Predictive Ability of Fahrenheit, a Hand Motion Recording System for Assessing Hand Motor Function in Patients with Hemiplegia Post-Cerebrovascular Disease—A Pilot Study

The Brunnstrom recovery stage (BRS) assessment is a frequently used clinical instrument, but does not allow temporal or spatial analysis owing to its use of binary assessments. We developed a kinematic analysis system (Fahrenheit) that employs three-dimensional motor analysis using the Leap Motion Controller as an infrared camera to assess hand motor function in patients post- cerebrovascular disease (CeVD)/stroke, according to the BRS assessment criteria. We investigated whether Fahrenheit could predict the outcome of the BRS assessment of hand motor function in post-CeVD patients with hemiplegia. Thirty-two inpatients with CeVD were recruited in this pilot study. Participants’ hand motor function after CeVD was assessed through their performance of nine tasks according to the BRS assessment. We constructed a receiver operating characteristic (ROC) curve based on each participants’ performance, and compared the results of the BRS assessment and computed the area under the curve (AUC) for each ROC curve. All task values showed significant differences between sufficient and insufficient movements. AUC analyses showed that the nine tasks assessed using Fahrenheit had high predictability (all AUC values ≥ 0.7), which were comparable to those of the therapists’ assessment. Measurements with Fahrenheit showed high predictability with respect to the BRS criteria, indicating that Fahrenheit may have clinical application for assessing post-CeVD finger movement and motor functions. Further verification involving more patients is required to ensure that Fahrenheit becomes a more reliable evaluation tool.

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Simultaneous external validation of various cardiac arrest prognostic scores: a single-center retrospective study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00935-w ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Takumi Tsuchida ◽

Kota Ono ◽

Kunihiko Maekawa ◽

Takeshi Wada ◽

Kenichi Katabami ◽

...

Keyword(s):

Cardiac Arrest ◽

Roc Curve ◽

External Validation ◽

Area Under The Curve ◽

Predictive Ability ◽

Prognostic Scores ◽

Low Flow ◽

Neurological Outcomes ◽

Shockable Rhythm ◽

End Stage

Abstract Background This study aimed to compare and validate the out-of-hospital cardiac arrest (OHCA); cardiac arrest hospital prognosis (CAHP); non-shockable rhythm, unwitnessed arrest, long no-flow or long low-flow period, blood pH < 7.2, lactate > 7.0 mmol/L, end-stage chronic kidney disease, age ≥ 85 years, still resuscitation, and extracardiac cause (NULL-PLEASE) clinical; post-cardiac arrest syndrome for therapeutic hypothermia (CAST); and revised CAST (rCAST) scores in OHCA patients treated with recent cardiopulmonary resuscitation strategies. Methods We retrospectively collected data on adult OHCA patients admitted to our emergency department between February 2015 and July 2018. OHCA, CAHP, NULL-PLEASE clinical, CAST, and rCAST scores were calculated based on the data collected. The predictive abilities of each score were tested using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results We identified 236 OHCA patients from computer-based medical records and analyzed 189 without missing data. In OHCA patients without bystander witnesses, CAHP and OHCA scores were not calculated. Although the predictive abilities of the scores were not significantly different, the NULL-PLEASE score had a large AUC of ROC curve in various OHCA patients. Furthermore, in patients with bystander-witnessed OHCA, the NULL-PLEASE score had large partial AUCs of ROC from sensitivity 0.8–1.0 and specificity 0.8–1.0. Conclusions The NULL-PLEASE score had a high, comprehensive predictive ability in various OHCA patients. Furthermore, the NULL-PLEASE score had a high predictive ability for good and poor neurological outcomes in patients with bystander-witnessed OHCA.

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Maximal kidney length predicts need for native nephrectomy in ADPCKD patients undergoing renal transplantation

Canadian Urological Association Journal ◽

10.5489/cuaj.2128 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 278 ◽

Cited By ~ 4

Author(s):

Octav Cristea ◽

Daniel Yanko ◽

Sarah Felbel ◽

Andrew House ◽

Alp Sener ◽

...

Keyword(s):

Renal Transplantation ◽

Roc Curve ◽

Test Performance ◽

Area Under The Curve ◽

Predictive Ability ◽

Roc Curves ◽

Clinical Tool ◽

Roc Curve Analysis ◽

Kidney Length ◽

Autosomal Dominant Polycystic Kidney

Introduction: Native nephrectomy in patients with autosomal dominant polycystic kidney disease (ADPKD) is performed on a case-by-case basis. We determine if pre-transplant maximal kidney length (MKL) can be used to predict ultimate nephrectomy status.Methods: We performed a retrospective review of ADPKD patients who underwent renal transplantation at our centre between January2000 and December 2012. Pre-transplant measurements of MKL alone, MKL adjusted for height (HtMKL), weight (WtMKL) and body mass index (BMI-MKL) were each assessed for their predictive ability via a receiver operating characteristic (ROC) curve analysis.Results: In total, 84 patients met our inclusion criteria, of which17 (20.2%) underwent native nephrectomy. An MKL ROC curve analysis revealed an area under the curve (AUC) of 0.867 (95% confidence interval [CI] 0.775–0.931; p < 0.001). An optimal cut-off criterion of >21.5 cm revealed a sensitivity of 94.1% (95% CI 71.3–99.9) and specificity of 70.1% (95% CI 57.7–80.7) for eventual nephrectomy. The AUC of HtMKL, WtMKL and BMI-MKL ROC curves did not differ significantly from MKL alone. HtMKL improved specificity, but not overall test performance. The determination of the cut-off MKL may be influenced by the single-centre retrospective nature of this analysis, as well as the fact that renal size was determined by ultrasound and not computerized tomography or magnetic resonance imaging.Conclusion: MKL in patients with ADPKD is associated with the eventual need for nephrectomy and may be a useful clinical tool to risk stratify these patients and therefore guide patient conversations to a decision to leave the native kidneys in situ.

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Prognostic nomogram for predicting long-term cancer-specific survival in patients with lung carcinoid tumors

10.21203/rs.3.rs-19426/v1 ◽

2020 ◽

Author(s):

Yanqi He ◽

Feng Zhao ◽

Qingbing Han ◽

Yiwu Zhou ◽

Shuang Zhao

Keyword(s):

Roc Curve ◽

Area Under The Curve ◽

Predictive Ability ◽

Primary Site ◽

Carcinoid Tumors ◽

Cancer Specific Survival ◽

Internal Validation ◽

N Stage ◽

Good Concordance ◽

Lung Carcinoid

Abstract Background Lung carcinoid is a rare malignant tumor with poor survival. The current study aimed to build a nomogram model for predicting cancer-specific survival (CSS) of patients with lung carcinoid tumors. Methods A total of 1,956 patients diagnosed with primary lung carcinoid tumors were extracted from the Surveillance, Epidemiology, and End Results database. The specific predictors of CSS for lung carcinoid tumors were identified and integrated to build a nomogram. Validation of the nomogram was conducted using parameters concordance index (C-index), calibration plots, decision curve analyses (DCAs), and the receiver operating characteristic (ROC) curve. Results Age at diagnosis, grade, histological type, N stage, M stage, surgery of the primary site, radiation of the primary site, and tumor size were independent prognostic factors of CSS. High discriminative accuracy of the nomogram model was shown in the training cohort (C-index = 0.873), which was also testified in the internal validation cohort (C-index = 0.861). In both cohorts, the calibration plots showed good concordance between the predicted and observed CSS at 3, 5, and 10 years. The DCA showed great potential for clinical application. The ROC curve showed superior survival predictive ability of the nomogram model (area under the curve = 0.868). Conclusions We developed a practical nomogram that provided independent predictions of CSS for patients with lung carcinoid tumors. This nomogram may have the potential to assist clinicians in prognostic evaluations or developing individualized therapies for patients with this neoplasm.

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Prognostic nomogram for predicting long-term cancer-specific survival in patients with lung carcinoid tumors

BMC Cancer ◽

10.1186/s12885-021-07832-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yanqi He ◽

Feng Zhao ◽

Qingbing Han ◽

Yiwu Zhou ◽

Shuang Zhao

Keyword(s):

Roc Curve ◽

Area Under The Curve ◽

Predictive Ability ◽

Primary Site ◽

Carcinoid Tumors ◽

Cancer Specific Survival ◽

Internal Validation ◽

N Stage ◽

Good Concordance ◽

Lung Carcinoid

Abstract Background Lung carcinoid is a rare malignant tumor with poor survival. The current study established a nomogram model for predicting cancer-specific survival (CSS) in patients with lung carcinoid tumors. Methods A total of 1956 patients diagnosed with primary lung carcinoid tumors were extracted from the Surveillance, Epidemiology, and End Results database. The specific predictors of CSS for lung carcinoid tumors were identified and integrated to build a nomogram. Validation of the nomogram was conducted using parameters concordance index (C-index), calibration plots, decision curve analyses (DCAs), and the receiver operating characteristic (ROC) curve. Results Age at diagnosis, grade, histological type, N stage, M stage, surgery of the primary site, radiation of the primary site, and tumor size were independent prognostic factors of CSS. High discriminative accuracy of the nomogram model was shown in the training cohort (C-index = 0.873), which was also testified in the internal validation cohort (C-index = 0.861). In both cohorts, the calibration plots showed good concordance between the predicted and observed CSS at 3, 5, and 10 years. The DCA showed great potential for clinical application. The ROC curve showed superior survival predictive ability of the nomogram model (area under the curve = 0.868). Conclusions We developed a practical nomogram that provided independent predictions of CSS for patients with lung carcinoid tumors. This nomogram may have the potential to assist clinicians in prognostic evaluations or developing individualized therapies for patients with this neoplasm.

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Risk of Conversion to Arthroplasty After Hip Arthroscopy: Validation of a Published Risk Score Using an Independent, Prospectively Collected Database

The American Journal of Sports Medicine ◽

10.1177/0363546521993829 ◽

2021 ◽

pp. 036354652199382

Author(s):

Mario Hevesi ◽

Devin P. Leland ◽

Philip J. Rosinsky ◽

Ajay C. Lall ◽

Benjamin G. Domb ◽

...

Keyword(s):

Risk Score ◽

Roc Curve ◽

Hip Arthroscopy ◽

External Validation ◽

Area Under The Curve ◽

Harris Hip Score ◽

Brier Score ◽

Level Of Evidence ◽

Center Edge ◽

Modified Harris Hip Score

Background: Hip arthroscopy is rapidly advancing and increasingly commonly performed. The most common surgery after arthroscopy is total hip arthroplasty (THA), which unfortunately occurs within 2 years of arthroscopy in up to 10% of patients. Predictive models for conversion to THA, such as that proposed by Redmond et al, have potentially substantial value in perioperative counseling and decreasing early arthroscopy failures; however, these models need to be externally validated to demonstrate broad applicability. Purpose: To utilize an independent, prospectively collected database to externally validate a previously published risk calculator by determining its accuracy in predicting conversion of hip arthroscopy to THA at a minimum 2-year follow-up. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: Hip arthroscopies performed at a single center between November 2015 and March 2017 were reviewed. Patients were assessed pre- and intraoperatively for components of the THA risk score studied—namely, age, modified Harris Hip Score, lateral center-edge angle, revision procedure, femoral version, and femoral and acetabular Outerbridge scores—and followed for a minimum of 2 years. Conversion to THA was determined along with the risk score’s receiver operating characteristic (ROC) curve and Brier score calibration characteristics. Results: A total of 187 patients (43 men, 144 women, mean age, 36.0 ± 12.4 years) underwent hip arthroscopy and were followed for a mean of 2.9 ± 0.85 years (range, 2.0-5.5 years), with 13 patients (7%) converting to THA at a mean of 1.6 ± 0.9 years. Patients who converted to THA had a mean predicted arthroplasty risk of 22.6% ± 12.0%, compared with patients who remained arthroplasty-free with a predicted risk of 4.6% ± 5.3% ( P < .01). The Brier score for the calculator was 0.04 ( P = .53), which was not statistically different from ideal calibration, and the calculator demonstrated a satisfactory area under the curve of 0.894 ( P < .001). Conclusion: This external validation study supported our hypothesis in that the THA risk score described by Redmond et al was found to accurately predict which patients undergoing hip arthroscopy were at risk for converting to subsequent arthroplasty, with satisfactory discriminatory, ROC curve, and Brier score calibration characteristics. These findings are important in that they provide surgeons with validated tools to identify the patients at greatest risk for failure after hip arthroscopy and assist in perioperative counseling and decision making.

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Leap Motion Controller Video Game-Based Therapy for Upper Extremity Motor Recovery in Patients with Central Nervous System Diseases. A Systematic Review with Meta-Analysis

Sensors ◽

10.3390/s21062065 ◽

2021 ◽

Vol 21 (6) ◽

pp. 2065

Author(s):

Irene Cortés-Pérez ◽

Noelia Zagalaz-Anula ◽

Desirée Montoro-Cárdenas ◽

Rafael Lomas-Vega ◽

Esteban Obrero-Gaitán ◽

...

Keyword(s):

Systematic Review ◽

Central Nervous System ◽

Nervous System ◽

Motor Function ◽

Video Game ◽

Meta Analysis ◽

Leap Motion ◽

Motion Controller ◽

Motor Dexterity ◽

Quality Evidence

Leap Motion Controller (LMC) is a virtual reality device that can be used in the rehabilitation of central nervous system disease (CNSD) motor impairments. This review aimed to evaluate the effect of video game-based therapy with LMC on the recovery of upper extremity (UE) motor function in patients with CNSD. A systematic review with meta-analysis was performed in PubMed Medline, Web of Science, Scopus, CINAHL, and PEDro. We included five randomized controlled trials (RCTs) of patients with CNSD in which LMC was used as experimental therapy compared to conventional therapy (CT) to restore UE motor function. Pooled effects were estimated with Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). At first, in patients with stroke, LMC showed low-quality evidence of a large effect on UE mobility (SMD = 0.96; 95% CI = 0.47, 1.45). In combination with CT, LMC showed very low-quality evidence of a large effect on UE mobility (SMD = 1.34; 95% CI = 0.49, 2.19) and the UE mobility-oriented task (SMD = 1.26; 95% CI = 0.42, 2.10). Second, in patients with non-acute CNSD (cerebral palsy, multiple sclerosis, and Parkinson’s disease), LMC showed low-quality evidence of a medium effect on grip strength (GS) (SMD = 0.47; 95% CI = 0.03, 0.90) and on gross motor dexterity (GMD) (SMD = 0.73; 95% CI = 0.28, 1.17) in the most affected UE. In combination with CT, LMC showed very low-quality evidence of a high effect in the most affected UE on GMD (SMD = 0.80; 95% CI = 0.06, 1.15) and fine motor dexterity (FMD) (SMD = 0.82; 95% CI = 0.07, 1.57). In stroke, LMC improved UE mobility and UE mobility-oriented tasks, and in non-acute CNSD, LMC improved the GS and GMD of the most affected UE and FMD when it was used with CT.

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Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

Entropy ◽

10.3390/e23020255 ◽

2021 ◽

Vol 23 (2) ◽

pp. 255

Author(s):

Mario Gonzalez-Lee ◽

Hector Vazquez-Leal ◽

Luis J. Morales-Mendoza ◽

Mariko Nakano-Miyatake ◽

Hector Perez-Meana ◽

...

Keyword(s):

Fractional Calculus ◽

Roc Curve ◽

Gaussian Noise ◽

False Positive ◽

Operating Characteristic ◽

Image Watermarking ◽

Area Under The Curve ◽

Statistical Assessment ◽

Watermarking Scheme ◽

Fractional Equation

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.

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Abstract T MP108: A Concentration Response Relationship Between the Active Metabolite of Clopidogrel and its Antiplatelet Activity

Stroke ◽

10.1161/str.45.suppl_1.tmp108 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Stephen Wolff ◽

Francis Gengo ◽

Erica S Westphal ◽

Michelle Rainka ◽

Vernice Bates

Keyword(s):

Platelet Aggregation ◽

Roc Curve ◽

Active Metabolite ◽

Genetic Difference ◽

Active Form ◽

Area Under The Curve ◽

Blood Platelet ◽

Threshold Concentration ◽

Disease States ◽

Dependent Relationship

Background: Variability in antiplatelet response to clopidogrel is reported to be due, in part, to the reduced ability to metabolize clopidogrel to its active form. This can be a result of a genetic difference in metabolizer status or to drug interactions which can cause inhibition of either the CYP2C19 or CYP3A4 P450 isoenzymes. Although up to this point it has remained unclear whether there is a concentration dependent relationship between clopidogrel's active thiol metabolite and its antiplatelet effects and whether there is a threshold concentration of the active metabolite (AM) needed to produce an adequate antiplatelet effect, this 3-arm, complete crossover study demonstrates a statistical relationship between AM concentrations and antiplatelet response. Methods: Fourteen healthy male volunteers took clopidogrel doses of 25 mg, 50 mg, and 75 mg. Participants were excluded for tobacco, illicit substance, and alcohol use. AM concentrations were measured using liquid chromatography-mass spectrometry over a 4 hour period and an area under the curve (AUC) was calculated. Results: The median baseline whole blood platelet aggregation value was 8 Ω (IQR=7-8.5 Ω) and responsiveness to clopidogrel was defined as <6 Ω and a ≥60% decrease from baseline. Using a receiver operating characteristic (ROC) curve the optimal AUC 0-4 was found to be 784ng*min/mL. Sensitivity was 92.0% (95% CI: 48.0-100.0%) and specificity was 71.4% (95% CI: 46.4-85.7%). Area under the ROC curve was 84.0% (95% CI: 73.0-95.0%, p=1.867e-5) demonstrating statistical validity of the estimates of the AM threshold concentration needed to inhibit platelet aggregation. A Bayesian breakpoint analysis found the optimal threshold AUC to be in a range from 732-882 ng*min/mL. Conclusions: These findings could make it possible for clinicians to immediately tailor antiplatelet therapy to individual patients by measuring AM levels after the first dose of clopidogrel, conceivably preventing a secondary event at a time when risk is the highest. Additionally, research is ongoing to explore whether disease states commonly seen in stroke patients, such as diabetes, change the amount of the AM produced or whether they may actually result in a shift of the concentration response curve.

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