scholarly journals Correlating Pap Smear Results and Colposcopy-Directed Large Loop Excision of the Transformation Zone Histopathology in HIV-Infected and HIV-Uninfected Women: A Case-Control Study in South Africa

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Louis-J. van Bogaert
Keyword(s):  
Pap Smear ◽  
False Negative ◽  
Screening Methods ◽  
Cytological Diagnosis ◽  
Predictive Values ◽  
Transformation Zone ◽  
Large Loop ◽  
Cytological Abnormality ◽  
Sensitivity Specificity ◽  
Minimal Abnormality

Background. In low-resource settings (LRS) with high HIV/AIDS and cervical cancer rates, new screening strategies face many logistic hurdles. Since cytology is there to stay, at least in the median-term future, it is important to assess to what extent HIV-HPV coinfection impacts the accuracy of screening methods and strategies. Methods. We audited the correlation between cytological diagnosis of minimal abnormality (CIN1), CIN2+, or cancer and the histological diagnosis of colposcopy-directed large loop excision of the transformation zone of 399 HIV-uninfected controls and 389 HIV-infected cases. Results. The average age at diagnosis of CIN2+ of the cases was 4.2 years younger than controls (). The endpoint used to assess the accuracy of cytology was minimal cytological abnormality (≤CIN1/LGSIL). The sensitivity, specificity, and negative and positive predictive values were 92.7, 18.5, 45.1, and 77.9%, respectively. The overall ratio of discordance/concordance between cytology and histology was similar in both groups. Conclusion. In LRS, where rapid-HPV testing is not yet part of screening algorithms, a cytological diagnosis of minimal abnormality requires visual inspection and treatment of visualized lesions especially in HIV-infected women aged 30 years. The cytological endpoint of accuracy should be set low to avoid false negative smears.

scholarly journals A comparison of cervical cancer screening methods: pap smear, liquid based cytology and VIA VILI

2019 ◽  
Vol 8 (5) ◽  
pp. 1738
Author(s):  
Abinaya Maathuri Jeyakumar ◽  
Swarnalatha Mohanapu
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Pap Smear ◽  
Geographical Area ◽  
Screening Methods ◽  
Lower Sensitivity ◽  
Predictive Values ◽  
Advantages And Disadvantages ◽  
Liquid Based Cytology ◽  
Sensitivity Specificity

Background: There are multiple screening methods available for screening cervical cancer with their advantages and disadvantages, researches that compare the sensitivity, specificity, positive and negative predictive values of these tests in a low-cost setting specific to a geographical area is lacking and has to be enhanced. The objective of this study was to determine and compare the agreement, sensitivity, specificity and predictive values of conventional Pap smear cytology, liquid-based cytology and VIA/VILI with cervix biopsy.Methods: This cross sectional study was conducted on women of >35 years of age. Pap smear specimen was collected followed by Liquid Base Cytology (LBC) using cytobrush specimen after which visual inspection with 5% acetic acid (VIA) and visual inspection with Lugol’s Iodine (VILI) procedure was carried out and followed by cervix biopsy. All methods were analyzed for accuracy.Results: Sensitivity was lowest for PAP smear (39.1%, 95% CI 19.18% to 59.1%), followed by VIA VILI (95.7%, 95% CI 87.32% to 100%), and highest for LBC (100.0%). The negative predictive value was lowest for PAP smear (87.4%, 95% CI 81.21% to 93.6%), followed by VIA VILI (99.0%, 95% CI 96.99% to 100.0%) and highest for LBC (100%). The overall diagnostic accuracy was lowest for PAP smear (88.3%) followed by VIA/VILLI (99.2%) and highest for LBC (100%).Conclusions: Treatment decisions based on findings of the PAP smear have to be taken with caution, considering the lower sensitivity. Wherever resources are available more accurate screening methods like liquid-based cytology must be used.

Effectiveness of the Pattern-Based Approach in the Cytodiagnosis of Salivary Gland Lesions

2016 ◽  
Vol 60 (2) ◽  
pp. 107-117 ◽  
Author(s):  
K. Amita ◽  
S. Vijay Shankar ◽  
M. Sanjay ◽  
B.M. Sarvesh
Keyword(s):  
Salivary Gland ◽  
False Negative ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Cytological Diagnosis ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Prior Informed Consent ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Objective: The aim of this study is to investigate, primarily, the effectiveness of the application of pattern-based analysis in the diagnosis of salivary gland (SG) lesions. Secondarily, an attempt was made to study the cytomorphology of the various lesions in detail and discuss the pitfalls and solutions involved in the challenging conditions at cytology. Materials and Methods: This was a prospective, cross-sectional study. All SG lesions over 2 years were subjected to fine-needle aspiration cytology with patients' prior informed consent. The lesions were classified based on the predominant pattern, and a provisional diagnosis was made. The secondary pattern and other features, such as background, were then taken note of, and a combined cytological diagnosis was rendered. The entire spectrum of lesions was divided into 6 morphological categories. Results: We had a total of 72 SG lesions. The most commonly affected gland was the parotid gland in 79.16% (57/72) of the cases. Surgery was performed in 26 cases (36.11%). A concordant diagnosis was obtained in 22 cases. The sensitivity, specificity and diagnostic accuracy by the pattern-based approach was 75, 100 and 88.46%, respectively. There were no false-positive cases, but 2 false-negative cases were recorded. Conclusion: The precise cytological preoperative diagnosis of SG lesions is important for the management of patients. The pattern-based approach can be used routinely in the cytological diagnosis of SG lesions.

scholarly journals THE ROLE OF ULTRASONOGRAPHY IN THE DETECTION OF UROLITHIASIS IN PATIENTS WITH ACUTE RENAL COLIC

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sanjay Narayangiri Gosavi ◽  
Virendra K Meena ◽  
Ayush Tambi
Keyword(s):  
Ct Scan ◽  
Renal Colic ◽  
False Negative ◽  
Helical Ct ◽  
Urinary Stones ◽  
Predictive Values ◽  
Acute Renal Colic ◽  
Mean Size ◽  
Acute Flank Pain ◽  
Sensitivity Specificity

This study was conducted to assess the diagnostic Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who undergo unenhanced urinary tract CT scan and ultrasonography for thought of urolithiasis. Both techniques were used to resolve the presence or absence, site, size, and number of urinary stones, as well as company of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were deliberate considering unenhanced CT scan as a gold normal. Unpaired two-tailed student’s t-test was used for judgment between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 ± 3.3 mm, 6 ± 1.8 mm and 4.18 ± 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and correctness of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is uncertain. Keywords: Ultrasonography, CT scan

scholarly journals An assessment of chromosomal alterations detected by fluorescence in situ hybridisation in pancreatobiliary tract malignancy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaohong Pu ◽  
Hongwei Zheng ◽  
Xin Yang ◽  
Qing Ye ◽  
Zhiwen Fan ◽  
...  
Keyword(s):  
Predictive Value ◽  
In Situ Hybridisation ◽  
False Negative ◽  
Chinese Patients ◽  
Fluorescence In Situ Hybridisation ◽  
Predictive Values ◽  
Formalin Fixed Paraffin Embedded ◽  
9P21 Locus ◽  
Sensitivity Specificity

Abstract Background Using fluorescence in situ hybridisation (FISH) to detect any gain of chromosomes 3, 7, or 17 and loss of the 9p21 locus has been proven to be sensitive in the diagnosis of pancreatobiliary tumors. However, both genetic and environmental factors contribute to the pathogenesis of pancreatobiliary tumors. Therefore, it is unknown whether this method is suitable for Chinese patients with pancreatobiliary tumors. This study aims to compare the sensitivity, specificity, predictive values and accuracy of cytology, ERCP/MRCP and FISH based on Chinese patients with pancreatobiliary tumors,and to analyze differences between brushing-based and formalin-fixed paraffin-embedded (FFPE)-based FISH. Methods A total of 66 brush cytology specimens obtained during ERCP were detected by FISH and cytology test respectively to compare the sensitivity, specificity, predictive values and accuracy. Besides, FFPE-based FISH was performed on 46 corresponding paraffin sections of pancreatobiliary tumors obtained by surgical resection. Results Our findings demonstrate that FISH greatly improves diagnostic sensitivity and negative predictive value compared to ERCP/MRCP and cytology without much reduction in specificity and positive predictive value. However, our results also indicate that FFPE-based FISH could not effectively identify the false-negative of brushing-based FISH. Conclusions We believe that FISH can effectively distinguish true positive and false positive results of cytological or radiological suspicions of malignancy. However, FFPE-based FISH still does not precisely recognize the false-negative of brushing-based FISH. Both cytology-based and PPFE-based FISH had limitation in some specimens.

The role of ultrasonography in the diagnosis of talocalcaneal coalitions

2020 ◽  
pp. 028418512094491
Author(s):  
Tiezheng Wang ◽  
Hengtao Qi ◽  
Kai Rong ◽  
Shuqian Zhang ◽  
Shougang Bao ◽  
...  
Keyword(s):  
False Negative ◽  
Fibrous Tissue ◽  
Joint Space ◽  
Clinical Suspicion ◽  
Youden Index ◽  
Imaging Method ◽  
Predictive Values ◽  
Negative Results ◽  
Reduced Space ◽  
Sensitivity Specificity

Background Patients with talocalcaneal coalitions (TCC) often undergo computed tomography (CT). However, ultrasonography diagnosis of TCC has been seldom done according to the literature. Purpose To investigate the accuracy of ultrasonography in diagnosing TCC compared to CT. Material and Methods Ninety-seven consecutive patients with a clinical suspicion of TCC were included. Ultrasonography was used to assess the classification and complication of TCC. The main sonographic criteria for a positive diagnosis in cases of osseous coalition were the joint space between the medial surface of talar head and the underlying sustentaculum tali of calcaneus disappearing and being replaced by a continuous hyperechoic bony structure. In cases of fibrous coalition, ultrasonography revealed a reduced space of the joint associated with an irregular, angular appearance of its outline and hypoechoic fibrous tissue inside. These data were compared with CT findings. κ statistic was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed. Results Ultrasonography findings were positive in 20 of 97 patients with a clinical suspicion of TCC. The diagnosis was confirmed by CT in 21 patients. There were one false-positive result and two false-negative results by ultrasonography. The κ value was 0.907. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 90.5%, 98.7%, 95.0%, 97.4%, 96.9%, and 0.892, respectively. Conclusion Ultrasonography could be a reliable, accurate, and non-radioactive diagnostic imaging method in diagnosis of patients with suspected TCC.

scholarly journals Comparison of Five Methods for the Determination of Rubella Immunity

1994 ◽  
Vol 1 (4) ◽  
pp. 188-192
Author(s):  
Robert L. Sautter ◽  
Arthur E. Crist ◽  
Lynn M. Johnson ◽  
William D. LeBar
Keyword(s):  
Medical Center ◽  
False Negative ◽  
Latex Agglutination ◽  
Walk Away ◽  
Becton Dickinson ◽  
Predictive Values ◽  
Research Triangle ◽  
System A ◽  
Sensitivity Specificity

Objective:The purpose of this study was to compare the accuracy of commonly used methods for the detection of rubella immunity, especially the fully automated IMx assay.Methods:A total of 190 sera (101 immune and 89 non-immune) submitted to Harrisburg Hospital or Polyclinic Medical Center for the determination of rubella immunity were tested by enzyme immunoassay (IMx and Rubazyme, Abbott Diagnostic Laboratories, North Chicago, IL), indirect immunofluorescence (FIAX, Whittaker Bioproducts, Walkersville, MD), and latex agglutination (Rubascan, Becton Dickinson Microbiology Systems, Cockeysville, MD, and Rubalex, Wellcome Diagnostics, Research Triangle Park, NC). Specimens were frozen at –30℃ until the study was initiated. Each of the assays was performed according to the manufacturers' specifications. Sensitivity, specificity, accuracy, and positive and negative predictive values for each assay were calculated using a consensus result of the 5 methods tested.Results:The sensitivity, specificity, and accuracy, respectively, of the test systems were as follows: IMx, 96%, 97%, and 96%; Rubazyme, 100%, 99%, and 99%; Rubascan, 100%, 98%, and 99%; Rubalex, 99%, 97%, and 98%; and FIAX 90%, 100%, and 95%. False negative reactions were seen with the FIAX system.Conclusions:The IMx system, a new “walk away” system from Abbott Diagnostic Laboratories and the Rubazyme systems performed well; however the latex agglutination tests proved to be the most rapid and convenient methods for screening sera for the presence of rubella immunity.

Evaluation of the EYTEX® System as a Screening Method for the Ocular Irritancy of Chemical Products

1994 ◽  
Vol 22 (1) ◽  
pp. 32-50
Author(s):  
Jean-François Régnier ◽  
Christophe Imbert ◽  
Jean-Charles Boutonnet
Keyword(s):  
False Negative ◽  
Screening Method ◽  
In Vitro Test ◽  
Predictive Values ◽  
Ocular Irritation ◽  
Wide Range ◽  
Dangerous Substances ◽  
Sensitivity Specificity ◽  
Interlaboratory Reproducibility

The EYTEX® method is an in vitro test used to predict ocular irritation, based on alterations in a protein matrix. We have evaluated this method with the aim of using it to screen chemicals. One hundred and forty-two products (commodities and specialities), having a wide range of chemical properties and ocular irritation potential in the rabbit, were tested with either the standard, MPA, AMA, KMA or UMA protocols. The results were compared with in vivo data obtained previously for each chemical and with the EEC labelling of eye irritation for dangerous substances. Intralaboratory repeatability and interlaboratory reproducibility were evaluated with seven other laboratories. Ninety-three per cent of the chemicals tested were qualified with the EYTEX method. The coefficients of the linear correlation between the EYTEX score and the maximal Draize score on the one hand and the maximal corneal score on the other hand, were 0.69 and 0.65, respectively. Compared to the EEC classification, the labelling of dangerous substances and for the prediction of severe irritants, sensitivity, specificity and equivalence were 94%, 89% and 78%, respectively. We observed nine false positives (22%) and two false negatives (2%) for the identification of R41-, R34- and R35-labelled products. The predictive values, for identifying R41, R34 and R35 products and non-irritants or R36 products were 78% and 97%, respectively. Repeatability (6.3) and reproducibility (8.9) were quite satisfactory. The EYTEX system exhibits the characteristics of a good screening method: compatibility with a large range of chemicals; a simple and rapid procedure; good intralaboratory and interlaboratory reproducibility; cost effectiveness; high sensitivity, specificity and predictive value; and a low incidence of false negative and false positive results. Based on these results, we consider the EYTEX method to be a valuable tool for the screening of eye irritancy.

scholarly journals Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 197
Author(s):  
Hannes Seuss ◽  
Matthias Hammon ◽  
Frank Roemer ◽  
Rafael Heiss ◽  
Rolf Janka ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
False Negative ◽  
Ankle Sprains ◽  
Tibiofibular Syndesmosis ◽  
Mr Images ◽  
Predictive Values ◽  
Tibiofibular Ligament ◽  
Ligament Rupture ◽  
Sensitivity Specificity ◽  
Oblique Images

To evaluate the diagnostic performance and reader agreement of a novel MRI image fusion method enabling the reconstruction of oblique images for the assessment of the tibiofibular syndesmosis. We evaluated 40 magnetic resonance imaging examinations of patients with ankle sprains (16 with ruptures and 24 without) for the presence of anteroinferior tibiofibular ligament rupture. For all patients, we performed a fusion of standard two-dimensional transversal and coronal 3 mm PDw TSE images into an oblique-fusion reconstruction (OFR) and compared these against conventionally scanned oblique sequence for the evaluation of the tibiofibular syndesmosis. To evaluate diagnostic performance, two expert readers independently read the OFR images twice. We analyzed sensitivity, specificity, negative and positive predictive values, accuracy, and agreement. Reader 1 misinterpreted one OFR as a false negative, demonstrating a sensitivity of 0.94 and specificity of 1.00, reader 2 demonstrated perfect accuracy. Intrareader agreement was almost perfect for reader 1 (α = 0.95) and was perfect for reader 2 (α = 1.00). Additionally, interreader agreement between all fusion sequence reads was almost perfect (α = 0.97). The proposed OFR enables reliable detection of anteroinferior tibiofibular ligament rupture with excellent inter- and intrareader agreement, making conventional scanning of oblique images redundant and supplies a method to retroactively create oblique images, e.g., from external examinations.

scholarly journals On the importance of early testing even when imperfect in a pandemic such as COVID-19

2020 ◽  
Author(s):  
Neal D. Goldstein ◽  
Igor Burstyn
Keyword(s):  
False Negative ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Predictive Values ◽  
Clinical Observations ◽  
The Face ◽  
The Usa ◽  
Early Testing ◽  
The Difference ◽  
Sensitivity Specificity

Diagnosis of COVID-19 may be based on clinical observations, laboratory findings, and epidemiological linkage.1 Underscoring this diagnosis is accurate data from laboratory tests: this can make the difference between a false positive based on the clinical findings that are attributable to another cause, or a false negative based on lack of clinical findings that are attributable to SARS-CoV-2 viral infection, the causal agent for COVID-19. We conducted a simulation depicting how predictive values vary in the face of unknown data surrounding test sensitivity, specificity, and reported cases. in the USA. There are two main implications of our findings. First, the prevalence of COVID-19 in the tested population is likely inflated: clinical disease attributable to other sources of infection such as influenza, or other respiratory viruses, is a plausible explanation. Second, we should be less alarmed by not being able to trace chain of transmission for many who test positive early in this pandemic when population prevalence is low.

scholarly journals Comparison of Auramine Phenol and ZN Staining in Diagnosis of Pulmonary Tuberculosis with GeneXpert MTB/RIF as Gold Standard

2020 ◽  
Vol 9 (3) ◽  
pp. 190-194
Author(s):  
Naureen Saeed ◽  
Fatima-tuz-zuhra ◽  
Nadeem Ikram ◽  
Farhana Shaukat ◽  
Fareeha Sardar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Sputum Sample ◽  
False Negative ◽  
Smear Microscopy ◽  
Predictive Values ◽  
Pulmonary Tb ◽  
Sensitivity Specificity

Background: Pakistan faces an immense burden of pulmonary tuberculosis (TB) due to large number of cases and limited resources. Despite the recent advancement in the diagnostic techniques for pulmonary TB, smear microscopy is still a useful technique for the diagnosis of this disease. This study was conducted in order to compare the diagnostic value of Auramine stain with the conventional Ziehl-Neelsen (ZN) stain on the sputum smear for the diagnosis of pulmonary TB, keeping GeneXpert MTB/RIF as the gold standard. Method: This cross-sectional study was conducted on 356 suspected patients of pulmonary TB referred to the Pathology laboratory from TB ward and OPD of District Head Quarter (DHQ) teaching hospital Rawalpindi, Pakistan. Sputum specimen were collected and two smears were prepared from each sputum sample on which Auramine phenol and Ziehl-Neelsen staining were carried out as per WHO recommendations. All these samples were further tested using Gene Xpert MTB/RIF technique. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive values (NPV) of ZN and Auramine stain were calculated and compared with GeneXpert MTB/RIF technique. Results: Out of the total 356 samples, 64(18%) were positive and 291(82%) were negative by GeneXpert which was taken as the gold standard. On comparison with GeneXpert, percentage of true positive was greater in case of Auramine than ZN stained samples (16.29% versus 12.92%), while the percentage of false positive was same for both staining techniques (0.28%). There were lesser false negative cases observed in samples stained by Auramine as compared to the ones stained by ZN (1.68% versus 5.05%). The sensitivity, specificity, positive predictive value and negative predictive values were 97.87%, 94.17%, 71.88 and 99.66%, respectively for the ZN staining and 98.31%, 97.98%, 90.63% and 99.66% respectively, for the Auramine phenol staining. Conclusion: Smear microscopy using Auramine phenol stain is a useful technique for the diagnosis of pulmonary TB. The Auramine phenol staining with fluorescent microscopy is found to be superior to ZN staining because of higher sensitivity and specificity. Keywords: Auramine phenol, Fluorescence microscopy, GeneXpert, Mycobacterium tuberculosis, Ziehl-Neelsen

Sign in / Sign up

Export Citation Format

Share Document