scholarly journals Three-dimensional camera anthropometry to assess risk of cephalopelvic disproportion-related obstructed labour in Ethiopia

2019 ◽  
Vol 9 (5) ◽  
pp. 20190036 ◽  
Author(s):  
Lorenzo Tolentino ◽  
Mahlet Yigeremu ◽  
Sisay Teklu ◽  
Shehab Attia ◽  
Michael Weiler ◽  
...  
Keyword(s):  
False Negative ◽  
Three Dimensional ◽  
False Negative Rate ◽  
Detection Rates ◽  
Cephalopelvic Disproportion ◽  
Obstructed Labour ◽  
Tape Measure ◽  
Negative Rate ◽  
Positive Rate ◽  
Tape Measurement

Cephalopelvic disproportion (CPD)-related obstructed labour requires delivery via Caesarean section (C/S); however, in low-resource settings around the world, facilities with C/S capabilities are often far away. This paper reports three low-cost tools to assess the risk of CPD, well before labour, to provide adequate time for referral and planning for delivery. We performed tape measurement- and three-dimensional (3D) camera-based anthropometry, using two 3D cameras (Kinect and Structure) on primigravida, gestational age ≥ 36 weeks, from Addis Ababa, Ethiopia. Novel risk scores were developed and tested to identify models with the highest predicted area under the receiver-operator characteristic curve (AUC), detection rate (true positive rate at a 5% false-positive rate, FPR) and triage rate (true negative rate at a 0% false-negative rate). For tape measure, Kinect and Structure, the detection rates were 53%, 61% and 64% (at 5% FPR), the triage rates were 30%, 56% and 63%, and the AUCs were 0.871, 0.908 and 0.918, respectively. Detection rates were 77%, 80% and 84% at the maximum J -statistic, which corresponded to FPRs of 10%, 15% and 11%, respectively, for tape measure, Kinect and Structure. Thus, tape measurement anthropometry was a very good predictor and Kinect and Structure anthropometry were excellent predictors of CPD risk.

Effects of Previous Surgery on the Detection of Sentinel Nodes in Women With Vulvar Cancer

2011 ◽  
Vol 21 (9) ◽  
pp. 1679-1683 ◽  
Author(s):  
Tessa A. Ennik ◽  
David G. Allen ◽  
Ruud L.M. Bekkers ◽  
Simon E. Hyde ◽  
Peter T. Grant
Keyword(s):  
Vulvar Cancer ◽  
False Negative ◽  
False Negative Rate ◽  
Blue Dye ◽  
Previous Surgery ◽  
Detection Rates ◽  
Reliable Technique ◽  
Appearance Time ◽  
Negative Rate ◽  
Significant Difference

BackgroundThere is a growing interest to apply the sentinel node (SN) procedure in the treatment of vulvar cancer. Previous vulvar surgery might disrupt lymphatic patterns and thereby decrease SN detection rates, lengthen scintigraphic appearance time (SAT), and increase SN false-negative rate. The aims of this study were to evaluate the SN detection rates at the Mercy Hospital for Women in Melbourne and to investigate whether previous vulvar surgery affects SN detection rates, SAT, and SN false-negative rate.MethodsData on all patients with vulvar cancer who underwent an SN procedure (blue dye, technetium, or combined technique) from November 2000 to July 2010 were retrospectively collected.ResultsSixty-five SN procedures were performed. Overall detection rate was 94% per person and 80% per groin. Detection rates in the group of patients who underwent previous excision of the primary tumor were not lower compared with the group without previous surgery or with just an incisional biopsy. There was no statistical significant difference in SAT between the previous excision group and the other patients. None of the patients with a false-negative SN had undergone previous excision.ConclusionsResults indicate that previous excision of a primary vulvar malignancy does not decrease SN detection rates or increase SN false-negative rate. Therefore, the SN procedure appears to be a reliable technique in patients who have previously undergone vulvar surgery. Previous excision did not significantly lengthen SAT, but the sample size in this subgroup analysis was small.

709 24 Hour Patterns of Vital Signs as Predictors of Blood Infection in Pediatric Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S186-S186
Author(s):  
Elena Maria S Munoz ◽  
Joan Weber ◽  
Martha Lydon ◽  
Korkut Uygun ◽  
Robert Sheridan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Predictive Value ◽  
Clinical Care ◽  
False Negative ◽  
False Negative Rate ◽  
Vital Signs ◽  
Burn Patients ◽  
Negative Rate ◽  
Positive Rate

Abstract Introduction Blood infection diagnosis requires a positive blood culture, which may take 3 days, thus hindering early treatment and negatively impacting clinical outcomes. Methods In a retrospective review, 100 patients were screened, 34 remained after exclusions for incomplete data, leaving 89 blood cultures. Subjects were separated by infection (positive blood culture), or control (negative blood culture) groups. Results A combination of vital signs to aid in early and accurate prediction of blood infection. Within 24 hours of blood draws and antipyretic administration, the vital sign combination of 1 or more MAP Dips (MAP below 60 mmHg) and 2 or more Fever Spikes (temperature above 39°C) or 2 or more Heartrate Spikes (heartrate above 2 SD age-specific norms), show: True Positive Rate (Sensitivity), 95%, True Negative Rate (Specificity), 94%, Positive Predictive Value (Precision), 92%, Negative Predictive Value, 96%, False Positive Rate, 6%, False Negative Rate, 5%, False Discovery Rate, 8%, Accuracy, 94%, F1 Score, 94%, Informedness, 0.89, Markedness, 0.88, Matthews Correlation Coefficient, 0.89. We evaluated different combinations of vital signs associated with blood infection including temperature below 36.5°C and various numbers of MAP dips, fever spikes, and heartrate spikes, with weaker predictive metric values. Conclusions Blood infection can be predicted with patterns in vital signs within 24 hours. Applicability of Research to Practice Vital signs and readily available data may be beneficial for use in clinical care of pediatric burn patients in relation to blood infection. We are currently analyzing dynamic trends in vital signs and infectious organism to not only predict infection, but anticipate appropriate treatments.

High Resolution CT and Bronchography in the Assessment of Bronchiectasis

1991 ◽  
Vol 32 (6) ◽  
pp. 439-441 ◽  
Author(s):  
K. Young ◽  
F. Aspestrand ◽  
A. Kolbenstvedt
Keyword(s):  
Retrospective Study ◽  
High Resolution ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
High Resolution Ct ◽  
Negative Rate ◽  
Different Types ◽  
Positive Rate

To elucidate the reliability of CT in the assessment of bronchiectasis, a retrospective study of high resolution CT and bronchography was carried out. A segment by segment comparison of 259 segmental bronchi from 70 lobes of 27 lungs in 19 patients was performed using bronchography as standard. CT was positive in 87 of 89 segmental bronchi with bronchiectasis giving a false-negative rate of 2%. CT was negative in 169 of 170 segmental bronchi without bronchiectasis at bronchography, giving a false-positive rate of 1%. There was agreement between the two modalities in identifying the different types of bronchiectasis.

scholarly journals Evaluating the usefulness of breast strain elastography for intraductal lesions

2021 ◽  
Author(s):  
Yumi Kokubu ◽  
Keiko Yamada ◽  
Masahiko Tanabe ◽  
Ayumi Izumori ◽  
Chieko Kato ◽  
...  
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Intraductal Papilloma ◽  
Breast Diseases ◽  
Strain Elastography ◽  
Negative Rate ◽  
Positive Rate ◽  
Sensitivity Specificity

Abstract Purpose Strain elastography for imaging lesion stiffness is being used as a diagnostic aid in the malignant/benign discrimination of breast diseases. While acquiring elastography in addition to B-mode images has been reported to help avoid performing unnecessary biopsies, intraductal lesions are difficult to discriminate whether they are malignant or benign using elastography. An objective evaluation of strain in lesions was performed in this study by measuring the elasticity index (E-index) and elasticity ratio (E-ratio) of lesions as semi-quantitative numerical indicators of the color distribution of strain. We examined whether ductal carcinoma in situ (DCIS) and intraductal papilloma could be distinguished using these semi-quantitative numerical indicators. Methods In this study, 170 ultrasonographically detected mass lesions in 162 cases (106 malignant lesions and 64 benign lesions)—in which tissue biopsy by core needle biopsy and vacuum-assisted biopsy, or surgically performed histopathological diagnosis, was performed—were selected as subjects from among 1978 consecutive cases (from January 2014 to December 2016) in which strain elastography images were acquired, in addition to standard B-mode breast ultrasonography, by measuring the E-index and E-ratio. Results The cut-off values for E-index and E-ratio in the malignant/benign discrimination of breast lesions were determined to be optimal values at 3.5 and 4.2, respectively, based on receiver operating characteristic (ROC) curve analysis. E-index sensitivity, specificity, accuracy, and AUC value (area under the curve) were 85%, 86%, 85%, and 0.860, respectively, while those for E-ratio were 78%, 74%, 74%, and 0.780, respectively. E-index yielded superior results in all aspects of sensitivity, specificity, accuracy, and AUC values, compared to those of E-ratio. The mean E-index values for malignant tumors and benign tumors were 4.46 and 2.63, respectively, indicating a significant difference (P < 0.001). E-index values of 24 DCIS lesions and 25 intraductal papillomas were 3.88 and 3.35, respectively, which showed a considerably close value, while the false-negative rate for DCIS was 29.2%, and the false-positive rate for intraductal papilloma was as high as 32.0%. Conclusion E-index in strain elastography yielded better results than E-ratio in the malignant/benign discrimination of breast diseases. On the other hand, E-index has a high false-negative rate and false-positive rate for intraductal lesions, a factor which should be taken into account when making ultrasound diagnoses.

scholarly journals Evaluation of the Sensitivity and Specificity of Two Diagnostic Tests for Antibodies to Pseudorabies Virus Glycoprotein X

1992 ◽  
Vol 4 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Ronald M. Weigel ◽  
William F. Hall ◽  
Gail Scherba ◽  
Arthur M. Siegel ◽  
Edwin C. Hahn ◽  
...  
Keyword(s):  
False Positive ◽  
Pseudorabies Virus ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
T Test ◽  
Serum Samples ◽  
Negative Rate ◽  
Positive Rate ◽  
The Cost

The diagnostic performance of 2 enzyme-linked immunosorbent assays (gX-T, gX-H) for antibodies to pseudorabies virus (PRV) glycoprotein X (gX) were evaluated using 311 serum samples from a nonvaccinated quarantined herd. When the standardized virus neutralization (VN) test, which uses the Shope strain (VN Shope), was used as the comparative diagnostic standard, the gX-T test had a 7% false-negative rate and a 52% false-positive rate, and the gX-H test had a 19% false-negative rate and a 19% false-positive rate. When the VN test with a Bartha recombinant strain (VN Bartha gIIIKa) was used as the diagnostic standard, the gX-T test had a 9% false-negative rate and a 26% false-positive rate, and the gX-H test had a 24% false-negative rate and a 11% false-positive rate. Thus, the gX-T test was more sensitive and the gX-H test was more specific. Additional diagnostic tests on 79 serum samples from a noninfected herd did not produce false positives for the gX-H test, but there was an 8% false-positive rate for the gX-T test. Previous studies from our laboratory have demonstrated that VN Bartha gIIIKa has higher sensitivity than VN Shope, without losing specificity, and thus is a better comparative diagnostic standard. When adding a suspect range to the gX-T test, using the same criteria as the suspect range for the gX-H test, the false-positive rate of the gX-T test was reduced to 5% when evaluated versus VN Bartha gIIIKa in the infected herd and to 1% for the PRV-negative herd. However, 18% of the positive samples were classified as suspect (vs. 8% for the gX-H test). In PRV eradication programs, the cost of false negatives is greater than the cost of false positives; thus, the gX-T diagnostic used in this study is of greater diagnostic value.

scholarly journals Improving Detection Efficiency of SARS-CoV-2 Nucleic Acid Testing

2020 ◽  
Vol 10 ◽  
Author(s):  
Jie Zhang ◽  
Kecheng Li ◽  
Ling Zheng ◽  
Jianbo Zhang ◽  
Zhilin Ren ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Symptom Onset ◽  
Detection Efficiency ◽  
False Negative ◽  
False Negative Rate ◽  
Nucleic Acid Testing ◽  
Detection Rates ◽  
High False Negative Rate ◽  
Before And After ◽  
Positive Rate

BackgroundSARS-CoV-2 nucleic acid testing (NAT) has been routinely used for COVID-19 diagnosis during this pandemic; however, there have been concerns about its high false negative rate. We dissected its detection efficiency with a large COVID-19 cohort study.MethodsWe analyzed SARS-CoV-2 NAT positive rates of 4,275 specimens from 532 COVID-19 patients in Sichuan Province with different disease severities, statuses, and stages, as well as different types and numbers of specimens.ResultsThe total positive rate of the 4,275 specimens was 37.5%. Among seven specimen types, BALF generated a 77.8% positive rate, followed by URT specimens (38.5%), sputum (39.8%), and feces/rectal swabs (34.1%). Specimens from critical cases generated a 43.4% positive rate, which was significantly higher than that of other severities. With specimens from patients at stable status, the SARS-CoV-2 positive rate was 40.6%, which was significantly higher than that of improved status (17.1%), but lower than that of aggravated status (61.5%). Notably, the positive rate of specimens from COVID-19 patients varied significantly from 85 to 95% during 3 days before and after symptom onset, to 20% at around 18 days after symptom onset. In addition, the detection rate increased from 72.1% after testing one throat swab, to 93.2% after testing three consecutive respiratory specimens from each patient.ConclusionsSARS-CoV-2 NAT detection rates vary with patient disease severity and status, specimen type, number of specimens, and especially disease progression. Sampling as close to symptom onset as possible, and consecutively collecting more than one respiratory specimen could effectively improve SARS-CoV-2 NAT detection efficiency.

Stepwise strategies in analysing haematuria and leukocyturia in screening

2006 ◽  
Vol 44 (4) ◽  
Author(s):  
Josiane Steinmetz ◽  
Joseph Henny ◽  
René Gueguen
Keyword(s):  
Microscopic Examination ◽  
Predictive Value ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Microscopic Analysis ◽  
Test Strip ◽  
Negative Rate ◽  
Positive Rate

AbstractThe aim of the present work was to compare in a supposed healthy population of 680 subjects several algorithms for positive selection of urine samples requiring microscopic examination for erythrocytes and leukocytes after screening by automated test-strip measurement and particle counting on a Sysmex UF-50™ flow cytometer. Four strategies have been formulated and the sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate, and microscopic review rate were measured. The strategy combining test strip analysis and automated counting on all samples, followed by microscopic examination of only discordant samples gave the best results. When the two methods of haematuria screening were in agreement (91% of samples), the false negative rate for microscopy was 1.1%, with a false positive rate of 0.8%, sensitivity of 66% and specificity of 99%, and the results are acceptable without any other examination. When the two methods of haematuria screening were discrepant, visual microscopic analysis was necessary to obtain definitive results. For leukocyturia screening, 80% of results were in agreement by test strip and automatic sediment urinalysis, with only ten results considered as false negatives (1.8%) and four as false positives (0.7%). Agreement was good and the other criteria were good (sensitivity 79%, specificity 99%). On conflicting samples, there was no agreement between methods and microscopic analysis was essential. The benefit of such an algorithm would be optimisation of the workflow without any loss of sensitivity and specificity at the expense of a two-fold increase in cost.

scholarly journals Multimodális hiperspektroszkópia – előrelépés a digitális technológia felé a méhnyakszűrésben

2021 ◽  
Vol 162 (20) ◽  
pp. 790-799
Author(s):  
Zoárd Tibor Krasznai ◽  
Zsuzsa Bagoly ◽  
Eszter Nagy ◽  
Zsolt Farkas ◽  
Róbert Póka ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Digital Technology ◽  
Predictive Value ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Hpv Testing ◽  
Negative Rate ◽  
Positive Rate

Összefoglaló. Bevezetés: Bevezetés: A citológiai alapú méhnyakrákszűrés átmeneti kategóriáinak optimális menedzselése a humán papillomavírus (HPV) szűrése és tipizálása ellenére jelenleg is kihívás. Vizsgálatunk célja a modern cervixspektroszkópiának (multimodális hiperspektroszkópia – MHS), egy azonnali eredményt nyújtó, digitális technológiára épülő módszernek a vizsgálata volt a citológiai alapú méhnyakszűrés találati biztonságának javítására. Betegek és módszer: Vizsgálatainkat 208, 18 és 75 év közötti nőbeteg bevonásával végeztük, akiknél már indikálásra került valamely, a méhnyakon végzendő műtét, citológiai eredményük rendelkezésre állt (a HPV-tesztet, amennyiben nem történt meg, elvégeztük), valamint valamennyi betegnél elvégeztük a műtét előtt az MHS-vizsgálatot. A szövettani mintavétel 166 betegnél történt meg. Eredmények: A citológiai vizsgálatot (az összes betegre tekintve) magas álpozitív arány jellemezte (69,28%), amely megfigyelések mindenképpen utalnak az újabb komponens alkalmazásának igényére a triázsban. Az összes citológiai kategóriára nézve az MHS-eredmények közül kiemelendő az álnegatív leletek rendkívül alacsony aránya (3/166 = 1,8%), mely a HPV-teszt esetén ennél magasabb volt (11/165 = 6,66%). A spektroszkópiás vizsgálat álpozitív aránya ugyanakkor kedvezőtlenebbnek bizonyult (91/166 = 54,81%) a HPV-vizsgálat álpozitív arányánál (40/165 = 24,24%). Az atípusos laphámsejt (ASC-US/ASC-H) citológiai kategória esetén a spektroszkópia álnegatív eredményeinek aránya (3/126 = 2,38%) szintén kedvezőbb volt, mint a HPV-vizsgálaté (9/126 = 7,14%). A cervicalis intraepithelialis neoplasia-2 vagy súlyosabb fokozatú hámelváltozások azonosításában a spektroszkópia szenzitivitása 94% (95% CI = 0,84–0,99), specificitása 22% (95% CI = 0,15–0,31), negatív prediktív értéke 90% (95% CI = 0,73–0,98), pozitív prediktív értéke 34% (95% CI = 0,26–0,43) volt (p = 0,00130). Következtetés: Az MHS fejlett innovatív technológián alapuló, azonnali eredményt adó vizsgálóeljárás, amely kiemelkedően alacsony álnegatív eredménye miatt nagy segítséget nyújt a citológiai eltéréssel rendelkező betegek további vizsgálatában. Orv Hetil. 2021; 162(20): 790–799. Summary. Introduction: Despite the use of human papillomavirus (HPV) testing, the management of the transitional categories of cytology-based screening still remains a challenge. The modern multimodal hyperspectroscopy (MHS) of the cervix is a novel digital technology based on artificial intelligence, providing an instant result in the assessment of cytology-based screening abnormalities. Patients and methods: 208 women (age 18–75) were enrolled. The patients already had cytology results and an operation on the cervix indicated at the time of inclusion. HPV and the hyperspectroscopy examination was performed pre-operatively. The pre-indicated operation was performed on 166 patients. Results: Cytology-based screening alone (in the category of all patients) resulted in a high false-positive rate (69.28%). In this category, the MHS had an outstanding false-negative rate (3/166 = 1.80%) compared to the HPV (11/165 = 6.66%). The false-positive rate of the spectroscopy examination (91/166 = 54.81%) was higher than that of the HPV testing (40/165 = 24.24%). In the atypical squamous cell (ASC-US/ASC-H) category, the false-negative rate of the spectroscopy (3/126 = 2.38%) was also lower than that of the HPV test (9/126 = 7.14%). In the detection of high-grade abnormalities (cervical intraepithelial neoplasia 2 and worse), the spectroscopy had a 94% sensitivity (95% CI = 0.84–0.99), with a 22% specificity (95% CI = 0.15–0.31), an 90% negative predictive value (95% CI = 0.73–0.98), and a 34% positive predictive value (95% CI = 0.26–0.43) (p = 0.00130). Conclusion: In the case of cytological abnormality, the MHS provides an immediate result based on advanced digital technology, and because of its outstanding false negative rate it is a great aid and should be considered in the triage of such patients. Orv Hetil. 2021; 162(20): 790–799.

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