What is the risk of mortality for people who are screen positive in a diabetes screening programme but who do not have diabetes on biochemical testing? Diabetes screening programmes from a public health perspective

2002 ◽  
Vol 9 (4) ◽  
pp. 187-190 ◽  
Author(s):  
A. Spijkerman ◽  
S. Griffin ◽  
J. Dekker ◽  
G. Nijpels ◽  
N.J. Wareham
Keyword(s):  
Public Health ◽  
High Risk ◽  
Mortality Risk ◽  
False Positive ◽  
True Positive ◽  
Negative Group ◽  
Diabetes Screening ◽  
True Negative ◽  
Risk Of Mortality ◽  
Biochemical Testing

OBJECTIVES: To assess mortality risk in people classified by the Cambridge risk score (CRS), a previously validated simple screening tool for undiagnosed type 2 diabetes that uses only information routinely available in primary care. SETTING: Random sample of the general population between 50 and 75 years of age in Hoorn, The Netherlands METHODS: The results of the CRS were compared with the gold standard for diabetes, the oral glucose tolerance test (OGTT) results classified according to the World Health Organisation (WHO) 1999 diagnostic criteria. Cox’s proportional hazards regression was used to assess the risk of mortality of screen positive and screen negative people. RESULTS: 154 people out of the total population of 2297 had previously undiagnosed diabetes and 113 (73%) of these would have been detected with the CRS (true positive). However, the CRS identified a much larger group (n=1037) who were positive for the score, but who did not have diabetes on biochemical testing (false positive). Unadjusted risk of mortality was highest in the true positive group (3.40 95% confidence interval (95% CI, 2.15 to 5.38)), intermediate in false positive people (2.62 (2.00 to 3.43)), and lowest in false negative people (1.50 (0.55 to 4.09)) with the true negative group as reference. Adjustment for age and sex resulted in similar risk estimates for all three groups, but mortality risk was significantly increased only in false positive and true positive groups compared with the true negative group. CONCLUSIONS: People who have a positive risk score are at high risk of mortality whether or not subsequent testing shows them to have diabetes. Direct public health interventions in this high risk population may be appropriate.

scholarly journals Multiple Compounds Recognition from The Tandem Mass Spectral Data Using Convolutional Neural Network

Molecules ◽  
2019 ◽  
Vol 24 (24) ◽  
pp. 4590
Author(s):  
Jiali Lv ◽  
Jian Wei ◽  
Zhenyu Wang ◽  
Jin Cao
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Spectral Data ◽  
Test Data ◽  
False Positive ◽  
Tandem Mass ◽  
True Positive ◽  
Mass Spectral Data ◽  
True Negative ◽  
Mass Spectral

Mixtures analysis can provide more information than individual components. It is important to detect the different compounds in the real complex samples. However, mixtures are often disturbed by impurities and noise to influence the accuracy. Purification and denoising will cost a lot of algorithm time. In this paper, we propose a model based on convolutional neural network (CNN) which can analyze the chemical peak information in the tandem mass spectrometry (MS/MS) data. Compared with traditional analyzing methods, CNN can reduce steps in data preprocessing. This model can extract features of different compounds and classify multi-label mass spectral data. When dealing with MS data of mixtures based on the Human Metabolome Database (HMDB), the accuracy can reach at 98%. In 600 MS test data, 451 MS data were fully detected (true positive), 142 MS data were partially found (false positive), and 7 MS data were falsely predicted (true negative). In comparison, the number of true positive test data for support vector machine (SVM) with principal component analysis (PCA), deep neural network (DNN), long short-term memory (LSTM), and XGBoost respectively are 282, 293, 270, and 402; the number of false positive test data for four models are 318, 284, 198, and 168; the number of true negative test data for four models are 0, 23, 7, 132, and 30. Compared with the model proposed in other literature, the accuracy and model performance of CNN improved considerably by separating the different compounds independent MS/MS data through three-channel architecture input. By inputting MS data from different instruments, adding more offset MS data will make CNN models have stronger universality in the future.

Parotid Tumors: Fine-Needle Aspiration and/or Frozen Section

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P42-P43
Author(s):  
Peter Zbaren ◽  
Heinz Loosli ◽  
Edouard Stauffer
Keyword(s):  
Sensitivity And Specificity ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Frozen Section ◽  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
True Negative ◽  
Fine Needle ◽  
Parotid Neoplasms

Objective Assess the difficulties of preoperative and intraoperative tumor typing of parotid neoplasms. Know the advantages and pitfalls of fine-needle-aspiration cytology (FNAC) and frozen section (FS) analysis in primary parotid neoplasms. Methods In 113 parotid neoplasms (70 malignancies and 43 benign tumors) preoperative FNAC as well as intraoperative FS analysis were performed. FNAC and FS findings were analyzed and compared with the final histopathologic diagnosis. Results The FNAC smear was non-diagnostic in 6 tumors. In 2 FS specimens, it was not possible to determine the tumor dignity. FNAC findings and FS findings were both available in 105 neoplasMS The FNAC findings were true positive for malignancy in 54, true negative in 36, false positive in 4, and false negative in 11 tumors. The accuracy, sensitivity, and specificity were 86%, 83%, and 90% respectively. The FS findings were true positive in 60, true negative in 38, false positive in 2, and false negative in 5 tumors. The accuracy, sensitivity, and specificity were 93%, 92% and 95% respectively. The exact histologic tumor typing by FNAC was correct, false or not mentioned in 58%, 20% and 22% true positive or true negative evaluated tumors, and by FS in 83%, 5% and 12% true positive or true negative evaluated tumors. Conclusions The current analysis showed a superiority of FS compared with FNAC regarding the diagnosis of malignancy and especially of tumor typing. FNAC alone is not prone in many cases to determine the surgical management of primary parotid carcinomas.

scholarly journals SPK Penentuan Lokasi ATM Menggunakan Metode AHP dan SAW

2019 ◽  
Vol 5 (1) ◽  
pp. 49-56
Author(s):  
Gede Surya Mahendra ◽  
Kadek Yota Ernanda Aryanto
Keyword(s):  
False Positive ◽  
Confusion Matrix ◽  
False Negative ◽  
True Positive ◽  
True Negative

Persaingan industri perbankan saat ini semakin meningkat, baik dalam hal penyediaan inovasi produk serta peningkatan kualitas transaksi dan pelayanan. Untuk mengatasi masalah tersebut diciptakan sebuah terminal yang dikenal dengan ATM. Namun fungsionalitas dan efektifitas ATM tersebut belum memenuhi kebutuhan nasabah dikarenakan pengambilan keputusan penentuan lokasi ATM belum menggunakan SPK sehingga banyak kriteria yang terlupakan dalam penentuan lokasi ATM terbaik. Metode AHP yang merupakan sebuah hierarki fungsional dengan input utamanya adalah persepsi manusia sedangkan metode SAW dengan konsep dasar mencari penjumlahan terbobot dari rating kinerja pada setiap alternatif pada semua atribut. AHP digunakan untuk memberikan pembobotan pada masing-masing kriteria dan SAW untuk melakukan perangkingan dari masing-masing alternatif. Terdapat 7 kriteria dengan 11 sub kriteria pada pembobotan dan 76 data alternatif. Pengujian dilakukan dengan membandingkan hasil delpoyment ATM dengan hasil perhitungan sistem. Dari 76 data alternatif yang diujikan, terdapat 38 lokasi deployment ATM. Dari hasil pengujian yang ditampilkan dalam confusion matrix, pada kriteria yang tidak teruji signifikansi didapatkan 33 data True Positive, 38 True Negative, 5 False Negative dan 5 False Positive dengan akurasi sebesar 86,84%, dan pada kriteria yang teruji signifikansi didapatkan 35 data True Positive, 35 True Negative, 3 False Negative dan 3 False Positive memiliki akurasi 92,11%.

scholarly journals Otkrivanje infekcija u abdomenu primenom radioobelezenog antibiotika

2003 ◽  
Vol 50 (2) ◽  
pp. 25-29 ◽  
Author(s):  
Vera Artiko ◽  
Branka Davidovic ◽  
Nadezda Nikolic ◽  
Milorad Petrovic ◽  
Nebojsa Petrovic ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
False Positive ◽  
Bacterial Infections ◽  
Conservative Therapy ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Exact Localization

The aim of the study is detection of the abdominal infective foci using 99mTc-ciprofloxacin, radiopharmaceutical supposed to distuinguish inflammation from infection. Twenty one patient was investigated. There were 11 true positive findings, 7 true negative, two were false negative, while 1 was false positive. Sensitivity of the method was 79% and specificity 91%. According to our results, scintigraphy with infecton is a useful method for detection and assessment of exact localization of deep seated bacterial infections, which might be useful for (differential) diagnosis, surgical treatment in due time as well as monitoring of the treatment of conservative therapy.

scholarly journals Outcomes of pregnancies with trisomy 16 mosaicism detected by NIPT: a series of case reports

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Haishan Peng ◽  
Jiexia Yang ◽  
Dongmei Wang ◽  
Fangfang Guo ◽  
Yaping Hou ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
High Risk ◽  
False Positive ◽  
Case Reports ◽  
Screening Method ◽  
Prenatal Testing ◽  
Chromosomal Microarray ◽  
Chromosomal Microarray Analysis ◽  
True Positive ◽  
Trisomy 16

Abstract Background Trisomy 16 (T16) is thought to be the most frequent chromosome abnormality at conception, which is often associated with a high risk of abnormal outcomes. Methods A retrospective analysis of 14 cases with high risk of T16 by noninvasive prenatal testing (NIPT) was conducted. All cases in the analysis involved prenatal diagnosis, karyotyping and chromosomal microarray analysis. Case reports NIPT detected 12 cases of T16 and 2 cases of T16 mosaicism. Prenatal diagnosis confirmed 5 true positive cases and 9 false positive cases. Among the 5 true positive cases, 3 cases had ultrasound abnormalities. All of the 9 false positive cases continued their pregnancies. The newborns who were from these 9 false positive cases except 1 case (case 7) had low birth weights (< 2.5 kg) and there were also 2 premature deliveries. Conclusion NIPT serves as a fast and early prenatal screening method, giving clues to chromosome abnormalities and providing guidance for managing pregnancy. Confined placental mosaicism in 16 pregnancies may be at higher risk for preterm delivery.

scholarly journals Preferred screening test for Cushing’s syndrome screening

2020 ◽  
Vol 4 (1) ◽  
pp. 01-05
Author(s):  
Ahmed Siddiqi
Keyword(s):  
False Positive ◽  
Screening Test ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Inhaled Steroids ◽  
Free Cortisol ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Hospital General

Background: In our practice 24 hours urine collection for free cortisol (24Hr UFC) and overnight dexamethasone suppression test (ONDST) are initial investigations to screen patients for hyper-cortisolism. I audited our practice to find our clinicians’ and patients’ choice of first screening investigation for hyper-cortisolism. Method & material: Electronic and paper medical records of patients who underwent 24Hr UFC and/or ONDST at our hospital over previous consecutive twenty four months were examined. 62 such patients were identified but 12 patients were excluded from analysis. We tried to contact 30 patients over consecutive 48 hours over the phone who underwent both 24Hr UFC and ONDST. We managed to contact 18 patients and asked them two study questions. Data & results: 33 (66%) patients were female and 17 (33%) were male. 20 (40%) had 24Hr UFC alone and 30 (60%) patients had both. In total 80 such investigations completed 30 being ONDST and 50 24hr UFC. 53 (66%) of the investigations were requested by Endocrinologists, 21 (26%) by Hospital General Physicians and 6 (8%) by General practitioners (GP). For UFC 10 (20%) were true positive, 31 (62%) were false positive, 6 (12%) were true negative and 0% false negative. 3 (6%) 24Hr UFC samples were not collected properly and were not processed for results. Out of the total false positives (31 patients), 6 (19.3%) cases were of alcohol excess, 4 (13%) of dépression, 3 (9.7%) of inhaled steroids and 1 (3.2%) of sleep apnea. For the ONDST 7 (23.3%) true positive, 4 (13.3%) false positive 19 (63.4%) true negative and 0% false negative. All 18 patients contacted over the phone answered both questions. 16 preferred ONDST over 24Hr UFC, 1 patient had no preference and 1 patient preferred 24Hr UFC over ONDST. Conclusion: Patients overwhelmingly preferred ONDST as first screening test in contrast to physician’s choice of 24Hr UFC.

scholarly journals Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Liwei Ni ◽  
Yuming Long ◽  
Xuya Yuan ◽  
Jianhao Xu ◽  
Jialong Tao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
High Risk ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Site Specific ◽  
Risk Of Mortality ◽  
Male Patients

Abstract Background: Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence. Method: We performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs). Results: Seven studies consisting of a total of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected. Conclusions: Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer and a high risk of mortality from prostate cancer.

scholarly journals Efficacy of Transcranial Motor Evoked Potential Monitoring During Intra- and Extramedullary Spinal Cord Tumor Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research

2021 ◽  
pp. 219256822110114
Author(s):  
Hiroki Ushirozako ◽  
Go Yoshida ◽  
Shiro Imagama ◽  
Kazuyoshi Kobayashi ◽  
Kei Ando ◽  
...  
Keyword(s):  
Spinal Cord ◽  
False Positive ◽  
Evoked Potential ◽  
Spinal Cord Tumor ◽  
False Negative ◽  
Motor Evoked Potential ◽  
True Positive ◽  
True Negative ◽  
Intramedullary Spinal Cord ◽  
Transcranial Motor Evoked Potential

Study Design: Multicenter prospective study. Objectives: Although intramedullary spinal cord tumor (IMSCT) and extramedullary SCT (EMSCT) surgeries carry high risk of intraoperative motor deficits (MDs), the benefits of transcranial motor evoked potential (TcMEP) monitoring are well-accepted; however, comparisons have not yet been conducted. This study aimed to clarify the efficacy of TcMEP monitoring during IMSCT and EMSCT resection surgeries. Methods: We prospectively reviewed TcMEP monitoring data of 81 consecutive IMSCT and 347 EMSCT patients. We compared the efficacy of interventions based on TcMEP alerts in the IMSCT and EMSCT groups. We defined our alert point as a TcMEP amplitude reduction of ≥70% from baseline. Results: In the IMSCT group, TcMEP monitoring revealed 20 true-positive (25%), 8 rescue (10%; rescue rate 29%), 10 false-positive, a false-negative, and 41 true-negative patients, resulting in a sensitivity of 95% and a specificity of 80%. In the EMSCT group, TcMEP monitoring revealed 20 true-positive (6%), 24 rescue (7%; rescue rate 55%), 29 false-positive, 2 false-negative, and 263 true-negative patients, resulting in a sensitivity of 91% and specificity of 90%. The most common TcMEP alert timing was during tumor resection (96% vs. 91%), and suspension surgeries with or without intravenous steroid administration were performed as intervention techniques. Conclusions: Postoperative MD rates in IMSCT and EMSCT surgeries using TcMEP monitoring were 25% and 6%, and rescue rates were 29% and 55%. We believe that the usage of TcMEP monitoring and appropriate intervention techniques during SCT surgeries might have predicted and prevented the occurrence of intraoperative MDs.

scholarly journals Assessment of Health Monitoring Trustworthiness of Avionics Systems

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Vladimir Ulansky ◽  
Igor Machalin ◽  
Iryna Terentyeva
Keyword(s):  
Health Monitoring ◽  
False Positive ◽  
False Negative ◽  
Measuring Channel ◽  
True Positive ◽  
Very High Frequency ◽  
True Negative ◽  
Automated Test Equipment ◽  
Intermittent Faults ◽  
Reliability Characteristics

The article provides a methodology for assessing the trustworthiness of health monitoring the dismounted avionics systems with automated test equipment (ATE). The indicators include the probabilities of false-positive, false-negative, true-positive, and true-negative. For the first time, we introduced into consideration the instability of the source of stimulus signal (SSS), the random and systematic component of the measuring channel error, and the reliability characteristics of the systems themselves. We consider a specific case of an exponential distribution of permanent failures and intermittent faults and derive formulas for calculating the trustworthiness indicators. Numerical calculations illustrate how the probabilities of correct and incorrect decisions depend on accuracy parameters. We show that the probabilities of false-positive and false-negative increase much faster than the probabilities of true-positive and true-negative decrease when the standard deviation of stimulus signal increases. For a Very High-Frequency Omni-Directional Range (VOR) receiver, we demonstrate that even with a zero random error generated by the source of the stimulus signal, the probabilities of false-positive and false-negative are different from zero.

Clinical significance of prenatal diagnosis of macrosomia by ultrasound

2014 ◽  
Vol 63 (3) ◽  
pp. 12-20
Author(s):  
Irina Yuryevna Bayeva
Keyword(s):  
Birth Weight ◽  
Prenatal Diagnosis ◽  
False Positive ◽  
False Negative ◽  
Fetal Weight ◽  
True Positive ◽  
Perinatal Complications ◽  
True Negative ◽  
Average Accuracy ◽  
Study Population

Оbjective: Establish the diagnostic value of ultrasound examination in prenatal diagnosis of macrosomia among the women without diabetes and to determine its effect on birth outcomes. Мethods: This is a retrospective cohort study done at the Orenburg municipal perinatal center and maternity hospital № 2 since 2006 to 2012. In this study 3760 pregnant women were analyzed who delivered term, singleton, live born infants. The estimated fetal sonographic weight by the formula Hadlock’s was obtained within the last week prior to delivery. The study population was divided into 4 groups (true positive, true negative, false positive, false negative) according to the estimated fetal weight (EFW) and regarding the birth weight (BW). Receiver-operating characteristics (ROC) curves were generated to compare the prediction of macrosomia when using different observation methods. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated. The mean value of two groups were compared using two sample t test and χ² test for comparison of proportions. Results: In order to assess the accuracy of the ultrasound in prenatal diagnosis of macrosomia the study population was divided into 4 groups according to the estimated fetal weight (EFW) and regarding the birth weight (BW): true positive (n-147), false negative (n-229 ), false positive (n-353), true negative (n-3031). Results of the study showed no statistically significant differences between the birth weight and estimated fetal weifht by ultrasound alone only in the macrosomia group with true-positive results (p = 0.9). In applying the ROC (Receiver Operating Characteristic curve) performance analysis sensitivity and spesificity in the prediction of the macrosomia by ultrasound revealed the average predictive power of the method. Area under the curve (Area under ROC curve, AUC) made 0.7295 (95 % CI: 0.695-0.781), which corresponds to a predetermined average accuracy. The accuracy of macrosomia prediction by ultrasound methods was 90 %, sensitivity - 35 %, specificity - 93,5 %. Сesarian sections were performed for 40 % of the pregnant women, where fetal macrosomia was truly ruled in (true positive) and 16% of the women who delivered normal weight infants (true negative). Overestimation of fetal weight (false positive) has led to the 30 % rate of cesarean sections. Underestimation of fetal weight (false negative) has decreased to the 24% rate of cesarean sections but in this case perinatal complications have increased. Conclusion: Results showed an average accuracy in predicting macrosomia by the formula Hadlock’s. The results of the study have proved that the inappropriate prediction macrosomia of fetal weight has influence on the mode of delivery. Overestimation of fetal weight has led the proportion of cesarian sections. Underestimation of fetal macrosomia has increased perinatal complications.

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