scholarly journals Surgeon Performed Ultrasound in Assessing Thyroid Nodule Using American College of Radiology Tirads and Total Malignancy Score (TMS): A Validation Cross Sectional Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Randeep Singh ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Nani Harlina Muhammad Latar
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodule ◽  
Predictive Value ◽  
Scoring System ◽  
Thyroid Nodules ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Sensitivity Specificity

INTRODUCTION: This study aims to evaluate the diagnostic reliability of the American College of Radiology Thyroid Imaging Report and Data System (ACR-TIRADS) and Total Malignancy Score (TMS) scoring system, in differentiating benign and malignant thyroid nodules. MATERIALS AND METHODS: This is a cross-sectional study involving patients with thyroid nodules treated at Hospital Canselor Tuanku Muhriz from October 2017 until October 2019. Ultrasound findings were scored according to the ACR[1]TIRADS and TMS scoring system. They were then correlated with the FNAC or histopathology report. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of both scoring system were calculated for analysis. RESULTS: A total of 150 patients with 223 thyroid nodules were included. 17% or 38 nodules were found to be malignant. The sensitivity, specificity, PPV, NPV and accuracy of ACR-TIRADS and TMS were 97.37% vs. 84.21 % , 52.97% vs. 62.70%, 29.84% vs. 31.68%, 98.99% vs. 95.08% and 61% vs. 66% respectively. According to the ACR-TIRADS, only hypoechoic nodules was a strong predictor of malignancy. Comparatively, in the TMS, strong predictors of malignancy include single nodule, hypoechogenicity, irregular margin, and nodules with peri and intranodular vascularity. CONCLUSION: Both ACR-TIRADS and TMS score had good diagnostic accuracy in predicting malignant thyroid nodule. TMS is comparable and not inferior to ACR[1]TIRADS however, the latter is more practical for use as growth and Doppler characteristic are not included in the assessment.

scholarly journals Reliability of visual assessment of neonatal jaundice among neonates of black descent: a cross-sectional study from Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikunda Dionis ◽  
Omary Chillo ◽  
George M. Bwire ◽  
Calvin Ulomi ◽  
Manase Kilonzi ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Neonatal Jaundice ◽  
Visual Assessment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Independent Variables ◽  
Sensitivity Specificity

Abstract Background Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing neonatal jaundice (NJ) using Kramer’s method (visual assessment) is considered user-friendly in resource-limited areas. However, there are conflicting findings on reliability of the Kramer’s method in the diagnosis of NJ, particularly of black descent. Therefore, study aimed to determine the accuracy of Kramer’s method in comparison to the total serum bilirubin (TSB) test in the diagnosis of NJ among neonates of black descent in Tanzania. Methods A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonate, jaundice was assessed using Kramer’s method and TSB test. NJ A total of 315 neonates were recruited i. A 2 X 2 table was created for the determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/−LR), and diagnostic accuracy (effectiveness) of Kramer’s method. Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using the chi-square test and the p < 0.05 was considered to be statistically significant. Results The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of Kramer’s method were 70.5, 86.1, 89.8, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34, respectively. The diagnostic accuracy of Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ = 0.524, P<0.001). No significant relationship was observed between the independent variables and the presence of NJ. Conclusion Kramer has a good positive predictive value. However, due to low sensitivity and NPV one cannot say that overall predictive ability is good. Also, clinical assessment by Kramer’s method should not be used for screening of NJ. Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.

scholarly journals Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1011
Author(s):  
Sofia Nevander ◽  
Eva Landberg ◽  
Marie Blomberg ◽  
Bertil Ekman ◽  
Caroline Lilliecreutz
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Sectional Study ◽  
Cross Sectional ◽  
Capillary Sampling

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.

scholarly journals ACCURACY OF THE UPPER LIP BITE TEST;

2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Difficult Intubation ◽  
Predictive Value ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Upper Lip ◽  
Cross Sectional ◽  
Sensitivity Specificity

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.

scholarly journals The Prevalence of Single and Multiple Thyroid Nodules and Its Association with Metabolic Diseases in Chinese: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Bing Zou ◽  
Li Sun ◽  
Xin Wang ◽  
Zongtao Chen
Keyword(s):  
Logistic Regression ◽  
Thyroid Nodule ◽  
Thyroid Disease ◽  
Thyroid Nodules ◽  
Metabolic Diseases ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Advanced Age ◽  
Sectional Study ◽  
Cross Sectional

Purpose. The present study aims to investigate the prevalence of single and multiple thyroid nodules and its association with metabolic diseases in subjects who participated in the heath examination in China. Methods. This is a cross-sectional study. The participants who attend the physical examination at the Health Management Center of Southwest Hospital, Army Military Medical University, between January 2014 and December 2018, were included. Thyroid nodules were diagnosed by thyroid ultrasound. Multivariable logistic regression was used to investigate the association between metabolic diseases and nodular thyroid disease. Results. A total of 9,146 subjects were included in this study; of them, 2,961 were diagnosed with thyroid nodules, with a prevalence of 32.4%. The prevalence in women was significantly higher than that in men (45.2% vs 26.0%; χ2 = 339.56, P<0.001), and the prevalence was gradually increased with age (Z = 20.05, P<0.001). Multivariable logistic regression analysis indicated that advanced age, female gender, and diabetes mellitus were positively associated with thyroid nodule in the general population. Additionally, the female gender, advanced age, and high LDL-C concentration were positively associated with high risk of multiple thyroid nodules, compared with patients of single thyroid nodule. Males and females showed heterogeneous associations with single and multiple thyroid nodule risk. Conclusions. The prevalence of thyroid nodules was relatively high. Age, female gender, and diabetes are positively associated with nodular thyroid disease. High LDL cholesterolemia is more likely to be associated with multiple thyroid sarcoidosis.

scholarly journals Pre-operative laparoscopic staging of gastric cancer in patients who are candidates for neo-adjuvant chemotherapy: A Cross Sectional Study

2019 ◽  
Vol 10 (1) ◽  
pp. 68-72
Author(s):  
Kourosh Ghanadi ◽  
Hormoz Mahmoudvand ◽  
Ali Bakhtiari ◽  
Mojtaba Gorji ◽  
Nasroallah Moradi-kor ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Predictive Value ◽  
Cancer Staging ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Operative Laparoscopy ◽  
Cross Sectional ◽  
Neo Adjuvant Chemotherapy ◽  
Sensitivity Specificity

AbstractObjectiveThe aim of this study is to evaluate the laparoscopic method in gastric cancer staging before surgery in patients undergoing Neo-adjuvant chemotherapy.MethodsThis was a cross-sectional study on patients with T3-T4 and node positive non-metastatic gastric adenocarcinoma who was candidates for neo-adjuvant chemotherapy. The patients were excluded from the study when they were not in the condition to continue the study. All eligible patients underwent metastases work up by abdominal, pelvic and chest CT scans and then received neo-adjuvant chemotherapy. Pre-operative laparoscopy was performed before definitive surgery. The collected data was analyzed using SPSS software. The statistical significance, sensitivity, specificity and predictive values were calculated from this data.ResultsIn this study, out of 50 patients, 26 (52%) were male. The mean age of the patients was 62.44 ± 12.136 years. Most tumors were located in one-third distal of stomach (21 patients, 42%). The accuracy of the laparoscopic method, to determine the degree of involvement of the lymph nodes, revealed that the method had a sensitivity of 84%, a specificity of 47.62%, a positive likelihood ratio (PLR) of 1.6, a negative likelihood ratio (NLR) of 0.33%, a positive predictive value of 65.62% and a negative predictive value of 71.43%. The accuracy of the laparoscopic method, regarding determining the presence or absence of metastasis, revealed that the method had a sensitivity, specificity, positive predictive value, and a negative predictive value of 100%.ConclusionBased on the evidence of this study, and other studies in this field, it seems that the use of a step-by-step combination methods in gastric cancer staging would be logical. Alone, no singular method would be sufficient in providing the physician with sufficient information to successfully stage the tumor and thus determine the appropriate treatment. Therefore, the combination of methods should be used which, in view of the economic constraints of health systems, would be recommended for high-risk patients for metastasis (N+/ T3-T4), diagnostic pre-operative laparoscopy.

scholarly journals Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

2020 ◽  
Vol 4 (2) ◽  
pp. 6-13
Author(s):  
Jackson Chipaila ◽  
◽  
Alex Makupe ◽  
Evans Malyangu ◽  
Daniel Maswahu ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Predictive Values ◽  
Tertiary Hospitals ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

scholarly journals Reliability of Visual Assessment for Diagnosis of Neonatal Jaundice Among Neonates of Black Descent: A Cross-Sectional Study From Tanzania.

2021 ◽  
Author(s):  
Ikunda Dionis ◽  
Omary Chillo ◽  
George M Bwire ◽  
Manase Kilonzi ◽  
Calvin Ulomi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Neonatal Jaundice ◽  
Visual Assessment ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Independent Variables ◽  
Sensitivity Specificity

Abstract Background: Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing of jaundice in neonates using Kramer’s method (visual assessment) is considered user friendly in resource limited areas. However, there are conflicting finding on reliability of the Kramer’s method in diagnosis of neonatal jaundice (NJ) particularly of black descent. Therefore, this study aimed to determine diagnostic accuracy of Kramer’s method in comparison with total serum bilirubin (TSB) test in diagnosis of NJ among neonates of black descent in Tanzania. Methods: A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonates’ jaundice was assessed by using Kramer’s method and TSB test. A 2 X 2 table was created for determination of sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/-LR) and diagnostic accuracy (effectiveness). Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using chi-square test and the p ˂ 0.05 was considered to be statistical significance. Results: The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of the Kramer’s method were 70.5%, 86.1%, 88.8%, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34 respectively. The diagnostic accuracy of the Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ= 0.524, P˂0.001). No significance relationship between the independent variables and presence of NJ. Conclusion: Kramer’s method was found to be inefficient in detecting NJ among neonates of black descent. However, it can be used as a predictor of NJ and whenever available invasive techniques should be applied.

scholarly journals Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Hina Hanif ◽  
Sohail Ahmed Khan ◽  
Sobia Muneer ◽  
Syed Omair Adil
Keyword(s):  
Obstructive Jaundice ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Positive Predicted Value ◽  
Sensitivity Specificity

Objective: To evaluate the diagnostic accuracy of ultrasound in obstructive jaundice taking MRCP as gold standard. Methods: This cross-sectional study was conducted at Dow Institute of Radiology (DIR), Dow University of Health Sciences (DUHS), Karachi from 2nd May 2018 till 2nd November 2018. Both male and female patients aged 30 to 80 years with suspected obstructive jaundice were included. Patients already diagnosed with obstructive jaundice were excluded. MRCP and ultrasound were performed in suspected patients. Diagnostic accuracy including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of obstructive jaundice were calculated using contingency tables using MRCP findings as gold standard. Results: Mean age of the patients was 54.73 ± 12.65 years. In causes of obstruction, choledocholothiasis was responsible for 85 (35.1%), stricture 61 (25.2%), carcinoma of head of pancreas 39 (16.1%), periampullary carcinoma 21 (8.7%), cholangiocarcinoma 10 (4.1%) and gallbladder carcinoma 26 (10.7%) of the cases. Diagnostic accuracy of ultrasound in obstructive jaundice taking MRCP findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 84.57%, 79.10%, 91.36%, 66.25% and 83.06%. Conclusion: Ultrasound has a high sensitivity, moderate specificity, and high diagnostic accuracy in diagnosis of obstructive jaundice. doi: https://doi.org/10.12669/pjms.36.4.1665 How to cite this:Hanif H, Khan SA, Muneer S, Adil SO. Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1665 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Self-reported insomnia as a marker for anxiety and depression among migraineurs: a population-based cross-sectional study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kyung Min Kim ◽  
Dong Hyun Lee ◽  
Eun Ju Lee ◽  
Yun Ho Roh ◽  
Won-Joo Kim ◽  
...  
Keyword(s):  
Predictive Value ◽  
Population Based ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sleep Study ◽  
Sensitivity Specificity ◽  
Anxiety Depression ◽  
Population Based Survey

AbstractAnxiety, depression, and insomnia are highly prevalent among migraineurs and are associated with negative health consequences. Anxiety and depression, however, unlike insomnia, are usually underdiagnosed, due to less self-reporting of these two conditions. The aim of the present study was to evaluate the risk of anxiety and depression in migraineurs with self-reported insomnia, using a general population-based sample. We used data from a nationwide population-based survey on headache and sleep, the Korean Headache-Sleep Study. Of all 2,695 participants, 143 (5.3%), 268 (10.0%), 116 (4.3%), and 290 (10.8%) were classified as having migraine, anxiety, depression, and self-reported insomnia, respectively. The risk of anxiety (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 3.0–16.7) and depression (OR = 3.3, 95% CI = 1.3–8.5) was significantly increased in migraineurs with self-reported insomnia. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for anxiety in migraineurs with self-reported insomnia were 46.5%, 89.0%, 64.5%, and 79.5%, respectively. For depression, the sensitivity, specificity, PPV, and NPV were 41.7%, 82.4%, 32.3%, and 87.5%, respectively. Self-reported insomnia is likely to be comorbid with anxiety and depression in migraineurs and could thus be a useful predictor of anxiety and depression in migraine.

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