• Title/Summary/Keyword: Diagnostic utility

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EVALUATION OF DIAGNOSTIC TESTS WITH MULTIPLE DIAGNOSTIC CATEGORIES

  • Birkett N.J.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.154-157
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    • 1994
  • The evaluation of diagnostic tests attempts to obtain one or more statistical parameters which can indicate the intrinsic diagnostic utility of a test. Sensitivity. specificity and predictive value are not appropriate for this use. The likelihood ratio has been proposed as a useful measure when using a test to diagnose one of two disease states (e.g. disease present or absent). In this paper, we generalize the likelihood ratio concept to a situation in which the goal is to diagnose one of several non-overlapping disease states. A formula is derived to determine the post-test probability of a specific disease state. The post-test odds are shown to be related to the pre-test odds of a disease and to the usual likelihood ratios derived from considering the diagnosis between the target diagnosis and each alternate in turn. Hence, likelihood ratios derived from comparing pairs of diseases can be used to determine test utility in a multiple disease diagnostic situation.

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A Study on Utility of Magnetic Resonance Imaging for Female Pelvic Cavity using Enteral MRI Contrast Media (Enteral MRI contrast media를 이용한 여성골반 자기공명영상의 유용성)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.20 no.1
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    • pp.29-34
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    • 1997
  • For radiological test in soft tissue or neighboring part with same signal intensity, proper test method and equipment shall be selected as needed. In case of female pelvic cavity, ultrasonography or computed tomography alternatively used, but MRI can be more usefully applied to design treatment method or operation plan by improving the diagnostic accuracy and careful observation of lesion characteristics. Magnetic Resonance Imaging using recently developed Enteral MRI contrast media can acquire more diagnostic information than using only intravenous contrast media. Thus this study attempted to examine the utility of anatomic structure and diagnostic acquisition by imaging the female pelvic cavity using Enteral MRI contrast media. As a result of analyzing magnetic resonance Imaging after administering Enteral MRI contrast media to pelvic cavity suspect patients, more diagnostic information media could be acquired than only using Intravenous contrast. Expecially, in the diagnosis of lesion position, shape, distinction from neighboring tissues it is thought that external Enteral MRI contrast media should be used.

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THE DIAGNOSTIC UTILITY OF THE RORSCHACH SCHIZOPHRENIA/DEPRESSION/COPING DEFICIT INDEX IN CHILD-ADOLESCENT PARENT GROUPS (아동 및 청소년 환자군의 Rorschach검사 Schizophrenia/Depression/Coping Deficit Index의 진단적 유용성에 관한 연구)

  • Seo, Soo-Gyoon;Shin, Min-Sup;Kim, Zoong-Sool
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.190-197
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    • 1998
  • Objectives:This study was conducted to investigate the diagnostic utility of the Rorschach schizophrenia/depression/coping deficite index in child-adolescent parent groups(schizophrenia, depression,depressive conduct disorder). Methods:Three child-adolescent parent groups(schizophrenia(18), depression(20), depressive conduct disorder(19)) were individyally assessed using the Rorschach test and schizophrenia/depression/coping deficite index scores were analyzed. Results:The results showed significant difference among three groups on only SCZI and significantly higher SCZI score of schizophrenia group than other two groups. When the critical value of SCZI was 4, diagnostic hit rate was 96.5%, and when the critical value of DEPI was 3, diagnostic hit rate was 57.9%, and when the critical value of CDI was 4, diagnostic hit rate was 66.6%.

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Fuzzy Inference in Medical Diagnosis

  • Kim, Soon-Ki
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1995.10b
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    • pp.92-97
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    • 1995
  • In medical diagnostic process we are dealing with the preliminary diagnosis based on the interview chart. We will quantify the qualitative information of a patient by dual scaling and establish both prototypes of fuzzy diagnostic sets and the fuzzy linear regressions. Its utility is shown in the diagnosis of headache and CAFDDH.

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Evaluation of the Malaria Rapid Diagnostic Kit in Ganghwa County (강화군에서 시행한 말라리아 신속진단킷트의 유용성 평가)

  • Kweon, Su-Jung;Kweon, Oh-Jun;Youn, Sung-Tae;Yim, Jun;Im, Jeong-Soo
    • Journal of agricultural medicine and community health
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    • v.31 no.2
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    • pp.157-164
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    • 2006
  • Objectives: Early diagnosis and treatment is the most important strategy to control malaria effectively. Microscopic examination of blood films is a traditional and standard method for diagnosing malaria, which takes a long time and needs expertise, Therefore, the alternative method, rapid diagnostic kit has been used for quick diagnosis in some counties, a highly infectious region by P. vivax. The purpose of this study was to evaluate the utility of malaria rapid diagnostic kit in Ganghwa county. Methods: The utility was evaluated by mean diagnosis time and sensitivity and specificity. For monitoring mean diagnosis time, 942 cases which were diagnosed for P. vivax were collected between 1998 and 2005, And for calculating sensitivity and specificity, 434 whole bloods in EDTA which were presented for P. vivax by microscopy and rapid diagnostic kit were collected between 2004 and 2005. Results: After malaria rapid diagnostic kit was used in 2003, mean diagnosis time has decreased to 3.36-3.14 day. The sensitivity and specificity of the rapid diagnostic kit was 98.2% and 98,5% and comparable to that of microscopic examination. Conclusions: The malaria rapid diagnostic kit is useful tool in a highly infectious region like Ganghwa county.

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Utility of Nuclear Morphometry in Effusion Cytology

  • Ambroise, Marie Moses;Jothilingam, Prabhavati;Ramdas, Anita
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6919-6922
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    • 2014
  • Background: The cytological analysis of serous effusions is a common investigation and yields important diagnostic information. However, the distinction of reactive mesothelial cells from malignant cells can sometimes be difficult for the cytopathologist. Hence cost-effective ancillary methods are essential to enhance the accuracy of cytological diagnosis. The aim of this study was to examine the utility of nuclear morphometry in differentiating reactive mesothelial cells from malignant cells in effusion smears. Materials and Methods: Sixty effusion smears consisting of 30 effusions cytologically classified as malignant (adenocarcinomas) and 30 benign effusions showing reactive mesothelial cells were included in the study. ImageJ was used to measure the nuclear area, perimeter, maximal feret diameter, minimal feret diameter and the circularity. A total of ten representative cells were studied in each case. Results: Significant differences were found between benign and malignant effusions for the nuclear area, perimeter, maximal feret diameter and minimal feret diameter. No significant difference was found for circularity, a shape descriptor. Receiver operating characteristic (ROC) curve analysis revealed that nuclear area, perimeter, maximal feret diameter, and minimal feret diameter are helpful in discriminating benign and malignant effusions. Conclusions: Computerised nuclear morphometry is a helpful ancillary technique to distinguish benign and malignant effusions. ImageJ is an excellent cost effective tool with potential diagnostic utility in effusion cytology.

Utility and Diagnostic Performance of Automated Breast Ultrasound System in Evaluating Pure Non-Mass Enhancement on Breast Magnetic Resonance Imaging

  • Bo Ra Kwon;Jung Min Chang;Soo-Yeon Kim;Su Hyun Lee;Sung Ui Shin;Ann Yi;Nariya Cho;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1210-1219
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    • 2020
  • Objective: To compare the utility and diagnostic performance of automated breast ultrasound system (ABUS) with that of handheld ultrasound (HHUS) in evaluating pure non-mass enhancement (NME) lesions on breast magnetic resonance imaging (MRI). Materials and Methods: One hundred twenty-six consecutive MRI-visible pure NME lesions of 122 patients with breast cancer were assessed from April 2016 to March 2017. Two radiologists reviewed the preoperative breast MRI, ABUS, and HHUS images along with mammography (MG) findings. The NME correlation rate and diagnostic performance of ABUS were compared with that of HHUS, and the imaging features associated with ABUS visibility were analyzed. Results: Among 126 pure NME lesions, 100 (79.4%) were malignant and 26 (20.6%) were benign. The overall correlation rate was 87.3% (110/126) in ABUS and 92.9% (117/126) in HHUS. The sensitivity and specificity were 87% and 50% for ABUS and 92% and 42.3% for HHUS, respectively, with no significant differences (p = 0.180 and 0.727, respectively). Malignant NME was more frequently visualized than benign NME lesions on ABUS (93% vs. 65.4%, p = 0.001). Significant factors associated with the visibility of ABUS were the size of NME lesions on MRI (p < 0.001), their distribution pattern (p < 0.001), and microcalcifications on MG (p = 0.027). Conclusion: ABUS evaluation of pure NME lesions on MRI in patients with breast cancer is a useful technique with high visibility, especially in malignant lesions. The diagnostic performance of ABUS was comparable with that of conventional HHUS in evaluating NME lesions.

Clinical Utility of CT-Based Bronchial Aspirate TB-PCR for the Rapid Diagnosis of Pleural Tuberculosis

  • Lee, Jaehee;Lee, So Yeon;Choi, Keum Ju;Lim, Jae Kwang;Yoo, Seung Soo;Lee, Shin Yup;Cha, Seung Ick;Park, Jae Yong;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.4
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    • pp.150-156
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    • 2013
  • Background: Thoracoscopic pleural biopsy is often required for rapid and confirmative diagnosis in patients with suspected pleural tuberculosis (PL-TB). However, this method is more invasive and costly than its alternatives. Therefore, we evaluated the clinical utility of the chest computed tomography (CT)-based bronchial aspirate (BA) TB-polymerase chain reaction (PCR) test in such patients. Methods: Bronchoscopic evaluation was performed in 54 patients with presumptive PL-TB through diagnostic thoracentesis but without a positive result of sputum acid-fast bacilli (AFB) smear, pleural fluid AFB smear, or pleural fluid TB-PCR test. Diagnostic yields of BA were evaluated according to the characteristics of parenchymal lesions on chest CT. Results: Chest radiograph and CT revealed parenchymal lesions in 25 (46%) and 40 (74%) of 54 patients, respectively. In cases with an absence of parenchymal lesions on chest CT, the bronchoscopic approach had no diagnostic benefit. BA TB-PCR test was positive in 21 out of 22 (95%) patients with early-positive results. Among BA results from 20 (37%) patients with patchy consolidative CT findings, eight (40%) were AFB smear-positive, 18 (90%) were TB-PCR-positive, and 19 (95%) were culture-positive. Conclusion: The BA TB-PCR test seems to be a satisfactory diagnostic modality in patients with suspected PL-TB and patchy consolidative CT findings. For rapid and confirmative diagnosis in these patients, the bronchoscopic approach with TB-PCR may be preferable to the thoracoscopy.

Use of Likelihood Ratios in Evidence-based Clinical Decision Making

  • Kim, Eu-Tteum;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.146-151
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    • 2008
  • During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.