scholarly journals Clinical versus neuropathological diagnosis in an ADRC sample: Factors impacting diagnostic concordance rates

2020 ◽  
Vol 16 (S2) ◽  
Author(s):  
Judith Neugroschl ◽  
Margaret Sewell ◽  
Mikayla Haas ◽  
Keith Radler ◽  
Dushyant Purohit ◽  
...  
Keyword(s):  
Neuropathological Diagnosis ◽  
Diagnostic Concordance

Drusen in the Peripheral Retina of the Alzheimer’s Eye

2018 ◽  
Vol 15 (8) ◽  
pp. 743-750 ◽  
Author(s):  
Kresimir Ukalovic ◽  
Sijia Cao ◽  
Sieun Lee ◽  
Qiaoyue Tang ◽  
Mirza Faisal Beg ◽  
...  
Keyword(s):  
Peripheral Retina ◽  
Amyloid Angiopathy ◽  
Temporal Region ◽  
Future Studies ◽  
Eye Tissues ◽  
Neuropathological Diagnosis ◽  
Ocular Imaging ◽  
Cerebral Amyloid ◽  
The Brain ◽  
Oil Red O

Background: Recent work on Alzheimer's disease (AD) diagnosis focuses on neuroimaging modalities; however, these methods are expensive, invasive, and not available to all patients. Ocular imaging of biomarkers, such as drusen in the peripheral retina, could provide an alternative method to diagnose AD. Objective: This study compares macular and peripheral drusen load in control and AD eyes. Methods: Postmortem eye tissues were obtained from donors with a neuropathological diagnosis of AD. Retina from normal donors were processed and categorized into younger (<55 years) and older (>55 years) groups. After fixation and dissection, 3-6 mm punches of RPE/choroid were taken in macular and peripheral (temporal, superior, and inferior) retinal regions. Oil red O positive drusen were counted and grouped into two size categories: small (<63 μm) and intermediate (63-125 μm). Results: There was a significant increase in the total number of macular and peripheral hard drusen in older, compared to younger, normal eyes (p<0.05). Intermediate hard drusen were more commonly found in the temporal region of AD eyes compared to older normal eyes, even after controlling for age (p<0.05). Among the brain and eye tissues from AD donors, there was a significant relationship between cerebral amyloid angiopathy (CAA) severity and number of temporal intermediate hard drusen (r=0.78, p<0.05). Conclusion: Imaging temporal drusen in the eye may have benefit for diagnosing and monitoring progression of AD. Our results on CAA severity and temporal intermediate drusen in the AD eye are novel. Future studies are needed to further understand the interactions among CAA and drusen formation.

scholarly journals Diagnostic Agreement between Physicians and a Consultation–Liaison Psychiatry Team at a General Hospital: An Exploratory Study across 20 Years of Referrals

2021 ◽  
Vol 18 (2) ◽  
pp. 749
Author(s):  
Mattia Marchi ◽  
Federica Maria Magarini ◽  
Giorgio Mattei ◽  
Luca Pingani ◽  
Maria Moscara ◽  
...  
Keyword(s):  
General Hospital ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Clinical Signs ◽  
Kappa Statistics ◽  
Comorbid Depression ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry ◽  
Psychiatric Conditions ◽  
Diagnostic Concordance

Consultation–liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000–2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.

Identifying Factors Associated With Diagnostic Concordance/Discordance in Oral Lichen Planus

2013 ◽  
Vol 71 (10) ◽  
pp. 1688-1693 ◽  
Author(s):  
Chong Huat Siar ◽  
Jimie Siew Mei Lim ◽  
Sum Pei Tang ◽  
Hui Shan Chia ◽  
Yi Min Loh ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Factors Associated ◽  
Diagnostic Concordance ◽  
Oral Lichen

Hypertension, Cerebrovascular Disease and Stomach Cancer: Is the Salt Hypothesis True?

1981 ◽  
Vol 61 (s7) ◽  
pp. 369s-371s ◽  
Author(s):  
Paul K. Whelton ◽  
Peter Goldblatt
Keyword(s):  
Stomach Cancer ◽  
Death Certificate ◽  
Positive Association ◽  
Special Relationship ◽  
Death Rates ◽  
Disease Associations ◽  
Strong Positive Association ◽  
Diagnostic Concordance ◽  
The Relationship ◽  
Unique Relationship

1. Analysis of age-adjusted death rates from 21 countries over a 20-year period identified the presence of a strong positive association between recorded mortality from stroke, hypertension and stomach cancer. However, the slopes of regression lines for secular trends analyses varied considerably from country to country, suggesting an inconsistency in the pattern of the relationship. 2. A death certificate study of diagnostic concordance correctly identified previously known disease associations but failed to recognise any special relationship between stroke and stomach cancer or hypertension and stomach cancer. 3. Our results fail to confirm the presence of a unique relationship between stroke and stomach cancer. On the basis of these observations, the hypothesis that exposure to salt increases an individual's risk of developing both stroke and stomach cancer seems unlikely.

Diagnostic concordance among pathologists interpreting breast core biopsies on secondary review over a 1‐year period at an Australian tertiary hospital

2021 ◽  
Author(s):  
Harry Hohnen ◽  
Benjamin Dessauvagie ◽  
Mireille Hardie ◽  
Dugald McCallum ◽  
Raoul Oehmen ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Diagnostic Concordance

Nuclear morphology in breast lesions: refining its assessment to improve diagnostic concordance

2021 ◽  
Author(s):  
Ayaka Katayama ◽  
Michael S Toss ◽  
Matthew Parkin ◽  
Takaaki Sano ◽  
Tetsunari Oyama ◽  
...  
Keyword(s):  
Nuclear Morphology ◽  
Breast Lesions ◽  
Diagnostic Concordance

The Diagnostic Concordance of Endoanal Ultrasonography and Endoanal MRI in Cases of Anorectal Fistula

2000 ◽  
Vol 43 (5) ◽  
pp. 585
Author(s):  
Wan Tae Kim ◽  
Seon Young Yoo ◽  
Hee Jung Moon ◽  
Hyun Ja Shin ◽  
Jae Sik Joo
Keyword(s):  
Anorectal Fistula ◽  
Endoanal Ultrasonography ◽  
Diagnostic Concordance

scholarly journals Low-Grade Squamous Intraepithelial Lesion or High-Grade Squamous Intraepithelial Lesion? Concordance Between the Interpretation of Low-Grade Squamous Intraepithelial Lesion and High-Grade Squamous Intraepithelial Lesion in Papanicolaou Tests: Results From the College of American Pathologists PAP Education Program

2018 ◽  
Vol 143 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Barbara A. Crothers ◽  
Mohiedean Ghofrani ◽  
Chengquan Zhao ◽  
Leslie G. Dodd ◽  
Kelly Goodrich ◽  
...  
Keyword(s):  
Education Program ◽  
Repeated Measures ◽  
False Negative ◽  
Misclassification Rate ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Diagnostic Concordance

Context.— Obtaining diagnostic concordance for squamous intraepithelial lesions in cytology can be challenging. Objective.— To determine diagnostic concordance for biopsy-proven low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) Papanicolaou test slides in the College of American Pathologists PAP Education program. Design.— We analyzed 121 059 responses from 4251 LSIL and HSIL slides for the interval 2004 to 2013 using a nonlinear mixed-model fit for reference diagnosis, preparation type, and participant type. We evaluated interactions between the reference diagnosis and the other 2 factors in addition to a repeated-measures component to adjust for slide-specific performance. Results.— There was a statistically significant difference between misclassification of LSIL (2.4%; 1384 of 57 664) and HSIL (4.4%; 2762 of 63 395). There was no performance difference between pathologists and cytotechnologists for LSIL, but cytotechnologists had a significantly higher HSIL misclassification rate than pathologists (5.5%; 1437 of 27 534 versus 4.0%; 1032 of 25 630; P = .01), and both were more likely to misrepresent HSIL as LSIL (P &lt; .001) than the reverse. ThinPrep LSIL slides were more likely to be misclassified as HSIL (2.4%; 920 of 38 582) than SurePath LSIL slides (1.5%; 198 of 13 196), but conventional slides were the most likely to be misclassified in both categories (4.5%; 266 of 5886 for LSIL, and 6.5%; 573 of 8825 for HSIL). Conclusions.— More participants undercalled HSIL as LSIL (false-negative) than overcalled LSIL as HSIL (false-positive) in the PAP Education program, with conventional slides more likely to be misclassified than ThinPrep or SurePath slides. Pathologists and cytotechnologists classify LSIL equally well, but cytotechnologists are significantly more likely to undercall HSIL as LSIL than are pathologists.

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