Erratum. The T2-FLAIR–mismatch sign as an imaging biomarker for IDH and 1p/19q status in diffuse low-grade gliomas: a systematic review with a Bayesian approach to evaluation of diagnostic test performance

Abstract Background Optimum management of low-grade gliomas remains controversial, and widespread practice variation exists. This evidence-based meta-analysis evaluates the association of extent of resection, radiation, and chemotherapy with mortality and progression-free survival at 2, 5, and 10 years in patients with low-grade glioma. Methods A quantitative systematic review was performed. Inclusion criteria included controlled trials of newly diagnosed low-grade (World Health Organization Grades I and II) gliomas in adults. Eligible studies were identified, assigned a level of evidence for every endpoint considered, and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality and of progression at 2, 5, and 10 years was calculated for patients undergoing resection (gross total, subtotal, or biopsy), radiation, or chemotherapy. Results Gross total resection was significantly associated with decreased mortality and likelihood of progression at all time points compared to subtotal resection. Early radiation was not associated with decreased mortality; however, progression-free survival was better at 5 years compared to patients receiving delayed or no radiation. Chemotherapy was associated with decreased mortality at 5 and 10 years in the high-quality literature. Progression-free survival was better at 5 and 10 years compared to patients who did not receive chemotherapy. In patients with isocitrate dehydrogenase 1 gene (IDH1) R132H mutations receiving chemotherapy, progression-free survival was better at 2 and 5 years than in patients with IDH1 wild-type gliomas. Conclusions Results from this review, the first to quantify differences in outcome associated with surgery, radiation, and chemotherapy in patients with low-grade gliomas, can be used to inform evidence-based management and future clinical trials.

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Minnesota Percepto-Diagnostic Test performance in educable mentally retarded children

Psychology in the Schools ◽

10.1002/1520-6807(196604)3:2<176::aid-pits2310030217>3.0.co;2-v ◽

1966 ◽

Vol 3 (2) ◽

pp. 176-180 ◽

Cited By ~ 1

Author(s):

Alastair Burnett ◽

Gerald B. Fuller

Keyword(s):

Diagnostic Test ◽

Test Performance ◽

Mentally Retarded ◽

Diagnostic Test Performance ◽

Mentally Retarded Children ◽

Educable Mentally Retarded

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Mutual Information as an Index of Diagnostic Test Performance

Methods of Information in Medicine ◽

10.1055/s-0038-1634358 ◽

2003 ◽

Vol 42 (03) ◽

pp. 260-264 ◽

Cited By ~ 15

Author(s):

W. A. Benish

Keyword(s):

Mutual Information ◽

Diagnostic Test ◽

Test Performance ◽

Random Variable ◽

Disease State ◽

Necessary Condition ◽

Conditional Probabilities ◽

Amount Of Information ◽

Diagnostic Test Performance ◽

Test Result

Summary Objectives: This paper demonstrates that diagnostic test performance can be quantified as the average amount of information the test result (R) provides about the disease state (D). Methods: A fundamental concept of information theory, mutual information, is directly applicable to this problem. This statistic quantifies the amount of information that one random variable contains about another random variable. Prior to performing a diagnostic test, R and D are random variables. Hence, their mutual information, I(D;R), is the amount of information that R provides about D. Results: I(D;R) is a function of both 1) the pretest probabilities of the disease state and 2) the set of conditional probabilities relating each possible test result to each possible disease state. The area under the receiver operating characteristic curve (AUC) is a popular measure of diagnostic test performance which, in contrast to I(D;R), is independent of the pretest probabilities; it is a function of only the set of conditional probabilities. The AUC is not a measure of diagnostic information. Conclusions: Because I(D;R) is dependent upon pretest probabilities, knowledge of the setting in which a diagnostic test is employed is a necessary condition for quantifying the amount of information it provides. Advantages of I(D;R) over the AUC are that it can be calculated without invoking an arbitrary curve fitting routine, it is applicable to situations in which multiple diagnoses are under consideration, and it quantifies test performance in meaningful units (bits of information).

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The management of incidental low-grade gliomas using magnetic resonance imaging: systematic review and optimal treatment paradigm

Neurosurgical FOCUS ◽

10.3171/2011.9.focus11219 ◽

2011 ◽

Vol 31 (6) ◽

pp. E12 ◽

Cited By ~ 14

Author(s):

Ashish H. Shah ◽

Karthik Madhavan ◽

Deborah Heros ◽

Daniel M. S. Raper ◽

J. Bryan Iorgulescu ◽

...

Keyword(s):

Systematic Review ◽

Mr Imaging ◽

Active Surveillance ◽

Case Series ◽

Treatment Decisions ◽

Low Grade ◽

Management Options ◽

Low Grade Gliomas ◽

Presenting Symptoms ◽

Radiological Evidence

Object The discovery of incidental low-grade gliomas (LGGs) on MR imaging is rare, and currently there is no existing protocol for management of these lesions. Various studies have approached the dilemma of managing patients with incidental LGGs. While some advocate surgery and radiotherapy, others reserve surgery until there is radiological evidence of growth. For neurosurgeons and radiologists, determining the course of action after routine brain imaging poses not only a medical but also an ethical dilemma. The authors conducted a systematic review of case reports and case series in hopes of enhancing the current understanding of the management options for these rare lesions. Methods A PubMed search was performed to include all relevant MR imaging studies in which management of suspected incidental LGG was reported. Comparisons were made between the surgical treatment arm and the active surveillance arm in terms of outcome, mode of discovery, reasons for treatment, and histology. Results Nine studies with 72 patients were included in this study (56 in the surgical arm and 16 in the active surveillance arm). Within the surgical arm, 49% remained deficit free after treatment, 25% showed evidence of tumor progression, 13% underwent a second treatment, and 7% died. The active surveillance group resulted in no unanticipated adverse events, with serial imaging revealing no tumor growth in all cases. Lesion regression was reported in 31% of this group. The surgical arm's mortality rate was 7% compared with 0% in the active surveillance arm. Conclusions Treatment decisions for incidental LGG should be individualized based on presenting symptoms and radiological evidence of growth. The asymptomatic patient may be monitored safely with serial MR imaging and occasionally PET scanning before treatment is initiated. In patients presenting with nonspecific symptoms or concurrent symptomatic lesions, treatment may be initiated earlier to reduce potential morbidity. All treatment decisions must be tempered by patient factors and expectations of anticipated benefit.

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