The Role of Clinical “Experience” in Diagnostic Performance

1998 ◽  
Vol 18 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Angelo Fasoli ◽  
Silvia Lucchelli ◽  
Renato Fasoli
Keyword(s):  
Pulmonary Embolism ◽  
Multiple Regression ◽  
Clinical Experience ◽  
Diagnostic Performance ◽  
Roc Curves ◽  
Clinical Findings ◽  
X Ray ◽  
Biochemical Studies ◽  
Recorded Data

Twenty-one physicians examined records of 43 patients who had attended the hospital because of chest pain. Of these patients, 20 had had coronary heart disease (CHD), 15 had had nonspecific pain, and eight had had pulmonary embolism. The physicians indicated the probability of CHD in each case on the basis of 18 clinical findings, not including ECG, x-ray, or biochemical studies. The trial was repeated five years later, using the same records, by 16 of the same physicians. Diagnostic accuracy was evaluated by ROC curves, and the weight ascribed to each cue was inferred by multiple regression with estimated probability of CHD as the dependent variable. No significant change of areas under the ROC curves with increasing length of clinical experience was observed. Multiple regression was significant in 30 of 37 analyses. The distributions of most physicians' estimates of probabilities had similar shapes five years apart. It is concluded that “experience” does not have a clear role in diagnostic performance based on recorded data and that personal calibration and preferences in estimating probabilities often persist for years.

scholarly journals The Role of Imaging In The Diagnosis of Pulmonary Embolism

2019 ◽  
Vol 2 (1) ◽  
pp. 57
Author(s):  
Alfian Nur Rosyid ◽  
M. Yamin ◽  
Arina Dery Puspitasari
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Gold Standard ◽  
Common Condition ◽  
X Ray ◽  
Life Threatening ◽  
Chest X Ray ◽  
Proper Diagnosis ◽  
D Dimer

Pulmonary embolism is a common condition and sometimes can be life-threatening. A proper diagnosis can reduce mortality. Some examinations are needed to diagnose pulmonary embolism, including assessing the risk factors, clinical examination, D-dimer tests, and imaging. Imaging is necessary when the previous assessment requires further investigation. There are more imaging that can be used to diagnose and assess the severity of pulmonary embolism. However, it is still controversial regarding imaging modalities for optimizing pulmonary embolism diagnose. Chest X-Ray cannot exclude pulmonary embolism, but it is needed to guide the next examinations and to find alternative diagnoses. Pulmonary Multi-Detector CT Angiography is the gold standard to diagnose pulmonary embolism.

scholarly journals The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

2020 ◽  
Author(s):  
Jing Wang ◽  
Jinyu Su ◽  
Yuan Yuan ◽  
Xiaxia Jin ◽  
Bo Shen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Red Blood Cell ◽  
Axial Spondyloarthritis ◽  
Roc Curves ◽  
X Ray ◽  
Lymphocyte Ratio ◽  
Asas Classification Criteria

Abstract Background: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging. Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05). Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

Statistical Considerations in X-Ray Fluorescence Analysis

1975 ◽  
Vol 19 ◽  
pp. 53-73 ◽  
Author(s):  
M. A. Short
Keyword(s):  
Regression Analysis ◽  
Standard Deviation ◽  
Least Squares ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Fluorescence Analysis ◽  
Single Element ◽  
X Ray ◽  
Experimental Parameters

The role of statistics in certain areas of X-ray fluorescence analysis is considered. The topics discussed include: calculating the standard deviation associated with the result of an analysis; optimizing experimental parameters for both wavelength and energy dispersive analyses; evaluating limits of detection, limits of decision, and limits of determination; and weighting in the least squares fitting of data in single element polynomial relationships and in multi-element multiple regression analysis.

scholarly journals The role of lymphocyte-monocyte ratio on ankylosing spondylitis diagnosis and sacroiliitis staging  

2020 ◽  
Author(s):  
Jing Wang ◽  
Jinyu Su ◽  
Yuan Yuan ◽  
Xiaxia Jin ◽  
Bo Shen ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Blood Cell ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Red Blood Cell ◽  
Roc Curves ◽  
X Ray ◽  
Lymphocyte Ratio ◽  
Asas Classification Criteria

Abstract Background: Ankylosing spondylitis (AS)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. Therefore, early diagnosis is essential to for AS treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in AS remains unclear. The aim of this study was to investigate the role of LMR in AS diagnosis, disease activity classification and sacroiliitis staging. Methods: Seventy-eight AS patients and 78 sex and age matched healthy controls (HCs) were enrolled in this study. The diagnosis of AS was performed according to the New York criteria or the Assessment of SpondyloArthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in AS patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of AS.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in AS patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05). Conclusions: Our study suggested that LMR could be an important inflammatory marker that can be used to diagnosis AS and identify disease activity and X-ray stage of sacroiliitis.

scholarly journals The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging  

2020 ◽  
Author(s):  
Jing Wang ◽  
Jinyu Su ◽  
Yuan Yuan ◽  
Xiaxia Jin ◽  
Bo Shen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Red Blood Cell ◽  
Axial Spondyloarthritis ◽  
Roc Curves ◽  
X Ray ◽  
Lymphocyte Ratio ◽  
Asas Classification Criteria

Abstract Background: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05).Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

Three-year clinical experience with VQ SPECT for diagnosing pulmonary embolism: diagnostic performance

2014 ◽  
Vol 38 (6) ◽  
pp. 831-835 ◽  
Author(s):  
Thomas Grüning ◽  
Brent E. Drake ◽  
Sally L. Farrell ◽  
Tim Nokes
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Experience ◽  
Diagnostic Performance

Radiology

2007 ◽  
pp. 343-364
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Pulmonary Oedema ◽  
X Ray ◽  
Massive Haemoptysis ◽  
Chest X Ray

Introduction 344 Infection 344 Role of ultrasound and CT 346 Pneumothorax 346 Pulmonary embolism 347 Pleural effusion and empyema 348 Pulmonary oedema and ARDS 349 COPD and asthma 349 Massive haemoptysis 350 Lobar collapse 351 Because of its portable nature and rapid interpretation, the PA chest X-ray (CXR) (...

scholarly journals The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jing Wang ◽  
Jinyu Su ◽  
Yuan Yuan ◽  
Xiaxia Jin ◽  
Bo Shen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Red Blood Cell ◽  
Axial Spondyloarthritis ◽  
Roc Curves ◽  
X Ray ◽  
Lymphocyte Ratio ◽  
Asas Classification Criteria

Abstract Background Axial spondyloarthritis (axial SpA) is a chronic inflammatory disorder could lead to disability due to the failure of timely treatment. The role of lymphocyte-to-monocyte ratio (LMR) in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging. Methods Seventy-eight axial SpA patients [51males and 27 females; mean age 41.0 (29–52) years] and 78 healthy controls (HCs) [55males and 23 females; mean age 40 (30–53) years] were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA. Results Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P < 0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI = 0.734–0.872) with a sensitivity and specificity of 62.8 and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948–1.000) with a sensitivity and specificity of 94.9 and 97.4%, respectively. LMR levels were lower (P < 0.05) and significant differences in LMR values were observed among different stages (P < 0.05). Conclusions Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

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