scholarly journals Cut-off value of serum homocysteine in relation to increase of coronary artery calcification

2020 ◽  
pp. jim-2020-001478
Author(s):  
Nam-Seok Joo ◽  
Susie Jung ◽  
Yu-Na Kim ◽  
Beom-Hee Choi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Homocysteine Concentration ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
Operating Characteristic Curve ◽  
Age And Sex

A recent study reported that coronary artery calcification (CAC) and serum homocysteine were well associated; however, no report is available for the cut-off value of serum homocysteine according to increase of coronary-artery calcification volume score (CVS). The data of 469 out of 777 subjects in 1 health promotion center located in Seoul were selected after exclusion of the missing data of serum homocysteine and CVS. CVS was categorized into 2 groups: CVS=0 and CVS>0. Serum homocysteine according to the CVS groups was compared, and the cut-off value of serum homocysteine according to the increase of CVS (>0) was calculated using the receiver operating characteristic curve. Mean age was 54.5 years and the proportion of females was 22.2%. Mean serum homocysteine concentration and CVS were 11.2 μmol/L and 50.4, respectively. After adjustments for age and sex, serum homocysteine was associated with CVS (r=0.167, p=0.001), and Log(Homocysteine) also showed a significant difference according to the CVS groups. The cut-off value of serum homocysteine according to the increase of CVS (>0) was 9.45 μmol/L (area under the curve=0.569 (95% CI 0.512 to 0.625), p=0.015). The cut-off value of serum homocysteine was 9.45 μmol/L according to the increase of coronary-artery CVS.

scholarly journals Prediction of anemia at delivery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enav Yefet ◽  
Avishag Yossef ◽  
Zohar Nachum
Keyword(s):  
Risk Factors ◽  
Operating Characteristic ◽  
Complete Blood Count ◽  
Characteristic Curve ◽  
Secondary Analysis ◽  
Area Under The Curve ◽  
Iron Supplement ◽  
Independent Risk Factors ◽  
Operating Characteristic Curve ◽  
Study Database

AbstractWe aimed to assess risk factors for anemia at delivery by conducting a secondary analysis of a prospective cohort study database including 1527 women who delivered vaginally ≥ 36 gestational weeks. Anemia (Hemoglobin (Hb) < 10.5 g/dL) was assessed at delivery. A complete blood count results during pregnancy as well as maternal and obstetrical characteristics were collected. The primary endpoint was to determine the Hb cutoff between 24 and 30 gestational weeks that is predictive of anemia at delivery by using the area under the curve (AUC) of the receiver operating characteristic curve. Independent risk factors for anemia at delivery were assessed using stepwise multivariable logistic regression. Hb and infrequent iron supplement treatment were independent risk factors for anemia at delivery (OR 0.3 95%CI [0.2–0.4] and OR 2.4 95%CI [1.2–4.8], respectively; C statistics 83%). Hb 10.6 g/dL was an accurate cutoff to predict anemia at delivery (AUC 80% 95%CI 75–84%; sensitivity 75% and specificity 74%). Iron supplement was beneficial to prevent anemia regardless of Hb value. Altogether, Hb should be routinely tested between 24 and 30 gestational weeks to screen for anemia. A flow chart for anemia screening and treatment during pregnancy is proposed in the manuscript.Trial registration: ClinicalTrials.gov Identifier: NCT02434653.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

scholarly journals Comprehensive and Integrative Analysis Reveals the Diagnostic, Clinicopathological and Prognostic Significance of Polo-Like Kinase 1 in Hepatocellular Carcinoma

2018 ◽  
Vol 47 (3) ◽  
pp. 925-947 ◽  
Author(s):  
Peng Lin ◽  
Dong-yue Wen ◽  
Yi-wu Dang ◽  
Yun He ◽  
Hong Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Cycle ◽  
Liver Cancer ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Summary Receiver Operating Characteristic ◽  
Operating Characteristic Curve ◽  
Standardized Mean Difference

Background/Aims: Liver cancer has the second highest cancer-related death rate globally and has relatively few targeted therapeutics. Polo-like kinase 1 (PLK1) is a fascinating trigger of the cell cycle; however, the still-rudimentary understanding of PLK1 at present is a significant barrier to its clinical applications. Here, we comprehensively clarified the clinicopathological value and potential functions of PLK1 in hepatocellular carcinoma (HCC). Methods: HCC-related microarrays, RNA-sequencing datasets and published studies were deeply mined and integrated from The Cancer Genome Atlas, Gene Expression Omnibus, ArrayExpress, Oncomine, literature databases, and immunohistochemistry experiments. Meanwhile, the associations between PLK1 expression and its clinicopathological implications and prognostic value in HCC patients were assessed. The standardized mean difference, summary receiver operating characteristic curve and the corresponding area under the curve, hazard ratios, odds ratios (ORs), and their 95% confidence intervals (CIs) were examined by STATA 12.0. Additionally, several bioinformatics methods were used to identify the potential function of PLK1 in HCC. Results: Comprehensive analyses revealed that PLK1 was significantly increased in HCC (standardized mean difference = 1.34, 95% CI: 1.03–1.65, P < 0.001). The results of diagnostic tests specified that in the summary receiver operating characteristic curve, the area under the curve was 0.88 (95% CI: 0.85–0.90). Furthermore, an elevated PLK1 level significantly predicted unfavorable overall survival (hazard ratio = 1.78, 95% CI: 1.10–2.88, P = 0.019) and was correlated with female gender (OR = 0.73, 95% CI: 0.56–0.95, P = 0.017), tumor thrombus (OR = 3.97, 95% CI: 1.46–10.78, P < 0.001), metastasis (OR = 3.46, 95% CI: 1.33–9.01, P = 0.011), pathologic stage (OR = 1.56, 95% CI: 1.17–2.07, P = 0.002), Barcelona Clinic Liver Cancer stage (OR = 5.76, 95% CI: 2.17–15.28, P < 0.001) and histologic grade (OR = 2.33, 95% CI: 1.12–487, P = 0.024). Through bioinformatics methods, we determined that enhancing the proliferative effect of PLK1 in HCC was associated with a series of hub genes and the activation of the cell cycle pathway. Conclusions: These findings substantiated that PLK1 may be an independent prognostic biomarker in HCC and may facilitate the development of targeted precision oncology.

Does Age Itself Have an Adverse Effect on Survivorship of Meniscal Allograft Transplantation? A Cartilage Status and Time From Previous Meniscectomy–Matched Cohort Study

2020 ◽  
Vol 48 (7) ◽  
pp. 1696-1701 ◽  
Author(s):  
Ju-Ho Song ◽  
Seong-Il Bin ◽  
Jong-Min Kim ◽  
Bum-Sik Lee ◽  
Dong-Wook Son
Keyword(s):  
Clinical Outcomes ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Rank Test ◽  
Meniscal Allograft Transplantation ◽  
Log Rank Test ◽  
Meniscal Allograft ◽  
Age Related ◽  
Significant Difference ◽  
Operating Characteristic Curve

Background: The aging process is accompanied by several conditions that could affect the outcome of meniscal allograft transplantation (MAT). These conditions have made it difficult for clinicians to determine the effect of chronologic age on survivorship after MAT. Hypothesis: Advanced age does not have an adverse effect on survivorship of MAT when controlling for age-related factors, such as cartilage status and time from previous meniscectomy. Study Design: Cohort study; Level of evidence, 3. Methods: The records of 264 consecutive patients who underwent primary medial or lateral MAT were reviewed. To check whether there was a difference in MAT survivorship according to age, a cutoff value was calculated from a time-dependent receiver operating characteristic curve. Survival rates, as well as clinical improvement as determined using the Lysholm score, were compared between groups divided by the cutoff value. Patients were matched for cartilage status and elapsed time from previous meniscectomy. Differences in survivorship and clinical outcomes were assessed between the matched groups. Results: A time-dependent receiver operating characteristic curve showed that the difference in MAT survivorship was maximized with a cutoff age of 43 years. Kaplan-Meier analysis showed a significant difference in MAT survivorship between the older and younger groups (log-rank test, P = .01). However, after matching for cartilage status and time from previous meniscectomy, which left 56 patients per group, there was no significant difference in MAT survivorship (log-rank test, P = .10) between the groups. Regarding clinical outcomes, the mean Lysholm scores were not significantly different between the older and younger groups ( P = .19, before matching; P = .39, after matching). Conclusion: MAT survivorship was more affected by age-related prognostic factors, such as cartilage status and time from previous meniscectomy, than age itself. Clinical outcomes did not show differences according to age, either.

Procalcitonin and Conventional Markers of Inflammation in Peritoneal Dialysis Patients and Peritonitis

2006 ◽  
Vol 26 (2) ◽  
pp. 240-248 ◽  
Author(s):  
Galip Guz ◽  
Bulent Colak ◽  
Kenan Hizel ◽  
Kadriye A. Reis ◽  
Yasemin Erten ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Hemodialysis Patients ◽  
Biochemical Tests ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Median Serum ◽  
Significant Difference

Objectives To determine the significance of a newly described marker of inflammation procalcitonin (PCT), and to investigate its relationship to conventional markers of inflammation, such as C-reactive protein (CRP), fibrinogen, and erythrocyte sedimentation rate (ESR), in patients on peritoneal dialysis (PD) and with peritonitis. Design A prospective, observational clinical study. Setting The Nephrology Division of a University-affiliated teaching hospital. Patients and Methods 51 consecutive patients on PD were included in the study. Of this number, 16 developed peritonitis during the observational period. Baseline PCT, CRP, and fibrinogen concentrations and ESR of 51 PD patients were determined at a time point (TB) prior to any evidence of infection. These results were compared with laboratory values from 74 hemodialysis patients and 34 nonuremic control subjects. All PD patients then were followed prospectively for evidence of peritonitis. In addition to routine blood tests, including hemoglobin and leukocyte count, and routine biochemical tests, blood samples were taken to measure PCT, CRP, and fibrinogen concentrations and ESR at the time (T0) when patients first were diagnosed with PD peritonitis and also on the 4th (T4) and the 14th (T14) days after treatment for peritonitis was initiated. PCT was assayed by immunoluminometry. Results No significant difference was observed between baseline median serum PCT concentrations in PD and hemodialysis patients; however, in both groups, baseline median PCT concentrations were significantly higher than those of nonuremic controls ( p < 0.05). The 16 patients on PD who developed peritonitis had 21 PD peritonitis episodes during the study period. The increased PCT concentration observed at T0 in PD peritonitis episodes decreased with therapy, and this change was statistically significant ( p < 0.05). In a receiver operating characteristic curve analysis for peritonitis, the area under the curve (AUC) for PCT was 0.80, which was significantly lower than the AUC for CRP and greater than the AUCs for fibrinogen and ESR. The sensitivity of PCT for peritonitis was lower than the sensitivity of conventional markers of inflammation; however, the specificity of PCT was higher. Conclusions Median serum PCT concentration in PD patients was significantly higher than in nonuremic controls but not hemodialysis patients. Serum PCT concentrations may serve as a useful adjunct to traditional markers of inflammation in detecting and monitoring inflammation and peritonitis in PD patients.

scholarly journals Evaluation of Nottingham Hip Fracture Score, Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity as predictors of mortality in elderly neck of femur fracture patients

2020 ◽  
Vol 8 ◽  
pp. 205031212091826 ◽  
Author(s):  
Michael James Nelson ◽  
Justin Scott ◽  
Palvannan Sivalingam
Keyword(s):  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Mortality Prediction ◽  
Mortality And Morbidity ◽  
Operative Severity Score ◽  
Significant Difference ◽  
Comorbidity Index ◽  
Operating Characteristic Curve

Background: This study evaluated the use of several risk prediction models in estimating short- and long-term mortality following hip fracture in an Australian population. Methods: Data from 195 patients were retrospectively analysed and applied to three models of interest: the Nottingham Hip Fracture Score, the Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity. The performance of these models was assessed with receiver operating characteristic curve as well as logistic regression modelling. Results: The median age of participants was 83 years and 69% were women. Ten percent of patients were deceased by 30 days, 25% at 6 months and 31% at 12 months post-operatively. While there was no statistically significant difference between the models, the Age-Adjusted Charlson Comorbidity Index had the largest area under the receiver operating characteristic curve for within 30 day and 12 month mortality, while the Nottingham Hip Fracture Score was largest for 6-month mortality. There was no evidence to suggest that the models were selecting a specific subgroup of our population, therefore, no indication was present to suggest that using multiple models would improve mortality prediction. Conclusions: While there was no statistically significant difference in mortality prediction, the Nottingham Hip Fracture Score is perhaps the best suited clinically, due to its ease of implementation. Larger prospective data collection across a variety of sites and its role in guiding clinical management remains an area of interest.

scholarly journals The Value of Serum Midkine Level in Diagnosis of Hepatocellular Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Karim Y. A. Shaheen ◽  
Abeer I. Abdel-Mageed ◽  
Eslam Safwat ◽  
Ashraf M. AlBreedy
Keyword(s):  
Healthy Subjects ◽  
Operating Characteristic ◽  
Diagnostic Marker ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Tumor Diameter ◽  
Control Groups ◽  
Tumor Number ◽  
Healthy Control ◽  
Operating Characteristic Curve

Background and Aim. Identification of sensitive biomarkers to improve early diagnosis of HCC is needed. We aimed to evaluate serum midkine (MDK) as a biomarker for HCC diagnosis.Patients and Methods. 40 HCCs, 30 liver cirrhosis patients, and 30 healthy subjects were enrolled. Serum MDK using ELISA was measured in all included subjects.Results. Serum MDK was significantly elevated in HCC group compared to cirrhotic and healthy control groups (0.625 versus 0.15 and 0.125 ng/mL), respectively. No significant association was found between MDK and either BCLC stage, tumor diameter, tumor number, or AFP level. Receiver operating characteristic curve showed that best cutoff for MDK and AFP was 0.387 and 88.5 ng/mL, respectively. Area under the curve of MDK was significantly larger than that of AFP (0.941 versus 0.671). The sensitivity of MDK at 0.387 ng/mL for HCC diagnosis was significantly higher than that of AFP at cutoffs 20, 88.5, and 200 ng/mL (92.5 versus 62.5, 40, and 25%), respectively. Sensitivity of MDK reached 93.3% in patients with AFP <20 ng/mL. Moreover, MDK at 0.387 ng/mL had significant better sensitivity than AFP at 20 ng/mL in distinguishing HCC from BCLC 0/A (90 versus 40%).Conclusion. Serum MDK might be a potential diagnostic marker for HCC particularity in its early stages.

scholarly journals Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

2019 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Dapeng Duan ◽  
Liqun Gong ◽  
Jue Wang ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Surgery ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Site Infection ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Operating Characteristic Curve

Abstract Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

Baseline NIH Stroke Scale is an inferior predictor of functional outcome in the era of acute stroke intervention

2018 ◽  
Vol 13 (8) ◽  
pp. 806-810 ◽  
Author(s):  
Michael E Reznik ◽  
Shadi Yaghi ◽  
Mahesh V Jayaraman ◽  
Ryan A McTaggart ◽  
Morgan Hemendinger ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Functional Outcome ◽  
Operating Characteristic ◽  
Mechanical Thrombectomy ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Operating Characteristic Curve

Background and aims Baseline National Institutes of Health Stroke Scale (NIHSS) scores have frequently been used for prognostication after ischemic stroke. With the increasing utilization of acute stroke interventions, we aimed to determine whether baseline NIHSS scores are still able to reliably predict post-stroke functional outcome. Methods We retrospectively analyzed prospectively collected data from a high-volume tertiary-care center. We tested strength of association between NIHSS scores at baseline and 24 h with discharge NIHSS using Spearman correlation, and diagnostic accuracy of NIHSS scores in predicting favorable outcome at three months (defined as modified Rankin Scale 0–2) using receiver operating characteristic curve analysis with area under the curve. Results There were 1183 patients in our cohort, with median baseline NIHSS 8 (IQR 3–17), 24-h NIHSS 4 (IQR 1–11), and discharge NIHSS 2 (IQR 1–8). Correlation with discharge NIHSS was r = 0.60 for baseline NIHSS and r = 0.88 for 24-h NIHSS. Of all patients with follow-up data, 425/1037 (41%) had favorable functional outcome at three months. Receiver operating characteristic curve analysis for predicting favorable outcome showed area under the curve 0.698 (95% CI 0.664–0.732) for baseline NIHSS, 0.800 (95% CI 0.772–0.827) for 24-h NIHSS, and 0.819 (95% CI 0.793–0.845) for discharge NIHSS; 24 h and discharge NIHSS maintained robust predictive accuracy for patients receiving mechanical thrombectomy (AUC 0.846, 95% CI 0.798–0.895; AUC 0.873, 95% CI 0.832–0.914, respectively), while accuracy for baseline NIHSS decreased (AUC 0.635, 95% CI 0.566–0.704). Conclusion Baseline NIHSS scores are inferior to 24 h and discharge scores in predicting post-stroke functional outcomes, especially in patients receiving mechanical thrombectomy.

A simple method to estimate the time-dependent receiver operating characteristic curve and the area under the curve with right censored data

2016 ◽  
Vol 27 (8) ◽  
pp. 2264-2278 ◽  
Author(s):  
Liang Li ◽  
Tom Greene ◽  
Bo Hu
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Disease Onset ◽  
Area Under The Curve ◽  
Time Dependent ◽  
Operating Characteristic Curve ◽  
Receiver Operating

The time-dependent receiver operating characteristic curve is often used to study the diagnostic accuracy of a single continuous biomarker, measured at baseline, on the onset of a disease condition when the disease onset may occur at different times during the follow-up and hence may be right censored. Due to right censoring, the true disease onset status prior to the pre-specified time horizon may be unknown for some patients, which causes difficulty in calculating the time-dependent sensitivity and specificity. We propose to estimate the time-dependent sensitivity and specificity by weighting the censored data by the conditional probability of disease onset prior to the time horizon given the biomarker, the observed time to event, and the censoring indicator, with the weights calculated nonparametrically through a kernel regression on time to event. With this nonparametric weighting adjustment, we derive a novel, closed-form formula to calculate the area under the time-dependent receiver operating characteristic curve. We demonstrate through numerical study and theoretical arguments that the proposed method is insensitive to misspecification of the kernel bandwidth, produces unbiased and efficient estimators of time-dependent sensitivity and specificity, the area under the curve, and other estimands from the receiver operating characteristic curve, and outperforms several other published methods currently implemented in R packages.

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