The Impact of Different Diagnostic Criteria on Prevalence Rates for Delirium

In examining the strikingly high prevalence rates of HIV in many parts of Africa, reaching as high as 5% in some areas, how does the discourse promoted by the predominant religions across the continent, Islam and Christianity, affect the outlook of their followers on the epidemic? This question becomes even more intriguing after discovering the dramatic difference in rate of HIV prevalence between Muslims and Christians in Africa, confirmed by studies that have found a negative relationship to exist between HIV prevalence and being Muslim in Africa, even in Sub-Saharan African nations. Why does this gap in prevalence rates exist? Does Islam advocate participating in less risky behavior more so than Christianity? By comparing the social construction, epidemiological understanding and public responses among Muslim populations in Africa with Christian ones, it becomes apparent that many similarities exist between the two regarding discourse and that, rather than religious discourse itself, other social factors, such as circumcision practices, contribute more to the disparity in HIV prevalence than originally thought.

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The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040666 ◽

2021 ◽

Vol 10 (4) ◽

pp. 666

Author(s):

Fahimeh Ramezani Tehrani ◽

Marzieh Saei Ghare Naz ◽

Razieh Bidhendi Yarandi ◽

Samira Behboudi-Gandevani

Keyword(s):

Systematic Review ◽

Gestational Diabetes ◽

Pregnant Women ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Population Based ◽

Maternal Outcomes ◽

Care Providers ◽

Iadpsg Criteria ◽

The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

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Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis

Heart ◽

10.1136/heartjnl-2020-317901 ◽

2020 ◽

pp. heartjnl-2020-317901

Author(s):

SungA Bae ◽

So Ree Kim ◽

Mi-Na Kim ◽

Wan Joo Shim ◽

Seong-Mi Park

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Relative Risk ◽

Elderly Patients ◽

Meta Analysis ◽

Fatal Outcome ◽

Young Patients ◽

Lower Prevalence ◽

Prevalence Rates ◽

The Impact

ObjectivePrevious studies that evaluated cardiovascular risk factors considered age as a potential confounder. We aimed to investigate the impact of cardiovascular disease (CVD) and its risk factors on fatal outcomes according to age in patients with COVID-19.MethodsA systematic literature review and meta-analysis was performed on data collected from PubMed and Embase databases up to 11 June 2020. All observational studies (case series or cohort studies) that assessed in-hospital patients were included, except those involving the paediatric population. Prevalence rates of comorbid diseases and clinical outcomes were stratified by mean patient age in each study (ranges: <50 years, 50–60 years and ≥60 years). The primary outcome measure was a composite fatal outcome of severe COVID-19 or death.ResultsWe included 51 studies with a total of 48 317 patients with confirmed COVID-19 infection. Overall, the relative risk of developing severe COVID-19 or death was significantly higher in patients with risk factors for CVD (hypertension: OR 2.50, 95% CI 2.15 to 2.90; diabetes: 2.25, 95% CI 1.89 to 2.69) and CVD (3.11, 95% 2.55 to 3.79). Younger patients had a lower prevalence of hypertension, diabetes and CVD compared with older patients; however, the relative risk of fatal outcomes was higher among the former.ConclusionsThe results of the meta-analysis suggest that CVD and its risk factors (hypertension and diabetes) were closely related to fatal outcomes in COVID-19 for patients across all ages. Although young patients had lower prevalence rates of cardiovascular comorbidities than elderly patients, relative risk of fatal outcome in young patients with hypertension, diabetes and CVD was higher than in elderly patients.Prospero registration numberCRD42020198152.

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Diagnostic Disparity of Previous and Revised American Thoracic Society Guidelines for Idiopathic Pulmonary Fibrosis

Canadian Respiratory Journal ◽

10.1155/2015/307893 ◽

2015 ◽

Vol 22 (2) ◽

pp. 86-90 ◽

Cited By ~ 2

Author(s):

Lee Fidler ◽

Shane Shapera ◽

Shikha Mittoo ◽

Theodore K Marras

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Diagnostic Criteria ◽

Retrospective Chart Review ◽

Patient Characteristics ◽

Disease Diagnosis ◽

American Thoracic Society ◽

Patient Classification ◽

High Resolution Computed Tomography ◽

The Impact

BACKGROUND: A revised guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) was formulated by the American Thoracic Society (ATS) in 2011 to improve disease diagnosis and provide a simplified algorithm for clinicians. The impact of these revisions on patient classification, however, remain unclear.OBJECTIVE: To examine the concordance between diagnostic guidelines to understand how revisions impact patient classification.METHODS: A cohort of 54 patients with either suspected IPF or a working diagnosis of IPF was evaluated in a retrospective chart review, in which patient data were examined according to previous and revised ATS guidelines. Patient characteristics influencing the fulfillment of diagnostic criteria were compared using one-way ANOVA and χ2tests.RESULTS: Revised and previous guideline criteria for IPF were met in 78% and 83% of patients, respectively. Revised guidelines modified a classification based on previous guidelines in 28% of cases. Fifteen percent of patients meeting previous ATS guidelines failed to meet revised criteria due to a lack of honeycombing on high-resolution computed tomography and the absence of a surgical lung biopsy. Patients failing to meet previous and revised diagnostic criteria for IPF were younger.CONCLUSION: The revised guidelines for the diagnosis of IPF classify a substantial proportion of patients differently than the previous guidelines.

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Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria

The British Journal of Psychiatry ◽

10.1192/bjp.182.5.449 ◽

2003 ◽

Vol 182 (5) ◽

pp. 449-454 ◽

Cited By ~ 142

Author(s):

Anja Busse ◽

Jeannette Bischkopf ◽

Steffi G. Riedel-Heller ◽

Matthias C. Angermeyer

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Longitudinal Study ◽

Diagnostic Criteria ◽

Community Sample ◽

Neuropsychological Testing ◽

Incidence Rates ◽

Prevalence Rates ◽

Case Definitions ◽

Increased Risk

BackgroundAlthough mild cognitive impairment is associated with an increased risk of developing dementia, there has been little work on its incidence and prevalence.AimsTo report age-specific prevalence, incidence and predictive validities for four diagnostic concepts of mild cognitive impairment.MethodA community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study.ResultsPrevalence rates ranged from 3% to 20%, depending on the concept applied. The annual incidence rates applying different case definitions varied from 8 to 77 per 1000 person-years. Rates of conversion to dementia over 2.6 years ranged from 23% to 47%.ConclusionsMild cognitive impairment is frequent in older people. Prevalence, incidence and predictive validities are highly dependent on the diagnostic criteria applied.

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The new diagnostic criteria for diabetes: the impact on management of diabetes and macrovascular risk factors

The American Journal of Medicine ◽

10.1016/s0002-9343(98)00206-x ◽

1998 ◽

Vol 105 (1) ◽

pp. 15S-19S ◽

Cited By ~ 14

Author(s):

Anne L Peters ◽

David L Schriger

Keyword(s):

Risk Factors ◽

Diagnostic Criteria ◽

The Impact

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Impact of Operational Definitions on the Predictors and Prevalence of Asthma Estimates: Experience from a University Students’ Survey and Implications for Interpretation of Disease Burden

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v28i6.7 ◽

1970 ◽

Vol 28 (6) ◽

Author(s):

Olufemi O. Desalu ◽

Emmanuel O. Sanya ◽

Adekunle O. Adeoti ◽

Sunday A. Aderibigbe ◽

Philip M. Kolo

Keyword(s):

University Students ◽

Disease Burden ◽

Respiratory Health ◽

Accurate Estimation ◽

Kappa Statistics ◽

Nasal Allergy ◽

Prevalence Rates ◽

Prevention Policy ◽

Cross Sectional ◽

The Impact

BACKGROUND: Inconsistent operational definitions during asthma surveillance can lead to inaccurate estimation of disease burden and formulation of health policy. This study aimed to evaluate the impact of different definitions on the prevalence estimates and predictors of asthma among university students in Ilorin, Nigeria. The secondary aim was to compare level of agreement of the different definitions.METHODS: This cross-sectional study was carried out from June to August 2015. The European Community Respiratory Health Survey (ECRHS) questionnaire was self administered by 1485 students. Asthma diagnosis was based on five definitions used in previous studies in the country. These were ECRHS, International Study of Asthma, Allergies in Childhood (ISAAC), Probable, Modified ECRHS and Modified Probable asthma definitions.RESULTS: The prevalence rates varied from 10.4 to 24.1% depending on the definition. Prevalence obtained by using ECRHS definition significantly differed from estimates by other definitions (Z score ≥ 1.96 p<0.0001) except modified probable asthma. Identified predictors of asthma varied from five to six depending on the definition, and their strength also differed by definition. Regardless of the definition, reported nasal allergy, skin allergy, family history of nasal allergy, asthma and parental smoking were the predictors of asthma. The Kappa statistics demonstrated a fair to almost perfect association between the ECRHS and other asthma definitions (Kappa = 0.334-0.841, p < 0.001).CONCLUSION: The prevalence rates and predictors of asthma are affected by operational definitions. Researchers need to adopt a uniform definition for accurate estimation of disease burden, international comparison of result and formulation of prevention policy.

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The impact of sonication cultures when the diagnosis of prosthetic joint infection is inconclusive

PLoS ONE ◽

10.1371/journal.pone.0252322 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0252322

Author(s):

Taiana Cunha Ribeiro ◽

Emerson Kiyoshi Honda ◽

Daniel Daniachi ◽

Ricardo de Paula Leite Cury ◽

Cely Barreto da Silva ◽

...

Keyword(s):

Tissue Culture ◽

Diagnostic Criteria ◽

Gold Standard ◽

Joint Infection ◽

Clinical Criterion ◽

Tissue Cultures ◽

Prosthetic Joint ◽

Prosthetic Joint Infections ◽

The Impact ◽

Sonication Culture

Background In the absence of a gold standard criterion for diagnosing prosthetic joint infections (PJI), sonication of the removed implant may provide superior microbiological identification to synovial fluid and peri-implant tissue cultures. The aim of this retrospective study was to assess the role of sonication culture compared to tissue cultures for diagnosing PJI, using different consensus and international guidelines for PJI definition. Methods Data of 146 patients undergoing removal of hip or knee arthroplasties between 2010 and 2018 were retrospectively reviewed. The International Consensus Meeting (ICM-2018), Musculoskeletal Infection Society (MSIS), Infectious Diseases Society of America (IDSA), the European Bone and Joint Infection Society (EBJIS), and a modified clinical criterion, were used to compare the performance of microbiological tests. McNemar´s test and proportion comparison were employed to calculate p-value. Results Overall, 56% (82/146) were diagnosed with PJI using the clinical criteria. Out of these cases, 57% (47/82) tested positive on tissue culture and 93% (76/82) on sonication culture. Applying this clinical criterion, the sensitivity of sonication fluid and tissue cultures was 92.7% (95% CI: 87.1%- 98.3%) and 57.3% (95% CI: 46.6%-68.0%) (p<0.001), respectively. When both methods were combined for diagnosis (sonication and tissue cultures) sensitivity reached 96.3% (95% CI: 91.5%-100%). Sonication culture and the combination of sonication with tissue cultures, showed higher sensitivity rates than tissue cultures alone for all diagnostic criteria (ICM-18, MSIS, IDSA and EBJIS) applied. Conversely, tissue culture provided greater specificity than sonication culture for all the criteria assessed, except for the EBJIS criteria, in which sonication and tissue cultures specificity was 100% and 95.3% (95% CI: 87.8–100%), respectively (p = 0.024). Conclusions In a context where diagnostic criteria available have shortcomings and tissue cultures remain the gold standard, sonication cultures can aid PJI diagnosis, especially when diagnostic criteria are inconclusive due to some important missing data (joint puncture, histology).

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Surgical outcomes for chronic exertional compartment syndrome following improved diagnostic criteria

BMJ Military Health ◽

10.1136/jramc-2019-001171 ◽

2019 ◽

Vol 166 (E) ◽

pp. e17-e20 ◽

Cited By ~ 2

Author(s):

Christopher Simpson ◽

D Roscoe ◽

S Hughes ◽

D Hulse ◽

H Guthrie

Keyword(s):

Compartment Syndrome ◽

Diagnostic Criteria ◽

Clinical Symptoms ◽

Diagnostic Testing ◽

Rank Test ◽

Anterior Compartment ◽

Chronic Exertional Compartment Syndrome ◽

Significant Difference ◽

Exertional Compartment Syndrome ◽

The Impact

IntroductionChronic exertional compartment syndrome (CECS) presents with pain during exercise, most commonly within the anterior compartment of the lower limb. A diagnosis is classically made from a typical history and the measurement of intramuscular compartmental pressure (IMCP) testing. Improved, more specific diagnostic criteria for IMCP testing allow clinicians to now be more certain of a diagnosis of CECS. Outcomes following surgical treatment in patients diagnosed using these more robust criteria are unknown.MethodsAll patients undergoing fasciectomy for anterior compartment CECS at a single rehabilitation unit were identified between 2014 and 2017. Wilcoxen signed-rank test was used to compare military fitness grading and paired t-test was used to compare Foot and Ankle Ability Measure, FAAM Sport Specific and Exercise-Induced LimbPain-G outcome measures, presurgery and postsurgery.ResultsThere was a significant difference in fitness grading between presurgical and postsurgical intervention (Z = −2.68, p < 0.01) with 46 % of patients improving their occupational medical grading. All secondary measures of outcome, looking at clinical symptoms, also improved.ConclusionAlmost half of the patients undergoing fasciectomy, following diagnosis using more specific criteria, will have an improvement in occupational medical grading. These outcomes represent the lower end of those reported in civilian populations. This is likely a result of a combination of factors, most notably the different diagnostic criteria followed and the more stringent criteria applied to military occupational grading, compared with civilian practice. Further work is now required to evaluate the impact of differing rehabilitation regimes on postoperative patients identified through this more specific diagnostic testing.

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