The Effect of Combining Radiographs and DIAGNOdent With Visual Examination on Detection and Treatment Decisions of Noncavitated Occluso-dentinal Caries

2015 ◽  
Vol 40 (3) ◽  
pp. 313-321 ◽  
Author(s):  
QD Alomari ◽  
M Qudiemat ◽  
ME Khalaf ◽  
Y Al-Tarakemah
Keyword(s):  
Area Under The Curve ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Treatment Decisions ◽  
Radiographic Examination ◽  
Lower Sensitivity ◽  
Visual Examination ◽  
Posterior Teeth ◽  
Restorative Treatment ◽  
Occlusal Surfaces

SUMMARY The aim of this laboratory study was to evaluate the effectiveness of incorporating radiographic examination and DIAGNOdent with visual examination for the detection and treatment of noncavitated occluso-dentinal caries. Four examiners examined the occlusal surfaces of 160 extracted posterior teeth. Teeth were examined three times with a one-month interval in between. The first examination was visual (V), the second examination was visual with radiograph (VR), and the third examination was visual with radiograph and DIAGNOdent (VRD). Examiners were asked to detect the presence of caries (if any) and identify the extent of caries (if present; ie, enamel or dentin). The examiners were also asked to choose a treatment for each tooth. The examined teeth were later sectioned, and the presence of caries was charted as 0 = no caries, 1 = caries confined to enamel, 2 = caries in the outer dentin, and 3 = caries in the inner dentin. Sensitivity, specificity, area under the curve (Az values), rank correlation coefficient, interexaminer reproducibility, and McNemar χ2 tests were calculated. VR had statistically higher specificity and lower sensitivity than V and VRD. The means of Az values ranged from 0.58 to 0.63, with no statistical difference between the three examinations (p>0.05). The means of the rank correlation coefficients with histology for detection of dentinal caries were 0.48, 0.23, and 0.44 using V, VR, and VRD, respectively. Interexaminer reproducibility was best for V alone. The percentages of teeth indicated for restorative treatment were 31%, 33%, and 41% using V, VR, and VRD, respectively. The percentages of teeth correctly treated according to histology were 69.4%, 70.0%, and 67.5% using V, VR, and VRD, respectively. There was no difference in the accuracy of treatment decisions between the three examination points (p>0.05). The addition of radiographs and DIAGNOdent to visual examination did not have a significant effect on the improvement of the detection or treatment decisions of examiners of noncavitated occluso-dentinal carious lesions.

scholarly journals Impact of Different Illumination Conditions on Visual Caries Detection with ICDAS

2015 ◽  
Vol 49 (6) ◽  
pp. 633-636 ◽  
Author(s):  
Klaus W. Neuhaus ◽  
Edi Jasarevic ◽  
Adrian Lussi
Keyword(s):  
Gold Standard ◽  
Area Under The Curve ◽  
Assessment System ◽  
Caries Detection ◽  
Lower Sensitivity ◽  
Pooled Data ◽  
Standard Operation ◽  
Occlusal Surfaces ◽  
Additional Illumination ◽  
Permanent Molars

The aim of this study was to test the influence of different degrees of additional illumination on visual caries detection using the International Caries Detection and Assessment System (ICDAS). Two calibrated examiners assessed 139 occlusal surfaces of extracted permanent molars using a standard operation lamp with or without an additional headlamp providing three default brightness intensities. Histology served as the gold standard. Pooled data showed no differences in sensitivities. Specificities were not influenced by additional light. The area under the curve for the Marthaler classification D3 threshold was significantly lower when an additional strong headlamp was used (0.59 compared to 0.69-0.72 when reduced illumination intensities were used). One of the two examiners also had a significantly lower sensitivity for the D1 threshold when an additional headlamp was used. The use of additional white light led to a reduced detection of dentine lesions.

The Use of a Microscope for Restorative Treatment Decision-making on Occlusal Surfaces

10.2341/08-45 ◽  
2009 ◽  
Vol 34 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Z. Z. Akarslan ◽  
H. Erten
Keyword(s):  
Decision Making ◽  
Clinical Relevance ◽  
Treatment Decision ◽  
Operating Microscope ◽  
Posterior Teeth ◽  
Restorative Treatment ◽  
Treatment Decision Making ◽  
Occlusal Surfaces

Clinical Relevance The use of an operating microscope at 16× magnification did not aid in the restorative treatment decision-making on posterior teeth.

Can the Oxford Knee and Hip Score identify patients who do not require total knee or hip arthroplasty?

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 23-30 ◽  
Author(s):  
M. E. Neufeld ◽  
B. A. Masri
Keyword(s):  
Hip Arthroplasty ◽  
Oxford Knee Score ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Primary Total Knee Arthroplasty ◽  
Correlation Coefficients ◽  
Roc Curve Analysis ◽  
Spearman’S Rank Correlation ◽  
Good Ability ◽  
Total Knee

AimsThe aim of this study was to determine if the Oxford Knee and Hip Score (OKHS) can accurately predict when a primary knee or hip referral is deemed nonsurgical versus surgical by the surgeon during their first consultation, and to identify nonsurgical OKHS screening thresholds.Patients and MethodsWe retrospectively reviewed pre-consultation OKHS for all consecutive primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) consultations of a single surgeon over three years. The 1436 knees (1016 patients) and 478 hips (388 patients) included were categorized based on the surgeon’s decision into those offered surgery during the first consultation versus those not (nonsurgical). Spearman’s rank correlation coefficients and receiver operating characteristic (ROC) curve analysis were performed.ResultsOxford Scores were better for the nonsurgical cohorts (p < 0.001) and correlated with the surgical decision (p < 0.001). ROC area under the curve values for knees (0.83, 95% confidence intervals (CI) 0.81 to 0.85) and hips (0.87, 95% CI 0.84 to 0.91) were excellent. A conservative and effective threshold for knees is Oxford Knee Score (OKS) > 32 points (sensitivity = 0.997, negative predictive value (NPV) = 0.992) and for hips is Oxford Hip Score (OHS) > 34 points (sensitivity = 0.997, NPV = 0.978). Severable potential lower OKHS thresholds were identified.ConclusionPre-consultation OKHS demonstrate good ability to predict when a primary TKA or THA referral will be deemed nonsurgical in a single surgeon’s practice. Multiple OKHS thresholds can effectively screen out nonsurgical referrals. Cite this article: Bone Joint J 2019;101-B(6 Supple B):23–30.

Restorative Treatment Decision Making with Unaided Visual Examination, Intraoral Camera and Operating Microscope

2006 ◽  
Vol 31 (1) ◽  
pp. 55-59 ◽  
Author(s):  
H. Erten ◽  
M. B. Üçtasli ◽  
Z. Z. Akarslan ◽  
Ö Uzun ◽  
M. Semiz
Keyword(s):  
Decision Making ◽  
Clinical Relevance ◽  
Treatment Decision ◽  
Operating Microscope ◽  
Visual Examination ◽  
Restorative Treatment ◽  
Treatment Decision Making ◽  
Occlusal Surfaces

Clinical Relevance The use of an intraoral camera aided in the treatment of occlusal surfaces of molars.

In Vitro Evaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions

2011 ◽  
Vol 36 (2) ◽  
pp. 133-142 ◽  
Author(s):  
MB Diniz ◽  
LM Lima ◽  
G Eckert ◽  
AG Ferreira Zandona ◽  
RCL Cordeiro ◽  
...  
Keyword(s):  
Preventive Intervention ◽  
Early Stage ◽  
Treatment Decisions ◽  
Assessment System ◽  
Caries Detection ◽  
Radiographic Examination ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Impact On Treatment

Clinical RelevanceIt has been suggested that occlusal caries detection has become more difficult due to the widespread use of fluoride, which slows down lesion progression and delays cavitation. The ability to detect caries lesions at an early stage has a significant impact on treatment decisions, improving the possibility for a successful preventive intervention. In this investigation, the authors found that the International Caries Detection and Assessment System associated with radiographic examination has the potential to support treatment decisions for occlusal surfaces.

A randomized cross-over trial in patients suspected of PAD on diagnostic accuracy of ankle-brachial index by Doppler-based versus four-point oscillometry based measurements

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 516-522 ◽  
Author(s):  
Verena Mayr ◽  
Mirko Hirschl ◽  
Peter Klein-Weigel ◽  
Luka Girardi ◽  
Michael Kundi
Keyword(s):  
Diagnostic Accuracy ◽  
Ankle Brachial Index ◽  
Area Under The Curve ◽  
High Volume ◽  
Epidemiologic Studies ◽  
Lower Sensitivity ◽  
Oscillometric Device ◽  
Specificity And Sensitivity ◽  
Time Requirements ◽  
Peripheral Arterial

Summary. Background: For diagnosis of peripheral arterial occlusive disease (PAD), a Doppler-based ankle-brachial-index (dABI) is recommended as the first non-invasive measurement. Due to limitations of dABI, oscillometry might be used as an alternative. The aim of our study was to investigate whether a semi-automatic, four-point oscillometric device provides comparable diagnostic accuracy. Furthermore, time requirements and patient preferences were evaluated. Patients and methods: 286 patients were recruited for the study; 140 without and 146 with PAD. The Doppler-based (dABI) and oscillometric (oABI and pulse wave index – PWI) measurements were performed on the same day in a randomized cross-over design. Specificity and sensitivity against verified PAD diagnosis were computed and compared by McNemar tests. ROC analyses were performed and areas under the curve were compared by non-parametric methods. Results: oABI had significantly lower sensitivity (65.8%, 95% CI: 59.2%–71.9%) compared to dABI (87.3%, CI: 81.9–91.3%) but significantly higher specificity (79.7%, 74.7–83.9% vs. 67.0%, 61.3–72.2%). PWI had a comparable sensitivity to dABI. The combination of oABI and PWI had the highest sensitivity (88.8%, 85.7–91.4%). ROC analysis revealed that PWI had the largest area under the curve, but no significant differences between oABI and dABI were observed. Time requirement for oABI was significantly shorter by about 5 min and significantly more patients would prefer oABI for future testing. Conclusions: Semi-automatic oABI measurements using the AngER-device provide comparable diagnostic results to the conventional Doppler method while PWI performed best. The time saved by oscillometry could be important, especially in high volume centers and epidemiologic studies.

Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

2019 ◽  
Vol 1 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Sarah Yaziz ◽  
Ahmad Sobri Muda ◽  
Wan Asyraf Wan Zaidi ◽  
Nik Azuan Nik Ismail
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Treatment Decision ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods:  A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

scholarly journals A Preliminary Study on Dependence of Mercury Distribution on the Degree of Coalification in Ningwu Coalfield, Shanxi, China

Energies ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 3119
Author(s):  
Yinjiao Su ◽  
Xuan Liu ◽  
Yang Teng ◽  
Kai Zhang
Keyword(s):  
Linear Correlation ◽  
Bituminous Coal ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Chemical Extraction ◽  
Mercury Distribution ◽  
Sequential Chemical Extraction ◽  
Average Proportion ◽  
Total Proportion ◽  
The Relationship

Mercury (Hg) is a toxic trace element emitted from coal conversion and utilization. Samples with different coal ranks and gangue from Ningwu Coalfield are selected and investigated in this study. For understanding dependence of mercury distribution characteristics on coalification degree, Pearson regression analysis coupled with Spearman rank correlation is employed to explore the relationship between mercury and sulfur, mercury and ash in coal, and sequential chemical extraction method is adopted to recognize the Hg speciation in the samples of coal and gangue. The measured results show that Hg is positively related to total sulfur content in coal and the affinity of Hg to different sulfur forms varies with the coalification degree. Organic sulfur has the biggest impact on Hg in peat, which becomes weak with increasing the coalification degree from lignite to bituminous coal. Sulfate sulfur is only related to Hg in peat or lignite as little content in coal. However, the Pearson linear correlation coefficients of Hg and pyritic sulfur are relatively high with 0.479 for lignite, 0.709 for sub-bituminous coal and 0.887 for bituminous coal. Hg is also related to ash content in coal, whose Pearson linear correlation coefficients are 0.504, 0.774 and 0.827 respectively, in lignite, sub-bituminous coal and bituminous coal. Furthermore, Hg distribution is directly depended on own speciation in coal. The total proportion of F2 + F3 + F4 is increased from 41.5% in peat to 87.4% in bituminous coal, but the average proportion of F5 is decreased from 56.8% in peat to 12.4% in bituminous coal. The above findings imply that both Hg and sulfur enrich in coal largely due to the migration from organic state to inorganic state with the increase of coalification degree in Ningwu Coalfield.

scholarly journals Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space

2021 ◽  
Author(s):  
Rei Nakamichi ◽  
Toshiaki Taoka ◽  
Hisashi Kawai ◽  
Tadao Yoshida ◽  
Michihiko Sone ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Subarachnoid Space ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Predictive Performance ◽  
Roc Curves ◽  
Imaging Findings ◽  
Spearman’S Rank Correlation ◽  
Sagittal Sinus ◽  
Magnetic Resonance Cisternography

Abstract Purpose To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

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