scholarly journals FEV1/FEV6: A Reliable, Easy-to-Use, and Cheaper Alternative to FEV1/FVC in Diagnosing Airway Obstruction in Indian Population

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Anupam Kumar Singh ◽  
Amit Lohia
Keyword(s):  
Airway Obstruction ◽  
Gold Standard ◽  
Indian Population ◽  
Area Under The Curve ◽  
Predictive Values ◽  
Tertiary Centre ◽  
Kappa Value ◽  
Sensitivity Specificity ◽  
Acceptability Criteria ◽  
Indian Data

Background. FEV1/FEV6 has been proposed as a cheap, reproducible and valid alternative to FEV1/FVC in spirometry. No Indian data exists on its utility to diagnose airway obstruction. Aim. we sought to determine a fixed cut off of FEV1/FEV6 to diagnose obstruction corresponding to FEV1/FVC < 0.70 proposed by GOLD guidelines. Method. Spirometry was done on patient referred to a tertiary centre in India. Age, sex, height weight were recorded in addition to spirometric variables like FEV1, FVC, FEV6. The sensitivity, specificity, positive and negative predictive values of FEV1/FEV6 were determined with respect to gold standard of FEV1/FVC < 0.70. Results. 467 spirometries were analysed after meeting the ATS acceptability criteria. Considering FEV1/FVC < 0.7 as being the gold standard for obstruction, ROC curve was used to determine the best corresponding cut-off for FEV1/FEV6. The area under the curve was 99.3% (95% CI: 98.1–99.8%), and the FEV1/FEV6 cut-off, corresponding to the greatest sum of sensitivity and specificity, was 73%. For the total population, the FEV1/FEV6 sensitivity, specificity, PPV, NPV were was 95.7 %, 94.2 %, 87.5 % and 97.9 % respectively. Agreement by Kappa value between two cut offs was excellent 0.89 (0.87–0.91). Conclusion. FEV1/FEV6 < 73% is a new reliable spirometry index to diagnose airway obstruction in Indian population.

scholarly journals Comparison of Hay’s Criteria with Nugent’s Scoring System for Diagnosis of Bacterial Vaginosis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Rohit Chawla ◽  
Preena Bhalla ◽  
Sanjim Chadha ◽  
Sujatha Grover ◽  
Suneela Garg
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Gold Standard ◽  
Tertiary Care ◽  
Gold Standard Method ◽  
Predictive Values ◽  
Intermediate Group ◽  
Kappa Value ◽  
Grade Ii ◽  
Sensitivity Specificity

Although Nugent’s criterion is considered as the gold standard for the diagnosis of bacterial vaginosis (BV), the method requires an experienced slide reader and considerable time and skill. In this study, we compared the method of Hay and Ison with Nugent’s scoring criteria. Vaginal specimens were collected from a total of 213 women, presenting with or without the symptoms of vaginitis. Diagnosis of BV was done using Nugent’ and Hay’s method. Sensitivity, specificity, and predictive values for positive and negative test were calculated for Hay’s method using Nugent’s method as the gold standard. We diagnosed 70 cases (32.86%) of BV by Nugent’s method and 87 (40.85%) cases by the Hay’s method. Sensitivity, specificity, predictive value of positive result, predictive value of negative result, and Kappa value when evaluating Hay’s criteria using Nugent’s criteria as the gold standard were ≥97.2%, ≥88.1%, ≥80.4%, ≥97.1%, and ≥0.830, respectively, when Hay’s grade II and/or Nugent’s intermediate score were considered either as negative or positive or excluded. Using Nugent score for the intermediate group is the most difficult. Hay’s method shows good agreement with the gold standard method of Nugent et al. and can be used as an alternative to Nugent’s criteria in busy tertiary care hospitals.

Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI-RADS

2020 ◽  
Vol 163 (6) ◽  
pp. 1156-1165
Author(s):  
Juan Xiao ◽  
Qiang Xiao ◽  
Wei Cong ◽  
Ting Li ◽  
Shouluan Ding ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Study ◽  
Diagnostic Efficiency ◽  
Training Set ◽  
Multivariable Logistic Regression Model ◽  
Predictive Values ◽  
Validation Set ◽  
Sensitivity Specificity

Objective To develop an easy-to-use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Study Design Retrospective diagnostic study. Setting The Second Hospital of Shandong University. Subjects and Methods From March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI-RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated. Results The nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI-RADS (0.826, P = .008) and the ACR TI-RADS (0.810, P < .001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI-RADS (0.852, P < .001) and the ACR TI-RADS (0.853, P < .001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI-RADS ( P < .05), each in the whole series and separately for nodules >1 or ≤1 cm. Conclusions When compared with the Kwak and ACR TI-RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.

scholarly journals Investigation of the rapid immunochromatographic test performance in the diagnosis of syphilis; comparison of four serological methods

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Huseyin Agah Terzi ◽  
Ozlem Aydemir ◽  
Engin Karakece ◽  
Huseyin Hatipoglu ◽  
Mehmet Olmez ◽  
...  
Keyword(s):  
Test Performance ◽  
Gold Standard ◽  
Treponema Pallidum ◽  
Rapid Test ◽  
Immunochromatographic Test ◽  
Rapid Plasma Reagin ◽  
Serum Samples ◽  
Hemagglutination Assay ◽  
Predictive Values ◽  
Sensitivity Specificity

AbstractObjectivesTo test the performance of the newly available rapid test for syphilis, we compared it with Treponema pallidum hemagglutination assay (TPHA). Additionally, we investigated the performance of rapid plasma reagin (RPR) and chemiluminescence microparticle immunoassays (CMIA) at our laboratory using TPHA as a gold standard.MethodsThe serum samples of 595 patients with the pre-diagnosis of syphilis were studied by four serological methods. The sensitivity, specificity, and predictive values of RPR, CMIA, and syphilis rapid test were assessed by utilizing TPHA as a gold standard for the diagnosis of syphilis.ResultsOf the patients, 6.2% (37/595) had positive RPR, 5.5% (33/595) had positive CMIA, 5.5% (33/595) had a positive rapid immunochromatographic method and 5% (30/595) had positive TPHA. When TPHA results were taken as the reference, the sensitivity of the rapid test for syphilis was 100%, the specificity was 99.5%, PPV was 90.9%, and NPV was 100.0%.ConclusionsIt was observed that the rapid test for syphilis used in the study was quite successful, its cost was appropriate, and the test was very fast and easy to apply. At the same time, the agreement between syphilis rapid test and TPHA was found to be excellent.

scholarly journals Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in A Poor-Resource Setting

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 109 ◽  
Author(s):  
Ukweh ◽  
Ugbem ◽  
Okeke ◽  
Ekpo
Keyword(s):  
Predictive Value ◽  
Performance Metrics ◽  
Area Under The Curve ◽  
Youden Index ◽  
Likelihood Ratios ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Resource Setting ◽  
Post Test ◽  
Sensitivity Specificity

Background: Ultrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. Materials and Methods: We surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th–22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities. Results: In total, 6520 fetuses of women aged 15–46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68–84.6), 99.5 (95% CI: 99.3–99.7), and 88.3 (95% CI: 83.7–92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7–79.0), negative predictive value, 99.6 (95% CI: 99.5–99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37–2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7–221.4) and 0.23 (95% CI: 0.16–0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65–79). Conclusion: Fetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed.

scholarly journals The discrepancy between manual and computerized leukocyte and thrombocyte counts

2016 ◽  
Vol 43 (3) ◽  
pp. 95
Author(s):  
Bambang Permono ◽  
Retno Asih ◽  
I Dewa Gede Ugrasena
Keyword(s):  
Gold Standard ◽  
Leukocyte Count ◽  
Predictive Values ◽  
Thrombocyte Count ◽  
Randomized Sampling ◽  
Manual Group ◽  
Manual Examination ◽  
Blood Specimens ◽  
Sensitivity Specificity ◽  
Normal Leukocyte

Background Discrepancy between results of leukocyte and throm-bocyte count by computerized and manual examination may existObjective To determine the discrepancy between computerizedand manual leukocyte and thrombocyte count.Methods The design was a randomized sampling cross sectionalstudy. The blood sample was examined with computerized CellDyn 1400 instrument for the leukocyte and thrombocyte count. Formanual examination, blood smear was performed to measurethrombocyte while leukocyte was measured in Improved Neubauerhemocytometer. The results of computerized examination wereused as gold standard. Sensitivity, specificity, predictive values ofmanual count were calculated. The agreement of Kappa and McNemar test were determinedResults Blood specimens drawn from 100 patients with differentkinds of diagnoses were examined using computerized and manualmethods. In computerized group, 66% had normal leukocyte and55% had normal thrombocyte count. In the manual group, 78% ofsubjects had normal leukocyte and 82% had normal thrombocytecount. From leukocyte examination, the sensitivity of manual countwas 87.9%, specificity was 41.2%, and positive predictive valuewas 74.36 with the agreement of Kappa of 0.32 and Mc Nemarvalue of 0.036. From thrombocyte examination, the sensitivity was96.4%, specificity was 35.6%, and positive predictive value was64.6 with the agreement of Kappa of 0.41 and Mc Nemar value of0.41.Conclusion The result of manual thrombocyte count was in ac-cordance with computerized with the agreement of Kappa of 0.41.On the other hand, there was a discrepancy between manual infavor of computerized leukocyte count with the agreement of Kappaof 0.32

scholarly journals 006 Can seizure-related heart rate differentiate epileptic seizures from psychogenic non-epileptic seizures?

2019 ◽  
Vol 90 (e7) ◽  
pp. A2.3-A3
Author(s):  
Hue Mun Au Yong ◽  
Erica Minato ◽  
Eldho Paul ◽  
Udaya Seneviratne
Keyword(s):  
Heart Rate ◽  
Area Under The Curve ◽  
Epileptic Seizures ◽  
Roc Curve Analysis ◽  
Predictive Values ◽  
Minute Post ◽  
Poor Differentiation ◽  
Good Differentiation ◽  
Sensitivity Specificity ◽  
Video Eeg

IntroductionThis study aims to (i)evaluate the diagnostic sensitivity, specificity and predictive values of seizure-related heart rate (HR) in differentiating epileptic seizures(ES) from psychogenic non-epileptic seizures(PNES), (ii)define the most useful point of HR measurement: pre-ictal, ictal-onset, maximal-ictal or post-ictal, and (iii)define the HR cut-off points to differentiate ES from PNES.MethodsAll video EEG(VEEG) at Monash Health from May 2009 to November 2015 were retrospectively reviewed. Baseline(during wakefulness), one-minute pre-ictal, ictal-onset, maximal-ictal and one-minute post-ictal HR were measured for each ES and PNES event. Events less than ten seconds or with uninterpretable ECG due to artefacts were excluded. ROC curve analysis was performed to study the diagnostic accuracy reflected by area under the curve(AUC). The AUC was interpreted as follows; ≤0.5, differentiation of PNES from ES no better than chance; 0.80–0.89, good differentiation; and 0.9–1, excellent differentiation.ResultsVEEG of 341 ES and 265 PNES from 130 patients were analysed. The AUC for pre-ictal, ictal-onset, maximal-ictal and post-ictal HR were found to have poor differentiation between ES and PNES. Comparing PNES and bilateral tonic-clonic ES, AUC for absolute maximal-ictal HR was 0.84(CI 0.73–0.95) and for absolute post-ictal HR was 0.90(CI 0.81–1.00). Using Youden’s index, to diagnose tonic-clonic ES, the optimal cut-off point for absolute maximal-ictal HR was 114bpm (sensitivity 84%;specificity 82%;PPV 26.7%,NPV 98.5%) and for absolute post-ictal HR was 90bpm(sensitivity 91%;specificity 82%;PPV 30.3%;NPV 99.1%).ConclusionsThese findings suggest that seizure-related HR increase is useful in differentiating bilateral tonic-clonic ES from PNES. Based on the AUC, the best diagnostic measureme.

Good diagnostic accuracy of a chemiluminescent immunoassay in stool samples for diagnosis of Helicobacter pylori infection in patients with dyspepsia

2016 ◽  
Vol 64 (2) ◽  
pp. 388-391 ◽  
Author(s):  
María José Ramírez-Lázaro ◽  
Josep Lite ◽  
Sergio Lario ◽  
Pepa Pérez-Jové ◽  
Antònia Montserrat ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gold Standard ◽  
Rapid Urease Test ◽  
Diagnostic Reliability ◽  
Predictive Values ◽  
Urease Test ◽  
Stool Samples ◽  
H Pylori ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.

scholarly journals Evaluation of WHO criteria to determine degree of dehydration in children with acute diarrhea

2016 ◽  
Vol 45 (2) ◽  
pp. 76
Author(s):  
Suprawita Sari ◽  
Supriatmo Supriatmo ◽  
S L Margaretha ◽  
S Nafianti ◽  
B Hasibuan ◽  
...  
Keyword(s):  
Acute Diarrhea ◽  
Clinical Signs ◽  
Severe Dehydration ◽  
Chi Square ◽  
Predictive Values ◽  
Who Criteria ◽  
Significant Difference ◽  
Kappa Value ◽  
The Difference ◽  
Sensitivity Specificity

Objective To evaluate the diagnostic accuracy and agreementbetween the 1980 and 1990 WHO criteria for determining the de-gree of dehydration in children with acute diarrhea.Methods This prospective study was conducted in two hospitalsfrom October 2002 to February 2003. Clinical signs of dehydrationall patients were recorded. The degree of dehydration based onthe 1980 and 1990 WHO criteria was determined and comparedwith fluid deficit measured by the difference of body weight on ad-mission and on discharge. Chi-square test and kappa value analy-ses were performed. Sensitivity, specificity, predictive values, andaccuracy of each WHO criteria were assessed. The prevalence ofdehydration was also determined.Results Sixty-five patients, comprising 40 boys and 25 girls, werestudied. There was a significant difference between the two WHOcriteria in differentiating between dehydration and non-dehydra-tion (P<0.05). Based on the 1980 WHO criteria the prevalence ofdehydration was 62.2%. Its sensitivity, specificity, and accuracy indiagnosing dehydration were 100.0%, 55.5%, and 86.2%, respec-tively. Based on the 1990 WHO criteria, the prevalence of dehy-dration was 60.0%. Its sensitivity, specificity, and accuracy in diag-nosing dehydration were 94.9%, 46.1%, and 75.4%, respectively.There was also a significant difference between both criteria indetermining severe dehydration (P<0.05). Based on the 1980 cri-teria, the prevalence of severe dehydration was 15.4%. Its sensi-tivity, specificity, and accuracy in diagnosing severe dehydrationwere 30.0%, 94.5%, and 84.6%, respectively. Based on the 1990criteria, these results were 40.0%, 94.5%, and 86.2%, respectively.The prevalence was 15.4%. Kappa value comparing the two WHOcriteria was 0.852 in diagnosing dehydration and 0.915 in diag-nosing severe dehydration. There was no significant differencebetween the two criteria in their sensitivity and specificity (P>0.05).Conclusion Both WHO criteria can be applied to determine de-hydration in patients with acute diarrhea, although we feel that the1990 criteria is simpler

Cytomorphometric Neutrophil and Monocyte Markers May Strengthen the Diagnosis of Sepsis

2016 ◽  
Vol 33 (12) ◽  
pp. 656-662
Author(s):  
Joy Mammen ◽  
Jui Choudhuri ◽  
Joshua Paul ◽  
Thomas Isaiah Sudarsan ◽  
T. Josephine ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Donors ◽  
Area Under The Curve ◽  
Standard Test ◽  
Suspected Sepsis ◽  
Predictive Values ◽  
Reactive Protein ◽  
Sensitivity Specificity

Background: The diagnosis of sepsis is challenging in the absence of a gold standard test. Recent studies have explored the role of neutrophil and monocyte volume, conductivity, and scatter (VCS), derived from automated hematology analyzers, in diagnosing sepsis. We assessed the diagnostic accuracy of VCS parameters in critically ill patients with sepsis. Methodology: In this prospective study, VCS parameters, procalcitonin, and C-reactive protein (CRP) were assessed in patients with proven sepsis (cases) and 2 control groups (intensive care unit [ICU] patients without sepsis and healthy blood donors). The diagnostic property of each test was explored by calculating sensitivity, specificity, negative and positive predictive values, and area under the curve (AUC). Results: The study included 65 patients with sepsis, 58 nonseptic ICU controls, and 98 blood donors. Procalcitonin and CRP were not significantly different ( P > .06) between patients with sepsis and nonseptic patients. Mean (95% confidence interval [CI]) neutrophil volume (MNV) was significantly higher ( P < .001) in patients with sepsis (165.5; 95%CI 161.6-169.4) than in nonseptic (157.3; 95%CI 154.6-160.1) patients and donors (148.9; 95%CI 147.9-150). A similar pattern was seen with mean monocyte volume (MMoV). Neutrophil and monocyte conductivity and scatter parameters were variably associated. The AUC was highest for MMoV (0.74) and lowest for CRP (0.62). Among all parameters, MNV and MMoV had the highest specificity of 85% and 80%, respectively. Conclusion: In critically ill patients with suspected sepsis, VCS parameters may help strengthen the diagnostic probability of sepsis. Future studies may explore the role of serial monitoring of VCS to track response to antimicrobial therapy.

Sign in / Sign up

Export Citation Format

Share Document