Sensitivity and Specificity Analysis of Urine NMP22, Cytokeratin-18, CA 19-9 and Cytology, for Diagnosing Bladder Malignancy

Abstract Objectives Urinalysis (UA) is used to screen for multiple medical abnormalities. Microscopic analysis of urine requires trained morphologists and can be time-consuming; therefore, a reflex strategy where microscopic analysis is only performed when the chemstrip is positive is an attractive strategy. We previously described the retrospective performance of the iChem VELOCITY (Beckman Coulter, CA, USA) and CLINITEK Novus strip cassettes (Siemens, Munich, DE) for detecting microscopic abnormalities. The iRICELL is iQ microscopic and is now paired with the AX-4030 (Arkray, JP). During our validation of the new workcell, we tested the sensitivity and specificity of the chemstrip results for microscopic abnormalities. Methods A total of 60 samples were analyzed on both the VELOCITY and AX-4030. Microscopic evaluation was performed by centrifuging the urine and examining by light microscope. Sensitivity and specificity for each chemstrip result were calculated and compared. Results Looking at sensitivity of any chemistry abnormality for any microscopic abnormality, the AX-4030 was 90.2% sensitive compared to 80.5% on the VELOCITY. The AX-4030 leukocyte esterase result was slightly less sensitive but more specific than the VELOCITY for presence of leukocytes (94.7% sensitivity and 95.1% specificity compared to 100% sensitivity and 87.8% specificity). The AX-4030 blood results were slightly more sensitive for detection of RBC (77.8% vs 72.2%) and more specific (100% vs 92.9%), perhaps related to the known interference of ascorbic acid with the VELOCITY strips. Conclusion Overall, the AX-4030 chemstrip results were more sensitive for microscopic abnormalities than the VELOCITY, although 10% of cases would still be missed. For a general population, a reflex methodology may be adequate. However, in patients with a higher likelihood of microscopic abnormalities, performing routine microscopic analysis may still be prudent.

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Applying Item Response Theory Modeling to Identify Social (Pragmatic) Communication Disorder

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00284 ◽

2020 ◽

Vol 63 (6) ◽

pp. 1916-1932 ◽

Cited By ~ 1

Author(s):

Haiying Yuan ◽

Christine Dollaghan

Keyword(s):

Item Response Theory ◽

Item Response ◽

Sensitivity And Specificity ◽

Social Communication ◽

National Database ◽

Communication Disorder ◽

Social Communication Questionnaire ◽

Autism Research ◽

The Social ◽

Pragmatic Communication

Purpose No diagnostic tools exist for identifying social (pragmatic) communication disorder (SPCD), a new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition category for individuals with social communication deficits but not the repetitive, restricted behaviors and interests (RRBIs) that would qualify them for a diagnosis of autism spectrum disorder (ASD). We explored the value of items from a widely used screening measure of ASD for distinguishing SPCD from typical controls (TC; Aim 1) and from ASD (Aim 2). Method We applied item response theory (IRT) modeling to Social Communication Questionnaire–Lifetime ( Rutter, Bailey, & Lord, 2003 ) records available in the National Database for Autism Research. We defined records from putative SPCD ( n = 54), ASD ( n = 278), and TC ( n = 274) groups retrospectively, based on National Database for Autism Research classifications and Autism Diagnostic Interview–Revised responses. After assessing model assumptions, estimating model parameters, and measuring model fit, we identified items in the social communication and RRBI domains that were maximally informative in differentiating the groups. Results IRT modeling identified a set of seven social communication items that distinguished SPCD from TC with sensitivity and specificity > 80%. A set of five RRBI items was less successful in distinguishing SPCD from ASD (sensitivity and specificity < 70%). Conclusion The IRT modeling approach and the Social Communication Questionnaire–Lifetime item sets it identified may be useful in efforts to construct screening and diagnostic measures for SPCD.

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