scholarly journals Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting

2019 ◽  
Vol 105 (6) ◽  
pp. 524-529 ◽  
Author(s):  
Ifeyinwa Obiageli Ezeofor ◽  
Ada Lizbeth Garcia ◽  
Charlotte Margaret Wright
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Resource Poor Setting ◽  
High Risk Population ◽  
Diagnostic Accuracy Study ◽  
Z Scores ◽  
Accuracy Study ◽  
Weight Faltering

PurposeWe aimed to describe the prevalence of undernutrition in hospitalised infants aged under 6 months and test the utility of simple index measures to detect undernutrition.DesignDiagnostic accuracy study: weight, length, mid-upper arm circumference (MUAC), triceps and subscapular skinfolds were measured in infants aged 2 weeks to 6 months admitted to a Teaching Hospital in Enugu, Nigeria. Index criteria: low (<−2SD) weight-for-age Z-scores (WAZ), weight-for-length Z-scores (WLZ); MUAC <11 cm. Reference definition: weight faltering (conditional weight gain below fifth percentile for healthy Nigerian infants) or sum of skinfolds (SSF) <10 mm.ResultsOf 125 hospitalised infants, only 5% (6) were admitted specifically for undernutrition, but low SSF were found in 33% (41) and, 24% (25) with known birth weight had weight faltering, giving an undernutrition prevalence of 36%. Low WAZ was the most discriminating predictor of undernutrition (sensitivity 69%, positive predictive value 86%, likelihood ratio 5.5; area under receiver operator curves 0.90) followed by MUAC (73%, 73%, 4.9; 0.86), while WLZ performed least well (49%, 67%, 2.9; 0.84). Where both MUAC and WAZ were low, there was sensitivity 90%, positive predictive value 82% and likelihood ratio 8.7.ConclusionsInfants aged under 6 months admitted to hospital in Nigeria had a high prevalence of undernutrition. In young, high-risk population, a low WAZ alone was a valuable screening criterion, while combining weight with MUAC gave even higher discrimination. Measurement of length to calculate WLZ was a less useful predictor in this population.

scholarly journals Prevalence and identification of anxiety disorders in pregnancy: the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2)

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023766 ◽  
Author(s):  
Selina Nath ◽  
Elizabeth G Ryan ◽  
Kylee Trevillion ◽  
Debra Bick ◽  
Jill Demilew ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Positive Predictive Value ◽  
Anxiety Disorders ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Stratified Sampling ◽  
Generalised Anxiety Disorder ◽  
Population Prevalence

ObjectiveTo estimate the population prevalence of anxiety disorders during pregnancy and investigate the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2) for a) GAD and b) any anxiety disorder.DesignCross-sectional survey using a stratified sampling design. Sampling weights were used in the analysis to adjust for the bias introduced by the stratified sampling.SettingInner-city maternity service, South London.Participants545 pregnant women were interviewed after their first antenatal appointment; 528 provided answers on the GAD-2 questions.Main outcome measuresDiagnosis generated by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID).ResultsPopulation prevalence of anxiety disorders was 17% (95% CI 12% to 21%): 5% (95% CI 3% to 6%) for GAD, 4% (95% CI 2% to 6%) for social phobia, 8% (95% CI 5% to 11%) for specific phobia and 2% (95% CI 1% to 4%) for obsessive-compulsive disorder. Post-traumatic stress disorder (PTSD) prevalence was unclear due to higher levels of reluctance to respond to PTSD interview questions but sensitivity analyses suggest population prevalence maybe up to 4% (95% CI 2% to 6%). Weighted sensitivity of GAD-2 for GAD (cut-off ≥3) was 69%, specificity 91%, positive predictive value 26%, negative predictive value 98% and likelihood ratio 7.35. For any anxiety disorder the weighted sensitivity was 26%, specificity 91%, positive predictive value 36%, negative predictive value 87% and likelihood ratio 2.92.ConclusionsAnxiety disorders are common but GAD-2 generates many false positives and may therefore be unhelpful in maternity services.

Restricted Diffusion of the Optic Nerves in Patients with Acute Optic Neuritis: A Diagnostic Accuracy Study

2021 ◽  
Vol 104 (2) ◽  
pp. 271-276
Keyword(s):  
Diagnostic Accuracy ◽  
Optic Neuritis ◽  
Predictive Value ◽  
Diffusion Mri ◽  
Restricted Diffusion ◽  
Diagnostic Accuracy Study ◽  
Optic Nerves ◽  
Acute Optic Neuritis ◽  
Apparent Diffusion ◽  
Accuracy Study

Objective: To evaluate the diagnostic accuracy of restricted diffusion of the optic nerves in patients with acute optic neuritis (ON). Materials and Methods: The present study was a diagnostic accuracy study, including all acute ON patients, admitted to Ramathibodi Hospital in Thailand, between January 2014 and December 2018 (ID 075739). Patients were divided into acute ON and non-optic neuritis condition (non-ON) groups. The acute ON group was divided further into neuromyelitis optica spectrum disorder-associated optic neuritis (NMOSD-ON) group and other types of ON (other-ON) group. Patients’ clinical information and MRI scans were reviewed retrospectively. Restricted diffusion of the optic nerves was present if hyperintense signals were observed on diffusion-weighted imaging (DWI) and hypointense signals were observed on the apparent diffusion coefficient (ADC) map. Results: A total of 102 patients were included in the present study (141 optic nerves). Of all patients, 78 had acute ON (76.5%), and 24 had non-ON (23.5%). Of all optic nerves, there were 95 optic nerves in the acute ON group (67.4%) and 46 in the non-ON group (32.6%). Of 95 optic nerves in the acute ON group, there were 52 optic nerves in the NMOSD-ON group (54.7%) and 43 in the other-ON group (45.3%). Restricted diffusion of the optic nerves demonstrated a sensitivity of 77.9%, specificity of 95.7%, positive predictive value of 97.4%, and negative predictive value of 67.7% in identifying acute ON. It had a sensitivity of 86.5%, specificity of 32.6%, positive predictive value of 60.8%, and negative predictive value of 66.7% in differentiating NMOSD-ON from other-ON. Conclusion: The diffusion MRI can be a marker of acute ON. The test is most useful for ruling in acute ON when restricted diffusion is positive. However, further investigations might be required in negative tests. Restricted diffusion is positive in several types of ON. It is difficult to differentiate NMOSD-ON from other ON types using diffusion MRI alone. Keywords: Neuromyelitis optica spectrum disorders, Optic neuritis, Diffusion-weighted imaging, Apparent diffusion coefficient, Restricted diffusion

THE PREDICTIVE VALUE OF LUNG ULTRASOUND SCORES IN DEVELOPING BRONCHOPULMONARY DYSPLASIA: A PROSPECTIVE MULTICENTER DIAGNOSTIC ACCURACY STUDY

CHEST Journal ◽  
2021 ◽  
Author(s):  
Almudena Alonso-Ojembarrena ◽  
Iker Serna-Guerediaga ◽  
Victoria Aldecoa-Bilbao ◽  
Rebeca Gregorio-Hernández ◽  
Paula Alonso-Quintela ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Bronchopulmonary Dysplasia ◽  
Predictive Value ◽  
Lung Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study

scholarly journals Assessing Histological Inflammatory Activity in Patients With Ulcerative Colitis: A Diagnostic Accuracy Study Testing Fecal Biomarkers Lactoferrin and Calprotectin

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Jost Langhorst ◽  
Lana Kairey ◽  
Angela Oberle ◽  
James Boone ◽  
Gustav Dobos ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Diagnostic Accuracy ◽  
Disease Activity ◽  
Predictive Value ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study ◽  
Histological Indices ◽  
Grade 3 ◽  
Histological Remission ◽  
Fecal Biomarkers

Abstract Background and Aims Histological remission has arisen as the optimal treatment outcome in ulcerative colitis (UC). The aim of this retrospective study was to explore the diagnostic performance of the noninvasive fecal biomarkers calprotectin (FC) and lactoferrin (FL) compared to the histological indices Nancy Index (NI) and Riley Index (RI). Methods This study is a retrospective diagnostic accuracy study based on secondary analysis of patient data from 2002 to 2017 extracted from medical registries of our clinics in Essen-Mitte, Germany. Patients with UC underwent a colonoscopy, with biopsies taken from the rectum and the sigmoid scored by 2 experienced pathologists according to NI and RI and provided a stool sample within 7 days pre- or post-colonoscopy. Diagnostic accuracy of recommended cutoffs for FC (&gt;50 μg/g) and FL (≥7.25 μg/g) were tested against our reference standard (NI ≥2) in terms of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy (effectiveness). Results The number of patients with UC recruited was n = 226, aged 45.2 (SD 13.3). Histological indices were highly correlated (r = 0.980, P &lt; 0.001). Fecal biomarkers correlated moderately with NI (FC: r = 0.383, P &lt; 0.001; FL: r = 0.420, P &lt; 0.001) and RI (FC: r = 0.395, P &lt; 0.001; FL: r = 0.424, P &lt; 0.001). Fecal biomarker concentrations were increased in patients with active histological disease (NI ≥2), median [IQR], FC 69.72 [20.07–254.38], FL 18.59 [6.06–44.42], compared to those with inactive disease (NI ≤1), FC 12.35 [3.89 – 32.16], FL 3.14 [0.75–11.05], z = −6.60, P &lt; 0.001. Fecal biomarker concentrations differed significantly across NI grades 0–4 (FC: H4 = 45.2; FL: H4 = 47.5, both P &lt; 0.001). Patients with grade 0 had significantly lower concentrations of fecal biomarkers than those with grade 3 (median; FC 10.94 vs 72.22; FL 2.30 vs 29.10; both P &lt; 0.001) or grade 4 (FC 10.94 vs 67.00; FL 2.30 vs 27.64; both P &lt; 0.001), as well as grade 2 for FC only (10.94 vs 56.22, P = 0.001). Concentrations were also lower in patients with grade 1 compared to those with grade 3 (FC 17.49 vs 72.22; FL 4.24 vs. 29.10; both P ≤ 0.001) or grade 4 (FC 17.49 vs 67.00; FL 4.24 vs 27.64; both P &lt; 0.001). Receiver operating characteristics area under the curve showed moderate diagnostic accuracy for both FC 0.76 (95% confidence interval [CI] 0.70–0.83) and FL 0.73 (95% CI 0.66–0.80). Optimized cutoffs for both FC (≥34.29) and FL (≥5.85 μg/g) had slightly improved accuracy, compared with the manufacturer’s cutoffs (FC: 69.9% vs 65.9%; FL: 71.7% vs 69.0%). Conclusions Fecal biomarkers calprotectin and lactoferrin correlate with histological disease activity and differentiate between patients in histological remission from those with evidence of moderate to severe disease activity. Their noninvasiveness, in addition to being inexpensive, supports their use in the clinical monitoring of patients with UC.

scholarly journals Diagnostic accuracy of Schistoso ma ICT Ig G - IgM and comparison to other used techniques screening urinary schistosomiasis in Nigeria

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Robert Soumay Houmsou ◽  
Binga Emmanuel Wama ◽  
Hemen Agere ◽  
John Ador Uniga ◽  
Timothy Jerry Jerry ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Statistical Significance ◽  
Positive Likelihood Ratio ◽  
Youden Index ◽  
P Value ◽  
Urinary Schistosomiasis

Abstract Objectives Schistosomiasis is a blood fluke parasitic illness affecting human lives in rural endemic areas. This study evaluated the performance of Schistosoma ICT Ig G - IgM for screening urinary schistosomiasis in Nigeria. Methods Three hundred and seventy four (374) urine samples were examined. Reagent strips, urine filtration and Schistosoma ICT Ig G - IgM were used for analysis. Schistosoma ICT Ig G - IgM used 2 mL of each serum for serological examination. Then, 3 mL of each preserved serum was sent to LDBIO Diagnostics, France for re-examination with Schistosoma ICT IgG-IgM and confirmation with SCHISTO Western blot (WB) IgG. The performance of the index tests was determined using sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and positive likelihood ratio (PLR). The Youden index (YI) and diagnostic accuracy (DA) were used to determine the accuracy of each test. The statistical significance was at p-value ≤0.05. Results The test had a sensitivity of 94.9%, specificity of 63.9%, positive predictive value of 72.4%, negative predictive value of 92.6%, and positive likelihood ratio of 2.62. Schistosoma ICT Ig G - IgM had a good Cohen’s kappa index (κ=0.68), good Youden index (YI=0.58) and good diagnostic accuracy (DA=0.78). Conclusions Schistosoma ICT Ig G - IgM has proven to be the best technique for the screening of urinary schistosomiasis in Nigeria.

scholarly journals Comparison of magnetic resonance arthrography with arthroscopy for imaging of shoulder injuries: retrospective study

2017 ◽  
Vol 99 (4) ◽  
pp. 271-274 ◽  
Author(s):  
R Saqib ◽  
J Harris ◽  
L Funk
Keyword(s):  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Loose Bodies ◽  
Slap Lesions ◽  
Labral Tears ◽  
Shoulder Disorders

BACKGROUND Arthroscopy is the established ‘gold standard’ diagnostic investigation for detection of shoulder disorders. We aimed to compare the diagnostic accuracy of arthroscopy with magnetic resonance arthrography (MRA) for detection of shoulder disorders. METHODS Patients who underwent arthroscopy by a single surgeon and preoperative MRA between February 2011 and March 2012 for shoulder instability were identified. MRAs were reported by experienced musculoskeletal radiologists. Labral tears, anterior labral tears, superior labral anterior posterior (SLAP) lesions, posterior labral tears, rotator-cuff tears (RCTs), osteoarthritis, loose bodies and Hill–Sachs lesions were identified. Sensitivity, specificity, positive predictive value and negative predictive value, positive likelihood ratio and negative likelihood ratio were calculated. RESULTS A total of 194 patients were identified. The sensitivity and specificity for anterior labral tears was 0.60 and 0.92, SLAP lesions was 0.75 and 0.81, posterior labral tears was 0.57 and 0.96, any labral tear was 0.87 and 0.76, Hill–Sachs lesions was 0.91 and 0.91, RCTs was 0.71 and 0.86, osteoarthritis was 0.72 and 0.95, and loose bodies was 0.22 and 0.96, respectively. The positive predictive value and negative predictive value for anterior labral tears were 0.88 and 0.71, SLAP lesions was 0.64 and 0.88, posterior labral tears was 0.74 and 0.45, any labral tear was 0.89 and 0.71, Hill–Sachs lesions was 0.66 and 0.98, RCTs was 0.47 and 0.95, osteoarthritis was 0.70 and 0.95, and loose bodies was 0.27 and 0.95, respectively. CONCLUSIONS MRA has high diagnostic accuracy for labral tears and Hill–Sachs lesions, but whether MRA should be the first-line imaging modality is controversial.

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