scholarly journals AB0541 PREDICTING THE INITIATION OF BIOLOGIC DMARDS IN EARLY PSORIATIC ARTHRITIS WITHIN 1-YEAR OF TREAT-TO-TARGET STRATEGY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1303.1-1303
Author(s):  
E. Loginova ◽  
T. Korotaeva ◽  
E. Gubar ◽  
Y. Korsakova ◽  
S. Glukhova
Keyword(s):  
Early Stage ◽  
Plantar Fascia ◽  
Treat To Target ◽  
Biologic Dmards ◽  
Eular Recommendations ◽  
Chronic Illness Therapy ◽  
Severe Fatigue ◽  
Area Under Roc Curve ◽  
Group 2 ◽  
Sensitivity Specificity

Background:According to the EULAR recommendations and treat-to-target (T2T) strategy synthetic (s) DMARDs are the first-line of PsA therapy and biologic (b) DMARDs are the second one [1]. The value of early intervention by bDMARDs in PsA has been demonstrated recently [2]. But factors which can predict bDMARDs initiation have not been evaluated yet.Objectives:To identify prognostic factors for initiation of bDMARDs within 1-year of T2T strategy in early PsA.Methods:70 patients (pts) (M/F=35/35) with active early PsA fulfilling the CASPAR criteria treated by T2T strategy were included. Mean age 36.9±10.2 years (yrs), PsA duration 11.3±10.6 months (mos.), psoriasis duration 80.6±89.9 mos. Median DAPSA= 29.4 [23.1;36.0]. At baseline (BL) all pts were given therapy with Methotrexate (MTX) s/c with escalating dose from 5 to 25 mg/wk, then over a period of 12 mos pts with ineffectiveness of MTX were added bDMARDs. At BL and every 3 month of therapy all pts underwent standard clinical examinations of PsA activity. DAPSA, ESR (mm/h), CRP (mg/l), the number of pts with dactylitis, enthesitis by LEI and plantar fascia, BSA (%), HAQ and fatigue by FACIT (Functional Assessment of Chronic Illness Therapy) Fatigue Scale (Version 4), BMI (kg/m2) were evaluated. DAPSA > 28 indicate high activity, a score FACIT < 30 - severe fatigue, BMI >25 overweight and obese. At 12 mos. pts were divided into two groups. Group 1 included 42 pts who were treated with MTX only and group 2 - 28 pts those with added bDMARDs during 12 mos. Multi-dimensional step-by-step discriminant analysis was used to identify a group of signs associated with the need to initiate bDMARDs within 12 mos.Results:Comparative analysis of two groups showed the following features proved to be the most informative at BL and at 3 mos. of sDMARDs therapy with MTX: high PsA activity by DAPSA ≥ 30 (р = 0.009), BMI (kg/m2) ≥ 27 (р = 0.019), entesitis ≥ 1 (p= 0.005), ESR ≥ 20 mm/h (p= 0.007), FACIT < 30 (p= 0.074), male sex (р = 0.098). Early PsA pts with combination of these features at the first visit and at 3 mos. of MTX monotherapy have more chance to initiate bDMARDs in comparison to pts without them. Area Under ROC Curve (AUC) 0.892; 95% CI (0.818-0.966). Sensitivity/ Specificity of model 82% / 76% accordingly. (Figure 1).Figure 1.Conclusion:It is a combination of features from first visit to clinic and at 3 mos. of MTX monotherapy – high PsA activity by DAPSA, male gender, persistent entesitis, obesity, ESR increase and severe fatigue by FACIT - that constitutes a prognostic factor for the initiation of bDMARDs at an early-stage of PsA. These factors should be considered in clinical practice to avoid losing time for the early initiation of bDMARDs and improved outcomes of PsA.References:[1]Gossec L, et al. Ann Rheum Dis. 2020;79:700–712. doi:10.1136/annrheumdis-2020-217159. 2. van Mens LJJ, et al. Ann Rheum Dis 2019;78:610–616. doi:10.1136/annrheumdis-2018-214746Disclosure of Interests:None declared.

scholarly journals AB0575 FACTORS ASSOCIATED WITH PSORIATIC ARTHRITIS ACTIVITY IN CLINICAL PRACTICE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1325.1-1325
Author(s):  
Y. Korsakova ◽  
E. Loginova ◽  
T. Korotaeva ◽  
E. Gubar ◽  
S. Glukhova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Plantar Fascia ◽  
New Combination ◽  
Composite Indices ◽  
Chronic Illness Therapy ◽  
Valid Instrument ◽  
The Russian Federation ◽  
Sensitivity Specificity

Background:Psoriatic Arthritis (PsA) is a multifaceted disease with various clinical domains. A number of composite indices has been developed recently [1, 2]. DAPSA (Disease Activity in PSoriatic Arthritis) is the valid instrument for assessment of PsA activity focused on peripheral arthritis. But other factors can influence on PsA activity and haven’t studied yet.Objectives:to identify factors that are associated with PsA activity based on the data from RU-PsART cohort.Methods:117 (M/F=63(54%)/54(46%)) patients (pts) with active PsA fulfilling the CASPAR criteria mean age 44.3 ± 10.9 yrs, mean DAPSA 37.8±21.4, mean PsA duration 73.4±78.4 mo, mean PsO duration 213.4±152.5 mo, were included. Data was collected from 43 rheumatology centers of the Russian Federation. All pts underwent standard clinical examination of PsA activity at enrollment. DAPSA, ESR (mm/h), CRP (mg/L), dactylitis, enthesitis by LEI plus Plantar Fascia, BSA (%), HAQ-DI and fatigue by Fatigue Scale (V.4) FACIT (Functional Assessment of Chronic Illness Therapy), BMI (kg/m2) were evaluated. DAPSA > 28 indicate high activity. Multi-dimensional step-by-step discriminant analysis was used to identify a group of features that are associated with high PsA activity by DAPSA. M±SD, %, OR 95% (CI) were performed.Results:The following features proved to be the most informative: LEI (p=0.739), tenderness of the Plantar Fascia (p=0.003), age (p=0.0004), FACIT (p=0.092), PsA duration >2 yrs (p=0.013), BSA>3% (p=0.021), Nail PsO (p=0.092), BMI (kg/m2) (p=0.22). The area under the ROC-curve (AUC) 0.768, 95% CI (0.624-0.913). Sensitivity/ Specificity of model 77.0%/ 69% accordingly (Figure 1).Figure 1ROC analysis of the Sensitivity and Specificity of the model.Conclusion:Weight, enthesitis, skin and nail PsO severity, fatigue and PsA duration >2 yrs are associated with high PsA activity as well as articular symptoms. New combination indices based on these features should be developed and validated in clinical practice.References:[1]Helliwell P, et al. The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project). Ann Rheum Dis. 2013; 72: 986-91. doi: 10.1136/annrheumdis-2012-201341.[2]Salaffi F, et al. Disease Activity in Psoriatic Arthritis: Comparison of the Discriminative Capacity and Construct Validity of Six Composite Indices in a Real World. BoiMed Res Int 2014; 2014:52805 http://dx.doi.org/10.1155/2014/528105Disclosure of Interests:None declared.

scholarly journals Comparison of saliva with healthcare workers- and patient-collected swabs in the diagnosis of COVID-19 in a large cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitnala Sasikala ◽  
Yelamanchili Sadhana ◽  
Ketavarapu Vijayasarathy ◽  
Anand Gupta ◽  
Sarala Kumari Daram ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Early Stage ◽  
Cost Effective ◽  
Hospitalized Patients ◽  
Detection Sensitivity ◽  
Nasopharyngeal Swab ◽  
Predictive Values ◽  
Qrt Pcr ◽  
Asymptomatic Patients ◽  
Sensitivity Specificity

Abstract Background A considerable amount of evidence demonstrates the potential of saliva in the diagnosis of COVID-19. Our aim was to determine the sensitivity of saliva versus swabs collected by healthcare workers (HCWs) and patients themselves to assess whether saliva detection can be offered as a cost-effective, risk-free method of SARS-CoV-2 detection. Methods This study was conducted in a hospital involving outpatients and hospitalized patients. A total of 3018 outpatients were tested. Of these, 200 qRT-PCR-confirmed SARS-CoV-2-positive patients were recruited for further study. In addition, 101 SARS-CoV-2-positive hospitalized patients with symptoms were also enrolled in the study. From outpatients, HCWs collected nasopharyngeal swabs (NPS), saliva were obtained. From inpatients, HCWs collected swabs, patient-collected swabs, and saliva were obtained. qRT-PCR was performed to detect SARS-CoV-2 by TAQPATH assay to determine the sensitivity of saliva detection. Sensitivity, specificity and positive/negative predictive values (PPV, NPV) of detecting SARS-CoV-2 were calculated using MedCalc. Results Of 3018 outpatients (asymptomatic: 2683, symptomatic: 335) tested by qRT-PCR, 200 were positive (males: 140, females: 60; aged 37.9 ± 12.8 years; (81 asymptomatic, 119 symptomatic). Of these, saliva was positive in 128 (64%); 39 of 81 asymptomatic (47%),89 of 119 symptomatic patients (74.8%). Sensitivity of detection was 60.9% (55.4–66.3%, CI 95%), with a negative predictive value of 36%(32.9–39.2%, CI 95%).Among 101 hospitalized patients (males:65, females: 36; aged 53.48 ± 15.6 years), with HCW collected NPS as comparator, sensitivity of saliva was 56.1% (47.5–64.5, CI 95%), specificity 63.5%(50.4–75.3, CI95%) with PPV of 77.2% and NPV of 39.6% and that of self-swab was 52.3%(44–60.5%, CI95%), specificity 56.6% (42.3–70.2%, CI95%) with PPV 77.2% and NPV29.7%. Comparison of positivity with the onset of symptoms revealed highest detection in saliva on day 3 after onset of symptoms. Additionally, only saliva was positive in 13 (12.8%) hospitalized patients. Conclusion Saliva which is easier to collect than nasopharyngeal swab is a viable alternate to detect SARS-COV-2 in symptomatic patients in the early stage of onset of symptoms. Although saliva is currently not recommended for screening asymptomatic patients, optimization of collection and uniform timing of sampling might improve the sensitivity enabling its use as a screening tool at community level.

scholarly journals Gout of feet and ankles in different disease durations: diagnostic value of single-source DECT and evaluation of urate deposition with a novel semi-quantitative DECT scoring system

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Jin Shang ◽  
Xiao-Hu Li ◽  
Shu-Qin Lu ◽  
Yi Shang ◽  
Lu-Lu Li ◽  
...  
Keyword(s):  
Scoring System ◽  
Diagnostic Performance ◽  
Disease Duration ◽  
Bone Erosion ◽  
Early Stage ◽  
Gouty Arthritis ◽  
Single Source ◽  
Crystal Deposition ◽  
Urate Crystal ◽  
Sensitivity Specificity

Abstract Objectives To investigate the diagnostic performance of single-source dual-energy computed tomography (DECT) based on gemstone spectral imaging technology (including Discovery CT750HD and Revolution CT) in patients with suspected feet/ankles gouty arthritis, and evaluate the urate deposition with a novel semi-quantitative DECT scoring system. Methods A total of 196 patients were consecutively included. Feet and ankles were evaluated in all patients by single-source DECT scan. The 2015 EULAR/ACR criteria were used as the reference for the diagnosis of gout. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of DECT for the diagnosis of gout in the early (≤1 year), middle (1–3 years), and late (> 3 years) disease durations were calculated. Besides, a novel semi-quantitative DECT scoring system was assessed for the measurement of urate deposition, and the correlation between the scores and the clinical and serological data were also evaluated. Moreover, the influences of artifacts on the diagnostic performance of DECT were also determined. Results The sensitivity, specificity, and AUC of DECT in 196 patients were 38.10, 96.43%, and 0.673 in the early-stage group; 62.96, 100.00%, and 0.815 in the middle-stage group; and 77.55, 87.50%, and 0.825 in the late-stage group, respectively. The overall diagnostic accuracies in the AUC of DECT (Discovery CT750HD and Revolution CT) in the middle and late stages of gout were higher than that in the early stage of gout. Besides, the monosodium urate crystals were deposited on the first metatarsophalangeal joints and ankles/midfeet. Age, the presence of tophus, bone erosion, and disease duration considerably affected the total urate score. No statistical difference in the positive detection of nail artifact, skin artifact, vascular calcification, and noise artifact was found between the case and control groups. Conclusion DECT (Discovery CT750HD and Revolution CT) showed promising diagnostic accuracy for the detection of urate crystal deposition in gout but had limited diagnostic sensitivity for short-stage gout. Longer disease duration, the presence of tophus, and bone erosion were associated with the urate crystal score system. The artifacts do not remarkably affect the diagnostic performance of DECT in gout.

scholarly journals AB0546 5 YEARS FOLLOW-UP OF PSORIATIC ARTHRITIS PATIENTS TREATED ACCORDING TREAT-TO-TARGET STRATEGY. PRELIMINARY RESULTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1306.1-1306
Author(s):  
P. Tremaskina ◽  
E. Loginova ◽  
T. Korotaeva ◽  
S. Glukhova ◽  
A. Lila
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Standard Care ◽  
Early Stage ◽  
Treat To Target ◽  
Moderate Activity ◽  
Long Term Outcomes ◽  
Mean Values

Background:The concept of treat to target (T2T) in psoriatic arthritis (PsA) has been established recently and already shown its benefits [1]. But the long-term outcomes of the T2T have not been studied yet.Objectives:To study 5 years (yrs) follow-up of PsA patients (pts) treated according to T2T strategy at the early stage.Methods:35 (M/F–17/18) PsA pts fulfilling CASPAR criteria, who were treated according to T2T strategy at the early stage (PsA duration≤2 yrs) within 24 months (mos) were analyzed. At the time of evaluation mean age is 42.7±11.2 yrs, median (Me) PsA duration 72 [60;95] mos, psoriasis duration 120 [88;180] mos. All pts underwent standard clinical examinations of PsA before started T2T therapy and at follow-up. Within 24 mos of T2T strategy all pts were taking Methotrexate (MTX) monotherapy in increasing dose up to 25 mg/wk and 18 out of 35 (51%) pts received MTX in combination with iTNF. When T2T study was stopped all pts were treated according to standard care with NSAIDs, bDMARDs, MTX, tsDMARDs based on PsA activity and physician decision. The number of pts achieved minimal disease activity (MDA, 5 of 7) and remission by DAPSA (≤4)/low disease activity (LDA)≤14) at the 24 mos of T2T strategy and at 5 yrs follow-up were calculated. The results are presented in the form of mean values, median, upper and lower quartiles.Results:Me duration of follow-up is 68 [53.5;81.5] mos. At 24 mos Me DAPSA 3.48 [0.45;21.76], remission by DAPSA (REM-DAPSA) were seen in 20 out of 35 (57%) pts, LDA-DAPSA in 4 (12%) pts, moderate activity (MoA) by DAPSA in 6 (17%) pts and high disease activity by DAPSA (HDA-DAPSA) in 5 (14%) pts. MDA was noted in 21 out of 35 (60%) pts. At 5 yrs Me DAPSA 7.4 [2.22;13.87], REM-DAPSA was noted in 12 (34%) pts, LDA-DAPSA in 14 (40%), MoA-DAPSA in 5 (14%), HDA-DAPSA in 4 (12%) pts. MDA was observed in 17 of 35 pts (49%). Among 20 pts who had REM-DAPSA at 24 mos only 6 pts (30%) remained in remission at 5 yrs follow-up and 12 out of 21 pts (57.14%) remained in MDA status.Conclusion:In early PsA pts remission and MDA are achievable goal of T2T strategy. But most pts lost remission/MDA after this strategy was changed to a standard care, despite being in remission/MDA status before change of therapy. Further investigations of the long-term outcomes of T2T strategy in PsA, including radiographic outcomes are needed.References:[1]Coates LC, Moverley AR, McParland L, et al. Lancet 2015; 386: 2489–98.Disclosure of Interests:None declared.

scholarly journals Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer

Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 372
Author(s):  
Vanessa Silva ◽  
Cecília Peirone ◽  
Rosa Capita ◽  
Carlos Alonso-Calleja ◽  
José A Marques-Magallanes ◽  
...  
Keyword(s):  
Wound Healing ◽  
Animal Model ◽  
Topical Application ◽  
Early Stage ◽  
Bacterial Load ◽  
Ozone Treatment ◽  
Diabetic Patients ◽  
Colony Forming Units ◽  
Group 2 ◽  
Epidermal Regeneration

Diabetic foot ulcers are a common cause of morbidity in diabetic patients. One of the main pathogens found in these ulcers is methicillin-resistant Staphylococcus aureus (MRSA). MRSA often carries resistance to several classes of antibiotics and their infections are becoming harder to treat. Therefore, new alternatives are urgently needed. Thus, this study aimed to investigate the capacity of topical ozonated oil application on the treatment of early-stage skin infected with MRSA in an animal model. Ozonated oil was prepared from a mixture of oils subjected to a gas stream of O2/O3 mixture. Sixteen Wistar rats were inoculated by an intradermic injection of MRSA suspension, producing an abscess lesion. After 3 days, the skin epidermis was removed to open the wound. Group 1 received an application of oil mixture without ozone treatment and Group 2 received an application of ozonated oil. After the treatment period, skin was collected, colony-forming units (CFU) of bacteria were quantified and the histological analysis of the skin was carried out. Skin samples from the control 1 and 2 had a bacterial load was of 1.1 × 105 and 5.7 × 103 CFU/mL, respectively. Group 2 showed better wound healing from mild to moderate epidermal regeneration. Topical application of ozonated vegetable oil in MRSA-infected skin in rats showed a small reduction of the bacterial load and better wound healing.

scholarly journals Circulating Heat Shock Protein 70 Is a Novel Biomarker for Early Diagnosis of Lung Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tielong Tang ◽  
Chao Yang ◽  
Ham Ebo Brown ◽  
Jing Huang
Keyword(s):  
Lung Cancer ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Cancer Patients ◽  
Heat Shock Protein 70 ◽  
Early Stage ◽  
Growth And Survival ◽  
Lung Cancer Patients ◽  
Cellular Stresses ◽  
Sensitivity Specificity

Heat shock protein 70 (HSP70) was a highly conserved protein which was significantly induced in response to cellular stresses. HSP70 played an important role in the pathogenesis of cancer which stabilized the production of large amount of oncogenic proteins and finally supported growth and survival of tumor. However, there was no report about the diagnosis of circulating HSP70 in lung cancer patients. In this study, a total of 297 participants (lung cancer: 197, healthy control: 100) were enrolled in the detection of circulating HSP70 level in plasma by ELISA assay. The results indicated that circulating HSP70 significantly decreased in lung cancer patients compared to healthy controls (P<0.0001). Receiver operating characteristic (ROC) analysis showed that HSP70 (AUC: 82.2%, SN: 74.1%, SP: 80.0%) had higher diagnosis value than clinical existing biomarkers CEA (AUC: 80.1%, SN: 76.8%, SP: 67.3%) and CA 19-9 (AUC: 63.7%, SN: 64.2%, SP: 54.0%). In the analysis of early lung cancer patients, ROC results also revealed that HSP70 (AUC: 83.8%, SN: 71.2%, SP: 84.0%) have higher sensitivity, specificity, and AUC than CEA (AUC: 73.7%, SN: 73.2%, SP: 69.1%) and CA 19-9 (AUC: 61.5%, SN: 69.4%, SP: 53.4%). In analysis of specific histological classifications, HSP70 showed more valuable in the diagnosis of SCC (AUC: 85.9%, SN: 86.1.9%, SP: 81.0%) than ADC (AUC: 81.0%, SN: 69.1%, SP: 81.0%). Combined analysis of HSP70 and existing biomarker: CEA and CA 19-9 exhibited that HSP70 combined CEA and CA 19-9 showed the highest AUC (0.945, 95% CI, 0.855–1.000). The importance of our results was that we found decreased circulating HSP70, in combination with elevated CEA and CA 19-9, could be utilized in the diagnosis of early (stage I and II) lung cancer.

Morphological Contour Based Blood Vessel Segmentation in Retinal Images Using Otsu Thresholding

2018 ◽  
Vol 9 (4) ◽  
pp. 48-63 ◽  
Author(s):  
S. Saranya Rubini ◽  
A. Kunthavai ◽  
M.B. Sachin ◽  
S. Deepak Venkatesh
Keyword(s):  
Blood Vessel ◽  
Blood Vessels ◽  
Early Stage ◽  
Histogram Equalization ◽  
Vessel Segmentation ◽  
Contour Detection ◽  
Experimental Result ◽  
Blood Vessel Segmentation ◽  
Otsu Thresholding ◽  
Sensitivity Specificity

Retinal image analysis plays an important part in identifying various eye related diseases such as diabetic retinopathy (DR), glaucoma and many others. Accurate segmentation of blood vessels plays an important part in identifying the retinal diseases at an early stage. In this article, an unsupervised approach based on contour detection has been proposed for effective segmentation of retinal blood vessels. The proposed morphological contour-based blood vessel segmentation (MCBVS) method performs preprocessing using contrast limited adaptive histogram equalization followed by alternate sequential filtering to generate a noise-free image. The resultant image undergoes Otsu thresholding for candidate extraction followed by contour detection to properly segment the blood vessels. The MCBVS method has been tested on the DRIVE dataset and the experimental result shows that the proposed method achieved a sensitivity, specificity and accuracy of 58.79%, 90.77% and 86.7%, respectively. The MCBVS method performs better than the existing methods Sobel, Prewitt and Modified U-Net in terms of accuracy.

scholarly journals Early Autism Screening: A Comprehensive Review

2019 ◽  
Vol 16 (18) ◽  
pp. 3502 ◽  
Author(s):  
Fadi Thabtah ◽  
David Peebles
Keyword(s):  
Autistic Spectrum Disorder ◽  
Early Stage ◽  
Screening Tools ◽  
Screening Methods ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Speed Up ◽  
Sensitivity Specificity ◽  
Further Development ◽  
Lengthy Process

Autistic spectrum disorder (ASD) refers to a neurodevelopmental condition associated with verbal and nonverbal communication, social interactions, and behavioural complications that is becoming increasingly common in many parts of the globe. Identifying individuals on the spectrum has remained a lengthy process for the past few decades due to the fact that some individuals diagnosed with ASD exhibit exceptional skills in areas such as mathematics, arts, and music among others. To improve the accuracy and reliability of autism diagnoses, many scholars have developed pre-diagnosis screening methods to help identify autistic behaviours at an early stage, speed up the clinical diagnosis referral process, and improve the understanding of ASD for the different stakeholders involved, such as parents, caregivers, teachers, and family members. However, the functionality and reliability of those screening tools vary according to different research studies and some have remained questionable. This study evaluates and critically analyses 37 different ASD screening tools in order to identify possible areas that need to be addressed through further development and innovation. More importantly, different criteria associated with existing screening tools, such as accessibility, the fulfilment of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifications, comprehensibility among the target audience, performance (specifically sensitivity, specificity, and accuracy), web and mobile availability, and popularity have been investigated.

scholarly journals Ensemble Comparative Study for Diagnosis of Breast Cancer Datasets

2018 ◽  
Vol 7 (4.15) ◽  
pp. 281
Author(s):  
Bibhuprasad Sahu ◽  
Sujata Dash ◽  
Sachi Nandan Mohanty ◽  
Saroj Kumar Rout
Keyword(s):  
Breast Cancer ◽  
Neural Network ◽  
Early Stage ◽  
Breast Cancer Dataset ◽  
Classification Rate ◽  
Cancer Dataset ◽  
Cancer Data ◽  
Cad System ◽  
Result Analysis ◽  
Sensitivity Specificity

Every disease is curable if a little amount of human effort is applied for early diagnosis. The death rate in world increases day by day as patient fail to detect it before it becomes chronic. Breast cancer is curable if detection is done at early stage before it spread across all part of body. Now-a-days computer aided diagnosis are automated assistance for the doctors to produce accurate prediction about the stage of disease. This study provided CAD system for diagnosis of breast cancer. This method uses Neural Network (NN) as a classifier model and PCA/LDA for dimension reduction method to attain higher classification rate. Multiple layers of neural network are applied to classify the breast cancer data. This system experiment done on Wisconsin breast cancer dataset (WBCD) from UCI repository. The dataset is divided into 2 parts train and test. With the result of accuracy, sensitivity, specificity, precision and recall the performance can be measured. The results obtained are this study is 97% using ANN and PCA-ANN, which is better than other state-of-art methods. As per the result analysis this system outperformed then the existing system.  

scholarly journals P227 Defining faecal calprotectin thresholds to predict endoscopic and histological healing in ulcerative colitis (UC) by using advanced optical enhancement techniques

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S255-S256
Author(s):  
R Cannatelli ◽  
D Zardo ◽  
O Nardone ◽  
A Bazarova ◽  
U Shivaji ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Surrogate Marker ◽  
Scoring Systems ◽  
Roc Curves ◽  
Mucosal Healing ◽  
Faecal Calprotectin ◽  
Area Under Roc Curve ◽  
Index Of Severity ◽  
Sensitivity Specificity ◽  
A Prospective Study

Abstract Background Faecal calprotectin (FC) is the most common surrogate marker of mucosal healing (MH) in UC. A number of endoscopic and histologic scoring systems in UC have been developed for defining MH. We report the optimum FC thresholds for defining MH using all the assessment methods. Methods In a prospective study we collected all clinical, endoscopic and histologic data and FC from 76 UC patients (mean age 44.2y, 50.0% male) who attended endoscopy unit for colitis assessment or surveillance. Endoscopic scores were determined by the same endoscopist (MI) and included Mayo Endoscopic Score (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and PICaSSO (Paddington International virtual ChromoendoScopy ScOre). Histological activity was scored by the Robarts Histology Index (RHI) and Nancy Index by the same pathologist (DZ). Faecal calprotectin was assayed using Buhlmann faecal turbo test, particle enhanced turbidimetric immunoassay. ROC curves were performed to evaluate sensitivity, specificity and accuracy of the optimum cut-off of FC to predict endoscopic and histological healing. Results The best cut-off for FC to predict endoscopic healing calculated as Picasso≤3 was 161 μg/g with Area Under ROC curve (AUROC) of 85.3% (95% CI 76.2, 94.4). Sensitivity, specificity and accuracy were 87.9% (95% CI 57.6, 100), 76.7% (95% CI 53.5, 90.7) and 81.6% (95% CI 68.4, 89.5), respectively. While, the best threshold of FC to predict UCEIS≤1 was 148 μg/g with AUROC of 89.2 (95% CI 81.9, 96.5). Sensitivity was 93.5% (95% CI 50.5, 100), specificity 82.2% (95% CI 53.3, 91.1) and accuracy 86.8% (95% CI 69.7, 92.1). The best threshold for FC to predict MES equal to 0, was 112 μg/g, with AUROC of 89.6 μg/g, (95% CI 82.5, 96.7). Sensitivity, specificity and accuracy were 89.7%ww (95% CI 39.2, 100), 85.1% (95% CI 55.3, 93.6) and 86.9% (95% CI 68.4, 92.1), respectively. The best value of FC to predict histological healing with RHI≤3 was 112μg/g with AUROC of 88.0% (95% CI 80.6, 95.4). Sensitivity, specificity and accuracy were 88.5% (95% CI 53.8, 100), 80.0% (95% CI 62.0, 90.0) and 82.9% (95% CI 72.5, 89.5), respectively. When used Nancy≤1 FC cut-off to predict healing was 172 μg/g with AUROC of 87.1% (95% CI 78.6, 95.6). Sensitivity was 96.4% (95% CI 60.7, 100), specificity 72.9% (54.2, 85.4) and accuracy 81.6% (69.7, 89.5). Conclusion Advanced enhancement technologies can accurately define the level of FC to predict endoscopic and histological healing in UC. The optimum FC threshold for MH by PICaSSO and by Nancy was similar (161 and 172 μg/g respectively), while the FC threshold for mucosal healing by MES and by RHI was 112 μg/g. The FC threshold for determining MH in clinical practice should be lower than at least 200 μg/g.

Sign in / Sign up

Export Citation Format

Share Document