scholarly journals Application of Statistics in Establishing Diagnostic Certainty

2012 ◽  
Vol 47 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Craig R. Denegar ◽  
Mitchell L. Cordova
Keyword(s):  
Health Care ◽  
Confidence Intervals ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Diagnostic Tests ◽  
Athletic Trainers ◽  
Negative Outcomes ◽  
Certified Athletic Trainers ◽  
Statistical Procedures ◽  
Diagnostic Certainty

The examination and assessment of injured and ill patients leads to the establishment of a diagnosis. However, the tests and procedures used in health care, including procedures performed by certified athletic trainers, are individually and collectively imperfect in confirming or ruling out a condition of concern. Thus, research into the utility of diagnostic tests is needed to identify the procedures that are most helpful and to indicate the confidence one should place in the results of the test. The purpose of this report is to provide an overview of selected statistical procedures and the interpretation of data appropriate for assessing the utility of diagnostic tests with dichotomous (positive or negative) outcomes, with particular attention to the interpretation of sensitivity and specificity estimates and the reporting of confidence intervals around likelihood ratio estimates.

scholarly journals How to Analyze the Diagnostic Performance of a New Test? Explained with Illustrations

2021 ◽  
Author(s):  
Deepak Dhamnetiya ◽  
Ravi Prakash Jha ◽  
Shalini Shalini ◽  
Krittika Bhattacharyya
Keyword(s):  
Diagnostic Test ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Classification Model ◽  
Statistical Decision ◽  
Diagnostic Indices

AbstractDiagnostic tests are pivotal in modern medicine due to their applications in statistical decision-making regarding confirming or ruling out the presence of a disease in patients. In this regard, sensitivity and specificity are two most important and widely utilized components that measure the inherent validity of a diagnostic test for dichotomous outcomes against a gold standard test. Other diagnostic indices like positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy of a diagnostic test, and the effect of prevalence on various diagnostic indices have also been discussed. We have tried to present the performance of a classification model at all classification thresholds by reviewing the receiver operating characteristic (ROC) curve and the depiction of the tradeoff between sensitivity and (1–specificity) across a series of cutoff points when the diagnostic test is on a continuous scale. The area under the ROC (AUROC) and comparison of AUROCs of different tests have also been discussed. Reliability of a test is defined in terms of the repeatability of the test such that the test gives consistent results when repeated more than once on the same individual or material, under the same conditions. In this article, we have presented the calculation of kappa coefficient, which is the simplest way of finding the agreement between two observers by calculating the overall percentage of agreement. When the prevalence of disease in the population is low, prospective study becomes increasingly difficult to handle through the conventional design. Hence, we chose to describe three more designs along with the conventional one and presented the sensitivity and specificity calculations for those designs. We tried to offer some guidance in choosing the best possible design among these four designs, depending on a number of factors. The ultimate aim of this article is to provide the basic conceptual framework and interpretation of various diagnostic test indices, ROC analysis, comparison of diagnostic accuracy of different tests, and the reliability of a test so that the clinicians can use it effectively. Several R packages, as mentioned in this article, can prove handy during quantitative synthesis of clinical data related to diagnostic tests.

scholarly journals Assessment of Certified Athletic Trainers' Levels of Cultural Competence in the Delivery of Health Care

2010 ◽  
Vol 45 (4) ◽  
pp. 380-385 ◽  
Author(s):  
Jeremy Marra ◽  
Tracey Covassin ◽  
René R. Shingles ◽  
Renee Branch Canady ◽  
Tom Mackowiak
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Athletic Training ◽  
Delivery Of Health Care ◽  
Athletic Trainers ◽  
Years Of Experience ◽  
Culturally Competent ◽  
Culturally Competent Care ◽  
Certified Athletic Trainers ◽  
Race Ethnicity

Abstract Context: The concept of culture and its relationship to athletic training beliefs and practices is virtually unexplored. The changing demographics of the United States and the injuries and illnesses of people from diverse backgrounds have challenged health care professionals to provide culturally competent care. Objective: To assess the cultural competence levels of certified athletic trainers (ATs) in their delivery of health care services and to examine the relationship between cultural competence and sex, race/ethnicity, years of athletic training experience, and National Athletic Trainers' Association (NATA) district. Design: Cross-sectional survey. Setting: Certified member database of the NATA. Patients or Other Participants: Of the 13 568 ATs contacted, 3102 (age  =  35.3 ± 9.41 years, experience  =  11.2 ± 9.87 years) responded. Data Collection and Analysis: Participants completed the Cultural Competence Assessment (CCA) and its 2 subscales, Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behavior (CCB), which have Cronbach alphas ranging from 0.89 to 0.92. A separate univariate analysis of variance was conducted on each of the independent variables (sex, race/ethnicity, years of experience, district) to determine cultural competence. Results: The ATs' self-reported scores were higher than their CCA scores. Results revealed that sex (F1,2929  =  18.63, P  =  .001) and race/ethnicity (F1,2925  =  6.76, P  =  .01) were indicators of cultural competence levels. However, we found no differences for years of experience (F1,2932  =  2.34, P  =  .11) or NATA district (F1,2895  =  1.09, P  =  .36) and cultural competence levels. Conclusions: Our findings provide a baseline for level of cultural competence among ATs. Educators and employers can use these results to help develop diversity training education for ATs and athletic training students. The ATs can use their knowledge to provide culturally competent care to athletes and patients and promote a more holistic approach to sports medicine.

scholarly journals National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

2016 ◽  
Vol 51 (12) ◽  
pp. 1053-1070 ◽  
Author(s):  
Joel W. Beam ◽  
Bernadette Buckley ◽  
William R. Holcomb ◽  
Mario Ciocca
Keyword(s):  
Health Care ◽  
Adverse Reactions ◽  
Athletic Trainers ◽  
Position Statement ◽  
Athletic Trainer ◽  
Medical Professionals ◽  
Specific Knowledge ◽  
Certified Athletic Trainers ◽  
National Athletic Trainers Association ◽  
Certified Athletic Trainer

Objective:  To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. Background:  Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications. Recommendations:  These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma.

scholarly journals Validation of diagnostic tests and epidemiology of Helicobacter pylori infection in Bangladesh

2018 ◽  
Vol 12 (05) ◽  
pp. 305-312 ◽  
Author(s):  
Hafeza Aftab ◽  
Yoshio Yamaoka ◽  
Faruque Ahmed ◽  
Azad AK Khan ◽  
Phawinee Subsomwong ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Diagnostic Tests ◽  
Age Groups ◽  
Endoscopic Examination ◽  
Helicobacter Pylori Infection ◽  
Predictive Values ◽  
Urease Test ◽  
H Pylori

Introduction: Helicobacter pylori infection is associated with gastritis, peptic ulcer, and gastric cancer. We conducted a cross-sectional study to compare five diagnostic tests for H. pylori infection and studied the epidemiology of the infection in Bangladesh. Methodology: Bangladeshi patients with dyspeptic symptoms referred for endoscopic examination were enrolled in this study. Each patient underwent upper endoscopic examination and four gastric biopsy specimens were taken. We used 5 tests for the diagnosis of H. pylori; culture, histology confirmed by immunohistochemistry, rapid urease test (RUT), urinary and serological test. Demographic and environmental variables were collected. Results: A total of 133 patients participated in the study, 61 males and mean age 37.3 ± 12.3 years. We used the culture and/or histology results as the gold standard to estimate the sensitivity, specificity, positive and negative predictive values for the studied diagnostic tests. RUT, culture and histology had high sensitivity and specificity with moderate positive and negative likelihood ratio, whereas urine test and serology showed a good sensitivity and specificity but poor likelihood ratio. The overall prevalence of H. pylori among study subjects was 47% with no difference between gender and age groups. Conclusions: The invasive tests showed better performance than noninvasive tests among Bangladeshi population. The overall prevalence of H. pylori was less than the previously reported in the region with no difference among all age groups.

scholarly journals National Athletic Trainers' Association Position Statement: Environmental Cold Injuries

2008 ◽  
Vol 43 (6) ◽  
pp. 640-658 ◽  
Author(s):  
Thomas A. Cappaert ◽  
Jennifer A. Stone ◽  
John W. Castellani ◽  
Bentley Andrew Krause ◽  
Daniel Smith ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care Providers ◽  
Athletic Trainers ◽  
Position Statement ◽  
Care Providers ◽  
Certified Athletic Trainers ◽  
Problem Solving Skills ◽  
Work Related ◽  
National Athletic Trainers Association

Abstract Objective: To present recommendations for the prevention, recognition, and treatment of environmental cold injuries. Background: Individuals engaged in sport-related or work-related physical activity in cold, wet, or windy conditions are at risk for environmental cold injuries. An understanding of the physiology and pathophysiology, risk management, recognition, and immediate care of environmental cold injuries is an essential skill for certified athletic trainers and other health care providers working with individuals at risk. Recommendations: These recommendations are intended to provide certified athletic trainers and others participating in athletic health care with the specific knowledge and problem-solving skills needed to address environmental cold injuries. Each recommendation has been graded (A, B, or C) according to the Strength of Recommendation Taxonomy criterion scale.

Injury incidence and characteristics for elite, male, artistic USA gymnastics competitions from 2008 to 2018

2020 ◽  
pp. bjsports-2019-101297
Author(s):  
David William Kruse ◽  
Andrew Seiji Nobe ◽  
John Billimek
Keyword(s):  
Athletic Trainers ◽  
Common Type ◽  
Injury Incidence ◽  
Muscle Strain ◽  
Time Loss ◽  
Certified Athletic Trainers ◽  
Injury Site ◽  
The Usa ◽  
Location Type ◽  
Type Of Injury

ObjectivesTo determine the injury incidence and characteristics for elite, male, artistic USA gymnasts during gymnastics competitions, held in the USA, from 2008 to 2018.MethodsInjury documentation performed by lead physician and certified athletic trainers at elite junior and senior USA Gymnastics competitions from 2008 to 2018 were reviewed and compiled into an excel database. Injury incidence was computed per 1000 registered gymnasts by competition setting as well as injury location, type, cause, severity, and setting.ResultsFrom 2008 to 2018, 180 injuries were reported in a total of 2102 gymnasts with injury incidence of 85.6 per 1000 gymnasts (95% CI 73.4 to 97.8). The most common injury site was at the ankle (16.7 per 1000 gymnasts, 95% CI 10.9 to 22.4), and muscle strain/rupture/tear was the most common type of injury (28.5 per 1000 gymnasts, 95% CI 21.2 to 35.9). The most common cause was contact with surface (56.1 per 1000 gymnasts, 95% CI 46.1 to 66.2), and the event where most injuries were sustained was the vault (21.9 per 1000 gymnasts, 95% CI 15.4 to 28.4). Incidence of time loss injuries was 38.5 per 1000 gymnasts (95% CI 30.1 to 47.0). Injury incidence was higher during competition (58.5 per 1000 gymnasts, 95% CI 48.2 to 68.8) than during training (27.1 per 1000 RG, 95% CI 19.9 to 34.3; RR 2.16, 95% CI 1.59 to 2.94, p<0.001); injury incidence was greater at Olympic Trials (RR 3.23, 95% CI 1.24 to 8.47, p=0.017) than at National Qualifier meets. We report concussion incidence in gymnastics (5.7 per 1000 gymnasts, 95% CI 2.3 to 9.2).ConclusionsThis is the largest injury study to date for male artistic gymnasts (180 injuries, 2102 gymnasts, 11 years).

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