“Category 4A” microcalcifications: how should this subcategory be applied to microcalcifications seen on mammography?

2017 ◽  
Vol 59 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Jihee Kim ◽  
Eun-Kyung Kim ◽  
Min Jung Kim ◽  
Hee Jung Moon ◽  
Jung Hyun Yoon
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Imaging Features ◽  
Reference Standard ◽  
Predictive Values ◽  
Guided Biopsy

Background The BI-RADS provides descriptors for microcalcifications based on morphology and distribution. However, the descriptor for category 4A microcalcifications is not specified in the 5th BI-RADS nor in the prior editions. Purpose To investigate how the category 4A assessment is applied to suspicious microcalcifications, and the appropriate descriptors for category 4A assessment for microcalcifications seen on mammography. Material and Methods From June 2008 to November 2011, 296 women with 305 suspicious microcalcifications that were assessed as BI-RADS category 4A, who underwent imaging-guided biopsy or surgery, were included. Mammograms were reviewed and imaging features were analyzed according to the morphology and distribution descriptors of the 5th edition of BI-RADS. Pathological results were considered as the reference standard. Positive predictive values were calculated and compared between morphology and distribution descriptors. Results The overall positive predictive value (PPV) of category 4A microcalcifications was 17.7% (54/305). Most common descriptors for category 4A microcalcifications were amorphous morphology (73.1%) and grouped distribution (71.1%). PPVs of individual morphology descriptors were as follows: amorphous = 7.2%; coarse heterogeneous = 12.8%; fine pleomorphic or fine linear/fine linear branching = 91.4% ( P < 0.001). PPVs of distribution descriptors were as follows: regional = 13.2%; grouped = 16.1%; linear/segmental = 54.5% ( P < 0.001). For morphology and distribution descriptors combinations, PPVs for amorphous/regional and amorphous/grouped microcalcifications were 6.8% and 6.9%, while PPVs of other combinations were higher than 10%, respectively. Conclusion Common descriptors used in category 4A assessment for microcalcifications are amorphous morphology and grouped distribution. PPV of amorphous/regional and amorphous/grouped microcalcifications were suitable for category 4A assessment.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

scholarly journals Evaluating Specivity, Sensitivity, Positive and Negative Predictive Values of CA125 for Diagnosing Ovarian Cancer

2021 ◽  
Vol 24 (2) ◽  
pp. 196-203
Author(s):  
Elahe Fini ◽  
◽  
Neda Nasirian ◽  
Bahram Hosein Beigy ◽  
◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Tumor Marker ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Screening Test ◽  
High Sensitivity ◽  
Medical Community ◽  
Cross Sectional ◽  
Predictive Values

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.

scholarly journals Diagnostic Value of CK19, HBME-1 and TROP2 Biomarkers in Identification of Different Types of Thyroid Follicular Neoplasms

2021 ◽  
Author(s):  
Shohreh Vojuhi ◽  
Masoud Mohebbi ◽  
Zohreh Mousavi ◽  
Mohammadali Yaghoubi ◽  
Reza Ziaolhagh
Keyword(s):  
Positive Predictive Value ◽  
Papillary Carcinoma ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Thyroid Neoplasms ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Different Types

Thyroid malignancies are found in 7% to 15% of all thyroid nodules. Immunohistochemical markers, including CK19, HBME-1and TROP2, have shown an effective role in identifying these malignancies. Hence, due to the lack of appropriate diagnostic tests for the identification of thyroid neoplasms, in this study, we aimed to determine the diagnostic value of these biomarkers in the identification of different types of follicular thyroid neoplasms. In this cross-sectional study, paraffin-embedded tissue blocks from the surgical resection of patients with thyroid nodules, referring to Imam Reza and Razavi Hospitals of Mashhad in 2017, were studied. Sensitivity, specificity, and positive and negative predictive values of these biomarkers for the identification of different types of follicular thyroid neoplasms were also studied. 129 patients with a mean age of 44.65±12.59 years participated in this study, of whom 101 (78.29%) were women. The most common type of follicular thyroid neoplasm was papillary carcinoma (60.47%). The highest sensitivity (94.87%) and positive predictive value (68.51%) in the detection of follicular neoplasms was observed by CK19 in papillary carcinoma. The sensitivity and positive predictive value of TROP2 in the detection of papillary neoplasms was 93.58% and 75.25%, respectively. In addition, HBME-1 had the highest specificity (72.54 %) and positive predictive value (81.57%) in identifying this neoplasm. The results of this study showed that CK19, HBME-1, and TROP2 had high diagnostic value in the detection of papillary thyroid neoplasms. Although these biomarkers had low diagnostic value in identifying follicular adenoma and carcinoma, given the high negative predictive value, they can be considered as powerful markers in identifying negative cases.

Association of Bacteria Species with Positive Predictive Value of Bacteria Isolated from Cerebrospinal Fluid Cultures: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yi Ye ◽  
Guanghui Zheng ◽  
Yueyue Kong ◽  
Jiawei Ma ◽  
Guojun Zhang ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Positive Predictive Value ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Klebsiella Oxytoca ◽  
P Value ◽  
Coagulase Negative Staphylococci ◽  
Predictive Values

Abstract Background: Previous studies discuss the positive predictive value through whether the bacteria are coagulase-negative staphylococci. The view may need to be updated. The aim was to evaluate the positive predictive value of different bacteria species isolated from cerebrospinal fluid cultures and discuss the rationality to view coagulase-negative staphylococci as a group.Methods: This retrospective cohort study recruit all adults with positive cerebrospinal fluid cultures sampled by lumbar puncture 2012-2020 in the Department of Neurosurgery. The exposure was bacteria species, and the outcome was positive predictive value. An episode was defined as a patient with one bacteria. When episodes with a bacteria species reached five, the bacteria species was analyzed specifically. The positive predictive value was defined as the incidence of isolated-bacteria-related infected episodes. The isolated-bacteria-related infected episode was defined as the patient was with clinical features of bacterial meningitis, and the improvement was related to sensitive antibacterial agents. Then the differences of the positive predictive value of different bacteria in all specific bacteria species, coagulase-negative staphylococci, and non-coagulase-negative staphylococci bacteria were calculated, respectively. The results were statistically significant when P-value <.05.Results: 1180 episodes from 1133 patients with 79 bacteria were studied; the positive predictive value was 54.3%. The bacteria included 67 bacteria species, ten bacteria genus, viridans streptococci, and unclassified coagulase-negative staphylococci. Twenty-four specific bacteria species were analyzed. The range of positive predictive values of them was 29.4%-100.0% (P<.0001). The positive predictive value for Enterobacter aerogenes, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca was the highest, while the positive predictive value for Staphylococcus cohnii was the lowest. Moreover, 767 (65.0%) were with coagulase-negative staphylococci, the positive predictive value was 46.4%, and the range was 29.4%-85.7% (P=.0020); 413 (35.0%) were with non-coagulase-negative staphylococci bacteria, the positive predictive value was 69.0%, and the range was 40.0%-100.0% (P<.0001).Conclusions: This study suggests that the positive predictive value of different bacteria species is different. It is more reasonable to discuss the positive predictive value of bacteria isolated from cerebrospinal fluid cultures through the bacteria species rather than whether they are coagulase-negative staphylococci.Trial registration: This is a retrospective study without interventions on participants.

Evaluation of a Rapid Immunochromatographic test kit to the Gold Standard Fluorescent Antibody test for diagnosis of rabies in animals in Bhutan 

2020 ◽  
Author(s):  
Tenzin Tenzin ◽  
Kelzang Lhamo ◽  
Purna B Rai ◽  
Dawa Tshering ◽  
Pema Jamtsho ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fluorescent Antibody ◽  
False Negative ◽  
Rapid Test ◽  
Antibody Test ◽  
Reference Standard ◽  
Predictive Values ◽  
Percent Agreement ◽  
Test Kit ◽  
Resource Poor

Abstract Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. In this study, a total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) relative to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response and enhancing rabies surveillance. Results: Among 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall, there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively. Conclusions: Our finding demonstrated that the rapid test kit (BioNote) can be used for rabies surveillance and confirming clinical case of rabies in animals for making rapid decisions particularly controlling rabies outbreaks in resource poor settings.

scholarly journals Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Konuralp Yakar
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Performance ◽  
High Specificity ◽  
Screening Criteria ◽  
Predictive Values ◽  
Before And After ◽  
Sensitivity Specificity ◽  
Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

scholarly journals The Utility of the King-Devick Test in Evaluating Professional Ice Hockey Players with Suspected Concussion

2019 ◽  
Vol 34 (5) ◽  
pp. 781-781
Author(s):  
R J Echemendia ◽  
J M Bruce ◽  
J Thelen ◽  
P Comper ◽  
M Hutchison ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Rugby Union ◽  
Ice Hockey ◽  
Diagnostic Utility ◽  
Predictive Values ◽  
Cut Score ◽  
Hockey Players ◽  
Active Controls ◽  
Number Naming

Abstract Purpose The King-Devick (KD) is a measure of rapid number naming used in the evaluation of sports-related concussion (SRC). Recent data from the Canadian Football League and Rugby Union suggest that the KD should not be used as a stand-alone measure of SRC. The purpose of this study was to examine the diagnostic utility of the KD in professional ice hockey players. Methods NHL players who were suspected of having a concussion were evaluated with the KD and either the SCAT3 or the SCAT5. Players who were evaluated and not diagnosed with concussion served as Active controls. A small group of non-Active control players was also tested twice and was included in the present study for comparison. Results 1605 players were evaluated with the KD at baseline. Of these, 53 were diagnosed with concussion, 76 were Active controls, and 11 were non-Active controls. Concussed players revealed a decline in performance from baseline to acute evaluation, t(52)=3.05, p<.01, d=.42 while Active controls significantly improved, t(75)=2.05, p<.05, d=.24. No significant change between baseline and acute testing was observed for non-Active controls. Using a cut score of any decline in performance from baseline to suspected injury evaluation yielded Sensitivity=64%, Specificity=61%, Positive Predictive Value=53% and Negative Predictive Value=71%. Conclusion Our data are consistent with previous studies suggesting that while the KD is useful in differentiating concussed and not concussed athletes acutely, the relatively low predictive values indicate that a decline in KD performance should not be used as a standalone measure to diagnose concussion.

scholarly journals Classifying Ectopia Lentis in Marfan Syndrome into Five Grades of Increasing Severity

2020 ◽  
Vol 9 (3) ◽  
pp. 721
Author(s):  
Jean-Christophe Zech ◽  
Audrey Putoux ◽  
Evelyne Decullier ◽  
Anne-Emmanuelle Fargeton ◽  
Patrick Edery ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Marfan Syndrome ◽  
Predictive Value ◽  
Anterior Segment ◽  
Control Group ◽  
Clinical Practices ◽  
Predictive Values ◽  
Ectopia Lentis ◽  
Grade Classification

Purpose: To describe a five-grade classification of ectopia lentis in Marfan syndrome (MFS) and to evaluate the positive predictive value of the early grades of ectopia lentis. Methods: We prospectively included MFS patients and their healthy relatives. The anterior segment examination was classified into grades 0 to 5, and we studied the sensitivity, specificity, and positive predictive value of ectopia lentis in this classification. Results: Seventy-four MFS patients and thirty-six healthy controls were examined. In the MFS group, grades 1, 2, 3, and 4 were present in 15, 24, 17, and 7 patients, respectively, whereas 11 patients in this group did not present ectopia lentis. In the control group, grades 0 and 1 were observed in 30 and 6 individuals, respectively. Sensitivity to ectopia lentis of at least grade 2 was 64.9%, with 100% specificity, whereas sensitivity to ectopia lentis of at least grade 1 was 85.1%, with 83.3% specificity. The positive predictive value of ectopia lentis that was greater than or equal to grade 2 was 100%, whereas that of ectopia lentis greater than or equal to grade 1 was 91.3%. Conclusions: High positive predictive values s were found to be associated with grades 2 and higher of the five-grade classification of ectopia lentis. This classification should help to harmonize clinical practices for this major feature of MFS.

Imaging-Guided Biopsy of 18F-FDG–Avid Extrapulmonary Lesions: Do Lesion Location and Morphologic Features on CT Affect the Positive Predictive Value for Malignancy?

2013 ◽  
Vol 201 (2) ◽  
pp. 433-438 ◽  
Author(s):  
My-Linh Nguyen ◽  
Debra A. Gervais ◽  
Michael A. Blake ◽  
Peter R. Mueller ◽  
Dushyant V. Sahani ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Lesion Location ◽  
Guided Biopsy ◽  
18F Fdg

Administrative Data Fail to Accurately Identify Cases of Healthcare-Associated Infection

2006 ◽  
Vol 27 (4) ◽  
pp. 332-337 ◽  
Author(s):  
Eileen R. Sherman ◽  
Kateri H. Heydon ◽  
Keith H. St. John ◽  
Eva Teszner ◽  
Susan L. Rettig ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Administrative Data ◽  
Active Surveillance ◽  
Predictive Value ◽  
Healthcare Associated Infection ◽  
Cross Sectional ◽  
Policy Makers ◽  
Predictive Values ◽  
Healthcare Associated ◽  
Very High

Objective.Some policy makers have embraced public reporting of healthcare-associated infections (HAIs) as a strategy for improving patient safety and reducing healthcare costs. We compared the accuracy of 2 methods of identifying cases of HAI: review of administrative data and targeted active surveillance.Design, Setting, and Participants.A cross-sectional prospective study was performed during a 9-month period in 2004 at the Children's Hospital of Philadelphia, a 418-bed academic pediatric hospital. “True HAI” cases were defined as those that met the definitions of the National Nosocomial Infections Surveillance System and that were detected by a trained infection control professional on review of the medical record. We examined the sensitivity and the positive and negative predictive values of identifying HAI cases by review of administrative data and by targeted active surveillance.Results.We found similar sensitivities for identification of HAI cases by review of administrative data (61%) and by targeted active surveillance (76%). However, the positive predictive value of identifying HAI cases by review of administrative data was poor (20%), whereas that of targeted active surveillance was 100%.Conclusions.The positive predictive value of identifying HAI cases by targeted active surveillance is very high. Additional investigation is needed to define the optimal detection method for institutions that provide HAI data for comparative analysis.

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