New recommendations for retinal monitoring in hydroxychloroquine users: Baseline testing is no longer supported

2021 ◽  
Author(s):  
I.H. Yusuf ◽  
F. Latheef ◽  
M. Ardern‐Jones ◽  
A.J. Lotery
Keyword(s):  
Baseline Testing

Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis

1996 ◽  
Vol 75 (03) ◽  
pp. 412-416 ◽  
Author(s):  
Armando D’Angelo ◽  
Gabriella D’Alessandro ◽  
Loredana Tomassini ◽  
Jean Louis Pittet ◽  
G Dupuy ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Cost Savings ◽  
Pretest Probability ◽  
First Episode ◽  
Consecutive Series ◽  
Vein Thrombosis ◽  
Baseline Testing ◽  
Deep Vein ◽  
D Dimer

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.

Baseline Concussion Testing Increases Agreement With Favorable Concussion Safety Decisions in Hypothetical Scenarios

2021 ◽  
pp. 109019812110035
Author(s):  
Christina Deuschle ◽  
Julian Keith ◽  
Kelly Dugan ◽  
Mark Williams ◽  
Sasi Taravath ◽  
...  
Keyword(s):  
General Population ◽  
National Collegiate Athletic Association ◽  
Effective Means ◽  
Safety Behavior ◽  
Knowledge And Attitudes ◽  
Attitudes And Perceptions ◽  
Student Version ◽  
Baseline Testing ◽  
Added Benefit ◽  
Concussion Knowledge

Background Dangers of sports-related concussion are well documented, and those participating in sports involving significant contact are at an even higher risk relative to the general population. Despite extensive concussion education, athletes still make decisions that would be considered unsafe, such as underreporting and continuing to play despite experiencing symptoms. Although baseline testing is an increasingly common practice at all levels of sport, little is known about its ability to improve player safety perceptions. Aims The current study examines whether taking part in a standardized baseline concussion assessment changes athletes’ knowledge, attitudes, or perceptions of concussion safety decisions. Method A total of 229 club and National Collegiate Athletic Association athletes completed a modified Rosenbaum Concussion Knowledge and Attitudes Survey–Student Version (RoCKAS-ST), which was used to evaluate knowledge, attitudes, and perceptions of concussion safety decisions in hypothetical scenarios. Athletes were randomly assigned to either complete baseline concussion testing prior to the RoCKAS-ST or complete baseline testing after the RoCKAS-ST. Results Athletes randomly assigned to complete baseline testing before the RoCKAS-ST demonstrated greater agreement with favorable concussion safety decisions in hypothetical scenarios relative to athletes completing baseline testing after the RoCKAS-ST. The two conditions did not differ with respect to concussion knowledge or attitudes. Discussion Baseline testing appears to have an added benefit of resulting in more favorable perceptions toward making safe decisions following suspected concussions. Conclusion Baseline testing may provide an effective means of improving a broader constellation of concussion safety behavior, particularly in club athletes, who are typically underserved in terms of concussion-related resources and care.

Facioscapulohumeral muscular dystrophy (FSHD): Design of natural history study and results of baseline testing

Neurology ◽  
1994 ◽  
Vol 44 (3, Part 1) ◽  
pp. 442-442 ◽  
Author(s):  
R. Tawil ◽  
M. P. McDermott ◽  
J. R. Mendell ◽  
J. Kissel ◽  
R. C. Griggs ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Natural History ◽  
Facioscapulohumeral Muscular Dystrophy ◽  
Natural History Study ◽  
Baseline Testing

scholarly journals Elevated HIV and STI Prevalence and Incidence Among Methamphetamine-Using Men Who Have Sex With Men in Los Angeles County

2018 ◽  
Vol 30 (4) ◽  
pp. 350-356 ◽  
Author(s):  
Cathy J. Reback ◽  
Jesse B. Fletcher
Keyword(s):  
Los Angeles ◽  
Sexual Risk ◽  
Risk Behaviors ◽  
Los Angeles County ◽  
Hiv Positive ◽  
Sexual Risks ◽  
Methamphetamine Use ◽  
Baseline Testing ◽  
Sex With Men

Methamphetamine use is associated with increased HIV/STI infection among men who have sex with men (MSM). From March 2014 through January 2016, 286 methamphetamine-using MSM enrolled in a study to reduce methamphetamine use and sexual risk behaviors. Participants were tested for HIV/STIs at baseline and every 3 months for 9 months. At baseline, 115 participants (40.2%) were HIV–positive; three participants seroconverted (incidence = 2.6/100 person-years). Baseline testing diagnosed 77 STI cases (21 chlamydia, 18 gonorrhea, 38 syphilis); by 9-month follow-up, 71 incident STIs were diagnosed (22 chlamydia, 24 gonorrhea, 25 syphilis); 78% occurred among HIV–positive participants. Despite efforts to reduce sexual risks among methamphetamine-using MSM, HIV/STI prevalence and incidence remain elevated.

scholarly journals One-year test-retest reliability of ten vision tests in Canadian athletes

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1032
Author(s):  
Mehdi Aloosh ◽  
Suzanne Leclerc ◽  
Stephanie Long ◽  
Guowei Zhong ◽  
James M. Brophy ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Intraclass Correlation ◽  
Limits Of Agreement ◽  
Male Athletes ◽  
Retest Reliability ◽  
Concussion Management ◽  
Baseline Testing ◽  
One Year ◽  
The One ◽  
Test Retest Reliability

Background: Vision tests are increasingly being suggested for use in concussion management and baseline testing. Concussions, however, often occur months after baseline testing and reliability studies generally examine intervals limited to days or one week. Therefore, our objective was to determine the one-year test-retest reliability of these tests. Methods: We assessed one-year test-retest reliability of ten vision tests in elite Canadian athletes followed by the Institut National du Sport du Quebec. We included athletes who completed two baseline (preseason) annual evaluations by one clinician within 365±30 days. We excluded athletes with any concussion or vision training in between the annual evaluations or presented with any factor that is believed to affect the tests (e.g. migraines, etc.). Data were collected from clinical charts. We evaluated test-retest reliability using Intraclass Correlation Coefficient (ICC) and 95% limits of agreement (LoA). Results: We examined nine female and seven male athletes with a mean age of 22.7 (SD 4.5) years. Among the vision tests, we observed excellent test-retest reliability in Positive Fusional Vergence at 30cm (ICC=0.93) but this dropped to 0.55 when an outlier was excluded in a sensitivity analysis. There was good to moderate reliability in Negative Fusional Vergence at 30cm (ICC=0.78), Phoria at 30cm (ICC=0.68), Near Point of Convergence break (ICC=0.65) and Saccade (ICC=0.56). The ICC for Positive Fusional Vergence at 3m (ICC=0.56) also decreased to 0.21 after removing one outlier. We found poor reliability in Near Point of Convergence (ICC=0.47), Gross Stereoscopic Acuity (ICC=0.03) and Negative Fusional Vergence at 3m (ICC=0.0). ICC for Phoria at 3m was not appropriate because scores were identical in 14/16 athletes. 95% LoA of the majority of tests were ±40% to ±90%. Conclusions: Four tests had moderate one-year test-retest reliability. The remaining tests had poor reliability. The tests would therefore be useful only if concussion has a moderate-large effect on scores.

Endocrine investigations and laboratory reference ranges

2020 ◽  
pp. 385-436
Author(s):  
Gary Butler ◽  
Jeremy Kirk
Keyword(s):  
False Negative ◽  
Risk Groups ◽  
Pituitary Hormones ◽  
Endocrine Disorders ◽  
Reference Ranges ◽  
Pubertal Stage ◽  
Optimal Outcomes ◽  
Negative Results ◽  
False Negative Results ◽  
Baseline Testing

While baseline testing may be appropriate in some endocrine disorders (e.g. hyper/hypothyroidism), many hormones are not secreted in a constant fashion (e.g. pulsatile (growth hormone), diurnal (cortisol)), and are also age (IGF-1) and pubertal stage (Luteinizing hormone/follicle-stimulating hormone/testosterone/oestradiol) dependent. In these circumstances, stimulation (or suppression) testing including using hypothalamic/pituitary hormones may be required. Testing can either be performed to identify occult endocrine dysfunction in high-risk groups, or alternatively to confirm (or exclude) endocrine disorders in conjunction with careful clinical assessment. These tests are, however, often complex and difficult to perform, with both false-positive and false-negative results, so careful and appropriate timing and choice of tests is required to ensure optimal outcomes.

scholarly journals How Accurate are Concussed College Athlete’s Self-reported Balance Problems?

2019 ◽  
Vol 34 (5) ◽  
pp. 793-793
Author(s):  
A DaCosta ◽  
M Fasciana ◽  
A Crane ◽  
A LoGalbo
Keyword(s):  
Assessment Tool ◽  
Collegiate Athletes ◽  
Self Report ◽  
Balance Performance ◽  
Post Injury ◽  
Sports Concussion ◽  
Baseline Testing ◽  
Balance Problems ◽  
Balance Error

Abstract Purpose The Balance Error Scoring System (BESS) has been determined to be a reliable and valid measure of balance performance (Bell et al., 2011). Previous research indicates self-reported balance difficulties and postural stability are positively correlated (Broglio et al., 2009). Furthermore, athletes exhibit an increase in errors on the BESS following a concussion (McCrea et al., 2004). Methods 68 collegiate athletes (age 18-23; M=19.62, SD=1.44) received baseline, post-concussion, and follow-up evaluations. Balance performance was measured via the BESS on the Sports Concussion Assessment Tool-5th edition (SCAT5), while symptom reporting was measured by the SCAT5 and ImPACT neurocognitive testing. Results Multiple simple linear regressions were conducted, suggesting that changes in BESS performance from baseline to post-trauma significantly predicted self-report of “balance problems” at post-trauma on ImPACT (F(1, 66)=11.94, p=.001; R2=.15) and SCAT5 (F(1, 66)=5.73, p=.02; R2=.08). While baseline BESS errors were significantly correlated with post-trauma BESS errors (r=.29, p=.02), BESS errors at post-trauma did not significantly predict self-reporting of balance problems on either assessment. Conclusion Results suggest that self-reported balance difficulties following a concussion are an indicator of change in intraindividual balance performance, but not post-trauma balance performance alone. Furthermore, it provides clinical context as the individuals’ perception of change may be greater, impacting the likelihood of self-reporting of balance problems at post-trauma. These results support the clinical utility of examining pre- and post-injury changes in balance by including balance measurements in pre-participation baseline testing.

The Rey Dot Counting Test as a Tool for Detecting Suboptimal Performance in Athlete Baseline Testing

2020 ◽  
Author(s):  
Andrew DaCosta ◽  
Frank Webbe ◽  
Anthony LoGalbo
Keyword(s):  
Cognitive Testing ◽  
Performance Validity ◽  
Baseline Assessment ◽  
Baseline Testing ◽  
Validity Measures ◽  
Significant Disagreement ◽  
Two Measures ◽  
Validity Tests ◽  
Performance Validity Tests ◽  
Suboptimal Effort

Abstract Objective The limitations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)’s embedded validity measures (EVMs) are well-documented, as estimates suggest up to 35% of invalid baseline performances go undetected. Few studies have examined standalone performance validity tests (PVT) as a supplement to ImPACT’s EVMs. Method College athletes (n = 1,213) were administered a preseason baseline assessment that included ImPACT and the Rey Dot Counting Test (DCT), a standalone PVT, among other measures. Results Sixty-nine athletes (5.69%) met criteria for suboptimal effort on either ImPACT or the DCT. The DCT detected more cases of suboptimal effort (n = 50) than ImPACT (n = 21). A χ2 test of independence detected significant disagreement between the two measures, as only two individuals produced suboptimal effort on both (χ2(2) = 1.568, p = .210). Despite this disagreement, there were significant differences between the suboptimal effort DCT group and the adequate effort DCT group across all four ImPACT neurocognitive domains (U = 19,225.000, p &lt; .001; U = 17,859.000, p &lt; .001; U = 13,854.000, p &lt; .001; U = 17,850.500, p &lt; .001). Conclusions The DCT appears to detect suboptimal effort otherwise undetected by ImPACT’s EVMs.

scholarly journals A-225 The Rey Dot Counting Test as a Tool for Detecting Suboptimal Performance in Athlete Baseline Testing

2020 ◽  
Vol 35 (6) ◽  
pp. 1020-1020
Author(s):  
Dacosta A ◽  
Roccaforte A ◽  
Sohoni R ◽  
Crane A ◽  
Webbe F ◽  
...  
Keyword(s):  
Cognitive Testing ◽  
Performance Validity ◽  
Baseline Assessment ◽  
Baseline Testing ◽  
Validity Measures ◽  
Significant Disagreement ◽  
Two Measures ◽  
Validity Tests ◽  
Performance Validity Tests ◽  
Suboptimal Effort

Abstract Objective The limitations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)‘s embedded validity measures (EVMs) are well-documented, as estimates suggest up to 35% of invalid baseline performances go undetected (Gaudet & Weyandt, 2017). Few studies have examined standalone performance validity tests (PVT) as a supplement to ImPACT’s EVMs (Gaudet & Weyandt, 2017). Method College athletes (n = 1,213) were administered a preseason baseline assessment that included ImPACT and the Rey Dot Counting Test (DCT), a standalone PVT, among other measures. Results Sixty-nine athletes (5.69&#37;) met criteria for suboptimal effort on either ImPACT or the DCT. The DCT detected more cases of suboptimal effort (n = 50) than ImPACT (n = 21). A χ2 test of independence detected significant disagreement between the two measures, as only 2 individuals produced suboptimal effort on both (χ2(2) = 1.568, p = .210). Despite this disagreement, there were significant differences between the suboptimal effort DCT group and the adequate effort DCT group across all four ImPACT neurocognitive domains (U = 19225.000, p &lt; .001; U = 17859.000, p &lt; .001; U = 13854.000, p &lt; .001; U = 17850.500, p &lt; .001). Conclusions The DCT appears to detect suboptimal effort otherwise undetected by ImPACT’s EVMs.

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