scholarly journals Evaluation of the risk of malignancy index in preoperative diagnosis of ovarian masses

2018 ◽  
Vol 7 (10) ◽  
pp. 4202
Author(s):  
Royyuru Suchitra ◽  
Kaustubh Burde ◽  
Nilima G. ◽  
P. L. S. Sahithi
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Low Cost ◽  
Age Groups ◽  
Screening Tests ◽  
Anatomical Location ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Grass Root Level

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.

scholarly journals Comparison of efficiency between RMI1 and RMI2 in diagnosing ovarian malignancy

2019 ◽  
Vol 8 (8) ◽  
pp. 2991
Author(s):  
Rashmi R. Shalagar ◽  
Narayan Y. Kabadi
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Medical Condition ◽  
Menopausal Status ◽  
False Negative ◽  
Histopathological Diagnosis ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background: This study was conducted in department of obstetrics and gynaecology, to know the efficiency of risk of malignancy index (RMI) to differentiate a malignant from a benign tumor and to compare the efficiency of risk of malignancy index 1 and 2 (RMI1 and RMI2). The study was conducted from June 2012 to August 2013 in women who got admitted with adnexal tumor.Methods: It was a prospective study. A proforma was designed for each patient which included, name, age, complaints, menopausal status, parity, past and family history and associated medical condition were asked. Indivisual parameters namely ultrasound score, CA125 and menopausal status and risk of malignancy index was calculated and compared with final histopathological diagnosis and sensitivity specificity and positive predictive value was calculated for each.Results: : The sensitivity of RMI1 is 87.95%, specificity is 75%, positive predictive value is 94.8%, negative predictive value is 54.54%, percentage of false negative is 12.04% and percentage of false positive is 25%. The sensitivity of RMI2 is 86.74%, specificity is 81.25%, positive predictive value is 96%, negative predictive value is 54.16%, percentage of false negative is 13.25% and percentage of false positive is 18.75%.Conclusions: The efficiency of RMI was definitely better than indivisual parameters and efficiency of RMI 1 and RMI2 are similar.

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

2021 ◽  
pp. 22-24
Author(s):  
Monica Sarohi ◽  
Kavita Mardi
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Management ◽  
Care Hospital ◽  
Conventional System ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

scholarly journals Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

2020 ◽  
Vol 9 (10) ◽  
pp. 4074
Author(s):  
Shazia Ashraf Khan ◽  
Shaista Rahi ◽  
Nahida Khan
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Tertiary Care ◽  
Age Groups ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Adnexal Masses

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.

Birthweight or Gestational Age Adjusted Second Tier LCMSMS Cut-offs Improve Newborn Screening for CAH in New Zealand

2021 ◽  
Author(s):  
Mark R de Hora ◽  
Natasha L Heather ◽  
Dianne Webster ◽  
Benjamin B Albert ◽  
Paul L Hofman
Keyword(s):  
New Zealand ◽  
Positive Predictive Value ◽  
Newborn Screening ◽  
Gestational Age ◽  
Predictive Value ◽  
False Positive ◽  
Age Groups ◽  
Screening Tests ◽  
Ratio Measurement ◽  
Second Tier

Abstract Context The positive predictive value of newborn screening for CAH in New Zealand is approximately 10%. The use of a second tier liquid chromatography tandem mass spectrometry bloodspot steroid profile test with birthweight or gestational age adjusted screening cut-offs may result in further screening improvements. Methods Three years of newborn screening data with additional second tier steroid metabolites was evaluated (n=167672 births). Data from babies with a negative screening test and confirmed CAH cases were compared. First and second-tier steroid measurements were correlated with both birthweight and with gestational age. Analysis of variance was used to determine birthweight and gestational age groups. Screening cut-offs were determined and applied retrospectively to model screening performance. Results First tier immunoassay data correlated better with gestational age than with birthweight but there was no difference with second tier steroid measurements. Four distinct birthweight and gestational age groups were established for 17-hydroxyprogesterone and a steroid ratio measurement. Application of 97.5 th percentile second tier birthweight or gestational age adjusted cut-offs would result in 10 positive tests over the period of the study with 8 true positive screens and 2 false positive tests. The positive predictive value of screening would be increased from 10.8% to 80%. Conclusions The use of either birthweight or gestational age adjusted cut-offs for second tier screening tests can significantly reduce the false positive rate of newborn screening for congenital adrenal hyperplasia in New Zealand without loss in screening sensitivity.

scholarly journals Role of eosinophil count and neutrophil: lymphocyte count ratio as prognostic markers in patients with sepsis

2017 ◽  
Vol 4 (7) ◽  
pp. 2243
Author(s):  
Prasan Kumar Hota ◽  
B. Gowtham Reddy
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Eosinophil Count ◽  
Lymphocyte Count ◽  
Prognostic Markers ◽  
Low Cost ◽  
Neutrophil Lymphocyte Ratio ◽  
Count Ratio ◽  
Diagnosis And Prognosis

Background: Several biomarkers, such as C-reactive protein (CRP) and Procalcitonin have been used to indicate bacterial infection in sepsis. They have limited sensitivity and specificity with high cost, placing them practically out of reach for poor patients in developing countries like India. Hence the need to evaluate eosinophil count and neutrophil-lymphocyte count ratio (NLCR) as an indicator of sepsis considering their lower cost and easier accessibility. The present study was done to establish that eosinopenia and the neutrophil-lymphocyte count are simple and effective tools as prognostic biomarkers for sepsis.Methods: A prospective observational study consisting of 50 patients with SIRS and sepsis on admission were studied. Neutrophil and lymphocyte count for first 4 consecutive days and then on alternate days up to one week was done. Absolute eosinophil count for first 2 consecutive days and then on alternate days up to one week was done.Results: Eosinopenia was noted to have 79.3% sensitivity, 76.2% specificity, positive predictive value 82.2% and negative predictive value 95.4% in predicting diagnosis and prognosis of sepsis. Neutrophil-lymphocyte ratio was found to have 86.2% sensitivity, 85.7% specificity, positive predictive value of 89.2%, negative predictive value of 81.1% in predicting diagnosis and prognosis of sepsis.Conclusions: Eosinophil count and neutrophil - lymphocyte count ratio are simple and effective prognostic markers of sepsis with low cost.

scholarly journals Assessment of Airway Parameters for Predicting Difficult Laryngoscopy and Intubation in a Tertiary Center in Western Nepal

2020 ◽  
Vol 17 (4) ◽  
pp. 516-520
Author(s):  
Gajal Lakhe ◽  
Hari Poudel ◽  
Krishna Murari Adhikari
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Difficult Intubation ◽  
Predictive Value ◽  
Area Under Curve ◽  
Difficult Laryngoscopy ◽  
Screening Tests ◽  
Upper Lip ◽  
Tertiary Center ◽  
Lehane Grade

Background: The screening tests used for pre-operative evaluation of airway to predict difficult laryngoscopy and intubation have variable diagnostic accuracy. The unanticipated poor laryngeal view is gold standard for defining difficult intubation. We aimed to find out the prevalence of difficult laryngoscopy and intubation, which airway parameter better predicts difficult intubation and whether difficult laryngoscopy is associated with difficult intubation or not.Methods: This analytic cross sectional study was conducted in 665 ASA I/II adult patients, aged 18-65, without obvious airway pathology undergoing elective surgery under general anesthesia. The pre-operative screening tests included mouth opening, modified mallampatti, ratio of height to thyromental distance, sternomentaldistance and upper lip bite test. Cormack-Lehane grade III/ IV was defined as difficult laryngoscopy and potentially difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under curve at 95% confidence interval was calculated for all five screening tests. Results: The prevalence of difficult laryngoscopy and intubation was 6.6% (44 cases). The upper lip bite test because of its highest specificity, positive predictive value, negative predictive value, accuracy and area under curve (99.7%; 93.9%; 99.7%; 95.2%; 85.1% respectively) with moderate level of sensitivity (70.5%) was better predictor of difficult intubation than other tests. The difficult laryngoscopy was associated with difficult intubation (p=0.00).Conclusions: The prevalence of difficult laryngoscopy and intubation was 6.6%.The upper lip bite test was a better predictor of difficult intubation and there was a significant association of difficult laryngoscopy with difficult intubation.Keywords: Difficult laryngoscopy and intubation; screening tests; upper lip bite test.

scholarly journals Comparison of ovarian crescent sign and risk of malignancy index for prediction of ovarian malignancy in adnexal masses

2021 ◽  
Vol 10 (2) ◽  
pp. 541
Author(s):  
Abha Sharma ◽  
Richa Sharma ◽  
Ashita Gulati
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Early Stage ◽  
Menopausal Status ◽  
Ovarian Malignancy ◽  
Adnexal Masses ◽  
Crescent Sign ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Mass Size

Background: Objective of the study was to evaluate ovarian crescent sign (OCS) as a sonographic parameter for prediction of ovarian cancer in adnexal masses suspicious of ovarian malignancy and to compare it with risk of malignancy index (RMI).Methods: Presence of OCS and calculation of RMI was done for 50 cases of adnexal masses scheduled to undergo surgery taking histopathology as gold standard.Results: 18% (9/50) of adnexal masses were malignant. OCS was absent in all malignant lesions, giving a sensitivity and negative predictive value of 100%. OCS was present in 33/41 of benign masses (specificity 80.4%). Relation of OCS to mass size<10 cm and menopausal status was significant (p<0.001). RMI≥200 could not diagnose malignancy in 4/9 cases (sensitivity 55.5%). RMI had specificity and negative predictive value of 95.1% and 90.7% respectively. Combining OCS and RMI had a lower specificity. Sequential application using OCS as first node and RMI as second node failed to diagnose 44.4% (4/9) cases as malignant.Conclusions: OCS is cheaper, easy to perform and appears to be a better test than RMI to differentiate between benign and early-stage malignant ovarian tumors. It can be used for triaging patient for referral.

scholarly journals Evaluation of sensitivity and spesitivity as COVID–19 screening method

2021 ◽  
Vol 10 (4) ◽  
pp. 758
Author(s):  
Atikah Nurhesti ◽  
Solikhah Solikhah ◽  
Siti Nur Djannah
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Close Contact ◽  
Screening Method ◽  
Rapid Test ◽  
Antibody Test ◽  
Screening Tests ◽  
Rapid Antibody

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Antibody rapid test is one of the COVID-19 screening tests that can be used in the community. The accuracy of the rapid antibody methods needs to be appropriately assessed, it is necessary to carry out a diagnostic accuracy study using a pairwise sensitivity and specificity analysis. This research aimed to assess the sensitivity and specificity of COVID-19 rapid tests, also assesses positive predictive value (PPV) and negative predictive value (NPV) of the rapid antibody test as a method of screening for COVID-19 in Sleman Regency, Indonesia. In total, 118 respondents who have contact with COVID-19 patients and have symptoms were enrolled in this study. The study was conducted on 118 patients who had been in contact with confirmed COVID-19 118 patients who met the close contact criteria were conducted a rapid antibody test. 64.41% patients were reactive. Real-time polymerase chain reaction (RT PCR) as a gold standard was also carried out for all patients and 63.56% affirmed positive for COVID-19. The sensitivity value was 97.33%, and the specificity value was 93.02%, while the positive predictive value (NPP) was 96.05%, and the negative predictive value (NPN) was 95.24%. These results meet the minimum recommendations for the screening method.

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
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Age Groups ◽  
Age Group ◽  
Combined Method ◽  
Predictive Values ◽  
Hpv Test ◽  
Hpv Genotypes ◽  
Liquid Based Cytology

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.

Diagnostic Value of Pap Smear and Colposcopy in Non-benign Cervical Lesions

2018 ◽  
Vol 7 (2) ◽  
pp. 211-215
Author(s):  
Manizheh Sayyah-Melli ◽  
Vahideh Rahmani ◽  
Elaheh Ouladsahebmadarek ◽  
Mehri Jafari-Shobeiri ◽  
Parvin Mostafa Gharabaghi ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Pap Smear ◽  
Screening Tests ◽  
Specific Method ◽  
Diagnostic Utility ◽  
Cervical Lesions ◽  
Sensitivity Specificity

Objectives: Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, colposcopy, and cytology in evaluating the non-benign cervical lesions. Materials and Methods: A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. Results: The mean age of patients was 38.49±10.31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, were 90.3%, 90.9%, 51.9%, 98.9%, 90.8%, and 99.2%, respectively. Conclusions: Based on our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.

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