scholarly journals Implications of Alterations in Pre-test Probability in the 2019 Update of ESC Guidelines for Chronic Coronary Syndromes on Diagnostic Accuracy of Pharmacological Stress-Echocardiography: A Retrospective Cohort Study

2021 ◽  
Vol 29 (2) ◽  
pp. 160 ◽  
Author(s):  
Iryna Dykun ◽  
Stefanie Hendricks ◽  
Bastian Balcer ◽  
Matthias Totzeck ◽  
Fadi Al-Rashid ◽  
...  
Keyword(s):  
Cohort Study ◽  
Diagnostic Accuracy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Stress Echocardiography ◽  
Pharmacological Stress ◽  
Coronary Syndromes ◽  
Esc Guidelines ◽  
Test Probability

scholarly journals Simplified Clinical Decision Rule Using Clinically Important Events for Risk Prediction in Pediatric Head Injury: A Retrospective Cohort Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5248
Author(s):  
Naoki Yogo ◽  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Head Injury ◽  
Diagnostic Accuracy ◽  
Decision Rule ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Characteristic Curve ◽  
Clinical Decision ◽  
The Novel ◽  
Clinical Decision Rule

Computed tomography (CT) scans are useful for confirming head injury diagnoses. However, there is no standard clinical decision rule (CDR) for determining the need for CT scanning in pediatric patients with head injuries. We developed a CDR and conducted a retrospective cohort study to evaluate its diagnostic accuracy in identifying children with clinically important traumatic brain injury (ciTBI). We selected predictors based on three existing CDRs: CATCH, CHALICE, and PECARN. Of the 2569 eligible patients, 645 (439 (68%) boys, median age: five years) were included in this study. In total, 59 (9%) patients showed ciTBI, and 129 (20%) were admitted to hospital. The novel CDR comprised six predictors of abnormal CT findings. It had a sensitivity of 79.5% (95% confidence interval (CI): 65.5–89.0%) and a specificity of 50.9% (95% CI: 48.9–52.3%). The area under the receiver-operating characteristic curve (0.72, 95% CI: 0.67–0.77) was non-inferior to those of CATCH, CHALICE, and PECARN (0.71, 95% CI: 0.66–0.77; 0.67, 95% CI: 0.61–0.74; and 0.69, 95% CI: 0.64–0.73, respectively; p = 0.57). The novel CDR was statistically noninferior in diagnostic accuracy compared to the three existing CDRs. Further development and validation studies are needed before clinical application.

Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single-centre retrospective cohort study

2018 ◽  
Vol 89 (4) ◽  
pp. 489-495 ◽  
Author(s):  
Asena Gökçay Canpolat ◽  
Mustafa Şahin ◽  
Elif Ediboğlu ◽  
Murat Faik Erdoğan ◽  
Sevim Güllü ◽  
...  
Keyword(s):  
Cohort Study ◽  
Parathyroid Hormone ◽  
Diagnostic Accuracy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Single Centre ◽  
Hormone Levels ◽  
Parathyroid Adenomas

Comparing the diagnostic accuracy of ultrasound in the community and in the hospital setting for urinary calculi: A retrospective cohort study

2016 ◽  
Vol 10 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Mathew Westergreen-Thorne ◽  
Sook Yan Lee ◽  
Kunle Babawale ◽  
Catherine Lovegrove ◽  
John Brewer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Diagnostic Accuracy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Urinary Calculi ◽  
Hospital Setting ◽  
Community Setting ◽  
Exact Test ◽  
Significant Difference ◽  
The Uk

Objective: The objective of this article is to test whether there is a significant difference in diagnostic accuracy between hospital and community-based ultrasound (US) for the detection of urinary calculi in the United Kingdom (UK). Materials and methods: A 30-month, single-blind, retrospective cohort study of all patients referred to Kent and Canterbury Hospital urology multidisciplinary meeting for suspected urinary calculi was conducted. Only those investigated with US and non-contrast computed tomography (NCCT, the gold standard) for their calculi were included. Concordance of US and NCCT was stratified by US location: i.e. either the hospital or community setting (e.g. the latter via general practitioners (GPs) or independent radiographers). Fisher’s exact test was subsequently utilised to test for any significant difference between these two patient groups. Results: Of 2464 patients referred, 257 had both ultrasound and NCCT in their diagnostic workup. Of these, 150 and 107 patients had their US performed in hospital and community settings, respectively. No significant difference in the accuracy of US was detected between the two groups for the detection of urinary calculi when compared with NCCT. Conclusion: US carried out by independent radiographers and GPs in the community is just as accurate as US carried out by hospital sonographers for the detection of urinary calculi in the UK. Greater use of community US for the diagnosis of urinary calculi may promote greater patient/GP satisfaction and reduce hospital attendance without loss of diagnostic accuracy.

scholarly journals P3. Acute coronary syndromes in patients with giant cell arteritis: a population based retrospective cohort study

Rheumatology ◽  
2014 ◽  
Vol 53 (suppl 2) ◽  
pp. i13-i13
Author(s):  
P. Deepak Udayakumar ◽  
A. K. Chandran ◽  
C. S. Crowson ◽  
K. J. Warrington ◽  
E. L. Matteson
Keyword(s):  
Cohort Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Retrospective Cohort Study ◽  
Acute Coronary Syndromes ◽  
Retrospective Cohort ◽  
Population Based ◽  
Coronary Syndromes

scholarly journals The diagnostic and predictive accuracy of thyroglobulin to TSH ratio and TSH to thyroglobulin ratio in detecting differentiated thyroid carcinoma in normothyroid patients with thyroid nodules: A retrospective cohort study and systematic review of the literature

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Evangelos Karvounis ◽  
Ioannis Kappas ◽  
Anna Angelousi ◽  
George-Marios Makris ◽  
Thomas D. Siamatras ◽  
...  
Keyword(s):  
Cohort Study ◽  
Diagnostic Accuracy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Thyroid Nodules ◽  
Predictive Accuracy ◽  
Predictive Marker ◽  
Thyroid Stimulating Hormone ◽  
Benign Disease ◽  
International Literature

The purpose of the present study is to examine the diagnostic and predictive accuracy of the thyroglobulin (Tg) to thyroid stimulating hormone (TSH) and TSH/Tg ratios in normothyroid patients with differentiated thyroid cancer (DTC). We conducted a retrospective cohort study evaluating the diagnostic accuracy of the serum Tg/TSH and TSH/Tg ratios in normothyroid patients with thyroid nodules. We also systematically searched the international literature using the Medline, Cochrane’s CENTRAL, Scopus, Clinicaltrials.gov, EMBASE, and Google Scholar databases for evidence concerning the diagnostic and predictive accuracy of these ratios. Overall, 374 patients were identified in our cohort study of whom 240 were treated for benign disease and 134 were treated for DTC. Significant differences were noted in the Tg/TSH and TSH/Tg values among cases with malignant and benign disease (P=0.020). However, the diagnostic ROC curve did not confirm these results (Tg/TSH=0.572 and TSH/Tg=0.428). After searching the international literature, we identified 8 studies. The majority of the included data reported significant differences among patients with benign/malignant disease and those with successful iodine therapy compared to those with disease relapse. However, the clinical relevance was clearer among studies that investigated the usefulness of these ratios in predicting recurrent disease. The findings of our study support that the Tg/TSH ratio increases in patients with DTC and can, thus, become useful in the future as a predictive marker of ablative 131I therapy success. However, given the significant variability of Tg its diagnostic accuracy remains to date minimal; thus, the actual cut-off value that can be used to discriminate cancer cases from benign disease has not been determined yet.

scholarly journals Diagnostic accuracy of subjective dyspnoea in detecting hypoxaemia among outpatients with COVID-19: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046282
Author(s):  
Linor Berezin ◽  
Alice Zhabokritsky ◽  
Nisha Andany ◽  
Adrienne K Chan ◽  
Jose Estrada-Codecido ◽  
...  
Keyword(s):  
Cohort Study ◽  
Diagnostic Accuracy ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Likelihood Ratios ◽  
Primary Analysis ◽  
Risk Patients

ObjectivesThe majority of patients with mild-to-moderate COVID-19 can be managed using virtual care. Dyspnoea is challenging to assess remotely, and the accuracy of subjective dyspnoea measures in capturing hypoxaemia have not been formally evaluated for COVID-19. We explored the accuracy of subjective dyspnoea in diagnosing hypoxaemia in COVID-19 patients.MethodsThis is a retrospective cohort study of consecutive outpatients with COVID-19 who met criteria for home oxygen saturation monitoring at a university-affiliated acute care hospital in Toronto, Canada from 3 April 2020 to 13 September 2020. Dyspnoea measures were treated as diagnostic tests, and we determined their sensitivity (SN), specificity (SP), negative/positive predictive value (NPV/PPV) and positive/negative likelihood ratios (+LR/−LR) for detecting hypoxaemia. In the primary analysis, hypoxaemia was defined by oxygen saturation <95%; the diagnostic accuracy of subjective dyspnoea was also assessed across a range of oxygen saturation cutoffs from 92% to 97%.ResultsDuring the study period, 89/501 (17.8%) of patients met criteria for home oxygen saturation monitoring, and of these 17/89 (19.1%) were diagnosed with hypoxaemia. The presence/absence of dyspnoea had limited accuracy for diagnosing hypoxaemia, with SN 47% (95% CI 24% to 72%), SP 80% (95% CI 68% to 88%), NPV 86% (95% CI 75% to 93%), PPV 36% (95% CI 18% to 59%), +LR 2.4 (95% CI 1.2 to 4.7) and −LR 0.7 (95% CI 0.4 to 1.1). The SN of dyspnoea was 50% (95% CI 19% to 81%) when a cut-off of <92% was used to define hypoxaemia. A modified Medical Research Council dyspnoea score >1 (SP 98%, 95% CI 88% to 100%), Roth maximal count <12 (SP 100%, 95% CI 75% to 100%) and Roth counting time <8 s (SP 93%, 95% CI 66% to 100%) had high SP that could be used to rule in hypoxaemia, but displayed low SN (≤50%).ConclusionsSubjective dyspnoea measures have inadequate accuracy for ruling out hypoxaemia in high-risk patients with COVID-19. Safe home management of patients with COVID-19 should incorporate home oxygenation saturation monitoring.

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