scholarly journals The sensitivity and specificity of wideband absorbance measure in identifying pathologic middle ears in adults living with HIV

2021 ◽  
Vol 68 (1) ◽  
Author(s):  
Ben Sebothoma ◽  
Katijah Khoza-Shangase ◽  
Duane Mol ◽  
Dipuo Masege
Keyword(s):  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Gold Standard ◽  
Screening Tool ◽  
Peak Pressure ◽  
Pure Tone Audiometry ◽  
Operating Characteristics ◽  
Immunodeficiency Virus ◽  
Living With Hiv ◽  
Better Than

Background: Limited research exists on the sensitivity and specificity of wideband acoustic immittance (WAI) in adults living with human immunodeficiency virus (HIV). This study forms part of the bigger study titled ‘wideband acoustic immittance in adults living with HIV’.Objectives: To determine the sensitivity and specificity of the wideband absorbance measure at tympanic peak pressure (TPP), as a screening tool for detecting middle ear pathologies in adults living with HIV.Method: A prospective nonexperimental study comprising 99 adults living with HIV was performed. All participants underwent a basic audiological test battery which included case history, video otoscopy, tympanometry, wideband absorbance at TPP and pure tone audiometry. Middle ear pathologies were established by two otorhinolaryngologists using asynchronous video otoscopic images analysis. The outcomes of the otorhinolaryngologists served as the gold standard against which the wideband absorbance at TPP and tympanometry were measured. The receiver operating characteristics (ROC) curve was calculated.Results: ROC revealed the sensitivity of wideband absorbance at TPP to be higher in low to mid frequencies, but significantly lower in frequencies above 971.53 Hz. The sensitivity of tympanometry was lower. However, there was no difference between the specificity of wideband absorbance at TPP and tympanometry, indicating that when there are no pathologies, tympanometry is equally accurate.Conclusion: The current findings reveal that wideband absorbance at TPP can distinguish middle ear pathologies better than the tympanometry. Incorporating wideband absorbance at TPP in clinical practice may improve early identification and intervention of middle ear pathologies.

Middle ear Pathologies in Adults Living with Human Immunodeficiency Virus: A Systematic Review

2020 ◽  
Vol 129 (8) ◽  
pp. 821-828
Author(s):  
Ben Sebothoma ◽  
Katijah Khoza-Shangase
Keyword(s):  
Systematic Review ◽  
Middle Ear ◽  
Pure Tone Audiometry ◽  
Careful Analysis ◽  
Negative Control ◽  
Occurrence Rate ◽  
Control Group ◽  
Published Evidence ◽  
Assessment Measures ◽  
Living With Hiv

Introduction: Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group. Purpose: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in adults living with HIV. Methods: A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included. Results: Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well as the different cut-off criteria used in studies seem to have an influence in the findings, with pure tone audiometry identifying more middle ear pathologies in the current review than tympanometry with 226 Hz probe tone and clinical examination. Otitis media, conductive hearing loss, and type B tympanogram were common findings reported in this study. No evidence of an association between the use of antiretroviral therapy (ART) and the rates of middle ear pathologies was found. Conclusion: Although there are very few studies that have reported on middle ear pathologies in adults living with HIV, the available studies have sufficiently established a link between HIV and middle ear disease in this population, and have revealed that the rate of occurrence is influenced by a number of factors. Key amongst these is the type of assessment measure used. Careful analysis of middle ear pathologies in this population through well controlled research designs that include different assessment measures. The use of case-control and longitudinal designs to determine differences between groups and to establish the time of onset and development of middle ear pathologies is required.

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

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
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.

scholarly journals Fukuda Stepping Test: Sensitivity and Specificity

2009 ◽  
Vol 20 (05) ◽  
pp. 311-314 ◽  
Author(s):  
Julie A. Honaker ◽  
Thomas E. Boismier ◽  
Nathan P. Shepard ◽  
Neil T. Shepard
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Analysis ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Future Research ◽  
Operating Characteristics ◽  
Caloric Irrigation ◽  
Test Sensitivity ◽  
Unilateral Weakness ◽  
Vestibular Asymmetry

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.

O003. Validity and acceptability of the Swahili pGALS screening tool at a tertiary referral hospital in Kenya

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Kawishe Jacqueline ◽  
Ngugi Anthony ◽  
Migowa Angela
Keyword(s):  
Median Time ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Screening Tool ◽  
Clinical Skills ◽  
Lower Sensitivity ◽  
African Countries ◽  
Tertiary Referral Hospital ◽  
Paediatric Rheumatologist

Abstract Background A common reason implicated in the severity of presentation and mortality caused by most rheumatic conditions among children is the delay of presentation to a paediatric rheumatologist. Evidence suggests poor practice of paediatric musculoskeletal clinical skills could be a cause for delay and that history suggestive of musculoskeletal disease alone has poor sensitivity in detecting rheumatological conditions. The paediatrics gait, arms, legs and spine (pGALS) musculoskeletal screening tool was therefore developed to encourage early detection of paediatric rheumatological conditions. It has been validated and translated successfully in other countries. Swahili is well understood and spoken in Kenya and other East African countries and for the pGALS to be incorporated in our setting, we needed to translate and asses its validity in Swahili. The objective is todetermine the sensitivity and specificity of the translated Swahili pGALS screening tool in detecting abnormal joints among children aged 5-16 years. To measure the acceptability of the Swahili pGALS screening tool with reference to time taken performing the examination and the discomfort as perceived by the children and their guardians. Methods We conducted a diagnostic utility study. The three English pGALS screening questions were translated into Swahili according to the WHO standard of translation of a tool and the manoeuvres were performed by a ‘copy me’ approach. The ‘copy me’ approach entailed asking the participants to imitate the research assistants as various manoeuvres were done. Children between the ages of 5–16 years seen at the Aga Khan University Accident and emergency department and family medicine clinic who spoke Swahili and had symptoms suggestive of musculoskeletal conditions were enrolled using systematic random sampling. Children who were already on follow up with the Aga Khan paediatric rheumatologist were excluded. Children had the Swahili pGALS and gold standard review (with the paediatric rheumatologist) on the same day. Guardians were asked to answer questions on acceptability with regards to time taken to perform the tool and level of discomfort. Those with possible rheumatological condition as per the gold standard were offered follow up. Results We enrolled one hundred children with a median age of the children was nine years (IQR 7–11). The sensitivity and specificity of the Swahili pGALS screening tool were 76.8% (CI 63.6–87.0%) and 40.0% (CI 23.9–57.9%). The diagnostic accuracy was 62.7% (CI 52.1–72.1%) and the ROC area was 0.58 (CI 0.48–0.68). The median time taken to perform the Swahili pGALS was 5.0 minutes (IQR 3.5-6.0 minutes). Ninety percent of the guardians found the practice of pGALS to have ‘no’ to ‘some’ discomfort. Conclusions This study had a lower sensitivity and specificity than what was seen with similar studies. Although the sensitivity seen was low, it was still within acceptable range for a screening tool and may still be applicable in Kenya and other Swahili speaking countries if used in conjunction with good rheumatological history to refer early the 76% of children picked up by the screening tool. However, the low specificity implies that relatively large number of false positives would still need to be reviewed by a rheumatologist if the tool is adapted for use. The median time taken to perform the tool was also longer than observed in previous studies but the tool was overall deemed acceptable by majority of the guardians/ parents. Keywords pGALS, Kenya, Swahili, Paediatric, Rheumatology

scholarly journals A comparison between video otoscopy and standard tympanometry findings in adults living with human immunodeficiency virus (HIV) in South Africa

2018 ◽  
Vol 65 (1) ◽  
Author(s):  
Ben Sebothoma ◽  
Katijah Khoza-Shangase
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Correlation Coefficient ◽  
Middle Ear ◽  
Probe Tone ◽  
Pearson’S Correlation Coefficient ◽  
Immunodeficiency Virus ◽  
Pearson's Correlation ◽  
Living With Hiv ◽  
Pearson's Correlation Coefficient

Background: Literature suggests that there is a correlation between video otoscopy and standard tympanometry findings. However, there is limited evidence on whether these two measures are comparable in the identification of middle ear pathologies in adults living with human immunodeficiency virus (HIV). Objective: This study aimed to determine the correlation between video otoscopy and standard tympanometry with 226 Hz probe tone in the identification of middle ear pathologies in adults living with HIV in Limpopo, South Africa. Method: A prospective, non-experimental, comparative design was employed on HIV-positive adults aged 18 years and older. All participants underwent basic audiological assessment including case history interviews, video otoscopy, tympanometry with a 226 Hz probe tone and pure tone audiometry. Two ear, nose and throat (ENT) specialists independently analysed video otoscopic images and provided their reports to the researcher, and these were compared to the tympanometry results. The IBM SPSS v.24 was used for data analysis, including the use of Cohen’s kappa to determine the agreement between the two procedures. Pearson’s correlation coefficient was used to determine the strength of the correlation between tympanometry and video otoscopy. Results: A total of 87 adults (N = 161 ears) took part in the study. Middle ear pathology was observed in 8% (n = 13) of the sample when tympanometry was used, and this increased to 10.6% (n = 17) when video otoscopy was utilised. Kappa statistics found a good agreement (k = 0.7) between the diagnoses made by two ENTs. However, there was poor agreement (k = 0.2) between the diagnoses by video otoscopy and tympanometry. Pearson’s correlation coefficient indicated weak correlation between video otoscopy and tympanometry (r = 0.195). Conclusion: Findings from this study suggest that video otoscopy may be more accurate in the identification of middle ear pathologies in adults living with HIV when compared to tympanometry. These findings have training implications in the use of video otoscopy to ensure accuracy and reliability. Clinical implications of current findings include the use of both video otoscopy and tympanometry in a complementary manner for more sensitive identification of middle ear pathologies in this population. Lastly, tele-audiologic implications of the use of video otoscopy to increase access in resource-constrained contexts are raised.

scholarly journals Sensitivity and specificity test of alarm malnutrition for hospital-acquired malnutrition among pediatric patients

2021 ◽  
Vol 43 (s1) ◽  
Author(s):  
Yuni Maria Olviani Ndede ◽  
Dessie Wanda ◽  
Efa Apriyanti
Keyword(s):  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Statistical Tests ◽  
Screening Tools ◽  
Nutritional Screening ◽  
Cross Sectional ◽  
Specificity Test ◽  
Cross Sectional Design ◽  
Hospital Acquired ◽  
Better Than

Detecting the risks for hospital-acquired malnutrition in children can be performed by using nutritional screening tools. One of the screening tools that has been created is Alarm Malnutrition. This study aimed to test the sensitivity and specificity of Alarm Malnutrition in detecting the risks for hospitalacquired malnutrition in comparison to Screening Tool for the Risk on Nutritional status and Growth (STRONGkids). This study employed cross sectional design and involved 168 hospitalized children (1 month to 18 years) at pediatric ward. The data were analyzed using diagnostic approach which resulted in sensitivity and specificity values. The statistical tests showed that the sensitivity and specificity values of Alarm Malnutrition and STRONGKids were 32,2% and 81,6% respectively. These results indicated that this screening tool was not better than STRONGkids which has been previously used in Indonesia. Alarm Malnutrition needs to be developed and improved in order to achieve better performance in detecting the risks for hospital-acquired malnutrition.

Predictive Accuracy of Wideband Absorbance at Ambient and Tympanometric Peak Pressure Conditions in Identifying Children with Surgically Confirmed Otitis Media with Effusion

2020 ◽  
Author(s):  
Venkatesh Aithal ◽  
Sreedevi Aithal ◽  
Joseph Kei ◽  
Shane Anderson ◽  
David Wright
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Peak Pressure ◽  
Predictive Accuracy ◽  
Otitis Media With Effusion ◽  
Ambient Pressure ◽  
Pressure Effects ◽  
Healthy Children ◽  
Operating Characteristics ◽  
Middle Ear Pressure

Background: Wideband absorbance (WBA) measured at ambient pressure (WBAA) does not directly accountfor middle ear pressure effects. On the other hand, WBA measured at tympanometric peak pressure(TPP) (WBATPP) may compensate for the middle ear pressure effects. To date, there are no studies thathave compared WBAA and WBATPP in ears with surgically confirmed otitis media with effusion (OME).<br />Purpose: The purpose of this study was to compare the predictive accuracy of WBAA and WBATPP inears with OME.<br />Research Design: Prospective cross-sectional study.<br />Study Sample: A total of 60 ears from 38 healthy children (mean age = 6.5 years, SD = 1.84 years) and60 ears from 38 children (mean age = 5.5 years, SD = 3.3 years) with confirmed OME during myringotomywere included in this study.<br />Data Collection and Analysis: Results were analyzed using descriptive statistics and analysis of variance.The predictive accuracy of WBAA and WBATPP was determined using receiver operating characteristics(ROC) analyses.<br />Results: Both WBAA and WBATPP were reduced in ears with OME compared with that in healthy ears.The area under the ROC (AROC) curve was 0.92 for WBAA at 1.5 kHz, whereas that for WBATPP at 1.25kHz was 0.91. In comparison, the AROC for 226-Hz tympanometry based on the static acoustic admittance(Ytm) measure was 0.93.<br />Conclusions: Both WBAA and WBATPP showed high and similar test performance, but neither test performedsignificantly better than 226-Hz tympanometry for detection of surgically confirmed OME.<br />

scholarly journals Development of a Brief Pre-Implementation Screening Tool to Identify Teachers Who Are at Risk for Not Implementing Intervention Curriculum and High-Implementing Teachers

2016 ◽  
Vol 44 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Bo Wang ◽  
Bonita Stanton ◽  
Sonja Lunn ◽  
Pooja Patel ◽  
Veronica Koci ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
High Performing ◽  
Hiv Intervention ◽  
School Based ◽  
National Implementation ◽  
School Based Interventions ◽  
Receiver Operating

Few questionnaires have been developed to screen for potentially poor implementers of school-based interventions. This study combines teacher characteristics, perceptions, and teaching/training experiences to develop a short screening tool that can identify potential “low-performing” or “high-performing” teachers pre-implementation. Data were gathered from 208 teachers and 4,411 students who participated in the national implementation of an evidence-based HIV intervention in The Bahamas. Sensitivity and specificity were evaluated for the detection of “low-performing” and “high-performing” teachers. The validity of the screening tool was assessed using receiver operating characteristics analysis. The School Pre-implementation Screening Tool consists of seven predictive factors: duration as teacher, working site, attendance at training workshops, training in interactive teaching, perceived importance of the intervention, comfort in teaching the curriculum, and program priority. The sensitivity and specificity were 74% and 57% in identifying “low-performing” teachers and 81% and 65% with “high-performing” teachers. The screening tool demonstrated an acceptable/good validity (area under the receiver operating characteristics curve was 0.68 for “low-performing teachers” and 0.78 for “high-performing” teachers). Our brief screening tool can facilitate teacher training and recruitment of engaged teachers in implementation of school-based interventions.

scholarly journals Operating Characteristics of a Tuberculosis Screening Tool for People Living with HIV in Out-Patient HIV Care and Treatment Services, Rwanda

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0163462 ◽  
Author(s):  
Kenneth Turinawe ◽  
Greet Vandebriel ◽  
David W. Lowrance ◽  
Francois Uwinkindi ◽  
Philippe Mutwa ◽  
...  
Keyword(s):  
Screening Tool ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Operating Characteristics ◽  
Tuberculosis Screening ◽  
Treatment Services ◽  
Care And Treatment ◽  
Living With Hiv

The Use of Tympanometry and Pneumatic Otoscopy for Predicting Middle Ear Disease

2005 ◽  
Vol 14 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Paula K. Harris ◽  
Kathleen M. Hutchinson ◽  
Joseph Moravec
Keyword(s):  
Otitis Media ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Gold Standard ◽  
Pediatric Population ◽  
Common Condition ◽  
Routine Basis ◽  
History Of ◽  
Middle Ear Disease ◽  
Larger Sample

Purpose: Otitis media is the most common condition diagnosed by pediatricians and is estimated to affect approximately 70% of the pediatric population. The goal of this study was to evaluate the effectiveness of otoscopy and multifrequency tympanometry (MFT) for diagnosis of otitis media in children. Method: Twenty-one children, age 1 to 10 years, who were seeking medical treatment for suspected middle ear disease were selected to participate. Data were collected prior to myringotomy to determine the sensitivity and specificity rates of the following otologic and audiologic measures: (a) pneumatic otoscopy, (b) conventional tympanometry, and (c) MFT. For this study, the "gold standard," myringotomy, was used along with pneumatic otoscopy to determine the effectiveness, sensitivity, and specificity of conventional 226-Hz tympanometry, 678-Hz tympanometry, and 1000-Hz tympanometry to predict middle ear disease. Results: The diagnoses provided with pneumatic otoscopy and tympanometry were both similar, agreeing in diagnosis 80%–100% of the time. The diagnoses from 678-Hz and 1000-Hz tympanometry were nearly equal and proved to detect abnormality at a higher rate. Conclusions: MFT is recommended on a routine basis with children having a history of otitis media, or else abnormal or notched 226-Hz tympanograms. Further research with a larger sample size will illuminate the possible predictive potential of MFT in otitis media.

Sign in / Sign up

Export Citation Format

Share Document