scholarly journals A reduced lymphocyte ratio as an early marker for predicting acute pancreatitis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiuzhong Qi ◽  
Fangyong Yang ◽  
Haitao Huang ◽  
Yiqi Du ◽  
Yan Chen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Disease Process ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Roc Curves ◽  
Lymphocyte Ratio ◽  
Severity Prediction ◽  
Severity Grading ◽  
Mild Acute Pancreatitis

Abstract The early diagnosis and severity grading for acute pancreatitis (AP) are difficult to determine because of the complexity and differences in disease process. To date, few studies have investigated the role of lymphocyte ratio (LR) in AP. Therefore, the objective of the present study was to investigate the prognostic value of LR as an indicator in AP, as well as determine an optimal cut-off value for the severity prediction. There were two hundred four patients involved in this study, ninety-two of whom had severe acute pancreatitis (SAP). The LR was analyzed on admission and correlated with severity, which was determined using the Atlanta classification. The optimal cut-off value for LR was generated using receiving operator characteristic (ROC) curves. The results showed that the LR in the SAP group decreased significantly compared to the mild acute pancreatitis (MAP) group (8.82 vs. 13.43). The optimal cut-off value obtained from ROC curves was 0.081, with a sensitivity of 80.4%, a specificity of 53.3%, a positive likelihood ratio of 1.722, and a negative likelihood ratio of 0.368. In conclusion, the LR is obviously related to the condition of AP patients and is valuable for the differential diagnosis of SAP in early stages of AP.

scholarly journals Diagnostic Value of Neutrophil-Lymphocyte Ratio for Predicting the Severity of Acute Pancreatitis: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Weihao Kong ◽  
Yuanyuan He ◽  
Huarui Bao ◽  
Wenlong Zhang ◽  
Xingyu Wang
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Mixed Model ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background. Acute pancreatitis (AP) is a life-threatening disease caused by a variety of factors, and once it progresses to severe acute pancreatitis, the prognosis is poor. The purpose of this study was to investigate the diagnostic value of the neutrophil-lymphocyte ratio (NLR) for predicting the severity of acute pancreatitis. Materials and Methods. We searched the databases of PubMed, EMBASE, Web of Science, and Cochrane Library to identify eligible studies using the NLR to predict the severity of AP. The sensitivity (SEN), specificity (SPE), negative likelihood ratio (NLR), positive likelihood ratio (PLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were combined using a bivariate mixed model. Results. A total of 10 articles containing 394 cases and 1319 controls were included in the study. The combined SEN, SPE, NLR, PLR, DOR, and AUC are 79% (73%-84%), 71% (59%-80%), 0.30 (0.21-0.41), 2.7 (1.8-4.0), 9 (5-18), and 0.82 (0.78-0.85), respectively. Conclusions. NLR has a moderately high diagnostic value in predicting the severity of acute pancreatitis.

scholarly journals Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score

2020 ◽  
Vol 7 (5) ◽  
pp. 1473
Author(s):  
Amulya Aggarwal ◽  
Alok V. Mathur ◽  
Ram K. Verma ◽  
Megha Gupta ◽  
Dheeraj Raj
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Treatment Protocol ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Clinical Scoring

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.

Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of patients with hepatocellular: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Shan Lin ◽  
Shiping Hu ◽  
Yun Ran ◽  
Fenfang Wu
Keyword(s):  
Likelihood Ratio ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cochrane Library ◽  
Summary Receiver Operating Characteristic ◽  
Lymphocyte Ratio ◽  
Meta Analyses

Abstract Background: Neutrophil-to-lymphocyte ratio (NLR) is one of the poor prognostic factors of Hepatocellular carcinoma (HCC) in patients. As contradictory data are seen concerning the predictive ability of NLR, a meta-analysis is performed for the determination of its prognostic value in patients with HCC in this study.Methods: We systematically searched several databases including PubMed, EMBASE, and Cochrane Library with the updated date of January 21, 2020. Pooled estimates of odds ratio (OR) and diagnostic odds ratio (DOR) were used to assess the prognostic performance of NLR in HCC patients.Results: Nine studies containing a total of 3,862 HCC patients were included. High baseline NLR was correlated with poor prognosis or recurrence significantly. The patient-based analysis of pooled estimates was as follows: sensitivity 0.68 [95% confidence interval (CI), 0.58-0.77], specificity 0.73 (95% CI, 0.61-0.82), and DOR 6.347 (95% CI, 5.450-7.391), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLHR) were 2.5 (95% CI, 1.8-3.6) and 0.43 (95% CI, 0.33-0.57). Furthermore, the area under the curve (AUC) of summary receiver operating characteristic (SROC) reflecting the diagnostic accuracy was 0.76 (95% CI, 0.72-0.80). Results obtained from subgroup meta-analyses and overall meta-analyses were accordingly consistent with each other.Conclusions: Our findings suggested that NLR is an efficient prognostic factor for patients with HCC, especially for those from East Asian with high incidence. In the future, trails with larger sample sizes and more high-quality evidence are needed to further enhance the patient outcomes.

Is the diagnostic value of either ESR or CRP sufficient to exclude the need to measure both in paediatric patients presenting with non-traumatic limb pain?

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A8.1-A8
Author(s):  
Sara Robinson
Keyword(s):  
Emergency Department ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Roc Curves ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Limb Pain ◽  
Time Of Presentation

BackgroundLaboratory tests for cases of suspected orthopaedic infection usually include measurement of both the erythrocyte sedimentation rate (ESR) and the C reactive protein (CRP). This has a time and cost implication for the laboratories. The measurement of both also requires a larger volume blood sample, which can be difficult to obtain.ObjectiveTo assess if the measurement of either CRP or ESR individually has a likelihood ratio equivalent to that of the measurement of both.SettingEmergency Department of a Paediatric Teaching Hospital.Study designRetrospective study of Case Notes for patients attending the Emergency Department with a complaint of atraumatic limb pain and in whom both ESR and CRP were measured at the time of presentation. Laboratory results at the time of presentation were recorded along with the final diagnosis. Receiver operating characteristic (ROC) curves were created using the data. Likelihood Ratios for ESR and CRP individually and in combination were calculated.Results259 patients were included in the study of whom 17 were considered to have an Orthopaedic infection. The ROC curves revealed the best results were obtained using cut off values of CRP>7 and ESR>12. The combination of a CRP>7 and an ESR>12 gave the best positive Likelihood Ratio at 6.26 (Likelihood ratio 5.34 (CRP>7) vs 2.57 (ESR>12)) For ruling out disease the combination of CRP≤7 and an ESR≤12 also outperformed either variable individually (negative likelihood ratio 0.09 (CRP≤7 and ESR≤12) vs 0.34 (CRP≤7) vs 0.18 (ESR≤12)).ConclusionA raised CRP is a more specific indicator of orthopaedic infection than a raised ESR; however the ESR is more sensitive. Thus the Likelihood Ratios produced by the combination of the two results are superior to those of either measurement individually. The measurement of both CRP and ESR should be considered an important aid in the investigation of atraumatic limb pain.

scholarly journals Exploration of the Efficiency of Radiomics Applied to Left Ventricular Tomograms Obtained From D-SPECT MPI for the Auxiliary Diagnosis of Myocardial Ischemia in CAD

2021 ◽  
Author(s):  
Junpeng Wang ◽  
Xin Fan ◽  
Shanshan Qin ◽  
Han Zhang ◽  
Fei Yu
Keyword(s):  
Myocardial Ischemia ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Roc Curves ◽  
Left Ventricular ◽  
Operating Characteristics ◽  
Evaluation Indexes ◽  
Spect Mpi

Abstract Purpose: To explore the feasibility and efficacy of radiomics with left ventricular tomograms obtained from D-SPECT myocardial perfusion imaging (MPI) for auxiliary diagnosis of myocardial ischemia in coronary artery disease (CAD).Methods: The images of 103 patients with CAD myocardial ischemia between September 2020 and April 2021 were retrospectively selected. After information desensitization processing, format conversion, annotation using the Labelme tool on an open-source platform, lesion classification, and establishment of a database, the images were cropped for analysis. The ResNet18 model was used to automate two steps (classification and segmentation) with five randomization, training and validation steps. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, Youden’s index, agreement rate, and kappa value were calculated as evaluation indexes of the classification results for each training-validation step; then, receiver operating characteristics (ROC) curves were drawn, and the areas under the curve (AUCs) were calculated. The Dice coefficient, intersection over union, and Hausdorff distance were calculated as evaluation indexes of the segmentation results for each training-validation step; then, the predicted images were exported.Results: Under the existing conditions, the radiomics model can distinguish myocardial ischemia quite accurately, with AUCs all exceeding 0.95, and predict the areas of myocardial ischemia quite accurately; all evaluated indexes were close to those of the gold standard.Conclusion: Radiomics can be feasibly applied to left ventricular tomograms obtained from D-SPECT MPI for auxiliary diagnosis, with quite good results. Patients may benefit from this approach as technology evolves and associated software is developed.

scholarly journals Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Ying Wang ◽  
Jingyi Zhao ◽  
Lan Yang ◽  
Junhui Hu ◽  
Yinhui Yao
Keyword(s):  
Likelihood Ratio ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Severe Disease ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background. Coronavirus disease 2019 (COVID-19) is highly contagious and continues to spread rapidly. However, there are no simple and timely laboratory techniques to determine the severity of COVID-19. In this meta-analysis, we assessed the potential of the neutrophil-lymphocyte ratio (NLR) as an indicator of severe versus nonsevere COVID-19 cases. Methods. A search for studies on the NLR in severe and nonsevere COVID-19 cases published from January 1, 2020, to July 1, 2021, was conducted on the PubMed, EMBASE, and Cochrane Library databases. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) analyses were done on Stata 14.0 and Meta-disc 1.4 to assess the performance of the NLR. Results. Thirty studies, including 5570 patients, were analyzed. Of these, 1603 and 3967 patients had severe and nonsevere COVID-19, respectively. The overall sensitivity and specificity were 0.82 (95% confidence interval (CI), 0.77-0.87) and 0.77 (95% CI, 0.70-0.83), respectively; positive and negative correlation ratios were 3.6 (95% CI, 2.7-4.7) and 0.23 (95% CI, 0.17-0.30), respectively; DOR was 16 (95% CI, 10-24), and the AUC was 0.87 (95% CI, 0.84-0.90). Conclusion. The NLR could accurately determine the severity of COVID-19 and can be used to identify patients with severe disease to guide clinical decision-making.

scholarly journals The Potential Diagnostic Accuracy of Circulating MicroRNAs for Leukemia: A Meta-Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110119
Author(s):  
Wen-Ting Zhang ◽  
Guo-Xun Zhang ◽  
Shuai-Shuai Gao
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Background: Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia. Methods: A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias. Results: 49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found. Conclusions: Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.

scholarly journals The value of glycosylated hemoglobin in the diagnosis of diabetic retinopathy: a systematic review and Meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Zhang ◽  
Bingjie Zhang ◽  
Zhulin Zhou ◽  
Yutong Guo ◽  
Dan Wang
Keyword(s):  
Diabetic Retinopathy ◽  
Likelihood Ratio ◽  
Roc Curve ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Clinical Value

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI:  0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

scholarly journals Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199296
Author(s):  
Juan Wang ◽  
Liu Yang ◽  
Yanjun Diao ◽  
Jiayun Liu ◽  
Jinjie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dna Methylation ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Control Group ◽  
Control Subjects ◽  
Droplet Pcr ◽  
Healthy Control

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

scholarly journals Test characteristics of history, examination and investigations in the evaluation for septic arthritis in the child presenting with acute non-traumatic limp. A systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038088
Author(s):  
Jacky Tu ◽  
Peter Gowdie ◽  
Julian Cassar ◽  
Simon Craig
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Septic Arthritis ◽  
Quality Assessment ◽  
Likelihood Ratio ◽  
Risk Prediction ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Prediction Tools ◽  
Clinical Risk

BackgroundSeptic arthritis is an uncommon but potentially significant diagnosis to be considered when a child presents to the emergency department (ED) with non-traumatic limp. Our objective was to determine the diagnostic accuracy of clinical findings (history and examination) and investigation results (pathology tests and imaging) for the diagnosis of septic arthritis among children presenting with acute non-traumatic limp to the ED.MethodsSystematic review of the literature published between 1966 and June 2019 on MEDLINE and EMBASE databases. Studies were included if they evaluated children presenting with lower limb complaints and evaluated diagnostic performance of items from history, physical examination, laboratory testing or radiological examination. Data were independently extracted by two authors, and quality assessment was performed using the Quality Assessment Tool for Diagnostic Accuracy Studies 2 tool.Results18 studies were identified, and included 2672 children (560 with a final diagnosis of septic arthritis). There was substantial heterogeneity in inclusion criteria, study setting, definitions of specific variables and the gold standard used to confirm septic arthritis. Clinical and investigation findings were reported using varying definitions and cut-offs, and applied to differing study populations. Spectrum bias and poor-to-moderate study design quality limit their applicability to the ED setting.Single studies suggest that the presence of joint tenderness (n=189; positive likelihood ratio 11.4 (95% CI 5.9 to 22.0); negative likelihood ratio 0.2 (95% CI 0.0 to 1.2)) and joint effusion on ultrasound (n=127; positive likelihood ratio 8.4 (95% CI 4.1 to 17.1); negative likelihood ratio 0.2 (95% CI 0.1 to 0.3)) appear to be useful. Two promising clinical risk prediction tools were identified, however, their performance was notably lower when tested in external validation studies.DiscussionDifferentiating children with septic arthritis from non-emergent disorders of non-traumatic limp remains a key diagnostic challenge for emergency physicians. There is a need for prospectively derived and validated ED-based clinical risk prediction tools.

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