Diagnostic laboratory test to verify ovulation occurrence with evaluation of accuracy of rectal palpation in buffaloes

Abstract Background: The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. Methods: We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term “sensitivity and specificity” (exploded) with the text words “specificity”, “false negative”, and “accuracy”. We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645–51) of papers published in general medical journals. Three observers evaluated each article independently. Results: Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. Conclusions: The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.

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Polymyalgia rheumatica

Reviews in Clinical Gerontology ◽

10.1017/s0959259803013248 ◽

2003 ◽

Vol 13 (2) ◽

pp. 129-136 ◽

Cited By ~ 1

Author(s):

HA Bird

Keyword(s):

Laboratory Test ◽

Polymyalgia Rheumatica ◽

Temporal Arteritis ◽

The Elderly ◽

Diagnostic Laboratory ◽

Disease Spectrum ◽

Diagnostic Laboratory Test

Polymyalgia rheumatica and temporal arteritis represent opposite poles of a single disease spectrum. In the former, girdle stiffness predominates; in the latter, frank vasculitis is demonstrable. There is no diagnostic laboratory test for polymyalgia rheumatica, and earlier reviews in 1993 and 1998 in this journal both drew attention to the difficulty in diagnosing polymyalgia rheumatica, particularly in the elderly.

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The Utility of the Cl:PO4 Ratio in Patients With Variant Versions of Primary Hyperparathyroidism

Otolaryngology ◽

10.1177/0194599820947009 ◽

2020 ◽

pp. 019459982094700

Author(s):

Courtney Wright ◽

Deanne King ◽

Mariah Small ◽

Celeste Gibson ◽

Reed Gardner ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Tertiary Care ◽

Area Under The Curve ◽

Health Sciences ◽

Sensitive Test ◽

Diagnostic Laboratory ◽

Academic Health ◽

Diagnostic Laboratory Test ◽

Normal Calcium ◽

Retrospective Database

Objective To determine the significance and impact of additional chloride testing as part of a diagnostic laboratory test battery for borderline primary hyperparathyroidism (pHPT). Study Design Retrospective database review of parathyroidectomy patients. Setting A tertiary care, academic health sciences center. Subjects and Methods Patients referred to a head and neck endocrine clinic for evaluation and treatment for pHPT. Results After exclusions, there were a total of 226 patients who underwent parathyroidectomy for primary hyperparathyroidism with the requisite preoperative and postoperative labs. Seventy-seven additional patients who had a thyroid operation for a nonmalignant cause were included as controls. Of the 303 total patients, 166 had normal calcium levels (<10.4 mg/dL), and 54 (32.5%) also exhibited hyperchloremia (>106 mmol/L). Of the 47 patients with normal calcium and parathyroid hormone (PTH) levels (<88 pg/mL), 6 (12.8%) had hyperchloremia, and of the 118 patients with normocalcemic pHPT, 48 (40.7%) were hyperchloremic. The area under the curve for the Cl:PO4 was 0.712. When using a cutoff of 33, the reported sensitivity and specificity of the curve were 58.4% and 28.6%, respectively. Conclusion The Cl:PO4 ratio was a moderately sensitive test for the diagnosis of the borderline variants of primary hyperparathyroidism. The Ca:PO4 ratio was superior to the Cl:PO4 ratio. Our data also showed the superiority of preoperative calcium and ionized calcium over PTH when predicting the presence of pHPT.

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Effects of the new diagnosis-related group-based payment system and the increased incentive policy rates on the utilization rate of diagnostic laboratory test in Korea

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.8.493 ◽

2020 ◽

Vol 63 (8) ◽

pp. 493-503

Author(s):

Hye Ryun Lee ◽

Sollip Kim ◽

Yeo-Min Yun ◽

Jae-Hyeok Heo ◽

Kun Sei Lee ◽

...

Keyword(s):

Laboratory Tests ◽

Utilization Rate ◽

Diagnostic Laboratory ◽

Drg System ◽

Incentive Policy ◽

Related Group ◽

Participant Group ◽

Diagnostic Laboratory Test ◽

New Diagnosis ◽

Diagnostic Laboratory Tests

A new diagnosis-related group (DRG) based payment system has been implemented in most public hospitals in Korea. We investigated the effects of the new DRG system and its incentive policy on the utilization rate of diagnostic laboratory tests. Three groups were categorized; 36 hospitals under the new DRG system (participant group), 72 hospitals (control-1) matching with 36 participants according to the number of beds, and 42 tertiary hospitals (control-2). The patients of acute myocardial infarction, cerebral infarction, type 2 diabetes mellitus, and gonarthrosis receiving total arthroplasty were included. We analyzed the mean length of stay and the number of diagnostic laboratory tests conducted during hospitalization of the three groups according to the new DRG system and the incentive policy rates under the new DRG system. Before participating in the new DRG system, the number of diagnostic laboratory tests in the participant group was less than that in the two control groups for all four diseases. However, although the participant group’s length of stay decreased under the new DRG system, the number of diagnostic laboratory tests increased as the maximum incentive policy rate increased. The increment of the number of diagnostic laboratory tests was prominent in the period of a maximum of 35% incentive policy rates. Finally, the number of diagnostic laboratory tests of the participant group was similar to or exceeded that of the control-2 group. The new DRG system’s incentive policy rates played a driving force on the increased utilization rate of the diagnostic laboratory test. For preparing in advance for the change in incentive policy rates, monitoring and guidelines for the utilization of diagnostic laboratory tests are necessary.

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Effect of a price display intervention on laboratory test ordering behavior of general practitioners

BMC Family Practice ◽

10.1186/s12875-021-01591-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Dennis M. J. Muris ◽

Max Molenaers ◽

Trang Nguyen ◽

Paul W. M. P. Bergmans ◽

Bernadette A. C. van Acker ◽

...

Keyword(s):

Primary Care ◽

The Netherlands ◽

Laboratory Test ◽

General Practitioners ◽

Laboratory Tests ◽

Future Research ◽

Post Intervention ◽

Diagnostic Laboratory ◽

The Mean ◽

Test Ordering

Abstract Background Redundant use of diagnostic tests in primary care has shown to be a contributor to rising Dutch healthcare costs. A price display in the test ordering system of the electronic health records (EHRs) could potentially be a low-cost and easy to implement intervention to a decrease in test ordering rate in the primary care setting by creating more cost-awareness among general practitioners (GPs). The aim of this study was to assess the effect of a price display for diagnostic laboratory tests in the EHR on laboratory test ordering behavior of GPs in the Westelijke Mijnstreek region in the Netherlands. Methods A pre-post intervention study among 154 GPs working in 57 general practices was conducted from September 2019, until March 2020, in the Netherlands. The intervention consisted of displaying the costs of 22 laboratory tests at the time of ordering. The primary outcome was the mean test ordering rate per 1.000 patients per month, per general practice. Results Test ordering rates were on average rising prior to the intervention. The total mean monthly test order volume showed a non-statistically significant interruption in this rising trend after the intervention, with the mean monthly test ordering rate levelling out from 322.4 to 322.2 (P = 0.86). A subgroup analysis for solely individually priced tests showed a statistically significant decrease in mean monthly test ordering rate after implementation of the price display for the sum of all tests from 67.2 to 63.3 (P = 0.01), as well as for some of these tests individually (i.e. thrombocytes, ALAT, TSH, folic acid). Leucocytes, ESR, vitamin B12, anti-CCP and NT-proBNP also showed a decrease, albeit not statistically significant (P > 0.05). Conclusions Our study suggests that a price display intervention is a simple tool that can alter physicians order behavior and constrain the expanding use of laboratory tests. Future research might consider alternative study designs and a longer follow-up period. Furthermore, in future studies, the combination with a multitude of interventions, like educational programs and feedback strategies, should be studied, while potentially adverse events caused by reduced testing should also be taken into consideration.

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Hematological Findings in COVID-19 Patients at Birat Medical College Teaching Hospital

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v9i01.37977 ◽

2021 ◽

Vol 9 (01) ◽

pp. 52-55

Author(s):

Mrinalini Singh ◽

Santosh Upadhyay Kafle ◽

Surya B Parajuli ◽

Neeta Kafle ◽

Amrita Sinha ◽

...

Keyword(s):

Laboratory Test ◽

Complete Blood Count ◽

Hematological Parameters ◽

White Blood Cells ◽

College Teaching ◽

Clinical Information ◽

Rt Pcr ◽

Diagnostic Laboratory ◽

Pathology Laboratory ◽

Differential White Blood Cell

INTRODUCTION The outbreak of 2019 novel corona virus has also affected the Nepalese population. Real Time-Polymerase Chain Reaction (RT-PCR) is the diagnostic laboratory test for confirming the diagnosis. The complete blood count (CBC) is the laboratory test routinely done in patients suffering from any type of infection. This test provides the information to physicians regarding the inflammatory process. The objective of this study was to evaluate and find out whether hematologic parameters are affected in a person suffering from Covid-19 infections. MATERIAL AND METHODS This is a prospective study done from 3rd December 2020 to 3rd February 2021 for a period of two months. All the confirmed patients of corona (COVID-19) with RT-PCR, between days-1 to day-15 of PCR positivity, whose hematological profile was sent to the pathology laboratory department, were studied. The hematologic parameters studied include total white blood cells count (TLC), differential white blood cell count (DLC), hemoglobin and platelet counts. RESULTS Out of one hundred (100) RT-PCR positive patients eighty (80%) were male and twenty (20%) were female. Age group of patients ranged from 27 years to 94 years. Ninety-four (94%) patients reveal leukocytosis and Ninety-six (96%) patients showed increased in differential neutrophil count. Fifty-two (52%) patients reveal anemia and platelets count was normal in seventy-eight (78%) cases. CONCLUSION Covid-19 infection causes changes in the hematological parameters. Study of these parameters provides significant clinical information.

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Ultrastructural Studies of Bovine Respiratory Disease Complex

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100115766 ◽

1975 ◽

Vol 33 ◽

pp. 428-429

Author(s):

James C.S. Kim

Keyword(s):

Michigan State University ◽

State University ◽

Diagnostic Laboratory ◽

Ultrastructural Studies ◽

Bovine Respiratory Diseases ◽

Etiologic Agents ◽

Diagnostic Difficulties ◽

The Subject ◽

Capillary Walls ◽

Alveolar Capillary

Bovine respiratory diseases cause serious economic loses and present diagnostic difficulties due to the variety of etiologic agents, predisposing conditions, parasites, viruses, bacteria and mycoplasma, and may be multiple or complicated. Several agents which have been isolated from the abnormal lungs are still the subject of controversy and uncertainty. These include adenoviruses, rhinoviruses, syncytial viruses, herpesviruses, picornaviruses, mycoplasma, chlamydiae and Haemophilus somnus.Previously, we have studied four typical cases of bovine pneumonia obtained from the Michigan State University Veterinary Diagnostic Laboratory to elucidate this complex syndrome by electron microscopy. More recently, additional cases examined reveal electron opaque immune deposits which were demonstrable on the alveolar capillary walls, laminae of alveolar capillaries, subenthothelium and interstitium in four out of 10 cases. In other tissue collected, unlike other previous studies, bacterial organisms have been found in association with acute suppurative bronchopneumonia.

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