scholarly journals Diagnostic Performance and Appropriate Cut-Offs of Different Anthropometric Indicators for Detecting Children with Overweight and Obesity

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Muhammad Asif ◽  
Muhammad Aslam ◽  
Kalim Ullah ◽  
Muhammad Qasim ◽  
Khurram Afzal ◽  
...  
Keyword(s):  
Roc Curve ◽  
Area Under The Curve ◽  
Overweight And Obesity ◽  
Clinical Settings ◽  
Height Ratio ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Predictive Values ◽  
Anthropometric Indicators ◽  
Obesity In Children

In the clinical settings, different anthropometric indicators like neck circumference (NC), waist circumference (WC), midupper arm circumference (MUAC), waist-to-height ratio (WHtR), and arm-to-height ratio (AHtR) have been suggested for evaluating overweight and obesity in children. The comparative ability of these indicators in Pakistan is yet unknown. This study is aimed at examining the validity of different anthropometric indicators of overweight and obesity simultaneously and at determining their superlative cut-off values that would correctly detect overweight and obesity in children. For this purpose, the dataset of anthropometric measurements height, weight, WC, MUAC, and NC of 5,964 Pakistani children, aged 5-12 years collected in a cross-sectional multiethnic anthropometric survey (MEAS), was used. Receiver operating characteristic (ROC) curve analysis was performed to assess the validity of different anthropometric indicators. The most sensitive and specific cut-off points, positive and negative predictive values of each indicator were also calculated. The results of the ROC curve indicated that all the studied indicators had a good performance but the indicators AHtR and WHtR had the highest value of the area under the curve (AUC) for the screening of children with overweight and obesity ( AUC > 0.80 ). In the overall sample, AHtR, WHtR, MUAC, WC, and NC cut-off points indicative of overweight, in both boys and girls, were 0.14, 0.46, 18.41 cm, 62.86 cm, and 26.36 cm and 0.14, 0.47, 18.16 cm, 64.39 cm, and 26.54 cm, respectively; the corresponding values for obesity were 0.14, 0.47, 18.67 cm, 62.10 cm, and 26.36 cm and 0.14, 0.48, 20.19 cm, 64.39 cm, and 25.27 cm. We concluded that the sex-specific cut-off points for AHtR, WHtR, MUAC, WC, and NC can be used to diagnose overweight and obesity in Pakistani children.

scholarly journals What are the optimal cut-off points of anthropometric indices for prediction of overweight and obesity? Predictive validity of waist circumference, waist-to-hip and waist-to-height ratios

2020 ◽  
Vol 10 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Helda Tutunchi ◽  
Mehrangiz Ebrahimi-Mameghani ◽  
Alireza Ostadrahimi ◽  
Mohammad Asghari-Jafarabadi
Keyword(s):  
Waist Circumference ◽  
Roc Curve ◽  
Predictive Ability ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Roc Curve Analysis ◽  
Anthropometric Indices ◽  
Cross Sectional ◽  
Anthropometric Indicators

Background: Planning for obesity prevention is an important global health priority. Our aim in this study was to find the optimal cut-off points of waist circumference (WC), waist- to- hipratio (WHR) and waist- to- height ratio (WHtR), as three anthropometric indices, for prediction of overweight and obesity. We also aimed to compare the predictive ability of these indices to introduce the best choice. Methods: In this cross-sectional study, a total of 500 subjects were investigated. Anthropometric indicators were measured using a standard protocol. We considered body mass index (BMI) as the simple and most commonly used index for measuring general obesity as the comparison indicator in the present study to assess the diagnostic value for other reported obesity indices.We also performed receiver operating characteristic (ROC) curve analysis to define the optimal cut-off points of the anthropometric indicators and the best indices for overweight and obesity. Results: The proposed optimal cut-offs for WC, WHtR, and WHR were 84 cm, 0.48 and 0.78for women and 98 cm, 0.56 and 0.87 for men, respectively. The area under the ROC curve ofWHtR (women: AUC=0.97, 95% CI: 0.96-0.99 vs. men: AUC=0.97, 95%CI: 0.96-0.99) and WC(women: AUC=0.97, 95% CI, 0.95-0.99 vs. men: AUC=0.98, 95% CI: 0.97-0.99) were greater than WHR (women: AUC=0.79, 95% CI =0.74-0.85 vs. men: AUC=0.84, 95% CI=0.79-0.88). Conclusion: This study demonstrated that the WC and WHtR indicators are stronger indicators compared to the others. However, further studies using desirable and also local cutoffs against more accurate techniques for body fat measurement such as computerized tumor (CT) scans and dual-energy x-ray absorptiometry (DEXA) are required.

scholarly journals Sensitivity and specificity of waist circumference as a single screening tool for assessment of overweight and obesity

2017 ◽  
Vol 4 (11) ◽  
pp. 4254
Author(s):  
Anubrata Karmakar ◽  
Shobhit Garg ◽  
Aparajita Dasgupta ◽  
Bobby Paul ◽  
Swanya P. Maharana
Keyword(s):  
Waist Circumference ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Public Health Perspective ◽  
Cross Sectional

Background: Generalised and central obesity are established risk factors for metabolic syndrome and cardiovascular diseases. Easy assessment of overweight or obesity is the need of the hour from public health perspective. Waist circumference (WC) can be a simple screening tool for identifying overweight individuals since measuring WC is simple, inexpensive, less time consuming, convenient for self-monitoring and needs no complicated calculation as BMI.Methods: A community based cross-sectional study was conducted in January-February 2017 among 338 adults, in a village of Singur Block, West Bengal. Height, weight and WC were measured for each subject. Receiver Operating Characteristic (ROC) curve analysis was used to estimate the cut-off values of WC.Results: The sensitivity and specificity of WC ≥90 centimeters for men for identifying overweight (BMI ≥25) were 78.8% and 75.6% respectively, whereas those of WC ≥80 cm for women were 80.3% and 44% respectively. ROC curve analysis revealed good diagnostic accuracy at 88.5 cm for WC cut-off for men (area under curve (AUC) 0.854, sensitivity 86.5%, specificity 67.6%) and fair accuracy (AUC 0.744, sensitivity 80.3%, specificity 44%) for WC cut-off for 80 cm for women.Conclusions: This study shows, WC can be used for screening of overweight individual infield practice as measuring tape is inexpensive and easy-to-carry compared to a weighing scale. More research may be done on larger sample size to establish an optimal WC cut-off value for Indian population. 

scholarly journals BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital out patients: a cross-sectional study

2020 ◽  
Author(s):  
Rajan Shrestha ◽  
Bijay Khatri ◽  
Madan P. Upadhyay ◽  
Janak R. Bhattarai ◽  
Manish Kayastha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Area Under The Curve ◽  
Overweight And Obesity ◽  
Anthropometric Measurements ◽  
Height Ratio ◽  
Cross Sectional ◽  
High Waist Circumference ◽  
Waist To Height Ratio

Abstract Background: Obesity has become a global epidemic with a rise in noncommunicable diseases. It is now becoming the problem of low- and middle-income countries such as Nepal. Conventional risk factors are present in a high proportion in the Nepalese population. As a routine surveillance or registry system is absent, the actual burden and trend of obesity and hypertension in Nepal are unknown. Hypertension and other cardiovascular diseases can be prevented by detecting risk factors such as obesity and high blood pressure. A simple anthropometric measurement could be used to determine the risk of hypertension. However, the best predictor of hypertension remains contentious and controversial. We aimed to determine the burden of obesity and hypertension and test the ability to determine hypertension through different anthropometric measurements in hospital outpatients in a low-income setting.Methods: This hospital-based cross-sectional descriptive study was conducted from June to December 2019 among 40-69 year outpatients in a tertiary eye and ENT hospital in a semi-urban area of Nepal among a randomly selected sample of 2,256 participants from 6,769 outpatients visited in Health Promotion and risked factor screening service. We performed a correlation analysis to determine the relationship between anthropometric measurements and blood pressure. The area under the receiver operating characteristic (ROC) curve of body mass index (BMI), waist to height ratio (WHtR) and waist circumference (WC) was calculated and compared.Results: The mean (SD) age of the participants was 51.75 (8.47) years. The overall prevalence of obesity and overweight by BMI was 16.09% and 42.20%, respectively. The overall prevalence of abdominal obesity by waist-to-height ratio was 32.76%, which is higher than obesity by BMI. High waist circumference was observed among 66.76% participants, whereas female participants had a very higher prevalence of high waist circumference (77.46%) and male participants (53.73%) (p<0.001). The prevalence of hypertension among the participants with BMI≥25 kg/m2, WHtR≥0.5 and WC≥ cutoff values was 45.97%, 42.52% and 45.28%, respectively. The overall prevalence of hypertension and prehypertension was 40.67% and 36.77%, respectively. Male participants had a slightly higher prevalence of hypertension (42.72%) than female participants (39.00%). The areas under the curve (AUCs) were significantly higher than 0.5 for BMI (0.570, 95% CI: 0.548-0.592), WC (0.585, 95% CI: 0.563-0.607) and WHtR (0.586, 95% CI: 0.564-0.608). In both genders, the area under the curve was significantly higher than 0.5 (P<0.01). In all age groups, the area under the curve was also significantly higher than 0.5.Conclusion: Waist circumference was both correlated as well as had higher predictive capacity amongst WHtR and BMI and may play a major role in the future diagnosis of HTN in Nepali adults. Regardless of the anthropometric metrics used to measure overweight and obesity, the hospital setting is an opportunity centre to screen for overweight, obesity and hypertension, which are major risk factors for NCDs.

scholarly journals Propriedade diagnóstica dos indicadores antropométricos na predição do excesso de gordura corporal estimado por meio do DXA em mulheres hipertensas

2017 ◽  
Vol 19 (3) ◽  
pp. 299
Author(s):  
Camila Tomicki ◽  
Aline Mendes Gerage ◽  
Raphael Mendes Ritti-Dias ◽  
Diego Augusto Santos Silva ◽  
Tânia Rosane Bertoldo Benedetti
Keyword(s):  
Body Fat ◽  
Roc Curve ◽  
Reference Method ◽  
Cross Sectional Study ◽  
Height Ratio ◽  
Cross Sectional ◽  
Anthropometric Indicators ◽  
Waist To Height Ratio ◽  
Total Fat ◽  
Conicity Index

Excess body fat is an important risk factor for the development of arterial hypertension. The aim of this study was to verify the diagnostic performance of anthropometric indicators in the prediction of excess body fat estimated by Dual-energy Radiometric Absorptiometry (DXA) in hypertensive women. A cross-sectional study with 71 hypertensive women (57.9 ± 10.1 years; 77.8 ± 15.1 kg; 156.8 ± 5.2 cm) was carried out. he anthropometric indicators analyzed were: Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR) and Conicity Index (C Index). Body fat measured by DXA was used as the reference method. Descriptive statistics and ROC curve were used for data analysis. Comparing the anthropometric indicators with the percentage of total fat estimated by DXA, signiicant diferences were observed in BMI, WC and WHR (P <0.05). In relation to the percentage of trunk fat, a diference was identiied in BMI and WC (P <0.05). Among the anthropometric indicators analyzed, BMI (0.83), WC (0.79) and WHtR (0.80) had the largest areas under the ROC curve in relation to excess body fat determined by DXA. he cutof points were conservative in relation to those suggested in literature. Anthropometric indicators BMI (24.72 kg/m²), WC (87.81 cm) and WHtR (0.55) can be adopted in the evaluation of excess body fat in hypertensive women, since they demonstrated to be good predictors when confronted with DXA.

scholarly journals Platelet miRNA bio-signature discriminates between dementia with Lewy bodies and Alzheimer disease: A cross-sectional study.

2020 ◽  
Author(s):  
Ana Gámez-Valero ◽  
Jaume Campdelacreu ◽  
Dolores Vilas ◽  
Lourdes Ispierto ◽  
Daniela Samaniego ◽  
...  
Keyword(s):  
Roc Curve ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Area Under The Curve ◽  
Target Prediction ◽  
Cross Sectional Study ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Diagnostic Potential ◽  
Degenerative Dementia

Abstract Background Dementia with Lewy bodies (DLB) is one of the most common causes of degenerative dementia after Alzheimer’s disease (AD) and presents pathological and clinical overlap with both AD and Parkinson’s disease (PD). Consequently, only one in three DLB cases is diagnosed correctly. Platelets have been previously related to neurodegeneration. They contain microRNAs (miRNAs), and their analysis may provide disease biomarkers. Methods Small RNAs from platelets of DLB patients and controls were analyzed by Next Generation Sequencing (NGS), and miRNAs deregulated in DLB were selected. Expression of these miRNAs was then determined and validated by LNA-based qRT-PCR in three consecutive studies from 2017 to 2019 enrolling 162 individuals, including DLB, AD, and PD patients, and healthy controls. Their predictive diagnostic potential was calculated by ROC curve analysis. miRTarbase and miRGate were used for target prediction. Results We profiled the whole platelet miRNA transcriptome from 7 DLB patients and 7 controls using NGS. Twenty-two selected miRNAs were further validated in independent studies (2017–2019) including DLB (n = 59), AD (n = 28), and PD (n = 24) patients, and control individuals (n = 51). Our results demonstrated downregulated expression levels for hsa-let-7d-5p (fold change 0.14; p = 0.006), hsa-miR-132-5p (0.12; p = 0.0015), hsa-miR-142-3p (0.07; p = 0.00047), hsa-miR-146a-5p (0.07; p = 0.00035), hsa-miR-150-5p (0.10; p = 0.0098), hsa-miR-25-3p (0.13; p = 0.0019) and hsa-miR-26b-5p (0.09; p = 0.0014) in DLB compared to AD. ROC curve for this seven-miRNA biosignature yielded an area under the curve (AUC) of 1. Both hsa-miR-142-3p and hsa-miR-150-5p, were down-regulated in DLB compared to controls (AUC = 0.85). Comparing AD and controls, miRNAs hsa-miR-132-5p, hsa-miR-146a-5p, hsa-miR-25-3p, and hsa-miR-6747-3p were up-regulated in AD (AUC = 0.94); and hsa-miR-128-3p and hsa-miR-139-5p were down-regulated in PD compared to controls (AUC = 0.81). Predictive target analysis identified three disease-specific pathway clusters as a result of platelet-miRNA deregulation. In DLB, pathways related to gene expression and small RNA metabolism; in AD, pathways related to stress response and RNA stress granules; and in PD pathways related to protein phosphorylation, metabolism and degradation were identified. Conclusion A platelet-associated bio-signature composed of 7 miRNAs is highly specific and sensitive for distinguishing DLB from AD.

scholarly journals Upper arm circumference measurement for detecting overweight and obesity in children aged 6-7 years

2017 ◽  
Vol 57 (1) ◽  
pp. 23
Author(s):  
Dewi Rosariah Ayu ◽  
Aditiawati Aditiawati ◽  
Julius Anzar ◽  
Erial Bahar
Keyword(s):  
Primary Schools ◽  
Diagnostic Value ◽  
Overweight And Obesity ◽  
Diagnostic Study ◽  
Roc Curve Analysis ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Increased Risk ◽  
Obesity In Children

Background Obesity is a worldwide problem and is associated with increased risk of metabolic syndrome. Nutritional status in children has traditionally been determined by body mass index (BMI) scores, but with limitations. Upper arm circumference measurement may be a better predictor of energy, protein, and fat storage, as well as a simpler method for screening overweight and obesity in children.Objective To determine the diagnostic value of upper arm circumference compared to BMI for detecting overweight and obesity in children aged 6-7 years.Methods This diagnostic study with a cross-sectional design was performed from September to October 2015 at 16 primary schools in Palembang, Indonesia. We measured the heights, weights, and upper arm circumferences, and calculated BMIs of 2,258 children. Receiver-operator characteristic (ROC) curve analysis was used to find an optimal upper arm circumference cut-off point to detect overweight and obesity. Diagnostic value was calculated by using a 2x2 table analysis.Results The prevalences of overweight and obesity were 5.8% and 11.7%, respectively. The optimal upper arm circumference cut-off points for detecting overweight in children aged 6-7 years was 185 mm (sensitivity 88.1% and specificity 78.3%), and for obesity was 195 mm (sensitivity 90.15% and specificity 86.65%). Upper arm circumference had a strong correlation with BMI.Conclusion Upper arm circumference measurement is an accurate method fordistinguishing between normoweight, overweight, and obesity in children aged 6-7 years.

Relationship Among Adherence to The Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity

2020 ◽  
Vol 20 ◽  
Author(s):  
Luisa Lampignano ◽  
Roberta Zupo ◽  
Rossella Donghia ◽  
Vito Guerra ◽  
Fabio Castellana ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Hdl Cholesterol ◽  
Fat Distribution ◽  
Serum Levels ◽  
Overweight And Obesity ◽  
Height Ratio ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Waist To Height Ratio ◽  
The Mediterranean

Background: There is moderate-to-high evidence that the Mediterranean diet prevents increases in body weight and waist circumference in non-obese individuals but less is known about its effects in subjects with overweight and obesity. The present study was focused on exploring the cross-sectional association among the adherence to Mediterranean diet and the most commonly used variables of metabolic and cardiovascular risk factors in a cohort of overweight subjects from a typical Mediterranean region, Apulia, in Southern Italy. Methods:: The study was performed in a cohort of 1214 individuals, all with overweight or obesity but no other clinical condition. We investigated the association among adherence to Mediterranean diet, assessed with the PREDIMED score, and anthropometric parameters [namely body mass index (BMI), WC, waist to height ratio (WHtR) and neck circumference (NC)], fasting serum levels of glucose, insulin, uric acid and lipids (triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol), and blood pressure and insulin resistance, measured by HOMA-IR. Results:: The waist to height ratio was negatively associated to a PREDIMED score ≥7 (p<0.04), whereas HDL cholesterol was positively associated to a PREDIMED score ≥7 (p<0.04) Conclusion: This study suggests that body fat distribution and HDL-cholesterol are the parameters most strongly influenced by MedDiet in Apulian subjects.

scholarly journals Prevalence of Overweight and Obesity in Children and Adolescents from the Age Range of 2 to 19 Years Old in Brazil

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Janaina R. Niehues ◽  
Ana Inês Gonzales ◽  
Robson R. Lemos ◽  
Poliana Penasso Bezerra ◽  
Patrícia Haas
Keyword(s):  
Public Health ◽  
Children And Adolescents ◽  
National Level ◽  
Public Health Problem ◽  
Overweight And Obesity ◽  
Obese Children ◽  
Cross Sectional ◽  
Juvenile Obesity ◽  
Age Range ◽  
Obesity In Children

Introduction. Infant juvenile obesity is currently a worldwide public health problem and it is increasing at alarming rate in the Brazilian population, showing its relevance in terms of public health.Objectives. Determine the prevalence of overweight and obesity in children and adolescents between 2 and 19 years old in different regions of Brazil.Methods. The following electronic databases were searched (from September through November 2013): Medline (PubMed), LILACS, and SciELO, using the descriptors and Boolean operators (obesity) and (overweight) and (child) and (prevalence) and (Brazil). Prospective and/or cross-sectional designs studies were found regarding the prevalence of overweight and obese children and adolescents in the five regions of Brazil.Results. A total of 191 scientific articles were found of which 17 met all inclusion criteria. A higher prevalence of overweight was found in the south (25.7%) and north (28.8%) of the country, and obesity in the southeast (15.4%) and south (10.4%).Conclusions. The scope of the studies was mostly based on municipal coverage, which resulted in limitations for conclusive analysis, showing the need for further studies of prevalence at the national level, with emphasis on public health in obese children and adolescents throughout the Brazilian territory.

Serum diiodotyrosine—a biomarker to differentiate destructive thyroiditis from Graves’ disease

2021 ◽  
Author(s):  
Naoya Fujita ◽  
Yosuke Ono ◽  
Azusa Sano ◽  
Motohiro Kimata ◽  
Seigo Oyama ◽  
...  
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
Cross Sectional Study ◽  
Curve Analysis ◽  
Diagnostic Methods ◽  
Graves Disease ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass

Objective: Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves’ disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves’ disease. Design: Patients with destructive thyroiditis (n = 13) and Graves’ disease (n = 22) were enrolled in this cross-sectional study. Methods: We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves’ disease. Results: The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves’ disease. The ROC curve analysis showed that the serum DIT levels (≥ 359.9 pg/mL) differentiated destructive thyroiditis from Graves’ disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < .001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = .001). Conclusions: The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves’ disease.

scholarly journals 006 Can seizure-related heart rate differentiate epileptic seizures from psychogenic non-epileptic seizures?

2019 ◽  
Vol 90 (e7) ◽  
pp. A2.3-A3
Author(s):  
Hue Mun Au Yong ◽  
Erica Minato ◽  
Eldho Paul ◽  
Udaya Seneviratne
Keyword(s):  
Heart Rate ◽  
Area Under The Curve ◽  
Epileptic Seizures ◽  
Roc Curve Analysis ◽  
Predictive Values ◽  
Minute Post ◽  
Poor Differentiation ◽  
Good Differentiation ◽  
Sensitivity Specificity ◽  
Video Eeg

IntroductionThis study aims to (i)evaluate the diagnostic sensitivity, specificity and predictive values of seizure-related heart rate (HR) in differentiating epileptic seizures(ES) from psychogenic non-epileptic seizures(PNES), (ii)define the most useful point of HR measurement: pre-ictal, ictal-onset, maximal-ictal or post-ictal, and (iii)define the HR cut-off points to differentiate ES from PNES.MethodsAll video EEG(VEEG) at Monash Health from May 2009 to November 2015 were retrospectively reviewed. Baseline(during wakefulness), one-minute pre-ictal, ictal-onset, maximal-ictal and one-minute post-ictal HR were measured for each ES and PNES event. Events less than ten seconds or with uninterpretable ECG due to artefacts were excluded. ROC curve analysis was performed to study the diagnostic accuracy reflected by area under the curve(AUC). The AUC was interpreted as follows; ≤0.5, differentiation of PNES from ES no better than chance; 0.80–0.89, good differentiation; and 0.9–1, excellent differentiation.ResultsVEEG of 341 ES and 265 PNES from 130 patients were analysed. The AUC for pre-ictal, ictal-onset, maximal-ictal and post-ictal HR were found to have poor differentiation between ES and PNES. Comparing PNES and bilateral tonic-clonic ES, AUC for absolute maximal-ictal HR was 0.84(CI 0.73–0.95) and for absolute post-ictal HR was 0.90(CI 0.81–1.00). Using Youden’s index, to diagnose tonic-clonic ES, the optimal cut-off point for absolute maximal-ictal HR was 114bpm (sensitivity 84%;specificity 82%;PPV 26.7%,NPV 98.5%) and for absolute post-ictal HR was 90bpm(sensitivity 91%;specificity 82%;PPV 30.3%;NPV 99.1%).ConclusionsThese findings suggest that seizure-related HR increase is useful in differentiating bilateral tonic-clonic ES from PNES. Based on the AUC, the best diagnostic measureme.

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