scholarly journals Clinically Important Differences for the Upper-Extremity Fugl-Meyer Scale in People With Minimal to Moderate Impairment Due to Chronic Stroke

2012 ◽  
Vol 92 (6) ◽  
pp. 791-798 ◽  
Author(s):  
Stephen J. Page ◽  
George D. Fulk ◽  
Pierce Boyne
Keyword(s):  
Upper Extremity ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Empirical Work ◽  
Area Under The Curve ◽  
Chronic Stroke ◽  
Global Rating ◽  
Roc Curve Analysis ◽  
Clinically Important Difference ◽  
Before And After

BackgroundThe upper-extremity portion of the Fugl-Meyer Scale (UE-FM) is one of the most established and commonly used outcome measures in stroke rehabilitative trials. Empirical work is needed to determine the amount of change in UE-FM scores that can be regarded as important and clinically meaningful for health professionals, patients, and other stakeholders.ObjectiveThis study used anchor-based methods to estimate the clinically important difference (CID) for the UE-FM in people with minimal to moderate impairment due to chronic stroke.MethodOne hundred forty-six individuals with stable, mild to moderate upper-extremity (UE) hemiparesis were administered the UE-FM before and after an intervention targeting their affected UEs. The treating therapists rated each participant's perceived amount of UE motor recovery on a global rating of change (GROC) scale evaluating several facets of UE movement (grasp, release, move the affected UE, perform 5 important functional tasks with the affected UE, overall UE function). Estimated CID of the UE-FM scores was calculated using receiver operating characteristic (ROC) curve with the GROC scores as the anchor.ResultsThe ROC curve analysis revealed that change in UE-FM scores during the intervention period distinguished participants who experienced clinically important improvement from those that did not based on the therapists' GROC scores. The area under the curve ranged from 0.61 to 0.70 for the different facets of UE movement.ConclusionsThe estimated CID of the UE-FM scores ranged from 4.25 to 7.25 points, depending on the different facets of UE movement.

scholarly journals Evaluation of serum AFP and DCP levels in the diagnosis of early-stage HBV-related HCC under different backgrounds

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096908
Author(s):  
Ting Song ◽  
Lili Wang ◽  
Ruopei Xin ◽  
Liping Zhang ◽  
Yun Tian
Keyword(s):  
Roc Curve ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Early Stage ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Chronic Hbv Infection ◽  
B Virus ◽  
Chronic Hbv

Objective This study compared the diagnostic performance of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) in early-stage hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) under different backgrounds. Methods Patients were enrolled and divided in four groups: chronic HBV infection (CHB), liver cirrhosis (LC), early-stage CHB-HCC, and early-stage LC-HCC. Serum AFP and DCP levels were measured. Receiver-operating characteristic (ROC) curve and area under the curve (AUC) analyses were applied to compare the diagnostic performance of DCP and AFP for HCC. Results In total, 200 patients were enrolled, including 48, 64, 33, and 55 patients with CHB, LC, CHB-HCC, and LC-HCC, respectively. ROC curve analysis revealed that the AUCs of AFP, DCP, and their combination in differentiating early-stage LC-HCC from LC were 0.776, 0.758, and 0.786, respectively. The values of these markers in discriminating early-stage CHB-HCC from CHB were 0.828, 0.731, and 0.862, respectively. Conclusions DCP was inferior to AFP in differentiating early-stage CHB-HCC from CHB. However, AFP and DCP displayed similar performance in distinguishing early-stage LC-HCC and LC.

Increased Levels of Soluble Programmed Death Ligand 1 Associate with Malignancy in Patients with Dermatomyositis

2018 ◽  
Vol 45 (6) ◽  
pp. 835-840 ◽  
Author(s):  
He Chen ◽  
Qinglin Peng ◽  
Hanbo Yang ◽  
Liguo Yin ◽  
Jingli Shi ◽  
...  
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Programmed Death Ligand 1 ◽  
Programmed Death ◽  
Diagnostic Values ◽  
Diagnostic Indicator ◽  
New Onset

Objective.To investigate the levels of soluble programmed death ligand 1 (sPD-L1) and evaluate its association with malignancy in patients with dermatomyositis (DM).Methods.Levels of sPD-L1 were measured in serum from 88 DM patients without malignancies (sDM), 40 with cancer-related DM (CRDM), and 30 healthy controls (HC) using ELISA. The CRDM subjects were divided into new-onset cancers (nCRDM) and stable cancers (sCRDM). Receiver-operating characteristic (ROC) curve analysis was performed to determine the cutoff sPD-L1 value that distinguished patients with nCRDM from those who were sDM. Serum antitranscriptional intermediary factor 1-γ (TIF1-γ) antibodies were detected using immunoblot, and the diagnostic values for malignancy were compared with sPD-L1 levels in patients with DM.Results.Serum sPD-L1 levels were significantly higher in sDM [median 12.3 ng/ml, interquartile range (IQR) 8.4–16.2] than in HC (median 1.3 ng/ml, IQR 0.4–2.2, p = 0.0001). Extremely high sPD-L1 levels were seen in nCRDM (median 18.5 ng/ml, IQR 13.8–22.4), much higher than those in sCRDM (median 8.5 ng/ml, IQR 6.8–11.8, p = 0.0001). The sPD-L1 levels in 4 patients with nCRDM decreased after curative cancer treatment (p = 0.013). ROC curve analysis revealed that the sPD-L1 value distinguishing nCRDM from sDM was 16.1 ng/ml, with an area under the curve value of 0.72 ± 0.04 (p = 0.0001). The combination of sPD-L1 and anti-TIF1-γ antibodies yielded greater specificity and positive predictive value in diagnosing cancer, reaching values of 95% and 70%, respectively.Conclusion.Serum sPD-L1 levels increased significantly in sDM, and markedly high sPD-L1 levels could be a diagnostic indicator for malignancies in patients with DM, especially in those with anti-TIF1-γ antibodies.

scholarly journals A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

2021 ◽  
pp. 026921552110251
Author(s):  
Marla K Beauchamp ◽  
Rudy Niebuhr ◽  
Patricia Roche ◽  
Renata Kirkwood ◽  
Kathryn M Sibley
Keyword(s):  
Stroke Rehabilitation ◽  
Minimal Clinically Important Difference ◽  
Clinical Importance ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Detectable Change ◽  
Clinically Important Difference ◽  
Before And After ◽  
Small Change ◽  
A Prospective Study

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

scholarly journals Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

Entropy ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 255
Author(s):  
Mario Gonzalez-Lee ◽  
Hector Vazquez-Leal ◽  
Luis J. Morales-Mendoza ◽  
Mariko Nakano-Miyatake ◽  
Hector Perez-Meana ◽  
...  
Keyword(s):  
Fractional Calculus ◽  
Roc Curve ◽  
Gaussian Noise ◽  
False Positive ◽  
Operating Characteristic ◽  
Image Watermarking ◽  
Area Under The Curve ◽  
Statistical Assessment ◽  
Watermarking Scheme ◽  
Fractional Equation

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

scholarly journals Identification of an optimal prolactin threshold to determine prolactinoma size using receiver operating characteristic analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bianca M. Leca ◽  
Maria Mytilinaiou ◽  
Marina Tsoli ◽  
Andreea Epure ◽  
Simon J. B. Aylwin ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Tumour Size ◽  
Area Under The Curve ◽  
Serum Prolactin ◽  
Pituitary Neoplasms ◽  
Characteristic Analysis ◽  
Roc Curve Analysis ◽  
Baseline Serum ◽  
Receiver Operating

AbstractProlactinomas represent the most common type of secretory pituitary neoplasms, with a therapeutic management that varies considerably based on tumour size and degree of hyperprolactinemia. The aim of the current study was to evaluate the relationship between serum prolactin (PRL) concentrations and prolactinoma size, and to determine a cut-off PRL value that could differentiate micro- from macro-prolactinomas. A retrospective cohort study of 114 patients diagnosed with prolactinomas between 2007 and 2017 was conducted. All patients underwent gadolinium enhanced pituitary MRI and receiver operating characteristic (ROC) analyses were performed. 51.8% of patients in this study were men, with a mean age at the time of diagnosis of 42.32 ± 15.04 years. 48.2% of the total cohort were found to have microadenomas. Baseline serum PRL concentrations were strongly correlated to tumour dimension (r = 0.750, p = 0.001). When performing the ROC curve analysis, the area under the curve was 0.976, indicating an excellent accuracy of the diagnostic method. For a value of 204 μg/L (4338 mU/L), sensitivity and specificity were calculated at 0.932 and 0.891, respectively. When a cut off value of 204 μg/L (4338 mU/L) was used, specificity was 93.2%, and sensitivity 89.1%, acceptable to reliably differentiate between micro- and macro- adenomas.

Minimal clinically important difference of the 6-min walking test in patients with asthma

2021 ◽  
Vol 25 (3) ◽  
pp. 215-221
Author(s):  
E. Zampogna ◽  
N. Ambrosino ◽  
R. Centis ◽  
F. Cherubino ◽  
G. B. Migliori ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Operating Characteristic ◽  
Minimal Clinically Important Difference ◽  
Walking Ability ◽  
Walking Test ◽  
Receiver Operating Characteristic Curves ◽  
Clinically Important Difference ◽  
Copd Assessment Test ◽  
Before And After ◽  
Perceived Change

BACKGROUND: The 6‐min walking test (6MWT) is responsive to physiological changes and pulmonary rehabilitation (PR) in patients with asthma. The minimal clinically important difference (MCID) has not been established yet.OBJECTIVE: To determine the MCID of 6MWT in patients with asthma.METHODS: Using the perceived change in walking ability and the modified Medical Research Council (mMRC) score as anchors, receiver operating characteristic curves and quantile regression, we evaluated 6MWT before and after PR in these patients. The St George Respiratory Questionnaire (SGRQ), the COPD assessment test (CAT) and other outcome measures were also assessed.RESULTS: Of 142 patients with asthma, 37 were enrolled. After PR, 6MWT increased from 453.4 m ± 88.8 to 493.0 m ± 97.2 (P = 0.0001); other outcome measures also increased. There was a slight correlation between baseline 6MWT and SGRQ, CAT and mMRC. No significant correlations were found between post‐PR changes in 6MWT and in other outcome measures. Comparing different methods of assessment, the MCID ranged from 26 m to 27 m.CONCLUSION: The most conservative estimate of the MCID of 6MWT after PR was 26 m in patients with asthma. This estimate may be useful in clinical interpretation of data, particularly in response to intervention studies.

scholarly journals Development and validation of a prognostic model to predict clinical deterioration in hospitalized patients with COVID-19

2021 ◽  
Author(s):  
Javid Azadbakht ◽  
Sina Rashedi ◽  
Soheil Kooraki ◽  
Hamed Kowsari ◽  
Elnaz Tabibian
Keyword(s):  
Roc Curve ◽  
Scoring System ◽  
Prognostic Model ◽  
Operating Characteristic ◽  
Clinical Laboratory ◽  
External Validation ◽  
Clinical Deterioration ◽  
Roc Curve Analysis ◽  
Prospective Multicenter Study ◽  
Development And Validation

Abstract Objectives We aimed to develop and validate a prognostic model to predict clinical deterioration defined as either death or intensive care unit admission of hospitalized COVID-19 patients.Methods This prospective, multicenter study investigated 172 consecutive hospitalized COVID-19 patients who underwent a chest computed tomography (CT) scan between March 20 and April 30, 2020 (development cohort), as well as an independent sample of 40 consecutive patients for external validation (validation cohort). The clinical, laboratory, and radiologic data were gathered, and logistic regression along with receiver operating characteristic (ROC) curve analysis was performed.Results The overall clinical deterioration rates of the development and validation cohorts were 28.4% (49 of 172) and 30% (12 of 40), respectively. Seven predictors were included in the scoring system with a total score of 15: CT severity score\(\ge\)15 (Odds Ratio (OR)=6.34, 4 points), pleural effusion (OR = 6.80, 2 points), symptom onset to admission ≤ 6 days (OR = 2.44, 2 points), age\(\ge\)70 years (OR = 2.44, 2 points), diabetes mellitus (OR = 2.24, 2 points), dyspnea (OR = 2.17, 1.5 points), and abnormal leukocyte count (OR = 1.89, 1.5 points). The area under the ROC curve for the scoring system in the development and validation cohorts was 0.823 (CI [0.751–0.895]) and 0.558 (CI [0.340–0.775]), respectively.Conclusion This study provided a new easy-to-calculate scoring system with external validation for hospitalized COVID-19 patients to predict clinical deterioration based on a combination of seven clinical, laboratory, and radiologic parameters.

Serum diiodotyrosine—a biomarker to differentiate destructive thyroiditis from Graves’ disease

2021 ◽  
Author(s):  
Naoya Fujita ◽  
Yosuke Ono ◽  
Azusa Sano ◽  
Motohiro Kimata ◽  
Seigo Oyama ◽  
...  
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
Cross Sectional Study ◽  
Curve Analysis ◽  
Diagnostic Methods ◽  
Graves Disease ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass

Objective: Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves’ disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves’ disease. Design: Patients with destructive thyroiditis (n = 13) and Graves’ disease (n = 22) were enrolled in this cross-sectional study. Methods: We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves’ disease. Results: The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves’ disease. The ROC curve analysis showed that the serum DIT levels (≥ 359.9 pg/mL) differentiated destructive thyroiditis from Graves’ disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < .001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = .001). Conclusions: The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves’ disease.

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