Eosinophilic disorders: evaluation of current classification and diagnostic criteria, proposal of a practical diagnostic algorithm

BackgroundThe nosological status of olfactory reference syndrome (ORS) is a matter of debate and there is uncertainty as to what treatments are effective.MethodThe world literature was searched for reports of cases of ORS. Clinical, nosological and therapeutic information from cases meeting proposed diagnostic criteria for the disorder was summarized and tabulated.ResultsA total of 84 case reports (52 male/32 female) were found. Age of onset was <20 years in almost 60% of cases. Smell-related precipitating events were recorded in 42%. Most patients could not smell the smell or only did so intermittently. Authors of the reports expressed reservations about the delusional nature of the belief in slightly under half of the cases. Over two-thirds were improved or recovered at follow-up, with the disorder responding to antidepressants and psychotherapy more frequently than to neuroleptics.ConclusionsORS is a primary psychiatric syndrome that does not fit well into its current classification as a subtype of delusional disorder, both in terms of its nosology and its response to treatment.

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Diagnostic algorithm of centrally mediated abdominal pain syndrome — does it need changes? According to the materials of Rome IV Criteria

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2021-99-7-8-465-468 ◽

2022 ◽

Vol 99 (7-8) ◽

pp. 465-468

Author(s):

A. A. Sheptulin

Keyword(s):

Abdominal Pain ◽

Diagnostic Criteria ◽

Research Methods ◽

Laboratory Tests ◽

Diagnostic Algorithm ◽

Pain Syndrome ◽

Functional Abdominal Pain ◽

Rome Criteria ◽

Functional Abdominal Pain Syndrome ◽

Rome Iv

The article discusses the algorithm for diagnosing of centrally mediated abdominal pain syndrome (CAPS), formerly called functional abdominal pain syndrome, contained in the Rome Criteria of the IV revision (2016). Recommendations for the diagnosis of CAPS, mainly based on the compliance of the signs available in patients with the developed diagnostic criteria with a minimum of additional laboratory tests, are criticized, since such an approach is fraught with possible errors. The author considers the diagnosis of CAPS as a “diagnosis of exclusion”, which can be made only after a thorough examination of patients using laboratory and instrumental research methods (including ultrasound and endoscopic), confi rming the absence of organic diseases in patients.

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Study of the application of international diagnostic criteria for temporomandibular disorders – DC/TMD, as the main diagnostic algorithm for research and clinical purposes (analysis of literature)

SUCHASNA STOMATOLOHIYA ◽

10.33295/1992-576x-2019-3-88 ◽

2019 ◽

pp. 88-95

Author(s):

S. Klochan ◽

Keyword(s):

Diagnostic Criteria ◽

Temporomandibular Disorders ◽

Diagnostic Algorithm

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Prognostic Implication of Diagnostic Confidence Level in Patients with Fibrotic Hypersensitivity Pneumonitis

Respiration ◽

10.1159/000517921 ◽

2021 ◽

pp. 1-9

Author(s):

Jieun Kang ◽

Yeon Joo Kim ◽

Jooae Choe ◽

Eun Jin Chae ◽

Joon Seon Song ◽

...

Keyword(s):

Diagnostic Criteria ◽

Confidence Level ◽

Hypersensitivity Pneumonitis ◽

Respir Crit ◽

Diagnostic Algorithm ◽

Diagnostic Confidence ◽

Prognostic Implication ◽

Confidence Levels ◽

Cox Proportional Hazard ◽

Cox Analysis

Background: Hypersensitivity pneumonitis (HP) has various clinical courses and outcomes, but the prognostic factors are not well-defined. Vasakova et al. [Am J Respir Crit Care Med. 2017 Sep;196(6):680–9] have proposed a diagnostic algorithm that categorized suspected patients according to the level of confidence in the diagnosis. This study aimed to investigate whether the confidence level of clinical diagnosis has prognostic implication in patients with fibrotic HP. Methods: This study included 101 biopsy-proven fibrotic HP patients diagnosed between 2002 and 2017. The patients were retrospectively classified into confident, probable, possible, and unlikely chronic HP, according to the confidence level in the diagnostic criteria/algorithm. The survival and forced vital capacity (FVC) changes were compared between the groups. Risk factors for mortality were analysed using a Cox proportional hazard model. Results: The median follow-up duration was 67.6 months. The mean age was 60.4 years, and percentages of women were 60.4%. When classified based on the diagnostic criteria/algorithm, possible HP was the most common (51.5%), followed by probable (26.7%), confident (9.9%), and unlikely HP (6.9%). Distinctive survival curves were found according to the diagnostic confidence level, showing the worst outcome in unlikely chronic HP (median survival, 30.2 months). In a multivariable Cox analysis, unlikely HP was a significant predictor of poor survival (hazard ratio, 4.652; 95% confidence interval, 1.231–17.586; p = 0.023), after adjustment for age, body mass index, FVC, and diffusing capacity. Conclusions: The diagnostic confidence level may predict clinical outcomes in patients with HP. Unlikely HP was shown to have a significantly poorer survival than other diagnostic confidence levels.

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Are new diagnostic criteria and classification of diabetes necessary?

Problems of Endocrinology ◽

10.14341/probl11764 ◽

1999 ◽

Vol 45 (3) ◽

pp. 21-25

Author(s):

M. I. Balabolkin ◽

V. M. Kreminskaya

Keyword(s):

Diagnostic Criteria ◽

Clinical Picture ◽

Diagnostic Algorithm ◽

Classification Of Diseases ◽

Diagnosis And Classification

The issues of diagnosis and classification of diseases are given priority. This is understandable, since each classification reflects the level of our knowledge and ideas about the pathogenesis of the disease for a certain period of time. The classification of diseases, therefore, is a kind of tool that helps practitioners navigate the diverse clinical picture of the same disease and correctly conduct the diagnostic algorithm. Ultimately, the classification of the disease, based on current pathogenesis data, provides practical assistance to the doctor in matters of both diagnosis and therapeutic tactics of the disease.

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Critical Analysis of the International Classification of Headache Disorders Diagnostic Criteria (ICHD I-1988) and (ICHD II-2004), for Migraine in Children and Adolescents

Cephalalgia ◽

10.1111/j.1468-2982.2005.00954.x ◽

2005 ◽

Vol 25 (11) ◽

pp. 1042-1047 ◽

Cited By ~ 42

Author(s):

MMF Lima ◽

NAMR Padula ◽

LCA Santos ◽

LDB Oliveira ◽

S Agapejev ◽

...

Keyword(s):

Children And Adolescents ◽

Diagnostic Criteria ◽

Predictive Value ◽

Gold Standard ◽

Critical Analysis ◽

High Specificity ◽

Classification Criteria ◽

Headache Disorders ◽

Current Classification

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

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Változások a pulmonalis hypertonia 2015. évi irányelvében

Orvosi Hetilap ◽

10.1556/650.2016.30576 ◽

2016 ◽

Vol 157 (38) ◽

pp. 1522-1525

Author(s):

Tamás Forster

Keyword(s):

Pulmonary Hypertension ◽

Diagnostic Criteria ◽

Diagnostic Algorithm ◽

Therapeutic Algorithm ◽

Sequential Combination ◽

Initial Combination

The new 2015 ESC/ERS Guideline refined the diagnostic criteria of pulmonary hypertension. A new diagnostic algorithm is suggested. The therapeutic algorithm is renewed on the basis of newly registered drugs. Besides the usual sequential combination, the immediate (initial) combination is proposed as an alternative way. Pulmonary hypertension should be treated in expert referral centers. Orv. Hetil., 2016, 157(38), 1522–1525.

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Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: Implications for the diagnostic algorithm

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.150078 ◽

2015 ◽

Vol 206 (3) ◽

pp. 245-251 ◽

Cited By ~ 20

Author(s):

David Forbes ◽

Emma Lockwood ◽

Mark Creamer ◽

Richard A. Bryant ◽

Alexander C. McFarlane ◽

...

Keyword(s):

Diagnostic Criteria ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Factor Model ◽

Diagnostic Algorithm ◽

Latent Structure ◽

Ptsd Symptoms ◽

Post Traumatic Stress ◽

Post Traumatic

BackgroundThe latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored.AimsTo investigate the latent structure of the proposed ICD-11 PTSD symptoms.MethodConfirmatory factor analyses using data from structured clinical interviews administered to injury patients (n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered.ResultsAlthough the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P<0.05), they identified individuals with similar levels of disability (P = 0.933) and QoL (P = 0.591) to those identified by the ICD-11 criteria.ConclusionsConsistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.

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O32 LYON CONSENSUS CRITERIA SIGNIFICANTLY CHANGES THE PH IMPEDANCE DIAGNOSIS OF GASTROESOPHAGEAL REFLUX DISEASE (GERD)

Diseases of the Esophagus ◽

10.1093/dote/doz092.32 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

Ioannou Alexandros ◽

Mandolesi Daniele ◽

Chaita Stavroula ◽

Torresan Francesco ◽

Bazzoli Franco

Keyword(s):

Diagnostic Criteria ◽

Complex Disease ◽

Diagnostic Algorithm ◽

Conclusive Evidence ◽

Outcome Analysis ◽

Residual Pressure ◽

The Past ◽

Symptom Profile ◽

One Year ◽

New Criteria

Abstract Aim To investigate the Lyon Consensus Criteria impact on Ph-Impedance diagnosis of GERD and their relation to high resolution manometric tracing results. Background & Methods GERD is a complex disease with a heterogeneous symptom profile and a multifaceted pathogenic basis that defies a simple diagnostic algorithm or categorical classification. The Lyon Consensus defines parameters on esophageal testing that conclusively establish the presence of GERD and characteristics that rule out GERD. We retrospectively evaluated according the new criteria our patients underwent pH-Impedance one year before the publication of Lyon Consensus Criteria and analyzed the differences in relation to the older diagnostic criteria. Results 130 patients (56 M, median age 52,03 R18-77) Ph-impedance exams for suspected typical and atypical GERD were re-evaluated. According to Lyon criteria for conclusive evidence of GERD 15,38% of them were over-diagnosticated and 1,53% had inconclusive evidence of the disease using the past criteria. In the evaluation of 94 patients with typical symptoms 23,4% were over-diagnosticated in according to the past diagnostic criteria. Statistical analysis of manometric values of the patients highlight that LES basal pressure (median 108.95, R38.7-283.4) (p=0,049) and UES residual pressure (median 7.8 R0.6-63.5) (p=0,003) significantly predict the Lyon criteria pH-impedance outcome. Analysis of manometric values of the patients with typical symptoms revealed that LES residual pressure (median 5,21 R0,1-20,7) (p=0,007) and Total Number of refluxes (median 28,03 R1-122) (p=0,013) significantly predict the Lyon criteria pH-impedance outcome. Conclusion Lyon Consensus Criteria significantly changes the pH-impedance diagnosis in patients undergoing testing for suspected GERD. In patients with typical symptoms new criteria allow not to overdiagnose 25% of GERD patient. Manometric values analysis significantly correlates and predict the Lyon criteria pH-impedance outcome.

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