scholarly journals Time to blood, respiratory and urine culture positivity in the intensive care unit: Implications for de-escalation

2021 ◽  
Vol 9 ◽  
pp. 205031212110407
Author(s):  
Lindsey A Sellers ◽  
Kathryn M Fitton ◽  
Margaret F Segovia ◽  
Christy C Forehand ◽  
Kevin K Dobbin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Urine Culture ◽  
Culture Collection ◽  
Empiric Antibiotic Therapy ◽  
Empiric Antibiotic ◽  
Sensitivity Specificity

Objectives: Concern for late detection of bacterial pathogens is a barrier to early de-escalation efforts. The purpose of this study was to assess blood, respiratory and urine culture results at 72 h to test the hypothesis that early negative culture results have a clinically meaningful negative predictive value. Methods: We retrospectively reviewed all patients admitted to the medical intensive care unit between March 2012 and July 2018 with blood cultures obtained. Blood, respiratory and urine culture results were assessed for time to positivity, defined as the time between culture collection and preliminary species identification. The primary outcome was the negative predictive value of negative blood culture results at 72 h. Secondary outcomes included sensitivity, specificity, positive predictive value and negative predictive value of blood, respiratory and urine culture results. Results: The analysis included 1567 blood, 514 respiratory and 1059 urine cultures. Of the blood, respiratory and urine cultures ultimately positive, 90.3%, 76.2% and 90.4% were positive at 72 h. The negative predictive value of negative 72-h blood, respiratory and urine cultures were 0.99, 0.82 and 0.97, respectively. Antibiotic de-escalation had good specificity, positive predictive value and negative predictive value for finalized negative cultures. Conclusion: Negative blood and urine culture results at 72 h had a high negative predictive value. These findings have important ramifications for antimicrobial stewardship efforts and support protocolized re-evaluation of empiric antibiotic therapy at 72 h. Caution should be used in patients with clinically suspected pneumonia, since negative respiratory culture results at 72 h were weakly predictive of finalized negative cultures.

scholarly journals Evaluation of a Candida Antigen Detection Method (Cand-Tec): Experience from a University Teaching Hospital

1992 ◽  
Vol 3 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Todd J Anderson ◽  
Heather E Bryant ◽  
Deirdre L Church
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Invasive Candidiasis ◽  
Predictive Value ◽  
High Probability ◽  
University Teaching ◽  
Candidal Infection

The usefulness of a rapid latex agglutination method for the detection of Candida antigen (Cand-Tec; Ramco Laboratories. Texas) was retrospectively assessed in a university teaching hospital over a one year period. Patients were enrolled when the managing physician requested Cand-Tec testing for confirmation of possible invasive candidal infection. The majority of patients were critically ill; 56% were in the intensive care unit, and 30% subsequently died. Analyses were available from 79 patients and 125 samples. Thirty-three patients were diagnosed as having either definite invasive candidiasis or a high probability of infection based upon clinical, microbiological and tissue criteria. The sensitivity and specificity of Candida antigen detection was determined for doubling titres ≥1:4 to ≥1:16. If a titre of ≥1:4 was used as the diagnostic cut-off level for definite candidal infection, overall sensitivity and specificity were 77% and 69%, respectively, while the positive predictive value was 48%, and the negative predictive value 89%. When patients with a high probability of invasive candidal infection were included in analyses for a cut-off titre of ≥1:4, overall sensitivity and specificity were 70% and 69%, respectively, while the positive predictive value was 68%, and the negative predictive value 71%. The usefulness of the Cand-Tec test was not improved further for any subgroup of patients (including those in the intensive care unit), nor by following serial titres in individual patients. In this experience, the Cand-Tec test did not add enough information to include definitively or exclude invasive candidiasis in this high risk general patient population.

scholarly journals Detection of Pyuria by Microscopic Urinalysis as a Marker of Pediatric Urinary Tract Infection

2019 ◽  
Vol 7 (1) ◽  
pp. 15-20
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Balkrishna Bhattachan ◽  
Hiramani Parajuli ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Urine Culture ◽  
Clinical Practices ◽  
Wet Mount ◽  
Sensitivity Specificity

Globally, different diagnostic tests of urinary tract infection (UTI) are in clinical practices. A reliable test can increase the efficiency of the healthcare system, especially in a developing country like Nepal, reducing cost and time. Thus, we accessed the possibility of pyuria detected by microscopic urinalysis as a marker of pediatric UTI. The prospective study was conducted fromJuly2014 to January 2015 at Alka hospital, Lalitpur. Microscopic urinalysis of 353clean-catch urine samples was done by the wet mount method, followed by urine culture by a semi-quantitative method. We confirmed 64 (18.1%) UTI cases by culture, the gold standard for UTI diagnosis. Fever was the most common clinical manifestation in UTI cases. The sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 50%, 70.9%, 27.6% and 86.5% respectively. In 318 febrile cases, the sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 73.2%, 72.6%, 28.3% and 94.8% respectively. The findings suggest pyuria detected by microscopic urinalysis as not a worth while marker of pediatric UTI. But it is a trust worthy marker in febrile pediatric cases.

scholarly journals Prognostic Value of Rapid Shallow Breathing Index for Weaning Success in Intensive Care Unit Patients under Mechanical Ventilation

2020 ◽  
Vol 6 (1) ◽  
pp. 9-14
Author(s):  
Md Sirajul Islam ◽  
Md Ali Haider ◽  
Uzzwal Kumar Mallick ◽  
Mohammad Asaduzzaman ◽  
Md Gias Uddin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prolonged Mechanical Ventilation ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Background: The weaning success in intensive care unit patients under mechanical ventilation is very important. Objective: The purpose of this study was to investigate the efficacy and effects of rapid shallow breathing index (RSBI) in predicting weaning success in patients with prolonged mechanical ventilation more than 48 hours. Methodology: This prospective cohort study was conducted in the Department of Anesthesia, Pain Palliative & Intensive Care Unit of Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2014 to December 2015 for a period of two (02) years. Patients on mechanical ventilation more than 48 hours with the age of 18 to 60 years were included in this study. During the weaning process, the arterial blood gases (ABG) values was checked and the patients was separated from mechanical ventilation. After measuring RSBI, patients was separated from mechanical ventilator and given T-piece trial (1 to 4 hours) and finally extubated as per advice of ICU consultant and observed for 48 hours. The patients were divided in two groups low RSBI ≤105 breath/min/L and high RSBI >105 breath/min/L. These patients were prospectively followed up to 48 hours in ICU and HDU. Result: A total of 117 patients were included in this study. The validity of RSBI evaluation for trail failure was correlated by calculating sensitivity, specificity, accuracy, positive and negative predictive values. The sensitivity of RSBI was 54.5% (95% CI 23.38% to 83.25%) and specificity was 82.1% (95% CI 73.43% to 88.85%). However, positive predictive value and negative predictive value were 24.0% (95% CI 13.84% to 38.30%) and 94.6% (95% CI 90.05% to 97.10%) respectively. The accuracy was found 79.5% (95% CI 71.03% to 86.39%). Receiver-operator characteristic (ROC) were constructed using RSBI of the weaning outcome, which gave a RSBI cut off value of ≥88 as the value with a best combination of sensitivity (72.7%) and specificity (61.3%), accuracy (60.7%), positive predictive value (15.7%), negative predictive value (95.5%) for trail failure. Conclusion: In conclusion the efficacy and effects of rapid shallow breathing index is found low sensitivity with high specificity in predicting weaning success in patients with prolonged mechanical ventilation more than 48 hours. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 9-14

scholarly journals Comparing the predicted accuracy of PO2\FIO2 ratio with rapid shallow breathing index for successful spontaneous breathing trail in Intensive Care Unit

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Dr Aamir Furqan ◽  
Dr Shumaila Ali Rai ◽  
Dr Liaqat Ali ◽  
Dr Rana Altaf Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Spontaneous Breathing ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Objective: To compare the predicted accuracy of PFR with RSBI for successful spontaneous breathing trail before extubation in intensive care unit. Methods: This cross sectional study was conducted at the ICU of Ch. Pervaiz Ellahi Institute of Cardiology, Multan Medical and Nishtar Medical University Hospital from July, 2017 to January, 2019. PO2/FIO2 and RSBI was measured by a different investigator, before and 20 minutes after the start of SBT. Heart rate, blood pressure and oxygen saturation were continuously measured throughout the trial. Trial outcome was labeled as unsuccessful or successful by the investigator who was blinded to the rapid shallow breathing index and PO2/FiO2 measurements. Patients with SpO2>85%, stable hemodynamics (HR and BP change <20%), stable respiration (RR change <50%), and the absence of (i) signs of labored breathing, (ii) emergence or worsened discomfort, (iii) change in mental status, were labeled as successful in bearing the SBT. Patients were divided into two groups i.e. successful and unsuccessful, gender, Age, GOLD stage, APACHE II score, pCO2, pO2, FiO2 and RSBI score were compared between the two groups after putting all the data in SPSS version 23. Chi square tests and Student’s t-test were used on the continuous data and nominal data, accordingly. The specificity, sensitivity, diagnostic accuracy, negative predictive value and positive predictive value of two threshold values of RSBI and PO2/FiO2 ratio were calculated from the 2X2 contingency tables. Results: RSBI threshold of 130 had 40.4% sensitivity, 51.1% specificity, 55.2% positive predictive value, 36.4% negative predictive value and 44.7% diagnostic accuracy while RSBI threshold of 105 had 94.1% sensitivity, 43.6% specificity, 71.4% positive predictive value, 83.2% negative predictive value and 73.8% diagnostic accuracy. pO2/FiO2>250 had 76.9% sensitivity, 24.5% specificity, 60.4% positive predictive value, 41.5% negative predictive value and 55.9% diagnostic accuracy. Conclusion: Even though neither rapid shallow breathing nor the PFR was enough accurate in prediction of successful extubation but rapid shallow breathing index 105 threshold had higher sensitivity and specificity as compared to RSBI threshold 130PFR. Therefore, RSBI105 is more accurate in predicting the outcome of extubation of ICU patients. doi: https://doi.org/10.12669/pjms.35.6.788 How to cite this:Furqan A, Rai SA, Ali L, Ahmed RA. Comparing the predicted accuracy of PO2\FIO2 ratio with rapid shallow breathing index for successful spontaneous breathing trail in Intensive Care Unit. Pak J Med Sci. 2019;35(6):1605-1610.  doi: https://doi.org/10.12669/pjms.35.6.788 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Diagnostic accuracy of monofilament test to detect diabetic neuropathy

2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diabetic Peripheral Neuropathy ◽  
Perception Threshold ◽  
Sensitivity Specificity ◽  
Vibration Perception ◽  
Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

scholarly journals Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

2019 ◽  
Vol 8 (9) ◽  
pp. 3602
Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Clinical Approach ◽  
Ovarian Mass ◽  
Medical College ◽  
Operative Evaluation ◽  
Sensitivity Specificity ◽  
Final Confirmation

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 

Συγκριτική μελέτη της μορφομετρίας κατά τον κλασικό ακτινολογικό έλεγχο (MRX) και της μορφομετρίας με χρήση απορροφησιομετρίας (VFA) στον καθορισμό σπονδυλικών παραμορφώσεων σε οστεοπορωτικούς ασθενείς μετά από κυφοπλαστική

2017 ◽  
Author(s):  
Ευστάθιος Δράμπαλος
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Predictive Value ◽  
Intraclass Correlation ◽  
Sensitivity Specificity

Σκοπός: H εφαρμογή για πρώτη φορά διεθνώς της μορφομετρίας της σπονδυλικής στήλης με χρήση απορροφησιομετρίας (VFA) σε ασθενείς με κυφοπλαστική. Αναλύονται τα πλεονεκτήματα και μειονεκτήματα της μεθόδου, ελέγχεται η αξιοπιστία της και συγκρίνεται με την μορφομετρία κατά τον κλασσικό ακτινολογικό έλεγχο (ΜRΧ) στην εκτίμηση των σπονδυλικών παραμορφώσεων στους συγκεκριμένους ασθενείς.Υλικά και Μέθοδος: Πραγματοποιήθηκαν μετρήσεις σε 42 ασθενείς με κυφοπλαστική λόγω οστεοπορωτικών σπονδυλικών καταγμάτων και αναλύθηκαν οι σπόνδυλοι από τον T4 μέχρι τον L4 με την VFA και την MRX. Μετρήθηκαν το πρόσθιο (ha), μέσο (hm) και οπίσθιο (hp) ύψος του σπονδυλικού σώματος και προσδιορίσθηκαν οι λόγοι ha/hp και hm/hp. Αναλύθηκαν για την VFA η συμφωνία αποτελεσμάτων του ίδιου παρατηρητή (IOA) και η συμφωνία αποτελεσμάτων μεταξύ ανεξάρτητων παρατηρητών (INA) για τους λόγους ha/hp και hm/hp καθώς και για την μέθοδο Genant σε επίπεδο σπονδύλου, ‘περιοχής της σπονδυλικής στήλης (θωρακική/ΘΜΣΣ ή οσφυϊκή/ΟΜΣΣ), σε επίπεδο ‘γειτονικών προς την κυφοπλαστική σπονδύλων’, και σε επίπεδο ‘σπονδύλων με κυφοπλαστική’. Σε κάθε επίπεδο χρησιμοποιήθηκε η μέση τιμή ha/hp και hm/hp. Στη συνέχεια, αναλύσαμε την συμφωνία μεταξύ VFA και MRX στον καθορισμό των λόγων ha/hp και hm/hp καθώς και μετά την διχοτόμηση των λόγων ha/hp περί της τιμής όριο που συνήθως χρησιμοποιείται για τον καθορισμό ενός κατάγματος. Αποτελέσματα: Οι IOA και INA για τους λόγους ha/hp και hm/hp στην VFA ήταν ‘σχεδόν τέλεια’ σε όλα τα επίπεδα (ICC 0.94-0.98). Η εφαρμογή της μεθόδου Genant κατά την VFA ανέδειξε επίσης ‘σχεδόν τέλεια’ INA (ICC=0.833). Η ανάλυση σε επίπεδο σπονδύλου έδειξε ‘σχεδόν τέλεια’ συμφωνία μεταξύ VFA και MRX για τον λόγο ha/hp [intraclass correlation coefficient, ICC=0.85], και ‘ισχυρή συμφωνία’ για τον λόγο hm/hp (ICC=0.78). Για τον λόγο ha/hp η συμφωνία ήταν ‘σχεδόν τέλεια’ τόσο στην ΘΜΣΣ (ICC=0.82) όσο και στην ΟΜΣΣ (ICC=0.87), ενώ για τον λόγο hm/hp η συμφωνία ήταν ‘ισχυρή’ στην ΘΜΣΣ (ICC=0.75) και ‘σχεδόν τέλεια’ στην ΟΜΣΣ (ICC=0.80). Η συμφωνία ήταν εξίσου ‘σχεδόν τέλεια’ σε επίπεδο ‘σπονδύλων με κυφοπλαστική’ (ICC=0.83) όσο και σε επίπεδο ‘γειτονικών προς την κυφοπλαστική σπονδύλων’ (ICC=0.80) για τον λόγο ha/hp. Όταν οι λόγοι ha/hp μετατράπηκαν σε κατάγματα (ναι ή όχι κάταγμα) χρησιμοποιώντας διαφορετικές τιμές κατώφλι για την διάγνωση κατάγματος (λόγοι ha/hp 0.75, 0.80 και 0.85) η συμφωνία μεταξύ των μεθόδων ήταν λιγότερο καλή, από μέτρια έως ουσιώδης (κ 0.52-0.63 στην ΟΜΣΣ και 0.53-0.66 στην ΘΜΣΣ). Χρησιμοποιώντας την κατάταξη Genant οι διαφορές στην ταξινόμηση των σπονδύλων ήταν περισσότερο προς την κατεύθυνση της MRX με 32 αναγνωρισμένα κατάγματα μόνο από την MRX και μόνο 5 μόνο από την VFA. Στη μελέτη αυτή, με επιπολασμό σφηνοειδών σπονδυλικών καταγμάτων 9.3%, οι δείκτες ακρίβειας sensitivity, specificity, positive predictive value (PPV) και negative predictive value (NPV) υπολογίστηκαν σε 0.522, 0.97, 0.87 και 0.92 αντίστοιχα. Συμπεράσματα: Η εφαρμογή της VFA σε ασθενείς με κυφοπλαστική έχει υψηλή επαναληψιμότητα και αναπαραγωγιμότητα. Η συμφωνία μεταξύ VFA και MRX στην εκτίμηση των λόγων ha/hp και hm/hm ήταν από ‘ισχυρή’ έως ‘σχεδόν τέλεια’ ανάλογα με το επίπεδο εξέτασης. Η συμφωνία στην αναγνώριση των σπονδυλικών καταγμάτων ήταν μέτρια. Οι διαφορές ήταν περισσότερο προς την κατεύθυνση της MRX. Η υψηλή τιμή του δείκτη NPV της VFA στους ασθενείς με κυφοπλαστική, δείχνει ότι η μέθοδος θα μπορούσε να χρησιμοποιηθεί για τον εντοπισμό αυτών που χρήζουν περαιτέρω ακτινολογικού ελέγχου.

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