Concordance and consistency in the evaluation of diagnostic images of periapical tissue in endodontics

Duazary ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 350-360
Author(s):  
Claudia García-Guerrero ◽  
Ángela V. Caicedo-Rosero ◽  
Cindy E. Delgado-Rodríguez ◽  
Sara Quijano-Guauque ◽  
Mauricio Rodriguez-Godoy ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Diagnostic Tests ◽  
Statistical Tests ◽  
Kappa Coefficient ◽  
Radiographic Images ◽  
Radiographic Findings ◽  
Observation Times ◽  
Coronal View ◽  
Degree Of Similarity ◽  
Axial View

To estimate the degree of concordance and consistency in the radiographic and tomographic evaluation of the periapical area. A study of diagnostic tests was designed. Three blind evaluators analyzed radiographic images, which were selected at two different points in time. An oral radiologist and an endodontist determined the second observation moment. The degree of similarity and variability, concordance and consistency for each radiograph was set at 95% confidence. A Kappa coefficient (κ), for radiographic findings and a correlation coefficient of Lin (CCC) for tomographic measurements was established. 12 radiographies and 19 tomographs were evaluated. The intraobserver consistency determined a k= 1 (Almost Perfect) and a CCC from 0.42 to 0.95 (Poor to Substantial) for both observation times. For radiographies, the interobserver concordance did not show changes between the first and second observation. Values include a k= 0.56-0.80 (Moderate to Good) and a CCC with greater degree of agreement, after training, as follows: axial view: CCC 0.86, 95% of Confidence Interval (CI) 0.69-0.94, coronal view: CCC 0.90 95%CI 0.75-0.96, and sagittal view: CCC 0.96, 95%CI 0.90-0.98. The statistical tests estimated the consistency and concordance to observe radiographically and tomographically the periapical tissue in endodontics.

scholarly journals Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

2021 ◽  
Vol 9 ◽  
pp. 205031212110202
Author(s):  
Rgda Mohamed Osman ◽  
Mounkaila Noma ◽  
Abdallah Elssir Ahmed ◽  
Hanadi Abdelbagi ◽  
Rihab Ali Omer ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Confidence Interval ◽  
Statistical Tests ◽  
Demographic Data ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Molecular Technique ◽  
Interleukin 17A ◽  
Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

scholarly journals Confidence interval approach for evaluating bias in laboratory methods

1988 ◽  
Vol 10 (3) ◽  
pp. 144-146 ◽  
Author(s):  
K. F. Yee
Keyword(s):  
Confidence Interval ◽  
Statistical Tests ◽  
Laboratory Methods ◽  
Mean Values ◽  
Practical Concern ◽  
Alternative Approach ◽  
Interval Approach ◽  
Significant Difference ◽  
The Mean

A statistically significant difference in mean values between two laboratory quantitation methods is interpreted as a bias. Sometimes such a difference is so minute that it does not constitute any practical concern. An alternative approach is to test statistically whether the two methods are close enough, not for equality. This is to look at the confidence interval of the mean method difference and does not entail any additional statistical tests.

scholarly journals PENGARUH PADAT TEBAR TERHADAP KANDUNGAN ZAT GIZI IKAN LELE YANG DIPELIHARA DENGAN TEKNOLOGI BIOFLOK

2019 ◽  
Vol 20 (2) ◽  
pp. 120-131
Author(s):  
Settings Anang Suhardianto ◽  
Ariyanti Hartari
Keyword(s):  
Fatty Acids ◽  
Confidence Interval ◽  
Water Content ◽  
Unsaturated Fatty Acids ◽  
Statistical Tests ◽  
Stocking Density ◽  
Nutrient Content ◽  
Omega 3 ◽  
Omega 6 ◽  
Total Fat

This study aims to determine the effect of stocking density on the nutrient content of catfish that is maintained with biofloc technology. Nutrients observed: 1) water content, 2) protein, 3) carbohydrates, 4) total fat, 5) saturated fatty acids / SFA, 6) monounsaturated fatty acids/ MUFA, 7) plural unsaturated fatty acids / PUFA , 8) omega-3, 9) omega-6, and 10) omega 9. Statistical tests on the 10 variables showed that stocking density did not have a significant effect on the 10 variables at a 5% confidence interval. Stocking density of treatment is 1000 heads/pond (T1), 2000 heads/pond (T2), 3000 heads/pond (T3), with a pond size of 2.0 m x height 1.0 m. Research results: 1. The average water content is 69.40–71.47% and the highest T3. 2. The protein content is 14.70-15.90%, the highest T2. 3. Carbohydrate content of 5.16-5.50%, the highest T2. 4. The average total fat content of 6.73-7.78%, the highest T1. 5. SFA content is around 43%, PUFA around 23%, and MUFA around 32%. 6. The highest omega-3 content is T3, then T1, and T2. Omega-6 and 9 sequence contents are T1, T2, and T3. It was concluded, the treatment of biofloc catfish stocking densities at a 5% confidence interval did not have a significant effect on the specified nutrient content. Penelitian ini bertujuan untuk menentukan pengaruh padat tebar terhadap kandungan zat gizi ikan lele yang dipelihara dengan teknologi bioflok. Zat gizi yang diamati: 1) kandungan air, 2) protein, 3) karbohidrat, 4) lemak total, 5) asam lemak jenuh/SFA, 6) asam lemak tak jenuh tunggal/MUFA, 7) asam lemak tak jenuh jamak/PUFA, 8) omega-3, 9) omega 6, dan 10) omega 9. Uji statistik terhadap ke-10 variabel menunjukkan padat tebar tidak memberikan pengaruh nyata terhadap ke-10 variabel pada selang kepercayaan 5%.  Padat tebar perlakuan adalah 1000 ekor/kolam (T1),  2000 ekor/kolam (T2), 3000 ekor/kolam (T3), dengan ukuran kolam diameter 2,0 m x tinggi 1,0 m. Hasil penelitian: 1. Rata-rata kandungan air 69,40–71,47% dan T3 tertinggi. 2. Kandungan protein 14,70–15,90%, T2 tertinggi. 3. Kandungan karbohidrat 5,16–5,50%, T2 tertinggi. 4. Rata-rata kandungan lemak total 6,73–7,98%, T1 tertinggi. 5. Kandungan SFA sekitar 43%, PUFA sekitar 23%, dan MUFA sekitar 32%. 6. Kandungan omega-3 tertinggi T3, kemudian T1, dan T2. Omega-6 dan 9 urutan kandungannya T1, T2, dan T3.  Disimpulkan, perlakuan padat tebar lele bioflok pada selang kepercayaan 5% tidak memberikan pengaruh yang nyata terhadap kandungan zat gizi yang ditentukan.

scholarly journals The Association Between Medicare Low-Income Subsidy and Anticancer Treatment Uptake in Advanced Lung Cancer

2019 ◽  
Vol 112 (6) ◽  
pp. 637-646 ◽  
Author(s):  
Yi-Ting Chou ◽  
Joel F Farley ◽  
Thomas E Stinchcombe ◽  
Amber E Proctor ◽  
Jennifer Elston Lafata ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Confidence Interval ◽  
Low Income ◽  
Advanced Nsclc ◽  
Statistical Tests ◽  
Advanced Lung Cancer ◽  
Part D ◽  
Treatment Uptake ◽  
Anticancer Treatment ◽  
Out Of Pocket Costs

Abstract Background High out-of-pocket costs may impact anticancer treatment uptake. The Low-Income Subsidy (LIS) program can reduce patient out-of-pocket cost for Medicare Part D–covered treatments. We examined whether the LIS increased uptake and reduced time to initiate orally administered anticancer drugs in patients with advanced non–small cell lung cancer (NSCLC). Methods Using Surveillance, Epidemiology and End Results (SEER)-Medicare data, we identified older adults (aged 65 years and older) diagnosed with advanced NSCLC from 2007 through 2013 and categorized them as full LIS, partial LIS, or non-LIS. We used propensity-score weighted (IPTW) Cox proportional hazards regression to assess the likelihood of and time to initiate Part D treatments. Part B medication uptake was our negative control because supplemental insurance reduces out-of-pocket costs for those drugs. All statistical tests were two-sided. Results Among 19 746 advanced NSCLC patients, approximately 10% initiated Part D treatments. Patients with partial or no LIS were less likely to initiate Part D treatments than were those with full subsidies (partial LIS vs full LIS HRIPTW = 0.77, 95% confidence interval = 0.62 to 0.97; non-LIS vs full LIS HRIPTW = 0.87, 95% confidence interval  = 0.79 to 0.95). Time to initiate Part D treatments was also slightly shorter among full-LIS patients (full LIS mean [SD] = 10.8 [0.04] months; partial LIS mean [SD] = 11.3 [0.08] months; and non-LIS mean [SD] = 11.1 [0.03] months, P &lt; .001). Conversely, patients with partial or no LIS had shorter time to initiation of Part B drugs. Conclusions Patients receiving the full LIS had higher orally administered anticancer treatment uptake than patients without LIS. Notably, patients with partial LIS had the lowest treatment uptake, likely because of their low incomes combined with high expected out-of-pocket spending. High out-of-pocket costs for Part D medications may be a barrier to treatment use for patients without full LIS.

Precision of sensitivity estimations in diagnostic test evaluations. Power functions for comparisons of sensitivities of two tests.

1985 ◽  
Vol 31 (4) ◽  
pp. 574-580 ◽  
Author(s):  
K Linnet
Keyword(s):  
Confidence Interval ◽  
Sample Size ◽  
Diagnostic Test ◽  
Diagnostic Tests ◽  
Sample Sizes ◽  
Power Functions ◽  
Gaussian Distributions ◽  
Sensitivity Estimate

Abstract The precision of estimates of the sensitivity of diagnostic tests is evaluated. "Sensitivity" is defined as the fraction of diseased subjects with test values exceeding the 0.975-fractile of the distribution of control values. An estimate of the sensitivity is subject to sample variation because of variation of both control observations and patient observations. If gaussian distributions are assumed, the 0.95-confidence interval for a sensitivity estimate is up to +/- 0.15 for a sample of 100 controls and 100 patients. For the same sample size, minimum differences of 0.08 to 0.32 of sensitivities of two tests are established as significant with a power of 0.90. For some published diagnostic test evaluations the median sample sizes for controls and patients were 63 and 33, respectively. I show that, to obtain a reasonable precision of sensitivity estimates and a reasonable power when two tests are being compared, the number of samples should in general be considerably larger.

scholarly journals Interexaminer agreement dental caries epidemiological surveys: the importance of disease prevalence in the sample

2016 ◽  
Vol 19 (2) ◽  
pp. 272-279 ◽  
Author(s):  
Aline Sampieri Tonello ◽  
Renato Pereira da Silva ◽  
Andréa Videira Assaf ◽  
Gláucia Maria Bovi Ambrosano ◽  
Silvia Helena de Carvalho Salles Peres ◽  
...  
Keyword(s):  
Dental Caries ◽  
Confidence Interval ◽  
Epidemiological Studies ◽  
Disease Prevalence ◽  
Kappa Coefficient ◽  
Caries Prevalence ◽  
Virtual Sample ◽  
Epidemiological Surveys ◽  
Virtual Samples ◽  
Small Confidence Interval

Abstract: Objective: To identify desirable characteristics, including different sample sizes and dental caries prevalences, in virtual samples that allow, at the same time, higher values of general agreement percentage (GPA) and Kappa coefficient (κ), under a low confidence interval (CI), in reproducibility studies. Method: A total of 384 statistical simulations of inter-examiner calibration, varying sample size (12, 15, 20, 60, 200 and 500 individuals), caries prevalence (30, 50, 60 and 90%) and percentages of positive (PA) and negative (NA) agreement (30, 50, 60 and 90%) were undertaken. GPA and κ were used to measure reproducibility and define deviation between them. Results: The sample of 60 individuals, under caries prevalence of 50%, PA and NA of 90%, presented a GPA and Kappa values of 90 and 80%, respectively, a relative small confidence interval (95%CI 0.65 - 0.95) and a GPA/Kappa deviation of 10.00. Conclusion: A virtual sample of 60 individuals, under caries prevalence of 50%, seems feasible to produce a satisfactory interexaminer agreement at epidemiological conditions. However, epidemiological studies to corroborate or refute this assertion are necessary.

Charcot's joint following Keller arthroplasty. A case report

1998 ◽  
Vol 88 (3) ◽  
pp. 140-143 ◽  
Author(s):  
MT Darst ◽  
TD Weaver ◽  
B Zangwill
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Peripheral Neuropathy ◽  
Diagnostic Tests ◽  
Foot Surgery ◽  
Radiographic Findings ◽  
Neuropathic Osteoarthropathy

Neuropathic osteoarthropathy, i.e., Charcot's joint, has not previously been reported as a sequela of elective foot surgery. The authors present a challenging case of a patient with long-standing diabetes mellitus and peripheral neuropathy who developed neuropathic osteoarthropathy after a Keller arthroplasty for a recalcitrant hallux ulcer. The radiographic findings, diagnostic tests, and histopathology are discussed. Finally, the authors offer suggestions for surgeons contemplating a Keller arthroplasty for patients with peripheral neuropathy.

Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay

2015 ◽  
Vol 51 (5) ◽  
pp. 306-310 ◽  
Author(s):  
Lauren Cunningham ◽  
Audrey Cook ◽  
Andrew Hanzlicek ◽  
Kenneth Harkin ◽  
Joseph Wheat ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Positive Predictive Value ◽  
Enzyme Immunoassay ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Kappa Coefficient ◽  
Urine Samples ◽  
Specificity And Sensitivity ◽  
Antigen Assay

The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131–1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.

scholarly journals Tuberculosis of the extra-axial skeleton in paediatric patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sravya Vajapey
Keyword(s):  
Diagnostic Tests ◽  
Clinical Presentation ◽  
Compliance Rate ◽  
Diagnostic Testing ◽  
Axial Skeleton ◽  
X Rays ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Cell Counts ◽  
Paediatric Patients

ABSTRACT BACKGROUND: Musculoskeletal tuberculosis (MSK TB) is a disease entity that often mimics other orthopaedic conditions in its radiographic and clinical presentation, which can delay diagnosis and treatment. The purpose of this study is to examine the clinical and radiographic presentation as well as the accuracy of various diagnostic tests, treatment, complications and outcome in paediatric patients diagnosed with MSK TB. We aim to provide insight into typical presenting features in order to expedite diagnosis in this perplexing disease. METHODS: We retrospectively reviewed 77 consecutive patients with extra-axial MSK TB treated at our institution over a ten-year period from 2008 to 2018. We collected data on initial clinical presentation, laboratory values, radiographic findings, diagnostic testing, treatment and outcomes. We performed quantitative and qualitative analysis to look for patterns in presentation that can help with diagnosis and factors affecting the clinical outcomes. RESULTS: The most common clinical presentation was pain of the affected limb. Constitutional symptoms were uncommon. Our patients presented with thrombocytosis and anaemia, but normal white cell counts. Inflammatory markers were mildly elevated. Of diagnostic tests employed, the Mantoux skin test yielded the most positive results (70%) followed by tissue PCR (53%). The hip was most frequently involved, followed by the knee and elbow. Most patients presented with normal appearing X-rays. We had a medical compliance rate of 94% with all patients followed up to completion of treatment having resolution of active disease. Thirty-nine per cent of our patients had residual joint stiffness or deformity following completion of treatment, ranging from ankylosis to mildly decreased joint range. CONCLUSION: Patients with MSK TB usually present with non-specific symptoms and signs, and a high index of suspicion should be maintained in endemic areas. Typical haematological findings are an elevated ESR and CRP accompanied by anaemia and thrombocytosis. Radiographs at presentation are non-specific in more than 50% of patients. A combination of diagnostic modalities should be employed as no single test is 100% sensitive or specific. Compliance with medical treatment reliably leads to resolution of the disease. Residual joint pathology is common and needs to be addressed secondarily. Level of evidence: Level 4 Keywords: musculoskeletal tuberculosis, paediatric tuberculosis, joints, anti-tuberculosis treatment, deformity, GeneXpert

Radiographic Location of the Lateral Intercondylar Ridge

2008 ◽  
Vol 36 (10) ◽  
pp. 2002-2006 ◽  
Author(s):  
Lutul D. Farrow ◽  
Robert J. Gillespie ◽  
Brian N. Victoroff ◽  
Daniel R. Cooperman
Keyword(s):  
Confidence Interval ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Radiographic Images ◽  
Cruciate Ligament Reconstruction ◽  
Blumensaat’S Line ◽  
The Mean ◽  
Anterior Cruciate ◽  
Lateral Intercondylar Ridge ◽  
Anterior Extent

Background The lateral intercondylar ridge (resident's ridge) is considered to be an important landmark during anterior cruciate ligament reconstruction. Presently, no study exists describing the location of this vital landmark on plain radiographic images. Hypothesis Lateral intercondylar ridge location can be estimated on lateral plain film images. Study Design Descriptive laboratory study. Methods Lateral radiographic images were taken of 20 distal femora with metallic markers overlying the lateral intercondylar ridge. The length of Blumensaat's line and the distance from the anterior extent of Blumensaat's line to the point where the lateral intercondylar ridge intersects Blumensaat's line were measured. The ratio of these measurements was then determined (Blumensaat's-ridge ratio). The angle of the lateral intercondylar ridge with respect to Blumensaat's line (Blumensaat's-ridge angle) was also determined. Results The mean length of Blumensaat's line was 32.1 mm (95% confidence interval, 31.0–33.2 mm). The mean distance from the anterior extent of Blumensaat's line to the point where the lateral intercondylar ridge intersects Blumensaat's line was 25.3 mm (95% confidence interval, 24.3–26.3 mm). The mean Blumensaat's-ridge ratio was 0.79 (95% confidence interval, 0.77–0.81). The mean Blumensaat's-ridge angle was 75.5° (95% confidence interval, 72.0°–79.1°). Conclusion The lateral intercondylar ridge intersects Blumensaat's line at a point defined by multiplying the Blumensaat's line length by 0.79. From this point, the ridge runs at a 75.5° angle with respect to Blumensaat's line. Clinical Relevance Awareness of the radiographic location of the lateral intercondylar ridge may help confirm accurate tunnel placement when arthroscopic positioning is in doubt. Furthermore, femoral tunnel position can be quickly and accurately assessed in the outpatient setting in patients with unsatisfactory outcomes after anterior cruciate ligament reconstruction.

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