scholarly journals Using the modified male osteoporosis self-assessment tool for Taiwan to predict osteoporosis onset – a sub-study of the Taiwan osteoporosis survey

2018 ◽  
Author(s):  
Dung-Huan Liu ◽  
Tien-Tsai Cheng ◽  
Jia-Feng Chen ◽  
Shan-Fu Yu ◽  
Wen-Chan Chiu ◽  
...  
Keyword(s):  
At Risk ◽  
Predictive Value ◽  
Risk Index ◽  
Univariate Analysis ◽  
Body Height ◽  
Mineral Density ◽  
Item Reduction ◽  
Taiwanese Men ◽  
Sensitivity Specificity ◽  
Dxa Scans

AbstractPurposeTo develop a risk index by item reduction from multiple variable regression, which can identify male Taiwanese patients at risk of developing osteoporosis.MethodsTo develop the model, a risk index was identified by item reduction from multivariate regression analysis. Using receiver operating characteristic (ROC) curve analysis and their sensitivity/specificity, MOSTAi was validated in a separate cohort of Taiwanese men and its performance with compared with the National Osteoporosis Foundation recommendations (NOF 2013).ResultsBetween 2008 and 2011 a total of 4,323 males were enrolled for bone mineral density (BMD) measurements. Univariate analysis identified four major risk factors for osteoporosis, including age, body weight (BW), previous fracture and body height. The ROC analysis showed the area under the curve (AUC) for the model based on the three-variable, two-variable (age and BW), and one-variable models (BW), was 0.701 (p<0.001, 95% confidence interval [CI] 0.658-0.744), 0.700 (p<0.001, 95% CI, 0.656-0.742), and 0.690 (p<0.001, 95% CI, 0.646-0.734), respectively. Using the optimal cutoff value (−2) for the OSTA, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in the validation cohort were 64.0%, 65.7%, 26.9% and 90.2%, respectively. The ROC curves for predicting osteoporosis by MOSTAi, OSTA and NOF 2013 and the AUC for MOSTAi, OSTA and NOF 2013 was 0.706 (p<0.001, 95% CI: 0.664-0.748) and 0.697(p<0.001, 95% CI: 0.657-0.738), respectively.ConclusionThe results showed that MOSTAi could be a more precise model than OSTA and NOF 2013, for identifying men in Taiwan with osteoporosis who require referrals for DXA scans. It was demonstrated that MOSTAi is a simple tool with fair sensitivity/specificity and PPV, and high NPV. MOSTAi could also be a more accurate model than OSTA for identifying men in Taiwan at risk of osteoporosis. In comparison with NOF 2013, MOSTAi is a more accurate and simpler tool for the referral of Taiwanese men for DXA scans.

Rater

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20678-e20678
Author(s):  
B. Rangarajan ◽  
K. Prabhash ◽  
R. Nair ◽  
H. Menon ◽  
P. Jain ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Predictive Value ◽  
Risk Index ◽  
Febrile Episode ◽  
Index Score ◽  
Low Risk ◽  
Mascc Score ◽  
Sensitivity Specificity ◽  
Risk Index Score

e20678 Background: Management of neutropenic fever is based on risk stratification of the episode which helps in optimizing treatment. MASCC is the most commonly used for risk stratification Patients with a score of > 21 were regarded as low risk; patients with a score of <21 were regarded as high risk. We tried to validate the MASCC index for our ethnic population. Methods: Patients were recruited throughout a 12 month period. Inclusion criteria were diagnosis of hematolymphoid malignancy, neutropenic febrile episode secondary to chemotherapy or during induction therapy of acute leukemia and more than 18 years of age All patients were risk stratified, hospitalized and treated with broad-spectrum, empiric, intravenous antibiotic therapy until recovery or outcome of the event. The incidence of medical complications in both groups and death related to the neutropenic infection was recorded. The data was entered on SPSS software and MASCC criteria was analyzed for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 81 febrile neutropenic episodes were included; 34 classified as low risk and 47 as high risk according to MASCC risk index score. The sensitivity, specificity, PPV, NPV and accuracy of MASCC risk index score were 45.5%, 40%, 11%, 82%, 40.7%. We subsequently analyzed the subset of Acute Myeloid Leukemia (AML) patients as they were the majority comprising of 62/81 episodes. The subset of AML patients risk stratified according to MASCC risk index showed sensitivity, specificity, PPV, NPV and accuracy of 71%, 25.5%, 11%, 87.5%, 31% respectively. Conclusions: In our patient group, the value of MASCC score is limited with poor sensitivity, specificity and PPV. This trend is also seen in the subset analysis of AML patients. The value of the MASCC index with the score of 21 as the cut-off between low risk and high risk seems limited in our patients and requires confirmation with larger set of patients. No significant financial relationships to disclose.

scholarly journals Simple Self-Assessment Tool to Predict Osteoporosis in Taiwanese Men

2021 ◽  
Vol 8 ◽  
Author(s):  
Dung-Huan Liu ◽  
Chung-Yuan Hsu ◽  
Pei-Ching Wu ◽  
Ying-Chou Chen ◽  
You-Yin Chen ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Risk Index ◽  
Area Under The Curve ◽  
Assessment Tools ◽  
Mineral Density ◽  
Self Assessment ◽  
Fracture Risk Assessment Tool ◽  
Patients At Risk ◽  
Taiwanese Men ◽  
Country Specific

Background: Although the self-assessment tools for predicting osteoporosis are convenient for clinicians, they are not commonly used among men. We developed the Male Osteoporosis Self-Assessment Tool for Taiwan (MOSTAi) to identify the patients at risk of osteoporosis.Methods: All the participants completed a questionnaire on the clinical risk factors for the fracture risk assessment tool. The risk index was calculated by the multivariate regression model through the item reduction method. The receiver operating characteristic (ROC) curve was used to analyze its sensitivity and specificity, and MOSTAi was developed and validated.Results: A total of 2,290 men participated in the bone mineral density (BMD) survey. We chose a model that considered two variables (age and weight). The area under the curve (AUC) of the model was 0.700. The formula for the MOSTAi index is as follows: 0.3 × (weight in kilograms) – 0.1 × (years). We chose 11 as the appropriate cut-off value for the MOSTAi index to identify the subjects at the risk of osteoporosis.Conclusions: The MOSTAi is a simple, intuitive, and country-specific tool that can predict the risk of osteoporosis in Taiwanese men. Due to different demographic characteristics, each region of the world can develop its own model to identify patients with osteoporosis more effectively.

scholarly journals Computed Tomography of the Chest as a Screening Tool for Low Bone Mineral Density

2021 ◽  
Author(s):  
Alan T Vanier ◽  
Donald Colantonio ◽  
Sameer K Saxena ◽  
Daniel Rodkey ◽  
Scott Wagner
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Negative Predictive Value ◽  
Thoracic Spine ◽  
Predictive Value ◽  
Screening Tool ◽  
Ct Scans ◽  
Mineral Density ◽  
Dxa Scans

ABSTRACT Introduction Computed tomography (CT) Hounsfield units (HU) recently emerged as a promising screening tool for low bone mineral density (BMD). We hypothesized that CT HU measurements of the thoracic spine would significantly and positively correlate with dual X-ray absorptiometry (DXA) BMD scans of the femoral neck. Materials and methods The study included patients with DXA scans and thoracic CT scans at the Walter Reed National Military Medical Center. One author, blinded to the DXA scans, measured HU from the cancellous bone in T4 vertebrae. Another author statistically compared femoral neck DXA T-scores to the CT HU measurements. Results The study included 145 patients with CT scans and femoral neck DXAs. The osteoporotic and osteopenic groups had a significant difference in HU measurements compared to the normal group within the study (P &lt; .0001 and .002, respectively). A low BMD screening value of 231 HU provided a sensitivity of 90.1% and negative predictive value of 85.7%. Conclusion Thoracic vertebrae HU measurements correlate with a low BMD of the femoral neck as determined by DXA T-scores. A high sensitivity and negative predictive value was achieved with a screening value of 231 HU. Utilization of chest or thoracic spine CT imaging as a screening method provides a quick and available screening tool for assessing low BMD in patients with these scans. Level of Evidence: III (Diagnostic)

scholarly journals Prediction of Difficult Tracheal Videolaryngoscopic Intubation Using El-Ganzouri Risk Index

2017 ◽  
Vol 17 (1) ◽  
pp. 18-22
Author(s):  
Antons Zakalkins ◽  
Sigita Kazune
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Evaluation Method ◽  
Characteristic Curve ◽  
Risk Index ◽  
Predictive Values ◽  
Specificity And Sensitivity ◽  
Laryngeal Exposure ◽  
Sensitivity Specificity ◽  
Induction Of Anaesthesia

Summary Introduction. Unanticipated difficult intubation still exists as a significant problem. El-Ganzouri risk index is a bedside difficult airway evaluation method, which can help determine risk of difficult airways. However, evidence of using of El-Ganzouri risk index in difficult laryngeal visualisation using videolaryngoscopes is limited. Aim of the Study. Determine the specificity and sensitivity of El-Ganzouri multivariate risk index to predict difficult laryngeal exposure using Storz C-MAC videolaryngoscope equipped with D type blade. Material and methods. We conducted a study of 29 patients, which were examined using El-Ganzouri risk index before induction of anaesthesia. After induction of anaesthesia videolaryngoscopy was performed using Storz C-MAC videolaryngoscope equipped with D-blade and laryngeal visualisation was graded using Cormack-Lehane scale. After laryngeal visualisation grading endotracheal tube insertion was performed and numbers of attempts as well as complications during intubation were recorded. Sensitivity, specificity, positive and negative predictive values were calculated, receiver operating characteristic curve and area under curve was obtained. Results. Sensitivity and specificity were 54.2% and 80.0% at El-Ganzouri risk index cut-off value of 2 points. Calculated positive predictive value was 26.7% and negative predictive value was 92.9%. Calculated AUC was 78.3%. Conclusions. El-Ganzouri risk index shows moderate sensitivity and specificity when used with Storz C-MAC videolaryngoscope. It can be used to predict difficult laryngeal visualization during videolaryngoscopic intubation.

Are You Puzzled When Credentialing Entities Ask You for Criteria for External Carotid Artery Stenosis? A Study Correlating Peak Systolic Velocities and Degree of External Carotid Artery Stenosis Based on CT Angiography

2018 ◽  
Vol 42 (4) ◽  
pp. 155-161
Author(s):  
Jing Xu ◽  
Samuel S. Rafla ◽  
Michelle K. Pouria ◽  
Drena Root ◽  
Shannon H. Lyons ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Predictive Value ◽  
Carotid Artery Stenosis ◽  
Univariate Analysis ◽  
Peak Systolic Velocity ◽  
External Carotid Artery ◽  
Artery Stenosis ◽  
Receiver Operating Curve ◽  
External Carotid ◽  
Sensitivity Specificity

External carotid artery (ECA) disease has been understated in the current literature, likely secondary to the lack of clinical neurological symptoms when this vessel is stenotic. However, vascular ultrasound credentialing entities request the adoption of specific criteria for the assessment of the ECA. Our purpose is to determine the ultrasound criteria for the detection of hemodynamically significant stenosis (50%-99%) using computed tomography angiography (CTA) as the reference standard. We included patients who had a carotid ultrasound and a CTA of the neck performed both within a 12-month period. Ultrasound measurements were reviewed for technical accuracy. CTAs were reassessed to determine the degree of stenosis of the bilateral ECAs adopting the North American Symptomatic Carotid Endarterectomy Trial criteria. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different peak systolic velocity (PSV) cutoff points to determine the most accurate PSV for detecting 50% to 99% stenosis of the ECA. Receiver operating curve analysis was used to assess diagnostic performance. Of the 536 ECAs included in this study, 13 were noted to be occluded by CTA. Six of these occlusions were accurately detected by ultrasound. There were 82 ECAs with 50% to 99% stenosis on CTA; these vessels had a significantly higher mean PSV compared to ECAs with <50% stenosis (294 vs 122 cm/s) ( P < .0001). A cutoff velocity of ⩾200 cm/s demonstrated a sensitivity, specificity, and overall accuracy of 0.84, 0.93, and 0.91, respectively. Using univariate analysis, smoking was significantly associated with the presence of ⩾50% ECA stenosis. We determined that a PSV cutoff of ⩾200 cm/s showed high sensitivity and specificity for detecting 50% to 99% ECA stenosis based on CTA.

scholarly journals A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 503-517
Author(s):  
Jeong Hee Yoon ◽  
Jeong Min Lee ◽  
Dong Ho Lee ◽  
Ijin Joo ◽  
Ju Hyun Jeon ◽  
...  
Keyword(s):  
High Risk ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Low Dose ◽  
Risk Index ◽  
High Risk Group ◽  
Current Recommendation ◽  
Two Phase ◽  
Sensitivity Specificity ◽  
Higher Sensitivity

Background and Aims: Biannual ultrasonography (US) is a current recommendation for hepatocellular carcinoma (HCC) surveillance in a high-risk group. The sensitivity of US, however, has been low in patients with a high risk of developing HCC. We aimed to compare sensitivity for HCC of biannual US and two-phase low-dose computed tomography (LDCT) in patients with a high risk of HCC. Methods: In this prospective single-arm study, participants with an annual risk of HCC greater than 5% (based on a risk index of ≥2.33) and who did not have a history of HCC were enrolled from November 2014 to July 2016. Participants underwent paired biannual US and two-phase LDCT 1–3 times. Two-phase LDCT included arterial and 3-min delayed phases. The sensitivity, specificity, and positive predictive value of HCC detection using US and two-phase LDCT were compared using a composite algorithm as a standard of reference. Results: Of the 139 enrolled participants, 137 underwent both the biannual US and two-phase LDCT at least once and had follow-up images. Among them, 27 cases of HCC (mean size: 14 ± 4 mm) developed in 24 participants over 1.5 years. Two-phase LDCT showed a significantly higher sensitivity (83.3% [20/24] vs. 29.2% [7/24], p < 0.001) and specificity (95.6% [108/113] vs. 87.7% [99/113], p =0.03) than US. A false-positive result was reported in 14 participants at US and 5 participants at two-phase LDCT, resulting in a significantly higher positive predictive value of two-phase LDCT (33.3% [7/21] vs. 80% [20/25], p < 0.001). Conclusions: Patients with a risk index ≥2.33 showed a high annual incidence of HCC development in our study, and two-phase LDCT showed significantly higher sensitivity and specificity for HCC detection than US.

scholarly journals Validity of a 2-item screening tool to identify families at risk for food insecurity in Brazil

2021 ◽  
Vol 37 (6) ◽  
Author(s):  
Ana Poblacion ◽  
Ana Maria Segall-Corrêa ◽  
John Cook ◽  
Jose Augusto de Aguiar Carrazedo Taddei
Keyword(s):  
At Risk ◽  
Food Insecurity ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Convergent Validity ◽  
Screening Tool ◽  
Roc Curves ◽  
Roc Area ◽  
Sensitivity Specificity

This manuscript aimed to develop a brief 2-item screening tool to identify Brazilian households that include families with children at risk for food insecurity. Psychometric analyses including sensitivity, specificity, positive and negative predictive value, accuracy, and ROC curves were used to test combinations of questions to determine the most effective screener to assess households at risk for food insecurity when compared to a gold standard scale. Participants included Brazilian National Survey of Demography and Health on Women and Children (PNDS) surveyed households with a valid Brazilian Food Insecurity Scale (EBIA) response. The sample included 3,920 households representing 11,779,686 households when expanded using PNDS sample weights. With overall prevalence of food insecurity at 21%, a Brazilian 2-item food-insecurity screen showed sensitivity of 79.31%, specificity of 92.95%, positive predictive value of 74.62%, negative predictive value of 94.5% and ROC area 86.13%. This screen also presented high convergent validity for children’s nutrition and health variables when compared with the gold standard, the EBIA full scale. Based on its ability to detect households at risk for food insecurity, a 2-item screening tool is recommended for widespread adoption as a screening measure throughout Brazil, especially when rapid decision-making has been made fundamental, as under the COVID-19 pandemic. This screener can enable providers to accurately identify families at risk for food insecurity and promptly intervene to prevent or ameliorate adverse health and developmental consequences associated with food insecurity and swiftly respond to crises.

scholarly journals Evaluation of different platforms for the detection of anti-SARS coronavirus-2 antibodies, Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hatairat Lerdsamran ◽  
Anek Mungaomklang ◽  
Sopon Iamsirithaworn ◽  
Jarunee Prasertsopon ◽  
Kriengkrai Prasert ◽  
...  
Keyword(s):  
At Risk ◽  
Test Performance ◽  
Predictive Value ◽  
Disease Diagnosis ◽  
Immunofluorescence Assay ◽  
Antibody Detection ◽  
Immunological Methods ◽  
Serum Samples ◽  
Previous Infection ◽  
Sensitivity Specificity

Abstract Background Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) help determine previous infection in individuals, regardless of whether they are asymptomatic or symptomatic. The detection of antibodies serves several purposes, including supporting other assays for disease diagnosis, conducting seroepidemiological studies, and evaluating vaccines. Many platforms of immunological methods for anti-SARS-CoV-2 antibody detection and their performance require validation. Methods This study evaluated the test performance of three autoanalyzer-based assays (Architect IgG, Vitros IgG, and Vitros total Ig) and one manual ELISA (Wantai total Ig) against a microneutralization (microNT) assay on the detection of SARS-CoV-2 antibodies. Furthermore, an indirect immunofluorescence assay verified the discordant results between the microNT and commercial assays. The test sensitivity, specificity, positive predictive value, and negative predictive value were determined based on four groups of 1005 serum samples: 102 COVID-19 prepandemic sera, 45 anti-SARS-CoV-2 positive sera, 366 sera of people at risk, and 492 sera of citizens returning from countries with a high prevalence of infection. Results The analyses as a whole showed that the performance of these commercial assays was comparable. Each group was also analysed separately to gain further insight into test performance. The Architect did not detect two positive sera of people at risk (prevalence of infection 0.55%). The other methods correctly identified these two positive sera but yielded varying false-positive results. The group of returning travellers with an infection rate of 28.3% (139 of 492) better differentiated the test performance of individual assays. Conclusions High-throughput Architect and Vitros autoanalyzers appear appropriate for working on large sample sizes in countries that can afford the cost. The Wantai ELISA, while requiring more individual time and technical skill, may provide reliable results at a lower cost. The selection of assays will depend on the laboratory facilities and feasibility.

Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

2012 ◽  
Vol 15 (1) ◽  
pp. 12 ◽  
Author(s):  
Levent Sahiner ◽  
Ali Oto ◽  
Kudret Aytemir ◽  
Tuncay Hazirolan ◽  
Musturay Karcaaltincaba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Predictive Value ◽  
Artery Bypass ◽  
Time Interval ◽  
Mdct Angiography ◽  
Sensitivity Specificity

<p><b>Background:</b> The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.</p><p><b>Results:</b> Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.</p><p><b>Conclusion:</b> Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.</p>

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