Validation of maternal report of early childhood caries status in Ile-Ife, Nigeria

Abstract Background To determine the validity of maternal reports of the presence of early childhood caries (ECC), and to identify maternal variables that increase the accuracy of the reports. Methods This secondary data analysis included 1155 mother–child dyads, recruited through a multi-stage sampling household approach in Ile-Ife Nigeria. Survey data included maternal characteristics (age, monthly income, decision-making ability) and maternal perception about whether or not her child (age 6 months to 5 years old) had ECC. Presence of ECC was clinically determined using the dmft index. Maternally reported and clinically determined ECC presence were compared using a chi-squared test. McNemar's test was used to assess the similarity of maternal and clinical reports of ECC. Sensitivity, specificity, positive and negative predictive values, absolute bias, relative bias and inflation factor were calculated. Statistical significance was determined at p < 0.05. Results The clinically-determined ECC prevalence was 4.6% (95% Confidence interval [CI]: 3.5–5.0) while the maternal-reported ECC prevalence was 3.4% (CI 2.4–4.6). Maternal reports underestimated the prevalence of ECC by 26.1% in comparison to the clinical evaluation. The results indicate low sensitivity (9.43%; CI 3.13–20.70) but high specificity (96.9%; CI 95.7–97.9). The positive predictive value was 12.8% (CI 4.3–27.4) while the negative predictive value was 95.7% (CI 94.3–96.8). The inflation factor for maternally reported ECC was 1.4. Sensitivity (50.0%; CI 6.8–93.2) and positive predictive value were highest (33.3%; CI 4.3–77.7) when the child had a history of visiting the dental clinic. Conclusions Mothers under-reported the presence of ECC in their children in this study population. The low sensitivity and positive predictive values of maternal report of ECC indicates that maternal reporting of presence of ECC may not be used as a valid tool to measure ECC in public health surveys. The high specificity and negative predictive values indicate that their report is a good measure of the absence of ECC in the study population. Child’s history of dental service utilization may be a proxy measure of presence of ECC.

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Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise

Journal of the American Academy of Audiology ◽

10.1055/s-0040-1718931 ◽

2020 ◽

Author(s):

Luma Cordeiro Rodrigues ◽

Silvia Ferrite ◽

Ana Paula Corona

Keyword(s):

Hearing Loss ◽

High Specificity ◽

Hearing Screening ◽

Youden Index ◽

Hearing Level ◽

Predictive Values ◽

Auditory Thresholds ◽

The Mean ◽

Low Sensitivity ◽

Sensitivity Specificity

Abstract Purpose This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. Research Design This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. Results A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. Conclusion The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.

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

Journal of Ophthalmology ◽

10.1155/2019/5329121 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

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.

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Epstein-Barr Virus (EBV)-Encoded RNA: Automated In-Situ Hybridization (ISH) Compared with Manual ISH and Immunohistochemistry for Detection of EBV in Pediatric Lymphoproliferative Disorders

Pediatric and Developmental Pathology ◽

10.2350/07-07-0316.1 ◽

2009 ◽

Vol 12 (3) ◽

pp. 195-199 ◽

Cited By ~ 22

Author(s):

Naim K. Fanaian ◽

Cynthia Cohen ◽

Sandra Waldrop ◽

Jennifer Wang ◽

Bahig M. Shehata

Keyword(s):

In Situ Hybridization ◽

Predictive Value ◽

Epstein Barr Virus ◽

High Sensitivity ◽

High Specificity ◽

Lymphoproliferative Disorders ◽

Barr Virus ◽

Epstein Barr ◽

Low Sensitivity

Detection of Epstein-Barr virus (EBV) may be achieved by various methods, including EBV-encoded RNA (EBER) in-situ hybridization (ISH) and immunohistochemistry (IHC) for latent membrane protein (LMP-1). We compared novel automated ISH and IHC techniques in pediatric lymphoproliferative disorders with results obtained by manual ISH. Thirty-seven pediatric cases previously studied by manual EBER ISH (including 18 EBER-positive, 15 EBER-negative, and 4 EBER-equivocal cases) were used for the study. Automated EBER ISH and automated LMP-1 IHC were performed using the BondMax autostainer and prediluted EBER probe and EBV cell surface 1 to 4 at 1:50 dilution, respectively. Results of each of the automated techniques for EBV detection were compared with results by manual EBER ISH. Compared with manual EBER ISH as the gold standard, automated ISH had a sensitivity and specificity of 94% and 69%, respectively, accuracy of 83%, positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 90%. Automated IHC had a sensitivity of 44%, specificity of 93%, accuracy of 67%, PPV of 88%, and NPV of 59%. Automated ISH and IHC correlated significantly ( P < 0.045). Automated ISH is useful for diagnosis of EBV-related pediatric neoplasms, being easy to perform and interpret and requiring only the technologist's time to set up and having a high sensitivity and NPV. The automated IHC protocol is of too low sensitivity for routine use, although results show high specificity and PPV.

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Factors Impacting the Performance Characteristics of Bile Duct Brushings: A Clinico-Cytopathologic Analysis of 253 Patients

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2017-0150-oa ◽

2018 ◽

Vol 142 (7) ◽

pp. 863-870 ◽

Cited By ~ 4

Author(s):

Ezgi Hacihasanoglu ◽

Bahar Memis ◽

Burcin Pehlivanoglu ◽

Vaidehi Avadhani ◽

Alexa A. Freedman, ◽

...

Keyword(s):

Bile Duct ◽

Predictive Value ◽

High Specificity ◽

Daily Practice ◽

Performance Characteristics ◽

Lower Sensitivity ◽

Current State ◽

Risk Of Malignancy ◽

Low Sensitivity ◽

Sensitivity Specificity

Context.— Literature on factors impacting bile duct brushings (BDBs) performance characteristics remain limited. Objective.— To capture the current state of daily practice with BDB sign-out. Design.— Two hundred fifty-three of 444 BDBs signed out by more than 7 cytopathologists, with histopathologic and/or clinical follow-up of at least 18 months, were examined. Results.— One hundred thirty-five of 253 BDBs (53%) had histologically confirmed malignancies, 22 (9%) had cancer-related deaths, and 96 (38%) were benign. Cytologic diagnoses in the 444 BDBs were nondiagnostic (11 [2.5%]), negative (284 [64%]), atypical (62 [13.9%]), suspicious (34 [7.7%]), and malignant (53 [11.9%]). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of malignancy detection were 35%, 100%, 100%, 58%, and 66%, respectively. When atypical, suspicious, and malignant (ASM) categories were combined, sensitivity increased (58%), specificity and PPV dropped (97%), and accuracy increased (73%). Carcinoma type (bile-duct versus pancreatic-ductal) had no effect on accuracy (P = .60) or diagnostic class (P = .84), nor did time of performance (first 7.5 versus latter 7.5 years, P = .13). Interestingly, ThinPrep + cell block (n = 41) had higher sensitivity (61%) and lower specificity (80%) than ThinPrep only (versus 51% and 100%, respectively). Sensitivity and specificity were higher (47% and 100%) in nonstented than stented specimens (59% and 97%). Relative risk of malignancy for “suspicious” (2.30) and “atypical” (2.28) categories was lower but not very different from that of “malignant” category (2.41). Conclusions.— Bile duct brushings had fairly low sensitivity but high specificity and PPV with no false positives. Sensitivity almost doubled and specificity dipped minimally when ASM categories were combined, highlighting the need for better classification criteria for atypical/suspicious cases. Higher specificity, PPV, NPV, and accuracy but lower sensitivity in stented BDBs suggest that they be called malignant only when evidence is overwhelmingly convincing.

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Correlation of fine needle aspiration cytology and histopathology of neck swellings

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180986 ◽

2018 ◽

Vol 4 (3) ◽

pp. 648

Author(s):

C. S. Asha ◽

B. R. Suchit Roy

Keyword(s):

Salivary Gland ◽

Lymph Node ◽

Predictive Value ◽

Age Groups ◽

Invasive Procedure ◽

High Specificity ◽

Cost Effective ◽

Needle Aspiration ◽

Predictive Values ◽

Specificity And Sensitivity

Background: Neck swellings are a common clinical finding affecting all age groups. FNAC is a minimally invasive procedure helpful in the diagnosis of various neck swellings. The purpose of this study is to determine the accuracy of FNAC in the diagnosis of neck swellings by comparing it with the histopathology which is taken as the gold standard.Methods: A prospective study which included 90 patients who attended ENT and surgery departments of Government Medical College, Trivandrum with neck swellings from July 2006-2007. FNAC of the swelling was done and the FNAC results were compared with the histopathology results. The specificity, sensitivity, positive and negative predictive values and accuracy of FNAC were calculated. Results: Of the 90 patients, thyroid swelling formed the major group followed by lymph node, salivary gland and miscellaneous swellings. Thyroid swellings had a female predominance while the other three groups namely lymph node, salivary gland and miscellaneous groups showed a male preponderance. When the neck swellings namely thyroid, salivary gland, lymph node and miscellaneous group were taken into consideration as a whole, the sensitivity of FNAC for detecting malignancy was 64.3%. The specificity, positive predictive value, negative predictive value and accuracy were 97.4%, 81.8%, 93.7% and 92% respectively.Conclusions: FNAC can be rated as a safe, simple, reliable, cost effective and rapid diagnostic tool with high specificity and sensitivity for the initial evaluation of neck swellings.

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False negativity rate of ultrasonography with mammography in women with palpable breast lumps

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4381 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 1800-1804

Author(s):

Sudha M ◽

Prashant Moorthy

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Breast Imaging ◽

False Negative ◽

False Negative Rate ◽

Predictive Values ◽

High Negative Predictive Value ◽

Study Population ◽

Palpable Breast ◽

Breast Lumps

This study was performed to determine the false negativity rates of ultrasonography with mammography in the assessment of women with palpable breast lumps. The relevant data on 202 female patients aged above 14 years of age, who had presented to our institution with a breast lump, had been retrospectively reviewed from our hospital database. Out of these, 155 patients for whom mammography with sonography imaging (MSI) was done were included in the study population. It consisted of tissue-positive cases, tissue-negative cases, and false-negative MSI confirmed on pathology. All cancer cases and false-negative cases using MSI were identified. Cancer rates, false-negative rates, and negative predictive values were calculated based on MSI breast imaging reporting and BI-RADS categories. Among patients who had undergone MSI, 73.55 % (114/155) of patients had BI-RADS 1–2. Despite a benign result, 10.5% (12/114) of them had gone ahead with a tissue diagnosis, whereas BI-RADS 4 and 5 had a 100% biopsy rate (28/28, 4/4, respectively). Out of the seventeen cancers detected in toto, only one belonged to BI-RADS 1–2. The false-negative rate of MSI (i.e., BI-RADS 1–2) was found to be 1.75% (1/114). As none of the remaining cases had progressed into malignancy post-follow-up (Median: 9 months, Range: 2 – 13 months), The negative predictive value (NPV) and cancer rate were estimated to be 99.12% and 0.88% respectively. Therefore, low false negativity and high negative predictive value of mammography with ultrasonography imaging for breast lumps were established.

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Molecular markers in the diagnosis of thyroid nodules

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302013000200001 ◽

2013 ◽

Vol 57 (2) ◽

pp. 89-97 ◽

Cited By ~ 19

Author(s):

Laura S. Ward ◽

Richard T. Kloos

Keyword(s):

Predictive Value ◽

High Sensitivity ◽

High Specificity ◽

Cost Effective ◽

Needle Aspiration ◽

Molecular Diagnostic ◽

Risk Of Malignancy ◽

Benign Nodules ◽

Low Sensitivity ◽

Rule Out

An indeterminate thyroid nodule cytology result occurs about every sixth fine-needle aspiration. These indeterminate nodules harbor a 24% risk of malignancy (ROM); too high to ignore, but driving surgery where most nodules are benign. Molecular diagnostics have emerged to ideally avoid surgery when appropriate, and to trigger the correct therapeutic surgery when indicated, as opposed to an incomplete diagnostic surgery. No current molecular test offers both high sensitivity and high specificity. A molecular diagnostic test with high sensitivity (e.g. Afirma Gene Expression Classifier sensitivity 90%) offers a high Negative Predictive Value when the ROM is relatively low, such as < 30%. Only such tests can "rule-out" cancer. In this setting, a molecularly benign result suggests the same ROM as that of operated cytologically benign nodules (~6%). Thus, clinical observation can replace diagnostic surgery; increasing quality of life and decreasing medical costs. However, its low specificity cannot "rule-in" cancer as a suspicious result has a Positive Predictive Value (PPV) of ~40%, perhaps too low to routinely reflex to definitive cancer surgery. Conversely, high specificity tests (BRAF, RAS, PPAR/PAX-8, RET/PTC, PTEN) offer high PPV results, and only these tests can "rule-in" cancer. Here a positive molecular result warrants definitive therapeutic surgery. However, their low sensitivity cannot "rule-out" cancer and a negative molecular result cannot dissuade diagnostic surgery; limiting their cost-effectiveness. Whether or not there is a useful and cost-effective role to sequentially combine these approaches, or to modify existing approaches, is under investigation.

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Reliability of Cobas Amplicor PCR test in detection of Mycobacterium tuberculosis in respiratory and nonorespiratory specimens

Vojnosanitetski pregled ◽

10.2298/vsp0912992l ◽

2009 ◽

Vol 66 (12) ◽

pp. 992-997

Author(s):

Zorica Lepsanovic ◽

Dejana Savic ◽

Branka Tomanovic

Keyword(s):

Mycobacterium Tuberculosis ◽

High Sensitivity ◽

High Specificity ◽

Diagnostic Methods ◽

Nucleic Acid Amplification ◽

Culture Methods ◽

Predictive Values ◽

Polymerase Chain ◽

Low Sensitivity ◽

Sensitivity Specificity

Background/Aim. Traditional methods for detection of mycobacteria, such as microscopic examination for the presence of acid-fast bacilli and isolation of the organism by culture, have either a low sensitivity and/or specificity, or take weeks before a definite result is available. Molecular methods, especially those based on nucleic acid amplification, are rapid diagnostic methods which combine high sensitivity and high specificity. The aim of this study was to determine the usefulness of the Cobas Amplicor Mycobacterium tuberculosis polymerase chain reaction (CAPCR) assay in detecting the tuberculosis cause in respiratory and nonrespiratory specimens (compared to culture). Methods. Specimens were decontaminated by the N-acetyl-L-cystein- NaOH method. A 500 ?L aliquot of the processed specimen were used for inoculation of L?wenstein-Jensen (L-J) slants, a drop for acid-fast staining, and 100 ?L for PCR. The Cobas Amplicor PCR was performed according to the manufacturer's instructions. Results. A total of 110 respiratory and 355 nonrespiratory specimens were investigated. After resolving discrepancies by reviewing medical history, overall sensitivity, specificity, and positive and negative predictive values for CA-PCR assay compared to culture, were 83%, 100%, 100%, and 96.8%, respectively. In comparison, they were 50%, 99.7%, 87.5%, and 98%, respectively, for the nonrespiratory specimens. The inhibition rate was 2.8% for respiratory, and 7.6% for nonrespiratory specimens. Conclusion. CA-PCR is a reliable assay that enables specialists to start treatment promptly on a positive test result. Lower value for specificity in a group of nonrespiratory specimens is a consequence of an extremely small number of mycobacteria in some of them.

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Combined Coronary CT Angiography With Plain Scan for Diagnosis of Ruptured Plaque: Comparison With Optical Coherence Tomography

10.21203/rs.3.rs-160611/v1 ◽

2021 ◽

Author(s):

Zhao-qian Wang ◽

Hai-xia Zhang ◽

Wei Wu ◽

You-sheng Yuan ◽

Ya-na Dou ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Predictive Value ◽

False Negative ◽

High Specificity ◽

Influential Factors ◽

Optical Coherence ◽

Cavity Depth ◽

Diagnostic Efficacy ◽

Predictive Values ◽

Coronary Ct

Abstract Purpose: To explore the diagnostic efficacy of CCTA + plain scan for ruptured plaques with optical coherence tomography (OCT) as the reference, and to preliminarily analyze the influential factors. Methods: Patients who underwent CCTA and OCT were retrospectively enrolled. Signs of ruptured plaque (plaque ulcer or intra-plaque dye penetration) and other plaque measurements on CCTA were recorded and compared with plain scans (calcification scoring scan) to differentiate calcifications from rupture signs. By OCT, presence of ruptured plaque was determined. Total 65 patients with 71 plaques were included. Results: There were 40 OCT-confirmed ruptured plaques in 38 patients and 31 OCT-confirmed non-ruptured plaques in 27 patients. CCTA+ plain scan identified 27 ruptured plaques in 27 patients and 28 non-ruptured plaques in 24 patients. With OCT as the gold standard, the per-patient sensitivity, specificity, positive and negative predictive values, and accuracy of CCTA + plain scan for diagnosing ruptured plaque were 71%, 89%, 90%, 69%, and 78%, and there was good agreement (Kappa=0.70) between CCTA + plain scan and OCT. Among 13 false negative ruptured plaques, 2 had calcifications close to the rupture, and the cavity depth in the remaining 11 was 0.46 ±0.17 mm, vs. 0.98±0.26 mm in 27 true positive ruptured plaques (P<0.01).Conclusion: CCTA + plain scan has high specificity and positive predictive value in diagnosing ruptured plaque with medium sensitivity and negative predictive value. The cavity depth of ruptured plaques and calcifications at the rupture site may be the main influential factors.

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The utility of Coccidioides antigen and antibody detection in cerebrospinal fluid in the diagnosis of canine central nervous system coccidioidomycosis

American Journal of Veterinary Research ◽

10.2460/ajvr.21.08.0121 ◽

2022 ◽

pp. 1-5

Author(s):

Christine D. Butkiewicz ◽

Cody J. Alcott ◽

Janelle Renschler ◽

Lawrence J. Wheat ◽

Lisa F. Shubitz

Keyword(s):

Clinical Signs ◽

High Specificity ◽

Antibody Detection ◽

Antibody Testing ◽

Endemic Region ◽

Predictive Values ◽

Csf Analysis ◽

Neurologic Disorders ◽

Low Sensitivity ◽

A Prospective Study

Abstract OBJECTIVE To evaluate the utility of enzyme immunoassays (EIAs) for the detection of Coccidioides antigen and antibody in CSF in the diagnosis of CNS coccidioidomycosis in dogs. ANIMALS 51 dogs evaluated for CNS disease in a single specialty center in Tucson in 2016. PROCEDURES Excess CSF after routine analysis was banked after collection from dogs presented to the neurology service. Samples were tested by EIA for presence of Coccidioides antigen and antibody. Clinical data were collected from medical records retrospectively. RESULTS 22 dogs were diagnosed with CNS coccidioidomycosis (CCM) or another neurologic disease (non-CCM). These groups of dogs overlapped in the presenting complaints, MRI results, and routine CSF analysis results. Four dogs, all with CCM, had positive antigen EIA results. With clinical diagnosis used as the reference standard, CSF antigen testing had low sensitivity (20%) but high specificity (100%) for diagnosis of CCM. Ten dogs with CCM and 4 dogs with other diagnoses had antibody detected in CSF by EIA. Sensitivity of CSF antibody testing was 46%, specificity was 86%, and positive and negative predictive values for the study population were 71% and 68%, respectively. Clinical Relevance Diagnosis of CNS coccidioidomycosis in dogs in an endemic region was hampered by overlap of clinical signs with other neurologic disorders and the low sensitivity of confirmatory diagnostics. The evaluated Coccidioides-specific EIAs performed on CSF can aid in the diagnosis. A prospective study is warranted to corroborate and refine these preliminary findings

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