scholarly journals Beta-D-Glucan for Diagnosing Pneumocystis Pneumonia: a Direct Comparison between the Wako β-Glucan Assay and the Fungitell Assay

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Toine Mercier ◽  
Ellen Guldentops ◽  
Sofie Patteet ◽  
Kurt Beuselinck ◽  
Katrien Lagrou ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Pneumocystis Pneumonia ◽  
Radiological Findings ◽  
Sample Testing ◽  
Overall Performance ◽  
Operating Characteristic Curve ◽  
Better Than

ABSTRACT Measuring serum beta-d-glucan (BDG) is a useful tool for supporting a quantitative PCR (qPCR)-based diagnosis of suspected Pneumocystis pneumonia (PCP) with bronchoalveolar lavage (BAL) fluid. Since the 2000s, the Fungitell assay was the only BDG assay which was FDA cleared and Conformité Européenne (CE) marked. However, the Wako β-glucan test was also recently CE marked and commercialized. We analyzed archived sera from 116 PCP cases (who were considered to have PCP based on compatible clinical and radiological findings plus a BAL fluid qPCR threshold cycle value of ≤28) and 114 controls (those with a BAL fluid qPCR threshold cycle value of >45 and no invasive fungal infection) using the Fungitell and Wako assays in parallel and assessed their diagnostic performance using the manufacturer’s proposed cutoffs of 80 pg/ml and 11 pg/ml, respectively. We found the Wako assay to be more specific (0.98 versus 0.87, P < 0.001) and the Fungitell assay to be more sensitive (0.78 versus 0.85, P = 0.039) at the proposed cutoffs. Overall performance, as determined by the area under the receiver operating characteristic curve, was similar for both assays. We determined a new Wako assay cutoff (3.616 pg/ml) to match the sensitivity of the Fungitell assay (0.88 at a cutoff of ≥60 pg/ml). Using this newly proposed cutoff, the specificity of the Wako assay was significantly better than that of the Fungitell assay (0.89 versus 0.82, P = 0.011). In conclusion, the Wako assay performed excellently compared to the Fungitell assay for the diagnosis of presumed PCP based on qPCR. In addition, contrary to the Fungitell assay, the Wako assay allows for single-sample testing with lower inter- and intrarun variability. Finally, we propose an optimized cutoff for the Wako assay to reliably exclude PCP.

Value of image-pro plus for assisting virtual touch tissue imaging in the diagnosis of thyroid nodules

2020 ◽  
pp. 1-9
Author(s):  
Kai-Mei Lian ◽  
Teng Lin
Keyword(s):  
Gold Standard ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Tissue Imaging ◽  
Operating Characteristic Curve ◽  
Virtual Touch Tissue Imaging ◽  
Better Than

Purpose: The value of virtual touch tissue imaging (VTI) with support of Image-Pro Plus (IPP) for diagnosing malignant thyroid tumors was assessed in the present study. Methods: In this retrospective study, we enrolled 160 patients with 198 thyroid nodules. TI-RADS, VTI grade, and VTI with support of IPP (VTI-IPP) were underwent for each nodule. With the pathological diagnosis as the gold standard, the receiver-operating characteristic curve (ROC) was drawn to evaluate the diagnostic performance of VTI-IPP, VTI, TI-RADS, VTI-IPP combinate with TI-RADS in thyroid carcinoma. Results: VTI-IPP score >2, VTI score >3, TI-RADS score >1, and VTI-IPP combine with TI-RADS score >4 expressed the highest diagnostic value for malignant thyroid nodules, the areas under the curve (AUC) were 0.939, 0.905, 0.925, and 0.967, respectively. The combination indicated the largest AUC, compared with VTI-IPP and TI-RADS, respectively (P = 0.0054 and 0.0009). The performance of VTI-IPP in diagnosing thyroid carcinomas was better than VTI (P = 0.0321). Conclusion: Compare with VTI, VTI-IPP exhibited more excellent value in distinguishing between benign and malignant thyroid nodules. The value of malignant thyroid nodules diagnosis can be improved when VTI-IPP combines with TI-RADS.

scholarly journals Are Body Composition Parameters Better than Conventional Anthropometric Measures in Predicting Pediatric Hypertension?

2020 ◽  
Vol 17 (16) ◽  
pp. 5771
Author(s):  
Chih-Yu Hsu ◽  
Rong-Ho Lin ◽  
Yu-Ching Lin ◽  
Jau-Yuan Chen ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Body Composition ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Fat Free Mass ◽  
Z Score ◽  
Pediatric Hypertension ◽  
Anthropometric Measures ◽  
Operating Characteristic Curve ◽  
Better Than

Body composition (BC) parameters are associated with cardiometabolic diseases in children; however, the importance of BC parameters for predicting pediatric hypertension is inconclusive. This cross-sectional study aimed to compare the difference in predictive values of BC parameters and conventional anthropometric measures for pediatric hypertension in school-aged children. A total of 340 children (177 girls and 163 boys) with a mean age of 8.8 ± 1.7 years and mean body mass index (BMI) z-score of 0.50 ± 1.24 were enrolled (102 hypertensive children and 238 normotensive children). Significantly higher values of anthropometric measures (BMI, BMI z-score, BMI percentile, waist-to-height ratio) and BC parameters (body-fat percentage, muscle weight, fat mass, fat-free mass) were observed among the hypertensive subgroup compared to their normotensive counterparts. A prediction model combining fat mass ≥ 3.65 kg and fat-free mass ≥ 34.65 kg (area under the receiver operating characteristic curve = 0.688; sensitivity = 66.7%; specificity = 89.9%) performed better than BMI alone (area under the receiver operating characteristic curve = 0.649; sensitivity = 55.9%; specificity = 73.9%) in predicting hypertension. In conclusion, BC parameters are better than anthropometric measures in predicting pediatric hypertension. BC measuring is a reasonable approach for risk stratification in pediatric hypertension.

scholarly journals Clinical validation of urine 3-methoxytyramine as a biomarker of neuroblastoma and comparison with other catecholamine-related biomarkers

2016 ◽  
Vol 54 (2) ◽  
pp. 264-272 ◽  
Author(s):  
Leo Lam ◽  
Gerald A Woollard ◽  
Lochie Teague ◽  
James S Davidson
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Homovanillic Acid ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Tumour Marker ◽  
Tumour Markers ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Background Urinary dopamine, homovanillic acid and 4-hydroxy-3-methoxymandelic acid are established tests for diagnosis and monitoring of neuroblastic disease. We compared the diagnostic performance of total urinary 3-methoxytyramine, the O-methylated product of dopamine, to these three established tumour markers. Methods Urinary 3-methoxytyramine, dopamine, homovanillic acid and 4-hydroxy-3-methoxymandelic acid were measured by high-performance liquid chromatography with electrochemical detection on consecutive urine samples from histologically proven neuroblastic patients and controls. Patients with neuroblastic disease were further classified as untreated, advancing, residual or absent disease based on clinical and radiological criteria. Receiver operating characteristic curve analysis was used to compare the diagnostic performance of the four tumour markers. Results Urinary 3-methoxytyramine was well correlated with established tumour markers and its concentration correlated with disease activity. It was the most commonly elevated tumour marker in neuroblastic disease and showed similar sensitivity to dopamine and homovanillic acid. The diagnostic utility of urinary 3-methoxytyramine as measured by area under the receiver operating characteristic curve was similar to dopamine and homovanillic acid. Conclusion Our results support the use of urinary 3-methoxytyramine as a tumour marker in the diagnosis and the monitoring of neuroblastoma disease.

scholarly journals Laboratory and Clinical Performance of the ADVIA Centaur Anticyclic Citrullinated Peptide Assay for Rheumatoid Arthritis Diagnosis

2018 ◽  
Vol 142 (12) ◽  
pp. 1554-1559 ◽  
Author(s):  
Banseok Kim ◽  
Yongjung Park ◽  
Jin-Su Park ◽  
Kyoung Ja Jang ◽  
Hyo Jun Ahn ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Cutoff Values ◽  
Operating Characteristic Curve ◽  
Citrullinated Peptide ◽  
Receiver Operating

Context.— Anticyclic citrullinated peptide antibodies are important serologic markers for the diagnosis of rheumatoid arthritis. Several kinds of test reagents for automated immunoassay systems have been developed and used in recent years. Objective.— To evaluate the analytic and diagnostic performance of the new ADVIA Centaur anticyclic citrullinated peptide assay (Siemens Healthineers, Erlangen, Germany) compared with the Elecsys assay (Roche Diagnostics, Mannheim, Germany). Design.— A total of 576 serum samples were collected from subjects, including 156 patients (27%) with rheumatoid arthritis. Precision performance and analytical measurement range for the ADVIA assay were evaluated. Diagnostic performance of the 2 assays was compared based on sensitivity, specificity, and area under the receiver operating characteristic curves. Results.— The ADVIA assay showed a within-laboratory imprecision of 3.4% coefficient of variation for levels of 3.36 and 24.99 U/mL. This assay was demonstrated to be linear from 0.4 to 180.0 U/mL. With default cutoff values, sensitivity and specificity for diagnosing rheumatoid arthritis were 71.2% and 97.9%, respectively, for the ADVIA assay and 73.1% and 96.9%, respectively, for the Elecsys assay. With the best cutoff values from the analyses of the receiver operating characteristic curve, the sensitivity of the 2 assays was the same at 75.6%. However, the specificity of the ADVIA assay was 96.4%, whereas that of the Elecsys assay was 94.3%. The area under the receiver operating characteristic curve value for the ADVIA assay was 0.867, which was not significantly different from that of the Elecsys assay (0.865). Conclusions.— The ADVIA Centaur anticyclic citrullinated peptide assay showed good analytic and diagnostic performance in diagnosing rheumatoid arthritis.

scholarly journals Conventional Laboratory Blood Indicators Are Valuable for Early Diagnosis of Colorectal Cancer

2021 ◽  
Author(s):  
Xia Gan ◽  
Zhi-Yong Chen ◽  
Zi-Hua Li ◽  
Jian-Ming Zhou ◽  
Ying Sun ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Diagnosis ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Clinical Laboratory ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Imaging Data ◽  
Operating Characteristic Curve ◽  
Better Than

Abstract Objective: Some conventional laboratory indicators have been found to be of value for the diagnosis of colorectal cancer (CRC). The present study aimed to systematically analyze the diagnostic value of conventional laboratory blood indicators for CRC, especially for early CRC. Methods: A total of 505 patients with CRC (n=210), colorectal adenoma (CRA) (n=167) or polyp (CRP) (n=128) were retrospectively collected. Clinical, laboratory and imaging data available before treatment were extracted. The diagnostic performances of laboratory blood indicators for discriminating total and early CRCs from CRA and CRP (CRA&P) were evaluated.Results: Fifty-three of 76 (69.7%) laboratory blood indicators were significant for discriminating CRC from CRA&P with areas under the receiver operating characteristic curve (AUC) ranging within 0.554-0.819, of these indicators, 17 had AUC > 0.7, three had AUC > 0.8, and five had AUCs greater than that for carcinoembryonic antigen (CEA). Fifteen indicators had overall sensitivities comparable to CEA for the diagnosis of CRC (35.7-55.4% vs. 47.7%, all P>0.05) at a specificity of 90%, and they were not or weakly correlated with CEA (absolute r = 0.058-0.333). For differentiating early CRC (TNM stage I+II, n=102) from CRA&P, the sensitivities for the 15 indicators ranged within 30.4%-55.5% at a specificity of 90% and similar to stage III+IV CRC.Conclusion: Conventional laboratory blood indicators are valuable for early CRC diagnosis, and are comparable to or better than CEA.

scholarly journals Using The Random Forest Algorithm To Detect The Activity of Thyroid-Associated Ophthalmopathy

2021 ◽  
Author(s):  
Minghui Wang ◽  
Hanqiao Zhang ◽  
Li Dong ◽  
Yang Li ◽  
Zhijia Hou ◽  
...  
Keyword(s):  
Random Forest ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Random Forest Model ◽  
Random Forest Algorithm ◽  
Forest Model ◽  
Thyroid Associated Ophthalmopathy ◽  
Operating Characteristic Curve

Abstract Objective: The aim of this study is to establish a random forest model to detect active and quiescent phases of patients with Thyroid-associated ophthalmopathy (TAO) and to evaluate its diagnostic performance.Methods：A total of 146 patients (292 eyes) who were diagnosed with TAO and were treated in the Ophthalmology Outpatient Clinic of Beijing TongRen hospital were retrospectively included in the study. We took the clinical activity score of TAO as the target; took gender, age, smoking status, I-131 treatment history, thyroid nodules, thyromegaly, thyroid hormone and TSH-receptor antibodies (TRAb) as predictive characteristic variables to establish a random forest model. The proportion of the training group to the testing group was 7:3. We analyzed the model’s accuracy, precision, sensitivity, specificity, positive predictive value (PPV), negative predictive value (PPV), F1 score and out-of-bag (OOB) error, with the accuracy, the brier loss and the area under the receiver operating characteristic curve compared with logistic regression model.Results：Our model has an accuracy of 0.93, a sensitivity of 0.88, a specificity of 0.96, a positive predictive value of 0.94, a negative predictive value of 0.93, an F1 score of 0.91 and an OOB error of 0.12. The accuracy of the random forest model and the logistic regression model were 0.93 and 0.79, respectively, the brier loss were 0.06 and 0.20, and the area under the receiver operating characteristic curve were 0.95 and 0.86.Conclusion：By integrating these high-risk factors, the random forest algorithm can be used as a complementary diagnostic method to determine the activity of TAO, showing prominent diagnostic performance.

scholarly journals Cerebellar Arteriovenous Malformations

Neurosurgery ◽  
2012 ◽  
Vol 71 (6) ◽  
pp. 1111-1124 ◽  
Author(s):  
◽  
Ana Rodríguez-Hernández ◽  
Helen Kim ◽  
Tony Pourmohamad ◽  
William L. Young ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Operating Characteristic ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Venous Drainage ◽  
Martin Grade ◽  
Operating Characteristic Curve ◽  
Cerebral Avms ◽  
Cerebellar Anatomy ◽  
Better Than

ABSTRACT BACKGROUND: Anatomic diversity among cerebellar arteriovenous malformations (AVMs) calls for a classification that is intuitive and surgically informative. Selection tools like the Spetzler-Martin grading system are designed to work best with cerebral AVMs but have shortcomings with cerebellar AVMs. OBJECTIVE: To define subtypes of cerebellar AVMs that clarify anatomy and surgical management, to determine results according to subtypes, and to compare predictive accuracies of the Spetzler-Martin and supplementary systems. METHODS: From a consecutive surgical series of 500 patients, 60 had cerebellar AVMs, 39 had brainstem AVMs and were excluded, and 401 had cerebral AVMs. RESULTS: Cerebellar AVM subtypes were as follows: 18 vermian, 13 suboccipital, 12 tentorial, 12 petrosal, and 5 tonsillar. Patients with tonsillar and tentorial AVMs fared best. Cerebellar AVMs presented with hemorrhage more than cerebral AVMs (P &lt; .001). Cerebellar AVMs were more likely to drain deep (P = .04) and less likely to be eloquent (P &lt; .001). The predictive accuracy of the supplementary grade was better than that of the Spetzler-Martin grade with cerebellar AVMs (areas under the receiver-operating characteristic curve, 0.74 and 0.59, respectively). The predictive accuracy of the supplementary system was consistent for cerebral and cerebellar AVMs, whereas that of the Spetzler-Martin system was greater with cerebral AVMs. CONCLUSION: Patients with cerebellar AVMs present with hemorrhage more often than patients with cerebral AVMs, justifying an aggressive treatment posture. The supplementary system is better than the Spetzler-Martin system at predicting outcomes after cerebellar AVM resection. Key components of the Spetzler-Martin system such as venous drainage and eloquence are distorted by cerebellar anatomy in ways that components of the supplementary system are not.

scholarly journals 2476

2017 ◽  
Vol 1 (S1) ◽  
pp. 19-19
Author(s):  
Samuel David Zetumer ◽  
Hobart Harris
Keyword(s):  
Operating Characteristic ◽  
Learning Algorithm ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Exploratory Laparotomy ◽  
Machine Learning Algorithm ◽  
Regression Algorithms ◽  
Study Population ◽  
Operating Characteristic Curve ◽  
Better Than

OBJECTIVES/SPECIFIC AIMS: Historically, logistic regression algorithms (LRAs) have failed to differentiate strangulated small bowel obstructions (SBOs) from nonstrangulated SBOs. Our hypothesis is that a machine learning algorithm (MLA) can differentiate strangulated from simple SBOs better than an LRA can. METHODS/STUDY POPULATION: We used records of patients presenting with acute SBO and managed with exploratory laparotomy to test and train algorithms. We compared MLA to LRA via area under the receiver operating characteristic curve (AUROC) and cut-off points maximizing sensitivity and specificity. RESULTS/ANTICIPATED RESULTS: With 192 patient records, the AUROC of the MLA was 0.85. At the sensitivity cutoff, the MLA had 100% sensitivity and 55% specificity. At the specificity cutoff, the MLA had 45% sensitivity and 100% specificity. We anticipate improvements as more records are incorporated, and that LRA will underperform MLA across all measures. DISCUSSION/SIGNIFICANCE OF IMPACT: Our MLA represents a significant improvement over past LRAs, and may provide decision assistance to surgeons managing SBO. If this MLA maintains its high sensitivity, it may be used in the future to prevent unnecessary surgeries.

scholarly journals The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)

2021 ◽  
Vol 10 (22) ◽  
pp. 5283
Author(s):  
Angela Maria Di Francesco ◽  
Elena Verrecchia ◽  
Ludovico Luca Sicignano ◽  
Maria Grazia Massaro ◽  
Daniela Antuzzi ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Fever Of Unknown Origin ◽  
Good Accuracy ◽  
Characteristic Curve ◽  
Unknown Origin ◽  
Curve Analysis ◽  
Overall Performance ◽  
Operating Characteristic Curve

Sarcoidosis is a multi-organ inflammatory granulomatosis with a lung-predominant involvement. The aim of this study was to investigate the use of serum chitotriosidase (CHIT1) in patients with fever of unknown origin (FUO); the patients with confirmed diagnosis of active sarcoidosis were compared with ones affected by inactive or treated sarcoidosis. CHIT1 activity was evaluated in 110 patients initially admitted at the hospital as FUOs. The overall performance of CHIT1 for active sarcoidosis diagnosis was assessed by performing an area under the receiver operating characteristic curve analysis (AUROC). The sarcoidosis patients were significantly older than the FUO patients not affected by sarcoidosis (p < 0.01). CHIT1 showed a good accuracy as a biomarker for active sarcoidosis in patients explored for FUO (AUROC 0.955; CI 95% 0.895–0.986; p < 0.001). A CHIT1 value >90.86 showed 96.8% sensitivity (84.2–99.9) and 85.5% specificity (75–92.8) in discriminating active sarcoidosis from other causes of FUO. CHIT1 significantly discriminated active versus inactive/under treatment sarcoidosis patients (with lower enzyme activity) (ROC analysis, sensitivity: 96.9%, specificity: 94.7%, value >83.01 nmol/mL/h, AUROC: 0.958, 0.862–0.994, p < 0.001) compared to ACE (ROC analysis, sensitivity: 25.8%, specificity: 93.7%, value >65 UI/L). In conclusion, CHIT1 is a reliable/sensitive biomarker of active sarcoidosis, with values significantly decreasing in remitted/treated patients. It significantly discriminates active sarcoidosis from FUO patients, providing a useful tool in the diagnosis-assessing process.

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