• Title/Summary/Keyword: predictive value

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Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

Evaluation of Validity of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 타당도 평가)

  • Choi, Heejung;Ok, Jong Sun;An, Soo Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.26-35
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    • 2019
  • Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

Estimation of Predictive Value of a Positive Test from a Screening Test

  • Shin, Hyun Chul;Park, Sang Gue;Kim, Yong Hee
    • Communications for Statistical Applications and Methods
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    • v.10 no.2
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    • pp.567-574
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    • 2003
  • The estimation problem of predictive value of a positive test(PVP), which is assessing the accuracy of a screening test is considered. Score methods discussed by Gart and Nam(1988) are proposed for constructing confidence interval for PVP. The simulation studies are conducted in evaluating the proposed methods and existing approximate ones.

The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

  • Miri, Shimasadat;Mehralizadeh, Sandra;Sadri, Donya;Motamedi, Mahmood Reza Kalantar;Soltani, Parisa
    • Imaging Science in Dentistry
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    • v.45 no.3
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    • pp.141-145
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    • 2015
  • Purpose: This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs. Materials and Methods: Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections $5{\mu}m$ in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (${\alpha}=0.05$). Results: Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p<0.05). However, no statistically significant differences were found regarding specificity, positive predictive value, negative predictive value, or accuracy (p>0.05). Conclusion: The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

Prediction of extreme rainfall with a generalized extreme value distribution (일반화 극단 분포를 이용한 강우량 예측)

  • Sung, Yong Kyu;Sohn, Joong K.
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.4
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    • pp.857-865
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    • 2013
  • Extreme rainfall causes heavy losses in human life and properties. Hence many works have been done to predict extreme rainfall by using extreme value distributions. In this study, we use a generalized extreme value distribution to derive the posterior predictive density with hierarchical Bayesian approach based on the data of Seoul area from 1973 to 2010. It becomes clear that the probability of the extreme rainfall is increasing for last 20 years in Seoul area and the model proposed works relatively well for both point prediction and predictive interval approach.

An Implementation of Classification Method of Osteoporosis using CT images (CT 영상을 이용한 골다공증 분류 방법의 구현)

  • Jung, Sung-Tae
    • Journal of Korea Multimedia Society
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    • v.19 no.1
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    • pp.1-9
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    • 2016
  • In this paper, we propose a method of measuring bone mineral density in a peripheral-type clinical X-ray CT using a phantom, and we propose a method of classifying osteoporosis using bone mineral density and bone structure parameters together. It segments the trabecular bone region and cortical bone region for the six sections of the phantom and calculates the average HU value of the segmented regions. By using these values, it derives an expression converting HU value to bone mineral density. It segments trabecular bone of 1 cm region in the end part of distal radius and extracts the bone mineral density and structural parameters for the trabecular bone region. We extracted bone mineral density and structural parameters for the 18 subjects each of normal and osteoporotic group. We carried out classification experiments using three classification methods; SAD, SVM, ANN. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved in the order of ANN, SVM and SAD. Also, The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved when we use the bone mineral density and structural parameters together.

Comparison of Radiography Findings and Magnetic Resonance Image Findings of Lumbar Spine Instability Patients (요추 불안정 환자에서 단순방사선 소견과 자기공명영상 소견의 비교)

  • Lee, In-Hee;Park, Hee-Joon;Jin, Jong-Sik;Lee, Jyung-Hyun;Kim, Yoon-Nyun
    • The Journal of Korean Physical Therapy
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    • v.19 no.3
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    • pp.41-46
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    • 2007
  • Purpose: This study was to investigate how dose the radiography findings are to magnetic resonance (MR) image findings in the L5-S1 instability patients. The subjects of this study were comprised of eleven males and fifteen females, who had Lumbago and agreed with this research. Methods: Radiography and MR images of Lumbar spine were acquired respectively from subjects in conditions of maximum flexion and extension. The horizontal and angular displacements in lumabosacral spine radiography were used to assess the instability of lumbar spine. MR images were also used to evaluate the intervertebral disc abnormalities and change of bone marrow. Results: The results are as follows. 1. In the case of flexion transitional displacement proposed by Dupuis et al, the specificity and negative predictive value were good accuracy ($0.7{\sim}0.8$), and the negative predictive value was in average. In the case of extension displacement, the negative predictive value was about average ($0.6{\sim}0.7$), but the sensitivity, specificity and positive predictive value were below the poor (<0.6). On the other side, the specificity was about average but other things were below in the case of angular displacement. 2. In the case of flexion transitional displacement proposed by Dupuis et al., compared with the intervertebral disc abnormalities, the negative prediction value was excellent, the sensitivity good, and the specificity about average. In the case of extension, the negative prediction value was about average, but the other things were poor. On the other side the specificity and negative predictive value had good accuracy and the sensitivity and positive prediction value were below average in the case of angular displacement. Conclusion: The above results show that the radiography finding is sufficiently helpful to find the lumbar spine instability as an economic point of view.

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Design of Model Predictive Controllers with Velocity and Acceleration Constraints (속도 및 가속도 제한조건을 갖는 모델예측제어기 설계)

  • Park, Jin-Hyun;Choi, Young-Kiu
    • Journal of the Korean Society of Mechanical Technology
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    • v.20 no.6
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    • pp.809-817
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    • 2018
  • The model predictive controller performance of the mobile robot is set to an arbitrary value because it is difficult to select an accurate value with respect to the controller parameter. The general model predictive control uses a quadratic cost function to minimize the difference between the reference tracking error and the predicted trajectory error of the actual robot. In this study, we construct a predictive controller by transforming it into a quadratic programming problem considering velocity and acceleration constraints. The control parameters of the predictive controller, which determines the control performance of the mobile robot, are used a simple weighting matrix Q, R without the reference model matrix $A_r$ by applying a quadratic cost function from which the reference tracking error vector is removed. Therefore, we designed the predictive controller 1 and 2 of the mobile robot considering the constraints, and optimized the controller parameters of the predictive controller using a genetic algorithm with excellent optimization capability.

Diagnostic Value of Urine Cytology in 236 cases; a Comparison of Liquid-Based Preparation and Conventional Cytospin Method (요 세포 검사의 진단적 가치; 액상세포검사와 고식적 방법의 비교)

  • Lee, Sun;Park, Jung-Hee;Do, Sung-Im;Kim, Youn-Wha;Lee, Ju-Hie;Chang, Sung-Gu;Park, Yong-Koo
    • The Korean Journal of Cytopathology
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    • v.18 no.2
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    • pp.119-125
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    • 2007
  • Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as $ThinPrep^{(R)}$, have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the $ThinPrep^{(R)}$ preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The $ThinPrep^{(R)}$ method showed 53.1% sensitivity, 92.6% specificity, a 92,6% positive predictive value, a 94.1% negative predictive value and 85,6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88,6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the $ThinPrep^{(R)}$ method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

Study on the Clinical Validity of Sperm Penetration Assay (Sperm Penetration Assay의 임상적 타당성에 관한 연구)

  • Pang, Myung-Geol;Oh, Sun-Kyung;Shin, Chang-Jae;Kim, Jung-Gu;Moon, Shin-Yong;Chang, Yoon-Seok;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.1-7
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    • 1993
  • The present study was designed to test the validity of the semen analysis(S/A) and the sperm penetration assay(SPA) as a prognostic indicator of male fertility in 123 patients undergoing in vitro fertilization(IVF). We attempted to correlate the traditional semen parameters or the extent of sperm penetration in SPA with the results of human IVF rate or cleavage rate. Poor correlation was found between the results of S/A and human IVF rate(sensitivity, 80.6% ;specificity, 46.7%; positive predictive value, 91.6%;negative predictive value, 25%). Conversely, good correlation was found between the results of SPA and human IVF rate(sensitivity, 100% ; specificity, 80% ;positive predictive value, 97.3% ;negative predictive value, 100%). Our results corroborate the conclusion that SPA can be a valuable tool as a prognostic indicator of male fertilizing ability.

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