scholarly journals Use of β-D-glucan in diagnosis of suspected Pneumocystis jirovecii pneumonia in adults with HIV infection

2021 ◽  
pp. 095646242110222
Author(s):  
Thomas Juniper ◽  
Chris P Eades ◽  
Eliza Gil ◽  
Harriet Fodder ◽  
Killian Quinn ◽  
...  
Keyword(s):  
Predictive Value ◽  
Diagnostic Tests ◽  
Elevated Serum ◽  
Clinical Information ◽  
High Sensitivity ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Alternative Diagnosis ◽  
Positive Threshold ◽  
Sensitivity Specificity

Objectives: An elevated serum (1-3)-β-D-glucan (BDG) concentration has high sensitivity for a diagnosis of Pneumocystis pneumonia (PCP) in people with HIV (PWH). At the current manufacturer-recommended positive threshold of 80 pg/mL (Fungitell), specificity for PCP is variable and other diagnostic tests are required. We evaluated the utility of serum BDG for diagnosis of suspected PCP in PWH at three inner-London hospitals to determine BDG concentrations for diagnosis and exclusion of PCP. Methods: From clinical case records, we abstracted demographic and clinical information and categorised patients as having confirmed or probable PCP, or an alternative diagnosis. We calculated sensitivity, specificity and positive predictive value (PPV) of serum BDG concentrations >400 pg/mL and negative predictive value (NPV) of BDG <80 pg/mL. Results: 76 patients were included; 29 had laboratory-confirmed PCP, 17 had probable PCP and 30 had an alternative diagnosis. Serum BDG >400 pg/mL had a sensitivity of 83%, specificity of 97% and PPV 97% for diagnosis of PCP; BDG <80 pg/mL had 100% NPV for exclusion of PCP. Conclusions: In PWH with suspected PCP, BDG <80 pg/mL excludes a diagnosis of PCP, whereas BDG concentrations >400 pg/mL effectively confirm the diagnosis. Values 80–400 pg/mL should prompt additional diagnostic tests.

scholarly journals Eotaxins and Their Receptor as Biomarkers of Colorectal Cancer

2021 ◽  
Vol 10 (12) ◽  
pp. 2675
Author(s):  
Monika Zajkowska ◽  
Agnieszka Kulczyńska-Przybik ◽  
Maciej Dulewicz ◽  
Kamil Safiejko ◽  
Marcin Juchimiuk ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Diagnostic Utility ◽  
Healthy Controls ◽  
Serum Concentrations ◽  
Chemiluminescent Microparticle Immunoassay ◽  
Sensitivity Specificity ◽  
Immunoenzymatic Assay

Colorectal cancer (CRC) is one of the most common malignancies. Despite the availability of diagnostic tests, an increasing number of new cases is observed. That is why it is very important to search new markers that would show high diagnostic utility. Therefore, we made an attempt to assess the usefulness of eotaxins, as there are few studies that investigate their significance, in patients with CRC. The study included 80 subjects (CRC patients and healthy volunteers). Serum concentrations of all eotaxins were measured using a multiplexing method (Luminex), while CCR3 was measured by immunoenzymatic assay (ELISA). CRP levels were determined by immunoturbidimetry and classical tumor marker levels (CEA and CA 19-9) and were measured using chemiluminescent microparticle immunoassay (CMIA). The highest usefulness among the proteins tested showed CCR3. Its concentrations were significantly higher in the CRC group than in healthy controls. The diagnostic sensitivity, specificity, positive and negative predictive value, and the area under the ROC curve (AUC) of CCR3 were higher than those of CA 19-9. The maximum values for sensitivity, negative predictive value, and AUC were obtained for a combination of CCR3 and CRP. Our findings suggest the potential usefulness of CCR3 in the diagnosis of CRC, especially in combination with CRP or CEA.

A Negative Antinuclear Antibody Does Not Indicate Autoantibody Negativity in Myositis: Role of Anticytoplasmic Antibody as a Screening Test for Antisynthetase Syndrome

2016 ◽  
Vol 44 (2) ◽  
pp. 223-229 ◽  
Author(s):  
Rohit Aggarwal ◽  
Namrata Dhillon ◽  
Noreen Fertig ◽  
Diane Koontz ◽  
Zengbiao Qi ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Predictive Value ◽  
Antinuclear Antibody ◽  
High Sensitivity ◽  
Epithelial Cell Line ◽  
Antisynthetase Syndrome ◽  
Control Groups ◽  
Serum Samples ◽  
Cytoplasmic Staining ◽  
Sensitivity Specificity

Objective.To evaluate the utility of anticytoplasmic autoantibody (anti-CytAb) in antisynthetase antibody–positive (anti-SynAb+) patients.Methods.Anti-SynAb+ patients were evaluated for antinuclear antibody (ANA) and anti-CytAb [cytoplasmic staining on indirect immunofluorescence (IIF)] positivity. Anti-SynAb+ patients included those possessing anti-Jo1 and other antisynthetase autoantibodies. Control groups included scleroderma, systemic lupus erythematosus, Sjögren syndrome, rheumatoid arthritis, and healthy subjects. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of anti-CytAb, and ANA were assessed. Anti-CytAb and ANA testing was done by IIF on human epithelial cell line 2, both reported on each serum sample without knowledge of the clinical diagnosis or final anti-SynAb results.Results.Anti-SynAb+ patients (n = 202; Jo1, n = 122; non-Jo1, n = 80) between 1985–2013 with available serum samples were assessed. Anti-CytAb showed high sensitivity (72%), specificity (89%), NPV (95%), and accuracy (86%), but only modest PPV (54%) for anti-SynAb positivity. In contrast, ANA showed only modest sensitivity (50%) and poor specificity (6%), PPV (9%), NPV (41%), and accuracy (12%). Positive anti-CytAb was significantly greater in the anti-SynAb+ patients than ANA positivity (72% vs 50%, p < 0.001), and 81/99 (82%) ANA-negative patients in the anti-SynAb+ cohort had positive anti-CytAb. In contrast, the control groups showed high rates for ANA positivity (93.5%), but very low rates for anti-CytAb positivity (11.5%). Combining anti-CytAb or Jo1 positivity showed high sensitivity (92%) and specificity (89%) for identification of anti-SynAb+ patients.Conclusion.Assessing patients for anti-CytAb serves as an excellent screen for anti-SynAb+ patients using simple IIF. Cytoplasmic staining should be assessed and reported for patients suspected of having antisynthetase syndrome and a negative ANA should not be used to exclude this diagnosis.

scholarly journals XPERT MYCOBACTERIUM TUBERCULOSIS/RIFAMPICIN ASSAY: A BOON IN TUBERCULOSIS DIAGNOSTICS

2016 ◽  
Vol 9 (5) ◽  
pp. 225 ◽  
Author(s):  
Sevitha Bhat ◽  
Kavya Ramamurthy ◽  
Shalini Shenoy ◽  
Aseem Rangnekar
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Predictive Value ◽  
High Sensitivity ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Promising Tool ◽  
Causes Of Mortality ◽  
Conventional Microscopy ◽  
Tb Diagnostics ◽  
Sensitivity Specificity

ABSTRACTObjectives: Mycobacterium tuberculosis (MTB) remains one of the most significant causes of mortality and morbidity in developing countriesespecially India. India has the highest burden of TB, with an estimated incidence figure of 2.1 million cases out of the 9 million cases of TB globally.Diagnosis of TB relies on conventional microscopy and culture with drawbacks related to sensitivity, specificity, turn around time (TAT). The aim ofthis study was to evaluate the performance of Xpert MTB/rifampicin (RIF) assay (GX) for MTB detection in pulmonary and extrapulmonary clinicalsamples.Methods: A total of 209 clinical specimens (182: pulmonary and 27: extrapulmonary) were processed using auramine smear, culture by mycobacteriagrowth indicator tube and GenXpert.Results: The sensitivity of GenXpert was 62.63% for pulmonary and 55% for extrapulmonary samples. The sensitivity and specificity of GX were100% for the smear positive cases. The sensitivity, specificity, positive predictive value, and negative predictive value of the GX for smear negativecases were 67.8%, 97.5%, 90.4%, and 89.6%, respectively. RIF resistance was detected in 3.8% the samples.Conclusion: GenXpert, with short TAT, high sensitivity, specificity and less technical expertise required is a promising tool in TB diagnostics for thefuture.Keywords: GenXpert, Tuberculosis diagnosis, Molecular method, Rifampicin resistance.

Evaluating Diagnostic Tests

1993 ◽  
Vol 7 (2) ◽  
pp. 66-69 ◽  
Author(s):  
C.W. Douglass
Keyword(s):  
Predictive Value ◽  
Diagnostic Tests ◽  
Clinical Decision Making ◽  
New Technologies ◽  
Clinical Decision ◽  
Future Research ◽  
Scientific Support ◽  
Body Of Knowledge ◽  
Efficacy Parameters ◽  
Sensitivity Specificity

The presentations at this conference will discuss new technologies and rapid scientific developments that have resulted in new diagnostic tests for periodontal disease, musculoskeletal imaging, temporomandibular joint dysfunctions, and incipient coronal and root dental caries. However, for many of these claims, there has been insufficient scientific support regarding the sensitivity and specificity of the tests, or their ability to predict the percent of cases in which the disease or condition progresses to the next state of development. Research is needed that will yield the basic diagnostic parameters of new diagnostic tests, i.e., their accuracy, precision, sensitivity, specificity, positive predictive value, and negative predictive value. The purpose and methods for calculating each of these measures are described in this paper. Five questions are then presented that will need to be addressed in future research regarding new diagnostic tests: (1) Does the scientific theory of the test fit with our current body of knowledge? (2) Have the efficacy parameters of the test been reliably determined? (3) How does the test affect clinical decision-making? (4) Does using the test improve the patient's health? and (5) Is the added expense of the test justified by increased effectiveness or by avoiding other health expenditures?

scholarly journals Diagnostic Performance of Bronchoalveolar Lavage (1,3)-β-d-Glucan Assay for Pneumocystis jirovecii Pneumonia

2020 ◽  
Vol 6 (4) ◽  
pp. 200
Author(s):  
Shiwei Zhou ◽  
Kathleen A. Linder ◽  
Carol A. Kauffman ◽  
Blair J. Richards ◽  
Steve Kleiboeker ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Test Performance ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Lavage Fluid ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Characteristic Area

We evaluated the performance of the (1,3)-β-d-glucan (BDG) assay on bronchoalveolar lavage fluid (BALF) as a possible aid to the diagnosis of Pneumocystis jirovecii pneumonia. BALF samples from 18 patients with well-characterized proven, probable, and possible Pneumocystis pneumonia and 18 well-matched controls were tested. We found that the best test performance was observed with a cut-off value of 128 pg/mL; receiver operating characteristic/area under the curve (ROC/AUC) was 0.70 (95% CI 0.52–0.87). Sensitivity and specificity were 78% and 56%, respectively; positive predictive value was 64%, and negative predictive value was 71%. The low specificity that we noted limits the utility of BALF BDG as a diagnostic tool for Pneumocystis pneumonia.

scholarly journals Role of MRI in the Diagnosis of Injury to the Lisfranc Ligament Complex

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Christopher Kreulen ◽  
Eric Giza ◽  
Eva Escobedo ◽  
Cyrus Bateni ◽  
Michael Doherty
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Lisfranc Injury ◽  
Radiology Reports ◽  
Lisfranc Ligament ◽  
Sensitivity Specificity

Category: Sports Introduction/Purpose: Subtle Lisfranc ligamentous injuries are difficult to diagnose and magnetic resonance is becoming a useful tool. The purpose of this study is to evaluate the efficacy of magnetic resonance (MR) imaging for the diagnosis of injuries of the Lisfranc ligament complex. Methods: The radiology database was searched between Jan 1, 2010 and Mar 10, 2015 to identify patients over the age of 18 years who had MR imaging of the foot for suspected injury of the Lisfranc ligament complex. MR images were reviewed by 2 fellowship trained musculoskeletal radiologists, whom were blinded to the original radiology reports. Findings were categorized as: no injury or injury present. Injury was deemed to be present if 2 of the 3 components of C1-M2 ligament showed disruption or signal alterations on T1 and T2 weighted images. Disagreements were resolved by consensus. Correlation was made with surgical findings whenever performed. In patients not undergoing surgery, the presence or absence of injury was determined by clinical examination performed by an orthopedic surgeon and follow-up. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of MR for diagnosis of Lisfranc ligament complex injury was determined. Results: Of 60 patients, 9 were excluded due to a lack of follow-up. Lisfranc injury was determined to be present on MR in 26 patients and 18 underwent surgery. Injury was confirmed in 16, and 2 were intact. 2 patients underwent closed reduction and were clinically determined to be injured. 6 of the injured 26 patients were sprained and not injured/torn on clinical evaluation. Of the 25 patients determined to have no injury on MR, 24 were intact clinically. 1 patient had a Lisfranc injury on follow-up. Sensitivity, specificity, PPV and NPV of MR for detection of significant Lisfranc injury were 94.7% (CI: 73.9% to 99.9%), 75% (CI: 56.6% to 88.5%), 69.2% (CI: 55% to 80.5%) and 96% (CI: 77.9% to 99.4%) respectively. Conclusion: MR has a high sensitivity and negative predictive value for diagnosis of injury to the Lisfranc ligament complex. MR of the foot should be considered in patients with clinical suspicion of injury to the Lisfranc ligament complex, and it is highly accurate in excluding such injuries.

Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Oligoclonal Bands ◽  
High Negative Predictive Value ◽  
Csf Oligoclonal Bands ◽  
Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

Diagnostic Tests in Occupational Therapy: A Model for Evaluation

1987 ◽  
Vol 7 (2) ◽  
pp. 111-122 ◽  
Author(s):  
Mary C. Law ◽  
Helene J. Polatajko
Keyword(s):  
Occupational Therapy ◽  
Predictive Value ◽  
Gold Standard ◽  
Diagnostic Tests ◽  
Southern California ◽  
Sensitivity Specificity

This article describes a model for the evaluation of diagnostic tests used in occupational therapy. In this model, new diagnostic tests are compared to valid tests (“gold standard”), and their sensitivity, specificity, predictive value, and agreement are calculated. The use of this method is illustrated with data from the Southern California Postrotary Nystagmus Test and the Stille-Werner Rotation Chair.

Sensitivity, Specificity, and Positive Predictive Value of Technetium 99-HMPAO SPECT in Discriminating Alzheimer's Disease from other Dementias

1997 ◽  
Vol 10 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Donna L. Masterman ◽  
Mario F. Mendez ◽  
Lynn A. Fairbanks ◽  
Jeffrey L. Cummings
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Single Photon ◽  
Photon Emission ◽  
High Sensitivity ◽  
Hmpao Spect ◽  
Clinical Diagnoses ◽  
Sensitivity Specificity

Investigators have reported high sensitivity and specificity values for single photon emission computerized tomography (SPECT) when distinguishing Alzheimer's disease (AD) patients from normal elderly controls or from selected patient groups. The role of SPECT in identifying AD among unselected patients with memory complaints requires investigation. We examined 139 consecutive patients with 99Tc-HMPAO SPECT. NINCDS-ADRDA diagnoses were determined blind to SPECT results, and scans were read and classified by visual inspection blind to clinical diagnoses. Bilateral temporoparietal hypoperfusion (TP) occurred in 75% of probable, 65% of possible, and 45% of unlikely AD patients, yielding a sensitivity of 75% and a specificity of 52% when comparing probable AD versus unlikely AD groups. A positive predictive value of 78% was obtained based on a 69% prevalence of AD in our total clinic population. Patients with false-positive results included a variety of dementing illnesses; all patients with bilateral hypoperfusion had dementia. A pattern of TP on SPECT scans is seen in most patients with AD, but could be found in other dementias as well and cannot be regarded as specific to AD. Reduced TP perfusion discriminated between demented and nondemented individuals. Further strategies for SPECT interpretation that improve diagnostic specificity should be sought.

The predictive value of videostroboscopy in the assessment of premalignant lesions and early glottis cancers

2017 ◽  
Vol 71 (4) ◽  
pp. 14-18 ◽  
Author(s):  
Anna Rzepakowska ◽  
Ewelina Sielska-Badurek ◽  
Ewa Osuch-Wójcikiewicz ◽  
Michał Sobol ◽  
Kazimierz Niemczyk
Keyword(s):  
Predictive Value ◽  
Vocal Fold ◽  
Histopathological Examination ◽  
High Sensitivity ◽  
Vocal Folds ◽  
Invasive Cancer ◽  
Premalignant Lesions ◽  
Good Tool ◽  
Malignant Lesions ◽  
Sensitivity Specificity

Objective: To assess the sensitivity and specificity of larngovideostroboscopy (LVS) in the diagnosis of precancerous and malignant lesions of the vocal folds. Material and methods: In 175 patients (128 men and 47 women), aged 19-88 years, mean age 61.5, who were admitted to the clinic with diagnosed premalignant conditions of vocal fold mucosa (leukoplakia, chronic hypertrophic inflammatory lesions) and thickening or tumor on the vocal fold, there was performed LVS before the laryngeal microsurgery. The LVS study included: localization of the leasion, movement of the vocal folds, mucosal wave, shape of glottis clousure, amplitude and symmetry of vocal fold vibration. In the evaluation, a point scale was applied for the individual functional parameters. The scale ranged from 0 to 14. Patients with impaired vocal fold motion or absent mucosal wave were positive on LVS for malignant lesions. Those with limitted mucosal wave were positive on LVS for dysplastic lesions. The results were compared with the final histopathological examination and the sensitivity, specificity, accuracy, positive (PPV) and negative (NPV) predictive value were calculated. Results: On the basis of histopathological examination, benign lesions (normal or inflammatory mucosa) accounted for 20% of diagnoses, hypertrophy and parakeratosis for 28%, low and middle grade dysplasia accounted for 10% and malignant lesions (high-grade dysplasia, pre-invasive cancer, Invasive cancer) was diagnosed in 42% of patients. The overall mean score for LVS was 4.5 and 8.0, respectively for benign and malignant lesions. Sensitivity, specificity, accuracy, PPV and NPV of LVS in detecting malignant lesions were respectively - 95.6%, 23.8%, 61.1%, 57.6% and 83.3% and in detecting both premalignant and malignant lesions were respectively – 90.7%, 31.4%, 78.9%, 84.1% and 45.8%. Conclusions: Because of the high sensitivity of LVS in detecting precancerous and malignant lesions, this method is a very good tool for screening of pathology within the larynx.

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