scholarly journals Classification: The key to understanding facial pain

Cephalalgia ◽  
2017 ◽  
Vol 37 (7) ◽  
pp. 609-612 ◽  
Author(s):  
Peter Svensson ◽  
Arne May
Keyword(s):  
Facial Pain ◽  
Conceptual Models ◽  
Temporomandibular Disorder ◽  
Classification Systems ◽  
Pain Condition ◽  
Good Classification ◽  
Rater Variability ◽  
Future Work ◽  
Homogenous Population

It is indisputable that the global scientific advances in headache research, be it bench or bedside, have benefited enormously from the operational diagnostic criteria published in 1988. Today, this classification system is indispensable. The reason for this success is a low inter-rater variability. In general, orofacial pain conditions are less well characterised – with the noticeable exemption of temporomandibular disorder pain. Tremendous work has been put into changing this, and significant progress has been achieved – in particular, in terms of the clinical implications and overriding conceptual models for oro-facial pain. Scientific classifications have only one goal: To provide a scientific agreement about the main features of an object of research and a scientific consensus regarding the name. The main significance is not the fact that a good classification offers a detailed and accurate image of the reality. If we want to overcome the obstacles of different competing classification systems, we need to overcome specialisation borders. The key to success is to understand that such a definition does not mirror all possible clinical facets of a given pain condition but is simply a convention – that is, a consensus on a word used for a pain condition. Simply speaking, a classification creates a common language to be used by more than one profession. It will be crucial to define any given pain condition as precisely and rigid as possible, in order to ensure a homogenous population. Only this ensures a low inter-rater variability, which consequently allows combining and comparing research on a population across different professional settings. This is not easy for chronic facial pain without verifiable morphological cause or structural lesions, as these syndromes are often rather featureless. The new IASP classification of chronic pain is a big step forward to a better characterisation of such conditions, and will trigger future work on a new and operationalised classification of oro-facial pain.

scholarly journals Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

2020 ◽  
Vol 83 (1) ◽  
pp. 5-16 ◽  
Author(s):  
Laura Van Deun ◽  
Muriel de Witte ◽  
Thaïs Goessens ◽  
Stijn Halewyck ◽  
Marie-Christine Ketelaer ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Classification System ◽  
Facial Pain ◽  
Correct Diagnosis ◽  
Headache Disorders ◽  
Comprehensive Review ◽  
Pain Condition ◽  
Throat Pain ◽  
Generic Framework

Background: Facial pain, alone or combined with other symptoms, is a frequent complaint. Moreover, it is a symptom situated at, more than any other pain condition, a crosspoint where several disciplines meet, for example, dentists; manual therapists; ophthalmologists; psychologists; and ear-nose-throat, pain, and internal medicine physicians besides neurologists and neurosurgeons. Recently, a new version of the most widely used classification system among neurologists for headache and facial pain, the International Classification of Headache Disorders, has been published. Objective: The aims of this study were to provide an overview of the most prevalent etiologies of facial pain and to provide a generic framework for the neurologist on how to manage patients presenting with facial pain. Methods: An overview of the different etiologies of facial pain is provided from the viewpoint of the respective clinical specialties that are confronted with facial pain. Key message: Caregivers should “think outside their own box” and refer to other disciplines when indicated. If not, a correct diagnosis can be delayed and unnecessary treatments might be given. The presented framework is aimed at excluding life- or organ-threatening diseases, providing several clinical clues and indications for technical investigations, and ultimately leading to the correct diagnosis and/or referral to other disciplines.

scholarly journals P.086 The clinical significance of trigeminal neuralgia nomenclature

2016 ◽  
Vol 43 (S2) ◽  
pp. S40-S40
Author(s):  
SV Nolin ◽  
L Barchet ◽  
A Kaufmann
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Classification Systems ◽  
Headache Disorders ◽  
Trigeminal Neuropathy ◽  
Study Population ◽  
Surgical Treatments

Background: A diagnosis of trigeminal neuralgia (TN) may be broadly applied to many neuralgic facial pains, while more stringent criteria are required for management decisions, outcome assessment, and pathophysiological correlations. Our aim was to evaluate existing classification systems of facial pain. Methods: The study population was comprised of 534 Manitobans referred to neurosurgery for facial pain from 2001 to 2013. A retrospective chart review identified presenting features; pain distribution, nature, and duration. The recorded diagnoses (rDx) were then re-classified according to the International Classification of Headache Disorders (ICHD-3) and Burchiel System of TN1 and TN2. Results: There was complete correlation between rDx and ICHD-3 for typical TN (tTN) in 266(49.8%) patients, atypical TN (aTN) in 39(7.3%), and idiopathic facial pain (IFP) in 59(11%). Idiopathic trigeminal neuropathy (iTn) in 35(6.6%) was not classified in ICHD-3. Burchiel-TN1 included heterogeneous diagnoses including tTN (266), aTN (27), iTn (2) and IFP (8); Burchiel-TN2 included aTN (10), iTn (23), and IFP (15). Another 135(25.5%) had other facial pain diagnoses. Conclusions: Classification of TN is especially important when selecting and evaluating surgical treatments. Diagnostic criteria should clearly differentiate between unique conditions and ideally have basis on underlying etiology. The ICHD-3 nomenclature best satisfies these aims although should be expanded to include iTn.

Classification of facial pain: a 13-year population-based study

2015 ◽  
Vol 42 (S1) ◽  
pp. S41-S41
Author(s):  
L Barchet ◽  
AM Kaufmann
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
International Association ◽  
Population Based ◽  
Classification Systems ◽  
Trigeminal Neuropathy ◽  
Diagnosis And Classification ◽  
Criteria For Diagnosis

Introduction: Accurate diagnosis and classification of facial pain is critical for assigning surgical treatment, avoiding misdirected interventions and studying outcomes. We conducted a population-based longitudinal study of patients with facial pain and compared diagnostic classification systems. Methods: Medical records for all Manitobans presenting to our centre with a primary complaint of facial pain from 2001 to 2013 were reviewed. We then applied diagnostic criteria from the International Classification of Headache Disorders (IHS-3), the International Association for the Study of Pain (IASP) and Burchiel’s system for comparisons. Results: There were 534 patients with facial pain (3.4/100,000/year) and two-thirds of these had conditions potentially amenable to neurosurgical interventions. Our most common diagnoses were typical trigeminal neuralgia(50%), atypical trigeminal neuralgia(7%), idiopathic trigeminal neuropathy(7%), idiopathic facial pain(11%); average ages were 65±14(22-99), 60±18(32-86), 55±16(28-83) and 48±12(28-82) with a female proportion of 55%, 59%, 65% and 80%, respectively. Other classification systems included no criteria for idiopathic trigeminal neuropathy. The classifications of “trigeminal neuralgia type-1 and type-2” did not differentiate between surgical and non-surgical candidiates. Conclusion: Published classification systems of facial pain have differing criteria for diagnosis of trigeminal neuralgia and none defines a large group with idiopathic trigeminal neuropathy. This may lead to considerable variability in determinations of potential surgical candidates and comparing outcomes of treatment.

scholarly journals Toward an Integrated Clinical, Molecular and Serological Classification of Inflammatory Bowel Disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology

2005 ◽  
Vol 19 (suppl a) ◽  
pp. 5A-36A ◽  
Author(s):  
Mark S Silverberg ◽  
Jack Satsangi ◽  
Tariq Ahmad ◽  
Ian DR Arnott ◽  
Charles N Bernstein ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Working Party ◽  
Integrated System ◽  
Classification Systems ◽  
Indeterminate Colitis ◽  
Clinical Classification ◽  
Inflammatory Bowel ◽  
Future Work

The discovery of a series of genetic and serological markers associated with disease susceptibility and phenotype in inflammatory bowel disease has led to the prospect of an integrated classification system involving clinical, serological and genetic parameters. The Working Party has reviewed current clinical classification systems in Crohn’s disease, ulcerative colitis and indeterminate colitis, and provided recommendations for clinical classification in practice. Progress with respect to integrating serological and genetic markers has been examined in detail, and the implications are discussed. While an integrated system is not proposed for clinical use at present, the introduction of a widely acceptable clinical subclassification is strongly advocated, which would allow detailed correlations among serotype, genotype and clinical phenotype to be examined and confirmed in independent cohorts of patients and, thereby, provide a vital foundation for future work.

scholarly journals Classification of Post-Fire Responses of Woody Plants to include Pyrophobic Communities

Fire ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 15 ◽  
Author(s):  
Lynda D. Prior ◽  
David M. J. S. Bowman
Keyword(s):  
Woody Plants ◽  
Seed Banks ◽  
Classification Systems ◽  
Woody Vegetation ◽  
General Category ◽  
Conifer Species ◽  
Soil Seed Banks ◽  
Obligate Seeder ◽  
In Fire

Developing standardised classification of post-fire responses is essential for globally consistent comparisons of woody vegetation communities. Existing classification systems are based on responses of species growing in fire-prone environments. To accommodate species that occur in rarely burnt environments, we have suggested some important points of clarification to earlier schemes categorizing post-fire responses. We have illustrated this approach using several Australasian conifer species as examples of pyrophobic species. In particular, we suggest using the term “obligate seeder” for the general category of plants that rely on seed to reproduce, and qualifying this to “post-fire obligate seeder” for the narrower category of species with populations that recover from canopy fire only by seeding; the species are typically fire-cued, with large aerial or soil seed banks that germinate profusely following a fire, and grow and reproduce rapidly in order to renew the seed bank before the next fire.

scholarly journals Interobserver agreement of the Paris and simplified classifications of superficial colonic lesions: a Western study

2021 ◽  
Vol 09 (03) ◽  
pp. E388-E394
Author(s):  
Francesco Cocomazzi ◽  
Marco Gentile ◽  
Francesco Perri ◽  
Antonio Merla ◽  
Fabrizio Bossa ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Classification Systems ◽  
Sensitivity Analyses ◽  
Size Estimation ◽  
Rater Agreement ◽  
Staff Members ◽  
Video Clips ◽  
Paris Classification ◽  
Level Of Agreement

Abstract Background and study aims The Paris classification of superficial colonic lesions has been widely adopted, but a simplified description that subgroups the shape into pedunculated, sessile/flat and depressed lesions has been proposed recently. The aim of this study was to evaluate the accuracy and inter-rater agreement among 13 Western endoscopists for the two classification systems. Methods Seventy video clips of superficial colonic lesions were classified according to the two classifications, and their size estimated. The interobserver agreement for each classification was assessed using both Cohen k and AC1 statistics. Accuracy was taken as the concordance between the standard morphology definition and that made by participants. Sensitivity analyses investigated agreement between trainees (T) and staff members (SM), simple or mixed lesions, distinct lesion phenotypes, and for laterally spreading tumors (LSTs). Results Overall, the interobserver agreement for the Paris classification was substantial (κ = 0.61; AC1 = 0.66), with 79.3 % accuracy. Between SM and T, the values were superimposable. For size estimation, the agreement was 0.48 by the κ-value, and 0.50 by AC1. For single or mixed lesions, κ-values were 0.60 and 0.43, respectively; corresponding AC1 values were 0.68 and 0.57. Evaluating the several different polyp subtypes separately, agreement differed significantly when analyzed by the k-statistics (0.08–0.12) or the AC1 statistics (0.59–0.71). Analyses of LSTs provided a κ-value of 0.50 and an AC1 score of 0.62, with 77.6 % accuracy. The simplified classification outperformed the Paris classification: κ = 0.68, AC1 = 0.82, accuracy = 91.6 %. Conclusions Agreement is often measured with Cohen’s κ, but we documented higher levels of agreement when analyzed with the AC1 statistic. The level of agreement was substantial for the Paris classification, and almost perfect for the simplified system.

scholarly journals Pyramidal Framework: Guidance for the Next Generation of GIS Spatial-Temporal Models

2021 ◽  
Vol 10 (3) ◽  
pp. 188
Author(s):  
Cyril Carré ◽  
Younes Hamdani
Keyword(s):  
Conceptual Models ◽  
Future Generations ◽  
Temporal Data ◽  
Temporal Modeling ◽  
Temporal Models ◽  
Gis Data ◽  
Spatio Temporal ◽  
New Interpretation ◽  
Conventional Literature

Over the last decade, innovative computer technologies and the multiplication of geospatial data acquisition solutions have transformed the geographic information systems (GIS) landscape and opened up new opportunities to close the gap between GIS and the dynamics of geographic phenomena. There is a demand to further develop spatio-temporal conceptual models to comprehensively represent the nature of the evolution of geographic objects. The latter involves a set of considerations like those related to managing changes and object identities, modeling possible causal relations, and integrating multiple interpretations. While conventional literature generally presents these concepts separately and rarely approaches them from a holistic perspective, they are in fact interrelated. Therefore, we believe that the semantics of modeling would be improved by considering these concepts jointly. In this work, we propose to represent these interrelationships in the form of a hierarchical pyramidal framework and to further explore this set of concepts. The objective of this framework is to provide a guideline to orient the design of future generations of GIS data models, enabling them to achieve a better representation of available spatio-temporal data. In addition, this framework aims at providing keys for a new interpretation and classification of spatio-temporal conceptual models. This work can be beneficial for researchers, students, and developers interested in advanced spatio-temporal modeling.

scholarly journals A hybrid CNN-LSTM model for pre-miRNA classification

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abdulkadir Tasdelen ◽  
Baha Sen
Keyword(s):  
Evaluation Criteria ◽  
Mature Mirnas ◽  
Structural Features ◽  
Linear Discriminant ◽  
Sequential Structure ◽  
Precursor Mirnas ◽  
Lstm Network ◽  
Future Work ◽  
Cumulative Evidence

AbstractmiRNAs (or microRNAs) are small, endogenous, and noncoding RNAs construct of about 22 nucleotides. Cumulative evidence from biological experiments shows that miRNAs play a fundamental and important role in various biological processes. Therefore, the classification of miRNA is a critical problem in computational biology. Due to the short length of mature miRNAs, many researchers are working on precursor miRNAs (pre-miRNAs) with longer sequences and more structural features. Pre-miRNAs can be divided into two groups as mirtrons and canonical miRNAs in terms of biogenesis differences. Compared to mirtrons, canonical miRNAs are more conserved and easier to be identified. Many existing pre-miRNA classification methods rely on manual feature extraction. Moreover, these methods focus on either sequential structure or spatial structure of pre-miRNAs. To overcome the limitations of previous models, we propose a nucleotide-level hybrid deep learning method based on a CNN and LSTM network together. The prediction resulted in 0.943 (%95 CI ± 0.014) accuracy, 0.935 (%95 CI ± 0.016) sensitivity, 0.948 (%95 CI ± 0.029) specificity, 0.925 (%95 CI ± 0.016) F1 Score and 0.880 (%95 CI ± 0.028) Matthews Correlation Coefficient. When compared to the closest results, our proposed method revealed the best results for Acc., F1 Score, MCC. These were 2.51%, 1.00%, and 2.43% higher than the closest ones, respectively. The mean of sensitivity ranked first like Linear Discriminant Analysis. The results indicate that the hybrid CNN and LSTM networks can be employed to achieve better performance for pre-miRNA classification. In future work, we study on investigation of new classification models that deliver better performance in terms of all the evaluation criteria.

scholarly journals Reliability of the classification of cartilage and labral injuries during hip arthroscopy

2020 ◽  
Vol 7 (3) ◽  
pp. 448-457
Author(s):  
Stephanie W Mayer ◽  
Tobias R Fauser ◽  
Robert G Marx ◽  
Anil S Ranawat ◽  
Bryan T Kelly ◽  
...  
Keyword(s):  
Femoral Head ◽  
Transition Zone ◽  
Central Compartment ◽  
Classification Systems ◽  
Cartilage Injury ◽  
Intraobserver Agreement ◽  
Acetabular Cartilage ◽  
Femoral Head Cartilage ◽  
Labral Tears

Abstract To determine interobserver and intraobserver reliabilities of the combination of classification systems, including the Beck and acetabular labral articular disruption (ALAD) systems for transition zone cartilage, the Outerbridge system for acetabular and femoral head cartilage, and the Beck system for labral tears. Additionally, we sought to determine interobserver and intraobserver agreements in the location of injury to labrum and cartilage. Three fellowship trained surgeons reviewed 30 standardized videos of the central compartment with one surgeon re-evaluating the videos. Labral pathology, transition zone cartilage and acetabular cartilage were classified using the Beck, Beck and ALAD systems, and Outerbridge system, respectively. The location of labral tears and transition zone cartilage injury was assessed using a clock face system, and acetabular cartilage injury using a five-zone system. Intra- and interobserver reliabilities are reported as Gwet’s agreement coefficients. Interobserver and intraobserver agreement on the location of acetabular cartilage lesions was highest in superior and anterior zones (0.814–0.914). Outerbridge interobserver and intraobserver agreement was >0.90 in most zones of the acetabular cartilage. Interobserver and intraobserver agreement on location of transition zone lesions was 0.844–0.944. The Beck and ALAD classifications showed similar interobserver and intraobserver agreement for transition zone cartilage injury. The Beck classification of labral tears was 0.745 and 0.562 for interobserver and intraobserver agreements, respectively. The Outerbridge classification had almost perfect interobserver and intraobserver agreement in classifying chondral injury of the true acetabular cartilage and femoral head. The Beck and ALAD classifications both showed moderate to substantial interobserver and intraobserver reliabilities for transition zone cartilage injury. The Beck system for classification of labral tears showed substantial agreement among observers and moderate intraobserver agreement. Interobserver agreement on location of labral tears was highest in the region where most tears occur and became lower at the anterior and posterior extents of this region. The available classification systems can be used for documentation regarding intra-articular pathology. However, continued development of a concise and highly reproducible classification system would improve communication.

Prospects for the classification of mental disorders of children and adolescents

2008 ◽  
Vol 23 (7) ◽  
pp. 481-485 ◽  
Author(s):  
M.H. Schmidt ◽  
J. Sinzig
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Classification Systems ◽  
General Question ◽  
Specific Information ◽  
Specific Symptom ◽  
Trade Offs ◽  
Dimensional Classification ◽  
Dsm V

AbstractSuggestions for classification of mental disorders of children and adolescents in DSM-V and ICD-11 have been made, which differ strongly from the current descriptive approach of dimensional classification.These suggestions even comprise a dichotomized system for health care as well as for scientific purposes.Nevertheless it is obvious that we are far behind an “etiological” classification, so that trade-offs have necessarily to be made in DSM-V and ICD-11.Appropriate proposals concern the strict separation of disorders that are typical for children and adolescents as well as for adults.Furthermore a differentiation of diagnosis for infants, toddlers and preschool children is required in both classification systems. As far as it is relevant for treatment, combined diagnosis in DSM-V and subthreshold diagnosis as well as coding-possibilities for findings in molecular biology should be permitted.As personality disorders should only be diagnosed after the age of 16, it is recommended to dimensionally classify personality traits that are pathognomonic for specific symptom patterns and of prognostic relevance.DSM-V and ICD-11 should allow age-specific information on axis-IV. The article discusses the general question of how relational disorders respectively disturbances should be classified and include furthermore special recommendations concerning ICD and DSM categories.

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