Predicting Difficult Intubation in Apparently Normal Patients

2005 ◽  
Vol 103 (2) ◽  
pp. 429-437 ◽  
Author(s):  
Toshiya Shiga ◽  
Zen’ichiro Wajima ◽  
Tetsuo Inoue ◽  
Atsuhiro Sakamoto
Keyword(s):  
Confidence Interval ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Screening Tests ◽  
Clinical Value ◽  
Bedside Test ◽  
Airway Pathology ◽  
Bedside Tests

The objective of this study was to systematically determine the diagnostic accuracy of bedside tests for predicting difficult intubation in patients with no airway pathology. Thirty-five studies (50,760 patients) were selected from electronic databases. The overall incidence of difficult intubation was 5.8% (95% confidence interval, 4.5-7.5%). Screening tests included the Mallampati oropharyngeal classification, thyromental distance, sternomental distance, mouth opening, and Wilson risk score. Each test yielded poor to moderate sensitivity (20-62%) and moderate to fair specificity (82-97%). The most useful bedside test for prediction was found to be a combination of the Mallampati classification and thyromental distance (positive likelihood ratio, 9.9; 95% confidence interval, 3.1-31.9). Currently available screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of tests add some incremental diagnostic value in comparison to the value of each test alone. The clinical value of bedside screening tests for predicting difficult intubation remains limited.

scholarly journals Prevalence and prediction of difficult intubation in Nepalese population

2015 ◽  
Vol 2 (1) ◽  
pp. 17-20
Author(s):  
Shristi Shah
Keyword(s):  
Prospective Study ◽  
General Anesthesia ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Preoperative Assessment ◽  
A Prospective Study ◽  
Bedside Tests

Background: Prevalence of difficult intubation is estimated as 3 -18% during routine anesthesia. There are various bedside tests to predict the difficult intubation, like Mallampati test, Thyromental distance, Sternomental distance and mouth opening. However, the prevalence and prediction in Nepalese population is still not estimated. So this study is to see the prevalence and to compare the efficacy of airway parameters to predict the difficult intubation in Nepalese population.Methods: A prospective study was done to estimate the prevalence and prediction of difficult intubation in Nepalese population. During six months period, 182 patients who were undergoing routine surgery under General anesthesia were included in the study. Mallampati grading, thyromental distance, mouth opening and sternomental distance were recorded in preoperative assessment. Cormack and Lehane grading were done during intubation and Grade I and II are considered as easy intubation/ laryngoscopy and III and IV are considered as difficult intubation.Results: The prevalence of difficult intubation was 4.9%. Sensitivity of different tests were as follows; Mallampati test – 55%, thyromental distance – 33%, mouth opening – 22% and sternomental distance – 11%. The Specificity of the test as Mallampati test – 98%, thyromental distance – 89%, mouth opening – 96% and sternomental distance – 97%. So the Mallampati test is more sensitive and specific among the tests done.Conclusion: This prospective study shows that the prevalence of difficult intubation is not different in Nepalese population and the bedside predictors also are good tests that could be continued in our population.Journal of Society of Anesthesiologists of Nepal 2015; 2(1): 17-20

Usefulness and diagnostic value of the NEMA parameter combined with other selected bedside tests for prediction of difficult intubation

2017 ◽  
Vol 37 ◽  
pp. 132-135 ◽  
Author(s):  
Kamil Torres ◽  
Marcin Błoński ◽  
Łukasz Pietrzyk ◽  
Małgorzata Piasecka-Twaróg ◽  
Ryszard Maciejewski ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Diagnostic Value ◽  
Bedside Tests

Diagnostic value of different screening tests for predicting difficult intubation

2019 ◽  
Vol 9 (3) ◽  
pp. 216-221
Author(s):  
Bharti R Rajani ◽  
◽  
Mitali B Saraswala ◽  
Shobhana C Gupta ◽  
◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Diagnostic Value ◽  
Screening Tests

scholarly journals The value of glycosylated hemoglobin in the diagnosis of diabetic retinopathy: a systematic review and Meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Zhang ◽  
Bingjie Zhang ◽  
Zhulin Zhou ◽  
Yutong Guo ◽  
Dan Wang
Keyword(s):  
Diabetic Retinopathy ◽  
Likelihood Ratio ◽  
Roc Curve ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Clinical Value

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI:  0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

scholarly journals Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

2016 ◽  
Vol 70 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Pēteris Priedītis ◽  
Maija Radziņa ◽  
Ilze Štrumfa ◽  
Zenons Narbuts ◽  
Arturs Ozoliņs ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Thyroid Nodules ◽  
Fine Needle Biopsy ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Clinical Value ◽  
Additional Tool ◽  
Ultrasound Evaluation ◽  
Contrast Enhanced ◽  
Benign Nodules

Abstract The aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant thyroid nodules. Thirty-five patients with morphologically proved thyroid nodules (17 malignant; 18 benign), underwent CEUS examination. Five enhancement patterns were evaluated: vascularisation, homogeneity, presence of peripheral rim type enhancement, wash-out rate of the contrast medium, and enhancement using microvascular imaging application. Time-intensity curves (TIC) were analysed in post-processing and defined as three types: slow versus rapid and stable versus rapid biphasic wash-out. Diagnostic value of the listed CEUS parameters was calculated. The results showed medium strength correlation between morphology (benign versus malignant nodule) and type of TIC curve rs = 0.38 (p = 0.021), as well as between mode of contrast enhancement rs = 0.39 (p = 0.022) and wash-out pattern rs =0.39 (p = 0.024). The overall pooled sensitivity of selected diagnostic parameters was 82%, specificity 57%, and accuracy 70%. Malignant nodules were characterised by iso- or hypovascular contrast enhancement and slow wash-out, while benign nodules showed hypervascular enhancement with rapid wash-out TIC curve and rim-like pattern. The CEUS patterns significantly differed between malignant and benign thyroid nodules with high diagnostic accuracy. Thus, CEUS has important clinical value as an additional tool to ultrasound and fine needle biopsy.

Diagnostic value of screening tests in subgroups of women with recurrent pregnancy loss

2014 ◽  
Vol 28 (4) ◽  
pp. 443-447 ◽  
Author(s):  
Ali Irfan Guzel ◽  
Selçuk Erkılınç ◽  
Irfan Özer ◽  
Yusuf Celik ◽  
Nafiye Yılmaz ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Diagnostic Value ◽  
Screening Tests

MiR-455-5p serves as a biomarker of atherosclerosis and inhibits vascular smooth muscle cell proliferation and migration

2021 ◽  
Author(s):  
Xiang Zhang ◽  
Yan Liu ◽  
Jing Zhao ◽  
Tingguo Yan
Keyword(s):  
Smooth Muscle ◽  
Vascular Smooth Muscle ◽  
Diagnostic Value ◽  
Luciferase Reporter ◽  
Luciferase Reporter Gene ◽  
Clinical Value ◽  
Gene Assay ◽  
And Migration ◽  
Clinical Experiments ◽  
Proliferation And Migration

Background: This study discussed the clinical value and expression level of miR-455-5p in atherosclerosis (AS) patients. Meanwhile, its regulatory effect on the proliferation and migration of vascular smooth muscle cells (VSMCs) was further analyzed. Materials & methods: Clinical experiments were detected by quantitative real-time PCR and receiver operating characteristic. Cell experiments were detected by CCK-8, transwell and luciferase reporter gene assay. Results: miR-455-5p was low expressed in AS patients and had diagnostic value to distinguish AS patients from healthy controls. MiR-455-5p inhibited the proliferation and migration of VSMCs. SOCS3 was the target gene of miR-455-5p. Conclusion: MiR-455-5p may be used as a potential diagnostic biomarker for AS. MiR-455-5p may inhibit the proliferation and migration of VSMCs through targeting SOCS3.

scholarly journals Correlation between maternal serum biochemical markers with karyotyping for prenatal screening of foetal chromosomal abnormalities

2017 ◽  
Vol 6 (11) ◽  
pp. 4851
Author(s):  
Ketki S. Kulkarni ◽  
Payal Lakhani ◽  
Sujata A. Dalvi ◽  
Chandrashankar Gupta
Keyword(s):  
Prenatal Screening ◽  
Chromosomal Abnormalities ◽  
Tertiary Care ◽  
False Negative ◽  
Positive Likelihood Ratio ◽  
Screening Tests ◽  
Confirmatory Test ◽  
Singleton Pregnancy ◽  
True Negative ◽  
Marker Test

Background: Prenatal screening for chromosomal abnormalities can be done by biochemical screening tests like dual marker test (DMT), triple marker test (TMT) and quadruple marker test (QMT). It is important to identify ideal screening test among them which best correlates with result of karyotyping which is confirmatory test of foetal chromosomal abnormalities. This helps to decrease need for invasive prenatal tests for foetal karyotyping. This study aims to evaluate sensitivity, specificity, diagnostic accuracy and correlation of DMT, TMT, and QMT with results of karyotyping.Methods: Retrospective observational study was conducted in tertiary care maternity hospital over one year- 1st January 2015 to 31st December 2015. Women with singleton pregnancy undergoing DMT, TMT or QMT were included.Results: Of the 529 women screened by biochemical marker tests, 462 (87.33%) were screen negative and 67 (12.66%) women were screen positive. In 56 women, it was false positive (83.58%) and in 11 women true positive (16.41%). In 461 women the test results were true negative (99.78%), but in one case, result was false negative (0.21%).  3/11 (27.27%)women with foetal chromosomal abnormalities were primigravidae. 4/11 (36.36%)women were below 35 years. DMT and QMT had higher sensitivity (both 100%) and specificity (90.00% and 93.18% respectively) than TMT (sensitivity 80% and specificity 82.61%). Positive likelihood ratio (LR+) was 1.00 in DMT. Diagnostic odds ratio was highest with DMT (DOR=115.11) and best correlated with karyotyping results (coefficient of correlation 0.4).Conclusions: Universal screening of antenatal women, irrespective of their age and parity is suggested. DMT has highest diagnostic value and best correlation with the results of karyotyping. Hence the dual marker test can be considered to be better test for screening for aneuploidy.

Sign in / Sign up

Export Citation Format

Share Document