• Title/Summary/Keyword: Predictive diagnosis

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Accuracy of the 2008 Simplified Criteria for the Diagnosis of Autoimmune Hepatitis in Children

  • Arcos-Machancoses, Jose Vicente;Busoms, Cristina Molera;Tatis, Ecaterina Julio;Bovo, Maria Victoria;Bernabeu, Jesus Quintero;Goni, Javier Juamperez;Martinez, Vanessa Crujeiras;Martin de Carpi, Javier
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.118-126
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    • 2018
  • Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.

Which Endometrial Pathologies Need Intraoperative Frozen Sections?

  • Balik, Gulsah;Kagitci, Mehmet;Ustuner, Isik;Akpinar, Funda;Guven, Emine Seda Guvendag
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6121-6125
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    • 2013
  • Background: Endometrial cancers are the most common gynecologic cancers. Endometrial sampling is a preferred procedure for diagnosis of the endometrial pathology. It is performed routinely in many clinics prior to surgery in order to exclude an endometrial malignancy. We aimed to investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathologies and which findings need intra-operative frozen sections. Materials and Methods: Three hundred nine women applying to a university hospital and undergoing endometrial sampling and hysterectomy between 2010 and 2012 were included to this retrospective study. Data were retrieved from patient files and pathology archives. Results: There was 17 patients with malignancy but endometrial sampling could detect this in only 10 of them. The endometrial sampling sensitivity and specificity of detecting cancer were 58.8% and 100%, with negative and positive predictive values of 97.6%, and 100%, respectively. In 7 patients, the endometrial sampling failed to detect malignancy; 4 of these patients had a preoperative diagnosis of complex atypical endometrial hyperplasia and 2 patients had a post-menopausal endometrial polyps and 1 with simple endometrial hyperplasia. Conclusions: There is an increased risk of malignancy in post-menopausal women especially with endometrial polyps and complex atypia hyperplasia. Endometrial sampling is a good choice for the diagnosis of endometrial pathologies. However, the diagnosis should be confirmed by frozen section in patients with post-menopausal endometrial polyps and complex atypia hyperplasia.

Accuracy of Frozen Sections for Intraoperative Diagnosis of Complex Atypical Endometrial Hyperplasia

  • Turan, Taner;Karadag, Burak;Karabuk, Emine;Tulunay, Gokhan;Ozgul, Nejat;Gultekin, Murat;Boran, Nurettin;Isikdogan, Zuhal;Kose, Mehmet Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1953-1956
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    • 2012
  • Objective: The purpose of this study was to correlate the histological diagnosis made during intraoperative frozen section (FS) examination of hysterectomy samples with complex atypical endometrial hyperplasia (CAEH) diagnosed with definitive paraffin block histology. Methods: FS pathology results of 125 patients with a preoperative biopsy showing CAEH were compared retrospectively with paraffin block pathology findings. Results: Paraffin block results were consistent with FS in 78 of 125 patients (62.4%). The FS sensitivity and specificity of detecting cancer were 81.1% and 97.9%, with negative and positive predictive values of 76.7%, and 98.4%, respectively. Paraffin block results were reported as endometrial cancer in 77 of 125 (61.6%) patients. Final pathology was endometrial cancer in 45.3% patients diagnosed at our center and 76.9% for patients who had their diagnosis at other clinics (p=0.018). Paraffin block results were consistent with FS in 62.4% of all cases Consistence was 98.4% in patients who had endometrial cancer in FS. Conclusion: FS does not exclude the possibility of endometrial cancer in patients with the preoperative diagnosis of CAEH. In addition, sufficient endometrial sampling is important for an accurate diagnosis.

The Development of Clinical Decision Support System for Diagnosing Neurogenic Bladder

  • Batmunh, Nyambat;Chae, Young M.
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.478-485
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    • 2001
  • In this study, we have developed a prototype of clinical decision support systems (CDSS) for diagnosing neurogenic bladder and compared its predicted diagnoses with the actual diagnoses using 92 patient\`s Urodynamic study cases. The CDSS was developed using a Visual Basic based on the evidence-based rules extracted from guidelines and other references regarding a diagnosis of neurogenic bladder. To compare with the 92 final diagnoses made by doctors at the Yonsei Rehabilitation Center, we classified all diagnoses into 5 groups. The predictive rates of the CDSS were: 48.0% for areflexic neurogenic bladder; 60.0% for hyperreflexic neurogenic bladder in a spinal shock recovery stage; 72.9% for hyperreflexic neurogenic bladder, and 80.0% for areflexic neurogenic bladder in a spinal shock stage, which was the highest predicted rate. There were only 2 cases for hyperreflexic neurogenic bladder in a well controlled detrusor activity, and its predictive rate was 0%. The study results showed that CDSS for diagnosing neurogenic bladder could provide a helpful advice on decision-making for doctors. The findings also suggest that physicians should be involved in all development stages to ensure that systems are developed in a fashion that maximizes their beneficial effect on patient care, and that systems are acceptable to both professionals and patients. The future studies will concentrate on including more validating the system.

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Accuracy, Sensitivity and Specificity of Fine Needle Aspiration Biopsy for Salivary Gland Tumors: A Retrospective Study from 2006 to 2011

  • Silva, William P P;Stramandinoli-Zanicotti, Roberta T;Schussel, Juliana L;Ramos, Gyl H A;Ioshi, Sergio O;Sassi, Laurindo M
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4973-4976
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    • 2016
  • Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.

Reliability of Stool Antigen Tests: Investigation of the Diagnostic Value of a New Immunochromatographic Helicobacter pylori Approach in Dyspeptic Patients

  • Korkmaz, Huseyin;Findik, Duygu;Ugurluoglu, Ceyha;Terzi, Yuksel
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.657-660
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    • 2015
  • Background: A diagnosis of H. pylori infection can be made by invasive or non-invasive methods. Several noninvasive diagnostic tests based on the detection of H. pylori stool antigen (HpSA) have been developed. The Genx H. pylori stool antigen card test is a new rapid, non-invasive test that is based on monoclonal immunochromatographic assay. The aim of this study was to determine its sensitivity, specificity, and diagnostic accuracy for diagnosing H. pylori infection in adult patients. Materials and Methods: A total of 162 patients were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: Using the reference test, 50.6% of the samples were positive for H. pylori infection. The Genx H. pylori antigen test was positive in 19.7% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the Genx H. pylori antigen test were 51.6%, 96.0%, 88.8%, 76.1%, and 79.0%, respectively. Conclusions: The Genx H. pylori stool antigen card test is a new non-invasive method that is fast and simple to perform but provides less reliable results.

Predictive Value of Baseline Plasma D-dimers for Chemotherapy-induced Thrombocytopenia in Patients with Stage III Colon Cancer: A Pilot Study

  • Tanriverdi, Ozgur
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.293-297
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    • 2013
  • Background: : Chemotherapy-induced thrombocytopenia (CIT) is an important cause of morbitity in patients with cancer. Aim: To investigate the effect of the baseline plasma D-dimer level, an important marker for thrombotic activity, on chemotherapy-induced thrombocytopenia in patients with stage III colon cancer. Materials and Methods: A total of 43 (28 men) eligible patients were divided into two groups according to whether they exhibited chemotherapy-induced thrombocytopenia: Group 1 (n=21) and Group 2 (n=22). Comparison was made using demographic, histopathologic, and laboratory variables. Additionally, baseline plasma D-dimer levels underwent receiver operation characteristics curve analysis, and areas under the curve were calculated. Sensitivity, specificity, and positive and negative likelihood rates were then determined. Results: The incidence of chemotherapy-induced thrombocytopenia had a significant correlation with baseline platelet count (r=0.568, P=0.031) and baseline plasma D-dimer levels (r=0.617, P=0.036). When the cut-off point for the latter was set as 498 ng/mL, the area under the curve was 0.89 (95%CI: 0.74-0.93), the sensitivity was 91.4%, the specificity was 89.7%, the positive likelihood rate was 3.64 and the negative likelihood rate was 0.24 for chemotherapy-induced thrombocytopenia diagnosis. Conclusions: The baseline level of plasma D-dimer could help to differentiate high-risk patients for chemotherapy-induced thrombocytopenia.

Relationship of Somatic Cell Count, Physical, Chemical and Enzymatic Properties to the Bacterial Standard Plate Count in Different Breeds of Dairy Goats

  • Ying, Chingwen;Yang, Cheng-Bin;Hsu, Jih-Tay
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.4
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    • pp.554-559
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    • 2004
  • The objective of the present study was to investigate the accuracy of mastitis diagnostic indicators for different dairy goat breeds. Biweekly milk samples were collected from individual half mammary gland of seven Saanen and seven Alpine dairy goats in the period of 40 to 120 days in milk. With threshold value set at 2.8 and 3.1 for Alpine and Saanen dairy goats, respectively, log (SPC) offered good sensitivity (0.89, 0.93), specificity (0.88, 0.95), positive predictive value (0.75, 0.85) and negative predictive value (0.95, 0.98) as a mastitis diagnostic tool. The correlations of log (SPC) with milk yield, log (SCC), ALP, LDH, $Na^{+}$, $K^{+}$ and EC were significant in Saanen dairy goats (p<0.05), with the highest correlation coefficient (0.653) existing between log (SPC) and log (SCC). The correlations of log (SPC) with milk yield, milk fat, milk protein, log (SCC), $Na^{+}$, $K^{+}$, EC were significant in Alpine dairy goats (p<0.05), with the highest correlation coefficient (0.416) existing between log (SPC) and log (SCC). There were different best-fit regression equations with different multiple diagnostic indicators for Saanen and Alpine dairy goats. In conclusion, different breeds of dairy goats may have to adapt different mastitis diagnostic parameters for a better diagnosis.

Controversies in Usefulness of EEG for Clinical Decision in Epilepsy: Pros. (간질 치료에서 뇌파의 임상적 유용성에 관한 논란: 긍정적 관점에서)

  • Shon, Young-Min;Kim, Yeong In
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.63-68
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    • 2007
  • The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.

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Usefulness of Liver Fibrosis According to Classification of Image Score System In Abdominal Ultrasonography (복부 초음파검사에서 영상 점수 시스템 분류에 따른 간 섬유화 평가의 유용성)

  • An, Hyun;Ji, Tae-jeong;Lee, Hyo-young;Im, In-chul
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.187-194
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    • 2019
  • The purpose of this study was to evaluate the pathologic results of hepatic parenchyma parameters such as liver parenchyma, liver surface, liver margin and liver, portal vein, spleen size, And to evaluate the usefulness of fibrosis progression and hepatic ultrasonography. The sensitivity, specificity, positive predictive value, and prognostic value according to the stage of fibrosis and grade of inflammation were divided into two groups according to the morphologic variable "A" through ultrasound and "B" We evaluated the predictive value and predicted the variables to evaluate fibrosis in clinical diagnosis and treatment of patients with chronic liver disease. The sensitivity and specificity of hepatic fibrosis in hepatic morphologic variables and other size variables were highest in liver surface and edge. The morphologic parameters used in the evaluation of fibrosis were clinically relevant in distinguishing the fibrosis stage from the results of liver biopsy.