Comparative Diagnostic Accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for Screening of Alzheimer Disease

Background: Our aim was to evaluate and compare the diagnostic properties of 5 screening tests for the diagnosis of mild Alzheimer disease (AD). Methods: We conducted a prospective and cross-sectional study of 92 patients with mild AD and of 68 healthy controls from our Department of Neurology. The diagnostic properties of the following tests were compared: Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination III (ACE-III), Memory Impairment Screen (MIS), Montreal Cognitive Assessment (MoCA), and Rowland Universal Dementia Assessment Scale (RUDAS). Results: All tests yielded high diagnostic accuracy, with the ACE-III achieving the best diagnostic properties. The area under the curve was 0.897 for the ACE-III, 0.889 for the RUDAS, 0.874 for the MMSE, 0.866 for the MIS, and 0.856 for the MoCA. The Mini-ACE score from the ACE-III showed the highest diagnostic capacity (area under the curve 0.939). Memory scores of the ACE-III and of the RUDAS showed a better diagnostic accuracy than those of the MMSE and of the MoCA. All tests, especially the ACE-III, conveyed a higher diagnostic accuracy in patients with full primary education than in the less educated group. Implementing normative data improved the diagnostic accuracy of the ACE-III but not that of the other tests. Conclusions: The ACE-III achieved the highest diagnostic accuracy. This better discrimination was more evident in the more educated group.

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Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

Current Diabetes Reviews ◽

10.2174/1573399815666190531093238 ◽

2020 ◽

Vol 16 (3) ◽

pp. 270-277 ◽

Cited By ~ 1

Author(s):

Mutasem Ababneh ◽

Mousab Y. Al Ayed ◽

Asirvatham A. Robert ◽

Mohamed A. Al Dawish

Keyword(s):

Diabetic Foot ◽

Statistical Significance ◽

Ankle Brachial Index ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Arterial Disease ◽

Cross Sectional Study ◽

Screening Tests ◽

Cross Sectional ◽

Toe Brachial Index

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

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Role of human epididymis protein 4 for detection of ovarian carcinoma in adnexal masses: A pilot study

10.1055/s-0039-1685305 ◽

2016 ◽

Author(s):

Nidhi Bansal ◽

A. Suneja ◽

K. Guleria ◽

N. B. Vaid ◽

K. Mishra ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Cross Sectional Study ◽

Ca 125 ◽

Serum Samples ◽

Cross Sectional ◽

Adnexal Masses ◽

Good Discriminator ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index ◽

Benign Tumours

Introduction: HE4 is a novel tumour biomarker used for early diagnosis of ovarian cancer. This study evaluated the diagnostic accuracy of HE4 alone and in combination with CA125, risk of malignancy index (RMI), risk of malignancy algorithm (ROMA). Methods: It was a cross sectional study conducted recruiting 88 women with adnexal masses who were planned for surgery. After baseline work up and ultrasound examination, serum samples were collected for estimation of CA 125 and HE4 levels. Serum HE4 levels were estimated using ELISA kit. RMI and ROMA score were calculated and diagnostic accuracy of HE4, CA 125, RMI, ROMA and their combination were compared. Cut off for HE4 and ROMA score were calculated using ROC curve. Results: Of 88 subjects, 66 were analyzed with 19 malignant (including 5 LMP) and 47 benign cases. The median value of HE4 among malignant cases was found to be significantly higher than among the benign cases. PPV and NPV of HE4 at a cut off 130.8 pMol/ml was 85.7% and 77.9% respectively. Highest PPV (88.9%) with acceptable NPV (80.7%) was found with ROMA followed by HE4 (PPV 85.7%; NPV 77.97%), RMI (PPV 76.92%; NPV 83%) and CA125 (PPV 52%; NPV 80.85%). Conclusion: HE4 levels were lower in Indian population both in malignant and benign tumours as compared to other studies. HE4 is a good discriminator and gives best accuracy when it is combined with CA125 in a logistic algorithm, ROMA.

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Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211002640 ◽

2021 ◽

pp. 089198872110026

Author(s):

Sivan Klil-Drori ◽

Natalie Phillips ◽

Alita Fernandez ◽

Shelley Solomon ◽

Adi J. Klil-Drori ◽

...

Keyword(s):

Cognitive Assessment ◽

Cross Sectional Study ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Cognitive Screening ◽

Cross Sectional ◽

A Prospective Study ◽

Sectional Analysis ◽

State Examination ◽

Normal Cognition

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.

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Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: a cross-sectional study in a cohort of 2,173 patients

BMC Infectious Diseases ◽

10.1186/s12879-021-05930-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Carlos Alfonso Romero-Gameros ◽

Tania Colin-Martínez ◽

Salomón Waizel-Haiat ◽

Guadalupe Vargas-Ortega ◽

Eduardo Ferat-Osorio ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Diagnostic Tool ◽

Clinical Decision Making ◽

Multivariate Logistic Regression Analysis ◽

Clinical Decision ◽

Cross Sectional Study ◽

World Health ◽

Likelihood Ratios ◽

Cross Sectional ◽

Health Organization

Abstract Background The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection. Methods An observational, cross-sectional, prospective and analytical study was carried out, during the period of time from April 14 to July 21, 2020. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios. A Mantel-Haenszel and multivariate logistic regression analysis was performed to assess the association of symptoms with COVID-19. Results A prevalence of 53.72% of SARS-CoV-2 infection was observed. The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%. The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking ≥2 symptoms as a cut-off point. The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2 (95% CI; 2.52–4.17), fever OR 2.98 (95% CI; 2.47–3.58), dyspnea OR 2.9 (95% CI; 2.39–3.51]) and cough OR 2.73 (95% CI: 2.27–3.28). Conclusion The combination of ≥2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation < 93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease. Trial registration Institutional registration R-2020-3601-145, Federal Commission for the Protection against Sanitary Risks 17 CI-09-015-034, National Bioethics Commission: 09 CEI-023-2017082.

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P0614URINARY EXOSOMAL MICRORNA-21 AS A MARKER OF SCRUB TYPHUS-ASSOCIATED ACUTE KIDNEY INJURY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0614 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

In O Sun ◽

Kwang Young Lee ◽

A Young Cho

Keyword(s):

Acute Kidney Injury ◽

Kidney Disease ◽

Scrub Typhus ◽

Area Under The Curve ◽

Kidney Injury ◽

Diagnostic Value ◽

Cross Sectional Study ◽

Total Leukocyte Count ◽

Cross Sectional ◽

Exosomal Mirna

Abstract Background and Aims Urinary microRNA (miRNA)-21 is reported to be a biomarker for detection of acute kidney injury (AKI). Analysis of urinary exsome may serve as a novel diagnostic approach in kidney disease. The aim of this study is to investigate the clinical significance of urinary exosomal miRNA-21 for AKI in patients with scrub typhus. Method In a cross-sectional study, we collected 138 urine samples at the time of admission from 145 patients with scrub typhus. For 25 patients with scrub typhus-associated AKI and 25 age, sex-matched scrub typhus patient without AKI, we measured miRNA-21 in urinary exosomal fraction and compared diagnostic value in predictiong AKI. Results Compared with patients in the non-AKI group, patients in the AKI group were more likely to have one or more comorbidity such as diabetes (50% vs. 5%, P<0.01) and chronic kidney disease (8% vs. 0%, P<0.01). Total leukocyte count were higher in patients with AKI than in those without AKI (10.40 × 103/ mL vs. 6.40 × 103/mL, P<0.01). The levels of urinary miRNA-21 were higher in the AKI group than in the non-AKI group. Urinary exosomal miRNA-21 levels correlated directly with serum neutrophil gelatinase-associated lipocalin values and total leukocyte counts and inversely with estimated glomerular filtration rate. The receiver operator characteristics curve analysis for urinary exosomal miRNA-21 showed good discriminative power for the diagnosis of scrub typhus-associated AKI, with area under the curve value of 0.907. Conclusion Urinary exosomal miRNA-21 could be a surrogate markers for the diagnosis of scrub typhus–associated AKI.

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Diagnostic accuracy of enthesis ultrasound in the diagnosis of early spondyloarthritis

Annals of the Rheumatic Diseases ◽

10.1136/ard.2010.134965 ◽

2010 ◽

Vol 70 (3) ◽

pp. 434-439 ◽

Cited By ~ 70

Author(s):

Eugenio de Miguel ◽

Santiago Muñoz-Fernández ◽

Concepción Castillo ◽

Tatiana Cobo-Ibáñez ◽

Emilio Martín-Mola

Keyword(s):

New York ◽

Diagnostic Accuracy ◽

Statistical Significance ◽

Area Under The Curve ◽

Roc Curves ◽

Controlled Study ◽

Diagnostic Classification ◽

Hla B27 ◽

Cross Sectional ◽

Ultrasound Score

ObjectiveTo determine the sensitivity and specificity of enthesis ultrasound for the diagnostic classification of early spondyloarthritis.MethodsA cross-sectional, blinded and controlled study. Standardised bilateral ultrasound of six entheses (Madrid sonography enthesitis index (MASEI)) was performed. Accepted diagnostic classification criteria were used as the gold standard. Validity was analysed by receiver operating characteristic (ROC) curves. Values of p<0.05 were considered significant.Results113 early spondyloarthritis patients were included (58 women/55 men), 57 non-inflammatory control individuals (29 women/28 men) and 24 inflammatory control individuals (11 women/13 men). The evolution time of spondyloarthritis was 10.9±7.1 months. At least some grade of sacroiliitis on x-ray was present in 59 patients, but only five fulfilled the radiographic sacroiliitis New York criteria. Human leucocyte antigen B27 (HLA-B27) was positive in 42% of patients. No statistical differences were found for the enthesis score among diagnostic spondyloarthritis subtypes form of presentation (axial, peripheral or mixed) or HLA-B27 positivity. The MASEI score achieved statistical significance for gender. The ultrasound score was 23.36±11.40 (mean±SD) in spondyloarthritis patients and 12.26±6.85 and 16.04±9.94 in the non-inflammatory and inflammatory control groups (p<0.001), respectively. The ROC area under the curve was 0.82, and a cut-off point of ≥20 points achieved a likelihood ratio of 5.30 and a specificity of 89.47%.ConclusionsEntheses are affected early in spondyloarthritis, and the incidence of involvement is higher in men and independent of the spondyloarthritis diagnostic subtype, HLA-B27 status or presentation pattern. The enthesis ultrasound score seems to have diagnostic accuracy and may be useful for improving the diagnostic accuracy of early spondyloarthritis.

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Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

10.53350/pjmhs211561679 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1679-1681

Author(s):

Afaque Ali ◽

Majid Shaikh ◽

Ahsanullah . ◽

Adeel Ahmed ◽

Abid Ali Sahito ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

Cross Sectional Study ◽

Radiology Department ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

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Clinical relevance of protruded retinal layers in minimum rim width measurement of the optic nerve head

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313070 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1401-1405

Author(s):

Lucas A Torres ◽

Faisal Jarrar ◽

Glen P Sharpe ◽

Donna M Hutchison ◽

Eduardo Ferracioli-Oda ◽

...

Keyword(s):

Optic Nerve ◽

Diagnostic Accuracy ◽

Optic Nerve Head ◽

Cross Sectional Study ◽

Retinal Nerve Fibre Layer ◽

Mean Deviation ◽

Cross Sectional ◽

Retinal Layers ◽

Rnfl Thickness ◽

Oct Imaging

Background/aimsOptical coherence tomography (OCT) imaging of the optic nerve head minimum rim width (MRW) has recently been shown to sometimes contain components besides extended retinal nerve fibre layer (RNFL). This study was conducted to determine whether excluding these components, termed protruded retinal layers (PRLs), from MRW increases diagnostic accuracy for detecting glaucoma.MethodsIn this cross-sectional study, we included 123 patients with glaucoma and 123 normal age-similar controls with OCT imaging of the optic nerve head (24 radial scans) and RNFL (circle scan). When present, PRLs were manually segmented, and adjusted MRW measurements were computed. We compared diagnostic accuracy of adjusted versus unadjusted MRW measurement. We also determined whether adjusted MRW correlates better with RNFL thickness compared with unadjusted MRW.ResultsThe median (IQR) visual field mean deviation of patients and controls was −4.4 (−10.3 to −2.1) dB and 0.0 (−0.6 to 0.8) dB, respectively. In the 5904 individual B-scans, PRLs were identified less frequently in patients (448, 7.6%) compared with controls (728, 12.3%; p<0.01) and were present most frequently in the temporal sector of both groups. Areas under the receiver operating characteristic curves and sensitivity values at 95% specificity indicated that PRL adjustment did not improve diagnostic accuracy of MRW, globally or temporally. Furthermore, adjusting MRW for PRL did not improve its correlation with RNFL thickness in either group.ConclusionWhile layers besides the RNFL are sometimes included in OCT measurements of MRW, subtracting these layers does not impact clinical utility.

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Diagnostic accuracy of anthropometric indices in predicting excess body fat among seven to ten-year-old children

Revista Brasileira de Epidemiologia ◽

10.1590/1415-790x201400010019eng ◽

2014 ◽

Vol 17 (1) ◽

pp. 243-254 ◽

Cited By ~ 4

Author(s):

Edineia Aparecida Gomes Ribeiro ◽

Danielle Biazzi Leal ◽

Maria Alice Altenburg de Assis

Keyword(s):

Diagnostic Accuracy ◽

Body Fat ◽

Roc Curves ◽

Cross Sectional Study ◽

The Body ◽

Anthropometric Indices ◽

Cross Sectional ◽

Standardized Residuals ◽

Highly Sensitive ◽

Anthropometric Index

PURPOSE: To evaluate the accuracy of the body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in detecting excess body fat among schoolchildren in Florianópolis, Santa Catarina. METHODS: Cross-sectional study with 2,772 schoolchildren aged seven to ten years. Receiver Operating Characteristic (ROC) curves were used to compare the diagnostic accuracy of the BMI, the WC and the WHtR in identifying children with excess body fat (defined as values that were equal to or higher than the 90th percentile of the standardized residuals obtained from the sum of the four skinfolds thickness). Likelihood ratio estimates were used to select, for each anthropometric index, the cut-off points that presented the highest association with excess body fat. RESULTS: The BMI, WC and WHtR performed well in detecting excess body fat, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly higher AUC for the BMI in comparison to the WC and the WHtR concerning both sexes. Highly sensitive and specific cut-off points were derived for the three anthropometric indices. Sensitivity ranged from 85.7 to 92.9% for the BMI, from 78.6 to 89.7% for the WC, and from 78.6 to 89.2% for the WHtR. Specificity ranged from 83.2 to 91.4%, from 75.0 to 90.7%, and from 77.4 to 88.3% for the BMI, the WC and the WHtR, respectively. CONCLUSION: BMI, WC and WHtR can be used as diagnostic tests to identify excess body fat in children from seven to ten years of age.

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Association of acylated ghrelin profiles with chronic inflammatory markers in overweight and obese postmenopausal women: a MONET study

Acta Endocrinologica ◽

10.1530/eje-07-0038 ◽

2007 ◽

Vol 157 (4) ◽

pp. 419-426 ◽

Cited By ~ 10

Author(s):

David H St-Pierre ◽

Jean-Philippe Bastard ◽

Lise Coderre ◽

Martin Brochu ◽

Antony D Karelis ◽

...

Keyword(s):

Postmenopausal Women ◽

Inflammatory Markers ◽

Area Under The Curve ◽

Blood Lipid ◽

Cross Sectional Study ◽

Acylated Ghrelin ◽

Euglycemic Hyperinsulinemic Clamp ◽

Cross Sectional ◽

Tnf Α ◽

Maximal Reduction

Objective: Recent reports have suggested that the existence of associations between hormonal dysregulation and chronic upregulation of inflammatory markers, which may cause obesity-related disturbances. Thus, we examined whether acylated ghrelin (AcylG) and total ghrelin (TotG) levels could be associated with the following inflammatory markers: C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and soluble TNF receptor 1 (sTNF-R1). Design: Cross-sectional study consisting of 50 overweight and obese postmenopausal women. Methods: AcylG and TotG levels were assessed at 0, 60, 160, 170, and 180 min of the euglycemic/hyperinsulinemic clamp (EHC). We evaluated insulin sensitivity, body composition, and blood lipid profiles as well as fasting concentrations of CRP, TNF-α, and sTNF-R1. Results: In fasting conditions, sTNF-R1 was negatively correlated with AcylG (r = −0.48, P < 0.001) levels. In addition, AcylG/TotG was associated negatively with sTNF-R1 (r = −0.44, P = 0.002) and positively with TNF-α (r = 0.38, P = 0.009) values. During the EHC, TotG (at all time points) and AcylG (at 60 and 160 min) values were significantly decreased from fasting concentrations. AcylG maximal reduction and area under the curve (AUC) values were correlated to sTNF-R1 (r = −0.35, P = 0.02 and r = −0.34, P = 0.02, respectively). Meanwhile, the AcylG/TotG AUC ratio was associated negatively with sTNF-R1 (r = −0.29, P < 0.05) and positively with TNF-α (r = 0.36, P = 0.02). Following adjustments for total adiposity, sTNF-R1 remained correlated with fasting and maximal reduction AcylG values. Similarly, AcylG/TotG ratios remained significantly correlated with sTNF-R1 and TNF-α. Importantly, 23% of the variation in sTNF-R1 was independently predicted by fasting AcylG. Conclusion: These results are the first to suggest that both fasting and EHC-induced AcylG profiles are correlated with fasting values of sTNF-R1, a component of the TNF-α system. Thus, AcylG may act, at least in part, as one mediator of chronic inflammatory activity in human obesity.

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