory ◽  
Predictive Value ◽  
Total Population ◽  
False Negative ◽  
Diagnostic Value ◽  
Self Report ◽  
Case Group ◽  
Predictive Values ◽  
Sensitivity Specificity

AbstractBackgroundDepression is a common cause of mortality and morbidity worldwide. To detect depression, we compared Beck Depression Inventory scoring as a valid tool with participants self-reporting depression.MethodologyThis cross-sectional study aimed to explore the diagnostic values of self-reporting in patients’ with depression comparing to Beck Depression Inventory scoring in Mazandaran Persian cohort study, with a total of 1300 samples. The sample size was determined to include 155 participants through the census method. In order to increase the test power, 310 healthy participants were included in the study through random selection. In order to evaluate the diagnostic value of self-reporting, BDI-II was completed by blind interviewing to the case group as well as to another group who reported that they were not depressed, as control.ResultsSensitivity, specificity, accuracy, false positive, false negative, positive and negative predictive values of self-reporting was calculated 58.4%, 79.1%,73.4%, 20.8%, 41.6%, 51.8%, and 83.2% for the total population respectively, as well as, sensitivity, specificity, accuracy, positive and negative predictive values of self-report in males were 83.3%, 77.2%, 77.1%, 43.8% and 95.6% and 53.7%, 78.1%, 71.2%, 49.2%, and 81.1% for females, respectively.ConclusionThe positive predictive value and sensitivity of self-reporting are insufficient in total population and females, and therefore self-reporting cannot detect depressed patients, but regarding to its average positive predictive value, perhaps, it can be used to identify non-depressant individuals.

scholarly journals Comparison of Nuclear Matrix Protein-22 and Urine Cytology in Diagnosing Bladder Cancer

2019 ◽  
Vol 12 (3) ◽  
pp. 76
Author(s):  
Mohamad Adi Soedarso ◽  
YinYin Wahyuni ◽  
Maria Immaculata Tjahjati
Keyword(s):  
Positive Predictive Value ◽  
Nuclear Matrix ◽  
Bladder Carcinoma ◽  
Predictive Value ◽  
Matrix Protein ◽  
Diagnostic Value ◽  
Urine Cytology ◽  
Nuclear Matrix Protein ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Urine cytology (UC) is a classic marker used to detect bladder malignancy through urine examination microscopically at the presence of malignant transitional cells that are released. UC  is also used to evaluate recurrence after past treatment. A new method that is simpler, faster and easier is by measuring protein in urine produced by malignant cells, namely nuclear matrix protein-22 (NMP-22). The aim of this study was to compare the diagnostic value of NMP-22 and UC to histopathological biopsy in diagnosing bladder carcinoma and to evaluate whether the NMP-22 test could be used for bladder carcinoma screening and recurrence monitoring.Methods: Diagnostic tests on 24 suspected bladder malignancies were performed by taking urine samples for NMP22 examination and UC. Sensitivity, specificity, positive predictive value and negative NMP-22 and UC on histopathological biopsy were analyzed.Results: Positive results were obtained in 21 (87.5%) and negative in 3 (12.5%) NMP22 examinations. The sensitivity, specificity, positive and negative predictive values of NMP-22 on histopathological biopsy were 95%; 67%, 95%, 67%. Sensitivity, specificity,positive predictive value and negative UC on histopathological biopsy were 38.1%; 100%, 100%, 18.8%.Conclusions: NMP-22 sensitivity is higher than UC in diagnosing bladder carcinoma. NMP-22 can be used for bladder carcinoma screening and for recurrence monitoring

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

scholarly journals Diagnostic Value of CK19, HBME-1 and TROP2 Biomarkers in Identification of Different Types of Thyroid Follicular Neoplasms

2021 ◽  
Author(s):  
Shohreh Vojuhi ◽  
Masoud Mohebbi ◽  
Zohreh Mousavi ◽  
Mohammadali Yaghoubi ◽  
Reza Ziaolhagh
Keyword(s):  
Positive Predictive Value ◽  
Papillary Carcinoma ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Thyroid Neoplasms ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Different Types

Thyroid malignancies are found in 7% to 15% of all thyroid nodules. Immunohistochemical markers, including CK19, HBME-1and TROP2, have shown an effective role in identifying these malignancies. Hence, due to the lack of appropriate diagnostic tests for the identification of thyroid neoplasms, in this study, we aimed to determine the diagnostic value of these biomarkers in the identification of different types of follicular thyroid neoplasms. In this cross-sectional study, paraffin-embedded tissue blocks from the surgical resection of patients with thyroid nodules, referring to Imam Reza and Razavi Hospitals of Mashhad in 2017, were studied. Sensitivity, specificity, and positive and negative predictive values of these biomarkers for the identification of different types of follicular thyroid neoplasms were also studied. 129 patients with a mean age of 44.65±12.59 years participated in this study, of whom 101 (78.29%) were women. The most common type of follicular thyroid neoplasm was papillary carcinoma (60.47%). The highest sensitivity (94.87%) and positive predictive value (68.51%) in the detection of follicular neoplasms was observed by CK19 in papillary carcinoma. The sensitivity and positive predictive value of TROP2 in the detection of papillary neoplasms was 93.58% and 75.25%, respectively. In addition, HBME-1 had the highest specificity (72.54 %) and positive predictive value (81.57%) in identifying this neoplasm. The results of this study showed that CK19, HBME-1, and TROP2 had high diagnostic value in the detection of papillary thyroid neoplasms. Although these biomarkers had low diagnostic value in identifying follicular adenoma and carcinoma, given the high negative predictive value, they can be considered as powerful markers in identifying negative cases.

scholarly journals Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Konuralp Yakar
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Performance ◽  
High Specificity ◽  
Screening Criteria ◽  
Predictive Values ◽  
Before And After ◽  
Sensitivity Specificity ◽  
Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

scholarly journals Sensitivity, Specificity and Predictive Values of Cytological and Microbiological Findings of Endometrial Biopsy, Cytobrush and Low Volume Uterine Lavage in Relation to Endometrial Histology in Barren Mares

2020 ◽  
Vol 15 (04) ◽  
pp. 75-79
Author(s):  
Agnus Mathew ◽  
DM Patel ◽  
KK Hadiya
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Endometrial Biopsy ◽  
Microbial Culture ◽  
K Value ◽  
Predictive Values ◽  
Low Volume ◽  
Sensitivity Specificity ◽  
Uterine Lavage

This study was carried out on 10 infertile barren mares to evaluate the sensitivity, specificity, predictive values and agreement (kappa value) of cytological and microbiological findings of three diagnosing techniques of endometritis, viz., endometrial biopsy (EB), cytobrush (CB) and low volume uterine lavage (LVL) in relation to endometrial histology. When histological examinations from EB were used as “the best standard,” the sensitivity of cytology from EB, CB and LVL technique was 0.33, 0.50 and 0.50; specificity 0.75, 1.00 and 0.75; positive predictive value 0.66, 1.00 and 0.75, and negative predictive value was 0.42, 0.57 and 0.50, respectively. The sensitivity of bacteriology from EB, CB and LVL technique was 0.83, 0.83 and 1.00; the specificity was 0.75, 0.75 and 0.50; positive predictive value 0.83, 0.83 and 0.75, and the negative predictive value was 0.75, 0.75 and 1.00, respectively. In all the cases, the sensitivity of the bacteriology was found to be higher than the sensitivity of cytology. When the results of cytological and bacteriological examinations were combined, no any increase in the sensitivity was found. Bacteriology and cytology from CB showed the highest positive predictive value demonstrating that a positive result is an accurate indication of endometritis. Sensitivity values were always higher if smears were evaluated according to PMNs to epithelial cell ratio, and the highest values were observed in specimens collected from CB and LVL. The evaluation of cytological smears based on counting PMNs in relation to epithelial cells was a better method for diagnosis of endometritis than counting the number of PMNs per high power microscopic field (k value 0.07-0.47 vs. 0.00). The agreement of the diagnosis of endometritis between the three techniques of the collection was from fair to poor and between the different criteria adopted to evaluate smears was always poor. However, the agreement of the diagnosis of endometritis by the microbial culture was moderate between the three techniques of the collection (k value 0.55-0.58).

scholarly journals Ovarian Malignancy Prediction by Gatot Purwoto (GP) Score, Risk Malignancy Index (RMI), and Frozen Section in Young Age

2016 ◽  
Author(s):  
Liva Wijaya
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Frozen Section ◽  
Diagnostic Value ◽  
Young Age ◽  
Ovarian Malignancy ◽  
Aged Patients ◽  
Sensitivity Specificity ◽  
Additional Value

Objective: To know the diagnostic value of a scoring system taken before surgery and frozen section in young-aged patients with suspected malignancy. Using that result, we can also investigate whether frozen section gives additional value to clinical scoring system. Method: This study is a diagnostic test. This study was carried out by accessing RSCM’s medical record from 2006-2011. From 437 patients suspected of ovarian malignancy, we included 157 patients due to age. Result: Diagnostic value of GP score are 77%, 49%, 61%, 68%, 63%, while RMI are 69%, 49%, 58%, 45%, 59%, (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy respectively). Diagnostic value of frozen section in patients with suspected malignancy using GP score >4 are 81.7%, 87.2%, 90.7%, 75.6%, 83%, while in patients with RMI 200 are 81%, 87%, 89%, 77%, 83% (sensitivity, spesificity, positive predictive value, negative predictive value, and accuracy respectively). Conclusion: Gatot Purwoto score and RMI have good diagnostic value in proving malignancy in young age. Its predictive value will be increased by frozen section. [Indones J Obstet Gynecol 2014; 3: 157-161] Keywords: frozen section, gatot purwoto score, ovarian malignancy, RMI, young age

scholarly journals A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

2018 ◽  
Vol 5 (3) ◽  
pp. 796
Author(s):  
Vamsavardhan Pasumarthi ◽  
C. P. Madhu
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Scoring System ◽  
Alvarado Score ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to ALVARADO Score, particularly when applied to Asian population. Not many studies have been conducted to compare RIPASA and ALVARADO scoring systems. Hence, author want to compare prospectively Alvarado and RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis.Methods: A prospective analysis of 116 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. ROC curve area analysis was performed to examine diagnostic accuracy of RIPASA and ALVARADO scores.Results: The sensitivity of ALVARADO score is estimated to be 52.08 for a cut off of 6. The specificity is 80%, positive predictive value is 92.59, negative predictive value is 25.81. The Diagnostic accuracy of ALVARADO scoring is found to be 56.9. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system are 75%, 65%, 91.14%, 35.14%. The diagnostic accuracy of RIPASA score is 73.28.Conclusions: The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis. When the ROC curve was observed the area under the curve is high for RIPASA scoring system.

Feasibility of Thyroid Imaging Reporting and Data System Classification in Predicting Thyroid Malignancy

2019 ◽  
Vol 85 (12) ◽  
pp. 1345-1349
Author(s):  
Ahmet Cem Dural ◽  
Nuri Alper Sahbaz ◽  
Cevher Akarsu ◽  
Sezer Akbulut ◽  
Rustu Turkay ◽  
...  
Keyword(s):  
Predictive Value ◽  
Daily Practice ◽  
Diagnostic Value ◽  
Data System ◽  
Thyroid Malignancy ◽  
Predictive Values ◽  
Thyroid Imaging ◽  
Ultrasound Findings ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

In this study, we aimed to evaluate the diagnostic value of thyroid imaging reporting and data system (TIRADS) in the estimation of malignancy and assess the concordance between TIRADS and the histopathology results of the postoperative specimens. Consecutive ultrasound imaging records of patients with multinodular goiter from January 2010 to December 2017 who underwent surgery were retrospectively reviewed. The risk of malignancy of each TIRADS category was determined, and correlation with pathology was assessed. The patients with malignant cytology findings (Bethesda 6) who were categorized TIRADS 6 were excluded from the study. The positive and negative predictive values, sensitivity, specificity, and accuracy of the TIRADS classification were calculated on a 2 x 2 table with their own formulas. A total of 1457 patients were evaluated, and 1122 of these were included in the study. The risk of malignancy for nodules evaluated as TIRADS 2 was 0.6 per cent, TIRADS 3 was 13.1 per cent, TIRADS 4a was 20 per cent, TIRADS 4b was 61.1 per cent, TIRADS 4c was 85.7 per cent, and TIRADS 5 was 93.3 per cent. The positive predictive value of TIRADS classification was found to be 43.4 per cent, negative predictive value was found to be 90.7 per cent, sensitivity was found to be 78 per cent, specificity was found to be 68.4 per cent, and accuracy was found to be 70.7 per cent for our institution. The TIRADS classification based on suspicious ultrasound findings is reliable in predicting thyroid malignancy and can be routinely used in daily practice.

Usefulness of Grey Scale and Doppler transvaginal sonography in diagnosis of ovarian torsion

2020 ◽  
Vol 14 (2) ◽  
pp. 97-102
Author(s):  
Khalid Rehman `Yousaf ◽  
Shahzad Saeed ◽  
Saman Chaudhry ◽  
Rabia Bashrat ◽  
Abadullah Khalid ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Ovarian Function ◽  
Imaging Modality ◽  
Ovarian Torsion ◽  
Transvaginal Sonography ◽  
Predictive Values ◽  
Grey Scale ◽  
Sensitivity Specificity

Background: Ovarian torsion diagnosis is a great challenge as delay in diagnosis can cause severe morbidity. Early accurate diagnosis is crucial to preserve ovarian function. Ultrasonography being the primary imaging modality plays a vital role in the evaluation of suspected ovarian torsion by helping surgeons reach the correct diagnosis, thus avoiding unnecessary intervention. This study aims to determine the diagnostic accuracy of isolated and combined sonographic features of ovarian torsion on grey scale and Doppler transvaginal ultrasonography. Patients and methods: From radiology database, from January 2016 till December 2019, sonographic signs of ovarian torsion in 113 women with suspected ovarian torsion on ultrasonography and subsequent surgical diagnosis were evaluated. Ultrasound findings were compared with surgical findings to determine the accuracy, sensitivity, specificity, and positive and negative predictive values of individual and combined ultrasound signs. Results: Diagnostic accuracy of ultrasound for ovarian torsion was 85.8%. Abnormal ovarian Doppler flow was the most accurate individual sonographic sign with accuracy, sensitivity, specificity and positive predictive value of 85.8%, 83.5%, 100% and 100% respectively followed by ovarian enlargement and ovarian edema. Combined ultrasound signs resulted in higher sensitivity and positive predictive values, and lower specificity and negative predictive values for ovarian torsion. Increasing the number of sonographic parameters increased the specificity but decreased sensitivity. High accuracy, sensitivity, positive predictive value, specificity and negative predictive value was seen when combination of three or two sonographic parameters was used as diagnostic criteria. Conclusion: Transvaginal sonography is a convenient, reliable and extremely useful imaging modality for preoperative diagnosis of ovarian torsion with high specificity, sensitivity, positive predictive value and diagnostic accuracy helping treating physicians to take prompt decisions regarding timely surgical intervention. However, due to low negative predictive values, absence of sonographic signs does not rule out ovarian torsion and high index of clinical suspicion remains of utmost importance.

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