scholarly journals The use of mean platelet volume for distinguishing the causes of thrombocytopenia in adult patients

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Lalita Norrasethada ◽  
Wichan Khumpoo ◽  
Ekarat Rattarittamrong ◽  
Thanawat Rattanathammethee ◽  
Chatree Chai-Adisaksopha ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Mean Platelet Volume ◽  
Bone Marrow Examination ◽  
Primary Objective ◽  
Operating Characteristics ◽  
Training Set ◽  
Platelet Volume ◽  
Secondary Objective ◽  
Validation Set ◽  
Sensitivity Specificity

Establishment and analysis of mean platelet volume (MPV) may be helpful in the discrimination between underproduction or over-destruction of platelets as the causes of thrombocytopenia. The primary objective is to find the cut-off point of MPV for distinguishing causes of thrombocytopenia. The secondary objective is to validate the cut-off value of the MPV by using bone marrow examination. Thrombocytopenic patients were enrolled in a training set and a receiving operating characteristics (ROC) curve was plotted to obtain the cut-off value of MPV. A validation set of patients was recruited to validate the cut-off value. The training set included 240 patients. Half with with underproductive (n=120) and half with over-destructive thrombocytopenia (n=120). The best cut-off value of MPV was 8.8 fL. The validation set included 119 patients in total, again in 2 groups, those with underproductive (n=84) and those with overdestructive thrombocytopenia (n=35). The sensitivity, specificity, PPV and NPV when MPV ≥8.8 fL indicating over-destructive thrombocytopenia were 77%, 89%, 89% and 77%, respectively. MPV is useful for differentiating the cause of thrombocytopenia. The value of MPV ≥8.8 fL has acceptable sensitivity and specificity for diagnosis of over-destructive thrombocytopenia.

scholarly journals The role of red cell distribution width in the differential diagnosis of iron deficiency anemia and non-transfusion dependent thalassemia patients

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Pokpong Piriyakhuntorn ◽  
Adisak Tantiworawit ◽  
Thanawat Rattanathammethee ◽  
Chatree Chai-Adisaksopha ◽  
Ekarat Rattarittamrong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Operating Characteristics ◽  
Training Set ◽  
Distribution Width ◽  
Validation Set ◽  
Sensitivity Specificity

This study aims to find the cut-off value and diagnostic accuracy of the use of RDW as initial investigation in enabling the differentiation between IDA and NTDT patients. Patients with microcytic anemia were enrolled in the training set and used to plot a receiving operating characteristics (ROC) curve to obtain the cut-off value of RDW. A second set of patients were included in the validation set and used to analyze the diagnostic accuracy. We recruited 94 IDA and 64 NTDT patients into the training set. The area under the curve of the ROC in the training set was 0.803. The best cut-off value of RDW in the diagnosis of NTDT was 21.0% with a sensitivity and specificity of 81.3% and 55.3% respectively. In the validation set, there were 34 IDA and 58 NTDT patients using the cut-off value of >21.0% to validate. The sensitivity, specificity, positive predictive value and negative predictive value were 84.5%, 70.6%, 83.1% and 72.7% respectively. We can therefore conclude that RDW >21.0% is useful in differentiating between IDA and NTDT patients with high diagnostic accuracy

Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI-RADS

2020 ◽  
Vol 163 (6) ◽  
pp. 1156-1165
Author(s):  
Juan Xiao ◽  
Qiang Xiao ◽  
Wei Cong ◽  
Ting Li ◽  
Shouluan Ding ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Study ◽  
Diagnostic Efficiency ◽  
Training Set ◽  
Multivariable Logistic Regression Model ◽  
Predictive Values ◽  
Validation Set ◽  
Sensitivity Specificity

Objective To develop an easy-to-use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Study Design Retrospective diagnostic study. Setting The Second Hospital of Shandong University. Subjects and Methods From March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI-RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated. Results The nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI-RADS (0.826, P = .008) and the ACR TI-RADS (0.810, P < .001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI-RADS (0.852, P < .001) and the ACR TI-RADS (0.853, P < .001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI-RADS ( P < .05), each in the whole series and separately for nodules >1 or ≤1 cm. Conclusions When compared with the Kwak and ACR TI-RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.

scholarly journals Preoperative Predicting the WHO/ISUP Nuclear Grade of Clear Cell Renal Cell Carcinoma by Computed Tomography-Based Radiomics Features

2020 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Claudia-Gabriela Moldovanu ◽  
Bianca Boca ◽  
Andrei Lebovici ◽  
Attila Tamas-Szora ◽  
Diana Sorina Feier ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Predictive Ability ◽  
Nuclear Grade ◽  
Training Set ◽  
Cell Renal Cell Carcinoma ◽  
Validation Set ◽  
Sensitivity Specificity

Nuclear grade is important for treatment selection and prognosis in patients with clear cell renal cell carcinoma (ccRCC). This study aimed to determine the ability of preoperative four-phase multiphasic multidetector computed tomography (MDCT)-based radiomics features to predict the WHO/ISUP nuclear grade. In all 102 patients with histologically confirmed ccRCC, the training set (n = 62) and validation set (n = 40) were randomly assigned. In both datasets, patients were categorized according to the WHO/ISUP grading system into low-grade ccRCC (grades 1 and 2) and high-grade ccRCC (grades 3 and 4). The feature selection process consisted of three steps, including least absolute shrinkage and selection operator (LASSO) regression analysis, and the radiomics scores were developed using 48 radiomics features (10 in the unenhanced phase, 17 in the corticomedullary (CM) phase, 14 in the nephrographic (NP) phase, and 7 in the excretory phase). The radiomics score (Rad-Score) derived from the CM phase achieved the best predictive ability, with a sensitivity, specificity, and an area under the curve (AUC) of 90.91%, 95.00%, and 0.97 in the training set. In the validation set, the Rad-Score derived from the NP phase achieved the best predictive ability, with a sensitivity, specificity, and an AUC of 72.73%, 85.30%, and 0.84. We constructed a complex model, adding the radiomics score for each of the phases to the clinicoradiological characteristics, and found significantly better performance in the discrimination of the nuclear grades of ccRCCs in all MDCT phases. The highest AUC of 0.99 (95% CI, 0.92–1.00, p < 0.0001) was demonstrated for the CM phase. Our results showed that the MDCT radiomics features may play a role as potential imaging biomarkers to preoperatively predict the WHO/ISUP grade of ccRCCs.

Validation of Michigan risk score and D-dimer to predict peripherally inserted central catheter-related thrombosis: A study of 206,132 catheter days

2021 ◽  
pp. 112972982110087
Author(s):  
Junren Kang ◽  
Wenyan Sun ◽  
Hailong Li ◽  
En ling Ma ◽  
Wei Chen
Keyword(s):  
Sensitivity And Specificity ◽  
Risk Score ◽  
Primary Objective ◽  
Class Iii ◽  
Operating Characteristics ◽  
Central Venous ◽  
Sensitivity Specificity ◽  
Catheter Related Thrombosis ◽  
D Dimer ◽  
Independent Cohort

Background: The Michigan Risk Score (MRS) was the only predicted score for peripherally inserted central venous catheters (PICC) associated upper extremity venous thrombosis (UEVT). Age-adjusted D-dimer increased the efficiency for UEVT. There were no external validations in an independent cohort. Method: A retrospective study of adult patients with PICC insertion was performed. The primary objective was to evaluate the performance of the MRS and age-adjusted D-dimer in estimating risk of PICC-related symptomatic UEVT. The sensitivity, specificity and areas under the receiver operating characteristics (ROC) of MRS and age-adjusted D-dimer were calculated. Results: Two thousand one hundred sixty-three patients were included for a total of 206,132 catheter days. Fifty-six (2.6%) developed PICC-UEVT. The incidences of PICC-UEVT were 4.9% for class I, 7.5% for class II, 2.2% for class III, 0% for class IV of MRS ( p = 0.011). The incidences of PICC-UEVT were 4.5% for D-dimer above the age-adjusted threshold and 1.5% for below the threshold ( p = 0.001). The areas under ROC of MRS and age-adjusted D-dimer were 0.405 (95% confidence interval (CI) 0.303–0.508) and 0.639 (95% CI 0.547–0.731). The sensitivity and specificity of MRS were 0.82 (95% CI, 0.69–0.91), 0.09 (95% CI, 0.08–0.11), respectively. The sensitivity and specificity of age-adjusted D-dimer were 0.64 (95% CI, 0.46–0.79) and 0.64 (95% CI, 0.61–0.66), respectively. Conclusions: MRS and age-adjusted D-dimer have low accuracy to predict PICC-UEVT. Further studies are needed.

scholarly journals Diagnostic value of mean platelet volume in neonatal sepsis

2019 ◽  
Vol 59 (6) ◽  
pp. 289-93
Author(s):  
Kristopher May Pamudji ◽  
I Made Kardana
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Mean Platelet Volume ◽  
Severe Disease ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Platelet Volume ◽  
Good Potential ◽  
Sensitivity Specificity

Background Neonatal sepsis is a severe disease with potentially serious impacts if not treated early. However, the symptoms and clinical signs are not specific. Several studies have been conducted to find early infection markers for detection of neonatal sepsis, but without satisfactory results. Mean platelet volume (MPV) is a new marker of infection that has good potential for diagnosing neonatal sepsis. Objective To assess the diagnostic value of MPV in early detection of neonatal sepsis. Methods This retrospective study with diagnostic testing was done with data collected from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in Sanglah Hospital, Denpasar from December 2018 to March 2019. Mean platelet volume cut-off point was determined using a receiver-operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MPV in neonatal sepsis were determined using a 2x2 table. Results Of 82 subjects, 55 subjects were male (67%). Positive blood culture results were found in 25 subjects (30%). Mean platelet volume with a cut-off point of 7.44 fL had 80% sensitivity, 84.2% specificity, 69% PPV, and 90.6% NPV. Conclusion Mean platelet volume with a cut-off point of 7.44 fL can be used to diagnose neonatal sepsis with a sensitivity of 80% and specificity of 84.2%.

scholarly journals Megakaryocyte growth and development factor ameliorates carboplatin- induced thrombocytopenia in mice

Blood ◽  
1995 ◽  
Vol 86 (3) ◽  
pp. 971-976 ◽  
Author(s):  
TR Ulich ◽  
J del Castillo ◽  
S Yin ◽  
S Swift ◽  
D Padilla ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Normal Level ◽  
Mean Platelet Volume ◽  
Growth And Development ◽  
Chemotherapeutic Agent ◽  
Platelet Volume ◽  
Once Daily ◽  
Development Factor ◽  
Dose Dependent Fashion ◽  
Dose Dependent

Abstract Megakaryocyte growth and development factor (MGDF) administered intraperitoneally (IP) to mice causes a dose-dependent thrombocytosis accompanied by a decrease in mean platelet volume. MGDF increases the number of megakaryocytes in the bone marrow and spleen. MGDF does not affect the circulating number of leukocytes. Carboplatin, a chemotherapeutic agent that causes thrombocytopenia in humans, administered to mice as a single IP injection at a nonlethal dose causes a significant, but reversible thrombocytopenia. The carboplatin- induced thrombocytopenia is accompanied by an increase in circulating endogenous MGDF that precedes the return of circulating platelets to a normal level. MGDF mRNA is constitutively present in the liver. After carboplatin treatment, hepatic MGDF mRNA does not increase in concordance with circulating MGDF. Circulating soluble MGDF receptor levels (c-mpl) do not change significantly during the course of carboplatin-induced thrombocytopenia. MGDF injected IP once daily beginning 1 day after injection of carboplatin reverses carboplatin- induced thrombocytopenia in a dose-dependent fashion. The normalization of circulating platelet numbers in carboplatin plus MGDF-treated mice is accompanied by a normalization of megakaryocyte numbers in the bone marrow. In conclusion, MGDF, by increasing the number of marrow megakaryocytes and circulating platelets is an effective therapy for carboplatin-induced thrombocytopenia in mice.

Serum microRNA signatures for the detection of pancreatobiliary cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15718-e15718
Author(s):  
Shuichi Mitsunaga ◽  
Shogo Nomura ◽  
Kazuo Hara ◽  
Yukiko Takayama ◽  
Makoto Ueno ◽  
...  
Keyword(s):  
Validation Cohort ◽  
External Validation ◽  
Diagnostic Value ◽  
Healthy Controls ◽  
Mirna Signature ◽  
Training Set ◽  
Linear Discriminant ◽  
Serum Mirna ◽  
Validation Set ◽  
Sensitivity Specificity

e15718 Background: The diagnostic value of serum microRNAs (miRNA) in a highly sensitive microarray for pancreatobiliary cancer (PBca) has been demonstrated. This study attempted to build and validate a signature comprised of multiple serum miRNA markers for discriminating PBca from healthy controls. Methods: A multicenter prospective study on the diagnostic performance of serum miRNAs was conducted. The patients (pts) with treatment-naïve PBca and healthy participants aged ≥60 years were enrolled. Clinical data and sera were collected. Target population was randomly divided to training or validation cohort with an allocation ratio of 2:1. Twenty-nine serum miRNA markers on the microarray data were analyzed. Using any combinations of the markers, a Fisher’s linear discriminant analysis was performed, and the resulting sensitivity, specificity and AUC of ROC curve to discriminate PBca from healthy controls were calculated for each combination. Marker combinations with a sensitivity/specificity (SN/SP) of ≥80%/90% and high AUC in comparison with AUC of CA19-9 were defined as the diagnostic miRNA signature, which were selected in the training cohort. Next, the signatures were screened out which showed a good reproducibility in the validation cohort. As an independent external cohort, PBca pts and healthy with pooled frozen sera were enrolled and the identified miRNA signatures were further validated. Results: Total of 546 participants (80 healthy and 223 PBca in training set, 40 healthy and 104 PBca in validation set, 49 healthy and 50 PBca in external validation set) were analyzed in this study. Four serum miRNA combinations were identified as the diagnostic miRNA signature. In the training set, four miRNA signatures, consisted of 10 miRNAs, were developed. For the best-performed miRNA signature, the SN/SP and AUC in the validation and external validation cohorts were 84/90% and 0.95 (CA19-9: 73/95% and 0.88) and 84/90% and 0.93 (CA19-9: 80/94% and 0.87), respectively. Conclusions: The diagnostic serum miRNA signatures for PBca were identified in this study.

Diagnostic Accuracy of Increased Mean Platelet Volume as Inflammatory Marker in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard

2021 ◽  
Vol 15 (10) ◽  
pp. 2790-2792
Author(s):  
Hina Rehman Siddiqui ◽  
Tahira Tariq ◽  
Samar Babiker Awadallah Omer ◽  
Nadia Rizvi
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Mean Platelet Volume ◽  
Inflammatory Marker ◽  
Total Leukocyte Count ◽  
Platelet Volume ◽  
Duration Of Symptoms ◽  
Predictive Values ◽  
Sensitivity Specificity

Objective: To determine diagnostic accuracy of increased mean platelet volume as inflammatory marker in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Cross Sectional Study. Setting: Department of Surgery, Abbasi Shaheed Hospital, Karachi. Duration: From 28th October 2016 To 27thApril 2017. Material and Methods: Total 229patients suffered from acute appendicitis were included. Venous blood (<20 ml) for complete blood count was sent to lab before surgery. MPV >11fl was taken as increased value. Post-appendicectomy appendix was sent for histopathology. Sensitivity, specificity, positive and negative predictive values were calculated. Stratification was done. Chi-square test was applied post stratification and p-value ≤0.05 was considered as significant. Results: There were 128 male and 101 female. Mean age was 34.09±6.63 years. Mean duration of symptoms was 28.97±11.89 hours. 107 patients were observed with total leukocyte count >10X103µL. Mean platelets volume was more than 11 fl in 47.2% patients. Sensitivity, Specificity, PPV, NPV and accuracy were 74.6%, 91.6%, 92.5%, 71.9%, and 81.6% respectively. Conclusion: In conclusion in patients with temporary diagnosis of acute appendicitis, high MPV “≥ 11fl” can assist in the identification of acute appendicitis hence negative rate of appendectomy can be decreased.. Keywords: Diagnostic Accuracy, Increased Mean Platelet Volume, Acute Appendicitis, Histopathology

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