diagnostic thresholds
Recently Published Documents


TOTAL DOCUMENTS

169
(FIVE YEARS 63)

H-INDEX

24
(FIVE YEARS 3)

2021 ◽  
Author(s):  
Sean Kim ◽  
Michelle Roytman ◽  
Gabriela Madera ◽  
Rajiv Magge ◽  
Benjamin Liechty ◽  
...  

Abstract PURPOSEMultiple approaches with [Ga68]-DOTATATE, a somatostatin analog PET radiotracer, have demonstrated clinical utility in evaluation of meningioma but have not been compared directly. Our purpose was to compare diagnostic performance of three approaches to quantitative brain [68Ga]-DOTATATE PET/MRI analysis in patients with suspected meningioma recurrence and to establish the optimal diagnostic threshold for each method.METHODSPatients with suspected meningioma were imaged prospectively with [68Ga]-DOTATATE brain PET/MRI. Lesions were classified as meningiomas and post-treatment change (PTC), based on pathology findings and follow up MRI appearance. Lesions were reclassified using the following methods: absolute SUV threshold (SUV), SUV ratio (SUVR) to superior sagittal sinus (SSS) (SUVRsss), and SUVR to the pituitary gland (SUVRpit). Diagnostic performance of the three methods was compared using contingency tables and McNemar’s test. Previously published pre-determined thresholds were assessed where applicable. The optimal thresholds for each method were identified using Youden’s J statistics.RESULTS166 meningiomas and 41 PTC lesions were identified across 62 patients. SUV, SUVRsss, and SUVRpit of meningioma were significantly higher than those of PTC (P<0.0001). The optimal thresholds for SUV, SUVRsss, and SUVRpit were 4.65, 3.23, and 0.260, respectively. At the optimal thresholds, SUV had the highest specificity (97.6%) and SUVRsss had the highest sensitivity (86.1%). An ROC analysis of SUV, SUVRsss, and SUVRpit revealed AUC of 0.932, 0.910, and 0.915, respectively (P<0.0001).CONCLUSIONWe found that the SUVRsss method may have the most robust combination of sensitivity and specificity in the diagnosis of meningioma in the post-treatment setting, with the optimal threshold of 3.23. Future studies validating our findings in different patient populations are needed to continue optimizing the diagnostic performance of [68Ga]-DOTATATE PET/MRI in meningioma patients. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04081701. Registered 9 September 2019. https://clinicaltrials.gov/ct2/show/NCT04081701


Author(s):  
Stanley S. Schwartz ◽  
Amy W. Rachfal ◽  
Barbara E. Corkey

Thyroid ◽  
2021 ◽  
Author(s):  
Tara Ma ◽  
Caitlin R Semsarian ◽  
Alexandra Barratt ◽  
Lisa Parker ◽  
M. Priyanthi Kumarasinghe ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Luisa Weiner ◽  
Andrea Guidi ◽  
Nadège Doignon-Camus ◽  
Anne Giersch ◽  
Gilles Bertschy ◽  
...  

AbstractThere is a lack of consensus on the diagnostic thresholds that could improve the detection accuracy of bipolar mixed episodes in clinical settings. Some studies have shown that voice features could be reliable biomarkers of manic and depressive episodes compared to euthymic states, but none thus far have investigated whether they could aid the distinction between mixed and non-mixed acute bipolar episodes. Here we investigated whether vocal features acquired via verbal fluency tasks could accurately classify mixed states in bipolar disorder using machine learning methods. Fifty-six patients with bipolar disorder were recruited during an acute episode (19 hypomanic, 8 mixed hypomanic, 17 with mixed depression, 12 with depression). Nine different trials belonging to four conditions of verbal fluency tasks—letter, semantic, free word generation, and associational fluency—were administered. Spectral and prosodic features in three conditions were selected for the classification algorithm. Using the leave-one-subject-out (LOSO) strategy to train the classifier, we calculated the accuracy rate, the F1 score, and the Matthews correlation coefficient (MCC). For depression versus mixed depression, the accuracy and F1 scores were high, i.e., respectively 0.83 and 0.86, and the MCC was of 0.64. For hypomania versus mixed hypomania, accuracy and F1 scores were also high, i.e., 0.86 and 0.75, respectively, and the MCC was of 0.57. Given the high rates of correctly classified subjects, vocal features quickly acquired via verbal fluency tasks seem to be reliable biomarkers that could be easily implemented in clinical settings to improve diagnostic accuracy.


2021 ◽  
Vol 15 (7) ◽  
pp. e0009610
Author(s):  
Ari Winasti Satyagraha ◽  
Arkasha Sadhewa ◽  
Lydia Visita Panggalo ◽  
Decy Subekti ◽  
Iqbal Elyazar ◽  
...  

Background Plasmodium vivax occurs as a latent infection of liver and a patent infection of red blood cells. Radical cure requires both blood schizontocidal and hypnozoitocidal chemotherapies. The hypnozoitocidal therapies available are primaquine and tafenoquine, 8-aminoquinoline drugs that can provoke threatening acute hemolytic anemia in patients having an X-linked G6PD-deficiency. Heterozygous females may screen as G6PD-normal prior to radical cure and go on to experience hemolytic crisis. Methods & findings This study examined G6PD phenotypes in 1928 female subjects living in malarious Sumba Island in eastern Indonesia to ascertain the prevalence of females vulnerable to diagnostic misclassification as G6PD-normal. All 367 (19%) females having <80% G6PD normal activity were genotyped. Among those, 103 (28%) were G6PD wild type, 251 (68·4%) were heterozygous, three (0·8%) were compound heterozygotes, and ten (2·7%) were homozygous deficient. The variants Vanua Lava, Viangchan, Coimbra, Chatham, and Kaiping occurred among them. Below the 70% of normal G6PD activity threshold, just 18 (8%) were G6PD-normal and 214 (92%) were G6PD-deficient. Among the 31 females with <30% G6PD normal activity were all ten homozygotes, all three compound heterozygotes, and just 18 were heterozygotes (7% of those). Conclusions In this population, most G6PD heterozygosity in females occurred between 30% and 70% of normal (69·3%; 183/264). The prevalence of females at risk of G6PD misclassification as normal by qualitative screening was 9·5% (183/1928). Qualitative G6PD screening prior to 8-aminoquinoline therapies against P. vivax may leave one in ten females at risk of hemolytic crisis, which may be remedied by point-of-care quantitative tests.


2021 ◽  
Author(s):  
Adam Michael Hoxie ◽  
Aline de Almeida Neves ◽  
Kevin Moss ◽  
Adalberto Bastos de Vasconcellos ◽  
Andrea Ferreira-Zandona ◽  
...  

Abstract A challenging and crucial component to clinical caries diagnosis is diagnosing the activity of early lesions because it may have a significant impact on treatment decisions. This study aims to utilize microtomographic (micro-CT) scans of the enamel smooth surface layer to serve as a reference standard for future ex vivo caries activity assessment validation studies. Sound and non-cavitated (ICDAS 1-3) smooth surfaces (n=59) of extracted permanent teeth were examined for caries activity by calibrated individuals via visual-tactile examination. Each surface was scanned via micro-CT and line plot analysis generated plots of the mineral density against lesion depth, where the AUC was calculated. AUC thresholds were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner’s ICCMS assessment of sound, inactive, and active lesions, respectively. Diagnostic thresholds were associated with caries ICCMS activity classification using AUC mineral density values of the most external 96 μm of enamel. The established thresholds demonstrated 76.3% agreement with the ICCMS assessment in identifying demineralized lesions (k=0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrates quantifiable differences among demineralized, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and technological caries examinations.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A208-A208
Author(s):  
John Feemster ◽  
Paul Timm ◽  
Luke Teigen ◽  
Sarah Faber ◽  
Tyler Steele ◽  
...  

Abstract Introduction Idiopathic/isolated REM sleep behavior disorder (iRBD) is a prodromal alpha-synucleinopathy characterized by dream enactment behavior and REM sleep without atonia (RSWA). We sought to define quantitative RSWA diagnostic thresholds in the North American Prodromal Synucleinopathy (NAPS) Consortium cohort. We analyzed RSWA between iRBD patients across participating NAPS sleep centers, compared to normative controls, and hypothesized that previous diagnostic RSWA thresholds were overestimates. Methods All digital polysomnography files were converted to European Data Format and scored at a central laboratory (Mayo Clinic) which standardized display scoring montages, channel sensitivities, and filtering, and scripted computational analyses for visual scoring. RSWA was quantitatively analyzed in the submentalis (SM) and anterior tibialis (AT) muscles in iRBD (n=86) patients and controls (n=118) utilizing well validated visual (Mayo) and automated (RAI) methods. Parametric statistics were used to compare RSWA metrics, and RSWA thresholds were developed using receiver operating characteristic curves. Results RSWA was significantly higher for the RAI and all visual individual and combined muscle activity metrics in iRBD compared to controls (all p&lt;0.001). Average SM phasic measures were: 14.2% (Mayo), 17.9% (McGill), 18.5% (UCLA), and 9.4% (Washington University). Average AT phasic measures at each site were: 26.7% (Mayo), 17.1% (McGill), 23.3% (UCLA), and 17.4% (Washington University). Average SM/AT ‘any’ measures at each site were: 45.4% (Mayo), 35.9% (McGill), 53.4% (UCLA), and 23.5% (Washington University). Overall cohort RBD diagnostic thresholds (AUC, specificity/sensitivity) were: SM phasic 4.9% (90.0, 82.2%/83.7%); AT phasic 7.6% (88.7%, 82.2%/81.4%) and combined SM/AT ‘any’ 13% (94.6, 83.9%/96.5%). Conclusion RSWA thresholds in the NAPS cohort were substantially lower than previously reported, suggesting previously overestimated diagnostic RSWA thresholds due to smaller, enriched patient samples and overfit statistical modeling. Confirmation of these findings in the complete NAPS cohort (n=300 iRBD patients across all 10 NAPS centers) is planned. Support (if any):


Sign in / Sign up

Export Citation Format

Share Document