Comparing the accuracy of lay diagnosis of childhood malaria and pneumonia with that of the revised IMCI guidelines in Nigeria

2020 ◽  
Author(s):  
K O Elimian ◽  
P R Myles ◽  
R Phalkey ◽  
A Sadoh ◽  
C Pritchard
Keyword(s):  
Health Workers ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Childhood Diseases ◽  
Cross Sectional ◽  
Predictive Values ◽  
Benin City ◽  
Sensitivity Specificity ◽  
Childhood Malaria ◽  
Pneumonia Diagnosis

Abstract Background Improving caregivers’ recognition of childhood malaria and pneumonia is crucial to early treatment and improving outcomes. The objective of this study was to assess the accuracy and reliability of caregivers’ recognition of malaria and pneumonia (lay diagnosis) as compared to the revised IMCI guidelines. Methods A cross-sectional study design was used to recruit 903 children aged 2–59 months who were assessed for malaria and pneumonia by health workers at five primary healthcare centres in Benin City, Nigeria. Accuracy of lay diagnosis as compared to the revised IMCI guidelines was assessed using sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic curve (AUROC) values. Results The accuracy of caregivers’ ability to recognise malaria (AUROC: 0.60; 95% CI: 0.57–0.64) and pneumonia (AUROC: 0.54; 95% CI: 0.50–0.58) was, respectively, moderate and poor as compared to the IMCI guidelines. Caregivers were better able to identify children without than those with malaria and pneumonia. Agreement between caregivers and the IMCI guidelines for malaria and pneumonia diagnosis was poor (k = 0.14, 95% CI: 0.09–0.19; P = 0.0001). Conclusion Caregivers’ ability to recognise these childhood diseases as compared to the IMCI guidelines was poor overall, which was partly due to the approach used to ascertain lay diagnosis.

scholarly journals Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Raja Kannan ◽  
Suchetha S. Rao ◽  
Prasanna Mithra ◽  
B. Dhanashree ◽  
Shantharam Baliga ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Clinical Sepsis ◽  
A Value ◽  
Sepsis Screen ◽  
Sensitivity Specificity

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.

scholarly journals VAGINAL SONOGRAPHY a HYSTEROSCOPY

2009 ◽  
Vol 16 (03) ◽  
pp. 432-437
Author(s):  
MASOMEH ASGHARNIA ◽  
Zahra Mohammad Tabar ◽  
MARZIEH MEHRAFZA ◽  
Mary am Shakiba ◽  
MONA OUDI ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Therapeutic Modality ◽  
Histological Evaluation ◽  
Complete Evaluation ◽  
Cross Sectional ◽  
Predictive Values ◽  
Infertile Women ◽  
Sensitivity Specificity

B a c k g r o u n d : Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. A i m : To evaluatethe consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. Materials andMethods: This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women beforeassisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsyperformed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosiswas confirmed by histologic studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterinecavity specimens. Sensitivity, specificity, predictive and negative predictive values were calculated for hysteroscopy considering the histologicalstudy as 100%. Results: Sensitivity and specificity of sonography in diagnosing the polyp were stated 81 % and 64% respectively. Sensitivityand specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that Sensitivity and specificity ofsonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myomawere expressed 50% and 93% respectively. C o n c l u s i o n : Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believeit should be replaced by the diagnostic hysteroscopy as a first line infertility investigation.

scholarly journals Comparing Predictive power of CT-scan Findings among the Malignant Hepatic Mass patients

2015 ◽  
Vol 12 (1) ◽  
pp. 2-6
Author(s):  
Wahida Begum ◽  
Ahmed Hossain ◽  
Waziha A Jahan ◽  
Mahbuba Shirin ◽  
M Abdullah Yusuf ◽  
...  
Keyword(s):  
Ct Scan ◽  
Vena Cava ◽  
Cross Sectional Study ◽  
Medical College Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Predictive Values ◽  
Medical College ◽  
Hepatic Mass ◽  
Sensitivity Specificity

Background: CT-scan is useful for the detection of hepatic mass. Objective: The purpose of the present study was to see the predictive values of CT scan in the diagnosis of malignant hepatic mass. Methodology: This cross sectional study was carried out in the Department of Radiology and Imaging at Mymensingh Medical College Hospital (MMCH), Mymensingh, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH), Dhaka during the period of 1st January 2006 to 31st December 2007. Patients admitted in the Department of Medicine and Department of Hepatobiliary of MMCH, BSMMU, and DMCH with the clinical diagnosis of fever, abdominal pain, anorexia, nausea/vomiting, loss of appetite, jaundice, weight loss and ascites were selected as study population. CT scan and histopathology were performed to all the patients. Result: A total number of 50 patients were recruited for this study.. The sensitivity for multiplicity was 71.4%, specificity was 63.6%, accuracy was 68%, PPV was 71.4% and NPV was 63.6%. The sensitivity for hypodensity as a sign of malignancy was 60.7%, specificity was 18.2%, accuracy was 42.0%, PPV was 48.6% and NPV was 26.7%. The sensitivity, specificity, PPV, NPV and accuracy of contrast enhancement were 100.0%, 22.7%, 62.2%, 100.0% and 66.0% respectively. Again the sensitivity, specificity, PPV, NPV and accuracy of detection of pressure effect on biliary apparatus by CT-scan were 100.0%, 22.7%, 62.2%, 100.0% and 66.0% respectively. Again the sensitivity, specificity, PPV, NPV and accuracy of detection of Lymphadenopathy by CT-scan were 35.7%, 95.5%, 90.9%, 53.8% and 62.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of Portal vein invasion by CT-scan were 14.3%, 100.0%, 100.0%, 47.8% and 52.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of hepatic vein invasion by CT-scan were 10.7%, 100.0%, 100.0%, 46.8% and 50.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of inferior vena cava (IVC) invasion by CT-scan were 7.1%, 100.0%, 100.0%, 45.8% and 48.0% respectively. Conclusion: CT is a useful diagnostic tool for the detection of malignant hepatic masses.Journal of Science Foundation, 2014;12(1):2-6

When Time is of the Essence: Preliminary Findings for a Quick Administration of the Dot Counting Test

2019 ◽  
Author(s):  
K Chase Bailey ◽  
Troy A Webber ◽  
Jacob I Phillips ◽  
Lindsay D R Kraemer ◽  
Janice C Marceaux ◽  
...  
Keyword(s):  
Classification Accuracy ◽  
Clinical Sample ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Receiver Operator Characteristic Curve ◽  
Performance Validity ◽  
Free Standing ◽  
Cross Sectional ◽  
Validity Measures ◽  
Sensitivity Specificity

Abstract Objective Performance validity research has emphasized the need for briefer measures and, more recently, abbreviated versions of established free-standing tests to minimize neuropsychological evaluation costs/time burden. This study examined the accuracy of multiple abbreviated versions of the Dot Counting Test (“quick” DCT) for detecting invalid performance in isolation and in combination with the Test of Memory Malingering Trial 1 (TOMMT1). Method Data from a mixed clinical sample of 107 veterans (80 valid/27 invalid per independent validity measures and structured criteria) were included in this cross-sectional study; 47% of valid participants were cognitively impaired. Sensitivities/specificities of various 6- and 4-card DCT combinations were calculated and compared to the full, 12-card DCT. Combined models with the most accurate 6- and 4-card combinations and TOMMT1 were then examined. Results Receiver operator characteristic curve analyses were significant for all 6- and 4-card DCT combinations with areas under the curve of .868–.897. The best 6-card combination (cards, 1-3-5-8-11-12) had 56% sensitivity/90% specificity (E-score cut-off, ≥14.5), and the best 4-card combination (cards, 3-4-8-11) had 63% sensitivity/94% specificity (cut-off, ≥16.75). The full DCT had 70% sensitivity/90% specificity (cut-off, ≥16.00). Logistic regression revealed 95% classification accuracy when 6-card or 4-card “quick” combinations were combined with TOMMT1, with the DCT combinations and TOMMT1 both emerging as significant predictors. Conclusions Abbreviated DCT versions utilizing 6- and 4-card combinations yielded comparable sensitivity/specificity as the full DCT. When these “quick” DCT combinations were further combined with an abbreviated memory-based performance validity test (i.e., TOMMT1), overall classification accuracy for identifying invalid performance was 95%.

Ratio of height to thyromental distance: a comparison with Mallampati and Upper lip Bite test for predicting difficult intubation in Pakistani population

2021 ◽  
pp. 1-15
Author(s):  
Saman Tauheed Ali ◽  
Khalid Samad ◽  
Syed Amir Raza ◽  
Muhammad Qamarul Hoda
Keyword(s):  
Predictive Value ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Difficult Laryngoscopy ◽  
University Hospital ◽  
Upper Lip ◽  
Cross Sectional ◽  
Elective Surgical Procedures ◽  
Lehane Grade ◽  
Sensitivity Specificity

Objectives: We conducted this study to compare the accuracy of three diagnostic tests; ratio of height to thyromental distance (RHTMD), Modified Mallampati Test (MMT) and Upper Lip Bite Test (ULBT) in predicting difficult laryngoscopy using Cormack and Lehane grade as gold standard.Methods: This study was conducted in Aga Khan University Hospital, Karachi. Based on calculated sample size, 383 patients who required endotracheal intubation for elective surgical procedures were enrolled with consecutive sampling techniques during August 2014 to August 2015 for this cross-sectional study. Primary investigator used RHTMD, ULBT, and MMT for assessing the airway and correlated with laryngoscopic view.Results: A total of 383 patients were incorporated in this research, out of which 59(15.4%) classified as difficult laryngoscopy based on Cormack and Lehane (CL) grading. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of RHTMD (84.7%, 90.1%, 60.9%, 97%, 89.3%) and ULBT (83.1%, 89.2%, 58.3%, 96.7%, 88.3%) values were highest as compared to MMT (30.5%, 84.3%, 26.1%, 86.9%, 79.9%). The area under a receiver-operating characteristic curve (AUC of ROC curve) for ULBT and RHTMD was significantly more than for MMT (P<0.01). RHTMD and ULBT both are acceptable alternatives for prediction of difficult laryngoscopy as a simple, single bed-side test. Continuous...

scholarly journals Evaluation of platelet count/spleen diameter ratio for detection of oesophageal varices in patients with cirrhosis of liver: a cross-sectional study

2021 ◽  
Author(s):  
Ashok Mysore Lakshminarayana ◽  
Shweta Mallikarjun Kumbar ◽  
Manohara Melur Chandregowda ◽  
Kiran Warrier
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Cross Sectional Study ◽  
Current Evidence ◽  
Oesophageal Varices ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gastroesophageal Varices ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.

scholarly journals Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

2020 ◽  
Vol 4 (2) ◽  
pp. 6-13
Author(s):  
Jackson Chipaila ◽  
◽  
Alex Makupe ◽  
Evans Malyangu ◽  
Daniel Maswahu ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Predictive Values ◽  
Tertiary Hospitals ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

ORAL SQUAMOUS PAPILLOMA AND SQUAMOUS CELL CARCINOMA

2015 ◽  
Vol 22 (11) ◽  
pp. 1494-1498
Author(s):  
Rajia Liaqat ◽  
Najiya Barkat ◽  
Asif Hanif
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cross Sectional Study ◽  
Diagnostic Utility ◽  
Cross Sectional ◽  
Predictive Values ◽  
P53 Expression ◽  
Squamous Papilloma ◽  
Sensitivity Specificity

Objectives: The objective of this study was to determine the diagnostic utility ofp53 in differentiating oral squamous papilloma and squamous cell carcinoma. Study Design:A cross-sectional study. Setting: Pathology Department of Shaukat Khanum Memorial CancerHospital and Research Center Lahore. Period: Six months (6-10-10 to 6-04-11). Patients andMethods: A total of 100 oral biopsies fulfilling the inclusion criteria were collected. The expressionof P53 was observed in biopsies of squamous papilloma and squamous cell carcinoma. Datawas entered and analyzed on SPSS version 20 and was analyzed in same package. Sensitivity,specificity, positive predictive and negative predictive values were calculated along theirconfidence intervals at 95% level. Results: One hundred oral lesions were studied, of which 90cases were of squamous cell carcinoma and 10 cases were of squamous papilloma. Majorityof the patients were male (60%). Mean age was 46 years. P53 IHC stain had sensitivity of 92%and specificity of 80% and diagnostic utility of 91% in lesions of squamous cell carcinoma.Conclusion: P53 is positively expressed in oral squamous cell carcinoma and is negativein squamous papilloma. Hence evaluation of p53 expression can be a useful adjunct in thediagnosis of squamous cell carcinoma, especially in cases where it is difficult to distinguishbetween these two entities on morphological grounds.

Accuracy of Ultrasound for Determination of Fetal Gender

2021 ◽  
Vol 15 (6) ◽  
pp. 1237-1239
Author(s):  
A. Ammar ◽  
M. A. Z. Husnain ◽  
M. Arshad ◽  
T. M. Mirza ◽  
Z. Arshad ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Ultrasound Examination ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Predictive Values ◽  
Fetal Gender ◽  
Sensitivity Specificity

Aim: To evaluate the accuracy of ultrasound in determining the phenotypic foetal gender in all three trimesters. Study design: Cross sectional study. Place and duration of study: Department of Diagnostic Radiology Combined Military Hospital Lahore from 1st January 2020 to 30th April 2020. Methodology: Three hundred and seventy two patients in the inclusion criteria were selected. Ages of patients, gestational ages of foetuses and their genders were determined according to the ultrasonographic signs using ultrasound examination. Patients were contacted 3 weeks after the estimated date of delivery and phenotypic sex recorded. Results: Mean age was 34 years. Median gestational age was 21 weeks 3 days. Accuracy of gender determination by ultrasound in 1st, 2nd and 3rd trimesters was 62%, 97% and 95% respectively. Sensitivity and specificity of ultrasound in 1st trimester for males are 66% and 72%; and for females are 72% and 66% respectively. Positive and negative predictive values for male are 69% and 71%; and for female are 71% and 69% respectively. Sensitivity and specificity of ultrasound in 2nd trimester for males are 95% and 100%; and for females are 100% and 95% respectively. Positive and negative predictive values for male are 100% and 94%; and for female are 94% and 100% respectively. Sensitivity and specificity of ultrasound in 3rd trimester for males are 94% and 96%; and for females are 96% and 94% respectively. Positive and negative predictive values for male are 97% and 93%; and for female are 93% and 97% respectively. Conclusion: There is a high accuracy of ultrasound in determination of fetal gender in second and third trimesters. Keywords: Ultrasound, Gender, Trimester, Sensitivity, Specificity, Predictive Value

scholarly journals Accuracy of abdominal circumference for diagnosing overweight in six-to-seven-years-old children

2022 ◽  
Vol 11 (1) ◽  
pp. e23511124638
Author(s):  
Eliane Traebert ◽  
Graziela Leão ◽  
Guilherme de Azevedo Traebert ◽  
Altaiana Portella da Rosa Flôres ◽  
Jefferson Traebert
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Characteristic Curve ◽  
Accurate Method ◽  
Standing Position ◽  
Overweight And Obesity ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Predictive Values ◽  
Sensitivity Specificity

Objective: To estimate the accuracy of abdominal circumference measurement as a method of diagnosing overweight in six-to-seven-years-old children. Methods: A cross-sectional study involving 1026 six-to-seven-years-old schoolchildren in southern Brazil was carried out. Children’s weight and height were collected at schools. Body mass index were calculated and categorized in z-score in eutrophy, overweight and obesity. Abdominal circumference was measured in centimeters with a tape with children in standing position at midpoint between the lower ribs margin and the iliac crest. Correlation between abdominal circumference and body mass index was performed through Pearson's correlation coefficient. Sensitivity, specificity, positive and negative predictive values of abdominal circumference were estimated. The Receiver Operating Characteristic Curve was used to measure the accuracy. Results: A positive linear correlation value of 0.582 and a determination coefficient 0.39 were observed. The accuracy value of 0.859 was observed. Sensitivity, specificity, positive and negative predictive values varied according to each value in centimeters of abdominal circumference. Conclusion: Abdominal circumference measure showed to be an accurate method for detecting overweight and obesity in six-to-seven-years-old children.

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