scholarly journals Comparison of International Federation of cervical pathology and colposcopy nomenclature (2011) and Swede score for assessment of cervical lesions

2021 ◽  
Author(s):  
Bindiya Gupta ◽  
Rashmi Shreya ◽  
Shalini Rajaram ◽  
Anshuja Singla ◽  
Sandhya Jain ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
International Federation ◽  
Objective Method ◽  
Cervical Lesions ◽  
Sensitivity Specificity ◽  
Strength Of Association

Abstract Purpose: Standardization of colposcopic evaluation is important as it is observer dependent.The aim of the study was to compare the strength of association of colposcopic findings by International Federation of Colposcopy and Cervical Pathology (IFCPC) nomenclature and Swede score. Methods: In the prospective study, 150 women aged 30 to 60 years with abnormal screening results underwent colposcopy, the findings were evaluated using both IFCPC and Swede score and biopsy was taken from abnormal areas. Performances by both the methods were calculated taking biopsy as gold standard. Results: Nineteen ≥ CIN2 lesions were detected. The sensitivity, specificity, positive predictive value and negative predictive value for detecting ≥ CIN2 lesion by IFCPC scoring was 63.6%, 96.0%, 78.7%, 91.9%. Using Swede score, sensitivity, specificity, positive predictive value and negative predictive value at cut off of 8 were 42.4, 95%, 96.6% and 81.8% while at cut-off of 5, these were 96%, 88.3%,76.7% and 93.6%. The agreement between IFCPC major lesion and Swede score ≥ 8 for ≥ CIN2 was 0.626 (p<0.01). Conclusion: Swede score is an easier and more objective method for colposcopic evaluation and a score >8 can be applied to the screen and treat programme.

scholarly journals Computed tomography versus ureteroscopy in identification of renal tract stone with ureteral stent in situ

2011 ◽  
Vol 93 (8) ◽  
pp. 639-641 ◽  
Author(s):  
VCY Tang ◽  
A Attwell-Heap
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Ureteral Stent ◽  
The Difference ◽  
Contrast Ct ◽  
Sensitivity Specificity

INTRODUCTION The aim of this study was to validate the use of non-contrast computed tomography (CT) with a ureteral stent in situ instead of ureteroscopy for identification of renal tract stones. METHODS All patients who had stents inserted for renal tract stones and underwent non-contrast CT with the stent in situ followed by ureteroscopy between May 2008 and October 2009 at The Canberra Hospital, Australia, were analysed retrospectively. Statistical analysis was performed to compare any differences between CT and ureteroscopy in the identification of stones. RESULTS Overall, 57 patients were included in the study. The difference between CT and ureteroscopy findings was statistically significant. CT identification of stones with a stent in situ had a sensitivity of 86%, a specificity of 46%, a positive predictive value of 63%, a negative predictive value of 76% and an accuracy of 67%. CONCLUSIONS Our study suggests that non-contrast CT is inferior to the ‘gold standard’ of ureteroscopy. It lacks sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Therefore, we cannot recommend using non-contrast CT to replace ureteroscopy.

scholarly journals Relationship between Clinical, MRI, and Arthroscopic Findings: A Guide to Correct Diagnosis of Meniscal Tears

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 164-167
Author(s):  
P. Antinolfi ◽  
R. Cristiani ◽  
F. Manfreda ◽  
S. Bruè ◽  
V. Sarakatsianos ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Clinical Examination ◽  
Predictive Value ◽  
Gold Standard ◽  
Careful Examination ◽  
Meniscal Tears ◽  
Arthroscopic Findings ◽  
Clinical Mri

Purpose The aim of this prospective study was to compare and correlate clinical, MRI, and arthroscopic findings in cases of suspected meniscal tears. Using arthroscopic findings as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of clinical investigation and MRI were evaluated to determine if is possible, after a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases. Methods A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department. All patients had a clinical examination performed by an experienced knee surgeon. These examiners evaluated and recorded the results of three tests: medial and lateral joint line tenderness test, McMurray's test, and Apley's test. The injury was classified as a meniscal tear if there were at least two positive tests. Finally, using the arthroscopic findings as the gold standard, sensibility, specificity, accuracy, positive and negative predictive values of clinical examination, and MRI were evaluated and compared. Results Clinical examination performed by an experienced knee surgeon reported better sensitivity (91 vs. 85%), specificity (87 vs. 75%), accuracy (90 vs. 82%), positive predictive value (94 vs. 88%), and negative predictive value (81 vs. 71%) than MRI for medial meniscal tears. These parameters showed minimal differences for lateral meniscal tears. Conclusion Clinical examination performed by an experienced knee surgeon provided equal or better results to diagnose meniscal injuries in comparison to MRI. MRI is not necessary to confirm these lesions and should not be used as the primary diagnostic tool. Level of Evidence Level II, prospective study.

scholarly journals The Value of Bacterial Culture During Clean Orthopedic Surgery a Prospective Study of 1,036 Patients

2004 ◽  
Vol 25 (6) ◽  
pp. 512-514 ◽  
Author(s):  
Louis Bernard ◽  
Christophe Sadowski ◽  
Daniel Monin ◽  
Richard Stern ◽  
Blaise Wyssa ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Orthopedic Surgery ◽  
Predictive Value ◽  
Postoperative Infection ◽  
Bacterial Culture ◽  
Bacterial Cultures ◽  
Sensitivity Specificity ◽  
A Prospective Study

AbstractObjective:To determine whether bacterial cultures of the wounds of patients undergoing clean orthopedic surgery would help predict infection.Methods:During 1 year, 1,256 cultures were performed for 1,102 patients who underwent clean orthopedic surgery. Results were analyzed to evaluate their ability to predict postoperative infection.Results:The sensitivity, specificity, positive predictive value, and negative predictive value of the cultures were 38%, 92%, 7%, and 99%, respectively.Conclusions:Cultures performed during clean orthopedic surgery were not useful for predicting postoperative infection.

scholarly journals Diagnostic Value of Computerized Dynamic Posturography in the Assessment of Peripheral Vestibular Disorders

2015 ◽  
Vol 30 (1) ◽  
pp. 14-16
Author(s):  
Ronaldo G. Soriano ◽  
Reylan B. David ◽  
Norberto V. Martinez
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Vestibular Dysfunction ◽  
Vestibular Disorders ◽  
Vestibular Disorder ◽  
Dynamic Posturography ◽  
Computerized Dynamic Posturography ◽  
Sensitivity Specificity

Objective: This study aims to determine the sensitivity, specificity, positive predictive value and negative predictive value of Computerized Dynamic Posturography (CDP) in properly labeling patients with peripheral vestibular disorders by Videonystagmography (VNG) as having vestibular dysfunction. Methods: Study Design: Case - Control Study Setting: Tertiary Private Hospital Subjects: Twenty-three (23) patients aged 18 and above, with no history of hypertension or cardiovascular disease and no intake of anti-vertigo medications for at least 48 hours prior to testing, and with complete VNG and CDP results obtained on the same day or at least two days apart were included in the study. Cases were defined as those diagnosed with a peripheral vestibular disorder by VNG while controls were defined as those with normal VNG results. Sensitivity, specificity, positive predictive value and negative predictive value of CDP in labeling those with peripheral vestibular disorders as vestibular were determined using VNG as gold standard. Results: There were 11 cases (4 males, 7 females) and 12 controls (8 males, 4 females). Using VNG as the gold standard for diagnosing peripheral vestibular disorders, CDP had a sensitivity of 45.45% and specificity of 66.67% with Positive Predictive Value(PPV) of 55.56% and Negative Predictive Value(NPV) of 57.14% in assessing peripheral vestibular disorders among the adults tested. Interestingly, 33.33% of patients with normal VNG may actually have had a vestibular dysfunction that could be detected by CDP. Conclusion: Prospective studies with larger sample sizes utilizing VNG and CDP are recommended in order to verify our findings. Keywords: dizziness, posturography, vertigo

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.

scholarly journals Accuracy of ultrasonography for differentiating between simple and complex appendicitis in children

2021 ◽  
Author(s):  
David J. Nijssen ◽  
Paul van Amstel ◽  
Joost van Schuppen ◽  
Laurens D. Eeftinck Schattenkerk ◽  
Ramon R. Gorter ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Laboratory Data ◽  
Clinical Signs ◽  
Simple Test ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Time Of Operation

Abstract Purpose Accurate differentiation between simple and complex appendicitis is important since differences in treatment exist. This study aimed to assess the accuracy of ultrasonography in differentiating between simple and complex appendicitis. Methods Data from children aged < 18 years who underwent appendectomy between the 1st of January 2013 and the 1st of January 2018 were analyzed retrospectively. Ultrasonography reports of eligible children were divided into simple (test negative) and complex appendicitis (test positive) based on predefined criteria and compared to a gold standard (a combination of predefined perioperative and histopathological criteria). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated to measure ultrasonographic accuracy in differentiating between simple and complex appendicitis. Results 176 children were eligible for inclusion. The mean age at the time of operation was 10.1 ± SD 4.6 years. 84 (47.7%) children had simple appendicitis and 92 (52.3%) had complex appendicitis. The use of ultrasonography yielded a sensitivity: 46%, specificity: 90%, PPV: 84%, and NPV: 60%. Conclusion Ultrasonography as standalone modality is not suitable for differentiating between simple and complex appendicitis in children. To improve preoperative differentiation, other variables such as clinical signs and laboratory data are necessary in conjunction with ultrasonography findings.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, 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 ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

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.

Diagnostic accuracy of monofilament test to detect diabetic neuropathy

2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diabetic Peripheral Neuropathy ◽  
Perception Threshold ◽  
Sensitivity Specificity ◽  
Vibration Perception ◽  
Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

scholarly journals Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination

2009 ◽  
Vol 25 (5) ◽  
pp. 1017-1024 ◽  
Author(s):  
Carolina Castro Martins ◽  
Loliza Chalub ◽  
Ynara Bosco Lima-Arsati ◽  
Isabela Almeida Pordeus ◽  
Saul Martins Paiva
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Examination ◽  
Predictive Value ◽  
Gold Standard ◽  
Dental Fluorosis ◽  
Digital Camera ◽  
High Specificity ◽  
Photographic Method ◽  
Pediatric Dentists

The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

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