scholarly journals Does the clinical assessment help in predicting malignancy in thyroid swell

2017 ◽  
Vol 5 (1) ◽  
pp. 12-13
Author(s):  
Ishwor Raj Devkota ◽  
S. Bhandary ◽  
S. Karki
Keyword(s):  
Positive Predictive Value ◽  
Clinical Assessment ◽  
Thyroid Surgery ◽  
Predictive Value ◽  
False Positive ◽  
Thyroid Nodules ◽  
False Negative ◽  
Male Ratio ◽  
The Mean ◽  
One Year

Objectives: To predict malignant nodules in solitary thyroid nodules on clinical assessment.Materials and methods: A total of 48 cases with thyroid nodule were clinically assessed in detail and underwent the standard thyroid surgery at BPKIHS, Dharan during the period of one year (April 2012 to march 2013).Results: The mean age was 41.42 years with female to male ratio of 15:1. Most of the patients were euthyroid (73%). Majority of the thyroid nodules were malignant (85.4%) and only 14.6% were benign on clinical assessment. The sensitivity of clinical evaluation was 84.6%, specificity 13.6%, positive predictive value 53.6%, negative predictive value 42.8%. Percentage of the false negative, false positive and overall accuracy was 57.1%, 46.3% and 52% respectively.Conclusion: Even though the sensitivity is high, clinical assessment has low specificity. So we cannot rely on clinical assessment in predicting malignancy in the thyroid nodules.  

Transcutaneous Bilirubin Measurements in Full-Term Infants

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 464-467 ◽  
Author(s):  
M. Jeffrey Maisels ◽  
Sarah Conrad
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
False Negative ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Term Infants ◽  
Transcutaneous Bilirubin

A total of 292 transcutaneous bilirubin (TcB) measurements were performed in 157 white full-term infants: 157 were obtained from the forehead and 135 from the midsternum. TcB measurements correlated well with serum bilirubin determinations (r = .93, P < .0001). The sensitivity of the test was 100% and the specificity 97%. It was possible to establish guidelines for the TcB measurement which identified all infants whose serum bilirubin concentrations exceeded 12.9 mg/100 ml (221 µmoles/liter) with no false-negative and only five false-positive determinations (3%). The positive predictive value for the TcB measurements was 58%. This implies that, in our population, an infant with a TcB index ≥24 has a 58% chance of having a serum bilirubin concentration >12.9 mg/100 ml. The negative predictive value was 100%. Thus, a negative test will correctly predict the absence of hyperbilirubinemia in all cases. As these measurements were obtained prospectively in a well-baby population with a prevalence of hyperbilirubinemia (>12.9 mg/100 ml) of 4.5%, the positive predictive value should be applicable to other similar populations and will, in fact, increase in populations with a higher prevalence of hyperbilirubinemia. TcB measurements can be recommended for the identification of significant neonatal jaundice in full-term infants. It is important to recognize, however, that because of potential variations in TcB meters as well as serum bilirubin measurements in different laboratories, each institution should establish its own criteria for the use of this instrument.

Prediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain

2019 ◽  
Vol 41 (06) ◽  
pp. 688-694
Author(s):  
Ron Bardin ◽  
Noga Perl ◽  
Reuven Mashiach ◽  
Eitan Ram ◽  
Sharon Orbach-Zinger ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Acute Abdominal Pain ◽  
Cohort Analysis ◽  
False Negative ◽  
True Positive ◽  
Adnexal Torsion ◽  
Positive Group

Abstract Purpose To investigate the accuracy of ultrasound in the diagnosis of adnexal torsion. Materials and Methods Retrospective cohort analysis of 322 women, presenting to a tertiary medical center with acute abdominal pain, who underwent gynecological examination, sonographic evaluation and laparoscopic surgery, between 2010 and 2016. Findings for adnexal torsion were compared among three groups: positive sonographic findings consistent with surgically confirmed adnexal torsion (true positive, n = 228); negative sonographic findings inconsistent with surgically confirmed adnexal torsion (false negative, n = 42); and positive sonographic findings inconsistent with a surgical diagnosis other than adnexal torsion (false positive, n = 52). Outcome measures were sensitivity and positive predictive value of ultrasound, and its specific features, for the diagnosis of adnexal torsion. Results The sensitivity of ultrasound for adnexal torsion diagnosis was 84.4 %, and the positive predictive value was 81.4 %. Edematous ovary and/or tube, as well as positive whirlpool sign had the highest sensitivity and positive predictive value. The false-negative group had the highest frequency of ovarian cysts (p = 0.0086) and the lowest frequency of ovarian edema (p < 0.0001). The false-positive group had the lowest proportion of pregnant women (p = 0.0022). Significantly more women in the true-positive group had a prior event of adnexal torsion (p = 0.026). Conclusion Ultrasound examination is highly accurate in the diagnosis of adnexal torsion. Clinicians should be aware of the presence of demographic and clinical characteristics that may positively or negatively affect sonographic diagnostic accuracy.

Multislice computed tomography angiography screening for new aneurysms in patients with previously clip-treated intracranial aneurysms: feasibility, positive predictive value, and interobserver agreement

2006 ◽  
Vol 105 (5) ◽  
pp. 682-688 ◽  
Author(s):  
Irene C. van der Schaaf ◽  
Birgitta K. Velthuis ◽  
Marieke J. H. Wermer ◽  
Nanne J. Frenkel ◽  
Charles B. L. M. Majoie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Ct Angiography ◽  
Predictive Value ◽  
False Positive ◽  
Intracranial Aneurysms ◽  
Multislice Computed Tomography ◽  
Interobserver Agreement ◽  
False Negative ◽  
Titanium Clips

Object Multislice computed tomography (CT) angiography may be useful for screening patients with intracranial aneurysms that are treated with clip occlusion. However, cobalt clips produce much more artifact on CT scans than titanium clips, which may hamper the evaluation of the image obtained at the clip site. Methods The authors screened 415 patients with previously ruptured aneurysms that had been treated using cobalt clips. Screening was performed using multislice CT angiography. The feasibility of this modality for screening these patients (based on the complication risk, CT angiography quality, and artifact avoidance) and interobserver agreement were evaluated. Patients in whom the presence of an aneurysm was suspected based on results of CT angiography studies underwent digital subtraction (DS) angiography. False-negative and false-positive findings were recorded, and the positive predictive value (PPV) was calculated. Eight patients (1.9%) had allergies to the contrast material. The quality of the CT angiography image was suboptimal in 14%. In 52%, clip artifacts hampered evaluation of the clip site. In 65 patients who underwent DS angiography, there were nine false-positive and eight false-negative reports related to aneurysms that were either small, located at the clip site, or were infundibula. The PPV on a per-patient basis was 86% (95% confidence interval [CI] 75–94%); for aneurysms at the clip site it was 83% (95% CI 61–95%); and for aneurysms at different locations it was 91% (95% CI 81–97%). The interobserver agreement was good (κ = 0.69; 95% CI 0.60–0.78). Conclusions Except for the evaluation of images from the clip site, CT angiography has good feasibility with good PPV and interobserver agreement. Drawbacks are that very small aneurysms can be missed and that visualization is poor at the clip site in patients in whom cobalt clips have been placed for occlusion. This second problem can be expected to resolve with the increasing use of titanium clips.

scholarly journals Evaluation of the positive predictive value of atypical thyroid cytology cases according to the Bethesda system taking histopathology as gold standard.

2019 ◽  
Vol 26 (11) ◽  
pp. 2015-2020
Author(s):  
Shireen Hamid ◽  
Aman ur Rehman ◽  
Muhammad Kashif Baig ◽  
Uzma Aslam ◽  
Nausheen Heena ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Thyroid Nodules ◽  
False Negative ◽  
Thyroid Function Tests ◽  
Thyroid Cytology ◽  
Bethesda System ◽  
The Bethesda System ◽  
Undetermined Significance

Objectives: For the past 20 years Fine Needle Aspiration Cytology (FNAC) has evolved as the most sensitive diagnostic tool for the initial screening of patients with thyroid nodules. Unfortunately FNAC is complicated by a recognized false negative rate of approximately 5%. The clinicians could face the difficulty in the management of patient when a cytological diagnosis is atypical only. The objective of study is to evaluate the positive predictive value (PPV) of atypical thyroid cytology cases according to the Bethesda system taking histopathology as gold standard. Study Design: Cross sectional study. Setting: Department of Pathology at Shaikh Zayed Hospital, Lahore. Period: Six months i.e. from 25.11.2014 to 25.5.2015. Materials and Methods: Patients presenting with solitary thyroid nodules in the outpatient department and fulfilling the inclusion criteria were included after evaluation by thyroid function tests and thyroid scan, FNAC was performed and reported according to Bethesda system of thyroid reporting. Later on, cases underwent lobectomy, total or hemi-thyroidectomy, the tissue was received in 10% formalin solution in our pathology department and then processed, stained and examined. FNAC results of atypical cases were then compared with the definitive histological diagnosis which were considered the gold standard. The slides were examined and any differences were sought by consensus of two pathologists. Eighty cases were observed with 95% confidence level, 11% margin of error, using non-probability purposive sampling technique for sample collection. Data was analyzed by SPSS version 15 (P value <0.05). Results: The mean age of patients was 38 years with SD ± 2.16. There were 22 (28%) males and 58 (72%) females in our study. In this study, positive predictive value for Atypia of undetermined significance/ Follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm (FN), suspicious for malignancy and positive for malignancy were 33.3%, 25%, 66.6% and 100% respectively. Overall PPV of atypical cytology was 35.71%. Overall accuracy of FNAC was 86.30%, 87.50% sensitivity and 86.15% specificity, PPV value 43.75% and negative predictive value was 98.25%. Conclusion: Results showed that Bethesda system of reporting is helpful for the management of patients who falls in to undetermined categories as it categorically divide atypical cytology cases in to three definite categories  AUS, FN and suspicious for malignancy and these categories have different risks of malignancy. Thus can help to determine a better patient outcome due to proper clinical management of thyroid swellings.

scholarly journals Systematic Sonography Looking for Occult Wounds: accuracy of an abdominal ultrasound adjunct in penetrating trauma

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Sri Devi Jagjit ◽  
Jordan Rupp ◽  
Robinson M. Ferre ◽  
Mary Kate Jordan ◽  
Brian Bales
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
False Positive ◽  
Fluid Collection ◽  
False Negative ◽  
Case Series ◽  
Penetrating Trauma ◽  
Care Surgery

Abstract Background Systematic Sonography Looking for Occult Wounds (SSLOW) in trauma is a novel technique for the evaluation of intra-abdominal wounds in penetrating trauma. No data exist regarding the effectiveness. The objective of this study was to evaluate the accuracy of the SSLOW exam. Methods This is a prospective collected case series conducted over a period of 10 months and took place at the Accident and Emergency Department (A&E) of the Georgetown Public Hospital Corporation (GPHC). The study enrolled patients presenting to the A&E who were 16 years old or greater with penetrating abdominal trauma. All patients with penetrating trauma received an E-FAST examination. If the E-FAST examination was negative, a SSLOW examination was completed. The sonographer evaluated for free fluid collection between the loops of bowel. The results of the SSLOW were compared to usual care (surgery consult, serial abdominal and E-FAST exams, laparotomy, and 7-day follow-up) and then categorized into four groups: true positive, false positive, true negative, and false negative. These results lead to four categorical values. From these results, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated. Results There were 5 (12%) true positives, 1 (2%) false positive, 37 (86%) true negatives, and zero (0%) false negative. The SSLOW was 100% sensitive (95% CI 5–100%) and 97% specificity (95% CI 74–96%). There was an 80% positive predictive value (95% CI 1.0–64% 95% CI) and 100% negative predictive value (95% CI 88–100%). The positive likelihood ratio was 8.4 (95% CI 3.69–19.1) and negative likelihood ratio was 0. Conclusion The SSLOW examination may be a useful tool in the evaluation of penetrating abdominal injuries.

scholarly journals Second-Generation Platelet Concentrates (PRFs): Estimation of Cellular Content

2021 ◽  
Vol 12 (4) ◽  
pp. 4747-4754
Keyword(s):  
Positive Predictive Value ◽  
Statistical Method ◽  
Predictive Value ◽  
False Positive ◽  
Second Generation ◽  
False Negative ◽  
Platelet Concentrates ◽  
Positive Proportion ◽  
Sensitivity Specificity ◽  
Exact Amount

We performed a study to evaluate the amount of Platelets and Leukocytes in a second-generation solid platelet concentrates in terms of Sensitivity, Specificity, Positive Predictive Value (VP+), Negative Predictive Value (VP-), False Negative Proportion, and False Positive Proportion of our Statistical Method. Blood was collected in anticoagulant-free PET tubes with silica for clot production and PRF membranes. The membranes and clots produced were examined. In a previous work, the authors, starting from the results obtained in Kitamura's work, wanted to elaborate a simpler and inexpensive system to calculate the exact amount of platelets and leukocytes contained in PRF, compared to the one present in whole blood, starting from a simple "haemochromocytometric examination". In this study, the authors have evaluated the Sensitivity, Specificity, Positive Predictive Value (VP+), Negative Predictive Value (VP-), False Negative Proportion, and False Positive Proportion of the "Statistical Method". Using the Statistical Method, we have that by reducing by 34.12% (±28.2) the value of leukocytes obtained from the CBC examination. We obtained the value of leukocytes contained in the PRF membrane by t-PA digestion and by reducing by 15.12% (±24.87) the value of platelets obtained by the same method, we obtained the value contained in solid platelet concentrates by t-PA digestion. The method thus proposed demonstrated a Se=0.75; Sp=0.86; VP+=0.75; VP-=0.86 for platelet counts, Se=0.47; Sp=0.66; VP+=0.80; VP-=0.30 for leukocyte counts. Conclusion: Our study sought to standardize the PRF preparation procedure by validating a statistical system to calculate the exact amount of platelets and leukocytes in second-generation solid platelet concentrates, making it easy to evaluate individual PRF arrays on time in the clinical setting. The Statistical method compared to the digestive method with t-PA for leukocyte and platelet counts demonstrated equal validity for platelets, but not so for leukocytes.

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.

scholarly journals Cytological Smear and Cell Block Versus Tissue Biopsies in the Diagnosis of Malignant Tumours in Non-Gynaecologic Specimens

1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Nasar Alwahaibi ◽  
Asmaa Alghallabi ◽  
Shadia Alsinawi ◽  
Najat Aldairi
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Cell Block ◽  
Malignant Tumours ◽  
Cytological Smear ◽  
Scanty Information ◽  
Sensitivity Specificity

BACKGROUND: Cytological smear and cell block (CB) are routinely used to diagnose non gynaecologic specimens. However, there is scanty information in the literature to compare cytological smear and CB with the corresponding tissue biopsies. This study is aimed at evaluating the accuracy of cytological smear and CB in the diagnosis of malignant tumours in non-gynaecologic specimens.MATERIALS AND METHODS: A total of 70 malignant cases were subjected to cytological smear and CB. Corresponding histopathology was also included. The most frequent immunomarkers found between CB and tissue biopsies were also correlated. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive and false negative values were analyzed for each method.RESULTS: The accuracy, sensitivity and positive predictive value for cytological smear were 92.8%, 100.0% and 92.9%, whereas for CB were 91.4%, 98.4% and 92.7%, respectively. In CB method, the accuracy, sensitivity and positive predictive value for CK7 were 88.9%, 91.7% and 95.6%, whereas for CK5/6 were 75%, 100% and 57.1%, respectively.CONCLUSION: Cytological smear and CB are very sensitive and accurate in the detection of malignant tumours in nongynaecologic specimens. Additional corresponding tissue biopsiesshould be re-evaluated. 

scholarly journals A machine learning approach for predicting suicidal thoughts and behaviours among college students

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melissa Macalli ◽  
Marie Navarro ◽  
Massimiliano Orri ◽  
Marie Tournier ◽  
Rodolphe Thiébaut ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Tools ◽  
Receiver Operating Curve ◽  
Depression Symptoms ◽  
Suicidal Thoughts ◽  
One Year

AbstractSuicidal thoughts and behaviours are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviours among college students within one-year of baseline assessment. We used data collected in 2013–2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviours. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviours in a community sample of college students.

scholarly journals Evaluation of the Carba NP Test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

2013 ◽  
Vol 57 (9) ◽  
pp. 4578-4580 ◽  
Author(s):  
Nathalie Tijet ◽  
David Boyd ◽  
Samir N. Patel ◽  
Michael R. Mulvey ◽  
Roberto G. Melano
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Rapid Detection ◽  
False Negative ◽  
Bacterial Extract ◽  
Content Type ◽  
Negative Results ◽  
False Negative Results

ABSTRACTThe Carba NP test was evaluated against a panel of 244 carbapenemase- and non-carbapenemase-producingEnterobacteriaceaeandPseudomonas aeruginosaisolates. We confirmed the 100% specificity and positive predictive value of the test, but the sensitivity and negative predictive value were 72.5% and 69.2%, respectively, and increased to 80% and 77.3%, respectively, using a more concentrated bacterial extract. False-negative results were associated with mucoid strains or linked to enzymes with low carbapenemase activity, particularly OXA-48-like, which has emerged globally in enterobacteria.

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