Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

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Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.07.590 ◽

2017 ◽

Vol 63 (7) ◽

pp. 590-599 ◽

Cited By ~ 2

Author(s):

Fabiana Carla Matos da Cunha Cintra ◽

Marco Túlio Gualberto Cintra ◽

Rodrigo Nicolato ◽

Laiss Bertola ◽

Rafaela Teixeira Ávila ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Likelihood Ratio ◽

Predictive Value ◽

Functional Decline ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Control Group ◽

P Value ◽

Cognitive Screening

Summary Objective: Translate, transcultural adaptation and application to Brazilian Portuguese of the Alzheimer’s Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale as a cognitive screening instrument. Method: We applied the back translation added with pretest and bilingual methods. The sample was composed by 95 elderly individuals and their caregivers. Thirty-two (32) participants were diagnosed as mild cognitive impairment (MCI) patients, 33 as Alzheimer’s disease (AD) patients and 30 were considered as cognitively normal individuals. Results: There were only little changes on the scale. The Cronbach alpha coefficient was 0.89. The scores were 72.9 for control group, followed by MCI (65.1) and by AD (55.9), with a p-value < 0.001. The ROC curve value was 0.89. We considered a cut point of 72 and we observed a sensibility of 86.2%, specificity of 70%, positive predictive value of 86.2%, negative predictive value of 70%, positive likelihood ratio of 2.9 and negative likelihood ratio of 0.2. Conclusion: ADCS-ADL scale presents satisfactory psychometric properties to discriminate between MCI, AD and normal cognition.

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Misuse of ultrasound for palpable undescended testis by primary care providers: A prospective study

Canadian Urological Association Journal ◽

10.5489/cuaj.3242 ◽

2015 ◽

Vol 9 (11-12) ◽

pp. 387 ◽

Cited By ~ 3

Author(s):

Nathan C Wong ◽

Rahul K Bansal ◽

Armando J Lorenzo ◽

Jorge DeMaria ◽

Luis H Braga

Keyword(s):

Primary Care ◽

Physical Examination ◽

Likelihood Ratio ◽

Predictive Value ◽

Undescended Testis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Primary Care Providers ◽

Care Providers ◽

Hospital Patients

Introduction: Although previous evidence has shown that ultrasound is unreliable to diagnose undescended testis, many primary care providers (PCP) continue to misuse it. We assessed the performance of ultrasound as a diagnostic tool for palpable undescended testis, as well as the diagnostic agreement between PCP and pediatric urologists.Methods: We performed a prospective observational cohort study between 2011 and 2013 for consecutive boys referred with a diagnosis of undescended testis to our tertiary pediatric hospital. Patients referred without an ultrasound and those with non-palpable testes were excluded. Data on referring diagnosis, pediatric urology examination and ultrasound reports were analyzed.Results: Our study consisted of 339 boys. Of these, patients without an ultrasound (n = 132) and those with non-palpable testes (n = 38) were excluded. In the end, there were 169 pateints in this study. Ultrasound was performed in 50% of referred boys showing 256 undescended testis. The mean age at time of referral was 45 months. When ultrasound was compared to physical examination by the pediatric urologist, agreement was only 34%. The performance of ultrasound for palpable undescended testis was: sensitivity = 100%; specificity = 16%; positive predictive value = 34%; negative predictive value = 100%; positive likelihood ratio = 1.2; and negative likelihood ratio = 0. Diagnosis of undescended testis by PCP was confirmed by physical examination in 30% of cases, with 70% re-diagnosed with normal or retractile testes.Conclusion: Ultrasound performed poorly to assess for palpable undescended testis in boys and should not be used. Although the study has important limitations, there is an increasing need for education and evidence-based guidelines for PCP in the management of undescended testis.

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Predictive Value of Interim PET/CT in DLBCL Treated with R-CHOP: Meta-Analysis

BioMed Research International ◽

10.1155/2015/648572 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

Na Sun ◽

Jinhua Zhao ◽

Wenli Qiao ◽

Taisong Wang

Keyword(s):

Likelihood Ratio ◽

Predictive Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Chop Chemotherapy ◽

Interim Pet ◽

Pet Ct ◽

Fdg Pet Ct

Objective.We conducted a meta-analysis to evaluate the predictive value of interim18F-FDG PET/CT in patients with DLBCL treated with R-CHOP chemotherapy.Methods.We searched for articles published in PubMed, ScienceDirect, Wiley, Scopus, and Ovid database from inception to March 2014. Articles related to interim PET/CT in patients with DLBCL treated with R-CHOP chemotherapy were selected. PFS with or without OS was chosen as the endpoint to evaluate the prognostic significance of interim PET/CT.Results.Six studies with a total of 605 cases were included. The sensitivity of interim PET/CT ranged from 21.2% to 89.7%, and the pooled sensitivity was 52.4%. The specificity of interim PET/CT ranged from 37.4% to 90.7%, and the pooled specificity was 67.8%. The pooled positive likelihood ratio and negative likelihood ratio were 1.780 and 0.706, respectively. The explained AUC was 0.6978 and theQ*was 0.6519.Conclusions.The sensitivity and specificity of interim PET/CT in predicting the outcome of DLBCL patients treated with R-CHOP chemotherapy were not satisfactory (52.4% and 67.8%, resp.). To improve this, some more work should be done to unify the response criteria and some more research to assess the prognostic value of interim PET/CT with semiquantitative analysis.

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Classification of Thyroid Nodules with Stacked Denoising Sparse Autoencoder

International Journal of Endocrinology ◽

10.1155/2020/9015713 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Zexin Li ◽

Kaiji Yang ◽

Lili Zhang ◽

Chiju Wei ◽

Peixuan Yang ◽

...

Keyword(s):

Likelihood Ratio ◽

Predictive Value ◽

Thyroid Nodules ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Discriminative Ability ◽

Sparse Autoencoder ◽

Immune Related Genes

Purpose. Several commercial tests have been used for the classification of indeterminate thyroid nodules in cytology. However, the geographic inconvenience and high cost confine their widespread use. This study aims to develop a classifier for conveniently clinical utility. Methods. Gene expression data of thyroid nodule tissues were collected from three public databases. Immune-related genes were used to construct the classifier with stacked denoising sparse autoencoder. Results. The classifier performed well in discriminating malignant and benign thyroid nodules, with an area under the curve of 0.785 [0.638–0.931], accuracy of 92.9% [92.7–93.0%], sensitivity of 98.6% [95.9–101.3%], specificity of 58.3% [30.4–86.2%], positive likelihood ratio of 2.367 [1.211–4.625], and negative likelihood ratio of 0.024 [0.003–0.177]. In the cancer prevalence range of 20–40% for indeterminate thyroid nodules in cytology, the range of negative predictive value of this classifier was 37–61%, and the range of positive predictive value was 98–99%. Conclusion. The classifier developed in this study has the superb discriminative ability for thyroid nodules. However, it needs validation in cytologically indeterminate thyroid nodules before clinical use.

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Diagnostic Test Validity of CT-Scan for Detection of Hepatocellular Carcinoma

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v4i2.38929 ◽

2018 ◽

Vol 4 (2) ◽

pp. 133-136

Author(s):

Md Akter Hossain ◽

Md Saiful Haque ◽

Mostaque Ahmed Bhuiya ◽

Abu Bakar Siddique

Keyword(s):

Hepatocellular Carcinoma ◽

Ct Scan ◽

Likelihood Ratio ◽

Tertiary Care ◽

Test Validity ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Care Hospital ◽

Hepatocelluar Carcinoma ◽

Cross Sectional

Background: CT-scan can detect hepatocelluar carcinoma among the patients.Objective: The purpose of the present study was to see the pattern of hepatocelluar carcinoma among the patients attended at a tertiary care hospital in Dhaka city.Methodology: This cross-sectional study was carried out in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to May 2008 for a period of around one and half year. All the patients presented with hepatocellular carcinoma at the age group of more than 20 years with both sexes were selected as study population. The patients were undergone CT-scan examination and the confirmation of tumor was performed by histopathological examination.Result: A total number of 50 patients were recruited in this study after fulfilling the inclusion and exclusion criteria. The sensitivity, specificity and accuracy of CT-scan in detecting hepatocellular carcinoma was seen to be 66%, 92% and 72% respectively. The PPV and NPV were 96.15% (95% CI 79.06% to 99.40%) and 45.83% (95% CI 34.53% to 57.58%) respectively. However, the Positive Likelihood Ratio and Negative Likelihood Ratio were 7.89 (95% CI 1.19 to 52.28) and 0.37(95% CI 0.23 to 0.60).Conclusion: In conclusion CT-scan is a good diagnostic tool for the detection of hepatocellular carcinoma.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 133-136

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Predictive value of pregnancy-associated plasma protein-A in relation to fetal loss: A systematic review and meta-analysis

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v13i6.7281 ◽

2020 ◽

Author(s):

Zahra Hadizadeh-Talasaz ◽

Ali Taghipour ◽

Seyede Houra Mousavi-Vahed ◽

Robab Latifnejad Roudsari

Keyword(s):

Systematic Review ◽

Likelihood Ratio ◽

Plasma Protein ◽

Predictive Value ◽

Meta Analysis ◽

Protein A ◽

Fetal Loss ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Forest Plot

Background: For a woman with bleeding and threatened abortion, ultrasound scan is done to confirm the viability of the fetus; however, 10-15% of the embryos are eventually aborted. Distinguishing between women with good and poor prognosis can be a helpful approach. Objective: This study aimed to review the predictive value of Pregnancy-associated Plasma Protein A (PAPP-A) in relation to the diagnosis of fetal loss. Materials and Methods: The articles published in multiple databases including Web of Science, PubMed, MEDLINE, Scopus, and Persian databases such as ISC, Magiran, and IranMedx were searched for articles published until May 2019. MeSH terms was used for searching the databases including fetal loss OR pregnancy loss OR abortion OR miscarriage with the following word using AND; Pregnancy-Associated Plasma Protein- A OR PAPP-A. Two reviewers extracted data and recorded them in a pre-defined form and assessed the quality of articles using the Newcastle-Ottawa tool. Meta-analysis was done using the Comprehensive Meta-Analysis/2.0 software and MetaDisc. Results: A total number of 16 studies were eligible for the qualitative data synthesis, out of which 8 studies were included in the meta-analysis. All studies had high and medium quality. The forest plot analysis showed a sensitivity of 57% (95% CI: 53-63%), a specificity of 83% (95% CI: 80-85%), a positive likelihood ratio of 3.52 (95% CI: 2.44- 5.07), a negative likelihood ratio of 0.54 (95% CI: 0.37-0.79), and a diagnostic odds ratio of 6.95 (95% CI: 3.58-13.50). Conclusion: PAPP-A cannot be recommended on a routine basis for predicting fetal loss and still further research with a combination of other biomarkers is required. Key words: Pregnancy-associated plasma protein-A, Fetal loss, Pregnancy, Systematic review.

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Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score

International Surgery Journal ◽

10.18203/2349-2902.isj20201854 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1473

Author(s):

Amulya Aggarwal ◽

Alok V. Mathur ◽

Ram K. Verma ◽

Megha Gupta ◽

Dheeraj Raj

Keyword(s):

Acute Pancreatitis ◽

Likelihood Ratio ◽

Sensitivity And Specificity ◽

Severe Acute Pancreatitis ◽

Predictive Value ◽

Scoring System ◽

Treatment Protocol ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Clinical Scoring

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.

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Diagnostic Accuracy of Plasma Ghrelin Concentrations in Pediatric Sepsis -associated ARDS: A Single-center Cohort Study

10.21203/rs.3.rs-49171/v1 ◽

2020 ◽

Author(s):

xiu yuan ◽

Shaojun Li ◽

Liang Zhou ◽

yanru LI ◽

tian tang ◽

...

Keyword(s):

Diagnostic Criteria ◽

Likelihood Ratio ◽

Predictive Value ◽

Protective Factor ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Ghrelin Level ◽

Inflammatory Factors ◽

Rank Test ◽

Growth Hormone Secretagogue

Abstract Background: Ghrelin is the endogenous ligand of growth hormone secretagogue receptor 1a (GHSR1a), which can regulate immunity and inflammation. To assess the diagnostic value of plasma ghrelin levels in sepsis-associated pediatric acute respiratory distress syndrome (PARDS).Methods: We recruited patients from the PICU of a third-class teaching hospital who met the diagnostic criteria for sepsis from January 2019 to January 2020. Clinical data, laboratory indicators, plasma ghrelin concentrations, and inflammatory factors of cohort were evaluated in detail, and patients were followed up for 28 days. The area under the receiver-operating characteristic curves (AUROC) was calculated using logistic regression to calculate and positivity cut-offs was tested. Ghrelin's ability to diagnose and differentiate sepsis-associated PARDS were determined. The log-rank test was used to compare the survival curves of different ghrelin level groups.Main results: Sixty-six PICU patients (30 with ARDS, 36 without ARDS) who met the diagnostic criteria of sepsis were recruited. The ghrelin level was significantly higher in the sepsis patients of the ARDS group than in those of the non-ARDS group. The AUROC of ghrelin was 0.708 (95% confidence interval: 0.584–0.833) and the positivity cutoff value was 445 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (–LR) of plasma ghrelin for diagnosis of sepsis with PARDS were 86.7%, 50.0%, 59.1%, 81.8%,1.734, and 0.266, respectively. The survival rate of sepsis patients was significantly improved when the ghrelin level was >445 pg/mL.Conclusions: Ghrelin plasma was higher in sepsis-associated PARDS, and accompanied by the increase of inflammatory factors. The increased plasma ghrelin may be due to the anti-inflammatory response, which may be a protective factor in children with sepsis. Yet, there is no evidence to prove that elevated ghrelin appears to be a promising diagnostic indicator of sepsis-associated PARDS. In addition, the ghrelin levels may be a positive predictor of sepsis.Trial registration: Clinicaltrials, ChiCTR1900023254. Registered 1 December 2018 - Retrospectively registered, http://www.clinicaltrials. gov/ChiCTR1900023254.

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Diagnostic accuracy of the risk of malignancy index 1 compared to the more recent IOTA ADNEX model in discriminating benign from malignant adnexal masses: a multi-centric study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190871 ◽

2019 ◽

Vol 8 (3) ◽

pp. 1001

Author(s):

Amita Ray ◽

Divya S. ◽

B. N. Kumar Guru ◽

A. S. Ramaswamy ◽

Bharat Kumar

Keyword(s):

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Predictive Value ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Adnexal Masses ◽

Medical College ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index ◽

Almost All

Background: Identification of the nature of an adnexal mass can ensure optimum management. Single parameters as well as diagnostic models using a combination of several parameters are in use. The International Ovarian Tumor Analysis (IOTA) consortium has developed and published the Assessment of Different NEoplasias in the adneXa (ADNEX) model, which differentiates between benign and malignant masses. Authors conducted this study with the aim of finding a cut off value for this model in the study population and comparing the diagnostic accuracy of this model to that of the risk of malignancy (RMI).Methods: Women with adnexal masses admitted to the 3 medical college affiliated hospitals for surgical management were included in this study. Appropriate investigations were done to calculate the RMI-I and ADNEX score for each participant. A cut off score for the ADNEX model was determined and diagnostic accuracy tests were done for comparison.Results: At a cut-off of 29 for the ADNEX model and 200 for RMI model the sensitivity was 75% and 77.8, specificity 100% and 80.6%; Positive Predictive Value (PPV) 100%and 60%; Negative Predictive Value (NPV) 91% and 90.6%; Positive Likelihood ratio of infinity and 4 and a negative Likelihood Ratio of 2.8 and 2.5 respectively.Conclusions: The ADNEX model rates higher than the RMI in almost all tests of diagnostic accuracy and can be used for triaging, framing a referral policy and prioritizing surgery.

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Diagnostic values of Xpert MTB/RIF, T-SPOT.TB and adenosine deaminase for HIV-negative tuberculous pericarditis in a high burden setting: a prospective observational study

Scientific Reports ◽

10.1038/s41598-020-73220-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Xu Hu ◽

Baochun Xing ◽

Wei Wang ◽

Pengwei Yang ◽

Yumei Sun ◽

...

Keyword(s):

Adenosine Deaminase ◽

Likelihood Ratio ◽

Predictive Value ◽

Mononuclear Cells ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Roc Curve Analysis ◽

High Burden ◽

Tuberculous Pericarditis ◽

Hiv Negative

Abstract The diagnosis of tuberculous pericarditis (TBP) remains challenging. This prospective study evaluated the diagnostic value of Xpert MTB/RIF (Xpert) and T-SPOT.TB and adenosine deaminase (ADA) for TBP in a high burden setting. A total of 123 HIV-negative patients with suspected TBP were enrolled at a tertiary referral hospital in China. Pericardial fluids were collected and subjected to the three rapid tests, and the results were compared with the final confirmed diagnosis. Of 105 patients in the final analysis, 39 (37.1%) were microbiologically, histopathologically or clinically diagnosed with TBP. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) for Xpert were 66.7%, 98.5%, 96.3%, 83.3%, 44.0, 0.338, and 130.0, respectively, compared to 92.3%, 87.9%, 81.8%, 95.1%, 7.6, 0.088, and 87.0, respectively, for T-SPOT.TB, and 82.1%, 92.4%, 86.5%, 89.7%, 10.8, 0.194, and 55.8, respectively, for ADA (≥ 40 U/L). ROC curve analysis revealed a cut-off point of 48.5 spot-forming cells per million pericardial effusion mononuclear cells for T-SPOT.TB, which had a DOR value of 183.8, while a cut-off point of 41.5 U/L for ADA had a DOR value of 70.9. Xpert (Step 1: rule-in) followed by T-SPOT.TB [cut-off point] (Step 2: rule-out) showed the highest DOR value of 252.0, with only 5.7% (6/105) of patients misdiagnosed. The two-step algorithm consisting of Xpert and T-SPOT.TB could offer rapid and accurate diagnosis of TBP.

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