scholarly journals A weighted generalized score statistic for comparison of predictive values of diagnostic tests

2012 ◽  
Vol 32 (6) ◽  
pp. 964-977 ◽  
Author(s):  
Andrzej S. Kosinski
Keyword(s):  
Diagnostic Tests ◽  
Score Statistic ◽  
Predictive Values

scholarly journals Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

2018 ◽  
Vol 52 (9) ◽  
pp. 557-565 ◽  
Author(s):  
Jonas Bloch Thorlund ◽  
Carsten Bogh Juhl ◽  
Lina Holm Ingelsrud ◽  
Søren Thorgaard Skou
Keyword(s):  
Risk Factors ◽  
Diagnostic Tests ◽  
Young Patients ◽  
Evaluation Framework ◽  
Diagnostic Tools ◽  
Meniscal Tears ◽  
Predictive Values ◽  
And Function ◽  
Surgical Treatments ◽  
Quality Evidence

This statement aimed at summarising and appraising the available evidence for risk factors, diagnostic tools and non-surgical treatments for patients with meniscal tears. We systematically searched electronic databases using a pragmatic search strategy approach. Included studies were synthesised quantitatively or qualitatively, as appropriate. Strength of evidence was determined according to the Grading of Recommendations Assessment Development and Evaluation framework. Low-quality evidence suggested that overweight (degenerative tears, k=3), male sex (k=4), contact and pivoting sports (k=2), and frequent occupational kneeling/squatting (k=3) were risk factors for meniscal tears. There was low to moderate quality evidence for low to high positive and negative predictive values, depending on the underlying prevalence of meniscal tears for four common diagnostic tests (k=15, n=2474). Seven trials investigated exercise versus surgery (k=2) or the effect of surgery in addition to exercise (k=5) for degenerative meniscal tears. There was moderate level of evidence for exercise improving self-reported pain (Effect Size (ES)−0.51, 95% CI −1.16 to 0.13) and function (ES −0.06, 95% CI −0.23 to 0.11) to the same extent as surgery, and improving muscle strength to a greater extent than surgery (ES −0.45, 95% CI −0.62 to −0.29). High-quality evidence showed no clinically relevant effect of surgery in addition to exercise on pain (ES 0.18, 95% 0.05 to 0.32) and function (ES, 0.13 95% CI −0.03 to 0.28) for patients with degenerative meniscal tears. No randomised trials comparing non-surgical treatments with surgery in patients younger than 40 years of age or patients with traumatic meniscal tears were identified. Diagnosis of meniscal tears is challenging as all clinical diagnostic tests have high risk of misclassification. Exercise therapy should be recommended as the treatment of choice for middle-aged and older patients with degenerative meniscal lesions. Evidence on the best treatment for young patients and patients with traumatic meniscal tears is lacking.

A new likelihood approach to inference about predictive values of diagnostic tests in paired designs

2016 ◽  
Vol 27 (2) ◽  
pp. 541-548 ◽  
Author(s):  
Tsung-Shan Tsou
Keyword(s):  
Diagnostic Tests ◽  
Screening Test ◽  
Score Test ◽  
Real Data ◽  
Test Results ◽  
Multinomial Model ◽  
Test Statistic ◽  
Predictive Values ◽  
Minimum Number ◽  
Likelihood Approach

Intuitively, one only needs patients with two positive screening test results for positive predictive values comparison, and those with two negative screening test results for contrasting negative predictive values. Nevertheless, current existing methods rely on the multinomial model that includes superfluous parameters unnecessary for specific comparisons. This practice results in complex statistics formulas. We introduce a novel likelihood approach that fits the intuition by including a minimum number of parameters of interest in paired designs. It is demonstrated that our robust score test statistic is identical to a newly proposed weighted generalized score test statistic. Simulations and real data analysis are used for illustration.

scholarly journals Accuracy of diagnostic tests for respiratory syncytial virus infection within a paediatric hospital population in Kilifi County, Kenya

2020 ◽  
Vol 5 ◽  
pp. 155
Author(s):  
Marshal M. Mweu ◽  
Nickson Murunga ◽  
Juliet W. Otieno ◽  
D. James Nokes
Keyword(s):  
Respiratory Syncytial Virus ◽  
Diagnostic Tests ◽  
Latent Class ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Predictive Values ◽  
Paediatric Hospital ◽  
Rsv Infection ◽  
Hospital Population ◽  
Syncytial Virus

Background: Respiratory syncytial virus (RSV)-induced lower respiratory tract disease is a prominent cause of hospitalisation among children aged <5 years in developing countries. Accurate and rapid diagnostic tests are central to informing effective patient management and surveillance efforts geared towards quantifying RSV disease burden. This study sought to estimate the sensitivity (Se), specificity (Sp) (along with the associated factors) and predictive values of a direct immunofluorescence test (IFAT), and two real-time reverse transcription polymerase chain reaction (rRT-PCR) assays for RSV infection within a paediatric hospital population: a multiplex rRT-PCR (MPX) and Fast-Track Diagnostics® (FTD) Respiratory Pathogens 33 (Resp-33) rRT-PCR. Methods: The study enlisted 1458 paediatrics aged ≤59 months admitted with acute respiratory illness at the Kilifi County Hospital between August 2011 and December 2013. A Bayesian latent class modelling framework was employed to infer the tests’ estimates based on the patients’ diagnostic data from the three tests. Results: The tests posted statistically similar Se estimates: IFAT (93.7%, [90.7; 95.0]), FTD (97.8%, [94.6; 99.4]) and MPX (97.5%, [94.2; 99.3]). As for Sp, FTD registered a lower estimate (97.4%, [96.2; 98.2]) than MPX (99.7%, [99.0; 100.0]) but similar to IFAT (99.0%, [98.2; 99.6]). The negative and positive predictive values were strong (>91%) and closely mimicked the pattern given by the Se and Sp values respectively. None of the examined covariates (age, sex and pneumonia status) significantly influenced the accuracy of the tests. Conclusions: The evaluation found little to choose between the three diagnostic tests. Nonetheless, with its relative affordability, the conventional IFAT continues to hold promise for use in patient care and surveillance activities for RSV infection within settings where children are hospitalised with severe acute respiratory illness.

scholarly journals Performance of Diagnostic Tests for Plasma Cell Myeloma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5570-5570
Author(s):  
Gilda Zagoya ◽  
Alejandro Ruiz-Argüelles ◽  
Guillermo J. Ruiz-Arguelles
Keyword(s):  
Plasma Cell ◽  
Diagnostic Tests ◽  
Laboratory Tests ◽  
Light Chains ◽  
Plasma Cell Myeloma ◽  
Immunoglobulin Light Chains ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Total Immunoglobulin

Abstract Introduction. In vitro laboratory tests to diagnose of plasma cell myeloma vary considerably in sensitivity, specificity and positive and negative predictive values. We compared the performance of quantification of free immunoglobulin light chains with other methods used to detect a monoclonal protein in serum and/or urine. Objective. Compare sensitivity, specificity and positive and negative predictive values of several in vitro laboratory tests to detect monoclonal proteins in serum and urine in persons with plasma cell myeloma. Methods. 70 subjects with plasma cell myeloma and 50 controls were studied. Diagnostic tests included: (1) quantification of free and total immunoglobulin light-chains by immune assays; (2) immune fixation of heavy-and light-chains in serum and urine after gel electrophoresis; and (3) serum protein capillary electrophoresis. Diagnosis of plasma cell myeloma was based on clinical and radiological criteria, bone marrow examination and flow cytometric immune phenotyping with monoclonal antibodies to CD56, CD19, CD138 (CD38) and CD45. Sensitivity, specificity and positive and negative predictive values for each tests were estimated from contingency tables. Results. Quantification of free immmunoglobulin light-chains had the highest sensitivity and specificity and best positive and negative predictive values. Immune fixation of serum immunoglobulins was next best. Quantification of total immunoglobulin light-chains was the least sensitive and specific with the worst positive and negative predictive values. Quantitation of free light-chains had the additional advantage of objectivity (independence from observer bias). The immune fixation test was the most subject to observer bias. Conclusion. Quantification of free immunoglobulin light-chains had the best sensitivity, specificity and positive and negative predictive values for diagnosing plasma cell myeloma. (Table 1) Disclosures No relevant conflicts of interest to declare.

scholarly journals Comparing the Performance of HIV Rapid Diagnostic Tests Used in Zambia: a Systematic Review of Clinical Data.

2021 ◽  
Author(s):  
Loveness Mukuka ◽  
Andros Theo ◽  
Mowa Zambwe ◽  
Peter J Chipimo
Keyword(s):  
Systematic Review ◽  
Clinical Data ◽  
Diagnostic Tests ◽  
Rapid Diagnostic Tests ◽  
Fourth Generation ◽  
Hiv Positive ◽  
Third Generation ◽  
Predictive Values ◽  
Rapid Tests ◽  
Positive Results

Objective: To investigate the performance of the HIV RDTs used in Zambia. Method: 2,564 participants aged between 15 and 95 years from two sites in Lusaka province years were tested on OraQuick ADVANCE, Abbot Determine, and then confirmed on Uni-Gold Recombigen. The data from the participants were analyzed using SPSS version 25.0. Results: The 3 RDTs when compared to the 4th generation Abbot Architect results had the following results: OraQuick ADVANCE, Alere Determine and Uni-Gold Ultra, at 95% CI had Sensitivities of: 91.8%, 93.3% and 92.5% respectively. The specificities of OraQuick ADVANCE and Uni-Gold were the same (100.0%; 95% CI: 98.8 -100.0) but slightly different from Alere Determine (99.8%). Positive predictive values at 95% CI were 100% for OraQuick ADVANCE and Uni-Gold and 98.4% for Alere Determine. Negative predictive values (at 95% CIs) were 99.1, 99.2 and 99.1 for OraQuick ADVANCE, Alere Determine, and Uni-Gold Ultra respectively. The results showed that these RDTs could only detect 12 out of every 13 HIV positive results. Conclusion: Third generation RDTs are not effective in detecting acute positive cases. Fourth generation Rapid Tests are required to capture the positive cases being missed out.

scholarly journals Bivariate meta-analysis of predictive values of diagnostic tests can be an alternative to bivariate meta-analysis of sensitivity and specificity

2012 ◽  
Vol 65 (10) ◽  
pp. 1088-1097 ◽  
Author(s):  
Mariska M.G. Leeflang ◽  
Jonathan J. Deeks ◽  
Anne W.S. Rutjes ◽  
Johannes B. Reitsma ◽  
Patrick M.M. Bossuyt
Keyword(s):  
Sensitivity And Specificity ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Predictive Values
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