scholarly journals Analysis of the efficacy of liquid-based cytology combined with HPV genotypes in screening cervical lesions in women of different ages

2020 ◽  
Vol 44 (3) ◽  
pp. 151-156
Author(s):  
Jun Jin ◽  
Chao-Yan Yue

Abstract Objectives To evaluate the value of liquid-based cell examination combined with human papillomavirus (HPV) genotypes in the detection of cervical intraepithelial neoplasia. Methods A total of 21,155 patients who had undergone cytology, HPV genotypes and colposcopy-guided biopsy were grouped into three groups. Sensitivity, specificity, positive predictive value, and negative predictive value of the test methods of the three groups were compared. Results In the age group of less than 50 years, the sensitivity of HPV genotype testing was significantly higher than that of liquid-based cytology. The specificity of liquid-based cytology was significantly higher in all age groups than that of HPV genotype testing. The positive predictive value of each test index was higher in the age group less than 30 years, and the negative predictive value was higher in the 30–50-year age groups. In different age groups, liquid-based cytology and HPV genotype combined method can improve the sensitivity of detection and negative predictive values. Conclusions The HPV test has higher sensitivity and negative predictive value, and the cytology method is relatively specific and less sensitive. The combined method has better sensitivity and negative predictive value.

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.


2021 ◽  
Vol 24 (2) ◽  
pp. 196-203
Author(s):  
Elahe Fini ◽  
◽  
Neda Nasirian ◽  
Bahram Hosein Beigy ◽  
◽  
...  

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Konuralp Yakar

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.


Author(s):  
Royyuru Suchitra ◽  
Kaustubh Burde ◽  
Nilima G. ◽  
P. L. S. Sahithi

Background: Ovarian cancer possesses a challenge to screening tests due to its anatomical location, poor natural history, lack of specific lesion, symptoms and signs and low prevalence. Authors shall be considering RMI 2 and RMI 4 (forms of RMI) and comparing them with histopathology report to derive the sensitivity, specificity and other parameters of these tests.Methods: A prospective   study was conducted from September 2016- September 2017 at Mazumdar Shaw Hospital, Narayana Hrudayalaya, Bangalore.73 patients met the inclusion criteria. RMI 2   and RMI4 were calculated for all the patients and these scores were compared to the final histopathology reports.Results: In present study of 73 patients RMI2 showed a sensitivity of 86.6%, specificity of 86.5 %, Positive predictive value of 81.25% and negative predictive value of 90.24 %. Whereas RMI4 showed a sensitivity of 86.6%, specificity of 86.5 %, Positive predictive value of 83.87 and negative predictive value of 90.48 %. These results are comparable to other studies conducted.  The risk of malignancy index 2 and 4 are also almost comparable with each other and so either can be used for determining the risk of malignancy in patients with adnexal masses. These results were derived in an Indian population across all age groups showing that authors can apply this low-cost method even in resource limited settings.Conclusions: Authors found that Risk of malignancy index is a simple and affordable method to determine the likelihood of a patient having adnexal mass to be malignant. This can thus help save the resources and make the services available at grass root level.


Author(s):  
Iqbal Rashid ◽  
Langalibalele H. Mabuza ◽  
Indiran Govender ◽  
Deidre Pretorius

Background: Optimum sputum results for acid-fast bacilli (AFB) microscopy are linked to a sputum quantity of at least 5.0 mL. This study was aimed at establishing the effect of sputum quantity in the pick-up rate of AFB microscopy by comparing sputum samples of 5.0 mL and 2.0 mL.Methods: An analytical cross-sectional study was carried out at the Dr George Mukhari Hospital (DGMH) in Pretoria, South Africa, from 05 January 2007 to 04 January 2008.Two sputum samples, 5.0 mL and 2.0 mL, were collected from each of the 330 adult PTB (pulmonary tuberculosis) suspects. Fluorescence microscopy was used in the sputum analysis. The yield through microscopy of the 2.0 mL specimen versus the 5.0 mL specimen was compared and analysed, using culture results as the gold standard.Results: From a sample of 330 specimens, 77 tested AFB positive on microscopy. In the 5.0 mL samples, the sensitivity was 76.6% (95% CI, 66.0% – 84.7%), specificity 99.6% (95% CI 97.8% – 99.9%), positive predictive value (PV+) 98.3% (95% CI 91.1% – 99.7%), negative predictive value (PV-) 93.3% (95% CI 89.7% – 95.7%), the likelihood ratio (LR) for a positive microscopy 192 and the LR for a negative test was 0.23. In the 2.0 mL specimens, the sensitivity was 75.3% (95% CI 64.6% – 83.6%), specificity 99.2% (95% CI 97.1% – 99.8%), positive predictive value (PV+) 96.7% (95% CI 88.6% – 99.1%), negative predictive value (PV-) 93.0% (95% CI 89.3% – 95.4%), the LR for a positive microscopy was 94 and 0.25 for a negative microscopy. There was a statistically significant association (p-value < 0.001) between the microscopy and culture tests in both the 5.0 mL and the 2.0 mL specimen categories. The strength of association between the microscopy and culture, as indicated by the kappa test was 0.83 and 0.81 in the 5.0 mL and 2.0 mL categories, respectively.Conclusion: Compared to the 2.0 mL specimen category, the yield for AFB microscopy in the 5.0 mL specimen category was consistently superior, as indicated by the higher sensitivity, specificity, predictive values and the likelihood ratios in the 5.0 mL specimen category. It is recommended that sputum specimen collection for AFB microscopy should aim for a minimum volume of 5.0 mL.


2020 ◽  
Vol 15 (04) ◽  
pp. 75-79
Author(s):  
Agnus Mathew ◽  
DM Patel ◽  
KK Hadiya

This study was carried out on 10 infertile barren mares to evaluate the sensitivity, specificity, predictive values and agreement (kappa value) of cytological and microbiological findings of three diagnosing techniques of endometritis, viz., endometrial biopsy (EB), cytobrush (CB) and low volume uterine lavage (LVL) in relation to endometrial histology. When histological examinations from EB were used as “the best standard,” the sensitivity of cytology from EB, CB and LVL technique was 0.33, 0.50 and 0.50; specificity 0.75, 1.00 and 0.75; positive predictive value 0.66, 1.00 and 0.75, and negative predictive value was 0.42, 0.57 and 0.50, respectively. The sensitivity of bacteriology from EB, CB and LVL technique was 0.83, 0.83 and 1.00; the specificity was 0.75, 0.75 and 0.50; positive predictive value 0.83, 0.83 and 0.75, and the negative predictive value was 0.75, 0.75 and 1.00, respectively. In all the cases, the sensitivity of the bacteriology was found to be higher than the sensitivity of cytology. When the results of cytological and bacteriological examinations were combined, no any increase in the sensitivity was found. Bacteriology and cytology from CB showed the highest positive predictive value demonstrating that a positive result is an accurate indication of endometritis. Sensitivity values were always higher if smears were evaluated according to PMNs to epithelial cell ratio, and the highest values were observed in specimens collected from CB and LVL. The evaluation of cytological smears based on counting PMNs in relation to epithelial cells was a better method for diagnosis of endometritis than counting the number of PMNs per high power microscopic field (k value 0.07-0.47 vs. 0.00). The agreement of the diagnosis of endometritis between the three techniques of the collection was from fair to poor and between the different criteria adopted to evaluate smears was always poor. However, the agreement of the diagnosis of endometritis by the microbial culture was moderate between the three techniques of the collection (k value 0.55-0.58).


2017 ◽  
Vol 10 (4) ◽  
pp. 251
Author(s):  
Miliva Mozaffor ◽  
Md. Matiur Rahman ◽  
Mariya Tabassum ◽  
Forhadul Hoque Mollah

<p>The aim of this study was to see the cardiometabolic risk among doctors using waist-to-height ratio index as tool. Cardiometabolic risk is an umbrella term that includes all the risk factors of diabetes and cardiovascular disease. The study was conducted among 195 doctors. According to waist-to-height ratio index 167 (85.6%) doctors had cardiometabolic risk. Waist-to-height ratio index was found good (area under the curve &gt;0.5, sensitivity 88.1%, specificity 23.2%, positive predictive value 53.9%, and negative predictive value 66.7%) for their predictive value of cardiometabolic risk. Age grouping was done and found that no age group was free from cardiometabolic risk.</p>


Author(s):  
Lakshmi Manjeera M. ◽  
Patricia Malini Pereira

Background: Pre-eclampsia is the most common pregnancy complication associated with serious maternal and fetal morbidity. Uterine artery Doppler reflects the impaired trophoblastic invasion of the uterine spiral arteries, which is involved in the aetiology of preeclampsia. Thus, uterine artery Doppler was proposed as a screening test for pre-eclampsia.Methods: A prospective cohort study of 100 singleton pregnancies was conducted in a tertiary centre and the study population were subjected to uterine artery Doppler study at 18-22 weeks gestation. Uterine artery Doppler indices of pulsatility index (PI), resistance index (RI) and persistence of diastolic notch was obtained and the outcome of pre-eclampsia was studied.Results: Out of 100 women, 14 women developed pre-eclampsia in which the resistance index showed a sensitivity of 21.4%, specificity of 91.8%, positive predictive value of 30% and negative predictive value of 87.7% and pulsatility index showed sensitivity of 35.7%, specificity of 90.6%, positive predictive value of 38.4% and negative predictive value of 89.6%. Diastolic notch had a sensitivity of 35.7%, specificity of 98.8%, positive predictive value of 83.3% and a negative predictive value of 90.4%.Conclusions: The high negative predictive values, indicated that women with normal Doppler velocimetry were unlikely to develop preeclampsia. Uterine artery Doppler, being non-invasive can be included during routine sonography to identify patients at risk of developing pre-eclampsia. Early, screening for pre-eclampsia will help in individualized antenatal surveillance and initiation of prophylactic therapy, early to reduce the adverse maternal and foetal complications of preeclampsia.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Juan Casanova-Sandoval ◽  
Diego Fernández-Rodríguez ◽  
Imanol Otaegui ◽  
Teresa Gil Jiménez ◽  
Marcos Rodríguez-Esteban ◽  
...  

Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (R2 = 0.81; P < 0.001 ) between the two techniques, with 79% agreement between RFR ≤ 0.89 and FFR ≤ 0.80 (positive predictive value, 68%, and negative predictive value, 80%). The hybrid RFR-FFR strategy, administering only adenosine in the “grey zone” (RFR: 0.86 to 0.92), exhibited an agreement of over 95% with FFR, with high predictive values (positive predictive value, 91%, and negative predictive value, 92%), reducing the need for vasodilators by 58%. Conclusions. Dichotomous agreement between RFR and FFR with the recommended thresholds is significant but limited. The adoption of a hybrid RFR-FFR strategy affords very high agreement, with minimization of vasodilator use.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1358 ◽  
Author(s):  
Paulina Krawiec ◽  
Elżbieta Pac-Kożuchowska

Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes’ indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.


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