The Sensitivity and Specificity of the Caffeine-Halothane Contracture Test 

1998 ◽  
Vol 88 (3) ◽  
pp. 579-588 ◽  
Author(s):  
Gregory C. Allen ◽  
Marilyn Green Larach ◽  
Allen R. Kunselman
Keyword(s):  
Malignant Hyperthermia ◽  
Sensitivity And Specificity ◽  
Clinical Laboratory ◽  
High Sensitivity ◽  
Youden Index ◽  
Clinical Criteria ◽  
The North ◽  
Diagnostic Thresholds ◽  
Diagnostic Threshold ◽  
Component Test

Background The caffeine-halothane contracture test (CHCT) is the only recognized laboratory test to diagnose malignant hyperthermia (MH). The authors report the results of their analysis of pooled data from the North American Malignant Hyperthermia Registry database to determine the sensitivity and specificity of the CHCT. Methods The MH Clinical Grading Scale was used to identify 32 case subjects who were "almost certain" to be MH susceptible based on clinical criteria alone. Their CHCT results were compared with those of a group of 120 control subjects considered to be at low risk for MH. Diagnostic thresholds of the CHCT were adjusted, and its component tests were combined to generate receiver operating characteristic curves. The maximal Youden index for each component test was chosen as the diagnostic threshold indicative of MH susceptibility. Results The highest sensitivity (97%; 95% CI, 84-100%) was achieved with a two-component test with thresholds of > or = 0.5 g contracture for 3% halothane, > or = 0.3 g contracture at 2 mM caffeine, or both, considered positive for MH. The test specificity was 78% (95% CI, 69-85%). The addition of other CHCT component tests did not improve CHCT sensitivity or specificity. Conclusion The CHCT achieves high sensitivity and acceptable specificity as a clinical laboratory diagnostic test when it is performed according to published standards. However, it cannot be used as a screening test because of the low prevalence of MH in the general population.

Algorithm of Screening and Monitoring of Hypertension in Rural Outpatient Clinics: the Realities of Practice Through the Prism of the Recommendations

2016 ◽  
pp. 88-93
Author(s):  
Khrystyna Symchych ◽  
Liubomyr Glushko ◽  
Serhii Fedorov ◽  
Irena Kozlova ◽  
Viktoriia Rudnyk ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Outpatient Clinic ◽  
Clinical Laboratory ◽  
Blood Pressure Measurement ◽  
Ankle Brachial Index ◽  
High Sensitivity ◽  
Home Blood Pressure ◽  
Diagnostic Methods ◽  
Vascular Pathology ◽  
Continuous Control

The objective: of the study was a comparative analysis and identify the informativeness of diagnostic methods available in conditions of rural outpatient clinic and formulate the algorithm of screening and monitoring of hypertension in the practice of family doctors. Patients and methods: The study involved 62 patients with hypertension of the second-degree severity. In the first group diagnosis of AH was performed by the methods available in conditions of rural outpatient clinic, in the second group the reference methods were used. The clinical laboratory tests and instrumental examination were made. Informativeness of the methods available in conditions of rural outpatient clinic was defined on base of data of sensitivity, specificity and positive predictive value. Results. Home blood pressure measurement in terms of rural family medicine is the most justified because of the low cost of the survey, the possibility of continuous control of hypertension, the relative autonomy of the patient and results with data DMAT is approximate, high rates of sensitivity and specificity. Use ECG criteria for their relatively high sensitivity and specificity of the method proves informative and justifies its use in the village for early diagnosis of heart damage in patients with hypertension. Definition of ankle brachial index is informative, non-invasive, affordable method to detect the presence of vascular pathology, to evaluate dynamics during treatment. Determination of MAU is an affordable quality marker of kidney damage in hypertension, with high sensitivity and specificity. For a more accurate diagnosis be to calculate glomerular filtration rate. Lipid metabolism at clinic should be determined by the level of total cholesterol. Carbohydrate metabolism enough to carry on fasting glucose and glucose1tolerant test. Conclusion. It is proved the simple in performance, the cheap and routine methods that are used widely can to inform about cardiovascular risk and to determine the prognosis of illness in patients with hypertension.

scholarly journals Accurate clinical detection of exon copy number variants in a targeted NGS panel using DECoN

2016 ◽  
Vol 1 ◽  
pp. 20 ◽  
Author(s):  
Anna Fowler ◽  
Shazia Mahamdallie ◽  
Elise Ruark ◽  
Sheila Seal ◽  
Emma Ramsay ◽  
...  
Keyword(s):  
False Discovery Rate ◽  
Sensitivity And Specificity ◽  
Copy Number ◽  
Clinical Laboratory ◽  
Copy Number Variants ◽  
High Sensitivity ◽  
Targeted Next Generation Sequencing ◽  
Gene Testing ◽  
False Discovery ◽  
Targeted Ngs

Background: Targeted next generation sequencing (NGS) panels are increasingly being used in clinical genomics to increase capacity, throughput and affordability of gene testing. Identifying whole exon deletions or duplications (termed exon copy number variants, ‘exon CNVs’) in exon-targeted NGS panels has proved challenging, particularly for single exon CNVs.  Methods: We developed a tool for the Detection of Exon Copy Number variants (DECoN), which is optimised for analysis of exon-targeted NGS panels in clinical settings. We evaluated DECoN performance using 96 samples with independently validated exon CNV data. We performed simulations to evaluate DECoN detection performance of single exon CNVs and evaluate performance using different coverage levels and sample numbers. Finally, we implemented DECoN in a clinical laboratory that tests BRCA1 and BRCA2 with the TruSight Cancer Panel (TSCP). We used DECoN to analyse 1,919 samples, validating exon CNV detections by multiplex ligation-dependent probe amplification (MLPA).  Results: In the evaluation set, DECoN achieved 100% sensitivity and 99% specificity for BRCA exon CNVs, including identification of 8 single exon CNVs. DECoN also identified 14/15 exon CNVs in 8 other genes. Simulations of all possible BRCA single exon CNVs gave a mean sensitivity of 98% for deletions and 95% for duplications. DECoN performance remained excellent with different levels of coverage and sample numbers; sensitivity and specificity was >98% with the typical NGS run parameters. In the clinical pipeline, DECoN automatically analyses pools of 48 samples at a time, taking 24 minutes per pool, on average. DECoN detected 24 BRCA exon CNVs, of which 23 were confirmed by MLPA, giving a false discovery rate of 4%. Specificity was 99.7%.  Conclusions: DECoN is a fast, accurate, exon CNV detection tool readily implementable in research and clinical NGS pipelines. It has high sensitivity and specificity and acceptable false discovery rate. DECoN is freely available at www.icr.ac.uk/decon.

scholarly journals Novel Cytological Diagnostic Scoring System for Pancreatic Specimens Obtained by Endoscopic Ultrasound-Guided Fine Needle Aspiration

2020 ◽  
Author(s):  
Yuri Kiso ◽  
Yoko Matsuda ◽  
Shikine Esaka ◽  
Yuri Hamashima ◽  
Hiroto Shirahata ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Sensitivity And Specificity ◽  
Fine Needle Aspiration ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Youden Index ◽  
Cytological Diagnosis ◽  
Benign Lesions ◽  
Ultrasound Guided ◽  
Fine Needle

Abstract Background: Cytological diagnosis of pancreatic specimens obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is often challenging because of the small amount of sample or well-differentiated adenocarcinoma with weak cytological atypia. Therefore, the sensitivity and specificity of cytological diagnosis for pancreatic cancer should be improved. Hence, we aimed to evaluate the indices, which are used to distinguish malignant from benign lesions for the cytological diagnosis of pancreatic EUS-FNA specimens. Methods: Seven reviewers, including 3 cytotechnologists and 4 medical doctors, evaluated 20 morphological indices in pancreatic specimens obtained by EUS-FNA (malignant, n=111; benign, n=31). Statistical analyses were performed using Fisher’s exact test, logistic regression analysis, area under the receiver operating characteristic curve, and Youden Index.Results: Among the 20 indices, there was a high incidence rate (>40%) of the following 13 indices in malignant cases: structural atypia, hyperchromatic nucleus, irregular cell polarity, unclear cell boundary, nuclear membrane thickening, anisonucleosis, overlapping, irregular nuclei, high nuclear/cytoplasmic ratio, binding decline, simultaneous appearance of malignant and benign cells, enlarged nucleoli, and background necrosis. When we diagnosed pancreatic specimens using these 13 cytological indices, the cutoff value of 8/9 showed the highest Youden index (0.950) as well as high sensitivity and specificity in distinguishing malignant from benign specimens (98% and 97%, respectively). Conclusion: Thirteen cytological indices showed high sensitivity and specificity in differentiating malignant and benign lesions using pancreatic EUS-FNA samples. Further validation or prospective studies are necessary to establish criteria for the cytological diagnosis of pancreatic cancer.

scholarly journals Application of Scheimpflug-Based Biomechanical Analyzer and Tomography in Early Detecting of Subclinical Keratoconus in Chinese Patients

2020 ◽  
Author(s):  
Yan Liu ◽  
Yu Zhang ◽  
Yue-guo Chen
Keyword(s):  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Roc Curves ◽  
Chinese Patients ◽  
Youden Index ◽  
Biomechanical Property ◽  
Surgical Safety ◽  
Morphological Index ◽  
Diagnostic Capacity

Abstract PurposeTo evaluate the value of Scheimpflug-based biomechanical analyzer combined with tomography in detecting early keratoconus by distinguishing normal eyes from frank keratoconus (KC) and forme frusta keratoconus (FFKC) eyes in Chinese patients. MethodsThis study included 31 bilateral frank keratoconus patients, 27 unilateral clinical manifest keratoconus patients with very asymmetric eyes, and 79 control subjects with normal corneas. Corneal morphological and biomechanical parameters were measured using the Pentacam HR and Corvis ST (OCULUS, Wetzlar, Germany). The diagnostic capacity of computed parameters reflecting corneal biomechanical and morphological traits [including Belin-Ambrósio deviation index (BAD_D), Corvis biomechanical index (CBI) and tomographic and biomechanical index (TBI)] was determined using receiver operating characteristic (ROC) curves and compared by DeLong test. Additionally, the area under the curve (AUC), the best cutoff values, and Youden index for each parameter were reported. The novel corneal stiffness parameter (Stress-Strain Index or SSI) was also compared between KC, FFKC and normal eyes.ResultsEvery morphological and biomechanical index analyzed in this study was significantly different between KC, FFKC and normal eyes (p=0.000). TBI was most valuable for detecting subclinical keratoconus (FFKC eyes) with an AUC of 0.928 (P=0.000), and any forms of corneal ectasia (FFKC and frank KC eyes) with an AUC of 0.966 (P=0.000). The sensitivity and specificity of TBI for detecting FFKC was 97.5% and 77.8%, for detecting any KC was 97.5% and 89.7%, with a cut-off value of 0.375. Morphological index BAD_D and biomechanical index CBI were also very useful in distinguishing any KC eyes from normal eyes with an AUC of 0.965 and 0.934, respectively. SSI was significantly different between KC, FFKC and normal eyes (P=0.000), indicating an independent decrease in corneal stiffness in KC eyes.Conclusion Combination of Scheimpflug-based biomechanical analyzer and tomography could increase the accuracy of detecting early keratoconus in Chinese patients. TBI was the most valuable index for detecting subclinical keratoconus with high sensitivity and specificity. Evaluation of corneal biomechanical property in refractive surgery candidates is helpful to recognize potential keratoconic eyes and increase surgical safety.

scholarly journals Application of a scheimpflug-based biomechanical analyser and tomography in the early detection of subclinical keratoconus in chinese patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Liu ◽  
Yu Zhang ◽  
Yueguo Chen
Keyword(s):  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Biomechanical Properties ◽  
Chinese Patients ◽  
Youden Index ◽  
Roc Curve Analysis ◽  
Surgical Safety ◽  
Morphological Index

Abstract Background In vivo corneal biomechanics evaluation has been used to help screen early keratoconus in recent years. This study is to evaluate the value of a Scheimpflug-based biomechanical analyser combined with tomography in detecting subclinical keratoconus by distinguishing normal eyes from frank keratoconus (KC) and forme frusta keratoconus (FFKC) eyes in Chinese patients. Methods Study design: diagnostic test. This study included 31 bilateral frank keratoconus patients, 27 unilateral clinically manifesting keratoconus patients with very asymmetric eyes, and 79 control subjects with normal corneas. Corneal morphological and biomechanical parameters were measured using a Pentacam HR and a Corvis ST (OCULUS, Wetzlar, Germany). The diagnostic ability of computed parameters reflecting corneal biomechanical and morphological traits [including the Belin-Ambrósio deviation index (BAD_D), the Corvis biomechanical index (CBI) and the tomographic and biomechanical index (TBI)] was determined using receiver operating characteristic (ROC) curve analysis and compared by the DeLong test. Additionally, the area under the curve (AUC), the best cut-off values, and the Youden index for each parameter were reported. A novel corneal stiffness parameter, the stress-strain index (SSI), was also compared between KC, FFKC and normal eyes. Results Every morphological and biomechanical index analysed in this study was significantly different among KC, FFKC and normal eyes (P = 0.000). The TBI was most valuable in detecting subclinical keratoconus (FFKC eyes), with an AUC of 0.928 (P = 0.000), and both forms of corneal ectasia (FFKC and frank KC eyes), with an AUC of 0.966 (P = 0.000). The sensitivity and specificity of the TBI was 97.5 and 77.8 % in detecting FFKC and 97.5 and 89.7 % in detecting any KC, respectively, with a cut-off value of 0.375. The morphological index BAD_D and the biomechanical index CBI were also very useful in distinguishing eyes with any KC from normal eyes, with AUCs of 0.965 and 0.934, respectively. The SSI was significantly different between KC, FFKC and normal eyes (P = 0.000), indicating an independent decrease in corneal stiffness in KC eyes. Conclusions The combination of a Scheimpflug-based biomechanical analyser and tomography could increase the accuracy in detecting subclinical keratoconus in Chinese patients. The TBI was the most valuable index for detecting subclinical keratoconus, with a high sensitivity and specificity. Evaluation of corneal biomechanical properties in refractive surgery candidates could be helpful for recognizing potential keratoconic eyes and increasing surgical safety.

CLINICAL, LABORATORY AND IMMUNOLOGICAL FEATURES IN PATIENTS OF SYSTEMIC LUPUS ERYTHEMATOSUS

2015 ◽  
pp. 62-69
Author(s):  
Tam Vo ◽  
Thị Nhu Hang Huynh
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Malar Rash ◽  
Clinical Criteria ◽  
Positive Direct

Objective: To describe the clinical, laboratory and immunological features in patients with systemic lupus erythematosus (SLE). Methods: This was a descriptive cross-sectional study of 120 SLE patients admitted to Rheumatology department of Cho Ray Hospital and 60 healthy subjects on routine exams from November 2013 to July 2015. Results: Of the 120 patients, 114 were females (95.0%) and 6 were males (5.0%), giving a female to male ratio of 19:1. The patients’ age varied from 16 to 64 years old, mean 27.86. The systematic symptoms include: hypertension (4.2%), oedema (35.8%), fatique (78.3%) and fever (66.7%). The clinical criteria include: photosensitivity (80%), malar rash (69,2%), discoid rash (2,5%), nasal DLE (9.2%), oral DLE (30.0%), alopecia (55.8%), arthritis (45.8%), serositis: cardiac effusion (5.8%), pleural effusion (9.2%), renal: proteinuria per day (39.2%), hematuria (53.3%), neurologic: psychosis (3.3%), headache (7.5%), anemia (66.7%), leukopenia (22.5%), lymphopenia (28.3%), thrombocytopenia (10.0%). The immunological criteria include: positive ANA (97.5%), positive anti-dsDNA (90.0%), positive anti Sm (36.7%), positive anti cardiolipin IgG (18.3%), positive anti cardiolipin IgM (6.7%), positive direct Coomb test (20.0%). Hypocomplementemia of C3: sensitivity (95.0%), specificity (88.3%). Hypocomplementemia of C4: sensitivity (81.7%), specificity (96.7%).Conclusions: C3, C4 in serum are good tests for diagnosing Systemic Lupus Erythematosus according to SLICC 2012, hypocomplementemia of C3 and C4 have high sensitivity and specificity. Keywords:SystemicLupusErythematosus,C3,C4.

scholarly journals Fast diagnostic test for familial Mediterranean fever based on a kinase inhibitor

2020 ◽  
Vol 80 (1) ◽  
pp. 128-132
Author(s):  
Flora Magnotti ◽  
Tiphaine Malsot ◽  
Sophie Georgin-lavialle ◽  
Fatima Abbas ◽  
Amandine Martin ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Sensitivity And Specificity ◽  
Kinase Inhibitor ◽  
Gene Dosage ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Inflammasome Activation ◽  
Clinical Criteria ◽  
Healthy Donors ◽  
Mediterranean Fever

Background and objectiveFamilial Mediterranean fever (FMF) is the most frequent hereditary autoinflammatory disease. Its diagnosis relies on a set of clinical criteria and a genetic confirmation on identification of biallelic pathogenic MEFV variants. MEFV encodes pyrin, an inflammasome sensor. Using a kinase inhibitor, UCN-01, we recently identified that dephosphorylation of FMF-associated pyrin mutants leads to inflammasome activation. The aim of this study was to assess whether quantifying UCN-01-mediated inflammasome activation could discriminate FMF patients from healthy donors (HD) and from patients with other inflammatory disorders (OID).MethodsReal-time pyroptosis and IL-1β secretion were monitored in response to UCN-01 in monocytes from FMF patients (n=67), HD (n=71) and OID patients (n=40). Sensitivity and specificity of the resulting diagnostic tests were determined by receiver operating characteristic curve analyses.ResultsInflammasome monitoring in response to UCN-01 discriminates FMF patients from other individuals. Pyroptosis assessment leads to a fast FMF diagnosis while combining pyroptosis and IL-1β dosage renders UCN-01-based assays highly sensitive and specific. UCN-01-triggered monocytes responses were influenced by MEFV gene dosage and MEFV mutations in a similar way as clinical phenotypes are.ConclusionsUCN-01-based inflammasome assays could be used to rapidly diagnose FMF, with high sensitivity and specificity.

Detector-C: A Blood-based IVD with High Sensitivity and Specificity for Early Detection and Screening of Colorectal Cancer

2010 ◽  
Vol 48 (08) ◽  
Author(s):  
A Rosenthal ◽  
H Köppen ◽  
R Musikowski ◽  
R Schwanitz ◽  
J Behrendt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Sensitivity And Specificity ◽  
High Sensitivity

Trends in Diagnosis for Active Tuberculosis Using Nanomaterials

2019 ◽  
Vol 26 (11) ◽  
pp. 1946-1959 ◽  
Author(s):  
Le Minh Tu Phan ◽  
Lemma Teshome Tufa ◽  
Hwa-Jung Kim ◽  
Jaebeom Lee ◽  
Tae Jung Park
Keyword(s):  
Sensitivity And Specificity ◽  
High Efficiency ◽  
Point Of Care ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Advantages And Disadvantages ◽  
Treatment And Prevention ◽  
Clinical Tools ◽  
Diagnostic Applications

Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.

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