Prevalence and diagnostic accuracy of in-toeing and out-toeing of the foot for patients with abnormal femoral torsion and femoroacetabular impingement

2019 ◽  
Vol 101-B (10) ◽  
pp. 1218-1229 ◽  
Author(s):  
Till D. Lerch ◽  
Patric Eichelberger ◽  
Heiner Baur ◽  
Florian Schmaranzer ◽  
Emanuel F. Liechti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Controlled Study ◽  
Femoral Torsion ◽  
Foot Position

Aims Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. Patients and Methods A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. Results We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. Conclusion In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218–1229

scholarly journals Sensitivity, Specificity and Accuracy of Color Doppler Ultrasonography for Diagnosis of Retinal Detachment

2020 ◽  
Author(s):  
Mohammadreza Akhlaghi ◽  
Masoomeh Zarei ◽  
Majid Ziaei ◽  
Mohsen Pourazizi
Keyword(s):  
Retinal Detachment ◽  
Diagnostic Accuracy ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Color Doppler Ultrasonography ◽  
Promising Tool ◽  
Sensitivity Specificity

Purpose: This study evaluated the sensitivity, specificity, and diagnostic accuracy of Color Doppler Ultrasonography (CDUS) in patients with suspected retinal detachment (RD) who underwent surgery. Methods: In this prospective, observational clinical study, 65 eyes of 65 consecutive patients with suspected RD with opaque media were included. Following a standardized protocol, CDUS of the retina of the affected eye was performed. The sensitivity, specificity, and diagnostic accuracy of CDUS were determined and compared to the findings during surgery. Results: The mean age of patients (18 men and 47 women) was 52.36 years (range: 8–77 years). The sensitivity, specificity, and overall accuracy of ocular CDUS were 91.3%, 88.1%, and 89.2%, respectively. The false-negative rate (negative CDUS images but presence of RD at operation) was 3.1% (2/65) and the false-positive rate (positive CDUS images but absence of RD at operation) was 7.7% (5/65). Conclusion: CDUS of the retina could be considered as a promising tool in the diagnosis of RD in patients with opaque media.

Low Complexity Adaptive Nonlinear Models for the Diagnosis of Periodontal Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 508-521
Author(s):  
Anurag Satpathy ◽  
Ganapati Panda ◽  
Rajasekhar Gogula ◽  
Renu Sharma
Keyword(s):  
Periodontal Disease ◽  
Diagnostic Accuracy ◽  
Nonlinear Models ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Clinical Problem ◽  
Basic Structure ◽  
Low Complexity ◽  
Percentage Error

Background / Objective: The paper addresses a specific clinical problem of diagnosis of periodontal disease with an objective to develop and evaluate the performance of low complexity Adaptive Nonlinear Models (ANM) using nonlinear expansion schemes and describes the basic structure and development of ANMs in detail. Methods: Diagnostic data pertaining to periodontal findings of teeth obtained from patients have been used as inputs to train and validate the proposed models. Results: Results obtained from simulations experiments carried out using various nonlinear expansion schemes have been compared in terms of various performance measures such as Mean Absolute Percentage Error (MAPE), matching efficiency, sensitivity, specificity, false positive rate, false negative rate and diagnostic accuracy. Conclusion: The ANM with seven trigonometric expansion scheme demonstrates the best performance in terms of all measures yielding a diagnostic accuracy of 99.11% compared to 94.64% provided by adaptive linear model.

Diagnostic Accuracy and Clinical Utility of Endoscopic Bile Duct Brushing in the Evaluation of Biliary Strictures

1999 ◽  
Vol 123 (8) ◽  
pp. 712-715 ◽  
Author(s):  
Vincent Trent ◽  
Kamal K. Khurana ◽  
Latha R. Pisharodi
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
False Positive ◽  
Clinical Utility ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Atypical Hyperplasia ◽  
Biliary Strictures

Abstract Pathologic evidence of malignancy in biliary strictures is useful in the preoperative setting because it helps define therapeutic planning and prognosis. The purpose of this study was to assess the diagnostic accuracy and clinical utility of endoscopic bile duct brushings in the evaluation of bile duct strictures. We retrospectively evaluated 34 endoscopic biliary brushings derived from 31 patients with bile duct strictures. Relevant clinical and follow-up data were collected. Histologic specimens were reviewed in patients undergoing subsequent biopsies. Patients included 18 men and 13 women with an age range of 25 to 79 years (mean, 52 years). All patients had histologic and/or clinical follow-up. Cytologic diagnosis included cholangiocarcinoma (14.7%), suspicious for cholangiocarcinoma (5.9%), atypical hyperplasia (17.6%), and negative for malignancy (61.7%). All positive diagnoses were confirmed by histologic testing (false-positive rate, 0%). The cases that were suspicious for cholangiocarcinoma and the 5 atypical hyperplasia cases were also subsequently diagnosed as cholangiocarcinoma by biopsy. One atypical case was diagnosed as pancreatic carcinoma. All 21 negative cases were confirmed by biopsies (15) and clinical follow-up (6) (false-negative rate, 20%). Endoscopic bile duct brushing is diagnostically accurate and hence clinically useful in the management of patients with bile duct strictures. Atypical hyperplasias may contribute to diagnostic pitfalls leading to false-positive and false-negative diagnoses.

scholarly journals The Diagnostic Accuracy of Dehydroepiandrosterone Sulfate in Diagnosing Adrenal Insufficiency

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A97-A98
Author(s):  
Malavika Suresh ◽  
Lucinda Gruber ◽  
Irina Bancos
Keyword(s):  
Diagnostic Accuracy ◽  
Adrenal Insufficiency ◽  
False Positive ◽  
Dynamic Testing ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Dehydroepiandrosterone Sulfate ◽  
Negative Rate ◽  
Positive Rate

Abstract Background: Evaluation for adrenal insufficiency (AI) includes dynamic testing that is cumbersome, expensive, and may not always be accessible. Our objective was to evaluate the diagnostic accuracy of dehydroepiandrosterone sulfate (DHEAS) in diagnosing AI. Methods: This is a single-center retrospective study of patients evaluated for AI between July 10th, 2012 to January 7th, 2020 who underwent Cosyntropin stimulation testing (CST) or Insulin tolerance test (ITT), and had baseline measurement of DHEAS. Diagnosis of adrenal insufficiency was based on peak cortisol of &lt;18 ug/dL during either CST or ITT. Results: We identified 491 patients (379 [77.2%] women, median age 42 years [range 18–84]) who met inclusion criteria. Primary adrenal insufficiency (PAI) was diagnosed in 16 (3%) patients, secondary adrenal insufficiency (SAI) was diagnosed in 211 (43%) patients, and AI was excluded in 264 (54%) patients. CST was performed in 478 (97%) patients, ITT was done in 45 (9%) patients, with 32 patients having both CST and ITT performed. Using a peak cortisol of &lt;18 mcg/dl during CST to diagnose AI, ROC analysis of DHEAS demonstrated an area under the curve of 0.79, p&lt;0.0001. A DHEAS cutoff of 100 mcg/dL excluded AI with a sensitivity of 93%, specificity of 41%, and a false negative rate of 3%. A DHEAS cut-off of 25 mcg/dl diagnosed AI with a false positive rate of 9% (Sensitivity 57% and specificity 85%). Notably, of 32 patients who had both CST and ITT performed, the diagnosis of AI was concordant in only 5 patients, while additional 27 patients had discordant results (26 were diagnosed with SAI based on ITT, but with a normal CST, and 1 patient was diagnosed with AI on CST but not on ITT). When excluding the 27 patients with discordant results, the overall performance of DHEAS in diagnosis of AI based on CST has not changed. Conclusion: DHEAS is a valuable baseline diagnostic test for AI. DHEAS &gt;100 mcg/dl predicts a normal response during CST with a false negative rate of 3%, while DHEAS &lt;25 mcg/dl is reflective of underlying adrenal insufficiency and predicts an abnormal CST with a false positive rate of 9%. In these situations, CST can be avoided.

Comparative study of ultrasonographic findings with the operative findings of biliary surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Imaging Modality ◽  
False Positive Rate ◽  
Gallstone Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Biliary Disease ◽  
Biliary Surgery ◽  
Operative Findings

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29

scholarly journals Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 259-260
Author(s):  
Laura Curtis ◽  
Lauren Opsasnick ◽  
Julia Yoshino Benavente ◽  
Cindy Nowinski ◽  
Rachel O’Conor ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Aging ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Self Report ◽  
Card Sorting ◽  
Primary Care Settings

Abstract Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of &lt;7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.

scholarly journals Ultrasound guided needle biopsy of axilla to evaluate nodal metastasis after preoperative systemic therapy in cohort of 106 breast cancers enriched with BRCA1/2 pathogenic variant carriers

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Baiba Līcīte ◽  
Arvīds Irmejs ◽  
Jeļena Maksimenko ◽  
Pēteris Loža ◽  
Genādijs Trofimovičs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Axillary Node ◽  
Pathogenic Variant ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Node Positive

Abstract Background Aim of the study is to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) in the restaging of node positive breast cancer after preoperative systemic therapy (PST). Methods From January 2016 – October 2020 106 node positive stage IIA-IIIC breast cancer cases undergoing PST were included in the study. 18 (17 %) were carriers of pathogenic variant in BRCA1/2. After PST restaging of axilla was performed with ultrasound and FNAC of the marked and/or the most suspicious axillary node. In 72/106 cases axilla conserving surgery and in 34/106 cases axillary lymph node dissection (ALND) was performed. Results False Positive Rate (FPR) of FNAC after PST in whole cohort and BRCA1/2 positive subgroup is 8 and 0 % and False Negative Rate (FNR) – 43 and 18 % respectively. Overall Sensitivity − 55 %, specificity- 93 %, accuracy 70 %. Conclusion FNAC after PST has low FPR and is useful to predict residual axillary disease and to streamline surgical decision making regarding ALND both in BRCA1/2 positive and negative subgroups. FNR is high in overall cohort and FNAC alone are not able to predict ypCR and omission of further axillary surgery. However, FNAC performance in BRCA1/2 positive subgroup is more promising and further research with larger number of cases is necessary to confirm the results.

scholarly journals A Method of Segmenting Apples Based on Gray-Centered RGB Color Space

2021 ◽  
Vol 13 (6) ◽  
pp. 1211
Author(s):  
Pan Fan ◽  
Guodong Lang ◽  
Bin Yan ◽  
Xiaoyan Lei ◽  
Pengju Guo ◽  
...  
Keyword(s):  
Vision System ◽  
False Positive Rate ◽  
Clustering Algorithms ◽  
False Negative ◽  
Color Space ◽  
False Negative Rate ◽  
Feature Selection Method ◽  
Image Features ◽  
Accurate Identification ◽  
Rgb Color Space

In recent years, many agriculture-related problems have been evaluated with the integration of artificial intelligence techniques and remote sensing systems. The rapid and accurate identification of apple targets in an illuminated and unstructured natural orchard is still a key challenge for the picking robot’s vision system. In this paper, by combining local image features and color information, we propose a pixel patch segmentation method based on gray-centered red–green–blue (RGB) color space to address this issue. Different from the existing methods, this method presents a novel color feature selection method that accounts for the influence of illumination and shadow in apple images. By exploring both color features and local variation in apple images, the proposed method could effectively distinguish the apple fruit pixels from other pixels. Compared with the classical segmentation methods and conventional clustering algorithms as well as the popular deep-learning segmentation algorithms, the proposed method can segment apple images more accurately and effectively. The proposed method was tested on 180 apple images. It offered an average accuracy rate of 99.26%, recall rate of 98.69%, false positive rate of 0.06%, and false negative rate of 1.44%. Experimental results demonstrate the outstanding performance of the proposed method.

Diagnostic Accuracy of Magnetic Resonance Imaging and Computed Tomography Scan in Young Athletes With Spondylolysis

2019 ◽  
Vol 58 (6) ◽  
pp. 671-676
Author(s):  
Amy M. West ◽  
Pierre A. d’Hemecourt ◽  
Olivia J. Bono ◽  
Lyle J. Micheli ◽  
Dai Sugimoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
False Negative ◽  
False Negative Rate ◽  
Ct Scans ◽  
Resonance Imaging ◽  
Young Athletes ◽  
Negative Rate

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.

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