scholarly journals Diagnostic Value of Serum Procalcitonin in Patients with Convulsion in Emergency Department, an Observational Study

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 683
Author(s):  
Hisashi Murakami ◽  
Hiromu Naraba ◽  
Takashi Gondo ◽  
Masaki Mochizuki ◽  
Hidehiko Nakano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Bacterial Infection ◽  
Likelihood Ratio ◽  
Bacterial Infections ◽  
Care Center ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Values ◽  
Group Members

Procalcitonin (PCT), a widely used biomarker for bacterial infections, is sometimes measured in convulsion patients to distinguish bacterial infections including bacterial meningitis. However, serum PCT elevation is reported in several other conditions. This study assessed the diagnostic value of serum PCT concentrations in convulsion patients. This study examined a convulsion group: patients admitted to our critical care center during April 2018 through September 2019 via the emergency department presenting with convulsions. Randomly sampled patients admitted without convulsions were categorized as a non-convulsion group. Serum PCT analysis was performed with consideration of whether or not the patient had an infection. Diagnostic values of serum PCT for bacterial infection were evaluated for convulsion and non-convulsion patients using the positive likelihood ratio of PCT. This study found 84 patients as eligible for the convulsion group; 1:2 matched 168 control patients were selected as non-convulsion group members. The positive likelihood ratio for bacterial infection was found to be significantly lower in the convulsion group than in the control group (1.94 vs. 2.65) when setting the positive cut-off for PCT as 0.5 ng/mL. Convulsion patients had a higher PCT value. The positive likelihood ratio for patients without bacterial infection was lower.

scholarly journals A meta-analysis of circulating microRNAs in the diagnosis of papillary thyroid carcinoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251676
Author(s):  
Yan liu ◽  
Houfa Geng ◽  
Xuekui Liu ◽  
Mingfeng Cao ◽  
Xinhuan Zhang
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Control Group ◽  
Papillary Thyroid ◽  
Circulating Micrornas

Background Aim of this meta-analysis was to evaluate the overall diagnostic value of circulating mini miRNAs for papillary thyroid carcinoma (PTC) and to find the possible molecular marker with higher diagnostic value for PTC. Methods We searched the Pubmed, Cochrane and Embase database until June 2020. We selected relevant literatures associated with the diagnosis of PTC with circulating miRNAs. The number of cases in experimental group and the control group, sensitivity and specificity could be extracted from the literatures. Results We got 9 literatures including 2114 cases of PTC. Comprehensive sensitivity was 0.79, comprehensive specificity was 0.82, positive likelihood ratio was 4.3, negative likelihood ratio was 0.26, diagnostic advantage ratio was 16. The summary receiver operating characteristic curve was drawn and the Area Under the Curve was 0.87. Conclusions Circulating microRNAs may be promising molecular markers for the diagnosis of papillary thyroid carcinoma. Combined detection of certain serum microRNAs can improve the diagnostic accuracy of papillary thyroid carcinoma. Especially MiR-222 and miR-146b may be prime candidates for the diagnosis of PTC in Asian population.

Is the diagnostic value of either ESR or CRP sufficient to exclude the need to measure both in paediatric patients presenting with non-traumatic limb pain?

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A8.1-A8
Author(s):  
Sara Robinson
Keyword(s):  
Emergency Department ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Roc Curves ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Limb Pain ◽  
Time Of Presentation

BackgroundLaboratory tests for cases of suspected orthopaedic infection usually include measurement of both the erythrocyte sedimentation rate (ESR) and the C reactive protein (CRP). This has a time and cost implication for the laboratories. The measurement of both also requires a larger volume blood sample, which can be difficult to obtain.ObjectiveTo assess if the measurement of either CRP or ESR individually has a likelihood ratio equivalent to that of the measurement of both.SettingEmergency Department of a Paediatric Teaching Hospital.Study designRetrospective study of Case Notes for patients attending the Emergency Department with a complaint of atraumatic limb pain and in whom both ESR and CRP were measured at the time of presentation. Laboratory results at the time of presentation were recorded along with the final diagnosis. Receiver operating characteristic (ROC) curves were created using the data. Likelihood Ratios for ESR and CRP individually and in combination were calculated.Results259 patients were included in the study of whom 17 were considered to have an Orthopaedic infection. The ROC curves revealed the best results were obtained using cut off values of CRP>7 and ESR>12. The combination of a CRP>7 and an ESR>12 gave the best positive Likelihood Ratio at 6.26 (Likelihood ratio 5.34 (CRP>7) vs 2.57 (ESR>12)) For ruling out disease the combination of CRP≤7 and an ESR≤12 also outperformed either variable individually (negative likelihood ratio 0.09 (CRP≤7 and ESR≤12) vs 0.34 (CRP≤7) vs 0.18 (ESR≤12)).ConclusionA raised CRP is a more specific indicator of orthopaedic infection than a raised ESR; however the ESR is more sensitive. Thus the Likelihood Ratios produced by the combination of the two results are superior to those of either measurement individually. The measurement of both CRP and ESR should be considered an important aid in the investigation of atraumatic limb pain.

scholarly journals The Diagnostic Value of the Ulnocarpal Stress Test for Differentiating the Symptomatic Triangular Fibrocartilage Complex Tear from the Incidental Tear

2020 ◽  
Vol 25 (4) ◽  
pp. 259-266
Author(s):  
Cheol-U Kim ◽  
Dong Hyun Kim ◽  
Bong Cheol Kwon
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Stress Test ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Triangular Fibrocartilage Complex ◽  
Diagnostic Process ◽  
Symptom Improvement ◽  
Control Group ◽  
Triangular Fibrocartilage

Purpose: The purpose of this study was to determine the diagnostic value of the ulnocarpal stress test (UCST) for differentiating the symptomatic triangular fibrocartilage complex (TFCC) tear from the incidental tear.Methods: From January 2013 to May 2020, a study was performed on 109 patients who underwent wrist arthroscopy and showed TFCC tear. Patients who had ulnar-sided wrist pain along with TFCC tear, and showed postoperative symptom improvement, and those with other lesions excluded were defined as symptomatic tear (experimental group) and the rest were defined as asymptomatic tear (control group). Diagnostic values of the UCST for differentiating the symptomatic TFCC tear from the incidental tear were calculated.Results: The UCST showed a sensitivity of 54%, a specificity of 95%, a positive predictive value of 98%, a negative predictive value of 31%, a positive likelihood ratio of 10.34, a negative likelihood ratio of 0.48, and an overall diagnostic accuracy of 61%. Conclusion: The UCST showed limited diagnostic value for symptomatic TFCC tear. Therefore, this test needs to be regarded as a part of diagnostic process and their results should be interpreted in the context of other relevant clinical information before reaching the diagnosis of symptomatic TFCC tear.

scholarly journals Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199296
Author(s):  
Juan Wang ◽  
Liu Yang ◽  
Yanjun Diao ◽  
Jiayun Liu ◽  
Jinjie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dna Methylation ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Control Group ◽  
Control Subjects ◽  
Droplet Pcr ◽  
Healthy Control

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

scholarly journals Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

scholarly journals Factors Affecting the Accuracy of Endoscopic Ultrasonography in the Diagnosis of Early Gastric Cancer Invasion Depth: A Meta-analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Ding Shi ◽  
Xiao-xia Xi
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasonography ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Depth Of Invasion ◽  
Invasion Depth ◽  
Sensitivity Specificity

Background. Endoscopic ultrasonography (EUS) is the first imaging modality for investigating the depth of invasion in early gastric cancer (EGC). However, there is presently no consensus on the accuracy of EUS in diagnosing the invasion depth of EGC. Aim. This study is aimed at systematically evaluating the accuracy of EUS in diagnosing the invasion depth of EGC and its affecting factors. Methods. The literatures were identified by searching PubMed, SpringerLink, Cochrane Library, Web of Science, Nature, and Karger knowledge databases. Two researchers extracted the data from the literature and reconstructed these in 2×2 tables. The Meta-DiSc software was used to evaluate the overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic advantage ratio, and 95% confidence interval (CI). The SROC was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value. Results. A total of 17 articles were selected, which included 4525 cases of lesions. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic dominance ratio, and 95% CI of EUS for diagnosing EGC was 0.87 (95% CI: 0.86-0.88), 0.67 (95% CI: 0.65-0.70), 2.90 (95% CI: 2.25-3.75), 0.17 (95% CI: 0.13-0.23), and 18.25 (95% CI: 12.61-26.39), respectively. The overall overstaging rate of mucosa/submucosa 1 (M/SM1) and SM by EUS was 13.31% and 32.8%, respectively, while the overall understaging rate of SM was 29.7%. The total misdiagnosis rates for EUS were as follows: 30.4% for lesions≥2 cm and 20.9% for lesions<2 cm, 27.7% for ulcerative lesions and 21.4% for nonulcerative lesions, and 22% for differentiated lesions and 26.9% for undifferentiated lesions. Conclusion. EUS has a moderate diagnostic value for the depth of invasion of EGC. The shape, size, and differentiation of lesions might be the main factors that affect the accuracy of EUS in diagnosing EGC.

scholarly journals Fever and laboratory profiles as predictors of serious bacterial infection in children

2012 ◽  
Vol 52 (6) ◽  
pp. 313
Author(s):  
Ni Putu Veny Kartika Yantie ◽  
BNP Arhana ◽  
Purnomo Suryantoro
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Controlled Study ◽  
Control Group ◽  
Case Group ◽  
Bacterial Gastroenteritis ◽  
Leukocyte Counts ◽  
Serious Bacterial Infections ◽  
Tract Infections

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3􀁉15% of children with fever of 2: 39°C.Various laboratory parameters including increased C􀁉reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 month􀁉 18 years.Methods A case􀁉controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (non􀁉SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively].Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

scholarly journals Comparison of ultrasonography and X-ray test for lateral malleolar fracture in ankle sprain

2020 ◽  
Vol 7 (8) ◽  
pp. 3939-3943
Author(s):  
Hamideh FeizDisfani ◽  
Ehsan Bolvardi ◽  
Mohadeseh Shourabi ◽  
Mohammad Davood Sharifi ◽  
Seyed Mohammad Mousavi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Likelihood Ratio ◽  
Ankle Sprain ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Malleolar Fracture ◽  
X Ray ◽  
Malleolar Fractures ◽  
Bedside Ultrasonography

Introduction: The use of ultrasonography for diagnosing musculoskeletal injuries, especially fractures, in the emergency department is on the rise because of its good diagnostic value. This study aimed to evaluate the diagnostic value of bedside ultrasonography in detecting the patients suffering from lateral malleolar fractures with an ankle sprain mechanism. Methods: This prospective study was conducted on patients having acute ankle injuries with ankle sprain mechanism and diagnosed with lateral malleolar tenderness. All patients underwent bedside ultrasonography with a 7.5 - 10 MHz probe by an emergency medicine specialist who was assisted by a radiologist. Next, they underwent lateral ankle and anteroposterior (AP) X-rays by another emergency medicine specialist who was blinded from the ultrasonography results. The ultrasonography and X-Ray results were then compared. Results: A total of 244 patients participated in this study, of whom 92 (37.70%) were diagnosed with lateral malleolar fracture through bedside ultrasonography and X-Ray tests. The results showed that ultrasonography had a sensitivity of 96.84% and a specificity of 97.31%. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 36.07 and 0.0325, respectively, and the positive and negative predictive values of bedside ultrasonography were 95.83% and 97.98%, respectively. Finally, the results indicated a percent agreement (accuracy) of 97.13% between the two tests with Kappa coefficient of 0.94 (z = 14.68, P value < 0.01). Conclusion: The results of this study showed that bedside ultrasonography has a high sensitivity and specificity in the diagnosis of lateral malleolar fractures with an ankle sprain mechanism. Conducting further studies will lead to the use of this diagnostic test in the emergency department.

scholarly journals The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Yao ◽  
Tao Bai ◽  
Bo Yang ◽  
Lizhong Sun
Keyword(s):  
Aortic Dissection ◽  
Likelihood Ratio ◽  
Acute Aortic Dissection ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Meta Regression ◽  
D Dimer

Abstract Objective This study aims to evaluate the diagnostic value of D-dimer for acute aortic dissection (AAD) by the method of meta-analysis. Methods PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases from the establishment of the databases to December 2020 were systematically searched, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the literature. STATA 15.0 software was applied to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR) to draw summary receiver operating characteristics (SROC) curve and calculate the area under the curve (AUC). Meta-regression and subgroup analyses were used to explore the source of heterogeneity. Results A total of 16 clinical studies were enrolled in this study, including 1135 patients. The results of the meta-analysis showed that the pooled sensitivity was 0.96 (95% CI 0.91–0.98), the pooled specificity was 0.70 (95% CI 0.57–0.81), and the pooled DOR was 56.57 (95% CI 25.11–127.44), the pooled +LR was 3.25 (95% CI 2.18–4.85), the pooled −LR was 0.06 (95% CI 0.03–0.12), and the AUC was 0.94 (95% CI 0.91–0.95). Meta-regression and subgroup analysis results showed that publication year, sample size and cutoff value might be sources of heterogeneity. When the concentration of D-dimer was less than or equal to 500 ng/ml, the sensitivity significantly increased. Conclusion D-dimer has an excellent diagnostic value for AAD. It is a useful tool for detecting suspected AAD because of the excellent pooled sensitivity. D-dimer ≤ 500 ng/ml increases the potential to identify the suspected patients with AAD.

scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Lymph Node Status ◽  
Transbronchial Needle Aspiration ◽  
Hilar Lymph Node ◽  
Malignant Lymph Nodes

Abstract Background Endobronchial ultrasound (EBUS) elastography has been used in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely utilized for onsite evaluation of sample adequacy and for guiding sampling during EBUS-TBNA. The aim of this study was to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating mediastinal and hilar lymph node status. Methods Retrospective chart review was performed from December 2018 to September 2020. Patient demographics, EBUS elastography scores, and ROSE, pathologic, and clinical outcome data were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly nonblue; Type 2, partially blue and partially nonblue; and Type 3, predominantly blue. A receiver operating characteristic curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for evaluation of malignant lymph nodes among the EBUS elastography, ROSE, and EBUS combined with ROSE groups. Results A total of 245 patients (345 lymph nodes) were included. The sensitivity and specificity of the EBUS elastography group for the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under the curve was 0.942. Conclusions Combining EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph node status compared to each method alone.

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