Positive predictive values of Breast Imaging Reporting and Data System (BI-RADS®) categories 3, 4 and 5 in breast lesions submitted to percutaneous biopsy

Objective To evaluate the BI-RADS as a predictive factor of suspicion for malignancy in breast lesions by correlating radiological with histological results and calculating the positive predictive value for categories 3, 4 and 5 in a breast cancer reference center in the city of São Paulo. Materials and Methods Retrospective, analytical and cross-sectional study including 725 patients with mammographic and/or sonographic findings classified as BI-RADS categories 3, 4 and 5 who were referred to the authors' institution to undergo percutaneous biopsy. The tests results were reviewed and the positive predictive value was calculated by means of a specific mathematical equation. Results Positive predictive values found for categories 3, 4 and 5 were respectively the following: 0.74%, 33.08% and 92.95%, for cases submitted to ultrasound-guided biopsy, and 0.00%, 14.90% and 100% for cases submitted to stereotactic biopsy. Conclusion The present study demonstrated high suspicion for malignancy in lesions classified as category 5 and low risk for category 3. As regards category 4, the need for systematic biopsies was observed.

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Serum procalcitonin as a biomarker of sepsis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20213704 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1494

Author(s):

Nyamnyei Konyak ◽

Linda Marangmei ◽

Medo M. Kuotsu ◽

Laishram Chittaranjan Singh ◽

L. Shaini Devi ◽

...

Keyword(s):

Early Diagnosis ◽

Positive Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Cross Sectional Study ◽

Sepsis Management ◽

Suspected Sepsis ◽

Cross Sectional ◽

Predictive Values ◽

Procalcitonin Level

Background: The overlap of clinical presentation between sepsis and SIRS has presented diagnostic difficulty in these two close common scenarios. Blood culture remains the gold standard for detection of specific micro-organism, the non-availability of culture report early and difficulty in culture of many organisms is a challenge in differentiation of sepsis from its mimickers. Keeping this background, a simple tool is needed to guide sepsis management while awaiting the culture report. Therefore, the present study is conducted to determine the procalcitonin level in the setting suspicious of sepsis and to differentiate it from SIRS. The objective of the study was to determine Serum procalcitonin level as a biomarker of early diagnosis of sepsis and also to differentiate sepsis from severe inflammatory response syndrome.Methods: Cross sectional study on 79 patients aged above 18 years with suspected sepsis admitted in medicine ward. Serum procalcitonin levels were measured and analysed to look for any association with sepsis.Results: Culture was positive in 41 patients and 38 patients were procalcitonin positive. The sensitivity, specificity, positive predictive value and negative predictive values of serum procalcitonin were found as 96.68%, 94.74%, 95% and 92.30% respectively.Conclusions: There was a significant association between serum procalcitonin and culture positivity. Procalcitonin levels was found to have high sensitivity and high positive predictive value which may aid in the early diagnosis and guide initiation of anti-microbial therapy in sepsis.

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ACCURACY OF THE UPPER LIP BITE TEST;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.01.589 ◽

2012 ◽

Vol 20 (01) ◽

pp. 132-138

Author(s):

MUHAMMAD ATIF ◽

MUHAMMAD ABDULLAH ◽

MUHAMMAD JAVAD YOUSAF ◽

Khalid Buland

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Difficult Intubation ◽

Predictive Value ◽

Elective Surgery ◽

Cross Sectional Study ◽

Military Hospital ◽

Upper Lip ◽

Cross Sectional ◽

Sensitivity Specificity

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.

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Evaluating Specivity, Sensitivity, Positive and Negative Predictive Values of CA125 for Diagnosing Ovarian Cancer

Journal of Arak University of Medical Sciences ◽

10.32598/jams.24.2.6002.1 ◽

2021 ◽

Vol 24 (2) ◽

pp. 196-203

Author(s):

Elahe Fini ◽

◽

Neda Nasirian ◽

Bahram Hosein Beigy ◽

◽

...

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Tumor Marker ◽

Negative Predictive Value ◽

Predictive Value ◽

Screening Test ◽

High Sensitivity ◽

Medical Community ◽

Cross Sectional ◽

Predictive Values

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.

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Diagnostic Value of CK19, HBME-1 and TROP2 Biomarkers in Identification of Different Types of Thyroid Follicular Neoplasms

ACTA MEDICA IRANICA ◽

10.18502/acta.v59i1.5397 ◽

2021 ◽

Author(s):

Shohreh Vojuhi ◽

Masoud Mohebbi ◽

Zohreh Mousavi ◽

Mohammadali Yaghoubi ◽

Reza Ziaolhagh

Keyword(s):

Positive Predictive Value ◽

Papillary Carcinoma ◽

Predictive Value ◽

Thyroid Nodules ◽

Follicular Adenoma ◽

Thyroid Neoplasms ◽

Diagnostic Value ◽

Cross Sectional ◽

Predictive Values ◽

Different Types

Thyroid malignancies are found in 7% to 15% of all thyroid nodules. Immunohistochemical markers, including CK19, HBME-1and TROP2, have shown an effective role in identifying these malignancies. Hence, due to the lack of appropriate diagnostic tests for the identification of thyroid neoplasms, in this study, we aimed to determine the diagnostic value of these biomarkers in the identification of different types of follicular thyroid neoplasms. In this cross-sectional study, paraffin-embedded tissue blocks from the surgical resection of patients with thyroid nodules, referring to Imam Reza and Razavi Hospitals of Mashhad in 2017, were studied. Sensitivity, specificity, and positive and negative predictive values of these biomarkers for the identification of different types of follicular thyroid neoplasms were also studied. 129 patients with a mean age of 44.65±12.59 years participated in this study, of whom 101 (78.29%) were women. The most common type of follicular thyroid neoplasm was papillary carcinoma (60.47%). The highest sensitivity (94.87%) and positive predictive value (68.51%) in the detection of follicular neoplasms was observed by CK19 in papillary carcinoma. The sensitivity and positive predictive value of TROP2 in the detection of papillary neoplasms was 93.58% and 75.25%, respectively. In addition, HBME-1 had the highest specificity (72.54 %) and positive predictive value (81.57%) in identifying this neoplasm. The results of this study showed that CK19, HBME-1, and TROP2 had high diagnostic value in the detection of papillary thyroid neoplasms. Although these biomarkers had low diagnostic value in identifying follicular adenoma and carcinoma, given the high negative predictive value, they can be considered as powerful markers in identifying negative cases.

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Comparison between qualitative and quantitative measurement of strength deficit in shoulder flexors of young females: a cross- sectional study

Journal of the Pakistan Medical Association ◽

10.47391/jpma.011431 ◽

2021 ◽

Vol 71 (11) ◽

pp. 2559-2562

Author(s):

Saadia Perwaiz ◽

Muhammad Waqar Afzal ◽

Ghulam Fatima

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Sampling Technique ◽

Cross Sectional Study ◽

Manual Muscle Testing ◽

Primary Analysis ◽

Cross Sectional ◽

Young Females ◽

Muscle Testing

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females. Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity. Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...

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Sensitivity and Specificity of Maternal Anthropometric Measures Relative to Infant Nutritional Status

Asia Pacific Journal of Public Health ◽

10.1177/101053959700900108 ◽

1997 ◽

Vol 9 (1) ◽

pp. 38-41

Author(s):

Nugroho Abikusno ◽

Rachel Novotny

Keyword(s):

Nutritional Status ◽

Positive Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Cross Sectional Study ◽

Maternal Weight ◽

Anthropometric Measures ◽

Cross Sectional ◽

Poor Nutritional Status ◽

Weight For Age

This cross-sectional study was done in July 1990 at health posts of two subdistricts in Cilandak, South Jakarta, Indonesia. The purpose of this study was to assess the sensitivity and specificity of maternal anthropometric measures against the functional outcome of infant nutritional status (weight-for-age). The study population consisted of 175 mother-infant pairs, who were between 14-45 years old, and their infants, who were 0-6 months old. The indicators that identified women at risk of their infant being poor nutritional status (weight-for-age less than −1 SD) were maternal weight (sensitivity 33%, specificity 89%, and positive predictive value 26%), height (sensitivity 39%, specificity 83% and positive predictive value 21%), and calf circumference (sensitivity 50%, specificity 85% and positive predictive value 28%).

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Prevalence of c-myc expression in breast lesions associated with microcalcifications detected by routine mammography

Sao Paulo Medical Journal ◽

10.1590/s1516-31802009000200003 ◽

2009 ◽

Vol 127 (2) ◽

pp. 66-70 ◽

Cited By ~ 2

Author(s):

Renato Coimbra Mazzini ◽

Simone Elias ◽

Afonso Celso Pinto Nazário ◽

Cláudio Kemp ◽

Ângela Flávia Logullo

Keyword(s):

Breast Imaging ◽

Ductal Carcinoma ◽

Percutaneous Biopsy ◽

Screening Mammography ◽

University Hospital ◽

Premalignant Lesions ◽

Breast Lesions ◽

Benign Lesions ◽

Cross Sectional ◽

Malignant Lesions

CONTEXT AND OBJECTIVE: Genetic abnormalities in cell proliferation-regulating genes have been described in premalignant lesions. The aims here were to evaluate c-myc protein expression in non-palpable breast lesions associated with microcalcifications, detected by screening mammography, and to compare these results with histopathological, clinical and epidemiological variables. DESIGN AND SETTING: Analytical cross-sectional study, with retrospective data collection, in a university hospital in São Paulo. METHODS: Seventy-nine female patients who underwent routine mammography between 1998 and 2004 were studied. Lesions classified by the Breast Imaging Reporting and Data System (BI-RADS) as 4 or 5 underwent percutaneous biopsy using a large-core needle. Ninety-eight lesions were studied anatomopathologically. Paraffin blocks properly representing the lesions were selected for immunohistochemical analyses using the streptavidin-biotin-peroxidase technique with monoclonal mouse c-myc antibodies. RESULTS: Among the 98 lesions, 29 (29.6%) contained malignant neoplasia; 40 (40.8%) had a positive immunohistochemical reaction for c-myc. When the groups were divided between lesions without atypias versus atypical lesions plus malignant lesions, 31.03% of the 58 lesions without atypias were positive for c-myc and 55% of the 40 malignant and atypical lesions (P = 0.018). Comparing the atypical lesions with ductal carcinoma in situ versus the benign lesions without atypias, c-myc was present in 51.61% of the 31 atypical lesions and 31.03% of the benign lesions without atypias (P = 0.057). CONCLUSION: C-myc protein was more frequently expressed in atypical and malignant lesions than in benign lesions without atypias. C-myc expression correlated with the presence of atypias (P = 0.018).

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Administrative Data Fail to Accurately Identify Cases of Healthcare-Associated Infection

Infection Control and Hospital Epidemiology ◽

10.1086/502684 ◽

2006 ◽

Vol 27 (4) ◽

pp. 332-337 ◽

Cited By ~ 77

Author(s):

Eileen R. Sherman ◽

Kateri H. Heydon ◽

Keith H. St. John ◽

Eva Teszner ◽

Susan L. Rettig ◽

...

Keyword(s):

Positive Predictive Value ◽

Administrative Data ◽

Active Surveillance ◽

Predictive Value ◽

Healthcare Associated Infection ◽

Cross Sectional ◽

Policy Makers ◽

Predictive Values ◽

Healthcare Associated ◽

Very High

Objective.Some policy makers have embraced public reporting of healthcare-associated infections (HAIs) as a strategy for improving patient safety and reducing healthcare costs. We compared the accuracy of 2 methods of identifying cases of HAI: review of administrative data and targeted active surveillance.Design, Setting, and Participants.A cross-sectional prospective study was performed during a 9-month period in 2004 at the Children's Hospital of Philadelphia, a 418-bed academic pediatric hospital. “True HAI” cases were defined as those that met the definitions of the National Nosocomial Infections Surveillance System and that were detected by a trained infection control professional on review of the medical record. We examined the sensitivity and the positive and negative predictive values of identifying HAI cases by review of administrative data and by targeted active surveillance.Results.We found similar sensitivities for identification of HAI cases by review of administrative data (61%) and by targeted active surveillance (76%). However, the positive predictive value of identifying HAI cases by review of administrative data was poor (20%), whereas that of targeted active surveillance was 100%.Conclusions.The positive predictive value of identifying HAI cases by targeted active surveillance is very high. Additional investigation is needed to define the optimal detection method for institutions that provide HAI data for comparative analysis.

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Volume of sputum to detect acid-fast bacilli as a measure of quality for the diagnosis of pulmonary tuberculosis at the Dr George Mukhari Hospital, South Africa

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v3i1.240 ◽

2011 ◽

Vol 3 (1) ◽

Author(s):

Iqbal Rashid ◽

Langalibalele H. Mabuza ◽

Indiran Govender ◽

Deidre Pretorius

Keyword(s):

South Africa ◽

Pulmonary Tuberculosis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

P Value ◽

Likelihood Ratios ◽

Cross Sectional ◽

Predictive Values ◽

Acid Fast Bacilli

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.

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Development of a Japanese version of the SARC-F for diabetic patients: an examination of reliability and validity

Aging Clinical and Experimental Research ◽

10.1007/s40520-016-0668-5 ◽

2016 ◽

Vol 29 (5) ◽

pp. 935-942 ◽

Cited By ~ 44

Author(s):

Satoshi Ida ◽

Kazuya Murata ◽

Daiki Nakadachi ◽

Yuki Ishihara ◽

Kanako Imataka ◽

...

Keyword(s):

Predictive Value ◽

Reliability And Validity ◽

Japanese Version ◽

Cross Sectional Study ◽

Kappa Coefficient ◽

Diabetic Patients ◽

Cross Sectional ◽

Predictive Values ◽

Retest Reliability ◽

European Working

Abstract Background SARC-F is a 5-item, self-administered questionnaire developed to screen sarcopenia. To date, no Japanese version of the SARC-F has been developed. Aims To create a Japanese version of the SARC-F (SARC-F-J), a questionnaire for diabetic patients, and to investigate its reliability and validity. Methods This was a cross-sectional study. A Japanese translation of the SARC-F was created and revised, and the authors of the original version of the SARC-F verified the back-translation. The questionnaire was tested in diabetic outpatients aged ≥65 years who had received treatment at our hospital. After 14 weeks, the kappa coefficient was used to evaluate the retest reliability. Using the diagnostic criteria for sarcopenia based on the European Working Group on Sarcopenia in Older People as the reference standard, we calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the SARC-F-J. Results The study comprised 207 patients (men, 60.8%; women, 39.2%). The kappa coefficient was 0.66. For men and women, the sensitivities were 14.6 and 33.3%, specificities were 85.8 and 72.4%, positive predictive values were 33.3 and 17.3%, and negative predictive values were 65.7 and 86.2%, respectively. Discussion The probability of identifying the condition is considered high when patients are diagnosed with sarcopenia using SARC-F-J. Conclusions The retest reliability of SARC-F-J was regarded to be good. When EWGSOP was assumed as a reference, the specificity of SARC-F-J was high. Because the sensitivity was low, patients with sarcopenia could not be screened, and hence, attention is needed.

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