scholarly journals The Prehospital Ambulance Stroke Test vs. the Cincinnati Prehospital Stroke Scale: a diagnostic accuracy study

2020 ◽  
Vol 17 ◽  
Author(s):  
Somayeh Karimi ◽  
Hassan Motamed ◽  
Ehsan Aliniagerdroudbari ◽  
Sepideh Babaniamansour ◽  
Arman Jami ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Facial Palsy ◽  
High Sensitivity ◽  
Assessment Tools ◽  
Screening Tools ◽  
Eye Position ◽  
Diagnostic Accuracy Study ◽  
Specificity And Sensitivity ◽  
Accuracy Study ◽  
Chain Of Care

IntroductionImmediate diagnosis of stroke is crucial in reducing its morbidity and mortality rate. There are various pre-hospital assessment tools, such as the Prehospital Ambulance Stroke Test (PreHAST) and the Cincinnati Prehospital Stroke Scale (CPSS) used to identify stroke early in the chain of care. The aim of this study is to compare the accuracy of PreHAST with CPSS in diagnosing stroke.MethodsIn this diagnostic accuracy study patients with suspicion of stroke were included in this study. In CPSS, the criterion used to indicate stroke are facial droop, speech and arm drift. In PreHAST it is eye position, visual field, facial palsy, right and left arms paresis, right and left legs paresis, sensory and speech. After data collection, sensitivity and specificity were calculated using standard formulae. Different cut-off points for the best diagnostic accuracy were examined in both CPSS and PreHAST.ResultsIn this study, 883 patients were investigated. The results demonstrated that in CPSS, the highest specificity and sensitivity was for facial droop (84.9%) and arm drift (82.7%); and in PreHAST it was eye position (99.6%) and facial palsy (49.2%). The best predictor of stroke in CPSS with highest sensitivity (78.5%) and specificity (66%) was a cut-off point of 1.5 (AUC: 0.744) (p<0.01(. In PreHAST, the highest sensitivity (68.4%) was a cut-off point of 2.5 and the highest specificity (90.2%) was a cut-off point of 5.5 (AUC: 0.775) (p<0.01).ConclusionBoth PreHAST and CPSS are useful screening tools in the pre-hospital diagnosis of stroke. In addition to high sensitivity, these tests provide a grading system in which higher cut-off points lead to higher specificity.

scholarly journals Old and New Geriatric Screening Tools in a Belgian Emergency Department: A Diagnostic Accuracy Study

2020 ◽  
Vol 68 (7) ◽  
pp. 1454-1461 ◽  
Author(s):  
Pieter Heeren ◽  
Els Devriendt ◽  
Nathalie I.H. Wellens ◽  
Mieke Deschodt ◽  
Johan Flamaing ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Screening Tools ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study ◽  
Geriatric Screening

scholarly journals Protocol for a prospective, controlled, cross-sectional, diagnostic accuracy study to evaluate the specificity and sensitivity of ambulatory monitoring systems in the prompt detection of hypoxia and during movement

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034404 ◽  
Author(s):  
Carlos Areia ◽  
Sarah Vollam ◽  
Philippa Piper ◽  
Elizabeth King ◽  
Jody Ede ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ambulatory Monitoring ◽  
Vital Signs ◽  
Diagnostic Accuracy Study ◽  
Cross Sectional ◽  
Major Barrier ◽  
Vital Signs Monitoring ◽  
Arterial Blood ◽  
Specificity And Sensitivity ◽  
Accuracy Study

IntroductionAutomated continuous ambulatory monitoring may provide an alternative to intermittent manual vital signs monitoring. This has the potential to improve frequency of measurements, timely escalation of care and patient safety. However, a major barrier to the implementation of these wearable devices in the ward environment is their uncertain reliability, efficiency and data fidelity. The purpose of this study is to test performance of selected devices in a simulated clinical setting including during movement and low levels of peripheral oxygen saturation.Methods and analysisThis is a single centre, prospective, controlled, cross-sectional, diagnostic accuracy study to determine the specificity and sensitivity of currently available ambulatory vital signs monitoring equipment in the detection of hypoxia and the effect of movement on data acquisition. We will recruit up to 45 healthy volunteers who will attend a single study visit; starting with a movement phase and followed by the hypoxia exposure phase where we will gradually decrease saturation levels down to 80%. We will simultaneously test one chest patch, one wrist worn only and three wrist worn with finger probe devices against ‘clinical standard ‘and ‘gold standard’ references. We will measure peripheral oxygen saturations, pulse rate, heart rate and respiratory rate continuously and arterial blood gases intermittently throughout the study.Ethics and disseminationThis study has received ethical approval by the East of Scotland Research Ethics Service REC 2 (19/ES/0008). The results will be broadly distributed through conference presentations and peer-reviewed publications.Trial registration numberISRCTN61535692registered on 10/06/2019.

Ultrasonographic 3D Evaluation in the Diagnosis of Bladder Endometriosis: A Prospective Comparative Diagnostic Accuracy Study

2021 ◽  
pp. 1-8
Author(s):  
Fabio Barra ◽  
Franco Alessandri ◽  
Carolina Scala ◽  
Simone Ferrero
Keyword(s):  
Diagnostic Accuracy ◽  
Three Dimensional ◽  
3D Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Extensive Experience ◽  
Deep Endometriosis ◽  
3D Reconstructions ◽  
Analysis Group ◽  
Bladder Endometriosis ◽  
Accuracy Study

<b><i>Objective:</i></b> The use of three-dimensional (3D) transvaginal ultrasonography (TVS) has been investigated for the diagnosis of deep endometriosis (DE). This study aimed to evaluate if 3D reconstructions improve the performance of TVS) in assessing the presence and characteristics of bladder endometriosis (BE). <b><i>Design:</i></b> This was a single-center comparative diagnostic accuracy study. <b><i>Participants/Materials, Setting, Methods:</i></b> Patients referred to our institution (Piazza della Vittoria 14 Srl, Genova, Italy) with clinical suspicion of DE were included. In case of surgery, women underwent systematic preoperative ultrasonographic imaging; an experienced sonographer performed a conventional TVS; another experienced sonographer, blinded to results of the previous exam, performed TVS, with the addition of 3D modality. The presence and characteristics of BE nodules were described in accord with International DE Analysis group consensus. Ultrasound data were compared with surgical and histological results. <b><i>Results:</i></b> Overall, BE was intraoperatively found in 34 out of 194 women who underwent surgery for DE (17.5%; 95% confidence interval: 12.8–23.5%). TVS without and with 3D reconstructions were able to detect endometriotic BE in 82.2% (<i>n</i> = 28/34) and 85.3% (<i>n</i> = 29/34) of the cases (<i>p</i> = 0.125). Both the exams similarly estimated the largest diameter of BE (<i>p</i> = 0.652) and the distance between the endometriotic nodule and the closest ureteral meatus (<i>p</i> = 0.341). However, TVS with 3D reconstructions was more precise in estimating the volume of BE (<i>p</i> = 0.031). In one case (2.9%), TVS without and with 3D reconstructions detected the infiltration of the intramural ureter, which was confirmed at surgery and required laparoscopic ureterovesical reimplantation. <b><i>Limitations:</i></b> The extensive experience of the gynecologists performing the ultrasonographic scans, the lack of prestudy power analysis, and the population selected, which may have been influenced by the position of the institution as a referral center specialized in the treatment of severe endometriosis, are limitations of the current study. <b><i>Conclusion:</i></b> Our results demonstrated the high accuracy of ultrasound for diagnosing BE. The addition of 3D reconstructions does not improve the performance of TVS in diagnosing the presence and characteristics of BE. However, the volume of BE may be more precisely assessed by 3D ultrasound.

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