Test interpretation: Talking with people about their test results.

2015 ◽  
pp. 3-10 ◽  
Author(s):  
Donald G. Zytowski
Keyword(s):  
Test Interpretation ◽  
Test Results

The thyrotropin-releasing hormone test: some statistical considerations

1992 ◽  
Vol 7 (1) ◽  
pp. 39-42
Author(s):  
CA de Mendonca Lima ◽  
S Vandel ◽  
P Bizouard
Keyword(s):  
Thyrotropin Releasing Hormone ◽  
Statistical Analyses ◽  
Test Interpretation ◽  
Test Results ◽  
Trh Test ◽  
Releasing Hormone ◽  
Administration Routes ◽  
Centre Hospitalier ◽  
Centre Hospitalier Universitaire ◽  
Sampling Times

SummaryFinal conclusions and data comparisons from the thyrotropin-releasing hormone (TRH) test results are made difficult by differences in test implementation methods, ie, TRH different administration routes, dosages and blood sampling times. A number of statistical analyses are feasible, which may also influence test interpretation. The authors review some types of statistical analyses and suggest using the area under curve (AUC) method as a means of evaluation. The TRH test was performed before treatment and after a 5-day wash-out period, in 40 depressed patients hospitalized in the Psychiatric Unit of Besancon Teaching Hospital (Centre Hospitalier Universitaire de Besançon). Variation analyses performed by peak and threshold comparison (7.0 IµU/ml) and by the AUC method (386 IµU/ml) in positive and negative patients revealed some statistical differences.

scholarly journals Information Theoretic Quantification of Diagnostic Uncertainty

2012 ◽  
Vol 6 (1) ◽  
pp. 36-50 ◽  
Author(s):  
M Brandon Westover ◽  
Nathaniel A Eiseman ◽  
Sydney S Cash ◽  
Matt T Bianchi
Keyword(s):  
Information Theory ◽  
Diagnostic Test ◽  
Probabilistic Reasoning ◽  
Test Interpretation ◽  
Test Results ◽  
Information Theoretic ◽  
Diagnostic Uncertainty ◽  
Point Estimates ◽  
Common Parlance ◽  
Test Probability

Diagnostic test interpretation remains a challenge in clinical practice. Most physicians receive training in the use of Bayes’ rule, which specifies how the sensitivity and specificity of a test for a given disease combine with the pre-test probability to quantify the change in disease probability incurred by a new test result. However, multiple studies demonstrate physicians’ deficiencies in probabilistic reasoning, especially with unexpected test results. Information theory, a branch of probability theory dealing explicitly with the quantification of uncertainty, has been proposed as an alternative framework for diagnostic test interpretation, but is even less familiar to physicians. We have previously addressed one key challenge in the practical application of Bayes theorem: the handling of uncertainty in the critical first step of estimating the pre-test probability of disease. This essay aims to present the essential concepts of information theory to physicians in an accessible manner, and to extend previous work regarding uncertainty in pre-test probability estimation by placing this type of uncertainty within a principled information theoretic framework. We address several obstacles hindering physicians’ application of information theoretic concepts to diagnostic test interpretation. These include issues of terminology (mathematical meanings of certain information theoretic terms differ from clinical or common parlance) as well as the underlying mathematical assumptions. Finally, we illustrate how, in information theoretic terms, one can understand the effect on diagnostic uncertainty of considering ranges instead of simple point estimates of pre-test probability.

scholarly journals Impact of interactions between drugs and laboratory test results on diagnostic test interpretation – a systematic review

2018 ◽  
Vol 56 (12) ◽  
pp. 2004-2009 ◽  
Author(s):  
Jasmijn A. van Balveren ◽  
Wilhelmine P.H.G. Verboeket-van de Venne ◽  
Lale Erdem-Eraslan ◽  
Albert J. de Graaf ◽  
Annemarieke E. Loot ◽  
...  
Keyword(s):  
Decision Support ◽  
Laboratory Test ◽  
Health Care Professionals ◽  
Test Interpretation ◽  
Test Results ◽  
Correct Interpretation ◽  
Laboratory Staff ◽  
Laboratory Test Results ◽  
Incorrect Diagnosis ◽  
Clinical Rules

Abstract Intake of drugs may influence the interpretation of laboratory test results. Knowledge and correct interpretation of possible drug-laboratory test interactions (DLTIs) is important for physicians, pharmacists and laboratory specialists. Laboratory results may be affected by analytical or physiological effects of medication. Failure to take into account the possible unintended influence of drug use on a laboratory test result may lead to incorrect diagnosis, incorrect treatment and unnecessary follow-up. The aim of this review is to give an overview of the literature investigating the clinical impact and use of DLTI decision support systems on laboratory test interpretation. Particular interactions were reported in a large number of articles, but they were fragmentarily described and some papers even reported contradictory findings. To provide an overview of information that clinicians and laboratory staff need to interpret test results, DLTI databases have been made by several groups. In a literature search, only four relevant studies have been found on DLTI decision support applications for laboratory test interpretation in clinical practice. These studies show a potential benefit of automated DLTI messages to physicians for the correct interpretation of laboratory test results. Physicians reported 30–100% usefulness of DLTI messages. In one study 74% of physicians sometimes even refrained from further additional examination. The benefit of decision support increases when a refined set of clinical rules is determined in cooperation with health care professionals. The prevalence of DLTIs is high in a broad range of combinations of laboratory tests and drugs and these frequently remain unrecognized.

Differences in lupus anticoagulant final conclusion through clotting time or Rosner index for mixing test interpretation

2016 ◽  
Vol 0 (0) ◽  
Author(s):  
Barbara Depreter ◽  
Katrien M.J. Devreese
Keyword(s):  
Lupus Anticoagulant ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Distinct Group ◽  
Activated Partial Thromboplastin Time ◽  
Final Conclusion ◽  
Test Interpretation ◽  
Test Results ◽  
Clotting Time

AbstractLupus anticoagulant (LAC) testing includes a screening, mixing and confirmation step. Although recently published guidelines on LAC testing are a useful step towards standardization, a lack of consensus remains whether to express mixing tests in clotting time (CT) or index of circulating anticoagulant (ICA). The influence of anticoagulant therapy, e.g. vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC) on both methods of interpretation remains to be investigated. The objective of this study was to contribute to a simplification and standardization of the LAC three-step interpretation on the level of the mixing test.Samples from 148 consecutive patients with LAC request and prolonged screening step, and 77 samples from patients non-suspicious for LAC treated with VKA (n=37) or DOAC (n=30) were retrospectively evaluated. An activated partial thromboplastin time (aPTT) and dilute Russell’s viper venom time (dRVVT) were used for routine LAC testing. The supplemental anticoagulant samples were tested with dRVVT only. We focused on the interpretation differences for mixing tests expressed as CT or ICA and compared the final LAC conclusion within each distinct group of concordant and discordant mixing test results.Mixing test interpretation by CT resulted in 10 (dRVVT) and 16 (aPTT) more LAC positive patients compared to interpretation with ICA. Isolated prolonged dRVVT screen mix ICA results were exclusively observed in samples from VKA-treated patients without suspicion for LAC.We recommend using CT in respect to the 99th percentile cut-off for interpretation of mixing steps in order to reach the highest sensitivity and specificity in LAC detection.

scholarly journals Oral Fluid Cannabinoids in Chronic, Daily Cannabis Smokers during Sustained, Monitored Abstinence

2011 ◽  
Vol 57 (8) ◽  
pp. 1127-1136 ◽  
Author(s):  
Dayong Lee ◽  
Garry Milman ◽  
Allan J Barnes ◽  
Robert S Goodwin ◽  
Jussi Hirvonen ◽  
...  
Keyword(s):  
Oral Fluid ◽  
Research Unit ◽  
Driving Under The Influence ◽  
Institutional Review Board ◽  
Test Interpretation ◽  
Test Results ◽  
Detection Rates ◽  
Institutional Review ◽  
Detection Window ◽  
Written Informed Consent

BACKGROUND Oral fluid (OF) is an accepted alternative biological matrix for drug treatment, workplace, and DUID (driving under the influence of drugs) investigations, but establishing the cannabinoid OF detection window and concentration cutoff criteria are important. METHODS Cannabinoid concentrations were quantified in OF from chronic, daily cannabis smokers during monitored abstinence. Δ9-tetrahydrocannabinol (THC)3, cannabidiol (CBD), cannabinol (CBN), and 11-nor-9-carboxy-THC (THCCOOH) were determined in daily OF samples collected with the Quantisal™ device. GC-MS limits of quantification (LOQ) were 0.5 μg/L for THC and CBD, 1 μg/L for CBN, and 7.5 ng/L for THCCOOH. RESULTS After providing written informed consent for this institutional review board–approved study, 28 participants resided from 4 to 33 days on the secure research unit and provided 577 OF specimens. At the LOQ, THC was generally quantifiable for 48 h, whereas CBD and CBN were detected only at admission. Median THCCOOH detection time was 13 days (CI 6.4–19.6 days). Mean THC detection rates decreased from 89.3% at admission to 17.9% after 48 h, whereas THCCOOH gradually decreased from 89.3% to 64.3% within 4 days. Criteria of THC ≥2 μg/L and THCCOOH ≥20 ng/L reduced detection to <48 h in chronic cannabis smokers. An OF THCCOOH/THC ratio ≤4 ng/μg or presence of CBD or CBN may indicate more recent smoking. CONCLUSIONS THC, THCCOOH, CBD, and CBN quantification in confirmatory OF cannabinoid testing is recommended. Inclusion of multiple cannabinoid cutoffs accounted for residual cannabinoid excretion in OF from chronic, daily cannabis smokers and could reduce the potential for positive test results from passive cannabis smoke exposure and lead to greatly improved test interpretation.

Comparing interview impressions and test results: A new test interpretation format and procedure.

1977 ◽  
Vol 8 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Richard J. Seime ◽  
Roger L. McCauley ◽  
Robert K. Madsen
Keyword(s):  
Test Interpretation ◽  
Test Results

Using Conventional Articulation Tests With Highly Unintelligible Children

1992 ◽  
Vol 23 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Pamela G. Garn-Nunn ◽  
Vicki Martin
Keyword(s):  
Test Results ◽  
Phonological Processes ◽  
Rule Based ◽  
Severity Level ◽  
Error Sensitivity ◽  
Conventional Tests ◽  
Severity Levels ◽  
Conventional Test ◽  
Impaired Children

This study explored whether or not standard administration and scoring of conventional articulation tests accurately identified children as phonologically disordered and whether or not information from these tests established severity level and programming needs. Results of standard scoring procedures from the Assessment of Phonological Processes-Revised, the Goldman-Fristoe Test of Articulation, the Photo Articulation Test, and the Weiss Comprehensive Articulation Test were compared for 20 phonologically impaired children. All tests identified the children as phonologically delayed/disordered, but the conventional tests failed to clearly and consistently differentiate varying severity levels. Conventional test results also showed limitations in error sensitivity, ease of computation for scoring procedures, and implications for remediation programming. The use of some type of rule-based analysis for phonologically impaired children is highly recommended.

Vestibular Function and Motion Sickness Susceptibility: Videonystagmographic Evidence From Oculomotor and Caloric Tests

2020 ◽  
Vol 29 (2) ◽  
pp. 188-198
Author(s):  
Cynthia G. Fowler ◽  
Margaret Dallapiazza ◽  
Kathleen Talbot Hadsell
Keyword(s):  
Phase Velocity ◽  
Motion Sickness ◽  
Repeated Measures ◽  
Short Form ◽  
Vestibular Function ◽  
Slow Phase ◽  
Test Results ◽  
Normal Range ◽  
Slow Phase Velocity ◽  
Caloric Tests

Purpose Motion sickness (MS) is a common condition that affects millions of individuals. Although the condition is common and can be debilitating, little research has focused on the vestibular function associated with susceptibility to MS. One causal theory of MS is an asymmetry of vestibular function within or between ears. The purposes of this study, therefore, were (a) to determine if the vestibular system (oculomotor and caloric tests) in videonystagmography (VNG) is associated with susceptibility to MS and (b) to determine if these tests support the theory of an asymmetry between ears associated with MS susceptibility. Method VNG was used to measure oculomotor and caloric responses. Fifty young adults were recruited; 50 completed the oculomotor tests, and 31 completed the four caloric irrigations. MS susceptibility was evaluated with the Motion Sickness Susceptibility Questionnaire–Short Form; in this study, percent susceptibility ranged from 0% to 100% in the participants. Participants were divided into three susceptibility groups (Low, Mid, and High). Repeated-measures analyses of variance and pairwise comparisons determined significance among the groups on the VNG test results. Results Oculomotor test results revealed no significant differences among the MS susceptibility groups. Caloric stimuli elicited responses that were correlated positively with susceptibility to MS. Slow-phase velocity was slowest in the Low MS group compared to the Mid and High groups. There was no significant asymmetry between ears in any of the groups. Conclusions MS susceptibility was significantly and positively correlated with caloric slow-phase velocity. Although asymmetries between ears are purported to be associated with MS, asymmetries were not evident. Susceptibility to MS may contribute to interindividual variability of caloric responses within the normal range.

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