scholarly journals Diagnosis of Fall Risk in Parkinson Disease: An Analysis of Individual and Collective Clinical Balance Test Interpretation

2008 ◽  
Vol 88 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Leland E Dibble ◽  
Jesse Christensen ◽  
D James Ballard ◽  
K Bo Foreman
Keyword(s):  
Parkinson Disease ◽  
Fall Risk ◽  
False Negative ◽  
Likelihood Ratios ◽  
Balance Test ◽  
Multiple Tests ◽  
Negative Results ◽  
Balance Tests ◽  
History Analysis ◽  
Validity Indices

Background and PurposeParkinson disease (PD) results in an increased frequency of falls relative to the frequency in neurologically healthy people. The purpose of this study was to compare the accuracy of PD fall risk diagnosis based on one test with that based on the collective interpretation of multiple tests.ParticipantsSeventy people with PD (mean age=73.91 years) participated in this study.MethodClinical balance tests were conducted during the initial examinations of people with PD. Validity indices were calculated for individual tests and compared with validity indices calculated for a combination of multiple tests.ResultsThirty-six participants reported a fall history. Analysis of individual tests revealed broad variations in validity indices, whereas the collective interpretation of multiple tests improved sensitivity and negative likelihood ratios.Discussion and ConclusionCollective interpretation of clinical balance tests resulted in fewer false-negative results and more substantial adjustments to the posttest probability of being a “faller” than the interpretation of one test alone. These results should be confirmed in a prospective examination of fall risk in PD.

scholarly journals Average Weighted Accuracy: Pragmatic Analysis for a Rapid Diagnostics in Categorizing Acute Lung Infections (RADICAL) Study

2019 ◽  
Vol 70 (12) ◽  
pp. 2736-2742 ◽  
Author(s):  
Ying Liu ◽  
Ephraim L Tsalik ◽  
Yunyun Jiang ◽  
Emily R Ko ◽  
Christopher W Woods ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Diagnostic Yield ◽  
False Negative ◽  
Rapid Diagnostics ◽  
Likelihood Ratios ◽  
Clinical Value ◽  
Predictive Values ◽  
Negative Results ◽  
Treatment Standard ◽  
Lung Infections

Abstract Patient management relies on diagnostic information to identify appropriate treatment. Standard evaluations of diagnostic tests consist of estimating sensitivity, specificity, positive/negative predictive values, likelihood ratios, and accuracy. Although useful, these metrics do not convey the tests’ clinical value, which is critical to informing decision-making. Full appreciation of the clinical impact of a diagnostic test requires analyses that integrate sensitivity and specificity, account for the disease prevalence within the population of test application, and account for the relative importance of specificity vs sensitivity by considering the clinical implications of false-positive and false-negative results. We developed average weighted accuracy (AWA), representing a pragmatic metric of diagnostic yield or global utility of a diagnostic test. AWA can be used to compare test alternatives, even across different studies. We apply the AWA methodology to evaluate a new diagnostic test developed in the Rapid Diagnostics in Categorizing Acute Lung Infections (RADICAL) study.

scholarly journals Accuracy of Fall Prediction in Parkinson Disease: Six-Month and 12-Month Prospective Analyses

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ryan P. Duncan ◽  
Abigail L. Leddy ◽  
James T. Cavanaugh ◽  
Leland E. Dibble ◽  
Terry D. Ellis ◽  
...  
Keyword(s):  
Pilot Study ◽  
Parkinson Disease ◽  
Roc Curve ◽  
Fall Risk ◽  
Roc Curves ◽  
Berg Balance Scale ◽  
Likelihood Ratios ◽  
Fall Prediction ◽  
Functional Gait ◽  
Prospective Analyses

Introduction. We analyzed the ability of four balance assessments to predict falls in people with Parkinson Disease (PD) prospectively over six and 12 months.Materials and Methods. The BESTest, Mini-BESTest, Functional Gait Assessment (FGA), and Berg Balance Scale (BBS) were administered to 80 participants with idiopathic PD at baseline. Falls were then tracked for 12 months. Ability of each test to predict falls at six and 12 months was assessed using ROC curves and likelihood ratios (LR).Results. Twenty-seven percent of the sample had fallen at six months, and 32% of the sample had fallen at 12 months. At six months, areas under the ROC curve (AUC) for the tests ranged from 0.8 (FGA) to 0.89 (BESTest) with LR+ of 3.4 (FGA) to 5.8 (BESTest). At 12 months, AUCs ranged from 0.68 (BESTest, BBS) to 0.77 (Mini-BESTest) with LR+ of 1.8 (BESTest) to 2.4 (BBS, FGA).Discussion. The various balance tests were effective in predicting falls at six months. All tests were relatively ineffective at 12 months.Conclusion. This pilot study suggests that people with PD should be assessed biannually for fall risk.

scholarly journals Validity of the GAITRite Walkway Compared to Functional Balance Tests for Fall Risk Assessment in Geriatric Outpatients

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 77
Author(s):  
Johannes Riis ◽  
Stephanie M. Byrgesen ◽  
Kristian H. Kragholm ◽  
Marianne M. Mørch ◽  
Dorte Melgaard
Keyword(s):  
Risk Assessment ◽  
Dual Task ◽  
Fall Risk ◽  
Timed Up And Go ◽  
Balance Test ◽  
Fall Risk Assessment ◽  
Functional Balance ◽  
Balance Tests ◽  
Gait Parameters ◽  
Task Conditions

This study examined the concurrent validity between gait parameters from the GAITRite walkway and functional balance test commonly used in fall risk assessment. Patients were sampled from one geriatric outpatient clinic. One physiotherapist evaluated the patients on the GAITRite walkway with three repetitions in both single- and dual-task conditions. Patients were further evaluated with Bergs Balance scale (BBS), Dynamic Gait index (DGI), Timed Up and Go (TUG), and Sit To Stand test (STS). Correlations between quantitative gait parameters and functional balance test were analyzed with Spearman’s rank correlations. Correlations strength was considered as follows: negligible <0.1, weak 0.10–0.39, moderate 0.40–0.69, and strong ≥0.70. We included 24 geriatric outpatients in the study with a mean age of 80.6 years (SD: 5.9). Patients received eight (SD: 4.5) different medications on average, and seven (29.2%) patients used walkers during ambulation. Correlations between quantitative gait parameters and functional balance test ranged from weak to moderate in both single- and dual-task conditions. Moderate correlations were observed for DGI, TUG, and BBS, while STS showed weak correlations with all GAITRite parameters. For outpatients analyzed on the GAITRite while using walkers, correlations showed no clear pattern across parameters with large variation within balance tests.

Evaluation of the Cardiac reader® as a point-of-care instrument for measurement of fibrin D-dimers in dogs

2009 ◽  
Vol 37 (05) ◽  
pp. 319-325 ◽  
Author(s):  
A. Moritz ◽  
N. Bauer
Keyword(s):  
Point Of Care ◽  
Plasma Concentrations ◽  
False Negative ◽  
Reference Interval ◽  
Comparison Method ◽  
Likelihood Ratios ◽  
Negative Results ◽  
Blood Specimens ◽  
Sensitivity Specificity ◽  
D Dimer

Summary Objective: The aim of this study was the evaluationof the automated point-of-care analyzer Cardiac reader® for quantitative fibrin D-dimer measurement compared to the Liatest™ D-Di™ run on the bench top analyzer STA Compact (all Roche). Material and methods: 41 fresh canine blood specimens submitted from the Clinic for Small Animals, Justus-Liebig-University Giessen were included. Measurement of fibrin D-dimers with the Liatest™ D-Di™ immunoturbidimetric assay was performed in citrated blood plasma stored at –80 °C until analysis. Using the Cardiac reader, D-dimer plasma concentrations were measured with an immunological assay in heparinized fresh (< 1 hour) whole blood specimens. Results: Mean intra-assay coefficient of variation (CV) was 6.13% (range: 2.2–10.0%) for the Liatest™ D-Di and 19.8% (range: 20.1–19.6%) for the Cardiac reader. Fibrin D-dimers detected with the STA Compact exceeded the upper limit of the reference interval (0.4 μg/ml; n = 62 healthy dogs) in 20/41 samples. There was a fair correlation between D-dimer measurements with the Cardiac reader and the comparison method (r = 0.78). Generally, results were underestimated with a mean proportional bias (0.45 μg/ml). The area under the Receiver Operating Characteristic (ROC) curve was 0.895 regarding the detection of increased fibrin D-dimers with the Cardiac reader. At a cut-off value of > 0.2 μg/ml, sensitivity/specificity were 85%/91% and positive/negative likelihood ratios were 8.93/0.17. At a lower cut-off value of 0.15 μg/ml sensitivity and specificity were 90% and 66%, respectively. Conclusion and clinical relevance: The Cardiac reader can be used for quantitative measurement of canine D-dimers, however, due to the odds of false negative results and the high imprecision the comparison method should be preferred.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

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