• Title/Summary/Keyword: Cutoff value

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Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions

  • Seigo Nakatani;Kosuke Okuwaki;Masafumi Watanabe;Hiroshi Imaizumi;Tomohisa Iwai;Takaaki Matsumoto;Rikiya Hasegawa;Hironori Masutani;Takahiro Kurosu;Akihiro Tamaki;Junro Ishizaki;Ayana Ishizaki;Mitsuhiro Kida;Chika Kusano
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.89-95
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    • 2024
  • Background/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs). Methods: In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA's diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs. Results: The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture. Conclusions: Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

Hypothesis Proposal about Predictive Factors and Optimal Age for Response to Herbal Medicine Treatment for Height Gain in Children: a Retrospective Review

  • Leem, Jungtae;Kim, Jeeyeun;Suh, Kyeungsuk;Lim, Youngkwern;Lee, Junhee
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.16-29
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    • 2018
  • Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.

Cutoff Values for Diagnosing Hepatic Steatosis Using Contemporary MRI-Proton Density Fat Fraction Measuring Methods

  • Sohee Park;Jae Hyun Kwon;So Yeon Kim;Ji Hun Kang;Jung Il Chung;Jong Keon Jang;Hye Young Jang;Ju Hyun Shim;Seung Soo Lee;Kyoung Won Kim;Gi-Won Song
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1260-1268
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    • 2022
  • Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

Mixed Noise Reduction Filters for CR Images (CR X선 영상의 복합잡음 감소에 관한 연구)

  • Min, Jung-Whan;Jeong, Hea-Won;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.1-6
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    • 2007
  • This study is to decrease compound noise in x-ray films. This study compared Signal to noise ratio(SNR), Peak signal to noise ratio(PSNR), Mean square error(MSE) to surface of the earth. In addition, we evaluated noise elimination effect according to the kernel size of Median filter. This experiments show that some filters are useful by finding image that is near in circle image comparing circle picture with each processed picture. In noise power value, when cutoff frequency was compared with other filters of cutoff frequency. Cutoff frequency of $2/3\pi{\sim}3/4\pi$ is good and it shows good SNR and PSNR. Therefore, it can display high filter effect. As Median Filter's Kernel size grows SNR value gets bigger, which shows better filter effect. Most pictures are distorted after filter application in medical treatment image. It is important to keep spatial resolution in most medical images. Visual estimation as well as quantitative indicators should be necessary for a better image.

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Review on the Pertinent Discount Rate for the Public Investment Project (공공투자사업(公共投資事業)의 적정(適正) 할인율(割引率) 검토(檢討)에 관(關)한 연구(硏究))

  • Park, Jae Keun;Lim, Jae Hwan
    • Korean Journal of Agricultural Science
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    • v.30 no.1
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    • pp.89-101
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    • 2003
  • For the pre-feasibility study and project evaluation, the discount rate or cutoff rate should be given by the government authority. To get the Benefit/Cost Ratio, NPV(Net Present Value) and IRR(Internal Rate of Return) of the public investment projects, the pertinent and realistic discount rate should be determined to be suitable to the present time period. The cut-off rates in Korea were equivalent to 15% in 1970's, 10% in 1980's and 8% in 1990's. The prevailing rate of discount as 8% is considered not to be suitable for the 2000's public project appraisal considering the present interest rates on deposit and national bonds. To determine the socio-economic feasibility of the public projects, the IRR should be bigger than the present cutoff rate. When we still use the high old rate of discount, the analytical results of project appraisal will show always economically unfeasible. Therefore the new rate of discount suitable for present time should be determined by the government. The public projects to be implemented in 2000 year onward are recommended to be adapted 5% of cutoff rate for the project appraisal and evaluation according to the results of reviewing the tendency of discount rates and market rates of interest in Korea.

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Are There Standardized Cutoff Values for Neutrophil-Lymphocyte Ratios in Bacteremia or Sepsis?

  • Gurol, Gonul;Ciftci, Ihsan Hakki;Terzi, Huseyin Agah;Atasoy, Ali Riza;Ozbek, Ahmet;Koroglu, Mehmet
    • Journal of Microbiology and Biotechnology
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    • v.25 no.4
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    • pp.521-525
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    • 2015
  • Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.

Developing Scales for the Assessment of Fatigue in Turkish Pediatric Oncology Patients Aged 13-18 and their Parents

  • Bektas, Murat;Kudubes, Asli Akdeniz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9891-9898
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    • 2014
  • Background: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatric oncology patients aged 13-18 and also for their parents. Materials and Methods: In collecting the study data, we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 for Parents. We also used Pearson correlation analysis, Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was 0.99, the total factor load was 0.72-0.94 with 95% the total variance being explained. The cutoff point of the parent form is 73 points. The total Cronbach alpha value of the child form was 0.99, the total factor load was 0.82-0.95, with 89.4% of the total variance being explained. The cutoff point of the child form was 75.5 points. Conclusions: This study suggests that the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 for Parents are valid and reliable instruments in assessing the fatigue symptoms of children in Turkey.

Developing a Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 for Children and Parents

  • Kudubes, Asli Akdeniz;Bektas, Murat;Ugur, Ozlem
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10199-10207
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    • 2015
  • Background: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatric oncology patients aged 7-12 as well as for their parents. Materials and Methods: In collecting the study data, we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach Alpha coefficient, Factor Analysis and ROC Analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was 0.95, the total factor load was 0.52-0.95 and the total variance being explained was 85.7%. The cutoff point of the parent form was 82 points. The total Cronbach alpha value of the child form was 0.98, the total factor load was 0.71-0.94 and the total variance being explained was 84.7%. The cutoff point of the child form was 75 points. Conclusions: This study suggests that our scales for the assessment of fatigue in pediatric oncology patients aged 7-12 and their parents are valid and reliable instruments.

Developing a Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 - Children and Parent Forms

  • Kudubes, Asli Akdeniz;Bektas, Murat
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.523-529
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    • 2015
  • Background: This study was planned in an attempt to develop a scale for the quality of life in pediatric oncology patients aged 7-12, with child and parents forms. Materials and Methods: In collecting the study data, we used the Child and Parent Information Form, Visual Quality of Life Scale, Scale for Quality of Life Pediatric Oncology Patients Aged 7-12 and the Scale for the Quality of Life in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was 0.96, the total factor load being 0.54-0.90 and the total variance explained was 82.5%. The cutoff point of the parent form was 93 points. The total Cronbach alpha value for the child form was 0.96, with a total factor load of 0.55-0.91 and the total variance being explained was 78.3%. The cutoff point of the child form was 65 points. Conclusions: This study suggests that the Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 Child and Parents Forms are valid and reliable instruments in assessing the quality of life of children.

Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic Review

  • Larry Ellee Nyanti;Muhammad Aklil Abd Rahim;Nai-Chien Huan
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.91-99
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    • 2024
  • Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.