scholarly journals MEASLES IN LARUT, MATANG AND SELAMA: ANALYSIS AND EVALUATION OF CLINICAL CASE DEFINITIONS FOR 2015-2019

2020 ◽  
Vol 20 (1) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Afiq Malek ◽  
Asnita Rozali ◽  
Norsihimah Wahid
Keyword(s):  
Positive Predictive Value ◽  
Incidence Rate ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Case ◽  
Case Definition ◽  
Case Definitions ◽  
Cross Sectional ◽  
Sensitivity Specificity ◽  
Clinical Case Definition

An accurate system of identifying measles cases is critical for the measles surveillance system. The objectives were: 1) To determine the incidence rate of measles in Larut, Matang and Selama district in Perak from 2015 to 2019 2) To evaluate the measles clinical case definition by comparing the performance of the measles clinical case definition in predicting laboratory-confirmed measles case. A cross-sectional analysis was carried out looking at all suspected and laboratory-confirmed measles cases in Larut, Matang and Selama District registered on the online measles surveillance reporting system between 2015 to 2019. The sensitivity, specificity, positive predictive value and negative predictive value of the clinical case definition as confirmed by the laboratory result were calculated. The incidence rate for suspected measles showed an increasing trend from 3.96 per 100,000 population in 2015 to 28.82 per 100,000 population in 2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. The sensitivity of the clinical case definition in confirming measles was 86.67% (95% CI: 69.28%, 96.24%) , specificity 47.52% (95% CI: 41.56%, 53.52%), positive predictive value 14.95% (95% CI 12.81%, 17.36%)  and negative predictive value 97.10% (93.03%, 98.83%). Measles incidence is increasing in trend. The clinical case definition is an effective tool to rule out measles in cases that failed to meet the criteria due to the high negative predictive value of the definition. However, for cases that meet the clinical case definition, laboratory confirmation or epidemiological link to a confirmed case is needed.

scholarly journals Interleukin 21 as a diagnostic marker of rheumatoid arthritis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Sensitivity Specificity

To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.

scholarly journals Evaluation of the Accuracy of Human Kallikrein6, Cancer Antigen125, and Human Epididymis 4 in Predicting Ovarian Cancer

2017 ◽  
pp. 110
Author(s):  
Yongki Wenas ◽  
Ketut Suwiyoga ◽  
I Nyoman H Sanjaya
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cancer Antigen 125 ◽  
Chi Square ◽  
Cross Sectional ◽  
Human Epididymis ◽  
Sensitivity Specificity ◽  
Histopathology Examination

Objective: To evaluate the accuracy of hK6, HE4, and CA125 in predicting the malignancy of ovarian mass. Methods: The design of this study was cross-sectional. This study was conducted in the Obstetrics and Gynecology Clinic, Sanglah Hospital, Denpasar, between the period of September 2014 and August 2016. Samples were all patients with ovarian tumors who underwent surgery at Sanglah Hospital, Denpasar. Data analysis was performed using McNemar and chi square test in SPSS for windows version 17.0. Results: 22 samples were obtained. P > 0.05 value of age and parity variables indicated no differences between the two groups. There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of hK6 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of HE4 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy difference (sensitivity, specificity, positive predictive value, negative predictive value) of CA125 compared to histopathology examination in diagnosing ovarian cancer (p = 0.687). Conclusion: There was no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) found between hK6, CA125, HE4 compared to histopathology examination in predicting ovarian cancer. [Indones J Obstet Gynecol 2017; 5-2: 110-113] Keywords: cancer antigen 125, human epididymis-4, human kallikrein 6, ovarian cancer

Case Definitions for Paediatric AIDS: The Zambian Experience

1993 ◽  
Vol 4 (2) ◽  
pp. 83-85 ◽  
Author(s):  
C Chintu ◽  
A Malek ◽  
M Nyumbu ◽  
C Luo ◽  
J Masona ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Clinical Case ◽  
Case Definition ◽  
World Health ◽  
Who Criteria ◽  
Number Of Patients ◽  
Definition Of ◽  
Hiv 1 ◽  
Clinical Case Definition

For the purpose of surveillance of the acquired immunodeficiency syndrome (AIDS) in developing countries, the World Health Organization (WHO) has recommended criteria for the clinical case definition of AIDS in adults and children. In a preliminary examination of children in Zambia a number of patients with obvious AIDS did not fit the published WHO case definition for paediatric AIDS. Based on this the Zambia National AIDS Surveillance Committee designed local criteria for the clinical case definition of paediatric AIDS. We compared the Zambian criteria with the WHO criteria for the diagnosis of paediatric AIDS by studying 134 consecutively admitted children to one of the paediatric wards at the University Teaching Hospital in Lusaka. Twenty-nine of the patients were HIV-1 seropositive and 105 were HIV-1 seronegative. Among the 29 HIV-seropositive patients, the Zambian criteria identified 23, and the WHO criteria identified 20 children as having AIDS. The 105 HIV-seronegative children were classified as having AIDS in 9 cases by the Zambian criteria and in 38 cases by the WHO criteria. These results give the Zambian criteria for the diagnosis of AIDS a sensitivity of 79.3%, a specificity of 91.4% and a positive predictive value of 86.8% compared to a sensitivity of 69%, specificity of 64% and a positive predictive value of 38% for the WHO criteria. The current WHO criteria are inadequate for the diagnosis of paediatric AIDS. The need to refine the WHO criteria for the diagnosis of paediatric AIDS is discussed.

scholarly journals Correlation between ultrasonographic and histopathological findings of hysterectomy specimen in patients with abnormal uterine bleeding

2020 ◽  
Vol 9 (10) ◽  
pp. 4123
Author(s):  
Kaushik Mahajan ◽  
R. K. Praneshwari Devi ◽  
Ajitkumar Singh ◽  
Dipenty Lairenjam ◽  
Leimapokpam Roshan Singh ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Uterine Bleeding ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Common Diagnosis ◽  
Sensitivity Specificity

Background: AUB is a common and debilitating condition and it is one of the main gynaecological reasons for hysterectomy. Ultrasonography can be as good as histopathology (HPE) in the diagnosis of abnormal uterine bleeding. Hence, our study was conducted to validate the ultrasonographic findings with HPE findings in diagnosis of AUB.Methods: A hospital based cross-sectional analytical study was conducted among 86 patients with abnormal uterine bleeding in the department of Obstetrics and Gynaecology in collaboration with department of Pathology, RIMS, Imphal from September 2017 to March 2019. The clinical history and socio demographic profile were collected using a pre-designed proforma. General physical examination, pelvic examination and ultrasonagraphy was carried out and the hysterectomy specimens were subjected to histopathological examination.Results: Fibromyoma was diagnosed by ultrasound in 62.8% of the patients and it was the common diagnosis in this study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing leiomyoma was 92.9%, 93.3%, 96.3%, 87.5% and 84.9% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing adenomyosis was 53.8%, 98.6%, 87.5%, 92.3% and 62.3% respectively.Conclusions: The study provides an evidence that ultrasonography has good diagnostic accuracy as histopathology in the diagnosis of fibroid in patients with abnormal uterine bleeding. However, as with all the diagnostic procedures, the utility of ultrasound in the diagnosis of adenomyosis is questionable, since it has a low sensitivity amidst good specificity.

scholarly journals NILAI DIAGNOSTIK MALARIA ANTIGEN CASSETTE PENYAKIT MALARIA

2018 ◽  
Vol 16 (1) ◽  
pp. 7
Author(s):  
Binawati . ◽  
Prihatini . ◽  
M.Y Probohoesodo
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Malaria Antigen ◽  
Peripheral Areas ◽  
Sensitivity Specificity ◽  
Death Cases

Malaria is an endemic disease in many countries. In 103 endemic countries with around 2.5 billion population, 1−3 million death cases were reported every year. Clinical criteria and blood smear established the diagnosis of malaria. ICT (imuno chromatographytest) is needed in peripheral areas where there are no experienced laboratory technicians. The procedure is simple, practical, easy, aswell as quicker than the conventional method, and no experienced technicians are needed this ICT advantages. The aim of this study isto know the diagnostic value of Malaria Antigen Cassette with microscopic examination as the gold standard examination of malaria.This research used observational cross-sectional method This study was done in Nusa Tenggara Barat during May−June 2008. Bloodsamples were taken by finger prick in patients with Malaria symptoms: fever, chill and sweating, followed by examining the blood smearby Malaria Antigen Cassette from Focus Diagnostic. The diagnostic value was then evaluated by calculating the sensitivity, specificity,positive predictive value as well as the negative predictive value. The diagnostic value of Malaria Antigen Cassette in patients withmalaria falciparum was found as follows: sensitivity 95.2%, specificity 100%, positive predictive value 100%, and negative predictivevalue 97.6%. The diagnostic value of Malaria Antigen Cassette in patients other types than malaria falciparum was as follows: sensitivity94.8%, specificity 100%, positive predictive value 100%, and negative predictive value 95.3%. The diagnostic value of Malaria AntigenCassette was very high in diagnosing malaria falciparum compared to other types than malaria falciparum.

Positive predictive value of the UK clinical case definition for H1N1/09 (‘swine’) influenza

2010 ◽  
Vol 60 (5) ◽  
pp. 405-407 ◽  
Author(s):  
T. Bicanic ◽  
A.W. Solomon ◽  
N. Karunaharan ◽  
F. Chua ◽  
C. Pope ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Clinical Case ◽  
Swine Influenza ◽  
Case Definition ◽  
The Uk ◽  
Clinical Case Definition

scholarly journals Comparing Diagnostic Value of Renal Parenchymal Resistive Index And Cortical Echogenicity in Chronic Kidney Disease Patients

2020 ◽  
Vol 4 (3) ◽  
pp. 194
Author(s):  
Dria Anggraeny Sutikno ◽  
Nurdopo Baskoro
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Renal Cortex ◽  
Resistive Index ◽  
Renal Ultrasound ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background: Chronic kidney disease (CKD) is a clinically impaired kidney degradation syndrome, which commonly is diagnosed based on glomerulus filtration rate (GFR). Renal parenchymal resistive index and the renal cortex echogenicity are ultrasound parameters that have been reported correlate with GFR values. This study aims to determine the sensitivity, specificity, positive predictive value, and negative predictive value between renal intra-parenchymal resistive index and renal cortical echogenicitybased on GFR in CKD patients.Materials and Methods: This study is a cross sectional design. A renal ultrasound examination was performed to forty one CKD patients to assess the resistive index of the renal intra-parenchymal artery and the echogenicityof the renal cortex. The creatinine serum levels were obtained from the patients, as the gold standard of CKD diagnosis. Statistical data processing uses diagnostic test and Inter class Correlation Coefficients (ICC).Results: The sensitivity, specificity, positive predictive value, and negative predictive value of renal intraparenchymal resistive indexes were 23%, 79%, 33%, and 69% respectively. Sensitivity, specificity, positive predictive value, and negative predictive value between renal cortex echogenicity were 23%, 96%, 75%, and 73% respectively. The ICC analysisreported a Single Rater value of 0.1538 and Average of Raters 0.3528.Conclusion: Renal intra-parenchymal resistive artery was more specific than renal cortex echogenicity for diagnosing patients with chronic kidney disease.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 194-199

scholarly journals Comparison of PCR, Culture, and Direct Fluorescent-Antibody Testing for Detection of Bordetella pertussis

1999 ◽  
Vol 37 (9) ◽  
pp. 2872-2876 ◽  
Author(s):  
Mike J. Loeffelholz ◽  
Curt J. Thompson ◽  
Karla S. Long ◽  
Mary J. R. Gilchrist
Keyword(s):  
Positive Predictive Value ◽  
Bordetella Pertussis ◽  
Predictive Value ◽  
Clinical Case ◽  
Fluorescent Antibody ◽  
Case Definition ◽  
Specific Method ◽  
Antibody Testing ◽  
Direct Fluorescent Antibody ◽  
Clinical Case Definition

We prospectively compared the performance of culture, direct fluorescent-antibody testing (DFA), and an in-house-developed PCR test targeting the repeated insertion sequence IS481 for the detection of Bordetella pertussis in nasopharyngeal swab specimens. We tested 319 consecutive paired specimens on which all three tests were performed. A total of 59 specimens were positive by one or more tests. Of these, 5 were positive by all three tests, 2 were positive by culture and PCR, 16 were positive by PCR and DFA, 28 were positive by PCR only, and 8 were positive by DFA only. Any specimen positive by culture was considered to be a true positive, as were specimens positive by both PCR and DFA. Specimens positive only by PCR or DFA were considered discrepant, and their status was resolved by review of patient histories. Patients with symptoms meeting the Centers for Disease Control and Prevention clinical case definition for pertussis and who had a specimen positive by PCR or DFA were considered to have true B. pertussis infections. Of the 28 patients positive by PCR only, 20 met the clinical case definition for pertussis, while 3 of the 8 patients positive by DFA only met the clinical case definition. After resolution of the status of discrepant specimens, the sensitivity, specificity, positive predictive value, and negative predictive value were 15.2, 100, 100, and 87.5%, respectively, for culture; 93.5, 97.1, 84.3, and 98.9%, respectively, for PCR; and 52.2, 98.2, 82.8, and 92.4%, respectively, for DFA. The actual positive predictive value of PCR was probably greater, as several PCR-positive patients who did not meet the clinical case definition had symptoms consistent with typical or atypical pertussis. PCR is a sensitive and specific method for the detection of B. pertussis.

Sequential Screening with Cytology and Colposcopy in Detection of Cervical Neoplasia

2009 ◽  
Vol 1 (3) ◽  
pp. 45-48 ◽  
Author(s):  
BR Desai ◽  
PR Malur ◽  
Dalal Anita ◽  
Durdi Geeta ◽  
Sherigar Bhavana ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Sequential Screening ◽  
Sensitivity Specificity

ABSTRACT Background Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008. Material and methods A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed. Statistical analysis Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard, keeping LSIL as a disease threshold for test positivity. Results Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%. Conclusion Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

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