scholarly journals Evaluation of the diagnostic accuracy of a hemoglobin S and C screening test: Sickle Scan

2021 ◽  
Vol 15 (1) ◽  
pp. 234-240
Author(s):  
L. Adjé ◽  
V. Yapo ◽  
M. Yayo-Ayé ◽  
S. Bognini ◽  
M. Meledje ◽  
...  

New tools for the rapid diagnosis of hemoglobinosis could encourage the extension of their screening in Africa. Our goal was to assess the analytical performances of a rapid hemoglobin S and C detection test, the Sickle Scan. This was a cross-sectional study carried out in March 2019 at the Yopougon Teaching Hospital. The subjects followed for hemoglobinosis as well as the subjects seeking out an electrophoresis of their hemoglobin were included. We carried out the hemogram, the electrophoresis of hemoglobin at alkaline pH (reference method) coupled with the metabisulfite sickling test (Emmel test) and the rapid detection test to be evaluated. This immunochromatographic test is capable of detecting hemoglobins A, S, and C, and to infer the hemoglobin phenotype from there. The study recruited 191 individuals. The test detected hemoglobins S and C with a sensitivity of 99.4% and 97.7% respectively; a specificity of 93.3% and 99.3%. The positive likelihood ratio for hemoglobins S and C was 15 and 144 respectively. The negative likelihood ratio was 0.01 for hemoglobin S, and 0.02 for hemoglobin C. The intrinsic characteristics obtained make this test an interesting screening tool for hemoglobinosis S and C. Keywords: Diagnostic test, hemoglobinosis, Abidjan, sensitivity, specificity.

Author(s):  
Fatma Hegazy ◽  
Emad Aboelnasr ◽  
Amr A. Abdel-Aziem ◽  
In-Ju Kim

Background: Clinical diagnosis of Paediatric flexible flatfoot is still a challenging issue for the healthcare professionals. Clarke's Angle (CA) is frequently used clinically for assessing foot posture; however there is still a debate about its validity and diagnostic accuracy in evaluation of static foot posture especially in Paediatric population with some previous studies supporting, while the others are refuting its validity. The current study aimed to investigate validity and diagnostic accuracy of CA using radiographic findings as a criterion standard measure to determine flexible flatfoot between ages of 6-18 years. Methods: A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6-18 years (12.36 {plus minus}3.39) was recruited. The clinical measures results were compared to the criterion standard radiographic measures and displayed on the receiver operating characteristic curve (ROC) and the area under ROC curve (AUC) was computed. Intra-rater reliability, sensitivity, specificity, predictive values, and likelihood ratios were calculated for CA. Fagan nomogram was used to detect the posttest probability. Results: Clarke's angle (CA) demonstrated higher intra-rater reliability (ICC=0.99). CA showed higher sensitivity (98.4%), specificity (98.8), positive predictive value (97.3), negative predictive value (99.3), positive likelihood ratio (84) and negative likelihood ratio (0.02). AUC was 0.98[95%CI= 0095-1.00]. The positive likelihood ratio (LR+) yielded a posttest probability of 97%, while the negative likelihood ratio (LR−) yielded a posttest probability of 0.02. Conclusions: CA is a valid with high diagnostic accuracy in diagnosis of flexible flatfoot between the ages of 6-18 years.


Dermatology ◽  
2019 ◽  
Vol 235 (2) ◽  
pp. 101-106
Author(s):  
María Victoria Martire ◽  
María Paula Girard Bosch ◽  
Santiago Scarafia ◽  
Vanesa Cosentino ◽  
Maria Janina Tapia Moreira ◽  
...  

Background/Objective: Psoriatic arthritis (PsA) is preceded by psoriasis in approximately 80% of cases. Dermatologists are pivotal for early detection. It is important to have simple tools that allow the detection of PsA in patients with skin psoriasis. The aim of our study was to evaluate the performance of an adapted version of the GEPARD Questionnaire in Spanish in Argentinian patients with psoriasis. Methods: This is a cross-sectional study. A new Spanish (Argentinian) (GEPARDa) translated version of the original questionnaire (German) was developed and then tested as a diagnostic tool in patients with psoriasis, PsA, osteoarthritis associated to psoriasis, and osteoarthritis, all evaluated by rheumatologists who used the CASPAR criteria. Results: Eighty-three patients were included (55 [66.3%] women with a mean age of 50.7 years [SD 6.3]). Forty-four patients had PsA (29 [34.9%] patients had previous diagnosis of PsA, and 15 [18%] were newly diagnosed after referral by their dermatologists), and 39 patients were without PsA (18 [21.6%] patients had psoriasis without articular involvement, 6 [7.22%] had psoriasis associated with osteoarthritis, and 15 [18%] had osteoarthritis). An area under the curve of 0.9554 (SD 0.01; 95% CI 0.91–0.99) was calculated considering the CASPAR criteria as the gold standard. With a cutoff of ≥6 the questionnaire showed a sensitivity of 88.64%, a specificity of 89.74%, a positive likelihood ratio of 8.6, and a negative likelihood ratio of 0.12. Conclusions: The GEPARDa version has proven to be a diagnostic tool with excellent performance so that it can be considered a valid tool for the detection of PsA in Argentinian patients.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Samaneh Rokhgireh ◽  
Abolfazl Mehdizadeh Kashi ◽  
Shahla Chaichian ◽  
Ali-Akbar Delbandi ◽  
Leila Allahqoli ◽  
...  

Background. The present study was designed to verify the accuracy of the noninvasive biomarkers enolase/Cr, CA125, and CA19-9 as a clinical diagnostic tool for the detection of endometriosis. Methods. A cross-sectional study was performed at Rasool-e-Akram Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran, from April 2015 to April 2018. Eighty-six women were scheduled to undergo laparoscopy due to chronic pelvic pain, infertility, pelvic mass, and abnormal uterine bleeding. Serum and urine samples of all patients were collected preoperatively. Serum levels of CA125 and CA19-9, and urine levels of enolase-1 were measured. Serum levels of CA125 and CA19-9 were determined by the electrochemiluminescence method (ECL). Urinary enolase-1 was measured by the ELISA method. Result. Serum levels of CA125 and CA19-9 were significantly higher in the endometriosis group than in controls (p<0.001, p=0.004, respectively). Levels of enolase I and enolase/Cr were higher in patients with endometriosis, but the differences were not statistically significant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of combined enolase/Cr, CA125, and CA19-9 were 65%, 66.6%, 71%, and 60.1%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of combined enolase/Cr, CA125, and CA19-9 was 1.94 and 0.52, respectively. The area under the ROC curve for enolase/Cr+CA125+CA19−9 was 0.675 (95% confidence interval 0.573-0.710). Conclusion. The present study revealed that concurrent measurement of enolase-1, CA125, and CA19-9 might be a valuable noninvasive test for the identification of endometriosis.


Author(s):  
Amar Taksande ◽  
Rupesh Rao ◽  
Sachin Yedve ◽  
Patel Zeeshan Jameel ◽  
Revat Meshram

Background: Planter reflex is still an essential part of the neurological examination. The usual plantar reflex involved bending of the big toe or no response. There is a positive Babinski signal with corticospinal dysfunction, which involves big toe dorsal flexion and the accompanying fanning of the other toes. It’s one of the infant reflexes that disappers as the infant nervous system grows. The plantar reaction is primarily extensive in stable, term neonates. Many have researched this reflex's accuracy but very few studies have analyzed the various techniques of the planting reflex. Objective: To assess the five different technique of eliciting the plantar reflex in newborn babies. Materials and Methods: In this cross-sectional study, the eligible healthy newborn will be given the different methods for the elicitation of the plantar reflex i.e. Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. During this procedure, we will record  the baseline RR, HR, and SpO2 before, and after the procedure. Three pediatric residents of the different years will be selected for examining the newborn reflexes throughout the study period. Results: After completion of the study, we will come to know the negative likelihood ratio, negative predictive value, positive predictive, specificity, positive likelihood ratio, and sensitivity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. Conclusion: The study will probably give us information about the sensitivity and specificity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign for the elicitation of the plantar reflex in the neonates.


Author(s):  
Giselle Fachetti-Machado ◽  
Rosane Ribeiro Figueiredo-Alves ◽  
Marise Amaral Rebouças Moreira

Abstract Purpose To evaluate prevalence and diagnostic performance of three colposcopic images to diagnose squamous and glandular cervical precursor neoplasias. Methods Cross-sectional study, conducted through analysis of stored digital colposcopic images. To evaluate the diagnostic performance of three images, herein named grouped glands, aceto-white villi, and atypical vessels, for detection of adenocarcinoma in situ (AIS) and cervical squamous intraepithelial neoplasias (CIN) grades 2 and 3, calculations of sensitivity, specificity, accuracy, positive likelihood ratio, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were made, with their respective 95% confidence intervals. Results Grouped glands, aceto-white villi, and atypical vessels images had: prevalence of 21.3, 53.8, and 33.8% in patients with AIS, and 16.2, 19.5, and 9.3% in those with CIN 2 and 3; for the diagnosis of AIS, sensitivity of 21.3, 53.8, and 33.8%, specificity of 89.8, 95.2, and 94.9%, accuracy of 76.6, 87.2, and 83.1%, positive likelihood ratio of 2.1, 11.2, and 6.6, and AUC of 0.55, 0.74, and 0.64; for the diagnosis of CIN 2 and 3, sensitivity of 16.2, 19.5, and 9.3%, specificity of 89.8, 95.2, and 94.9%, accuracy of 39.4, 43.4, and 36.3%, positive likelihood ratio of 1.6, 4.1, and 1, 8, and AUC of 0.53, 0.57, and 0.52, respectively. Conclusion Prevalence and accuracy of the three images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias. Sensitivity, specificity, positive likelihood, and AUC of aceto-white villi and atypical vessels images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias.


2021 ◽  
Vol 20 ◽  
pp. 153303382110119
Author(s):  
Wen-Ting Zhang ◽  
Guo-Xun Zhang ◽  
Shuai-Shuai Gao

Background: Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia. Methods: A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias. Results: 49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found. Conclusions: Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.


2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Zhanzhan Li ◽  
Yanyan Li ◽  
Jun Fu ◽  
Na Li ◽  
Liangfang Shen

AbstractWe conducted comprehensive analyses to assess the diagnostic ability of miRNA-451 in cancers. A systematic online search was conducted in PubMed, Web of Science, China’s national knowledge infrastructure, and VIP databases from inception to July 31, 2017. The bivariate random effect model was used for calculating sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under cure (AUC). The whole pooled sensitivity and specificity were 0.85 (0.77–0.90) and 0.85 (0.78–0.90) with their 95% confidence interval (95%CI), respectively. The pooled AUC was 0.91 (95%CI: 0.89–0.94). Positive likelihood ratio was 5.57 (95%CI: 3.74–8.31), negative likelihood ratio was 0.18 (95%CI: 0.11–0.28), and diagnostic odds ratio was 31.33 (95%CI: 15.19–64.61). Among Asian population, the sensitivity and specificity were 0.85 (95%CI: 0.77–0.91) and 0.86 (95%CI: 0.78–0.91), respectively. The positive likelihood ratio and negative likelihood ratio were 5.87 (95%CI: 3.78–9.12) and 0.17 (95%CI: 0.11–0.28). The diagnostic odds ratio and AUC were 34.31 (15.51–75.91) and 0.92 (0.89–0.94). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and AUC for digestive system cancer were 0.83, 0.88, 6.87, 0.20, 35.13, and 0.92, respectively. The other cancers were 0.87, 0.81, 4.55, 0.16, 28.51, and 0.90, respectively. For sample source, the results still remain consistent. Our results indicated miRNA-451 has a moderate diagnostic ability for cancers, and could be a potential early screening biomarker, and considered as an adjuvant diagnostic index when being combined with other clinical examinations.


2018 ◽  
Vol 4 (2) ◽  
pp. 133-136
Author(s):  
Md Akter Hossain ◽  
Md Saiful Haque ◽  
Mostaque Ahmed Bhuiya ◽  
Abu Bakar Siddique

Background: CT-scan can detect hepatocelluar carcinoma among the patients.Objective: The purpose of the present study was to see the pattern of hepatocelluar carcinoma among the patients attended at a tertiary care hospital in Dhaka city.Methodology: This cross-sectional study was carried out in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to May 2008 for a period of around one and half year. All the patients presented with hepatocellular carcinoma at the age group of more than 20 years with both sexes were selected as study population. The patients were undergone CT-scan examination and the confirmation of tumor was performed by histopathological examination.Result: A total number of 50 patients were recruited in this study after fulfilling the inclusion and exclusion criteria. The sensitivity, specificity and accuracy of CT-scan in detecting hepatocellular carcinoma was seen to be 66%, 92% and 72% respectively. The PPV and NPV were 96.15% (95% CI 79.06% to 99.40%) and 45.83% (95% CI 34.53% to 57.58%) respectively. However, the Positive Likelihood Ratio and Negative Likelihood Ratio were 7.89 (95% CI 1.19 to 52.28) and 0.37(95% CI 0.23 to 0.60).Conclusion: In conclusion CT-scan is a good diagnostic tool for the detection of hepatocellular carcinoma.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 133-136


2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Qingqin Hao ◽  
Yadi Han ◽  
Wei Xia ◽  
Qinghui Wang ◽  
Huizhong Qian

Emerging studies have reported circRNAs were dysregulated in HCC. However, the clinical value of these circRNAs remains to be clarified. Herein, we aimed to comprehensively explore their association with the diagnosis, prognosis, and clinicopathological characteristics of HCC. PubMed, EMBASE, Web of Science, and Cochrane Library databases were comprehensively searched for eligible studies up to October 30, 2018. The diagnostic effect was evaluated by the pooled sensitivity, specificity, and other indexes. The pooled hazard ratio (HR) for overall survival (OS) and recurrence free survival (RFS) was calculated to assess the prognostic value. Ten studies on diagnosis, 12 on prognosis, and 23 on clinicopathology were identified from the databases. A total of 11 upregulated and 11 downregulated circRNAs showed an association with clinicopathological features of HCC. For the diagnosis analyses, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of circRNAs for HCC were 0.74 (95%CI: 0.65-0.82) and 0.76 (95%CI: 0.70-0.81), 3.1 (95%CI: 2.5-3.8), 0.34 (95%CI: 0.25-0.47), and 9 (95%CI: 6-14), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.78–0.84), indicating moderate diagnostic accuracy. In stratified analyses, the diagnostic performance of circRNAs varied based on the source of control and specimen type. For the prognosis analyses, increased expression of upregulated circRNAs was associated with worse OS (HR: 3.67, 95%: 2.07-6.48), while high expression of downregulated circRNAs was associated with better OS (HR: 0.38, 95%: 0.30-0.48). In conclusion, this study reveals that circRNAs may serve as promising diagnostic and prognostic biomarkers for HCC. However, further investigations are still required to explore the clinical value of circRNAs.


2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Ding Shi ◽  
Xiao-xia Xi

Background. Endoscopic ultrasonography (EUS) is the first imaging modality for investigating the depth of invasion in early gastric cancer (EGC). However, there is presently no consensus on the accuracy of EUS in diagnosing the invasion depth of EGC. Aim. This study is aimed at systematically evaluating the accuracy of EUS in diagnosing the invasion depth of EGC and its affecting factors. Methods. The literatures were identified by searching PubMed, SpringerLink, Cochrane Library, Web of Science, Nature, and Karger knowledge databases. Two researchers extracted the data from the literature and reconstructed these in 2×2 tables. The Meta-DiSc software was used to evaluate the overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic advantage ratio, and 95% confidence interval (CI). The SROC was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value. Results. A total of 17 articles were selected, which included 4525 cases of lesions. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic dominance ratio, and 95% CI of EUS for diagnosing EGC was 0.87 (95% CI: 0.86-0.88), 0.67 (95% CI: 0.65-0.70), 2.90 (95% CI: 2.25-3.75), 0.17 (95% CI: 0.13-0.23), and 18.25 (95% CI: 12.61-26.39), respectively. The overall overstaging rate of mucosa/submucosa 1 (M/SM1) and SM by EUS was 13.31% and 32.8%, respectively, while the overall understaging rate of SM was 29.7%. The total misdiagnosis rates for EUS were as follows: 30.4% for lesions≥2 cm and 20.9% for lesions<2 cm, 27.7% for ulcerative lesions and 21.4% for nonulcerative lesions, and 22% for differentiated lesions and 26.9% for undifferentiated lesions. Conclusion. EUS has a moderate diagnostic value for the depth of invasion of EGC. The shape, size, and differentiation of lesions might be the main factors that affect the accuracy of EUS in diagnosing EGC.


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