scholarly journals Gold Standard Evaluation of an Automatic HAIs Surveillance System

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Beatriz Villamarín-Bello ◽  
Berta Uriel-Latorre ◽  
Florentino Fdez-Riverola ◽  
María Sande-Meijide ◽  
Daniel Glez-Peña
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Infection Type ◽  
University Hospital ◽  
Kappa Index ◽  
Best Value ◽  
Health Event ◽  
High Level ◽  
Hospital Acquired

Hospital-acquired Infections (HAIs) surveillance, defined as the systematic collection of data related to a certain health event, is considered an essential dimension for a prevention HAI program to be effective. In recent years, new automated HAI surveillance methods have emerged with the wide adoption of electronic health records (EHR). Here we present the validation results against the gold standard of HAIs diagnosis of the InNoCBR system deployed in the Ourense University Hospital Complex (Spain). Acting as a totally autonomous system, InNoCBR achieves a HAI sensitivity of 70.83% and a specificity of 97.76%, with a positive predictive value of 77.24%. The kappa index for infection type classification is 0.67. Sensitivity varies depending on infection type, where bloodstream infection attains the best value (93.33%), whereas the respiratory infection could be improved the most (53.33%). Working as a semi-automatic system, InNoCBR reaches a high level of sensitivity (81.73%), specificity (99.47%), and a meritorious positive predictive value (94.33%).

scholarly journals Diagnostic accuracy of frozen section in detecting malignant brain tumors taking histopathology as gold standard.

2020 ◽  
Vol 27 (09) ◽  
pp. 1814-1817
Author(s):  
Saad Akhter Khan ◽  
Badar Uddin Ujjan ◽  
Naveed Zaman Akhunzada ◽  
Saad Bin Anis
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Frozen Section ◽  
Malignant Gliomas ◽  
University Hospital ◽  
Neoplastic Tissue ◽  
Tissue Water

Objectives: To evaluate the diagnostic accuracy of frozen section in detecting malignant gliomas, taking histopathology as gold standard. Study Design: Cross-Sectional study. Setting: Neurosurgery Department, Aga Khan University Hospital, Karachi. Period: From March 2018 to Jan 2019. Material & Methods: Through consecutive sampling technique, total 100 specimens from patients suspected of malignant gliomas on MRI brain with contrast, who were admitted in the neurosurgery department for elective tumor surgery were included. Intraoperatively, the specimen from the lesion identified on imaging through neuro-navigation was taken and sent to histopathology department for frozen section analysis. The histopathology consultant was pre-informed about the case and probable time of receiving the specimen. The specimen for frozen section was sent in a dried container without formalin. Once received in pathology department, the tissue is rapidly cooled through a cryostat which converts tissue water into the ice and makes the tissue rigid for cutting into slices and viewing under the microscope for identifying the neoplastic tissue. The consultant histopathologist was request to provide frozen section report immediately and to keep the remaining specimen for definitive histopathology reporting as well. Data of malignancy on both Frozen Section and formal histopathology report was noted and comparison was done. Results: Mean age of the patients was 36.7±8.76 years. There were 64 (64%) male patients and 36 (36%) female patients. Diagnostic accuracy of frozen section taking histopathology as a gold standard shows that sensitivity was found to be 83.3%, specificity 84.4%, Positive predictive value (PPV) 71.4% and negative predictive value (NPV) 91.5% & Overall diagnosis accuracy was found 96.6%. Conclusion: The Diagnostic accuracy of frozen section (FS) in detection of brain malignant gliomas was found to be satisfactory. It has a diagnostic accuracy of 96.9%, sensitivity 83.3%, specificity 84.4%, Positive predictive value (PPV) 71.4% and negative predictive value (NPV) 91.5%.

scholarly journals 3124 Early Electrographic Seizure Detection by Neuro ICU Nurses via Bedside Real-Time Quantitative EEG

2019 ◽  
Vol 3 (s1) ◽  
pp. 38-38
Author(s):  
Safa Kaleem ◽  
Christa B. Swisher
Keyword(s):  
Positive Predictive Value ◽  
Real Time ◽  
Predictive Value ◽  
Quantitative Eeg ◽  
University Hospital ◽  
Duke University ◽  
Study Population ◽  
Time To Detection ◽  
Sensitivity Specificity ◽  
Improve Patient

OBJECTIVES/SPECIFIC AIMS: 1. Determine positive predictive value, negative predictive value, sensitivity, and specificity of Neuro ICU nurse interpretation of real-time bedside qEEG. 2. Determine difference in time to detection of first seizure between Neuro ICU nurse qEEG interpretation and EEG fellow reads of cEEG. 3. Determine what qualities of seizures make detection by neuro ICU nurses more or less likely – e.g. duration of seizures, type of seizures, spatial extent of seizures. METHODS/STUDY POPULATION: Recruit neuro ICU nurses taking care of 150 patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG monitoring. Nurses will be consented for their participation in the study. Neuro ICU nurses will evaluate the qEE RESULTS/ANTICIPATED RESULTS: From literature estimates of a 20% seizure prevalence in critical care settings, we hope to have 30 patients with seizures and 120 without. Based on prior study in the Duke Neuro ICU, we hypothesize that Neuro ICU nurses will have sensitivity and DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first prospective study of neuro ICU nurse interpretation of real-time bedside qEEG in patients with unknown NCSE/NCS presence. If nurse sensitivity, specificity, and positive predictive value are clinically useful, which we deem would be so at a sensitivity of 70% or greater, with acceptable false alarm rate, nurse readings of qEEG could significantly decrease the time to treatment of seizures in the Neuro ICU patient population, and perhaps could improve patient outcomes.

scholarly journals Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination

2009 ◽  
Vol 25 (5) ◽  
pp. 1017-1024 ◽  
Author(s):  
Carolina Castro Martins ◽  
Loliza Chalub ◽  
Ynara Bosco Lima-Arsati ◽  
Isabela Almeida Pordeus ◽  
Saul Martins Paiva
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Examination ◽  
Predictive Value ◽  
Gold Standard ◽  
Dental Fluorosis ◽  
Digital Camera ◽  
High Specificity ◽  
Photographic Method ◽  
Pediatric Dentists

The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

scholarly journals Correlation of clinical examination, ultrasound, magnetic resonance imaging and arthroscopy as diagnostic tools in shoulder pathology

2020 ◽  
Vol 6 (2) ◽  
pp. 247
Author(s):  
Sondipon Biswas ◽  
Naman Kanodia ◽  
Rajat Tak ◽  
Siddharth Agrawal ◽  
Kiran Shankar Roy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Arthroscopy ◽  
Resonance Imaging ◽  
Shoulder Pathologies

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

Abstract 3426: Approximate Volume Using "XYZ/2" Is Equivalent to Planimetric Volume Mismatch Evaluation

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Marie Luby ◽  
Jennifer Hong ◽  
José G Merino ◽  
John K Lynch ◽  
Amie W Hsia ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Correlation Coefficients ◽  
High Sensitivity ◽  
Evaluation Methods ◽  
Slice Thickness ◽  
Linear Measurements ◽  
Visual Evaluation ◽  
Volume Measurements

Objectives: In the clinical setting, the extent of mismatch on MRI is frequently assessed with an approximate “XYZ/2” method but the agreement with the “gold standard” planimetric volume and the “visual evaluation” methods are not known. In a published study, we established that the visual evaluation and planimetric methods are equivalent as far as mismatch classification. The objectives of this study were to quantify the agreement of the approximate method with the “gold standard” and “visual evaluation” methods and to compare the mismatch classification results. Methods: Patients were selected from the Lesion Evolution of Stroke and Ischemia On Neuroimaging (LESION) database if they: had an acute ischemic stroke, were treated with intravenous rt-PA only, and had a pre-treatment MRI with evaluable maps including trace or isotropic b1000 DWI and MTT images. A trained rater viewed the images on the PACS, placed the two perpendicular linear measurements, “X” and “Y”, on the slices with the largest DWI and MTT lesion areas, and then used a “XYZ/2” formula where “Z” was the product of the slice thickness and the total number of slices containing the lesion. A separate expert rater measured the planimetric volumes on a slice-by-slice basis with a semiautomated segmentation tool followed by manual editing. Expert readers evaluated the MRI scans for the presence of qualitative mismatch. The expert readers were not the trained reader that performed the approximate volume measurements. Quantitative mismatch was considered present if MTT volume - DWI volume ≥50 ml. Mismatch classifications using the ≥ 50 ml definition were compared by constructing contingency tables. Results: A total of 194 patients met the study criteria and had median DWI and MTT planimetric volumes of 13.06 ml and 99.27 ml respectively. For both the DWI (n=170) and MTT (n=164), 94% of the measurements were within two standard deviations of the difference between the planimetric and approximate volume measurements. Comparing the planimetric and approximate volume measurements, the Spearman correlation coefficients were 0.855 and 0.886 for the DWI and MTT measurements respectively (p<0.01). Compared to the planimetric method, the approximate “XYZ/2” method had a high sensitivity (0.91), specificity (0.80), accuracy (0.86) and positive predictive value (0.85) to detect mismatch using the ≥ 50 ml definition. Compared to the qualitative method, the approximate “XYZ/2” method had a sensitivity (0.77), specificity (0.76), accuracy (0.77) and positive predictive value (0.87) to detect mismatch using the ≥ 50 ml definition. Conclusions: The approximate “XYZ/2” method is sufficient for classifying the presence of MRI determined mismatch in acute stroke patients and therefore is a potential tool when using MRI determined mismatch as an inclusion criteria for clinical trials.

scholarly journals Comparison of International Federation of cervical pathology and colposcopy nomenclature (2011) and Swede score for assessment of cervical lesions

2021 ◽  
Author(s):  
Bindiya Gupta ◽  
Rashmi Shreya ◽  
Shalini Rajaram ◽  
Anshuja Singla ◽  
Sandhya Jain ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
International Federation ◽  
Objective Method ◽  
Cervical Lesions ◽  
Sensitivity Specificity ◽  
Strength Of Association

Abstract Purpose: Standardization of colposcopic evaluation is important as it is observer dependent.The aim of the study was to compare the strength of association of colposcopic findings by International Federation of Colposcopy and Cervical Pathology (IFCPC) nomenclature and Swede score. Methods: In the prospective study, 150 women aged 30 to 60 years with abnormal screening results underwent colposcopy, the findings were evaluated using both IFCPC and Swede score and biopsy was taken from abnormal areas. Performances by both the methods were calculated taking biopsy as gold standard. Results: Nineteen ≥ CIN2 lesions were detected. The sensitivity, specificity, positive predictive value and negative predictive value for detecting ≥ CIN2 lesion by IFCPC scoring was 63.6%, 96.0%, 78.7%, 91.9%. Using Swede score, sensitivity, specificity, positive predictive value and negative predictive value at cut off of 8 were 42.4, 95%, 96.6% and 81.8% while at cut-off of 5, these were 96%, 88.3%,76.7% and 93.6%. The agreement between IFCPC major lesion and Swede score ≥ 8 for ≥ CIN2 was 0.626 (p<0.01). Conclusion: Swede score is an easier and more objective method for colposcopic evaluation and a score >8 can be applied to the screen and treat programme.

scholarly journals UJI DIAGNOSTIK SEDIAAN POTONG BEKU TUMOR PAYUDARA DI LABORATORIUM PATOLOGI ANATOMI PADANG

2015 ◽  
Vol 38 (1) ◽  
pp. 7
Author(s):  
Aswiyanti Asri ◽  
Susanto Winarko
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Tumor ◽  
Frozen Section ◽  
Specific Test ◽  
Frozen Section Examination ◽  
Highly Sensitive ◽  
High Level ◽  
Histopathology Examination

AbstrakKanker payudara menempati urutan pertama tumor ganas pada wanita di Sumatera Barat dan merupakan penyebab kematian sebanyak 1.41% dari total kematian. Pemeriksaan potong beku menjadi salah satu pilihan dalam menegakkan diagnosis tumor payudara karena cepat dan akurasi yang cukup tinggi. Penelitian ini bertujuan untuk mengetahui akurasi sediaan potong beku pada tumor payudara yang didiagnosis di Laboratorium Patologi Anatomi di Padang, dengan konfirmasi histopatologi (blok parafin). Sebanyak 72 kasus tumor payudara yang dilakukan pemeriksaan potong beku, dikumpulkan dari laboratorium Patologi Anatomi RSUP Dr. M. Djamil dan RS Siti Rahmah Padang dari 1 Januari 2010 sampai dengan 31 Desember 2012. Data berupa hasil pemeriksaan potong beku dan histopatologi (blok parafin) dicatat, diolah dan dilakukan uji diagnostik dengan tabel kontingensi 2x2, kemudian dilakukan penghitungan sensitivitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, dan akurasi. Hasil uji diagnostik potong beku terhadap histopatologi pada kasus tumor payudara didapatkan sensitivitas 100%, spesifisitas 95,65%, nilai prediksi positif 98%, nilai prediksi negatif 100%, akurasi 98.6%. Pemeriksaan potong beku sangat sensitif dan spesifik yang sangat bermanfaat untuk diagnosis tumor payudara yang cepat dan akurat.AbstractBreast cancer is the most common cancer among female in West Sumatera and cause of 1.41% of the death. Frozen section examination of breast has been used as a diagnostic procedure because this method need less time and have high level of accuracy. The aim of this study is to evaluate the accuracy of frozen section examination with histopathologic confirmation.The study has been done retrospectively in 72 samples of breast tumor at the Anatomic Pathology of Dr.M.Djamil Public Hospital and Siti Rahmah Hospital Padang from January 1, 2008 to December 3, 2012. The result of frozen section and histopathology examination was collected and analyzed for counted the sensitivity and specificity value, positive predictive value, negative predictive value and accuracy value using contingency table 2 x 2. The result showed a 100% sensitivity, 95.65% specificity, 98% positive predictive value, 100% negative predictive value and 98.6% accuracy. Frozen section examination is a highly sensitive and specific test that can be useful for diagnostic choice of breast tumor and it is time less and accurate.

scholarly journals Comparison Between Normobaric Hypoxia Altitude Simulation Test and Altitude Hypoxia Predictive Equations in Cystic Fibrosis Patients

2019 ◽  
Author(s):  
Christine Costa ◽  
André Barros ◽  
João Valença Rodrigues ◽  
Richard Staats ◽  
Mariana Alves ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Individual Differences ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Healthy Controls ◽  
Simulation Test ◽  
Oxygen Supplementation ◽  
Predictive Equations ◽  
The Individual

AbstractBackground:The Hypoxia Altitude Simulation Test (HAST) is the Gold Standard to evaluate hypoxia in response to altitude and to decide on in-flight requirements for oxygen supplementation. Several equations are available to predict PaO2 in altitude (PaO2alt), but it remains unclear whether their predictive value is equivalent. We aimed to compare the results obtained by the available methods in a population of cystic fibrosis (CF) adults.Methods:Eighty-eight adults (58 healthy controls and 30 CF patients) performed a spirometry followed by an HAST. HAST results were compared with the predicted PaO2alt made by five equations: 1st: PaO2alt= 0,410 x PaO2ground + 1,7652; 2nd: PaO2alt= 0,519 x PaO2ground + 11,855 x FEV1 (L) − 1,760; 3rd: PaO2alt= 0,453 x PaO2ground + 0,386 x FEV1 (%) + 2,44; 4th: PaO2alt= 0,88 + 0,68 x PaO2ground; 5th: PaO2alt= PaO2ground − 26,6.Results:None of the controls required in-flight oxygen neither by HAST or by the five predictive equations. Eleven CF-patients had PaO2alt < 50 mmHg, accessed by HAST. The positive predictive value was 50% (1st), 87.5% (2nd and 3rd), 77.78% (4th) and 58.33% (5th). Areas under the curve were 78.95% (1st), 84.69% (2nd), 88.04% (3rd) and 78.95% (4th and 5th). FEV1 and PaO2ground were correlated with HAST results.Conclusions:The 3rd equation gave the best predictions in comparison with results obtained by HAST. However, because the individual differences found were substantial for all equations, we still recommend performing a HAST whenever possible to confidently access in-flight hypoxia and the need for oxygen.

scholarly journals DIAGNOSTIC ACCURACY OF ULTRASOUND IN THE DETECTION OF PNEUMOTHORAX IN CHEST TRAUMA PATIENTS WITH CT AS THE GOLD STANDARD

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Danquale Vance Kynshikhar ◽  
Chaman Lal Kaushal ◽  
Ashwani Tomar ◽  
Neeti Aggarwal
Keyword(s):  
Emergency Department ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Chest Trauma ◽  
Accurate Diagnosis ◽  
Trauma Patients ◽  
Chest Ultrasound

Background: To study the diagnostic accuracy of ultrasound in the detection of pneumothorax in chest trauma patients with CT as the Gold Standard Methods: The present study was conducted from 31th July 2018 to 30th July 2019. A total of 36 patients were enrolled in the study. Results: By chest ultrasound, pneumothorax was detected in 15 of 24 patients. The sensitivity of chest ultrasound for the diagnosis of pneumothorax was 62.5%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 54.14% and accuracy was 75%. Conclusion: Chest ultrasound can play an important role in the emergency department aiding a physician for bedside rapid and accurate diagnosis of pneumothorax without interruption in the resuscitation process and without transferring the patient to the radiology section. Keywords: Ultrasound, CT, Pneumothorax

Sign in / Sign up

Export Citation Format

Share Document