Fukuda Stepping Test: Sensitivity and Specificity

Background: A vestibulospinal test known as the Fukuda stepping test (FST) has been suggested to be a measure of asymmetrical labyrinthine function. However, an extensive review of the performance of this test to identify a peripheral vestibular lesion has not been reported. Purpose: The purpose of this study was to evaluate the sensitivity and specificity of the standard FST and a head shaking variation for identification of a peripheral vestibular system lesion. Research Design: In this retrospective review, we compared performance on the FST with and without a head shaking component to electronystagmography (ENG) caloric irrigation unilateral weakness results. Study Sample: We studied these factors in 736 chronic dizzy patients. Results: Receiving operating characteristics (ROC) analysis and area under the curve (AUC) indicated no significant benefit to performance from the head shaking variation compared to the standard FST in identifying labyrinthine weakness as classified by caloric unilateral weakness results. Conclusions: These findings suggest that the FST with and without head shake component is not a reliable screening tool for peripheral vestibular asymmetry in chronic dizzy patients; however, future research may hold promise for the FST as a tool for patients with acute unilateral disorders.

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The Edinburgh cognitive and behavioral amyotrophic lateral sclerosis screen (ECAS): sensitivity in differentiating between ALS and Alzheimer’s disease in a Greek population

10.31234/osf.io/vghct ◽

2021 ◽

Author(s):

Panagiotis Kourtesis ◽

Foteini Christidi ◽

Eleni Margioti ◽

Christina Demenega ◽

Mihail Rentzos ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Convergent Validity ◽

Normative Data ◽

Roc Analysis ◽

Area Under The Curve ◽

High Sensitivity ◽

Operating Characteristics ◽

Als Patients ◽

Lateral Sclerosis ◽

Better Than

Objectives: (1) Adapt the ECAS into Greek, validate it in ALS patients and compare with the ALS-CBS. (2) Determine the sensitivity and specificity of ECAS in the differentiation between AD and non-demented ALS patients as compared with the ACE-III and mini-ACE. Methods: ALS patients (n = 28) were recruited and AD patients (n = 26) were matched in age, sex, and education with ALS patients (n = 24). The normative data were derived from a random sample of controls (n = 52). Bayes correlation analysis was conducted to examine convergent validity. Bayes t-test was performed to assess between groups’ differences. Receiver operating characteristics (ROC) curve analyses and area under the curve (AUC) were implemented to appraise the sensitivity and specificity in the differentiation between the AD and non-demented ALS patients. Results: The ECAS and its sub-scores in addition to the behavior interview demonstrated robust correlations with the ALS-CBS. Impairment in language and verbal fluency were the most prominent deficits in the ALS patients. The most frequently reported change was apathy. The ROC analysis demonstrated that the ECAS-ALS nonspecific score (comprising memory and visuospatial domains) is the most sensitive and specific in differentiating the AD from ALS patients. The other measures expressed high sensitivity, yet a poor specificity. Conclusions: The ECAS is a multi-purpose screening tool. The ECAS-ALS specific appraises the whole spectrum of the highly prevalent cognitive impairments in ALS. The ECAS-ALS nonspecific (memory and visuospatial) is a sensitive score to detect AD related deficits and is able to differentiate the AD from the non-demented ALS patients better than the ACE-III and mini-ACE.

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Determining Postoperative Thrombocyte Reduction Cut Off to Predict 30-Day Mortality in Patients Undergo Coronary Artery Bypass Graft Surgery

Blood ◽

10.1182/blood-2019-125432 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 4914-4914

Author(s):

Ikhwan Rinaldi ◽

Arif Mansjoer

Keyword(s):

Sensitivity And Specificity ◽

Roc Analysis ◽

Conflicts Of Interest ◽

Artery Bypass ◽

Bypass Graft ◽

Area Under The Curve ◽

Early Mortality ◽

Receiver Operating Curve ◽

Thrombocyte Count ◽

Cabg Surgery

Background There are many factors associated with early mortality after CABG, including postoperative thrombocytopenia (Kertai, 2016). Many factors during CABG surgery, such as administration of heparin or cardio pulmonary bypass during surgery are related to thrombocyte count reduction (Hamid, Akhtar, Naqvi, & Ahsan, 2017; Arepally, 2017). However, it is possible for a post-CABG patient to suffer a significant thrombocyte reduction without reaching the thrombocytopenic state (thrombocyte count <150000/µL). Up to this time, there is still lack of study about association between thrombocyte reduction after surgery and 30-day mortality in patients undergo CABG. This study aim to determine cut off point for postoperative thrombocyte reduction as a predictor of 30-day mortality after CABG surgery. Method This is a retrospective cohort study using medical record of 263 adult patients who underwent CABG surgery in dr. Ciptomangunkusumo National Hospital on 2012-2015. Thrombocyte reduction was determined by substracting preoperative thrombocyte count from postoperative thrombocyte count. Receiver operating curve (ROC) analysis between percentage of thrombocyte reduction and 30-day mortality after surgery was done to obtain the sensitivity and specificity value of a particular degree of thrombocyte reduction. Cut off point was obtained from intersection between sensitivity and specificity value. Result Thirty-day mortality rate after CABG surgery in this study was 11.9%. Cut off point obtained from ROC analysis was 30% with area under the curve (AUC) 0.671. The sensitivity of this cut off point to predict early mortality after CABG surgery was 64.5%, while the specificity was 64.7% Conclusion Thrombocyte reduction more than or equal to 30% can be used as a predictor of 30-day mortality after CABG surgery. Figure Disclosures No relevant conflicts of interest to declare.

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Sensitivity and specificity of Sirius indices in diagnosis of keratoconus and suspect keratoconus

European Journal of Ophthalmology ◽

10.1177/11206721211060139 ◽

2021 ◽

pp. 112067212110601

Author(s):

Abdelrahman Salman ◽

Taym Darwish ◽

Ali Ali ◽

Marwan Ghabra ◽

Rafea Shaaban

Keyword(s):

Sensitivity And Specificity ◽

Predictive Accuracy ◽

Corneal Thickness ◽

Case Series ◽

Area Under The Curve ◽

Receiver Operating Characteristics ◽

Operating Characteristics ◽

Symmetry Index ◽

Case Series Study ◽

Receiver Operating

Aim To estimate the sensitivity and specificity of topographic and tomographic corneal parameters as determined by Sirius (CSO, Florence, Italy) in discriminating keratoconus (KC) and suspect keratoconus from normal cornea. Method In this retrospective case-series study, keratoconus screening indices were measured using Sirius tomographer. Receiver operating characteristics (ROC) curves were used to determine the test's overall predictive accuracy (area under the curve) and to identify optimal cut-off points to maximize sensitivity and specificity in differentiating keratoconus and suspect keratoconus from normal corneas. Results Receiver operating characteristics (ROC) curve analyses showed high predictive accuracy for Symmetry Index back (SIb), Keratoconus Vertex front (KVf), Symmetry Index front (SIf), Keratoconus Vertex back (KVb), Apex Keratometry (Curve-Apex) and Minimum corneal Thickness (ThkMin) to distinguish keratoconus from normal (area under the curve > 0.9, all). Symmetry Index back was identified as the best diagnostic parameter for detecting suspect keratoconus with AUC of 0.86. Highest specificity to detect keratoconus and suspect keratoconus was seen for SIb, 99.87% and 84.66%, respectively. These values were associated with optimal cut-off points of 0.46 D for keratoconus and 0.12 D for suspect keratoconus. Conclusion Sirius parameters evaluated in the study were effective to differentiate keratoconus from normal corneas. However, Symmetry Index back was the index with the highest ability to detect suspect keratoconus.

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On the Differential Diagnosis of Anxious from Nonanxious Major Depression by means of the Hamilton Scales

The Scientific World JOURNAL ◽

10.1155/2013/294516 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

George Konstantakopoulos ◽

Vasilios G. Masdrakis ◽

Manolis Markianos ◽

Panagiotis Oulis

Keyword(s):

Differential Diagnosis ◽

Sensitivity And Specificity ◽

Gold Standard ◽

Roc Analysis ◽

Operating Characteristics ◽

Middle Aged ◽

Large Effect Size ◽

Major Depressive ◽

Trade Off ◽

Severe Anxiety

Objective.Anxious major depressive disorder (A-MDD) is differentially diagnosed from nonanxious MDD (NA-MDD) as MDD with a cut-off score ≥7 on the HAM-D anxiety-somatization factor (ASF). We investigated whether additional HAM-D items discriminate A-MDD from NA-MDD. Moreover, we tested the validity of ASF criterion against HAM-A, gold standard of anxiety severity assessment.Methods.164 consecutive female middle-aged inpatients, diagnosed as A-MDD () or NA-MDD () by the normative HAM-A score for moderate-to-severe anxiety (≥25), were compared regarding 17-item HAM-D scores. The validity of ASF ≥7 criterion was assessed by receiver-operating characteristics (ROC) analysis.Results.We found medium and large effect size differences between A-MDD and NA-MDD patients in only four out of the six ASF items, as well as in three further HAM-D items, namely, those of agitation, middle insomnia, and delayed insomnia. Furthermore, the ASF cut-off score ≥9 provided the optimal trade-off between sensitivity and specificity for the differential diagnosis between A-MDD and NA-MDD.Conclusion.Additional HAM-D items, beyond those of ASF, discriminate A-MDD from NA-MDD. The ASF ≥7 criterion inflates false positives. A cut-off point ≥9 provides the best trade-off between sensitivity and specificity of the ASF criterion, at least in female middle-aged inpatients.

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PREDICTING SOFTWARE CHANGE IN AN OPEN SOURCE SOFTWARE USING MACHINE LEARNING ALGORITHMS

International Journal of Reliability Quality and Safety Engineering ◽

10.1142/s0218539313500253 ◽

2013 ◽

Vol 20 (06) ◽

pp. 1350025

Author(s):

RUCHIKA MALHOTRA ◽

ANKITA JAIN BANSAL

Keyword(s):

Machine Learning ◽

Open Source ◽

Open Source Software ◽

Roc Analysis ◽

Area Under The Curve ◽

Machine Learning Algorithms ◽

Operating Characteristics ◽

Preventive Actions ◽

Change Proneness ◽

The Relationship

Due to various reasons such as ever increasing demands of the customer or change in the environment or detection of a bug, changes are incorporated in a software. This results in multiple versions or evolving nature of a software. Identification of parts of a software that are more prone to changes than others is one of the important activities. Identifying change prone classes will help developers to take focused and timely preventive actions on the classes of the software with similar characteristics in the future releases. In this paper, we have studied the relationship between various object oriented (OO) metrics and change proneness. We collected a set of OO metrics and change data of each class that appeared in two versions of an open source dataset, 'Java TreeView', i.e., version 1.1.6 and version 1.0.3. Besides this, we have also predicted various models that can be used to identify change prone classes, using machine learning and statistical techniques and then compared their performance. The results are analyzed using Area Under the Curve (AUC) obtained from Receiver Operating Characteristics (ROC) analysis. The results show that the models predicted using both machine learning and statistical methods demonstrate good performance in terms of predicting change prone classes. Based on the results, it is reasonable to claim that quality models have a significant relevance with OO metrics and hence can be used by researchers for early prediction of change prone classes.

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Single Brain Metastasis vs Glioblastoma Multiforme: A Voi-Based Multiparametric Analysys for Differential Diagnosis

10.21203/rs.3.rs-528124/v1 ◽

2021 ◽

Author(s):

Andrea Romano ◽

Giulia Moltoni ◽

Alessia Guarnera ◽

Luca Pasquini ◽

Alberto Di Napoli ◽

...

Keyword(s):

Differential Diagnosis ◽

Roc Analysis ◽

Area Under The Curve ◽

Solid Component ◽

Signal Recovery ◽

Operating Characteristics ◽

Cerebral Lesions ◽

Perilesional Edema ◽

Volume Of Interest ◽

The Mean

Abstract PURPOSEThe authors purpose was to evaluate ADC and rCBV values in the enhanced lesion, in the peritumoral area and in distal oedema using a Volume of Interest (VOI) based method and to analysed hemodynamic curves obtained from DSC perfusion MRI, in order to create a valid multiparametric MRI model for the differential diagnosis between Glioblastoma and solitary Brain Metastasis.MATERIALS AND METHODSForty-one patients (twenty glioblastomas and twenty-one single brain metastases) were retrospectively evaluated. MRI images were acquired before surgery, radiotherapy and chemotherapy. MRIs were analysed with Olea Sphere® 3.0 (Olea Medical, La Ciotat, France), in particular with diffusion, perfusion and volume of interest segmentation plug-ins. FLAIR, 3D T1 MP-RAGE images after gadolinium, ADC and rCBV maps for each patient were co-registered by the OleaSphere software; this was followed by visual inspection to ensure adequate alignment. Volumes of interest (VOIs) of the lesions were drawn on enhanced 3D T1 MP-RAGE avoiding cyst or necrotic degeneration, and then projected on ADC and rCBV co-registered maps. Another 2 VOIs were drawn in the region of hyperintense cerebral oedema, surrounding the lesion (GB or BM) visible on FLAIR images. The first VOI was drawn into perilesional oedema within 5mm around the enhancing tumor. The second VOI was drawn into residual oedema. Both VOIs were projected on ADC and rCBV maps. Perfusion curves were obtained for each lesion and the value of signal recovery (SR) was reported. A Two sample T-Test was obtained to compare all parameters of GB and BM groups. Receiver operating characteristics (ROC) analysis was performed to determine the optimal parameter in distinguishing GB from BM. RESULTSComparing all parameters evaluated for patients with GB and BM, the cerebral lesions were distinguishable with the mean ADC VOI- values of solid component, the PSR values and the mean and max rCBV values in the perilesional edema within 5mm around the enhancing tumor. According to ROC analysis, the area under the curve was 88%, 78% and 74% respectively for mean ADC VOI-values of the solid component, the mean and max rCBV values in the perilesional edema and the PSR. The cumulative ROC curve of these parameters reached an area under the curve of 95% .Using perilesional max rCBV>1,37, PSR>75% and mean lesional ADC<1x10-3 mm2 s-1 GB could be differentiated from solitary BM with sensitivity and specificity of 95% and 86%. CONCLUSIONWe can conclude that lower values of ADC in the enhancing tumor volume and a higher percentage of signal recovery in perfusion curves, associated with higher values of rCBV in the peritumoral edema closed to the lesion, are strongly indicative of GB than solitary BM.

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Case linkage in Australian serial stranger rape

Journal of Criminological Research Policy and Practice ◽

10.1108/jcrpp-01-2020-0016 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Serena Davidson ◽

Wayne Petherick

Keyword(s):

Roc Analysis ◽

Area Under The Curve ◽

Empirical Support ◽

Theory And Practice ◽

Operating Characteristics ◽

Content Type ◽

Sexual Crimes ◽

Behavioural Consistency ◽

Sexual Assault Case ◽

Serial Rape

Purpose Case linkage theory and practice have received growing empirical support; however, they have yet to be examined fully within Australia. For sexual assault case linkage to be successful, it is assumed that a serial rapist will behave relatively consistently across offences yet distinctively compared to other offenders. The purpose of this paper is to test the underlying principles of case linkage, behavioural consistency and distinctiveness, as well as distinguishing accuracy. Design/methodology/approach In total, 250 solved stranger rapes by 171 offenders (46 serial rapists, 125 one-off rapists) were taken from Queensland Police Service (QPS) crime records. All possible crime pairings were created and cross-crime similarity was assessed using Jaccard’s coefficient. Receiver operating characteristics (ROC) analysis was used to examine the ability to distinguish between linked and unlinked offence pairs. Findings Serial linked pairs had the highest Jaccard’s coefficient (0.456), followed by non-serial unlinked (0.253) and finally, serial unlinked pairs (0.247). Within the ROC analysis, an area under the curve value was found of 0.913, indicating excellent distinguishing accuracy. Both the underlying principles of behavioural consistency and distinctiveness were supported through theoretical and practical methods. This paper provides the first analysis of serial rape case linkage in Australia, adding validity to this practice. Research limitations/implications The authors wish to acknowledge the support and assistance from the QPS in undertaking this research. The views expressed in this publication are not necessarily those of the QPS and any errors of omission or commission are the responsibility of the authors. Practical implications This paper provides validity to the practice of case linkage using a database within Australia. The results of this paper can be used to inform investigators of serial offender behaviours. The theories of offender consistency and distinctiveness are supported, highlighting the importance of behavioural evidence for practitioners. This paper provided a practical increase of the quantity and quality of offences uploaded on the Australian violent and sexual crimes database, which will assist further linkage efforts. Originality/value This paper is the first in Australia to examine consistency, distinctiveness and case linkage of serial stranger rape. Thus is contributes significantly not only to an increased understanding of serial rape and case linkage in Australia but also brings Australia closer to modern research practices in this field.

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Detecting psychiatric disorders in medical practice using the General Health Questionnaire. Why do cut-off scores vary?

Psychological Medicine ◽

10.1017/s003329170002818x ◽

1995 ◽

Vol 25 (1) ◽

pp. 165-170 ◽

Cited By ~ 28

Author(s):

A. M. Van Hemert ◽

M. Den Heijer ◽

M. Vorstenbosch ◽

J. H. Bolk

Keyword(s):

Psychiatric Disorders ◽

Sensitivity And Specificity ◽

Medical Practice ◽

General Health ◽

Roc Analysis ◽

General Health Questionnaire ◽

Area Under The Curve ◽

Health Questionnaire ◽

State Examination ◽

Discriminatory Capacity

SynopsisIn this study we assessed the accuracy of the General Health Questionnaire in detecting psychiatric disorders in general medical out-patients. A total of 290 newly referred patients were interviewed with the Present State Examination. Prior to the interview, 112 patients completed the full GHQ-60, 100 completed the GHQ-30 and 78 completed the GHQ-12. Data from the first group were used to study the full GHQ-60, together with the GHQ-30 and and GHQ-12, when disembedded from the full questionnaire. In a comparison between the disembedded and the separate versions of the GHQ-30 and GHQ-12 we observed considerable variation in the cut-off scores where a certain sensitivity and specificity was attained. In ROC-analysis, the versions were not materially different in their discriminatory capacity (area under the curve). The use of different criteria to define a ‘case’ demonstrated that case severity was another source of increasing cut-off scores. Our data demonstrate that the use of disembedded or separate versions of the questionnaire, together with variation in the case criteria can be a major explanation for variation in cut-off scores that was observed in previous studies.

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Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting

Palliative Medicine ◽

10.1177/0269216320954339 ◽

2020 ◽

pp. 026921632095433

Author(s):

Lisa Graham-Wisener ◽

Martin Dempster ◽

Aaroon Sadler ◽

Luke McCann ◽

Noleen K McCorry

Keyword(s):

Palliative Care ◽

Advanced Cancer ◽

Screening Tool ◽

Hospice Care ◽

Depression Scale ◽

Area Under The Curve ◽

Distress Thermometer ◽

Psychological Morbidity ◽

Specialist Palliative Care ◽

Operating Characteristics

Background: Ongoing assessment of psychological reaction to illness in palliative and end of life care settings is recommended, yet validated tools are not routinely used in clinical practice. The Distress Thermometer is a short screening tool developed for use in oncology, to detect individuals who would benefit from further psychological assessment. However the optimal cut-off to detect indicative psychological morbidity in patients with advanced cancer receiving specialist palliative care is unclear. Aim: To provide the first validation of the Distress Thermometer in an advanced cancer population receiving specialist palliative care in a UK hospice setting. Design: Receiver Operating Characteristics analysis was used to compare the sensitivity and specificity of cut-offs indicative of psychological morbidity on the Distress Thermometer in comparison to the Hospital Anxiety and Depression Scale. Setting/Participants: Data were derived from 202 patients with advanced cancer who were approached on admission to inpatient or day hospice care, with 139 patients providing complete data on both measures. Results: The area under the curve was optimal using a Distress Thermometer cut-off score of ⩾6 for total distress and for anxiety, and a cut-off score of ⩾4 optimal when screening for depression. Conclusions: The Distress Thermometer is a valid, accurate screening tool to be used in advanced cancer but with caution in relation to the lack of specificity. With little variation between the area under the curve scores, arguably a Distress Thermometer cut-off score of ⩾5 is most appropriate in screening for all types of psychological morbidity if sensitivity is to be prioritised.

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Correlation of Paraoxonase-1 with the Severity of Crohn’s Disease

Molecules ◽

10.3390/molecules23102603 ◽

2018 ◽

Vol 23 (10) ◽

pp. 2603

Author(s):

Katarzyna Szczeklik ◽

Tomasz Mach ◽

Dorota Cibor ◽

Danuta Owczarek ◽

Jacek Sapa ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Sensitivity And Specificity ◽

Activity Index ◽

Area Under The Curve ◽

Density Lipoprotein ◽

High Sensitivity ◽

Paraoxonase 1 ◽

Control Group ◽

Operating Characteristics

Diagnostics of Crohn’s disease (CD) requires noninvasive biomarkers facilitating early detection and differentiation of the disease. Therefore, in this study, we aimed to determine the relationship between paraoxonase-1 (PON-1), the severity of CD, oxidative stress, and inflammation in CD. The CD activity index was based on the current classification. Plasma PON-1 was measured in 47 patients with CD, and in 23 control volunteers. Using quantitative variables such as receiver operating characteristics (ROC) (area under the curve (AUC)), the diagnostic utility of PON-1 in differentiating the severity of CD was assessed. Circulating PON-1 was found to be decreased in the CD group compared to the control group (269.89 vs. 402.56 U/L, respectively), and it correlated well with the disease activity. PON-1 correlated positively with hemoglobin (Hb) (r = 0.539, p < 0.001), hematocrit (Ht) (r = 0.48, p < 0.001), total cholesterol (TC) (r = 0.343, p < 0.001), high density lipoprotein (HDL) (r = 0.536, p < 0.001), low density lipoprotein (LDL) (r = 0.54, p < 0.001), and triglyceride (TG) (r = 0.561, p < 0.001) and correlated negatively with white blood cell count (WBC) (r = −0.262, p = 0.029), platelet count (PLT) (r = −0.326, p = 0.006), C-reactive protein (CRP) (r = −0.61, p < 0.001), and malondialdehyde (MDA) (r = −0.924, p < 0.001). PON-1 as a marker for CD differentiation possessed a sensitivity and specificity of 93.62% and 91.30%, respectively. CD was found to be associated with the decrease in the levels of PON-1, which correlates well with activity of the disease and reflects the intensification of inflammation, as well as intensified lipid peroxidation. High sensitivity and specificity of PON-1 determines its selection as a good screening test for CD severity.

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