A Novel Algorithm using Within-leg Calibration for Enhanced Accuracy of Detection of Arthritis by Infrared Thermal Imaging in Children

2021 ◽  
pp. jrheum.210077
Author(s):  
Yongdong Zhao ◽  
Ramesh S. Iyer ◽  
Mahesh Thapa ◽  
Debosmita Biswas ◽  
Nivrutti Bhide ◽  
...  
Keyword(s):  
Thermal Imaging ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Absolute Temperature ◽  
Youden Index ◽  
Infrared Thermal Imaging ◽  
Optimal Thresholds ◽  
Custom Software ◽  
Active Arthritis

Objective To standardize and improve the accuracy of detection of arthritis by thermal imaging. Methods Children with clinically active arthritis in the knee or ankle, as well as healthy controls, were enrolled to the development cohort and another group of children with knee symptoms were enrolled to the validation cohort. Ultrasound was performed for the arthritis subgroup for the development cohort. Joint exam by certified rheumatologists was used as a reference for the validation cohort. Infrared thermal data were analyzed using a custom software. Temperature after within-limb calibration (TAWiC) was defined as the temperature differences between joint and ipsilateral midtibia. TAWiC of knees and ankles was evaluated using ANOVA across subgroups. Optimal thresholds were determined by receiver operating characteristic (ROC) analysis using Youden index. Results There were significant differences in mean and 95th TAWiC of knee in anterior, medial, lateral views, and of ankles in anterior view, between inflamed and uninflamed counterparts (p<0.05). The area under the curve (AUC) was higher by 36% when using TAWiCKnee than those when using absolute temperature. Within validation cohort, the sensitivity of accurate detection of arthritis in knee using both mean and 95th TAWiC from individual views or combined all 3 views ranged from 0.60 to 0.70 and the specificity was greater than 0.90 in all views. Conclusion Children with active arthritis or tenosynovitis in knees or ankles exhibited higher TAWiC than healthy joints. Our validation cohort study showed promise of the clinical utility of infrared thermal imaging for arthritis detection.

External Validation of Different Scoring Systems for Suspected Choledocholithiasis

2019 ◽  
Vol 36 (6) ◽  
pp. 530-538
Author(s):  
Nicolò Tamini ◽  
Davide Paolo Bernasconi ◽  
Luca Gianotti
Keyword(s):  
Operating Characteristic ◽  
Bile Duct Stone ◽  
Characteristic Curve ◽  
External Validation ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Youden Index ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Symptoms And Signs

Aim of the Study: The diagnosis of choledocholithiasis is challenging. Previously published scoring systems designed to calculate the risk of choledocholithiasis were evaluated to appraise the diagnostic performance. Patients and Methods: Data of patients who were admitted between 2013 and 2015 with the following characteristics were retrieved: bile stone-related symptoms and signs, and indication to laparoscopic cholecystectomy. To validate and appraise the performance of the 6 scoring systems, the acknowledged domains of each metrics were applied to the present cohort. Sensitivity, specificity, positive, negative predictive, Youden index, and receiver operating characteristic curve with the area under the curve (AUC) values of the scores were calculated. Results: Two-hundred patients were analyzed. The highest sensitivity and specificity were obtained from the Menezes’ (96.6%) and Telem’s (99.3%) metrics respectively. The Telem’s and Menezes’ scores had the best positive (75.0%) and negative (96.4%) predictive values respectively. The best accuracy, as computed by the Youden index and AUC, was found for the Soltan’s scoring system (0.628 and 0.88, respectively). Conclusion: The available scoring systems are precise only in identifying patients with a negligible risk of common bile duct stone, but overall insufficiently accurate to suggest the routine use in clinical practice.

scholarly journals Identification and Validation of Hematoma Volume Cutoffs in Spontaneous, Supratentorial Deep Intracerebral Hemorrhage

Stroke ◽  
2019 ◽  
Vol 50 (8) ◽  
pp. 2044-2049 ◽  
Author(s):  
Audrey C. Leasure ◽  
Kevin N. Sheth ◽  
Mary Comeau ◽  
Chad Aldridge ◽  
Bradford B. Worrall ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Hematoma Volume ◽  
Poor Outcome ◽  
C Statistic ◽  
Receiver Operating

Background and Purpose— Clinical trials in spontaneous intracerebral hemorrhage (ICH) have used volume cutoffs as inclusion criteria to select populations in which the effects of interventions are likely to be the greatest. However, optimal volume cutoffs for predicting poor outcome in deep locations (thalamus versus basal ganglia) are unknown. Methods— We conducted a 2-phase study to determine ICH volume cutoffs for poor outcome (modified Rankin Scale score of 4–6) in the thalamus and basal ganglia. Cutoffs with optimal sensitivity and specificity for poor outcome were identified in the ERICH ([Ethnic/Racial Variations of ICH] study; derivation cohort) using receiver operating characteristic curves. The cutoffs were then validated in the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage-2) by comparing the c-statistic of regression models for outcome (including dichotomized volume) in the validation cohort. Results— Of the 3000 patients enrolled in ERICH, 1564 (52%) had deep ICH, of whom 1305 (84%) had complete neuroimaging and outcome data (660 thalamic and 645 basal ganglia hemorrhages). Receiver operating characteristic curve analysis identified 8 mL in thalamic (area under the curve, 0.79; sensitivity, 73%; specificity, 78%) and 18 mL in basal ganglia ICH (area under the curve, 0.79; sensitivity, 70%; specificity, 83%) as optimal cutoffs for predicting poor outcome. The validation cohort included 834 (84%) patients with deep ICH and complete neuroimaging data enrolled in ATACH-2 (353 thalamic and 431 basal ganglia hemorrhages). In thalamic ICH, the c-statistic of the multivariable outcome model including dichotomized ICH volume was 0.80 (95% CI, 0.75–0.85) in the validation cohort. For basal ganglia ICH, the c-statistic was 0.81 (95% CI, 0.76–0.85) in the validation cohort. Conclusions— Optimal hematoma volume cutoffs for predicting poor outcome in deep ICH vary by the specific deep brain nucleus involved. Utilization of location-specific volume cutoffs may improve clinical trial design by targeting deep ICH patients that will obtain maximal benefit from candidate therapies.

scholarly journals Novel Prehospital Triage Scale for Detecting Large Vessel Occlusion and Its Cause

2021 ◽  
Author(s):  
Jianan Wang ◽  
Xiaoxian Gong ◽  
Wansi Zhong ◽  
Ying Zhou ◽  
Min Lou
Keyword(s):  
Atrial Fibrillation ◽  
Predictive Value ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Large Vessel ◽  
Basilar Artery Occlusion ◽  
Youden Index ◽  
Large Vessel Occlusion ◽  
Characteristic Analysis ◽  
Vessel Occlusion

Background Patients with large vessel occlusion stroke (LVOS) need to be rapidly identified and transferred to comprehensive stroke centers. However, current prehospital evaluation and strategies still remain challenging. Methods and Results We retrospectively reviewed our prospectively collected database of patients with acute ischemic stroke (AIS). Based on the items of National Institutes of Health Stroke Scale and medical history that had a strong association with LVOS, we designed the 4‐item Stroke Scale (4I‐SS) and validated it in multi‐centers. The 4I‐SS incorporated gaze, level of consciousness, arm weakness, and atrial fibrillation. Receiver operating characteristic analysis was used to compare the 4I‐SS with previously established prehospital prediction scales. Finally, 1630 and 11 440 patients were included in the derivation and validation cohort, respectively. In the validation cohort, Youden Index, area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the 4I‐SS≥4 to predict LVOS were 0.494, 0.800, 0.657, 0.837, 0.600, 0.868, and 0.788, respectively, and that of the 4I‐SS≥7 to predict basilar artery occlusion were 0.200, 0.669, 0.229, 0.971, 0.066, 0.974, and 0.899, respectively. Youden Index and area under the curve were higher than previously published scales for predicting LVOS. Further analysis showed that for predicting whether cardiogenic embolism was the cause, its accuracy was 0.922 when the 4I‐SS score, including atrial fibrillation, was ≥6, and its accuracy of predicting the occluded vessel was intracranial internal carotid artery or M1 segment of the middle cerebral artery when it was ≥7 was 0.590. Conclusions The 4I‐SS is an effective and simple tool that can identify LVOS and its cause. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03317639.

scholarly journals Schistocytes Evaluation in Iron Deficiency: An Assessment Adopted From ICSH Nomenclature Guideline

2020 ◽  
Author(s):  
Tri Ratnaningsih ◽  
Galih R Martani ◽  
Dhia C Putri ◽  
Usi Sukorini
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Youden Index ◽  
Diagnostic Validity ◽  
Roc Curve Analysis ◽  
Significant Difference ◽  
Iron Parameters

Abstract Objective The diagnostic validity of schistocyte count in diagnosing iron deficiency in the microcytic population is critical to evaluate. The purpose of this study is to identify the correlation between schistocyte count and iron parameters, and the performance of schistocyte count in diagnosing iron deficiency in the microcytic population.Results Out of 805 general check-up participants, 65 subjects consisting of 17 males and 48 females aged 18–56 years had Mean Corpuscular Value (MCV) < 80 fL. Serum ferritin examination showed 25 patients with iron deficiency and the other 40 subjects without iron deficiency. There was a significant difference in the schistocyte count between the two groups (p < 0,001). Correlation analysis obtained a significant relationship between schistocyte count and serum ferritin (r=-0,67, p < 0,001). The Receiver Operating Characteristic (ROC) curve analysis provided Area Under the Curve (AUC) of schistocyte count is 0.827 with Youden Index (YI) 55% for a cut-off of ≥0.75%.

A validated novel preoperative index to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology: A cohort study

2019 ◽  
Vol 30 (7-8) ◽  
pp. 221-228
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh ◽  
Nicholas Hobbs ◽  
Jigar Shah ◽  
Matthew Harris ◽  
...  
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Emergency Laparotomy ◽  
Contamination Index ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Aims To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology. Methods Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination. Results Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively. Conclusions As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.

Infrared thermal imaging denoising method based on second-order channel attention mechanism

2021 ◽  
pp. 103789
Author(s):  
Zhuo Li ◽  
Shaojuan Luo ◽  
Meiyun Chen ◽  
Heng Wu ◽  
Tao Wang ◽  
...  
Keyword(s):  
Thermal Imaging ◽  
Second Order ◽  
Attention Mechanism ◽  
Denoising Method ◽  
Infrared Thermal Imaging

Clot imaging characteristics predict first pass effect of aspiration—first approach to thrombectomy

2021 ◽  
pp. 159101992110191
Author(s):  
Muhammad Waqas ◽  
Weizhe Li ◽  
Tatsat R Patel ◽  
Felix Chin ◽  
Vincent M Tutino ◽  
...  
Keyword(s):  
Internal Carotid ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
First Pass Effect ◽  
Imaging Characteristics ◽  
First Pass ◽  
Sensitivity Specificity ◽  
Youden’S Index

Background The value of clot imaging in patients with emergent large vessel occlusion (ELVO) treated with thrombectomy is unknown. Methods We performed retrospective analysis of clot imaging (clot density, perviousness, length, diameter, distance to the internal carotid artery (ICA) terminus and angle of interaction (AOI) between clot and the aspiration catheter) of consecutive cases of middle cerebral artery (MCA) occlusion and its association with first pass effect (FPE, TICI 2c-3 after a first attempt). Results Patients ( n = 90 total) with FPE had shorter clot length (9.9 ± 4.5 mm vs. 11.7 ± 4.6 mm, P = 0.07), shorter distance from ICA terminus (11.0 ± 7.1 mm vs. 14.7 ± 9.8 mm, P = 0.048), higher perviousness (39.39 ± 29.5 vs 25.43 ± 17.6, P = 0.006) and larger AOI (153.6 ± 17.6 vs 140.3 ± 23.5, P = 0.004) compared to no-FPE patients. In multivariate analysis, distance from ICA terminus to clot ≤13.5 mm (odds ratio (OR) 11.05, 95% confidence interval (CI) 2.65–46.15, P = 0.001), clot length ≤9.9 mm (OR 7.34; 95% CI 1.8–29.96, P = 0.005), perviousness ≥ 19.9 (OR 2.54, 95% CI 0.84–7.6, P = 0.09) and AOI ≥ 137°^ (OR 6.8, 95% CI 1.55–29.8, P = 0.011) were independent predictors of FPE. The optimal cut off derived using Youden’s index was 6.5. The area under the curve of a score predictive of FPE success was 0.816 (0.728–0.904, P < 0.001). In a validation cohort ( n = 30), sensitivity, specificity, positive and negative predictive value of a score of 6–10 were 72.7%, 73.6%, 61.5% and 82.3%. Conclusions Clot imaging predicts the likelihood of achieving FPE in patients with MCA ELVO treated with the aspiration-first approach.

The use of infrared thermal imaging in tonometry with a Scheimpflug camera

2021 ◽  
Vol 96 ◽  
pp. 102823
Author(s):  
Magdalena Jędzierowska ◽  
Robert Koprowski ◽  
Sławomir Wilczyński ◽  
Dorota Tarnawska
Keyword(s):  
Thermal Imaging ◽  
Infrared Thermal Imaging ◽  
Scheimpflug Camera
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