• Title/Summary/Keyword: Accuracy of Triage

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PAX1 Methylation Analysis by MS-HRM is Useful in Triage of High-grade Squamous Intraepithelial Lesions

  • Wang, Zhen-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.891-894
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    • 2014
  • This study is aimed to investigate the role of paired boxed gene 1 (PAX1) methylation analysis by methylation-sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and compared its performance with the Hybrid Capture 2 (HC2) human papillomavirus (HPV) test. In our study, 130 cases with a diagnosis of ASC-H from the cervical cytological screening by Thinprep cytologic test (TCT) technique were selected for triage. Their cervical scrapings were collected and evaluated by using PAX1 methylation analysis (MS-HRM) and high-risk HPV DNA test (HC2), followed by colposcopy and cervical biopsy. Chi-square test were used to test the differences of PAX1 methylation or HPV infection between groups. In the detection of CIN2+, the sensitivity, specificity, the PPV, NPV and the accuracy of PAX1 MS-HRM assay and high-risk HPV (HR-HPV) tests were respectively 80.6% vs 67.7%, 94.9% vs 54.5%, 83.3%, vs 31.8%, 94.0% vs 84.4%, and 91.5% vs 57.7%. The PAX1 MS-HRM assay proved superior to HR-HPV testing in the detection of high grade lesions (CIN2+) in ASC-H. This approach could screen out the majority of high grade lesion cases of ASC-H, and thus could reduce the referral rate to colposcopy.

Clinical Investigation of Isolated Chest Injury (흉부 단독손상 환자의 임상적 고찰)

  • Lee, Keung Moo;Kim, Dong Soo;Lee, Suk Woo;Kim, Hoon
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.35-40
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    • 2006
  • Purpose: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. Methods: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. Results: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). Conclusion: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.

Availability of Toxicologic Screening Tests in the Emergency Department (응급센터에서 시행하는 약물선별현장검사의 유용성)

  • Um, In-Kyung;Park, Jong-Su;Han, Kap-Su;Cho, Han-Jin;Choi, Sung-Hyuck;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.26-29
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    • 2011
  • Purpose: The role of a point of care test (POCT) is currently becoming important when treating patients and making decisions in the emergency department. It also plays a role for managing patients presenting with drug intoxication. But the availability of the test has not yet been studied in Korea. Therefore, we investigated the utility and the availability of POCT for drug screening used in the emergency department. Methods: This was a retrospective study for those patients with drug intoxication between January 2007 and December 2010 in an urban emergency department. Results: Between the study period, 543 patients were examined with a Triage$^{(R)}$-TOX Drug Screen. Among those, 248 (45.7%) patients showed negative results and 295 (54.3%) patients showed positive results. The sensitivity of the test for benzodiazepine, acetaminophen and tricyclic antidepressants were 85.9%, 100%, 79.2%, respectively. Conclusion: POCT of drug screening in emergency department showed good accuracy especially in patient with benzodiazepine, acetaminophen and tricyclic antidepressant intoxication. Therefore, it can be useful diagnostic tool for the management of intoxicated patients.

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Value of PAX1 Methylation Analysis by MS-HRM in the Triage of Atypical Squamous Cells of Undetermined Significance

  • Li, Shi-Rong;Wang, Zhen-Ming;Wang, Yu-Hui;Wang, Xi-Bo;Zhao, Jian-Qiang;Xue, Hai-Bin;Jiang, Fu-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5843-5846
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    • 2015
  • Background: Detection of cervical high grade lesions in patients with atypical squamous cells of undetermined significance (ASCUS) is still a challenge. Our study tested the efficacy of the paired boxed gene 1 (PAX1) methylation analysis by methylation-sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in ASCUS and compared performance with the hybrid capture 2 (HC2) human papillomavirus (HPV) test. Materials and Methods: A total of 463 consecutive ASCUS women from primary screening were selected. Their cervical scrapings were collected and assessed by PAX1 methylation analysis (MS-HRM) and high-risk HPV-DNA test (HC2). All patients with ASCUS were admitted to colposcopy and cervical biopsies. The Chisquare test was used to test the differences of PAX1 methylation or HPV infection between groups. Results: The specificity, sensitivity, and accuracy for detecting CIN2 + lesions were: 95.6%, 82.4%, and 94.6%, respectively, for the PAX1 MS-HRM test; and 59.7%, 64.7%, and 60.0% for the HC2 HPV test. Conclusions: The PAX1 methylation analysis by MS-HRM demonstrated a better performance than the high-risk HPV-DNA test for the detection of high grade lesions (CIN2 +) in ASCUS cases. This approach could screen out the majority of low grade cases of ASCUS, and thus reduce the referral rate to colposcopy.

Study on Survival Effectiveness of Intelligent System for Warrior Platform by using AWAM (지상무기효과분석모델(AWAM)을 활용한 워리어 플랫폼 지능형 조절 시스템 생존 효과도에 관한 연구)

  • Kwon, Youngjin;Kim, Taeyang;Chae, Je Wook;Kim, Juhee
    • Journal of the Korea Institute of Military Science and Technology
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    • v.23 no.3
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    • pp.277-285
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    • 2020
  • Survivability in a battle field is the most important aspect to the warriors. To analyze the survival effectiveness of warrior platform, the simulation via war-game model is an essential step in advance to the development of platform. In this study, Army Weapon effectiveness Analysis Model(AWAM) was utilized for analysis. Several weapon parameters were adjusted to apply the characteristics of warrior platform in some cases of the defense and survival system. Especially, adjusted triage possibility, probability of kill, fatality and accuracy were employed as parameters in the simulation program to evaluate the survival effectiveness of intelligent system based on the previous researches. In the future battle field or virtual space in the AWAM, the warrior platform intelligent system could react emergency treatment on time by expoiting the bio-information of man at arms. Considering the order of supply priority, special force was selected as operating troops and battle scenario without engagement was selected to measure accurate survival effectiveness. In conclusion, the survivability of defence and survival system of the warrior platform was about 1.47 times higher than that of current system.

The Development of Hemodiafiltration Treatment Compliance Indicators and Discriminant Standards, Development of Hemodiafiltration Treatment Compliance Measurement - Convergent Form(HDFTCM-CF) : Focused on On-line Hemodiafiltration (혈액여과투석 환자의 치료이행 지표와 분류기준, 융합형 혈액여과투석 치료이행 측정도구 개발 : 온라인 혈액여과투석을 중심으로)

  • Hur, Jung
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.269-282
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    • 2015
  • This study is to define the hemodiafiltration treatment compliance indicators and discriminate standards for hemodiafiltration patients and development of hemodiafiltration treatment compliance measurement-convergent form. Date was collected from 300 on-line hemodiafiltration patients. To verify the hemodiafiltration treatment compliance indicators and discriminate standards, used construct validity and content validity by clinical professional group. Discriminant ability of 3 indicators-interdialysis weight gain rate(IWGR), serum phosphate level, rate of self change of total hemodiafiltration treatment time(SCR-HEFTT)- is 95.6%(wilks ramda=.256, p=.002). And hemodiafiltration treatment compliance measurement-convergent form has 91.7% discriminant accuracy. Hemodiafiltration treatment compliance is important that nurses can aware pre-stage of complication and give appropriate nursing intervention. Also this measurement can be used for foundation data of the nursing intervention development that prevent dialysis patient's complication.

Diagnostic Approach to a Soft Tissue Mass (연부조직 종양의 진단적 접근)

  • Chun, Young Soo;Song, Seung Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.293-301
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    • 2019
  • Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.