Improving the Positive Predictive Value of Non-Invasive Prenatal Screening (NIPS)

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

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Determination of urinary d-/l-arabinitol ratios as a biomarker for invasive candidiasis in children with cardiac diseases

Journal of Medical Microbiology ◽

10.1099/jmm.0.018135-0 ◽

2010 ◽

Vol 59 (12) ◽

pp. 1490-1496 ◽

Cited By ~ 3

Author(s):

Teresa J. Stradomska ◽

Dorota Sobielarska ◽

Zbigniew Mielniczuk ◽

Dorota Jagiełłowicz ◽

Małgorzata Syczewska ◽

...

Keyword(s):

Positive Predictive Value ◽

Congenital Heart Defects ◽

Invasive Candidiasis ◽

Predictive Value ◽

Congenital Heart ◽

Heart Defects ◽

Cardiac Diseases ◽

Non Invasive ◽

Antifungal Chemotherapy

A non-invasive, non-culture-based method of determining urinary d-/l-arabinitol (d-/l-ARA) ratios was investigated as a tool for the diagnosis of invasive candidiasis in nosocomial paediatric infection cases. The study encompassed 138 children aged 4 days to 16 years (mean±sd=1.6±4.2 years) with congenital heart defects (91.4 %) or with rhythm disorders or circulatory failure (8.6 %). ARA enantiomers were detected by GC using an electron capture detector. Positive d-/l-ARA ratios were found for 11/11 patients with proven candidiasis and 17/19 patients with clinically suspected invasive candidiasis. Thirty children were undergoing antifungal chemotherapy. d-/l-ARA ratios (mean±sd) were 2.601±0.544 in hospitalized cardiac patients without fungal infection and 5.120±1.253 in those receiving antifungal therapy (P<0.001). The sensitivity of the method was 100 %, the specificity 97.2 %, the positive predictive value was 78.6 % and the negative predictive value was 100 %.

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Clinical Efficiency of Non-invasive Prenatal Screening for Common Trisomies in Low-Risk and Twin Pregnancies

Frontiers in Genetics ◽

10.3389/fgene.2021.661884 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yanfei Xu ◽

Pengzhen Jin ◽

Yu Lei ◽

Yeqing Qian ◽

Yuqing Xu ◽

...

Keyword(s):

High Risk ◽

Predictive Value ◽

Prenatal Screening ◽

Low Risk ◽

Trisomy 13 ◽

Non Invasive ◽

Clinical Efficiency ◽

Sensitivity Specificity ◽

Twin Pregnancies ◽

Singleton Pregnancies

To evaluate the clinical efficiency of non-invasive prenatal screening (NIPS) for fetal aneuploidies in low-risk and twin pregnancies, patients who received NIPS in a tertiary university hospital were enrolled, and their clinical data, NIPS results and pregnancy outcomes were collected. Patients were divided into singleton and twin pregnancies, and then those with singleton pregnancies were divided into low- and high-risk pregnancies. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated. Comparisons were made on the clinical efficiency of NIPS between singleton and twin pregnancies, as well as between low- and high-risk pregnancies. Of 66,172 patients enrolled, 59,962 were eligible for analysis. The sensitivity, specificity and NPV were ≥ 99% in singleton and twin pregnancies. The PPVs were 90.4, 56.6, and 13.0% in singleton pregnancies, while 100, 33.3, and 0% in twin pregnancies for trisomy 21 (T21), trisomy 18 (T18) and trisomy 13 (T13), respectively (P > 0.05 for all). The PPVs were 97.4 and 90.0% in high-risk pregnancies, while 78.6 and 16.7% in low-risk pregnancies for T21 and T18, respectively (P < 0.05 for all). In summary, the performance of NIPS in singleton pregnancies was similar to that in twin pregnancies. NIPS can be recommended for all pregnancies regardless of the risks.

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Non-invasive adrenal imaging in primary aldosteronism. Sensitivity and positive predictive value of radiocholesterol scintigraphy, CT scan and MRI

Nuclear Medicine Communications ◽

10.1097/00006231-200306000-00011 ◽

2003 ◽

Vol 24 (6) ◽

pp. 683-688 ◽

Cited By ~ 25

Author(s):

F LUMACHI ◽

M C MARZOLA ◽

P ZUCCHETTA ◽

A TREGNAGHI ◽

D CECCHIN ◽

...

Keyword(s):

Positive Predictive Value ◽

Ct Scan ◽

Primary Aldosteronism ◽

Predictive Value ◽

Non Invasive ◽

Adrenal Imaging

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Comparison between Invasive & Non-Invasive Diagnostic Evaluation of Tuberculous Peritonitis In Our Prospective

Medicine Today ◽

10.3329/medtoday.v27i2.30039 ◽

2016 ◽

Vol 27 (2) ◽

pp. 20-22

Author(s):

Md Naushad Ali ◽

Rehana Parvin ◽

Md Abul Kalam Azad ◽

AKM Mazharul Islam

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Predictive Value ◽

Diagnostic Evaluation ◽

Ca 125 ◽

Histopathological Diagnosis ◽

Peritoneal Tuberculosis ◽

College Hospital ◽

Non Invasive

This cross sectional study was carried out in the department of gastroenterology, Rangpur Medical College Hospital, Rangpur from January 2014 to July 2014 to compare between Invasive & Non-Invasive Diagnostic Evaluation of Tuberculosis Peritonitis In our prospective in clinically suspected patients. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of peritoneal tuberculosis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with 'histopathological' diagnosis was considered as gold standard against which accuracies non-invasive test of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 is 24 U/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in peritoneal tuberculosis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively whereas CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers were simple, non-invasive, rapid and relatively cheap diagnostic test whereas laparoscopy was an invasive procedure, costly & requires trained staff and not without risk and also not feasible in the entire centre in our country. So ascitic fluid ADA and serum CA-125 was important non-invasive diagnostic test for peritoneal tuberculosis.Medicine Today 2015 Vol.27(2): 20-22

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NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.6352 ◽

2021 ◽

Vol 71 (1) ◽

pp. 12-17

Author(s):

Laima Alam ◽

Farrukh Saeed

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Chronic Hepatitis C ◽

Likelihood Ratio ◽

Predictive Value ◽

Screening Method ◽

Military Hospital ◽

Non Invasive

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (<65%). King’s score exhibited relatively higher positive-predictivevalue (70%) and negative predictive value (51.1%) and the lowest negative-likelihood-ratio (0.6) for predicting varices needing treatment. Taken together, none of the non-invasive biomarkers of fibrosis could predict the presence of varices-needing-treatment with adequate accuracy due to low positive-predictive-value (<85%) andlow negative-predictive-value (<65%). Conclusion: The calculated non-invasive biomarkers of fibrosis and their optimum cutoff values showed modest accuracy for predicting varices and varices-needing-treatment. These indices may be used as first-line screening method for segregation of clinically significant portal hypertension and high risk esophageal varices-needingtreatment but may not be able to replace the gold standards like Fibroscan liver and Hepatic Venous Pressure Gradient measurements.

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Platelet count splenic diameter ratio as predictor for esophageal varices in patients with cirrhosis: a diagnostic evaluation study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195513 ◽

2019 ◽

Vol 7 (12) ◽

pp. 4535

Author(s):

Sunil Mathew ◽

Sachin Chacko ◽

Tomy Philip ◽

R. N. Sharma ◽

Kanniyan Binub

Keyword(s):

Platelet Count ◽

Positive Predictive Value ◽

Esophageal Varices ◽

Predictive Value ◽

Evaluation Study ◽

Diameter Ratio ◽

Diagnostic Evaluation ◽

Esophageal Variceal ◽

Esophageal Variceal Bleeding ◽

Non Invasive

Background: Esophageal variceal bleeding is one among the common complication of cirrhosis which is fatal. Latest studies are focusing more on using non-invasive techniques to classify cirrhotic patients according to their risk of having varices. The platelet count-splenic diameter ratio is considered as one such parameter and is used in predicting esophageal varices in patients with cirrhosis. Objectives of the study was to assess the utility of platelet count-splenic diameter ratio as a useful non- invasive parameter in predicting the presence/ absence /size of esophageal varices in patients with cirrhosis.Methods: Diagnostic evaluation study was done in a tertiary hospital of Kerala state India. 93 adults above the age of 18 yrs with diagnosis of cirrhosis was selected and detailed history, physical, systemic examination and imaging was done. The degree of correlation between platelet count-splenic size ratio and the presence/absence/size of esophageal varices was studied along with its utility as an independent non- invasive marker. Frequency was expressed in percentages.Results: Best cut-off for prediction of esophageal varices Grade 1 was platelet count/spleen diameter ratio of 954, which had Specificity of 85.7% and Positive predictive value of 94.1% Cut-off for prediction of Grade 2 esophageal varices was platelet count/spleen diameter ratio of 916 which had a Sensitivity of 78.9%, Specificity of 88.9%. Whereas cut-off for prediction of Grade 3 esophageal varices was a ratio of 899 which had a high Sensitivity of 88% and Negative predictive value of 93.6 % but Specificity was only 64.7% and Positive predictive value of 47.8% only.Conclusions: The platelet count splenic diameter ratio is accurate to be used as screening tool to predict the presence of Grade 2 Esophageal varices in Patients with Cirrhosis. More studies need to be done around the globe for more evidence.

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Diagnostic Accuracy of Ultrasound in Palpable Breast Lesions

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i3.33697 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1196-1200

Author(s):

Manish Raj Pathak ◽

Mahesh Gautam ◽

Rashmita Bhandari

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Diagnostic Tool ◽

Predictive Value ◽

Breast Lesions ◽

Non Invasive ◽

Malignant Lesions ◽

Palpable Breast ◽

Sensitivity Specificity

Introduction: Breast carcinoma is the second leading cause of cancer related mortality in females around the world. Ultrasound plays a key role in differentiating cystic and solid lesions and is a convenient and non-invasive diagnostic tool to differentiate between benign and malignant lesions. Objectives: The aim of this study is to evaluate the diagnostic accuracy of ultrasound in palpable breast lesions. Methodology: A prospective cross-sectional study was carried out in patients with palpable breast lesions who presented in Department of radio diagnosis and imaging of Nobel Medical collegefor a period of one-year from February 2019- January 2020 using ultrasound. A total of 60 patientswereevaluated in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Out of 60 patients evaluated, ultrasound showed 46 (76.7%) cases to be benign and 14 (23.3%) cases to be malignant. FNAC revealed benign disease in 47 (78.3%) patients and malignant disease in 13 (21.7%) patients. The most common benign lesion was fibroadenoma. We found nearly 91.7% of the malignant lesions had spiculated margins and microcalcification. The sensitivity of ultrasound was 95.74% and specificity 92.3% with diagnostic accuracy 95%. Conclusion: Ultrasound is a convenient and non-invasive diagnostic tool with good sensitivity, specificity, positive predictive value, negative predictive value and accuracy in palpable breast lesions.

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