scholarly journals Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): our experience and a systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yanli Zhu ◽  
Yuntao Song ◽  
Guohui Xu ◽  
Zhihui Fan ◽  
Wenhao Ren
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Diagnostic Errors ◽  
Published Data ◽  
Cystic Lesions ◽  
Adenomatous Hyperplasia ◽  
Sensitivity Specificity

Abstract Objective FNA is a simple, safe, cost-effective and accurate diagnostic tool for the initial screening of patients with thyroid nodules. The aims of this study were to determine the diagnostic utility of FNAC performed in our institution, assess the cytomorphologic features that contribute to diagnostic errors and propose improvement measures. Methods A total of 2781 FNACs were included in the study, and 1122 cases were compared with their histological diagnoses. We retrospectively reexamined our discordant (both false-negative and false-positive) cases and performed a systematic review of previous studies on causes of misdiagnoses. Results When DC V and DC VI were both considered cytologic-positive, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 98.3, 30.9, 94.9, 58.3 and 93.5%, respectively. If DC VI was considered cytologic-positive, the sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC were 98.0, 84.0, 99.4, 58.3, and 97.5% respectively. The main cause of false-negative diagnoses was sampling error (13/15, 86.7%), while interpretation error led to the majority of the false-positive diagnoses (38/47, 80.9%). Overlapping cytological features in adenomatous hyperplasia, thyroiditis and cystic lesions were the major factors contributing to interpretation errors, while the size and number of nodules may have led to false-negative diagnoses because of heterogeneity and unsampled areas. Conclusions The sensitivity and PPV of thyroid FNAC in our institution were higher than those in the published data, while the specificity and NPV were lower. Regarding the FNA category DC V, a frozen section analysis during diagnostic lobectomy is necessary. Multiple passes should be performed in various parts of a large nodule or from different nodules to reduce the risk of false-negative findings. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis and cystic lesions to avoid false-positive diagnoses. NIFTP has little effect on diagnostic accuracy and the distribution of diagnostic errors.

scholarly journals Diagnostic Accuracy of Antibody-based Rapid Diagnostic Test in Detecting Coronavirus Disease 2019: Systematic Review

2021 ◽  
Author(s):  
Yanto Tjang ◽  
Tiara Gracienta ◽  
Ryan Herardi ◽  
Frans Santosa ◽  
Taufiq Pasiak
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Predictive Value ◽  
Detection Method ◽  
Target Antigen ◽  
Test Accuracy ◽  
Eligibility Criteria ◽  
Sensitivity Specificity

IntroductionThe rapid transmission of Coronavirus disease 2019 (COVID-19) requires a fast, accurate, and affordable detection method. Despite doubts of its diagnostic accuracy, Rapid Diagnostic Test (RDT) is world-widely used in consideration for its practicality. This systematic review aims to determine the diagnostic accuracy of antibody-based RDT in detecting COVID-19.Material and methodsA literature search was carried out on five journal databases using the PRISMA-P 2015 method. We included all studies published up to February 2021. The risk of bias was evaluated using The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Diagnostic Test Accuracy Studies. Data regarding peer-review status, study design, tests kit information, immunoglobulin class, target antigen, and the number of samples were extracted and tabulated. We estimated the pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with a 95% confidence interval.ResultsThirty-three studies met the eligibility criteria. The pooled data results showed that the combined detection method of IgM or IgG had the highest sensitivity and NPV, which were 73.41% (95% CI: 72.22-74.57) and 75.34% (95% CI: 74.51-76.16), respectively. The single IgG detection method had the highest specificity and PPV of 96.68% (95% CI: 96.25-97.07) and 95.97% (95% CI: 95.47-96.42%), respectively.ConclusionsAntibody-based RDT is not satisfactory as a primary diagnostic test but has utilities as a screening tool.

scholarly journals Comparison of diagnostic accuracy of papanicoloau (PAP) Smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma, taking biopsy as gold standard.

2020 ◽  
Vol 27 (04) ◽  
pp. 863-869
Author(s):  
Shakila Yasmin ◽  
Tahira Munir ◽  
Ayesha Javaid ◽  
Khalid Fahim Yasin ◽  
Junaid Hassan
Keyword(s):  
Acetic Acid ◽  
Diagnostic Accuracy ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Sensitivity Specificity

Study Design: Cross-sectional descriptive study. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital, Bahawalpur. Period: 05 August 2016 to 05 Feb 2017. Material & Methods: A total of 228 suspected patients of cervical carcinoma and age of 20-50 years were included. Patients with acute cervicitis, pregnant females, h/o abnormal cytology and obvious lesion on cervix were excluded. All the patients were underwent papanicoloau (PAP) smear and visual inspection using acetic acid. The results of papanicoloau (PAP) smear and visual inspection using acetic acid (VIA) were compared with cervical biopsy report. Results: In 110 papanicoloau (PAP) smear positive patients, 97 were True Positive and 13 were False Positive. Among, 118 papanicoloau (PAP) smear negative patients, 18 were False Negative whereas 100 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of papanicoloau ( PAP )smear in screening of cervical carcinoma was 84.35%, 88.50%, 88.18%, 84.75% and 86.40% respectively. In 114 visual inspection using acetic acid (VIA) positive patients, 95 were True Positive and 19 were False Positive. Among, 114 visual inspection using acetic acid (VIA) negative patients, 20 were False Negative whereas 94 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of visual inspection using acetic acid ( VIA) in  screening of cervical carcinoma was 82.61%, 83.19%, 83.33% 82.46% and 82.89% respectively. Conclusion: This study concluded that papanicoloau ( PAP) smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma are highly sensitive, accurate and having almost equal diagnostic accuracy.

scholarly journals Diagnostic Accuracy of Transvaginal Sonography in the Detection of Endometrial Polyps

2019 ◽  
Vol 36 (1) ◽  
pp. 31-35
Author(s):  
Yevheniia Poliakova ◽  
Nataliia Lutsenko
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
False Negative ◽  
Transvaginal Sonography ◽  
Endometrial Polyps ◽  
Sonographic Diagnosis ◽  
Dilation And Curettage ◽  
Uterine Anomalies ◽  
Sensitivity Specificity

Background: Transvaginal sonography (TVS) is considered a simple and generally accepted method for detecting uterine anomalies. With TVS, the uterus can be clearly visualized, but so far, the diagnostic accuracy of TVS varies across different studies. This retrospective study was devised to evaluate the accuracy of a sonographic diagnosis of endometrial polyps in a Ukrainian hospital. Methods: This was a single-center retrospective study of woman who underwent TVS and had hysteroscopy or dilation and curettage for endometrial pathology. A cohort of 156 women were included in this yearlong study. A comparative analysis was based on the preoperative diagnosis, according to TVS, compared with the postoperative histopathology results. Results: The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of TVS in diagnosing endometrial polyps were 69%, 51%, 73%, 46%, and 63%, respectively. Conclusion: This retrospective study provided data on the lack of accuracy for a sonographic diagnosis of endometrial polyps. This was based on 26% of women whose diagnosis was not confirmed by histology. A false-negative result occurred for 54% of women who had polyps that were not detected at the preoperative stage. These data raise the question of the feasibility of further invasive procedures based on a single TVS study.

scholarly journals Second-Generation Platelet Concentrates (PRFs): Estimation of Cellular Content

2021 ◽  
Vol 12 (4) ◽  
pp. 4747-4754
Keyword(s):  
Positive Predictive Value ◽  
Statistical Method ◽  
Predictive Value ◽  
False Positive ◽  
Second Generation ◽  
False Negative ◽  
Platelet Concentrates ◽  
Positive Proportion ◽  
Sensitivity Specificity ◽  
Exact Amount

We performed a study to evaluate the amount of Platelets and Leukocytes in a second-generation solid platelet concentrates in terms of Sensitivity, Specificity, Positive Predictive Value (VP+), Negative Predictive Value (VP-), False Negative Proportion, and False Positive Proportion of our Statistical Method. Blood was collected in anticoagulant-free PET tubes with silica for clot production and PRF membranes. The membranes and clots produced were examined. In a previous work, the authors, starting from the results obtained in Kitamura's work, wanted to elaborate a simpler and inexpensive system to calculate the exact amount of platelets and leukocytes contained in PRF, compared to the one present in whole blood, starting from a simple "haemochromocytometric examination". In this study, the authors have evaluated the Sensitivity, Specificity, Positive Predictive Value (VP+), Negative Predictive Value (VP-), False Negative Proportion, and False Positive Proportion of the "Statistical Method". Using the Statistical Method, we have that by reducing by 34.12% (±28.2) the value of leukocytes obtained from the CBC examination. We obtained the value of leukocytes contained in the PRF membrane by t-PA digestion and by reducing by 15.12% (±24.87) the value of platelets obtained by the same method, we obtained the value contained in solid platelet concentrates by t-PA digestion. The method thus proposed demonstrated a Se=0.75; Sp=0.86; VP+=0.75; VP-=0.86 for platelet counts, Se=0.47; Sp=0.66; VP+=0.80; VP-=0.30 for leukocyte counts. Conclusion: Our study sought to standardize the PRF preparation procedure by validating a statistical system to calculate the exact amount of platelets and leukocytes in second-generation solid platelet concentrates, making it easy to evaluate individual PRF arrays on time in the clinical setting. The Statistical method compared to the digestive method with t-PA for leukocyte and platelet counts demonstrated equal validity for platelets, but not so for leukocytes.

scholarly journals Cytological Smear and Cell Block Versus Tissue Biopsies in the Diagnosis of Malignant Tumours in Non-Gynaecologic Specimens

1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Nasar Alwahaibi ◽  
Asmaa Alghallabi ◽  
Shadia Alsinawi ◽  
Najat Aldairi
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Cell Block ◽  
Malignant Tumours ◽  
Cytological Smear ◽  
Scanty Information ◽  
Sensitivity Specificity

BACKGROUND: Cytological smear and cell block (CB) are routinely used to diagnose non gynaecologic specimens. However, there is scanty information in the literature to compare cytological smear and CB with the corresponding tissue biopsies. This study is aimed at evaluating the accuracy of cytological smear and CB in the diagnosis of malignant tumours in non-gynaecologic specimens.MATERIALS AND METHODS: A total of 70 malignant cases were subjected to cytological smear and CB. Corresponding histopathology was also included. The most frequent immunomarkers found between CB and tissue biopsies were also correlated. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive and false negative values were analyzed for each method.RESULTS: The accuracy, sensitivity and positive predictive value for cytological smear were 92.8%, 100.0% and 92.9%, whereas for CB were 91.4%, 98.4% and 92.7%, respectively. In CB method, the accuracy, sensitivity and positive predictive value for CK7 were 88.9%, 91.7% and 95.6%, whereas for CK5/6 were 75%, 100% and 57.1%, respectively.CONCLUSION: Cytological smear and CB are very sensitive and accurate in the detection of malignant tumours in nongynaecologic specimens. Additional corresponding tissue biopsiesshould be re-evaluated. 

scholarly journals Diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA for tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253658
Author(s):  
Guocan Yu ◽  
Yanqin Shen ◽  
Bo Ye ◽  
Yan Shi
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Meta Analysis ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Cell Free Dna ◽  
Free Dna ◽  
Sensitivity Specificity

Background Diagnosis of tuberculosis (TB) is still difficult. The purpose of our study was to evaluate the diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA (cfDNA) for diagnosing of TB. Methods We searched relevant databases for studies that used cfDNA to diagnose TB. We evaluated the accuracy of cfDNA compared with the composite reference standard (CRS) and culture. True positive, false positive, false negative, and true negative values for cfDNA were obtained first, then the estimated pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) of cfDNA for diagnosing TB were calculated with 95% confidence intervals (CIs). Heterogeneity was determined using the I2 statistic. When the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included 14 independent studies comparing cfDNA with the CRS, and 4 studies compared with culture. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 68%, 98%,99%, 62%, 83, and 0.97 as compared with the CRS, respectively. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 48%, 91%, 92%, 60%, 5, and 0.88 as compared with culture, respectively. The heterogeneity between studies was significant. Conclusions The accuracy of cfDNA testing for TB diagnosis was good compared with CRS and culture. cfDNA can be used for rapid early diagnosis of TB.

scholarly journals Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Adriana Sánchez-García ◽  
René Rodríguez-Gutiérrez ◽  
Leonardo Mancillas-Adame ◽  
Victoria González-Nava ◽  
Alejandro Díaz González-Colmenero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Biochemical Marker ◽  
Likelihood Ratios ◽  
Tyg Index ◽  
Cutoff Values ◽  
Language Restriction ◽  
Sensitivity Specificity

Introduction. The triglyceride and glucose (TyG) index has been described as a biochemical marker of insulin resistance (IR); however, its diagnostic accuracy remains uncertain. Objective. To summarize the evidence assessing the diagnostic accuracy of the TyG index regarding IR. Methods. A comprehensive search in MEDLINE, EMBASE, Web of Science, and Scopus was performed without any language restriction. Studies assessing the diagnostic accuracy of the TyG index against the hyperinsulinemic-euglycemic clamp (HIEC) or any other IR biochemical were assessed independently and in duplicate. Diagnostic accuracy measures (sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios) were extracted independently and in duplicate. The QUADAS-2 tool was used to assess the risk of bias of independent studies. Results. We identified 15 eligible studies with 69,922 participants and an overall quality of low to moderate. The TyG index was evaluated by HIEC and HOMA as reference tests. The highest achieved sensitivity was 96% using HIEC, and the highest specificity was of 99% using HOMA-IR, with a cutoff value of 4.68. AUC values varied from 0.59 to 0.88. Cutoff values for IR were variable between studies, limiting its comparability. Conclusion. In this systematic review, we found moderate-to-low quality evidence about the usefulness of the TyG index as a surrogate biochemical marker of IR. Due to the lack of a standardized IR definition and heterogeneity between studies, further validation and standardized cutoff values are needed to be used in clinical practice.

Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

2012 ◽  
Vol 15 (1) ◽  
pp. 12 ◽  
Author(s):  
Levent Sahiner ◽  
Ali Oto ◽  
Kudret Aytemir ◽  
Tuncay Hazirolan ◽  
Musturay Karcaaltincaba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Predictive Value ◽  
Artery Bypass ◽  
Time Interval ◽  
Mdct Angiography ◽  
Sensitivity Specificity

<p><b>Background:</b> The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.</p><p><b>Results:</b> Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.</p><p><b>Conclusion:</b> Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.</p>

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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