SAMe-TT₂R₂ Score for Prediction of Anticoagulation Control in Thai Patients with Non-Valvular Atrial Fibrillation

2021 ◽  
Vol 104 (6) ◽  
pp. 959-963
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
International Normalized Ratio ◽  
Control Objective ◽  
Anticoagulation Control ◽  
Sensitivity Specificity

Background: The quality of anticoagulation control is an important determination of thromboembolism and bleeding in patients with non-valvular atrial fibrillation. Previous trials have shown that SAMe-TT₂R₂ score could be used for prediction of anticoagulation control. Objective: To predict labile international normalized ratio (INR) by SAMe-TT₂R₂ score in Thai patients with non-valvular atrial fibrillation. Materials and Methods: The author retrospectively studied patients with non-valvularatrial fibrillation at Pranangklao Hospital between January 2019 and October 2020. Results: One hundred thirty patients were enrolled. The average ages of the patients were 67.5±10.2 years. The average SAMe-TT₂R₂ scores were 3.2±0.8 and the average CHA₂DS₂-VASc score was 3.3±1.4. Most patients had hypertension and dyslipidemia. Most patients were prescribed betablockers. Most patients had time in therapeutic range (TTR) lower than 65. The present study has shown that patients with SAMe-TT₂R₂ score of 3 or more has also had high proportion of labile INR with statical significance. The sensitivity, specificity, positive predictive value, and negative predictive value of different cut-offs of SAMe-TT₂R₂ score greater than 2 and SAMe-TT₂R₂ score when excluding race showed improvement of the sensitivity and specificity for prediction of labile INR. Conclusion: Labile INR was predicted by SAMe-TT₂R₂ score and the sensitivity and specificity increased in SAMe-TT₂R₂ score when excluding race. Keywords: SAMe-TT₂R₂ score; Non-valvular atrial fibrillation; Anticoagulation control

scholarly journals Utility of Thrombin Time in Management of Patients with Green Pit Vipers Bite

2020 ◽  
Vol 8 ◽  
pp. 205031212096646
Author(s):  
Achara Tongpoo ◽  
Pimjai Niparuck ◽  
Charuwan Sriapha ◽  
Winai Wananukul ◽  
Satariya Trakulsrichai
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Fibrinogen Level ◽  
Characteristic Curve ◽  
International Normalized Ratio ◽  
Thrombin Time ◽  
Coagulation Tests ◽  
Sensitivity Specificity ◽  
Gold Standards

Objectives: GGreen pit vipers (GPV) envenomation causes consumptive coagulopathy mainly by thrombin-like enzymes. Fibrinogen levels are generally investigated to help evaluate systemic envenomation. However, tests of fibrinogen levels may not be available in every hospital. This study aimed to determine the sensitivity, specificity and accuracy for a range of various coagulation tests (20 minute whole blood clotting test (20WBCT), prothrombin time, international normalized ratio and thrombin time (TT)), comparing to the two gold standards performed in patients with GPV bite. Methods: This was the pilot study which we retrospectively reviewed fibrinogen level results including the hospital records of 24 GPV ( Trimeresurus albolabris or macrops) bite patients visiting Ramathibodi Hospital, Thailand during 2013–2017 with 65 results of fibrinogen levels. The fibrinogen levels <164 and <100 mg/dL were used as the standard cut-off points or gold standards as the abnormal low and critical levels, respectively. Results: Most were male. All had local effects. For fibrinogen levels <164 and <100 mg/dL, prolonged TT had the highest sensitivity of 57.1% and 82.4%; the negative predictive value of 74.5% and 93.6%; the accuracy of 81.0% and 92.1%; and the area under a receiver operating characteristic curve of 0.762 and 0.873, respectively. For fibrinogen levels <164, unclotted 20WBCT and prolonged TT had the highest specificity and positive predictive value of 100% all. For fibrinogen levels <100, unclotted 20WBCT had the highest specificity and positive predictive value of 100% both, while prolonged TT had the specificity and positive predictive value of 95.7% and 87.5%, respectively. One patient developed isolated thrombocytopenia without hypofibrinogenemia and coagulopathy. Conclusions: Among four coagulation tests, TT was the most sensitive and accurate test to indicate hypofibrinogenemia in GPV bite patients. In case of unavailable fibrinogen levels thrombin time might be investigated to help evaluate patients’ fibrinogen status. Isolated thrombocytopenia could occur in GPV envenomation.

P4765Men who live alone have poor anticoagulation control: results from Danish registries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A N Bonde ◽  
J Bjerre ◽  
M Proietti ◽  
G Gislason ◽  
G Y H Lip ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K Antagonists ◽  
International Normalized Ratio ◽  
Living Alone ◽  
Efficacy And Safety ◽  
Men And Women ◽  
Anticoagulation Control ◽  
Cohabitation Status ◽  
Multivariable Adjustment

Abstract Background Efficacy and safety of vitamin K antagonists (VKAs) depend on quality of anticoagulation control, usually measured as time in therapeutic range (TTR). Factors that predict low TTR on VKAs could be used to identify patients who might benefit from interventions, or who would be better treated with a non-VKA oral anticoagulant (NOAC). Patients living alone may have difficulties in taking their medications, managing their diets, or coming to clinic for monitoring. Purpose To assess influence of cohabitation status on TTR with VKA among men and women. Methods We identified all Danish patients with atrial fibrillation (AF) who initiated VKA between 1997 and 2012, and studied patients who had 6 months of continuous VKA use and international normalized ratio (INR) monitoring. Patients were divided according to sex and whether they lived alone or with others. We calculated TTR using the Rosendaal method, and INR variability using Fihns method. We used a linear regression model to test for associations between TTR and covariates, and adjusted for age, income, medications and comorbidities. Results We identified 4,772 AF patients with 6 months of continuous VKA use and INR monitoring. 713 (15%) were men living alone, 1,073 (23%) were women living alone, 2,164 (45%) were men not living alone and 822 (17%) were women not living alone. INR was measured a median of 11 (interquartile range 8–15) times during the 180 days of VKA use, but men who lived alone had 0.6 (95% confidence interval (CI): 0.2 to 1.2) fewer INR measurements during the period. Median TTR was lowest among men living alone (57.2%), followed by women living alone (58.8%), women not living alone (61.0%) and men not living alone (62.5%). After multivariable adjustment, men who lived alone had a 3.6% (CI −5.6 to −1.6) lower TTR compared with men not living alone, but women who lived alone did not have significantly lower TTR (P=0.80) compared with women not living alone. Living alone had significantly greater effect on TTR among men than among women (interaction P=0.02). Men living alone also had higher adjusted INR variability (0.2, CI 0.0 to 0.4) compared with men not living alone. Conclusion Living alone was significantly related to low quality of anticoagulation control among men, but not among women. Acknowledgement/Funding this study was funded by an unrestricted grant from the Capital Region of Denmark, Foundation for Health Research

P3474Relationship between international normalized ratio variability, quality of anticoagulation control and outcomes in patients with atrial fibrillation: an AFFIRM post-hoc analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Proietti ◽  
G F Romiti ◽  
B Olshansky ◽  
G Y H Lip
Keyword(s):  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Standard Deviation ◽  
Major Bleeding ◽  
International Normalized Ratio ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Anticoagulation Control

Abstract Introduction Quality of anticoagulation control is essential to ensure better clinical outcomes in patients with atrial fibrillation (AF). Time in therapeutic range (TTR) is recommended as a measure of the quality of anticoagulation control. The International normalized ratio (INR) variability has been suggested as an alternative index, even though large independent validations for this index are still lacking. Purpose To provide validation of clinical usefulness of INR variability as a measure of the quality of anticoagulation control in a large cohort of AF patients. Methods Data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial were analysed. INR variability was defined as the standard deviation (SD) of mean INR values [INR-SD] recorded throughout the follow-up observation for each patient. All patients with available INR values were included in the analysis. Stroke, major bleeding, cardiovascular (CV) death and all-cause death were study outcomes. Results Among the original 4060 patients, a total of 3185 (78.4%) were available for analysis. Mean (SD) INR-SD was 0.58 (0.25). According to INR-SD patients were categorized into four quartiles. Mean (SD) CHA2DS2-VASc score was increased (p=0.040), with no difference in proportions of CHA2DS2-VASc ≥2 (p=0.582) between the subgroups. A significant inverse correlation was found between INR-SD and TTR (Spearman's Rho: −0.536, p<0.001). Continuous INR-SD, after multiple adjustments, was inversely associated with TTR (standardized beta: −0.451, p<0.001) and directly associated with SAMe-TT2R2score (standardized beta: 0.084, p<0.001). A fully adjusted Cox multivariate regression analysis found that INR-SD was directly associated with increased risk of stroke, major bleeding and all-cause death (Table). An INR-SD ≥0.85 was directly associated with all the study outcomes, on multivariate analysis (Table). Cox Regression Analysis INR-SD INR-SD ≥0.85 HR (95% CI) HR (95%) Stroke 2.52 (1.34–4.67) 1.62 (1.00–2.63) Major Bleeding 2.43 (1.49–3.96) 1.61 (1.10–2.36) CV Death 1.50 (0.87–2.59) 1.54 (1.07–2.24) All-Cause Death 1.79 (1.21–2.66) 1.55 (1.17–2.05) CI = Confidence Interval; CV = Cardiovascular; HR = Hazard Ratio; INR-SD = International Normalized Ratio Standard Deviation. Conclusions INR variability, expressed as INR-SD, was significantly correlated and associated with TTR. Both continuous INR-SD and INR-SD ≥0.85 were significantly associated with a higher risk of all study adverse outcomes. Acknowledgement/Funding None

scholarly journals Monofrequency electrical impedance mammography (EIM) diagnostic system in breast cancer screening

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Blanca Murillo-Ortiz ◽  
Abraham Hernández-Ramírez ◽  
Talia Rivera-Villanueva ◽  
David Suárez-García ◽  
Mario Murguía-Pérez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Electrical Impedance ◽  
Screening Method ◽  
Future Research ◽  
Predictive Values ◽  
Sensitivity Specificity

Abstract Background Some evidence has shown that malignant breast tumours have lower electrical impedance than surrounding normal tissues. Electrical impedance could be used as an indicator for breast cancer detection. The purpose of our study was to analyse the sensitivity and specificity of electrical impedance mammography (EIM) and its implementation for the differential diagnosis of pathological lesions of the breast, either alone or in combination with mammography/ultrasound, in 1200 women between 25 and 70 years old. Methods This study is a prospective, cross-sectional epidemiological observational study of serial screening. The women were invited to participate and signed a consent letter. Impedance imaging of the mammary gland was evaluated with the computerized mammography equipment of MEIK electroimpedance v.5.6. (0.5 mA, 50 kHz), developed and manufactured by PKF SIM-Technika®. The successful identification of breast cancer along with the sensitivity, specificity, and positive and negative predictive values of EIM were determined as follows: % sensitivity; % specificity; % positive predictive value (PPV); and % negative predictive value (NPV). Results EIM had a sensitivity of 85% and a specificity of 96%; the positive predictive value was 12%, and the negative predictive value was 99%. Seven cases were biopsy confirmed cancers. Significant correlations between the electrical conductivity index and body mass index (BMI) (p = 0.04) and patient age were observed (p = 0.01). We also observed that the average conductivity distribution increased according to age group (p = 0.001). We used the chi-squared test to assess the interactions between percent density and BMI (normal < 25 kg/m2 (n = 310), overweight 25–29.9 kg/m2 (n = 418) and obese ≥30 (n = 437)) (p <  0.05). The patients with a diagnosis of mammary carcinoma had a BMI of 35.51 kg/m2. Conclusions Our results demonstrate that the use of monofrequency electrical impedance mammography (EIM) in the detection of breast cancer had a sensitivity and specificity of 85 and 96%, respectively. These findings may support future research in the early detection of breast cancer. EIM is a non-radiation method that may also be used as a screening method for young women with dense breasts and a high risk of developing breast cancer.

scholarly journals Comparison of High Resolution Computed Tomography with Intraoperative Findings in Patient with Chronic Suppurative Otitis Media, NAMS, Bir Hospital, Kathmandu, Nepal

2019 ◽  
Vol 2 (2) ◽  
pp. 89-97
Author(s):  
Yagya Bahadur Rokaya ◽  
Prakash Shahi
Keyword(s):  
Soft Tissue ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Predictive Value ◽  
Soft Tissue Mass ◽  
Tissue Mass ◽  
Suppurative Otitis Media ◽  
Low Sensitivity ◽  
Sensitivity Specificity

 Introduction: Chronic suppurative otitis media (CSOM) is an important cause of middle ear disease and its complications challenge both otologist and radiologist. The major benefit of HRCT is an excellent visualization of the osseous structure by means of special algorithms. This study compares the HRCT with intraoperative findings in patients with CSOM. Methods: This is an observational descriptive study conducted at NAMS Bir Hospital. Total of 30 patients, referred for HRCT from the department of ENT were studied. Comparison of HRCT findings was done with intraoperative findings regarding the status of EAC, ossicular chain, bony plate, inner ear structure and facing nerve canal was done, considering intraoperative findings as the gold standard. Results: Out of 30 patients, 16 patients had CSOM with cholesteatoma and 14 patients had CSOM without cholesteatoma. HRCT presented sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 87.5%, 85.7%, 87.5%, 85.7% and 86.7% respectively in diagnosing CSOM with cholesteatoma. HRCT presented sensitivity and specificity of 85.7% and 87.5% in identification of malleus erosion, sensitivity and specificity of 86.7% and 80%, in the identification of incus erosion. HRCT showed the specificity of 85% with relatively low sensitivity of 70% in identification of erosion of stapes. HRCT showed a sensitivity of 100% and specificity of 85.7%. HRCT presented sensitivity and specificity of 83.3% and 95.8% in diagnosing tegmen tympanum erosion. HRCT showed the highest sensitivity (100%) and specificity (100%) in diagnosing erosion of sigmoid sinus plate and mastoid cortex. HRCT showed relatively low sensitivity of 66.7% and 75% in diagnosing erosion of LSCC and facial canal respectively. HRCT detected soft tissue mass in the middle ear/mastoid in all 30 patients of CSOM. Hence, the sensitivity, specificity, positive predictive value and negative predictive value of HRCT for soft tissue mass in the middle ear and mastoid, all were 100%. Conclusion: The HRCT has a valuable role in preoperative evaluation of a case of CSOM. It has high sensitivity in diagnosing CSOM with cholesteatoma. However, HRCT has relatively low sensitivity for LSCC and facial nerve canal erosion.

A new index to predict quality of anticoagulation control in patients on vitamin K antagonists: the DAFNE score

2020 ◽  
Author(s):  
Vivencio Barrios ◽  
Carlos Escobar ◽  
Luis Prieto ◽  
Jose Polo ◽  
Javier Muñiz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Clinical Score ◽  
International Normalized Ratio ◽  
Concomitant Treatment ◽  
Anticoagulation Control

Aim: To derive a new clinical score to improve the prediction of those at risk of poor International Normalized Ratio control among patients with atrial fibrillation taking vitamin K antagonists. Materials & methods: The score was calculated using PAULA database and validated in the FANTASIIA population. Results: The DAFNE score (cardiovascular Disease, concomitant treatment with Amiodarone, Food/dietary transgression and taking ≥7 pills daily, fEemale sex) score was related to a higher probability of poor International Normalized Ratio control. C-indexes were 0.611 and 0.576 (De Long test, p = 0.007) for the DAFNE and SAMe-TT2R2 scores, respectively. Conclusion: The DAFNE score is a new clinical score which may potentially help determine those patients with atrial fibrillation who are at high risk of poor anticoagulation control with vitamin K antagonists.

Evaluation of Wondfo Chlamydia Trachomatis Rapid Diagnostic Cassette Based on Nano-Gold Immunochromatography Gssay（GICA）

2011 ◽  
Vol 236-238 ◽  
pp. 2436-2440
Author(s):  
Yun Ping Peng ◽  
Ji Hua Wang ◽  
Wen Mei Li ◽  
Jun Lin Wu ◽  
Shu Juan Yu
Keyword(s):  
Chlamydia Trachomatis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Surveillance Data ◽  
Blind Detection ◽  
Test Results ◽  
Nano Gold ◽  
Sensitivity Specificity

This paper explains and demonstrates how to evaluate the sensitivity and specificity of wondfo chlamydia trachomatis rapid diagnostic cassette with GICA for detection of chlamydia trachomatis. 1026 genital specimens were collected from 630 females and 396 males.Two cassettes of wondfo and ClearView were used for the detection of Chlamydia trachomatis samples with blind detection simultaneously, inconsistent results by DFA. Sensitivity, specificity, positive predictive value and negative predictive value of wondfo cassette were analyzed. Out of 1026 samples detected, 83 were positive by both of wondfo and ClearView and 13 showed different results by wondfo and ClearView. Out of the 13 samples, the DFA confirmed 9 were positive. Therefore, 92 samples were truly positive and 934 were truly negative. The sensitivity, specificity, positive predictive value and negative predictive value of wondfo were 96.74% ,99.6% , 95.7% , 99.68%, respectively. The consistent rates of test results of the chlamydia trachomatis rapid diagnostic cassette , wondfo and ClearView, both were the same 98.64%. Of the three standard strains and two clinical strains of dilution test results showed that the sensitivity of wondfo slightly ClearView.The sensitivity and specificity of wondfo for the detection of Chlamydia trachomatis have the accept tability for clinical diagnostic and surveillance data.

Erratum to Palareti et al. “The SAME-TT2R2 score predicts the quality of anticoagulation control in patients with acute VTE. A real-life inception cohort study” (Thromb Haemost 2016; 115: 1101-1108)

2016 ◽  
Vol 116 (08) ◽  
pp. 396-396
Keyword(s):  
Cohort Study ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Real Life ◽  
Inception Cohort ◽  
C Statistic ◽  
Anticoagulation Control

In the Original Article “The SAME-TT2R2 score predicts the quality of anticoagulation control in patients with acute VTE. A real-life inception cohort study” (Thromb Haemost 2016; 115: 1101-1108) by Palareti et al. the last sentence at the end of the second paragraph on page 1105 of the article is wrong and should read as follows: “Regarding the ability of the score ≥2 to predict a TTR <65%, the C statistic was 0.52 (95% CI 0.48–0.55; p = 0.35); the sensitivity was 74% (70.4–77.8), specificity 29% (25.3–33.2), negative predictive value 52% (95% CI 45.8–57.7) and positive predictive value 53% (40.0–56.2).” The authors apologise for this error.

An investigation of new toxicity test method performance in validation studies: 3. sensitivity and specificity are not independent of prevalence or distribution of toxicity

2002 ◽  
Vol 21 (6) ◽  
pp. 325-334 ◽  
Author(s):  
L H Bruner ◽  
G J Carr ◽  
J W Harbell ◽  
R D Curren
Keyword(s):  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Test Performance ◽  
Predictive Value ◽  
Validation Studies ◽  
Toxicity Test ◽  
Test Method ◽  
Toxic Substances ◽  
Method Performance ◽  
Sensitivity Specificity

Often, the only measures of toxicity test performance provided in validation studies are the contingent probability statistics (CPS) sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity and specificity are generally used in preference to NPV and PPV since NPV and PPV are assumed to vary with changes in prevalence while sensitivity and specificity are assumed to be independent of changes in prevalence. The purpose of the studies reported here was to test whether or not sensitivity and specificity are actually independent of changes in prevalence. Results derived from these studies indicate that sensitivity and specificity vary significantly depending on the prevalence of toxic substances in the set of chemicals being tested. This means sensitivity and specificity should not always be considered constant indicators of toxicity test performance.

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