ADHD and the QbTest: Diagnostic Validity of QbTest

2015 ◽  
Vol 22 (11) ◽  
pp. 1074-1080 ◽  
Author(s):  
Nicklas Hult ◽  
Josefin Kadesjö ◽  
Björn Kadesjö ◽  
Christopher Gillberg ◽  
Eva Billstedt

Objective: We assess the diagnostic accuracy of the QbTest, which measures the cardinal symptoms of ADHD. Method: The study group comprised 182 children (mean age about 10 years), of whom 124 had ADHD and 58 had other clinical diagnosis of which 81% had ASD. Results: Only QbTest parameters for inattention and hyperactivity differentiated between ADHD and other clinical diagnoses at the p ≤ .01 level, not for measures of impulsivity. Sensitivity ranged from 47% to 67% and specificity from 72% to 84%. Positive predictive value ranged from 41% to 86%, and negative predictive value from 43% to 86%. Area under the curve varied from .70 to .80. Conclusion: The ability of the individual QbTest parameters to identify ADHD was moderate. The test’s ability to discriminate between ADHD subtypes was unsatisfactory.

2010 ◽  
Vol 4 ◽  
pp. CMC.S3864 ◽  
Author(s):  
M. Wehrschuetz ◽  
E. Wehrschuetz ◽  
H. Schuchlenz ◽  
G. Schaffler

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Moshage ◽  
S Smolka ◽  
S Achenbach ◽  
F Ammon ◽  
P Ferstl ◽  
...  

Abstract Background The accuracy of CT-derived FFR (FFRCT) has been repeatedly reported. However, the influence of lesion location on accuracy is unknown. Therefore, we evaluated the diagnostic accuracy of FFRCT to detect lesion-specific ischemia and determined the influence of lesion location (proximal vs. distal vessel segments) compared to invasively measured FFR in patients with suspected CAD. Methods A total of 136 vessels in which “Dual-Source”-CT coronary angiography had been performed due to suspected CAD and who were further referred for invasive coronary angiography with invasive FFR measurement within three months of the index CT examination were retrospectively identified and screened for inclusion in this analysis. Patients with either left main coronary artery stenoses, bifurcation or ostial stenoses were excluded. Invasive FFR was measured using a pressure wire (CERTUS®, St. Jude Medical, Minnesota, USA or Verrata®, Volcano, San Diego, USA). FFRCT was calculated using an on-site prototype (cFFR Version 3.0, Siemens Healthineers, Forchheim, Germany). All vessels were analyzed by an experienced observer blinded to the results of invasive FFR. Stenoses with invasively measured FFR ≤0.80 were classified as hemodynamically significant. We evaluated the diagnostic accuracy of FFRCT in proximal vs. non-proximal vessel segments. Proximal lesions included stenoses located in segment one, six, eleven and twelve. All other stenoses were categorized as distal lesions. Results Out of 136 coronary stenoses, 47 (35%) were located in proximal segments and 89 (65%) lesions were located in distal segments. Compared to invasive FFR, the sensitivity of FFRCT to correctly identify/exclude hemodynamically significant stenoses in proximal vessel segments was 93% (95% CI: 68–99.8%) and the specificity was 100% (95% CI: 89–100%), compared to a sensitivity of 72% (95% CI: 46.5–90%) and a specificity of 87% (95% CI: 77–94%) for FFRCT in distal lesions. The positive predictive value was 100% and the negative predictive value was 97% (95% CI: 82.8–99.5%) compared to a positive predictive value of 59% (95% CI: 42–93.9%) and a negative predictive value of 93% (95% CI: 85.4–96.3%) for proximal vs. distal vessel segment, respectively. This corresponds to an accuracy of 98% vs. 84%, respectively (p=0.02). ROC-Curve analysis showed a slightly higher – albeit non-significant – area under the curve for FFRCT to detect hemodynamic relevance in proximal lesions compared to distal lesions (AUC 0.95, p<0.001 vs. AUC: 0.86, p<0.001, respectively, p=0.2). Conclusion FFRCT obtained using an on-site prototype shows overall a high diagnostic accuracy for detecting lesions causing ischemia as compared to invasive FFR with a trend towards better diagnostic performance in proximal vessel segments. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.


2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoon Juneyoung ◽  
Xiongjie Jin ◽  
Kyong-Woo Seo ◽  
Jin-sun Park ◽  
Hyoung-Mo Yang ◽  
...  

Introduction: The pressure gradient of the circulation fluid in a stenosis area depends on minimal luminal area (MLA) of the stenosis, lesion length (LL), and the fluid velocity. However, the correlation of the LL and the MLA; the cutoff values are uncertain. Hypothesis: LL and MLA differently influences the FFR. Methods: We studied 117 patients with intermediate coronary artery disease who underwent FFR and IVUS measurement out of 302 patients in FAVOR study. This study was a prospective, 1:1 randomized, open label multicenter trial to demonstrate the clinical outcomes between FFR and IVUS-guided PCI. Inclusion criteria were as follows: 1)Angina or documented silent ischemia 2) De novo intermediate coronary artery disease (30-70% diameter stenosis) by visual estimation, 3) Reference vessel diameter ≥ 3.0mm by visual estimation. We excluded left main disease, MI, EF< 40%, and graft vessel. There were no significant differences in baseline clinical characteristics. The mean values are the QCA (54.3±14.0 %), MLA (3.6±1.4 mm2) and LL (20.6±1.4mm), respectively. We were performed the path analysis using AMOS 18, and estimated the ROC curve in SPSS 18. Results: Standardized estimates were the LL -0.47,QCA -0.28 and MLA -0.21 (R2=0.594, p<0.000) in path analysis. The model is recursive and statistically significant. The FFR was ≤0.80 in 47 lesions (31%). The optimal LL for an FFR of ≤0.80 was 15.8mm (90% sensitivity, 50% specificity, 44% positive predictive value, 87% negative predictive value, area under the curve: 0.75, 95% CI: 0.66 to 0.85; p < 0.001) and MLA 3.9mm (sensitivity 86%, specificity 59%, 35% positive predictive value , 94% negative predictive value, area under the curve: 0.78, 95% CI: 0.67 to 0.85; p < 0.001) Conclusions: The lesion length influenced more the FFR than MLA. The lesion length ≥ 15.8mm and MLA ≤ 3.9mm are risk zones, which need to be confirm the functional status with FFR because of the low positive predictive value


2021 ◽  
Author(s):  
Hideyuki Iwayama ◽  
Sachiko Kitagawa ◽  
Jyun Sada ◽  
Ryosuke Miyamoto ◽  
Tomohito Hayakawa ◽  
...  

Abstract Purpose We evaluated the diagnostic accuracy of insulin-like growth factor-1 (IGF-1) for screening growth hormone deficiency (GHD) to determine the usefulness of IGF-1 as a screening test. Methods On 298 consecutive children who had short stature or decreased height velocity, we measured IGF-1 levels and performed growth hormone (GH) secretion test using clonidine, arginine, and, in cases with different results of the two tests, L-dopa. Patients with congenital abnormalities were excluded. GHD was defined as peak GH ≤ 6.0 ng/mL in the two tests. Results We identified 60 and 238 patients with and without GHD, respectively. The mean IGF-1 (SD) was not significantly different between the GHD and non-GHD groups (p = 0.23). Receiver operating characteristic curve analysis demonstrated the best diagnostic accuracy at an IGF-1 cutoff of −1.493 SD, with sensitivity of 0.685, specificity of 0.417, positive predictive value of 0.25, negative predictive value of 0.823, and area under the curve of 0.517. Spearman’s rank correlation coefficient showed that IGF-1 (SD) was weakly correlated with age, bone age, height velocity before examination, weight (SD), and BMI (SD) and very weakly correlated with height (SD), target height (SD), and maximum GH peak. Conclusion IGF-1 level had poor diagnostic accuracy as a screening test for GHD. Correlation analysis revealed that none of the items increased the diagnostic power of IGF-1. Therefore, IGF-1 should not be used alone in the screening of GHD. A predictive biomarker for GHD should be developed in the future.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e37-e37
Author(s):  
Vinusha Gunaseelan ◽  
Patricia Parkin ◽  
Imaan Bayoumi ◽  
Patricia Jiang ◽  
Alexandra Medline ◽  
...  

Abstract BACKGROUND The Canadian Paediatric Society (CPS) recommends that every Canadian physician caring for young children provide an enhanced 18-month well-baby visit including the use of a developmental screening tool, such as the Nipissing District Developmental Screen (NDDS). The Province of Ontario implemented an enhanced 18-month well-baby visit specifically emphasizing the NDDS, which is now widely used in Ontario primary care. However, the diagnostic accuracy of the NDDS in identifying early developmental delays in real-world clinical settings is unknown. OBJECTIVES To assess the predictive validity of the NDDS in primary care for identifying developmental delay and prompting a specialist referral at the 18-month health supervision visit. DESIGN/METHODS This was a prospective longitudinal cohort study enrolling healthy children from primary care practices. Parents completed the 18-month NDDS during their child’s scheduled health supervision visit between January 2012 and February 2015. Using a standardized data collection form, research personnel abstracted data from the child’s health records regarding the child’s developmental outcomes following the 18-month assessment. Data collected included confirmed diagnoses of a development delay, specialist referrals, family history, and interventions. Research personnel were blind to the results of the NDDS. We assessed the diagnostic test properties of the NDDS with a confirmed diagnosis of developmental delay as the criterion measure. The specificity, sensitivity, positive predictive value, and negative predictive value were calculated, with 95% confidence intervals. RESULTS We included 255 children with a mean age of 18.5 months (range, 17.5–20.6) and 139 (55%) were male. 102 (40%) screened positive (1+ flag result on their NDDS). A total of 48 (19%) children were referred, and 23 (9%) had a confirmed diagnosis of a developmental delay (speech and language: 14; gross motor: 4; autism spectrum disorder: 3; global developmental delay: 1; developmental delay: 1). The sensitivity was 74% (95% CI: 52–90%), specificity was 63% (95% CI: 57–70%), positive predictive value was 17% (95% CI:10–25%), and the negative predictive value was 96% (95% CI: 92–99%). CONCLUSION For developmental screening tools, sensitivity between 70%-80% and specificity of 80% have been suggested. The NDDS has moderate sensitivity and specificity in identifying developmental delay at the 18-month health supervision visit. The 1+NDDS flag cut-point may lead to overdiagnosis with more children with typical development being referred, leading to longer wait times for specialist referrals among children in need. Future work includes investigating the diagnostic accuracy of combining the NDDS with other screening tools.


2018 ◽  
Vol 11 (3) ◽  
pp. 843-849 ◽  
Author(s):  
I. Wayan Sudarsa ◽  
Elvis Deddy Kurniawan Pualillin ◽  
Putu Anda Tusta Adiputra ◽  
Ida Bagus Tjakra Wibawa Manuaba

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.


2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Pokpong Piriyakhuntorn ◽  
Adisak Tantiworawit ◽  
Thanawat Rattanathammethee ◽  
Chatree Chai-Adisaksopha ◽  
Ekarat Rattarittamrong ◽  
...  

This study aims to find the cut-off value and diagnostic accuracy of the use of RDW as initial investigation in enabling the differentiation between IDA and NTDT patients. Patients with microcytic anemia were enrolled in the training set and used to plot a receiving operating characteristics (ROC) curve to obtain the cut-off value of RDW. A second set of patients were included in the validation set and used to analyze the diagnostic accuracy. We recruited 94 IDA and 64 NTDT patients into the training set. The area under the curve of the ROC in the training set was 0.803. The best cut-off value of RDW in the diagnosis of NTDT was 21.0% with a sensitivity and specificity of 81.3% and 55.3% respectively. In the validation set, there were 34 IDA and 58 NTDT patients using the cut-off value of >21.0% to validate. The sensitivity, specificity, positive predictive value and negative predictive value were 84.5%, 70.6%, 83.1% and 72.7% respectively. We can therefore conclude that RDW >21.0% is useful in differentiating between IDA and NTDT patients with high diagnostic accuracy


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