scholarly journals Routine Chest X-Rays Are Inaccurate in Detecting Relevant Intrapulmonary Anomalies During Medical Assessments of Fitness to Dive

2021 ◽  
Vol 11 ◽  
Author(s):  
Thijs T. Wingelaar ◽  
Leonie Bakker ◽  
Frank J. Nap ◽  
Pieter-Jan A. M. van Ooij ◽  
Edwin L. Endert ◽  
...  
Keyword(s):  
Medical Center ◽  
False Negative ◽  
False Negative Rate ◽  
Initial Assessment ◽  
X Rays ◽  
Healthy Individuals ◽  
High Resolution Computed Tomography ◽  
Pulmonary Barotrauma ◽  
High False Negative Rate ◽  
Fitness To Dive

Introduction: Intrapulmonary pathology, such as bullae or blebs, can cause pulmonary barotrauma when diving. Many diving courses require chest X-rays (CXR) or high-resolution computed tomography (HRCT) to exclude asymptomatic healthy individuals with these lesions. The ability of routine CXRs and HRCT to assess fitness to dive has never been evaluated.Methods: Military divers who underwent yearly medical assessments at the Royal Netherlands Navy Diving Medical Center, including CXR at initial assessment, and who received a HRCT between January and June 2018, were included. The correlations of CXR and HRCT results with fitness to dive assessments were analyzed using Fisher's exact tests.Results: This study included 101 military divers. CXR identified bullae or blebs in seven divers, but HRCT found that these anomalies were not present in three subjects and were something else in four. CXR showed no anomalies in 94 subjects, but HRCT identified coincidental findings in 23 and bullae or blebs in seven. The differences between CXR and HRCT results were statistically significant (p = 0.023). Of the 34 subjects with anomalies on HRCT, 18 (53%) were disqualified for diving.Discussion: Routine CXR in asymptomatic military divers does not contribute to the identification of relevant pathology in fitness to dive assessments and has a high false negative rate (32%). HRCT is more diagnostic than CXR but yields unclear results, leading to disqualification for diving. Fitness to dive tests should exclude routine CXR; rather, HRCT should be performed only in subjects with clinical indications.

scholarly journals COVIDPEN: A Novel COVID-19 Detection Model using Chest X-Rays and CT Scans

2020 ◽  
Author(s):  
Amit Kumar Jaiswal ◽  
Prayag Tiwari ◽  
Vipin Kumar Rathi ◽  
Jia Qian ◽  
Hari Mohan Pandey ◽  
...  
Keyword(s):  
False Negative ◽  
Healthcare Providers ◽  
False Negative Rate ◽  
X Rays ◽  
X Ray ◽  
Detection Model ◽  
Global Pandemic ◽  
High False Negative Rate ◽  
Proposed Model ◽  
Chest X Ray

The trending global pandemic of COVID-19 is the fastest ever impact which caused people worldwide by severe acute respiratory syndrome~(SARS)-driven coronavirus. However, several countries suffer from the shortage of test kits and high false negative rate in PCR test. Enhancing the chest X-ray or CT detection rate becomes critical. The patient triage is of utmost importance and the use of machine learning can drive the diagnosis of chest X-ray or CT image by identifying COVID-19 cases. To tackle this problem, we propose~COVIDPEN~-~a transfer learning approach on Pruned EfficientNet-based model for the detection of COVID-19 cases. The proposed model is further interpolated by post-hoc analysis for the explainability of the predictions. The effectiveness of our proposed model is demonstrated on two systematic datasets of chest radiographs and computed tomography scans. Experimental results with several baseline comparisons show that our method is on par and confers clinically explicable instances, which are meant for healthcare providers.

scholarly journals High mortality with High false negative rate: COVID-19 infection in patients with hematologic malignancies

2021 ◽  
Vol 106 ◽  
pp. 106582
Author(s):  
Alex Niu ◽  
Bo Ning ◽  
Francisco Socola ◽  
Hana Safah ◽  
Tim Reynolds ◽  
...  
Keyword(s):  
High Mortality ◽  
False Negative ◽  
False Negative Rate ◽  
Hematologic Malignancies ◽  
Negative Rate ◽  
High False Negative Rate

scholarly journals False Negative Mitigation in Group Testing for COVID-19 Screening

2021 ◽  
Vol 8 ◽  
Author(s):  
Amir Reza Alizad Rahvar ◽  
Safar Vafadar ◽  
Mehdi Totonchi ◽  
Mehdi Sadeghi
Keyword(s):  
Viral Load ◽  
False Negative ◽  
Group Testing ◽  
False Negative Rate ◽  
Screening Strategy ◽  
Web Interface ◽  
Rt Pcr ◽  
Promising Candidate ◽  
Testing Method ◽  
High False Negative Rate

After lifting the COVID-19 lockdown restrictions and opening businesses, screening is essential to prevent the spread of the virus. Group testing could be a promising candidate for screening to save time and resources. However, due to the high false-negative rate (FNR) of the RT-PCR diagnostic test, we should be cautious about using group testing because a group's false-negative result identifies all the individuals in a group as uninfected. Repeating the test is the best solution to reduce the FNR, and repeats should be integrated with the group-testing method to increase the sensitivity of the test. The simplest way is to replicate the test twice for each group (the 2Rgt method). In this paper, we present a new method for group testing (the groupMix method), which integrates two repeats in the test. Then we introduce the 2-stage sequential version of both the groupMix and the 2Rgt methods. We compare these methods analytically regarding the sensitivity and the average number of tests. The tradeoff between the sensitivity and the average number of tests should be considered when choosing the best method for the screening strategy. We applied the groupMix method to screening 263 people and identified 2 infected individuals by performing 98 tests. This method achieved a 63% saving in the number of tests compared to individual testing. Our experimental results show that in COVID-19 screening, the viral load can be low, and the group size should not be more than 6; otherwise, the FNR increases significantly. A web interface of the groupMix method is publicly available for laboratories to implement this method.

Pathologic Assessment of Computerized Tomography Accuracy for the Evaluation of the Laryngeal Cartilaginous Frame Work in Laryngopharyngeal Carcinomas

1989 ◽  
Vol 75 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Sandro Sulfaro ◽  
Francesco Querin ◽  
Luigi Barzan ◽  
Mario Lutman ◽  
Roberto Comoretto ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Cartilage Destruction ◽  
High False Negative Rate ◽  
Positive Rate ◽  
Pathologic Assessment ◽  
Low Sensitivity

Sixty-six whole-organ sectioned laryngopharyngectomy specimens removed for cancer during a seven-year period were uniformly examined to determine the accuracy of preoperative high resolution computerized tomography (CT) for detection of cartilaginous involvement. Our results indicate that CT has a high overall specificity (88.2%) but a low sensitivity (47.1 %); we observed a high false-negative rate (26.5%) and a fairly low false-positive rate (5.9%). Massive cartilage destruction was easily assessed by CT, whereas both small macroscopic and microscopic neoplastic foci of cartilaginous invasion were missed on CT scans. Moreover, false-positive cases were mainly due to proximity of the tumor to the cartilage. Clinical implications of these results are discussed.

scholarly journals 0587 Convenience vs Accuracy: Negative Predictability of the Home Sleep Test in Clinical Practice

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A225-A225
Author(s):  
C D Morse ◽  
S Meissner ◽  
L Kodali
Keyword(s):  
Clinical Practice ◽  
Sleep Apnea ◽  
False Negative ◽  
False Negative Rate ◽  
True Negative ◽  
Negative Rate ◽  
High False Negative Rate ◽  
Obstructive Sleep ◽  
Respiratory Disturbance ◽  
Lost To Follow Up

Abstract Introduction Sleep apnea is a serious disorder associated with numerous health conditions. In clinical practice, providers order screening home sleep testing (HST) for obstructive sleep apnea (OSA); however, there is limited research about the negative predictive value (NPV) and false negative rate of this test. Providers may not understand HST limitations; therefore, what is the NPV and false negative rate in clinical practice? Methods A retrospective study of non-diagnostic HST is conducted in a Northeastern US rural community sleep clinic. The study population includes adult patients ≥ 18 years old who underwent HST from 2016-2019. The non-diagnostic HST result is compared to the gold standard, the patient’s nocturnal polysomnogram (NPSG). The results provide the NPV (true negative/total) and false negative (true positive/total) for the non-diagnostic HST. Results We identified 211 potential patients with a mean age of 43 years, of which 67% were female. Of those, 85% (n=179) underwent NPSG, with the others declining/delaying testing or lost to follow up. The non-diagnostic HST showed 15.6% NPV for no apnea using AHI<5 and 8.4% NPV using respiratory disturbance index (tRDI)<5. The false negative rate for AHI/tRDI was 84.4% and 91.6%, respectively. The AHI for positive tests ranged from 5-89 per hour (mean AHI 14.9/tRDI 16/hour), of which OSA was identified with an elevated AHI (≥5) ranging from 54.2% mild, 21.8% moderate, and 8.4% severe. Conclusion The high false negative rate of the HST is alarming. Some providers and patients may forgo NPSG after non-diagnostic HST due to a lack of understanding for the HST’s limitations. Knowing that the non-diagnostic HST is a very poor predictor of no sleep apnea will help providers advise patients appropriately for the necessity of the NPSG. The subsequent NPSG provides an accurate diagnosis and, therefore, an informed decision about pursuing or eschewing sleep apnea treatment. Support none

scholarly journals A Deep-Learning-Based Framework for Automated Diagnosis of COVID-19 Using X-ray Images

Information ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 419 ◽  
Author(s):  
Irfan Ullah Khan ◽  
Nida Aslam
Keyword(s):  
Deep Learning ◽  
False Negative ◽  
False Negative Rate ◽  
Complex Nature ◽  
Learning Models ◽  
Daily Lives ◽  
X Ray ◽  
High False Negative Rate ◽  
Diagnosis Method ◽  
Novel Coronavirus

The emergence and outbreak of the novel coronavirus (COVID-19) had a devasting effect on global health, the economy, and individuals’ daily lives. Timely diagnosis of COVID-19 is a crucial task, as it reduces the risk of pandemic spread, and early treatment will save patients’ life. Due to the time-consuming, complex nature, and high false-negative rate of the gold-standard RT-PCR test used for the diagnosis of COVID-19, the need for an additional diagnosis method has increased. Studies have proved the significance of X-ray images for the diagnosis of COVID-19. The dissemination of deep-learning techniques on X-ray images can automate the diagnosis process and serve as an assistive tool for radiologists. In this study, we used four deep-learning models—DenseNet121, ResNet50, VGG16, and VGG19—using the transfer-learning concept for the diagnosis of X-ray images as COVID-19 or normal. In the proposed study, VGG16 and VGG19 outperformed the other two deep-learning models. The study achieved an overall classification accuracy of 99.3%.

scholarly journals Septic arthritis of the knee: the use and effect of antibiotics prior to diagnostic aspiration

2012 ◽  
Vol 94 (5) ◽  
pp. 351-355 ◽  
Author(s):  
P Hindle ◽  
E Davidson ◽  
LC Biant
Keyword(s):  
Septic Arthritis ◽  
Joint Infection ◽  
False Negative ◽  
False Negative Rate ◽  
Standard Test ◽  
Entire Cohort ◽  
High False Negative Rate ◽  
Total Knee ◽  
Prosthetic Knees ◽  
No Gold Standard

Septic arthritis of the native knee joint and total knee arthroplasty both cause diagnostic and treatment issues. There is no gold standard test to diagnose a joint infection and the use of joint aspiration is commonly relied on. It is widely accepted by orthopaedic surgeons that antibiotics should be withheld until aspiration has been performed to increase the odds of identifying an organism. Patients often present to other specialties that may not be as familiar with these principles. Our study found that 25 (51%) of the 49 patients treated for septic arthritis of the native or prosthetic knee in our unit over a 3-year period had received antibiotics prior to discussion or review by the on-call orthopaedic service. Patients were significantly less likely to demonstrate an organism on initial microscopy (entire cohort: p=0.001, native knees: p=0.006, prosthetic knees: p=0.033) or on subsequent culture (entire cohort: p=0.001, native knees: p=0.017, prosthetic knees: p=0.012) of their aspirate if they had received antibiotics. The sensitivity of microscopy in all patients dropped from 58% to 12% when patients had received antibiotics (native knees: 46% to 0%, prosthetic knees: 72% to 27%). The sensitivity of the culture dropped from 79% to 28% in all patients when the patient had received antibiotics (native knees: 69% to 21%, prosthetic knees: 91% to 36%). This study demonstrated how the management of patients with suspected cases of septic arthritis of the knee may be compromised by empirical administration of antibiotics. These patients were significantly less likely to demonstrate an organism on microscopy and culture of their initial aspirate. There is a significant high false negative rate associated with knee aspiration with prior administration of antibiotic therapy.

scholarly journals The Clinical Scaphoid Fracture: Early Computed Tomography as a Practical Approach

2008 ◽  
Vol 90 (6) ◽  
pp. 488-491 ◽  
Author(s):  
Q Nguyen ◽  
S Chaudhry ◽  
R Sloan ◽  
I Bhoora ◽  
C Willard
Keyword(s):  
Ct Scan ◽  
General Hospital ◽  
Scaphoid Fracture ◽  
False Negative ◽  
False Negative Rate ◽  
District General Hospital ◽  
X Rays ◽  
Fracture Clinic ◽  
Non Union ◽  
Scaphoid Fractures

INTRODUCTION Up to 40% of scaphoid fractures are missed at initial presentation as clinical examination and plain radiographs are poor at identifying scaphoid fractures immediately after the injury. Avoiding a delay in diagnosis is essential to prevent the risk of non-union and early wrist arthritis. We demonstrate the use of CT scanning for the early confirmation of a scaphoid fracture. PATIENTS AND METHODS We conducted a retrospective, chronological review of patients who attended an upper limb fracture clinic from January 2001 to October 2003 in a small district general hospital. We performed a CT scan on all ‘clinical scaphoid’ patients who had negative plain X-ray films. RESULTS Overall, 70% of patients had a CT scan within 1 week of injury and not from date of accident and emergency attendance; 83% of patients had a CT scan within 2 weeks of injury. Of 118 patients identified, 32% had positive findings and 22% of ‘clinical scaphoid’ patients had scaphoid fractures. The proportion of positive findings for an acute scaphoid fracture was 68%. Additional pathologies identified on CT were capitate, triquetral and radial fractures. CONCLUSIONS Our audit shows that it is practical to perform CT on suspicious scaphoid fractures in a small district general hospital. We identified an extremely high false-negative rate for plain X-rays and demonstrate that the appropriate use of CT at initial fracture clinic attendance with ‘clinical scaphoid’ leads to an earlier diagnosis and reduces the need for prolonged immobilisation and repeated clinical review.

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