Predictive Value of the Pretreatment Extent of Disease System in Hepatoblastoma: Results From the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 Study

2005 ◽  
Vol 23 (6) ◽  
pp. 1245-1252 ◽  
Author(s):  
Daniël C. Aronson ◽  
J. Marco Schnater ◽  
Chris R. Staalman ◽  
Gerrit J. Weverling ◽  
Jack Plaschkes ◽  
...  
Keyword(s):  
International Society ◽  
Pediatric Oncology ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Preoperative Staging ◽  
Study Group ◽  
Predictive Values ◽  
Tumor Study ◽  
Staging Systems ◽  
Extent Of Disease

Purpose Preoperative staging (pretreatment extent of disease [PRETEXT]) was developed for the first prospective liver tumor study by the International Society of Pediatric Oncology (SIOPEL-1 study; preoperative chemotherapy and delayed surgery). Study aims were to analyze the accuracy and interobserver agreement of PRETEXT and to compare the predictive impact of three currently used staging systems. Patients and Methods Hepatoblastoma (HB) patients younger than 16 years who underwent surgical resection (128 of 154 patients) were analyzed. The centrally reviewed preoperative staging was compared with postoperative pathology (accuracy) in 91 patients (81%), and the local center staging was compared with the central review (interobserver agreement) in 97 patients (86%), using the agreement beyond change method (weighted κ). The predictive values of the three staging systems were compared in 110 patients (97%) using survival curves and Cox proportional hazard ratio estimates. Results Preoperative PRETEXT staging compared with pathology was correct in 51%, overstaged in 37%, and understaged in 12% of patients (weighted κ = 0.44; 95% CI, 0.26 to 0.62). The weighted κ value of the interobserver agreement was 0.76 (95% CI, 0.64 to 0.88). The Children's Cancer Study Group/Pediatric Oncology Group–based staging system showed no predictive value for survival (P = .516), but the tumor-node-metastasis–based system and PRETEXT system showed good predictive values (P = .0021 and P = .0006, respectively). PRETEXT seemed to be superior in the statistical fit. Conclusion PRETEXT has moderate accuracy with a tendency to overstage patients, shows good interobserver agreement (reproducibility), shows superior predictive value for survival, offers the opportunity to monitor the effect of preoperative therapy, and can also be applied in patients who have not had operations. For comparability reasons, we recommend that all HB patients included in trials also be staged according to PRETEXT.

scholarly journals Comparison of the Main Staging Systems for Assessing the Severity of Lung Injury in Patients with COVID-19 and Evaluation of Their Predictive Value

2021 ◽  
Vol 102 (5) ◽  
pp. 296-303
Author(s):  
Y. S. Kudryavtsev ◽  
M. M. Beregov ◽  
A. B. Berdalin ◽  
V. G. Lelyuk
Keyword(s):  
Lung Tissue ◽  
Predictive Value ◽  
Prognostic Value ◽  
Time Course ◽  
Fatal Outcome ◽  
Chest Ct ◽  
Viral Pneumonia ◽  
Maximum Magnitude ◽  
Predictive Values ◽  
Staging Systems

Objective: to compare the results of staging the severity of viral pneumonia in patients with COVID-19 based on the results of chest computed tomography (CT) using the empirical visual scale CT 0–4 and chest CT severity score (CT-SS) point scale, as well as to assess their prognostic value.Material and methods. Chest CT scans and anamnestic data in patients hospitalized to a non-specialized center repurposed for the treatment of new coronavirus infection, were analyzed. Chest CT analysis was performed by two radiologists using CT 0–4 and CT-SS scales.Results. The time course of changes in the severity of lung parenchymal lesions, by using both scales, was found to be similar: the maximum magnitude of lung tissue changes was recorded on day 5 of the disease. In cases of death, there was a significantly more extensive lung parenchymal involvement at admission to the center than in recovered patients, which was also true for both CT data assessment systems. Bothscales demonstrated comparable diagnostic and prognostic value: there were no statistically significant differences in sensitivity, specificity, and predictive value of a fatal outcome. Both the CT 0–4 scales and the CT-SS are based on the estimation of the volume of the affected lung tissue, but when the CT 0–4 scale was employed, additional criteria were used in some cases: the presence of hydrothorax and the determination of the maximum score for the most affected lung. Not all patients with a pronounced CT picture of viral pneumonia had a fatal outcome, which may indicate the presence of other factors that increase its risk.Conclusion. Both CT 0–4 and CT-SS scales have similar predictive values. The greater severity of parenchymal damage assessed by these CT scales was associated with the higher mortality rate.

Clear Cell Sarcomas of the Kidney registered on International Society of Pediatric Oncology (SIOP) 93-01 and SIOP 2001 protocols: A report of the SIOP Renal Tumour Study Group

2013 ◽  
Vol 49 (16) ◽  
pp. 3497-3506 ◽  
Author(s):  
R. Furtwängler ◽  
S.L. Gooskens ◽  
H. van Tinteren ◽  
J. de Kraker ◽  
G. Schleiermacher ◽  
...  
Keyword(s):  
International Society ◽  
Pediatric Oncology ◽  
Clear Cell ◽  
Renal Tumour ◽  
Study Group

CT Hypoperfusion–Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012891
Author(s):  
Peter B Sporns ◽  
André Kemmling ◽  
Heike Minnerup ◽  
Lennart Meyer ◽  
Christos Krogias ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Symptom Onset ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Time Window ◽  
Stroke Onset ◽  
Class Iii ◽  
Predictive Values

ObjectiveTo test the hypothesis that CT hypoperfusion-hypodensity mismatch identifies patients with ischemic stroke within 4.5 hours of symptom onset.MethodsWe therefore performed the “retrospective multicenter hypoperfusion-hypodensity mismatch for the identification of patients with stroke within 4.5 hours study” of patients with acute ischemic stroke and known time of symptom onset. The predictive values of hypoperfusion-hypodensity mismatch for the identification of patients with symptom onset within 4.5 hours were the main outcome measure.ResultsOf 666 patients, 548 (82.3 %) had multimodal CT within 4.5 hours and 118 (17.7%) beyond. Hypoperfusion-hypodensity mismatch was visible in 516 (94.2%) patients with symptom onset within and in 30 (25.4%) patients beyond 4.5 hours. CT hypoperfusion-hypodensity mismatch identified patients within 4.5 hours of stroke onset with 94.2% (95% CI: 91.9-95.8%) sensitivity, 74.6% (95% CI: 66.0-81.6%) specificity, 94.5% (95% CI: 92.3-96.1%) positive predictive value, and 73.3% (95% CI: 64.8-80.4%) negative predictive value. Interobserver agreement for hypoperfusion-hypodensity mismatch was substantial (κ=0.61, 95% CI 0.53-0.69).ConclusionsIn conclusion, patients with acute ischemic stroke with absence of a hypodensity on native CT within the hypoperfused core lesion on perfusion CT (hypoperfusion-hypodensity mismatch) are likely to be within the time window of thrombolysis. Applying this method may guide the decision to use thrombolysis in patients with unknown time of stroke onset.Classification of EvidenceThis study provides Class III evidence that CT hypoperfusion-hypodensity mismatch identifies patients with stroke within 4.5 hours of onset.

scholarly journals Evaluation of urea and creatinine levels in vaginal wash fluid for the diagnosis of premature rupture of membranes

2020 ◽  
Vol 9 (8) ◽  
pp. 3449
Author(s):  
Abha Sharma ◽  
Richa Sharma ◽  
Tannavi Agarwal
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Control Group ◽  
Study Group ◽  
Premature Rupture ◽  
Predictive Values ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Vaginal Wash ◽  
Group 1

Background: Evaluation of urea and creatinine levels in vaginal wash fluid for the diagnosis of premature rupture of membranes.Methods: The study was conducted on150 pregnant patients, 50 in each group. Confirmed PROM and unconfirmed PROM. Per speculum examination was done to look for pooling, pH tested using the Pehanon paper and vaginal wash fluid was collected. Vaginal wash fluid urea and creatinine levels were tested by a kit based on spectrophotometry.Results: The mean urea levels were 26.35 mg/dl in the study Group 1 and 3.12 mg/dl in the control group. ROC curve was plotted and the cut off value of vaginal wash fluid urea was found to be 8.55 mg/dl. The vaginal wash fluid urea levels of >8.55 mg/dl detected PROM with a sensitivity, specificity, negative and positive predictive value of 100%. The mean creatinine levels were 0.62 mg/dl in study Group 1 and 0.20 mg/dl in the control group. ROC curve was plotted and the cut off value of vaginal wash fluid creatinine was found to be 0.405 mg/dl. Vaginal wash fluid creatinine levels detected PROM with a sensitivity of 76% and specificity of 100%. The negative predictive value and positive predictive values were 80.4% and 100%.Conclusions: Urea can be used as a definite marker of PROM and creatinine can be used as a supportive marker.

919: Ureteral Extension in Childhood Renal Tumors: A Report From the National Wilms Tumor Study Group (NWTSG)

2007 ◽  
Vol 177 (4S) ◽  
pp. 305-305
Author(s):  
Shane Daley ◽  
Michael Ritchey ◽  
Robert Shamberger ◽  
Robert Sawin ◽  
Thomas Hamilton ◽  
...  
Keyword(s):  
Wilms Tumor ◽  
Renal Tumors ◽  
Study Group ◽  
Tumor Study ◽  
Tumor Study Group

Predictive Value of Decreasing Antithrombin III in Deep-Vein Thrombosis

1980 ◽  
Vol 44 (03) ◽  
pp. 135-137 ◽  
Author(s):  
Thorkild Lund Andreasen
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Coronary Care Unit ◽  
Antithrombin Iii ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
At Iii ◽  
Coronary Care ◽  
Time Of Admission ◽  
Deep Vein

SummaryAntithrombin III (At-III) was measured at the time of admission and two days later in 131 patients laid up in a coronary care unit. The patients were examined for deep-vein thrombosis (DVT) clinically and by means of 125I-fibrinogen scanning. 19 patients developed DVT. In 11 subjects with and 25 without DVT At-III decreased more than 10%. And in 7 with and 17 without DVT At-III decreased more than 15%. One person with DVT had subnormal At-III. By using decrease of At-III or subnormal initial At-III to predict DVT the following predictive value (PV) were found. Decrease ≤ 10%, PV pos.= 0.32 and PV neg. = 0.93. Decrease ≤ 15%, PV pos. = 0.32 and PV neg. = 0.90. The positive predictive values obtained were too low to let decreasing At-III give occasion for prophylactic anticoagulant treatment.

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