Semiautomated procedures for evaluation of carbohydrate-deficient transferrin in the diagnosis of alcohol abuse

Abstract Carbohydrate-deficient transferrin (CDT) may now be the most valuable biological marker for diagnosis of alcohol abuse. We compared the diagnostic performance of two new CDT tests, Axis %CDT turbidimetric immunoassay (TIA) and Axis %CDT HPLC, against Specialty Laboratories’ isoelectric focusing/immunoblotting/laser densitometry (IEF/IB/LD). Both Axis tests include one-half the concentration of trisialotransferrin isoforms in their CDT quantitation schemes. Considering an alcohol abuse prevalence of 7%, Axis %CDT TIA shows a sensitivity of 87% at 98% specificity and a positive predictive value (PPV) of 0.75; %CDT HPLC shows a sensitivity of 87% at 100% specificity for a PPV of 1, and the IEF/IB/LD shows 81% sensitivity at 94% specificity for a PPV of 0.5. All three CDT tests show the same negative predictive value (0.98). Both Axis procedures perform better than IEF/IB/LD in the diagnosis of alcohol abuse; %CDT TIA is available in several semiautomated, cost-effective formats.

Download Full-text

Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽

10.3390/diagnostics11061110 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1110

Author(s):

Andrea Ronchi ◽

Marco Montella ◽

Federica Zito Marino ◽

Michele Caraglia ◽

Anna Grimaldi ◽

...

Keyword(s):

Metastatic Melanoma ◽

Molecular Analysis ◽

Predictive Value ◽

Diagnostic Performance ◽

Cost Effective ◽

Needle Aspiration ◽

Braf V600e ◽

Mutational Status ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

Download Full-text

1268A comparison between the diagnostic performance of quantitative flow ratio and non-invasive imaging modalities for diagnosing myocardial ischemia defined by FFR, a PACIFIC-trial interim analysis

European Heart Journal ◽

10.1093/eurheartj/ehz748.0038 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

P A A Van Diemen ◽

R S Driessen ◽

R A Kooistra ◽

W J Stuijfzand ◽

P G Raijmakers ◽

...

Keyword(s):

Coronary Angiography ◽

Myocardial Ischemia ◽

Positive Predictive Value ◽

Flow Velocity ◽

Predictive Value ◽

Diagnostic Performance ◽

Emission Tomography ◽

Flow Ratio ◽

Quantitative Flow Ratio ◽

Quantitative Flow

Abstract Background Quantitative flow ratio (QFR) uses fast computational algorithms based on 3-dimensional quantitative coronary angiography and estimation of contrast flow velocity during invasive coronary angiography (ICA) to obtain QFR values equivalent to fractional flow reserve (FFR). Objective To compare the diagnostic performance of QFR with coronary computed tomography angiography (CCTA), single-photon emission tomography (SPECT), and positron emission tomography (PET) for diagnosing myocardial ischemia defined by FFR. Method QFR computation was attempted in 109 patients (286 vessels without a subtotal/total lesion) of the 208 patients included in the PACIFIC-trial. Patients underwent 256-slice CCTA, Tetrofosmin SPECT, and [15O]H2O PET prior to ICA in conjunction with 3 vessel FFR measurements. ICA images were obtained without the use of a dedicated QFR acquistion protocol. QFR was calculated using a fixed empiric hyperemic flow velocity (fQFR) as well as using a patient specific flow velocity based on contrast passage through the coronary (cQFR). All analysis were performed on a per vessel level. Results Fixed QFR computation succeeded in 152 (53%) vessels while cQFR analysis was successful in 140 (49%) vessels. A good correlation between FFR and fQFR/cQFR was observed (R=0.774, p<0.001/R=0.790, p<0.001). The diagnostic performance in terms of sensitivity, specificity, negative predictive value, positive predictive value, and accuracy is presented in table 1. In total, 133 vessels with matched FFR, fQFR, cQFR, CCTA, SPECT, and PET results were available for the comparative C-statistic analysis, figure 1. The diagnostic performance of fQFR and cQFR was comparable (p=0.451) and superior to CCTA (p=0.004/p=0.003), SPECT (p<0.001/p<0.001), and PET (p=0.008/p=0.006), figure 1. CCTA, and PET performed alike (p=0.568) and outperformed SPECT (p=0.023, p=0.002). Table 1 % (95% Confidence Interval) fQFR n=152 cQFR (n=140) CCTA (n=152) SPECT (n=150) PET (n=149) Sensitivity 76 (59–89) 71 (53–86) 70 (51–84) 30 (16–49) 76 (58–89) Specificity 94 (88–98) 93 (86–97) 73 (64–81) 96 (90–99) 80 (72–87) Negative Predictive Value 93 (88–96) 92 (86–95) 90 (84–94) 83 (79–86) 92 (86–96) Positive Predictive Value 79 (64–89) 74 (59–85) 42 (33–51) 67 (42–84) 52 (42–62) Accuracy 90 (84–94) 88 (81–93) 72 (65–79) 81 (74–87) 79 (72–85) Figure 1. Conclusion Fixed QFR and cQFR correlate well with FFR with a high diagnostic accuracy as result. QFR outperformed CCTA, SPECT, and PET for the diagnosis of myocardial ischemia on a per vessel basis with the important footnote that fQFR and cQFR could only be computed in 53%, and 49% of the vessels.

Download Full-text

Towards malaria microscopy at the point-of-contact: an assessment of the diagnostic performance of the Newton Nm1 microscope in Uganda

Parasitology ◽

10.1017/s0031182014000833 ◽

2014 ◽

Vol 141 (14) ◽

pp. 1819-1825 ◽

Cited By ~ 10

Author(s):

J. RUSSELL STOTHARD ◽

BETTY NABATTE ◽

JOSE C. SOUSA-FIGUEIREDO ◽

NARCIS B. KABATEREINE

Keyword(s):

Confidence Interval ◽

Positive Predictive Value ◽

Predictive Value ◽

Blood Cells ◽

Diagnostic Performance ◽

White Blood Cells ◽

Sub Saharan Africa ◽

Resource Poor ◽

Sub Saharan ◽

Malaria Microscopy

SUMMARYMalaria microscopy in sub-Saharan Africa is often restricted by access to light microscopes. To address this gap, a novel portable inverted monocular microscope, the Newton Nm1, was designed and is now commercially available. Its diagnostic performance was assessed in a blinded-slide trial at ×1000 (oil) of Giemsa-stained thick blood films against a conventional microscope as undertaken by four Ugandan Ministry of Health technicians. With the Newton Nm1, diagnostic performance was: sensitivity 93·5% (95% confidence interval (CI) 78·6–99·2%), specificity 100·0% (95% CI 82·4–100·0%), positive predictive value 100·0% (95% CI 88·1–100·0%) and negative predictive value 90·5% (95% CI 69·6–98·8%). Discordance was due to a systematic error underestimating parasitaemia by ~45%; when counting Plasmodium parasites against 200 white blood cells, blood films with low parasitaemia (i.e. <100 μL−1 of blood) could be overlooked and misclassified. By contrast, specificity was excellent with no false positives encountered. Whilst proven useful, especially in resource-poor environments, it is still unclear how we can ensure the uptake of the Newton Nm1 within sub-Saharan Africa.

Download Full-text

Comparative Study of Imprint Cytology and Frozen Section in the Intraoperative Diagnosis of Thyroid Lesions

Bangladesh Journal of Pathology ◽

10.3329/bjpath.v24i1.2876 ◽

1970 ◽

Vol 24 (1) ◽

pp. 12-15 ◽

Cited By ~ 1

Author(s):

Sukumar Shaha ◽

AJE Nahar Rahman

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Frozen Section ◽

Cost Effective ◽

Imprint Cytology ◽

Intraoperative Diagnosis ◽

Fresh Specimen ◽

Sensitivity Specificity ◽

Thyroid Lesions

Imprint cytology can provide a useful adjunct to the frozen section diagnosis and may be used safely in the intraoperative diagnosis of thyroid nodules, especially in the centres where frozen section facilities are not available. This study was conducted to compare imprint cytology and frozen section in terms of diagnostic accuracy, sensitivity, specificity, positive predictive value and to assess the value of imprint cytology in the intraoperative diagnosis of thyroid lesions. A total of 57 consecutive patients were enrolled in the study. All of the patients underwent frozen section in the department of pathology, BSMMU, Dhaka. Imprints were taken from the fresh specimen sent for frozen section from departments of otolaryngology and surgery of BSMMU. Imprint slides were stained with rapid H & E staining method. Then the tissues were submitted for frozen section by standard method. In this study, diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of imprint cytology were 81.25%, 66.66%, 82.59%, 87.12% respectively. Frozen section revealed the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive as 88.46%, 72.72%, 100%, 100%, 83.33% respectively. Imprint cytology was found to be comparable with frozen section in diagnostic accuracy and sensitivity. Since imprint cytology is a simple and cost-effective procedure it can be used as an alternative to frozen section in hospitals where frozen section facilities are not available. Key Words: Imprint cytology, frozen section, intraoperative diagnosis of thyroid lesions doi: 10.3329/bjpath.v24i1.2876 Bangladesh J Pathol 24 (1) : 12-15

Download Full-text

Diagnostic performance of deep learning-based vascular extraction and stenosis detection technique for coronary artery disease

British Journal of Radiology ◽

10.1259/bjr.20191028 ◽

2020 ◽

Vol 93 (1113) ◽

pp. 20191028 ◽

Cited By ~ 2

Author(s):

Meng Chen ◽

Ximing Wang ◽

Guangyu Hao ◽

Xujie Cheng ◽

Chune Ma ◽

...

Keyword(s):

Coronary Artery Disease ◽

Deep Learning ◽

Coronary Artery ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Performance ◽

Operating Characteristics ◽

Stenosis Detection ◽

Artery Disease

Objective: To investigate the diagnostic performance of deep learning (DL)-based vascular extraction and stenosis detection technology in assessing coronary artery disease (CAD). Methods: The diagnostic performance of DL technology was evaluated by retrospective analysis of coronary computed tomography angiography in 124 suspected CAD patients, using invasive coronary angiography as reference standard. Lumen diameter stenosis ≥50% was considered obstructive, and the diagnostic performances were evaluated at per-patient, per-vessel and per-segment levels. The diagnostic performances between DL model and reader model were compared by the areas under the receiver operating characteristics curves (AUCs). Results: In patient-based analysis, AUC of 0.78 was obtained by DL model to detect obstructive CAD [sensitivity of 94%, specificity of 63%, positive predictive value of 94%, and negative predictive value of 59%], While AUC by reader model was 0.74 (sensitivity of 97%, specificity of 50%, positive predictive value of 93%, negative predictive value of 73%). In vessel-based analysis, the AUCs of DL model and reader model were 0.87 and 0.89 respectively. In segment-based analysis, the AUCs of 0.84 and 0.89 were obtained by DL model and reader model respectively. It took 0.47 min to analyze all segments per patient by DL model, which is significantly less than reader model (29.65 min) (p < 0.001). Conclusion: The DL technology can accurately and effectively identify obstructive CAD, with less time-consuming, and it could be a reliable diagnostic tool to detect CAD. Advances in knowledge: The DL technology has valuable prospect with the diagnostic ability to detect CAD.

Download Full-text

Reproduction management in dairy cattle: a prospective study using progesterone and oestrone sulphate for monitoring pregnancy

Animal Science ◽

10.1017/s1357729800008328 ◽

1995 ◽

Vol 60 (2) ◽

pp. 177-183 ◽

Cited By ~ 2

Author(s):

S. Kourletaki-Belibasaki ◽

A. Stefanakis ◽

D. Vafiadis ◽

G. Hatzidakis ◽

E. Krambovitis

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Cost Effective ◽

Sample Collection ◽

Predictive Values ◽

Animal Reproduction ◽

Lactating Cows ◽

Oestrone Sulphate ◽

Result Analysis ◽

A Prospective Study

AbstractIn a prospective 2-year study, milk progesterone and oestrone sulphate determinations were used to monitor and assess pregnancy in lactating cows. The testing was done centrally at a government regional veterinary establishment which was responsible for providing semen to the farms of the area and also had available specialist expertise in animal reproduction. Sample collection and dissemination of test results were achieved through the network of the artificial insemination service. This approach was preferred because it was considered ergonomic, cost-effective and reliable. Comparison of oestrus behavioural signs and progesterone on the day of insemination revealed that 7·8% (89/1133) of the animals tested had high progesterone levels. Single progesterone testing on day 21 post insemination was not satisfactory for pregnancy diagnosis as the positive predictive value was 83·0% (147/177). The combination of low progesterone on day 0 and high progesterone on day 21 improved the positive predictive value to 87·4% (235/269). Results from 400 samples taken 110 to 130 days post insemination from 53 animals revealed that cows with oestrone sulphate concentrations greater than 0·1 μg/l actually calved. This assay appears to be particularly suitable as a pregnancy confirmation test. A pilot field study implementing a programme of testing on days 0, 21 and 42 for progesterone and between days 110 to 130 for oestrone sulphate not only achieved almost absolute pregnancy predictive values but careful result analysis strongly indicated that the approach of systematic testing can also reveal the fertility profile of a given herd and help to identify potential causes of pregnancy failure from the period of the reproduction cycle in which they occur.

Download Full-text

Accuracy of Niacin Skin Flush Test for Diagnosing Schizophrenia

Iranian Journal of Psychiatry and Clinical Psychology ◽

10.32598/ijpcp.27.1.3144.1 ◽

2021 ◽

Vol 27 (1) ◽

pp. 78-91

Author(s):

Mohammad Arzanlou ◽

◽

Alireza Armanikian ◽

Omid Saed ◽

Faramarz Dobakhti ◽

...

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Biological Marker ◽

Test Accuracy ◽

Diagnostic Study ◽

Healthy Controls ◽

Evaluation Time ◽

Concentration Sensitivity ◽

Sensitivity Specificity

Objectives: This study aims to investigate niacin sensitivity in schizophrenia patients compared to healthy people and examine the accuracy of niacin skin flush test in diagnosing schizophrenia. Methods: This diagnostic study was conducted in 2018 in Zanjan, Iran. Three niacin concentrations (0.001 M, 0.01 M, and 0.1 M) was first applied topically to the skin of 36 schizophrenia patients and 33 healthy controls. Flush responses were evaluated at 10 and 15 min after application. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the test were measured for each niacin concentration and evaluation time. Results: At 10 min, the highest test accuracy was reported when 0.001 M niacin solution was used (Sensitivity=94%, specificity=50%, PPV= 51%, and NPV= 94%). At 15 min, the highest test accuracy was observed at 0.01 concentration (Sensitivity=52%, specificity=92%, PPV=79%, and NPV=77%). Conclusion: Flush responses to niacin is more impaired in patients with schizophrenia. Therefore, niacin can be considered as a biological marker of schizophrenia and can be used for its diagnosis.

Download Full-text

Perbandingan Rapid Diagnostic Test dan Pemeriksaan Mikroskopik pada Diagnosis Malaria

Kesmas National Public Health Journal ◽

10.21109/kesmas.v5i6.120 ◽

2011 ◽

Vol 5 (6) ◽

pp. 250 ◽

Cited By ~ 2

Author(s):

Lambok Siahaan

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Parasite Density ◽

Microscopic Examination ◽

Predictive Value ◽

Blood Film ◽

Other Hand ◽

Better Than

Penelitian ini dilakukan untuk membandingkan penggunaan Rapid diagnostic test dengan pemeriksaan mikroskopik (apusan darah) dalam menegakkan diagnosis malaria. Penelitian uji diagnostik ini dilakukan di Kabupaten Nias Selatan dan Kotamadya Sabang, Sumatera Utara. Apusan darah diwarnai dengan larutan Giemsa 10% dan dibaca oleh pemeriksa yang sudah terlatih. Rapid diagnostic test dilakukan dengan menggunakan parascreen. Uji diagnostik rapid diagnostic test secara umum diperoleh hasil yaitu sensitivitas 63,8%; spesifisitas 100%; Positive Predictive Value (PPV) 100%; dan negative predictive value (NPV)93,5%. Kepadatan parasit pada rapid diagnostic test (+) dan mikroskopik (+) adalah 1.483 ± 583 parasit/μl. Sementara, kepadatan parasit pada pemeriksaan rapid diagnostic test (-) dan mikroskopik (+) adalah 621 ± 335 parasit/μl. Pemeriksaan mikroskopik masih lebih baik dibandingkandengan rapid diagnostic test, terutama pada kepadatan parasit yang rendah. Kata kunci: Malaria, pemeriksaan mikroskopik, rapid diagnostic testAbstractThe study was conducted to compare rapid diagnostic test with microscopy (blood film) to diagnose malaria disease. This diagnostic test was done in South of Nias District and Sabang District, North Sumatera. Blood film were colored with Giemsa 10% solution and examined by trained microscopists. Rapid Diagnostic Test was done based on the manual procedure. The results of diagnostic test of rapid diagnostic test were sensitivity 63,5%; specificity 100%, positive predictive value (PPV) 100%, and negative predictive value (NPV) 93,5%. The density of parasite in rapid diagnostic test (+) were 1.483 + 583 parasite/μl (1.120-2.920 parasite/μl. In other hand, the density of parasite in rapid diagnostic test (-) and microscopy were 621 + 335 parasite/ μl (120-1.160 parasite/μl). Microscopy still better than rapid diagnostic test, especially in patient with low parasite density. Keywords: Malaria, microscopic examination, rapid diagnostic test

Download Full-text

Pancreatin-Cetyl Pyridinium Chloride Digestion and Decontamination Method; A Novel, Sensitive, Cost-Effective Method for Culturing Mycobacterium tuberculosis

Microorganisms ◽

10.3390/microorganisms9102025 ◽

2021 ◽

Vol 9 (10) ◽

pp. 2025

Author(s):

Pottathil Shinu ◽

Anroop B. Nair ◽

Snawar Hussain ◽

Mohamed A. Morsy ◽

Wafaa E. Soliman

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Cetylpyridinium Chloride ◽

Reference Method ◽

Cost Effective ◽

Mycobacterial Species ◽

Direct Microscopy ◽

Cost Effective Method ◽

Cetyl Pyridinium

The present study evaluated the performance of newly developed pancreatin-cetylpyridinium chloride (pancreatin-CPC) digestion and decontamination method (DDM) with N-acetyl L-Cysteine-sodium hydroxide (NALC-NaOH) DDM for isolation of Mycobacteria from clinically suspected pulmonary tuberculosis (PTB) patients. For the study, sputum samples (n = 613) obtained from clinically suspected PTB cases were subjected to direct microscopy, pretreatment with NALC-NaOH DDM (reference method), and pancreatin-CPC DDM followed by culture, and the data were analyzed. The direct microscopy illustrated diagnostic accuracies of 60.4% (sensitivity), 99.77% (specificity), 98.9% (positive predictive value) and 88.3% (negative predictive value), respectively (against culture) for the detection of Mycobacterial species. The pancreatin-CPC DDM showed competitive diagnostic accuracies (against NALC-NaOH DDM) of 99.32% (sensitivity), 94.07% (specificity), 85.05% (positive predictive value), and 99.76% (negative predictive value), respectively, for the isolation of Mycobacterial species. In conclusion, pancreatin-CPC DMM was a highly sensitive, technically simple, and cost-effective method, suggesting its competence to substitute the currently used NALC-NaOH DDM.

Download Full-text

CT Scan in the Prediction of Lymph Node Involvement in Ovarian Cancer – a Retrospective Analysis of a Tertiary Gyneco-Oncological Unit

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1079-5158 ◽

2020 ◽

Vol 80 (05) ◽

pp. 518-525 ◽

Cited By ~ 2

Author(s):

Peter Widschwendter ◽

Alexandra Blersch ◽

Thomas W. P. Friedl ◽

Wolfgang Janni ◽

Christopher Kloth ◽

...

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Positive Predictive Value ◽

Lymph Nodes ◽

Negative Predictive Value ◽

Computer Tomography ◽

Predictive Value ◽

Diagnostic Performance ◽

Lymph Node Involvement ◽

Lymph Node Status

Abstract Background The prognostic value of lymph node removal in ovarian cancer varies depending on the tumor stage. While in the advanced stage the removal of clinically normal lymph nodes does not improve the prognosis, this is still unclear in the early stages. Evaluation of the lymph nodes based on preoperative imaging influences the surgical procedure. Methods This retrospective analysis was performed by analyzing data from 114 patients with ovarian cancer, treated in our university hospital in the years 2000 – 2012. Diagnostic performance of imaging by computer tomography with respect to the correct prediction of lymph node status was analyzed in terms of sensitivity, specificity, positive predictive value and negative predictive value. Results Imaging by computer tomography showed a rather limited diagnostic performance with regard to the detection of lymph node metastases in ovarian cancer, with a sensitivity of 40.7%, a specificity of 89.1%, a positive predictive value of 80.0%, and a negative predictive value of 58.3%. A separate analysis for pelvic and paraaortic lymph node involvement showed a better diagnostic performance of computer tomography for the detection of positive paraaortic lymph nodes (41.2, 93.1, 84.0, and 64.3% for sensitivity, specificity, positive predictive value and negative predictive value, respectively) as compared to the detection of positive pelvic lymph nodes (25.6, 91.8, 62.5, and 69.8%). Conclusion The preoperative prediction of lymph node status by computer tomography is limited. A decision for or against lymphadenectomy should not be made solely on the basis of this approach.

Download Full-text