scholarly journals Inter- and intra-core laboratory variability in the quantitative coronary angiography analysis for drug-eluting stent treatment and follow up

2020 ◽  
Vol 14 ◽  
pp. 175394472095898
Author(s):  
Shigenori Ito ◽  
Kanako Kinoshita ◽  
Akiko Endo ◽  
Ryoko Kami ◽  
Yuko Kotake ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Coefficient Of Variation ◽  
Quantitative Coronary Angiography ◽  
Laboratory Analysis ◽  
Altman Analysis ◽  
Limits Of Agreement ◽  
Bland Altman Analysis ◽  
Late Loss ◽  
Drug Eluting ◽  
Loss Index

Aim: To evaluate inter-core laboratory variability of quantitative coronary angiography (QCA) parameters in comparison with intra-core laboratory variability in a randomized controlled trial evaluating drug-eluting stents. Methods: A total of 50 patients with 62 coronary lesions were analyzed by four analysis experts belonging to an Angiographic Core Laboratory (ACL: 1 expert) and a Cardiovascular Imaging Core Laboratory (CICL: 3 experts). QCA was based on the same standard operating procedure, but selections of projection and cine frames were at the discretion of each analyst. Inter- and intra-core laboratory variabilities were evaluated by accuracy, precision, Bland Altman analysis, and coefficient of variation. Results: Pre-MLD (minimal lumen diameter) was significantly smaller in results from ACL than those from all CICL experts. Number of analyzed projections did not affect pre-MLD results. Acute gain was larger in ACL than in CICL2. No significant difference was observed in late loss and loss index between inter-core laboratories. Agreement between core labs in the Bland-Altman analysis for each QCA parameter was as follows (mean difference, 95% limits of agreement): pre-MLD (–0.32, –0.74 to 0.10), stent MLD (0.08, –0.28 to 0.44), acute gain (0.22, –0.44 to 0.88), and late loss (–0.07, –0.69 to 0.55). Agreement between analysts in CICL (mean difference, 95% limits of agreement) was: pre MLD (–0.03, –0.37 to 0.31), stent MLD (0.15, –0.15 to 0.45), acute gain (0.05, –0.45 to 0.55), and late loss (0.04, –0.52 to 0.60). The widest limits of agreement among three analyses were shown in both analyses. Width of limited agreement in the intra-core laboratory analysis tended to be smaller than the inter-core laboratory analysis with these parameters. Coefficient of variation tended to be larger in lesion length (LL), acute gain, late loss, and loss index in inter- and in intra- core laboratory comparisons. Conclusion: Inter-core laboratory QCA variability in late loss and loss index analysis could be similar to intra-core laboratory variability, but more strict alignment between core laboratories would be necessary for initial procedural data analysis.

scholarly journals Comparison of two methods for measurement of equine adrenocorticotropin

2017 ◽  
Vol 30 (2) ◽  
pp. 233-237 ◽  
Author(s):  
Heidi E. Banse ◽  
Nichol Schultz ◽  
Molly McCue ◽  
Ray Geor ◽  
Dianne McFarlane
Keyword(s):  
Pars Intermedia ◽  
Plasma Samples ◽  
Altman Analysis ◽  
Poor Agreement ◽  
Limits Of Agreement ◽  
Cutoff Value ◽  
Bland Altman Analysis ◽  
Acth Concentration

Accurate measurement of equine adrenocorticotropin (ACTH) is important for the diagnosis of equine pituitary pars intermedia dysfunction (PPID). Several radioimmunoassays (RIAs) and chemiluminescent immunoassays (CIAs) are used for measurement of ACTH concentration in horses; whether these methods yield similar results across a range of concentrations is not determined. We evaluated agreement between a commercial RIA and CIA. Archived plasma samples ( n = 633) were measured with both assays. Correlation between the 2 methods was moderate ( r = 0.49, p < 0.001). Bland–Altman analysis revealed poor agreement, with a proportional bias and widening limits of agreement with increasing values. Poor agreement between assays was also observed when evaluating plasma samples with concentrations at or below the recommended diagnostic cutoff value for PPID testing. The lack of agreement suggests that measurements obtained should not be considered interchangeable between methods.

scholarly journals COMPARISON BETWEEN RECTAL AND BODY SURFACE TEMPERATURES OBTAINED BY DIGITAL AND NON-CONTACT INFRARED THERMOMETER IN SOME LARGE ANIMAL SPECIES

2019 ◽  
Vol 7 (8) ◽  
pp. 62-68
Author(s):  
Mera Usman Muhammed ◽  
Mayaki Abubakar Musa ◽  
Gambo Abdulrahman Abdullahi
Keyword(s):  
Animal Species ◽  
Large Animal ◽  
Altman Analysis ◽  
Limits Of Agreement ◽  
Infrared Thermometer ◽  
Bland Altman Analysis ◽  
The Face ◽  
Body Temperature Measurement ◽  
The Mean ◽  
The Moment

This study was carried out to compare the digital rectal (DR) thermometer with non-contact infrared thermometer (IRT) measurements at two locations on the face in some large animal species. Two hundred and forty (240) animals comprising of equal numbers of three species (cattle, camel and horses) of varying age and either sex was used. The IR temperature was taken from two sites [frontal (FIRT) and temporal (TIRT) region] on the animal face. The mean IR temperatures (FIRT and TIRT) were higher than the RT in all the animal species. The two thermometers correlate poorly in all the animal species. Bland-Altman analysis showed high biases and limits of agreement not acceptable for clinical purposes. In conclusion, IRT seems to offer a quick and easy way to determine the animal temperature but clinically it cannot be used interchangeably with DR thermometer at the moment for body temperature measurement in these animal species.

scholarly journals Better Performance of Flow-FISH in Comparison to qPCR As a Diagnostic Test for Telomere Diseases

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1605-1605
Author(s):  
Fernanda Gutierrez-Rodrigues ◽  
Bárbara A Santana-Lemos ◽  
Priscila Santos Scheucher ◽  
Raquel M Alves-Paiva ◽  
Rodrigo T. Calado
Keyword(s):  
Telomere Length ◽  
Diagnostic Test ◽  
Quantitative Pcr ◽  
Measurement Techniques ◽  
Healthy Individuals ◽  
Altman Analysis ◽  
Poor Agreement ◽  
Limits Of Agreement ◽  
Gold Standard Method ◽  
Bland Altman Analysis

Abstract Excessive telomere erosion is the molecular etiology of a group of disorders (dyskeratosis congenita, aplastic anemia, idiopathic pulmonary fibrosis) collectively called telomeropathies. Telomere length measurement is an essential diagnostic test for these diseases. The most commonly used methods are terminal restriction fragment (TRF) analysis by Southern blotting (the gold-standard method), flow cytometry combined with fluorescence in situ hybridization (flow-FISH), and quantitative PCR (qPCR). Although the clinical use of these methods has been reported, their utility and characteristics have not been widely compared. Measurement techniques and coefficients of variations often differ among diagnostic services. Here, we directly compared the accuracy, reproducibility, sensitivity, and specificity of flow-FISH and qPCR in comparison to TRF to measure peripheral blood leukocyte’s telomere length in healthy individuals and patients with telomeropathies. TRF analyses and flow-FISH showed good correlation in the analysis of samples from healthy subjects (R2=0.60; p<0.0001) and patients (R2=0.51; p<0.0001). Bland-Altman analyses also displayed a very good agreement between these methods for both healthy individuals (bias±SD = 0.17±1.03; limits of agreement ranging from 2.24 to -1.88) and patients (bias±SD = 0.0±1.21; limits of agreement ranging from 2.41 to -2.41). In contrast, the comparison between TRF and qPCR yielded modest correlation for the analysis of samples of healthy individuals (R2=0.35; p<0.0001) and low correlation for patients (R2=0.20; p=0.001). Bland-Altman analysis indicated poor agreement between the two methods for both patients and controls. The differences averages were very different from zero and standard deviation was wide. For patients, the bias±SD was 0.78±1.34 with limits of agreement ranging from 3.47 to -1.90, and for controls, the bias±SD was 1.15±1.49 with limits of agreement ranging from 4.14 to -1.84. Finally, qPCR and flow-FISH also modestly correlated in the analysis of healthy individual samples (R2=0.33; p<0.0001) and did not correlate in the comparison of patients’ samples (R2=0.1, p=0.08). Bland-Altman analysis corroborate this finding. For controls, the bias±SD were very similar to the one found by comparison between qPCR and TRF analysis (-0.6±1.27; limits of agreement ranging from 1.94 to -3.16). For patients, bias ± SD were -1.15 ± 1.65 with limits of agreement ranging from 2.15 to -4.45, which evidenced a poor agreement between flow-FISH and qPCR in these samples. Intra-assay coefficient of variation (CV) was 10.8±7.1% for flow-FISH and 9.5±7.4% for qPCR (p=0.35). The inter-assay CV was lower for flow-FISH (9.6±7.6%) in comparison to qPCR (16±19.5%; p=0.02). Flow-FISH and qPCR were sensitive (both 100%) and specific (93% and 89%, respectively) to distinguish very short telomeres. However, qPCR sensitivity (40%) and specificity (63%) to detect telomere length below tenth percentile were lower in comparison to flow-FISH (80% sensitivity and 85% specificity). Taken together, these findings indicate that, in the clinical setting, flow-FISH is more accurate and reproducible in the measurement of human leukocyte’s telomere length in comparison to qPCR. Quantitative PCR exhibited low accuracy in the analysis of samples of patients with short telomeres. In conclusion, flow-FISH appears to be a more appropriate method for diagnostic purposes. Studies that compare methodologies are helpful in the selection of standard methods and to narrow the differences among laboratories. Disclosures No relevant conflicts of interest to declare.

scholarly journals Comparison of Intravascular Imaging and Quantitative Coronary Angiography to Evaluate Neointimal Proliferation after Complex Lesion Stenting

2009 ◽  
Vol 63 (4-5) ◽  
pp. 168-173
Author(s):  
Sanda Jēgere ◽  
Inga Narbute ◽  
Indulis Kumsārs ◽  
Iveta Mintāle ◽  
Iļja Zakke ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Quantitative Coronary Angiography ◽  
Drug Eluting Stent ◽  
Intravascular Imaging ◽  
Chronic Total Occlusions ◽  
Neointimal Proliferation ◽  
Drug Eluting ◽  
Ivus Image ◽  
Uncovered Stent

Comparison of Intravascular Imaging and Quantitative Coronary Angiography to Evaluate Neointimal Proliferation after Complex Lesion Stenting Unlike quantitative coronary angiography (QCA), intravascular imaging methods allow direct visualisation of the arterial wall. Our goal was to determine several intravascular ultrasound (IVUS) and optical coherence tomography (OCT) parameters of neointimal proliferation and stent endothelisation after complex lesion intervention compared to QCA. We examined 261 patients who had underwent percutaneous intervention with bare metal (BMS) or drug eluting stent (DES) implantation for complex coronary lesions and had IVUS or OCT images at six-month follow-up. Percent diameter stenosis (QCA) was 25.2 ± 16.0 in BMS vs 21.7 ± 17.4 in DES (P < 0.05). Percent neointimal volume obstruction (IVUS) was 19.5 ± 14.4 in BMS vs. 5.8 ± 7.7 in DES (P < 0.001). A moderate correlation was observed between QCA and IVUS with an r value of 0.384 overall, 0.472 for BMS and 0.416 for DES (P < 0.001 for all). In patients with chronic total occlusions (n = 161) QCA was similar in BMS and DES patients (P > 0.05) while IVUS showed less neointima in DES (P < 0.05). Total number of uncovered stent struts per OCT image was 0.4 ± 0.8 while per IVUS image 1.2 ± 1.5 (P < 0.001). In conclusion, angiographic indexes correlate with volumetric intravascular parameters. Although IVUS was more sensitive than QCA to assess neointimal proliferation, the assessment of stent endothelisation was more precise using OCT.

scholarly journals Inter-Operator Reliability of an Onsite Machine Learning-Based Prototype to Estimate Ct Angiography-Derived Fractional Flow Reserve

2021 ◽  
Author(s):  
Yushui Han ◽  
Ahmed Ibrahim Ahmed ◽  
Chris Schwemmer ◽  
Myra Cocker ◽  
Talal S Alnabelsi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Sensitivity Analysis ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Altman Analysis ◽  
Fractional Flow ◽  
Limits Of Agreement ◽  
Bland Altman Analysis ◽  
Coronary Ct ◽  
Flow Reserve

Abstract Background: Advances in computed tomography (CT) and machine learning have enabled on-site non-invasive assessment of fractional flow reserve (FFRCT). Purpose: To assess the inter-operator variability of Coronary CT Angiography–derived FFRCT using a machine learning based post-processing prototype.Materials and Methods: We included 60 symptomatic patients who underwent coronary CT angiography. FFRCT was calculated by 2 independent operators after training using a machine learning based on-site prototype. FFRCT was measured 1 cm distal to the coronary plaque or in the middle of the segments if no coronary lesions were present. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to evaluate inter-operator variability effect in FFRCT estimates. Sensitivity analysis was done by cardiac risk factors, degree of stenosis and image quality. Results: A total of 535 coronary segments in 60 patients were assessed. The overall ICC was 0.986 per patient (95% CI: 0.977 - 0.992) and 0.972 per segment (95% CI: 0.967 - 0.977). The absolute mean difference in FFRCT estimates was 0.012 per patient (95% CI for limits of agreement: -0.035 - 0.039) and 0.02 per segment (95% CI for limits of agreement: -0.077 - 0.080). Tight limits of agreement were seen on Bland-Altman analysis. Distal segments had greater variability compared to proximal/mid segments (absolute mean difference 0.011 vs 0.025, p<0.001). Results were similar on sensitivity analysis. Conclusion: A high degree of inter-operator reproducibility can be achieved by onsite machine learning based FFRCT assessment. Future research is required to evaluate the physiological relevance and prognostic value of FFRCT.

scholarly journals ‘My Meal Mate’ (MMM): validation of the diet measures captured on a smartphone application to facilitate weight loss

2012 ◽  
Vol 109 (3) ◽  
pp. 539-546 ◽  
Author(s):  
Michelle C. Carter ◽  
V. J. Burley ◽  
C. Nykjaer ◽  
J. E. Cade
Keyword(s):  
Weight Loss ◽  
Assessment Tool ◽  
Dietary Assessment ◽  
Smartphone Application ◽  
Assessment Process ◽  
Nutritional Epidemiology ◽  
Altman Analysis ◽  
Limits Of Agreement ◽  
Bland Altman Analysis ◽  
Individual Level

Accurate dietary assessment is an essential foundation of research in nutritional epidemiology. Due to the weaknesses in current methodology, attention is turning to strategies that automate the dietary assessment process to improve accuracy and reduce the costs and burden to participants and researchers. ‘My Meal Mate’ (MMM) is a smartphone application designed to support weight loss. The present study aimed to validate the diet measures recorded on MMM against a reference measure of 24 h dietary recalls. A sample of fifty volunteers recorded their food and drink intake on MMM for 7 d. During this period, they were contacted twice at random to conduct 24 h telephone recalls. Daily totals for energy (kJ) and macronutrients recorded on MMM were compared against the corresponding day of recall using t tests for group means and Pearson's correlations. Bland–Altman analysis was used to assess the agreement between the methods. Energy (kJ) recorded on MMM correlated well with the recalls (day 1: r 0·77 (95 % CI 0·62, 0·86), day 2: r 0·85 (95 % CI 0·74, 0·91)) and had a small mean difference (day 1 (MMM −  recall): − 68 kJ/d (95 % CI − 553, 418 kJ) ( − 16 kcal/d, 95 % CI − 127, 100 kcal); day 2 (MMM −  recall): − 441 kJ/d (95 % CI − 854, − 29 kJ) ( − 105 kcal/d, 95 % CI − 204, − 7 kcal)). Bland–Altman analysis showed wide limits of agreement between the methods: − 3378 to 3243 kJ/d ( − 807 to 775 kcal/d) on day 1. At the individual level, the limits of agreement between MMM and the 24 h recall were wide; however, at the group level, MMM appears to have potential as a dietary assessment tool.

VALIDITY OF THE RETROSPECTIVE APPLICATION OF OXFORD HIP AND KNEE SCORES

2015 ◽  
Vol 18 (01) ◽  
pp. 1550003
Author(s):  
Travis M. Falconer ◽  
Julie Headford ◽  
Stephen Edmondston ◽  
Piers J. Yates
Keyword(s):  
Positive Relationship ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Altman Analysis ◽  
Limits Of Agreement ◽  
Bland Altman Analysis ◽  
Oxford Hip Score ◽  
The Mean ◽  
Mean Time

The Oxford Hip Score (OHS) and Oxford Knee Score (OKS) are validated, reliable and reproducible outcome measures, however their use retrospectively has not been examined. The aim of this prospective cohort study was to examine the accuracy and reliability of patients' ability to recall their OHS and OKS in a retrospective manner. A total of 137 patients undergoing primary hip (40) or primary knee (97) arthroplasty with a mean age of 70.8 years (range, 47–88) and a mean time to follow up of 27.2 months (range, 6–46) were included in the study. The mean retrospective OHS and OKS decreased compared to the pre-operative score (OHS = 1.6 ± SD, p = 0.36, OKS = 4.7 ± SD, p < 0.001). There was only a weak positive relationship between the actual pre-operative scores and the retrospective scores (OHS: r2 = 0.30, OKS: r2 = 0.19). Bland–Altman analysis demonstrated 95% limits of agreement between scores of -19.9 to 23.1 for the OHS and -15.3 to 24.8 for the OKS. This study shows that patients are poor at retrospectively recalling their pre-operative OHS and OKS and therefore these scores should not be used in a retrospective manner.

P2688A novel risk factor of stent restenosis after drug-eluting stent implantation; Involvement of triglyceride deposit cardiomyovasculopathy, coronary atherosclerosis with triglyceride deposition

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Nakano ◽  
M Suzuki ◽  
K Waseda ◽  
T Niwa ◽  
H Ando ◽  
...  
Keyword(s):  
Risk Factor ◽  
Coronary Angiography ◽  
Drug Eluting Stent ◽  
Control Group ◽  
Multivariable Logistic Regression Analysis ◽  
Luminal Diameter ◽  
2Nd Generation ◽  
Increased Risk ◽  
Late Loss ◽  
Drug Eluting

Abstract Background Triglyceride deposit cardiomyovasculopathy (TGCV) is a novel disease concept characterized by the excessive accumulation of triglyceride in cardiomyocytes and vascular smooth muscle cells, leading to coronary artery disease (CAD), heart failure, and arrhythmia. However, it is rarely known whether TGCV contributes to the increased risk of vascular failure after drug eluting stent (DES) implantation. Purpose The aim of this study was to evaluate vascular failure after 2nd generation DES implantation in patients with TGCV. Methods Among 637 consecutive patients suspected of having CAD who underwent both coronary angiography and iodine-123-β-methyliodophenyl-pentadecanoic acid (BMIPP) scintigraphy between 2010 and 2018, we analyzed the data from 92 patients who met the inclusion criteria (shown in Table and Figure). Ninety-two patients were allocated to the presence (TGCV group, 11 patients) or absence (control group, 81 patients) of TGCV. All of 92 patients were implanted 2nd generation DES and underwent planned follow up coronary angiography. Control patients were diagnosed of diabetes mellitus. Binary restenosis (ISR), defined as angiographic luminal diameter ≥50% by quantitative coronary angiography, target lesion revascularization (TLR), In-stent late loss and restenosis morphology were assessed in 23 stents of TGCV group and 120 stents of control group. Results There were no significant differences in baseline characteristics between the two groups except for the prevalence of hypertension. In-stent late loss was greater in TGCV than in control (0.45 (−0.04 to 3.33) vs. 0.15 (−0.18 to 2.75), p=0.ehz748.10067), resulting in greater incidence of ISR and TLR in TGCV than in control (34.8% vs. 10.0%, p=0.0017; 21.7% vs. 6.7%, p=0.021, respectively). On multivariable logistic regression analysis, TGCV was found to be a significant and independent predictor for ISR after 2nd generation DES implantation. Regarding restenosis morphology, diffuse and occlusive pattern of ISR, were more frequently observed in TGCV than control (87.5% and 33.3%, Fisher's exact test p=0.028). Table 1.The 4th edition diagnostic criteria for TGCV Items Clinical findings 2 points I) BMIPP scintigraphy Wash-Out Rare <10% II) Diffuse narrowng coronary arteries 1 point III) Jordans anomaly in peripheral blood smear IV) Diabetes Decision 4 points or more → Definite TGCV Figure 1 Conclusion Patients with TGCV showed the greater incidence of vascular failure even after 2nd generation DES implantation, contributing to the novel risk factor for coronary intervention even in the 2nd DES era.

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