scholarly journals Autonomous early detection of eye disease in childhood photographs

2019 ◽  
Vol 5 (10) ◽  
pp. eaax6363 ◽  
Author(s):  
Micheal C. Munson ◽  
Devon L. Plewman ◽  
Katelyn M. Baumer ◽  
Ryan Henning ◽  
Collin T. Zahler ◽  
...  
Keyword(s):  
Early Detection ◽  
Confidence Interval ◽  
Clinical Utility ◽  
Smartphone Application ◽  
Eye Disease ◽  
Computer Assisted ◽  
Eye Disorders ◽  
Coats Disease ◽  
Sensitivity Specificity

The “red reflex test” is used to screen children for leukocoria (“white eye”) in a standard pediatric examination, but is ineffective at detecting many eye disorders. Leukocoria also presents in casual photographs. The clinical utility of screening photographs for leukocoria is unreported. Here, a free smartphone application (CRADLE: ComputeR-Assisted Detector of LEukocoria) was engineered to detect photographic leukocoria and is available for download under the name “White Eye Detector.” This study determined the sensitivity, specificity, and accuracy of CRADLE by retrospectively analyzing 52,982 longitudinal photographs of children, collected by parents before enrollment in this study. The cohort included 20 children with retinoblastoma, Coats’ disease, cataract, amblyopia, or hyperopia and 20 control children. For 80% of children with eye disorders, the application detected leukocoria in photographs taken before diagnosis by 1.3 years (95% confidence interval, 0.4 to 2.3 years). The CRADLE application allows parents to augment clinical leukocoria screening with photography.

scholarly journals Discovery and function exploration of microRNA-155 as a molecular biomarker for early detection of breast cancer

Breast Cancer ◽  
2021 ◽  
Author(s):  
Xuemin Liu ◽  
Qingyu Chang ◽  
Haiqiang Wang ◽  
Hairong Qian ◽  
Yikun Jiang
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Protein Interactions ◽  
Meta Analysis ◽  
Enrichment Analysis ◽  
Diagnostic Value ◽  
Diagnostic Biomarker ◽  
Analysis Model ◽  
Sensitivity Specificity ◽  
Function Enrichment

Abstract Background MicroRNA-155 (miR-155) may function as a diagnostic biomarker of breast cancer (BC). Nevertheless, the available evidence is controversial. Therefore, we performed this study to summarize the global predicting role of miR-155 for early detection of BC and preliminarily explore the functional roles of miR-155 in BC. Methods We first collected published studies and applied the bivariate meta-analysis model to generate the pooled diagnostic parameters of miR-155 in diagnosing BC such as sensitivity, specificity and area under curve (AUC). Then, we applied function enrichment and protein–protein interactions (PPI) analyses to explore the potential mechanisms of miR-155. Results A total of 21 studies were finally included. The results indicated that miR-155 allowed for the discrimination between BC patients and healthy controls with a sensitivity of 0.87 (95% CI 0.78–0.93), specificity of 0.82 (0.72–0.89), and AUC of 0.91 (0.88–0.93). In addition, the overall sensitivity, specificity and AUC for circulating miR-155 were 0.88 (0.76–0.95), 0.83 (0.72–0.90), and 0.92 (0.89–0.94), respectively. Function enrichment analysis revealed several vital ontologies terms and pathways associated with BC occurrence and development. Furthermore, in the PPI network, ten hub genes and two significant modules were identified to be involved in some important pathways associated with the pathogenesis of BC. Conclusions We demonstrated that miR-155 has great potential to facilitate accurate BC detection and may serve as a promising diagnostic biomarker for BC. However, well-designed cohort studies and biological experiments should be implemented to confirm the diagnostic value of miR-155 before it can be applied to routine clinical procedures.

scholarly journals Secondary Analysis of an Electronic Surveillance System Combined with Multi-focal Interventions for Early Detection of Sepsis

2017 ◽  
Vol 26 (01) ◽  
pp. 47-66 ◽  
Author(s):  
Bonnie Westra ◽  
Sean Landman ◽  
Pranjul Yadav ◽  
Michael Steinbach
Keyword(s):  
Early Detection ◽  
Surveillance System ◽  
Point Of Care ◽  
Management Strategies ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Separate Analysis ◽  
Electronic Surveillance ◽  
Predictive Values ◽  
Sensitivity Specificity

SummarySummary: To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveil-lance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application. Methods: Propensity score matching was used to select subsets of the cohorts with balanced covariates. Bootstrapping was performed to build distributions of the measured difference in rates/ means. The effect of the sepsis intervention was evaluated for all patients, and High and Low Risk subgroups for illness severity. A separate analysis was performed patients on the intervention and non-intervention units (without the electronic surveillance). Sensitivity, specificity, and the positive predictive values were calculated to evaluate the accuracy of the alerting system for detecting sepsis or severe sepsis/ septic shock.Results: There was positive effect on the intervention units with sepsis electronic surveillance with an adjusted mortality rate of –6.6%. Mortality rates for non-intervention units also improved, but at a lower rate of –2.9%. Additional outcomes improved for patients on both intervention and non-intervention units for home discharge (7.5% vs 1.1%), total length of hospital stay (-0.9% vs –0.3%), and 30 day readmissions (-6.6% vs –1.6%). Patients on the intervention units showed better outcomes compared with non-intervention unit patients, and even more so for High Risk patients. The sensitivity was 95.2%, specificity of 82.0% and PPV of 50.6% for the electronic surveillance alerts. Conclusion: There was improvement over time across the hospital for patients on the intervention and non-intervention units with more improvement for sicker patients. Patients on intervention units with electronic surveillance have better outcomes; however, due to differences in exclusion criteria and types of units, further study is needed to draw a direct relationship between the electronic surveillance system and outcomes.

Estimated Placental Volume and Gestational Age

2017 ◽  
Vol 35 (08) ◽  
pp. 748-757
Author(s):  
Kimberly Isakov ◽  
John Emerson ◽  
Katherine Campbell ◽  
France Galerneau ◽  
Amber Anders ◽  
...  
Keyword(s):  
Birth Weight ◽  
Confidence Interval ◽  
Clinical Utility ◽  
Screening Tool ◽  
Placental Pathology ◽  
Parabolic Curve ◽  
Microscopic Evaluation ◽  
The Relationship ◽  
Placental Volume ◽  
Best Fit

Objective The objective of this study was to validate estimated placental volume (EPV) across a range of gestational ages (GAs). Study Design Three hundred sixty-six patients from 2009 to 2011 received ultrasound scans between 11 + 0 and 38 + 6 weeks GA to assess EPV. An EPV versus GA best fit curve was generated and compared with published normative curves of EPV versus GA in a different population. A subanalysis was performed to explore the relationship between EPV and birth weight (BW). Results Analysis of EPV versus GA revealed a parabolic curve with the following best fit equation: EPV = (0.372 GA − 0.00364 GA2)3. EPV was weakly correlated with BW, and patients with an EPV in the bottom 50th percentile had 2.42 times the odds of having a newborn with a BW in the bottom 50th percentile (95% confidence interval: 1.27–4.68). Microscopic evaluation of two placentas corresponding to the smallest EPV outliers revealed significant placental pathology. Conclusion Placental volume increases throughout gestation and follows a predictable parabolic curve, in agreement with the existing literature. Further validation is required, but EPV may have the potential for clinical utility as a screening tool in a variety of settings.

scholarly journals Sarcopenia as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease: a meta-analysis

Surgery Today ◽  
2019 ◽  
Vol 50 (10) ◽  
pp. 1138-1150 ◽  
Author(s):  
Adrienn Erős ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Zsolt Szakács ◽  
Márton Benke ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Postoperative Complications ◽  
Early Detection ◽  
Confidence Interval ◽  
Bowel Disease ◽  
Surgical Outcomes ◽  
Independent Predictor ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Inflammatory Bowel

Abstract Patients with inflammatory bowel disease (IBD) are at risk of sarcopenia, which is associated with poor clinical outcomes. We conducted this study to assess whether sarcopenia predicts the need for surgery and postoperative complications in patients with IBD. We performed a systematic search of four electronic databases, last updated in March, 2019. Data from studies comparing rates of surgery and postoperative complications in sarcopenic IBD patients versus non-sarcopenic IBD patients were pooled with the random-effects models. We calculated the odds ratios (OR) with a 95% confidence interval (CI). Ten studies with a collective total of 885 IBD patients were included in our meta-analysis. Although the analysis of raw data did not reveal significant differences between the two groups with respect to the rate of surgery and postoperative complications (OR = 1.826; 95% CI 0.913–3.654; p = 0.089 and OR = 3.265; 95% CI 0.575–18.557; p = 0.182, respectively), the analysis of adjusted data identified sarcopenia as an independent predictor for both of the undesirable outcomes (OR = 2.655; 95% CI 1.121–6.336; p = 0.027 and OR = 6.097; 95% CI 1.756–21.175; p = 0.004, respectively). Thus, early detection of sarcopenia in patients with IBD is important to prevent undesirable outcomes.

scholarly journals Diagnostic Validity of Digital Imaging Fiber-Optic Transillumination (DIFOTI) and Near-Infrared Light Transillumination (NILT) for Caries in Dentine

2020 ◽  
Vol 9 (2) ◽  
pp. 420
Author(s):  
Ana Marmaneu-Menero ◽  
José Enrique Iranzo-Cortés ◽  
Teresa Almerich-Torres ◽  
José Carmelo Ortolá-Síscar ◽  
José María Montiel-Company ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Qualitative Analysis ◽  
Near Infrared ◽  
Meta Analysis ◽  
Infrared Light ◽  
X Rays ◽  
Carious Lesions ◽  
Sensitivity Specificity

The objective of the study is to analyse the available evidence for the validity of the transillumination method in the diagnosis of interproximal caries. Bibliographic searches were carried out in three data bases (PubMed, Embase, Scopus) with the key words “Transillumination AND caries”. A total of 11 studies were selected for the qualitative analysis and meta-analysis. In the qualitative analysis, both in vivo and in vitro studies were included. The gold standards were tomography, digital radiography, and clinical visual diagnosis. The meta-analysis determined the sensitivity, specificity, and area below the ROC curve relative to the transillumination method in the diagnosis of caries in dentine. Meta-analysis results obtained for transillumination gave a sensitivity value of 0.69 (confidence interval: 0.54–0.81), a specificity value of 0.89 (confidence interval: 0.61–0.98), while giving an AUC value of 0.79 (confidence interval: 0.67–0.87). Transillumination is a method offering moderate validity in the diagnosis of carious lesions in dentine, there is no strong evidence that may enable us to affirm that transillumination may fully substitute X-rays in the complementary diagnosis of carious lesions

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