DIAGNOSTIC ACCURACY OF ONE SAMPLE OR TWO SAMPLES QUANTITATIVE FECAL IMMUNOCHEMICAL TESTS FOR INTESTINAL NEOPLASIA DETECTION

2020 ◽  
Vol 57 (3) ◽  
pp. 316-322
Author(s):  
Rejane MATTAR ◽  
Sergio Barbosa MARQUES ◽  
Maurício Kazuyoshi MINATA ◽  
Joyce Matie Kinoshita da SILVA-ETTO ◽  
Paulo SAKAI ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Negative Likelihood Ratio ◽  
Occult Blood ◽  
Test Methods ◽  
Advanced Adenoma ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Intestinal Neoplasia ◽  
Two Samples ◽  
Eiken Chemical

ABSTRACT BACKGROUND: Rectal bleeding is the most important symptom of intestinal neoplasia; thus, tests of occult blood detection in stools are widely used for pre neoplastic lesions and colorectal cancer (CRC) screening. OBJECTIVE: Evaluate the accuracy of OC-Sensor quantitative test (Eiken Chemical, Tokyo, Japan) at cut-off 10 µg Hb/g feces (50 ng/mL) in a cohort of subjects that had to undergo diagnostic colonoscopy, and if more than one sample collected in consecutive days would improve the diagnostic accuracy of the test. METHODS: Patients (mean age 56.3±9.7 years) that underwent colonoscopy prospectively randomly received one (1-sample FIT, FIT 1) or two (2-sample FIT, FIT 2) collection tubes. They collected the stool sample before starting colonoscopy preparation. Samples were analyzed by the OC-Auto Micro 80 (Eiken Chemical, Tokyo, Japan). The performance of FIT 1 and FIT 2 were compared to the colonoscopy findings. RESULTS: Among 289 patients, CRC was diagnosed in 14 (4.8%), advanced adenoma in 37 (12.8%), early adenoma in 71 (24.6%) and no abnormalities in 141 (48.8%). For FIT 1, the sensitivity for CRC was 83.3% (95%CI 36.5-99.1%), for advanced adenoma was 24% (95%CI 10.1-45.5%), with specificity of 86.9% (95%CI 77.3-92.9%). For FIT 2, the sensitivity for CRC was 75% (95%CI 35.6-95.5%), for advanced adenoma was 50% (95%CI 22.3-77.7%), with specificity of 92.9% (95%CI 82.2-97.7%). The positive likelihood ratios were 1.8 (95%CI 0.7-4.4 for FIT 1) and 7.1 (95%CI 2.4-21.4 for FIT 2) for advanced adenoma, and 6.4 (95%CI 3.3-12.3, for FIT 1) and 10.7 (95%CI 3.8-29.8, for FIT 2) for CRC. The negative likelihood ratio were 0.9 (95%CI 0.7-1, for FIT 1) and 0.5 (95%CI 0.3-0.9, for FIT 2) for advanced adenoma, and 0.2 (0.03-1.1, for FIT 1) and 0.3 (0.08-0.9, for FIT 2) for CRC. The differences between FIT 1 and FIT 2 performances were not significant. However, the comparison of the levels of hemoglobin in feces of patients of FIT 1 and FIT 2 showed that the differences between no polyp group and advanced adenoma and CRC were significant. CONCLUSION: The accuracy of OCR Sensor with 10 µg Hb/g feces cut-off was comparable to other reports and two-sample collection improved the detection rate of advanced adenoma, a pre neoplastic condition to prevent CRC incidence.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with fever, runny nose, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test that can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with runny nose, fever, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to children with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with acute catarrh, fever, and inflamed tonsils presenting to a pediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Diagnostic accuracy of the QV-SAT was achieved by estimating the area under the ROC curve (AUC). Furthermore, the positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals A meta-analysis of the diagnostic accuracy of dengue virus-specific IgA antibody-based tests for detection of dengue infection

2015 ◽  
Vol 144 (4) ◽  
pp. 876-886 ◽  
Author(s):  
K. ALAGARASU ◽  
A. M. WALIMBE ◽  
S. M. JADHAV ◽  
A. R. DEOSHATWAR
Keyword(s):  
Diagnostic Accuracy ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Dengue Infection ◽  
Immunoglobulin A ◽  
Diagnostic Odds Ratio ◽  
Small Sample ◽  
Significant Heterogeneity ◽  
Sample Collection ◽  
Likelihood Ratios

SUMMARYImmunoglobulin A (IgA)-based tests have been evaluated in different studies for their utility in diagnosing dengue infections. In most of the studies, the results were inconclusive because of a small sample size. Hence, a meta-analysis involving nine studies with 2096 samples was performed to assess the diagnostic accuracy of IgA-based tests in diagnosing dengue infections. The analysis was conducted using Meta-Disc software. The results revealed that IgA-based tests had an overall sensitivity, specificity, diagnostic odds ratio, and positive and negative likelihood ratios of 73·9%, 95·2%, 66·7, 22·0 and 0·25, respectively. Significant heterogeneity was observed between the studies. The type of test, infection status and day of sample collection influenced the diagnostic accuracy. The IgA-based diagnostic tests showed a greater accuracy when the samples were collected 4 days after onset of symptoms and for secondary infections. The results suggested that IgA-based tests had a moderate level of accuracy and are diagnostic of the disease. However, negative results cannot be used alone for dengue diagnosis. More prospective studies comparing the diagnostic accuracy of combinations of antigen-based tests with either IgA or IgM are needed and might be useful for suggesting the best strategy for dengue diagnosis.

The Diagnostic Accuracy of Cytology for the Diagnosis of Hepatobiliary and Pancreatic Cancers

2018 ◽  
Vol 62 (4) ◽  
pp. 311-316
Author(s):  
Marwan Al-Hajeili ◽  
Maryam Alqassas ◽  
Astabraq Alomran ◽  
Bashaer Batarfi ◽  
Bashaer Basunaid ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Biliary Tree ◽  
Needle Aspiration ◽  
Diagnostic Methods ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Histological Confirmation

Objective: Although cytology testing is considered a valuable method to diagnose tumors that are difficult to access such as hepato-biliary-pancreatic (HBP) malignancies, its diagnostic accuracy remains unclear. We therefore aimed to investigate the diagnostic accuracy of cytology testing for HBP tumors. Study Design: We performed a retrospective study of all cytology samples that were used to confirm radiologically detected HBP tumors between 2002 and 2016. The cytology techniques used in our center included fine needle aspiration (FNA), brush cytology, and aspiration of bile. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated in comparison to histological confirmation. Results: From a total of 133 medical records, we calculated an overall sensitivity of 76%, specificity of 74%, a negative likelihood ratio of 0.30, and a positive likelihood ratio of 2.9. Cytology was more accurate in diagnosing lesions of the liver (sensitivity 79%, specificity 57%) and biliary tree (sensitivity 100%, specificity 50%) compared to pancreatic (sensitivity 60%, specificity 83%) and gallbladder lesions (sensitivity 50%, specificity 85%). Cytology was more accurate in detecting primary cancers (sensitivity 77%, specificity 73%) when compared to metastatic cancers (sensitivity 73%, specificity 100%). FNA was the most frequently used cytological technique to diagnose HBP lesions (sensitivity 78.8%). Conclusion: Cytological testing is efficient in diagnosing HBP cancers, especially for hepatobiliary tumors. Given its relative simplicity, cost-effectiveness, and paucity of alternative diagnostic methods, cytology should still be considered as a first-line tool for diagnosing HBP malignancies.

scholarly journals The Addition of Other Fecal Biomarkers Does Not Improve the Diagnostic Accuracy of Immunochemical Fecal Occult Blood Test Alone in a Colorrectal Cancer Screening Cohort

2021 ◽  
Vol 8 ◽  
Author(s):  
Gonzalo Hijos-Mallada ◽  
Alberto Lué ◽  
Raul Velamazan ◽  
Nuria Saura ◽  
Carlos Abril ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Blood Test ◽  
Screening Program ◽  
Occult Blood ◽  
Advanced Adenoma ◽  
Fecal Occult Blood ◽  
Crc Screening ◽  
Advanced Neoplasia ◽  
Fecal Occult ◽  
Fecal Biomarkers

Background: Screening with fecal occult blood test reduces colorectal cancer (CRC) incidence and mortality, and is currently implemented in most countries. However, around 40% of screening colonoscopies are normal. Thus, strategies to avoid these colonoscopies are highly necessary. Adding other fecal biomarkers, such as fecal calprotectin (FC), lactoferrin, and transferrin may be useful, but evidence is scarce.Aims: To evaluate the diagnostic accuracy of fecal occult blood immunochemical test (FIT), FC, and a one-step combo card test for the simultaneous semi-qualitative detection of human hemoglobin (hHb), transferrin (hTf), calprotectin (hCp) and lactoferrin (hLf) in a CRC screening program population.Methods: Single-center, prospective observational study, enrolling patients included in a CRC screening program, referred for a colonoscopy due to a positive FIT test. Participants collected a stool sample prior to bowel preparation, and FIT, FC and the combo semi-qualitative tests were performed on the sample. Sensitivity, specificity, positive and negative predictive values and area under receiver operator curve (AUC) for diagnosis of advanced neoplasia, advanced adenoma and CRC were estimated for each biomarker and their combinations. The primary endpoint of the study was to assess whether these biomarkers could improve the diagnostic accuracy of FIT alone.Results: 336 consecutive patients (64% males) were recruited. Advanced neoplasia was found in 129/336 (38.4%) patients, and of these, 22/336 (6.5%) were diagnosed of CRC. 153/336 (45.5%) colonoscopies were completely normal. The AUC for the diagnosis of advanced neoplasia were 0.725 (95%CI 0.665–0.784) for FIT, 0.477 (95%CI 0.413–0.541) for FC and 0.732 (95%CI 0.674–0.791) for the combination of both (FIT + FC) quantitative tests. The AUCs for the combo test were 0.70 (95%CI 0.641–0.760) for hHb, 0.625 (95%CI 0.562–0.698) for hTf, 0.532 (95%CI 0.469–0.595) for hCp, 0.531 (95%CI 0.466–0.595 ) for hLf and 0.681 (95%CI 0.620–0.741) for the combination of the four biomarkers.Conclusion: In average-risk population, FIT appears to be the best fecal marker for the diagnosis of CRC and advanced adenoma. None of the other biomarkers explored or their combinations provided a better diagnostic accuracy. Only hTF showed an acceptable diagnostic accuracy. FC and hLF were not useful in this setting.

scholarly journals Comparative Diagnostic Accuracy of Fecal Protein Biomarkers for Colorectal Advanced Neoplasms: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Atefeh Nasir Kansestani ◽  
Mohammad Erfan Zare ◽  
Qingchao Tong ◽  
Jun Zhang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Negative Likelihood Ratio ◽  
Advanced Adenoma ◽  
Enzyme Linked Immunosorbent Assay ◽  
Fecal Occult Blood ◽  
Protein Biomarkers ◽  
Wide Range

Abstract Early diagnosis of colorectal advanced neoplasms (AN), including colorectal cancer (CRC) and advanced adenoma (AA), has positive effect on survival rate. As the first attempt, the aim of this meta-analysis was to compare the diagnostic accuracy of fecal protein biomarkers for detection of colorectal neoplasms with consideration of wide range covariates.Until Jun 10, 2021, a systematic literature search was performed on Web of Sciences, Scopus and PubMed. The diagnostic accuracies were calculated using the bivariate/hierarchical random effect model. Biomarkers were determined clinically applicable (CA) if they had area under the curves> 0.70, positive and negative likelihood ratio >2 and <0.5, respectively. A total of 47059 test results were extracted from 16 Immunochemical fecal occult blood test (iFOBT), 26 Pyruvate Kinase-M2 (PK-M2) and 23 Fecal Calprotectin (FC) studies. Only iFOBT, PK-M2 and FC for CRC plus iFOBT and PK-M2 for AN were CA. iFOBT had significantly superior accuracy (P= 0.02 versus PK-M2 and P< 0.01 versus FC for CRC; P< 0.01 versus PK-M2 for AN). Regarding covariates, lateral flow method of PK-M2 measurement increased its accuracy for CRC detection compared to enzyme-linked immunosorbent assay (P< 0.01). Briefly, iFOBT is the most accurate fecal biomarker for diagnosis of CRC and AN.

scholarly journals AB0537 DIAGNOSTIC ACCURACY OF SYMPTOMS AND SIGNS FOR GIANT CELL ARTERITIS: SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1565.1-1566
Author(s):  
K. Van der Geest ◽  
M. Sandovici ◽  
E. Brouwer ◽  
S. Mackie
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Clinical Diagnosis ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Reference Standard ◽  
Likelihood Ratios ◽  
Symptoms And Signs

Background:Making a correct diagnosis of giant cell arteritis (GCA) is critical given the potential complications of the disease and its therapy. Estimation of the clinical probability of GCA is challenging. Prediction models might be helpful, but have methodological and practical draw backs. One earlier meta-analysis described the diagnostic accuracy of symptoms and signs for a positive temporal artery biopsy [1]. In the latter study, the diagnostic accuracy of symptoms and signs might have been overestimated due to inclusion of case-control studies.Objectives:To evaluate the diagnostic accuracy of symptoms and signs for GCA.Methods:PubMed, EMBASE and the Cochrane Database were searched for relevant studies. Studies were eligible if: all patients were suspected of having GCA; either a temporal artery biopsy (TAB), imaging test, or clinical diagnosis was used as reference standard for GCA; a 2x2 table was available for at least one symptom, physical sign or routine laboratory test (i.e. the index tests). Case reports and case-control studies were excluded. The screening, full text review, quality assessment with QUADAS-2 tool and data extraction were performed by two investigators. Hierarchical logistic regression modelling provided the pooled estimates of likelihood ratios with their 95% confidence intervals. Likelihood ratios <0.5 (i.e. making GCA less likely) or >2.0 (i.e. making GCA more likely) were considered diagnostically relevant.Results:Out of 1359 reports screened, 59 studies were included in the study. These reports contained 13406 patients, including 3940 GCA patients. Most studies were retrospective, performed at tertiary centres and published after the prior meta-analysis [1]. TAB was the reference standard in 36 studies and a clinical diagnosis in 23 studies. Quality assessment revealed substantial risk of selection bias in the majority of studies. Studies using a clinical diagnosis were at risk of bias, as the reference standard might be influenced by the index tests (e.g. symptoms). Jaw claudication, limb claudication, temporal tenderness, temporal artery abnormalities, especially arterial thickening or loss of pulse, and anterior ischemic optic neuropathy provided a positive likelihood ratio >2.0. None of the 19 symptoms and 7 physical signs evaluated, provided a negative likelihood ratio <0.5. An ESR >60mm/hr and platelet count >400*109/L provided a positive likelihood ratio of >2.0. Absence of an elevated CRP level or ESR >60mm/hr yielded a negative likelihood ratio of <0.5. Studies using a clinical diagnosis as reference standard reported higher positive likelihood ratios for jaw claudication, weight loss and PMR when compared to TAB studies. Absence of an elevated CRP provided a lower negative likelihood ratio in studies using the clinical diagnosis.Conclusion:Few clinical findings may help to estimate the clinical probability of GCA. The presence or absence of any particular symptom or sign does not sufficiently rule out or rule in GCA. These findings highlight the need of additional tests (i.e. imaging, biopsy) in patients suspected of having GCA.References:[1]Smetana GW, Shmerling RH. Does this patient have temporal arteritis? Jama 2002 Jan 2;287(1):92-101.Disclosure of Interests:Kornelis van der Geest Speakers bureau: Roche (2019), Maria Sandovici: None declared, Elisabeth Brouwer Consultant of: Roche (consultancy fee 2017 and 2018 paid to the UMCG), Speakers bureau: Roche (2017 and 2018 paid to the UMCG), Sarah Mackie Grant/research support from: Roche (attendance of EULAR 2019; co-applicant on research grant), Consultant of: Sanofi, Roche/Chugai (monies paid to my institution not to me)

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with runny nose, fever, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

Clausal Density Between Ages 4 and 9 Years for the Edmonton Narrative Norms Instrument: Reference Data and Psychometric Properties

2020 ◽  
pp. 1-15
Author(s):  
Ling-Yu Guo ◽  
Phyllis Schneider ◽  
William Harrison
Keyword(s):  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Language Impairment ◽  
Reference Data ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Criterion Validity ◽  
Likelihood Ratios ◽  
Generation Task ◽  
Sensitivity Specificity

Purpose This study provided reference data and examined psychometric properties for clausal density (CD; i.e., number of clauses per utterance) in children between ages 4 and 9 years from the database of the Edmonton Narrative Norms Instrument (ENNI). Method Participants in the ENNI database included 300 children with typical language (TL) and 77 children with language impairment (LI) between the ages of 4;0 (years;months) and 9;11. Narrative samples were collected using a story generation task, in which children were asked to tell stories based on six picture sequences. CD was computed from the narrative samples. The split-half reliability, concurrent criterion validity, and diagnostic accuracy were evaluated for CD by age. Results CD scores increased significantly between ages 4 and 9 years in children with TL and those with LI. Children with TL produced higher CD scores than those with LI at each age level. In addition, the correlation coefficients for the split-half reliability and concurrent criterion validity of CD scores were all significant at each age level, with the magnitude ranging from small to large. The diagnostic accuracy of CD scores, as revealed by sensitivity, specificity, and likelihood ratios, was poor. Conclusions The finding on diagnostic accuracy did not support the use of CD for identifying children with LI between ages 4 and 9 years. However, given the attested reliability and validity for CD, reference data of CD from the ENNI database can be used for evaluating children's difficulties with complex syntax and monitoring their change over time. Supplemental Material https://doi.org/10.23641/asha.13172129

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