Diagnostic Accuracy of tumor marker CA 19-9 in patients with cholangiocarcinoma taking ERCP as gold standard test”

2021 ◽  
Vol 15 (8) ◽  
pp. 2027-2030
Author(s):  
Aftab Haider Alvi ◽  
Aijaz Zeeshan Khan Chachar ◽  
Abdul Kafi ◽  
Abdul Farooq ◽  
Sajjad Ali ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Tumor Marker ◽  
Gold Standard ◽  
Early Stage ◽  
Tumour Marker ◽  
Standard Test ◽  
Diagnostic Methods ◽  
Easy Access ◽  
Confirmatory Test ◽  
Gold Standard Test

Background: Majority of the cases of Cholangiocarcinoma at presentation are unresectable, it’s diagnosis at an early stage is pivotal but generally difficult due to lack of easy availaibility of confirmatory test at the moment in our country. Endoscopic Retrograde Cholangiopancreatography (ERCP) is not only helpful in reaching the diagnosis Aim: To find out the diagnostic accuracy of tumour marker CA 19-9, in suspected patients of Cholangiocarcinoma taking ERCP as gold standard test Methods: This cross sectional study was conducted in general and private clinics of Department of Gastroenterology of the Fatima Memorial Hospital Lahore from, October 21, 2014 to April 20, 2015. Sampling technique used was probability purposive sampling. Results: A total of 150 suspected patients of cholangiocarcinoma were included in the study in which 61 (40.7%) were male and 89(59.3%) were female with total mean age of 56.32±14.13 years. Among the studied patients, 88(58.7%) were found positive for malignant stricture on ERCP and CBD brushing cytology. Sensitivity, specificity and accuracy of the tumour marker CA 19-9 was 53.4%, 66.1% and 58% respectively. Conclusions: CA 19-9 is a very important tumor marker in making diagnosis of cholangiocarcinoma and in our country due to lack of easy access/availability to invasive diagnostic methods like endoscopic ultrasonography (EUS) and fine needle aspiration (FNA) of the tumor. It should be used as routine early diagnostic modality in suspected cases of Cholangiocarcinoma. Keywords: Cholangiocarcinoma, Cancer antigen (CA) 19-9, ERCP, biliary brushing and cytology

scholarly journals Complications of nasal SARS-CoV-2 testing: a review

2021 ◽  
pp. jim-2021-001962
Author(s):  
James H Clark ◽  
Sharon Pang ◽  
Robert M Naclerio ◽  
Matthew Kashima
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Middle Turbinate ◽  
Standard Test ◽  
Collection Site ◽  
Local Resources ◽  
Gold Standard Test ◽  
Specimen Collection ◽  
Increased Risk ◽  
Control And Prevention

Transnasal swab testing for the detection of SARS-CoV-2 is well established. The Centers for Disease Control and Prevention advocates swabbing either of the anterior nares, middle turbinate, or nasopharynx for specimen collection depending on available local resources. The purpose of this review is to investigate complications related to transnasal SARS-CoV-2 testing with specific attention to specimen collection site and swab approach. The literature demonstrates that while nasopharyngeal swabbing is associated with an increased risk of complications, it should remain the gold-standard test due to greater diagnostic accuracy relative to anterior nasal and middle turbinate swabs.

scholarly journals Diagnostic Value of Immature-to-Total Neutrophil Ratio in Neonatal Sepsis

2019 ◽  
Vol 8 (4) ◽  
pp. 166-170
Author(s):  
Husnain Ali ◽  
Ejaz Hussain ◽  
Imran Mahmood Khan ◽  
Iqtada Haider Shirazi ◽  
Muhammad Imran ◽  
...  
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Gold Standard ◽  
Diagnostic Value ◽  
Standard Test ◽  
Negative Blood Culture ◽  
Gold Standard Test ◽  
Sensitivity Specificity

Background: Neonatal sepsis is the third most common reason of neonatal mortality in Pakistan. Blood culture, the gold standard test for diagnosis of neonatal sepsis, is time consuming. Therefore, rapid diagnostic tests with good specificity and sensitivity is needed for accurate and early diagnosis of this condition. The objective of this study was to determine the diagnostic value of abnormal (≥ 0.2) immature-to-total-neutrophil ratio in neonatal sepsis.Material and Methods: This cross-sectional study was carried out on 288 neonates, aged 0-28 days, admitted with suspected sepsis. Detailed history of the neonates was recorded including gender, age, birth weight, maternal age, gestational age and clinical features. Blood culture and Peripheral blood films were done in each case. Differential leucocyte counts, total Polymorphoneutrophil count (PMN), immature neutrophil count, mature neutrophil count and calculation of I/T ratio was carried out in the Pathology Department of PIMS, Islamabad. The study outcome was divided into three groups on the basis of positive or negative blood culture and I/T ratio as normal, probable sepsis and proven sepsis group. Data was analyzed by SPSS version 21.0. Diagnostic value of I/T ratio was determined in NS by calculating values of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) by considering the blood culture as the gold standard test of NS.Results: The mean age and weight of the neonates at the time of admission was 1.1 (± 0.6) days and 2.51 (± 0.40) kg, respectively. About 60% of the neonates were males and 118(41%) neonates had I/T ratio of ≥ 0.2. On the basis of positive or negative blood culture and I/T ratio, 82 (28.5%) neonates were diagnosed as proven sepsis, 43 (14.9%) neonates had probable sepsis and remaining 163 (56.6%) neonates were declared as normal. Out of 82 neonates with positive blood cultures, 75 (91.5%) had I/T ratio ≥ 0.2, while 7 (8.5%) had I/T ratio ≤ 0.2. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of abnormal I/T ratio to diagnose neonatal sepsis was 91%, 79%, 64%, 96% and 83%, respectively.Conclusions: Due to substantially high diagnostic accuracy of I/T ratio ≥ 0.2, we recommend it as a useful, rapid and cost-effective tool in accurate diagnosis of neonatal sepsis.

scholarly journals Does low dose13C-urea breath test maintain a satisfactory accuracy in diagnosing Helicobacter pylori infection?

2011 ◽  
Vol 48 (2) ◽  
pp. 104-108 ◽  
Author(s):  
Luiz Gonzaga Vaz Coelho ◽  
Arilto Eleutério da Silva Jr ◽  
Maria Clara de Freitas Coelho ◽  
Francisco Guilherme Cancela e Penna ◽  
Rafael Otto Antunes Ferreira ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Breath Test ◽  
Standard Test ◽  
Urea Breath Test ◽  
Gold Standard Test ◽  
13C Urea Breath Test ◽  
H Pylori

CONTEXT: The standard doses of 13C-urea in 13C-urea breath test is 75 mg. OBJECTIVE: To assess the diagnostic accuracy of 13C-urea breath test containing 25 mg of 13C-urea comparing with the standard doses of 75 mg in the diagnosis of Helicobacter pylori infection. METHODS: Two hundred seventy adult patients (96 males, 174 females, median age 41 years) performed the standard 13C-urea breath test (75 mg 13C-urea) and repeated the 13C-urea breath test using only 25 mg of 13C-urea within a 2 week interval. The test was performed using an infrared isotope analyzer. Patients were considered positive if delta over baseline was >4.0‰ at the gold standard test. RESULTS: One hundred sixty-one (59.6%) patients were H. pylori negative and 109 (40.4%) were positive by the gold standard test. Using receiver operating characteristic analysis we established a cut-off value of 3.4% as the best value of 25 mg 13C-urea breath test to discriminate positive and negative patients, considering the H. pylori prevalence (95% CI: 23.9-37.3) at our setting. Therefore, we obtained to 25 mg 13C-urea breath test a diagnostic accuracy of 92.9% (95% CI: 88.1-97.9), sensitivity 83.5% (95% CI: 75.4-89.3), specificity 99.4% (95% CI: 96.6-99.9), positive predictive value 98.3% (95% CI: 92.4-99.4), and negative predictive value 93.0% (95% CI: 88.6-96.1). CONCLUSIONS: Low-dose 13C-urea breath test (25 mg 13C-urea) does not reach accuracy sufficient to be recommended in clinical setting where a 30% prevalence of H. pylori infection is observed. Further studies should be done to determine the diagnostic accuracy of low doses of 13C-urea in the urea breath test.

scholarly journals Prevalence of feline coronavirus antibodies in cats in Bursa province, Turkey, by an enzyme-linked immunosorbent assay

2009 ◽  
Vol 11 (10) ◽  
pp. 881-884 ◽  
Author(s):  
Annamaria Pratelli ◽  
Kadir Yesilbag ◽  
Marcello Siniscalchi ◽  
Ebru Yalçm ◽  
Zeki Yilmaz
Keyword(s):  
Immunosorbent Assay ◽  
Predictive Value ◽  
Gold Standard ◽  
Population Based ◽  
Standard Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
High Association ◽  
Gold Standard Test ◽  
Feline Coronavirus

Feline sera from Bursa province (Turkey) were assayed for coronavirus antibody using an enzyme-linked immunosorbent assay (ELISA). The study was performed on 100 sera collected from cats belonging to catteries or community shelters and to households. The serum samples were initially tested with the virus neutralisation (VN) test and the results were then compared with the ELISA. The VN yielded 79 negative and 21 positive sera but the ELISA confirmed only 74 as negative. The ELISA-negative sera were also found to be free of feline coronoviruses-specific antibodies by Western blotting. Using the VN as the gold standard test, ELISA had a sensitivity of 100% and a specificity of 93.6%, with an overall agreement of 95%. The Kappa (κ) test indicated high association between the two tests (κ=0.86, 95% confidence interval (CI) 0.743–0.980). The positive predictive value (PPV) was 0.8, and the negative predictive value (NPV) was 0.93. The prevalence of FCoV II antibodies in the sampled population based on the gold standard was 62% (95% CI 0.44–0.77) among multi-cat environments, and 4% (95% CI 0.01–0.11) among single cat households.

scholarly journals To evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24-hour urine sample in patients with preeclampsia

2014 ◽  
Vol 9 (2) ◽  
pp. 45-53
Author(s):  
S Hossain ◽  
A Ghosh ◽  
A Chatterjee ◽  
G Sarkar ◽  
SS Mondal
Keyword(s):  
Urine Sample ◽  
Gold Standard ◽  
Diagnostic Value ◽  
Standard Test ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Predictive Values ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Gold Standard Test

Objective: This study was done to evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24 hour urine sample in patients with preeclampsia. Methods: A prospective simple random sample study was done on the hypertensive pregnant women attending the antenatal clinic or admitted in Department of Obstetrics and Gynaecology. It included all women being evaluated for preeclampsia, regardless of the alerting sign or symptom, suspected severity or co-morbid conditions. The main measures were the urinary protein to urinary creatinine ratio by random (spot) direct measurement and the 24-h urinary protein excretion by a 24-h urine collection. The data obtained was statistically analyzed. Results: Out of the 78 patients with gestational hypertension included in our study 48 patients had significant proteinuria (e”300mg/day). Only 2 patients had proteinuria of the range of greater than 3500mg. Among the patients, 50 had a positive protein: creatinine ratio (e”0.3) while 28 patients had a negative protein: creatinine ratio (<0.3). The P: C ratio was able to correctly identify 44 out of 48 patients with significant proteinuria (when the comparison is made with the gold-standard test; i.e., 24-hour urine protein). It could also identify 24 out of 30 patients without significant proteinuria as compared to the gold-standard test. In this study, the Protein: Creatinine ratio with a sensitivity of 91.67%, a specificity of 80%, positive predictive values 88% and the negative predictive values 85.71%. Conclusions: Our data suggests that the protein: creatinine ratio in single voided urine is a highly accurate test (p value < 0.0000001) for discriminating between insignificant and significant proteinuria. Based on the above findings we conclude that a random urine protein excretion predicts the amount of 24- hour urine protein excretion with high accuracy. This could be a reasonable alternative to the 24-hour urine collection for detection of significant proteinuria in hospitalised pregnant women with suspected preeclampsia. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 45-53 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9687

Guideline adherence for diagnosis of liver cancer in veterans.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 89-89 ◽  
Author(s):  
Yvonne Sada ◽  
Eric David ◽  
Hashem El-Serag ◽  
Hardeep Singh ◽  
Jessica Davila
Keyword(s):  
Median Time ◽  
Guideline Adherence ◽  
Gold Standard ◽  
Diagnostic Delay ◽  
Standard Test ◽  
Diagnostic Process ◽  
Liver Mass ◽  
Missed Appointments ◽  
Gold Standard Test ◽  
Work Up

89 Background: The incidence of hepatocellular cancer (HCC) is rising. Practice guidelines provide the recommended approach for HCC diagnosis, but adherence to diagnostic guidelines is unknown. Methods: In a national sample of veterans with confirmed HCC, we performed a retrospective chart review of patients with cirrhosis and a new liver mass on imaging between 2005 and 2011. Clinical data was used to assess adherence to American Association for the Study of Liver Diseases guidelines. Patients with inadequate data to assess guideline adherence (missing liver mass size, imaging technique, or diagnostic report) were excluded. We identified factors that contributed to guideline non-adherence. Initial liver mass date was the first date a liver mass was reported on imaging (CT, MRI, or ultrasound). Gold standard test date was the date a diagnosis of HCC could have been made by guideline recommended testing and criteria. Diagnosis date was the date a provider documented the diagnosis. Results: We reviewed charts for 380 patients. Overutilization of diagnostic tests after a gold standard test occurred in 112 patients (31%), and 17 (4%) had insufficient tests. Guidelines were not followed in 124 (33%). Of these 124, 68 (55%) had liver masses that increased in size during diagnostic work-up. The most common factors associated with guideline non-adherence were unnecessary testing such as biopsy after a gold standard image (43%) and the presence of a contraindication to a guideline recommended image or biopsy (12%). Patient factors (missed appointments, declining work-up) accounted for only 3% of cases. Median time between the initial liver mass and gold standard test was 15 days (IQR: 0-99). Median time between the initial liver mass and diagnosis was 50 days (IQR: 12-191). Most diagnoses were made by gastroenterology (51%), followed by primary care (19%), and oncology (10%). Conclusions: One-third of patients with HCC were not diagnosed based on guidelines. These concerns include confidence in diagnosis (lack of recognizing HCC diagnosis despite gold standard evidence) and over testing, which both lead to diagnostic delay. Our findings warrant further evaluation of contributory factors to develop interventions that improve the diagnostic process for HCC.

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