Using ultrasound for screening scoliosis to reduce unnecessary radiographic radiation – a prospective diagnostic accuracy study on 442 schoolchildren

2021 ◽  
Author(s):  
H Pang ◽  
YS Wong ◽  
BHK Yip ◽  
ALH Hung ◽  
WCW Chu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Radiation Exposure ◽  
Screening Program ◽  
False Positive Rate ◽  
Diagnostic Accuracy Study ◽  
Positive Rate ◽  
Accuracy Study ◽  
Referral Status ◽  
Unnecessary Radiation ◽  
Scoliosis Screening

Scoliosis screening is important for timely initiation of brace treatment to mitigate curve progression in skeletally immature children. Scoliosis screening programs frequently include the protocol of referring children screened positive with Scoliometer and Moiré Topography for confirmatory standard radiography. Despite being highly sensitive (88%) for detecting those who require specialist referral, the screening program was found to have more than 50% false positive rate that leads to unnecessary radiation exposure. Radiation-free ultrasound has been reported to be reliable for quantitative assessment of scoliosis curves. The aim of this prospective diagnostic accuracy study was to determine the accuracy of ultrasound in determining the referral status for children initially screened positive for scoliosis. 442 schoolchildren with a mean Cobb angle of 14.0 ± 6.6° were recruited. Using x-ray as the gold standard, the sensitivity and specificity of ultrasound in predicting the correct referral status were 92.3% and 51.6% respectively. ROC curve analysis revealed an area under curve of 0.735 for ultrasound alone and 0.832 for ultrasound plus scoliometer measurement. The finding provided strong evidences on the accuracy of ultrasound in determining the referral status that could result in more than 50% reduction of unnecessary radiation exposure for children undergoing scoliosis screening.

scholarly journals Blood-based host biomarker diagnostics in active case finding for pulmonary tuberculosis: a diagnostic accuracy study

2021 ◽  
Author(s):  
Flora Martinez Figueira Moreira ◽  
Renu Verma ◽  
Paulo Cesar Pereira dos Santos ◽  
Alessandra Leite ◽  
Andrea da Silva Santos ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Screening Program ◽  
Point Of Care ◽  
Case Finding ◽  
National Council ◽  
Active Case Finding ◽  
Diagnostic Accuracy Study ◽  
Active Case ◽  
Accuracy Study ◽  
Triage Test

SummaryBackgroundThere is a need to identify scalable tuberculosis screening strategies among high burden populations. The WHO has identified a non-sputum-based triage test as a development priority.MethodsWe performed a diagnostic accuracy study of point-of-care C-reactive protein (CRP) and Xpert-MTB-Host-Response (Xpert-MTB-HR) assays in the context of a mass screening program for tuberculosis in two prisons in Brazil. Incarcerated individuals irrespective of symptoms were screened by sputum Xpert-MTB/RIF and sputum culture. CRP was quantified in serum by a point-of-care assay (iChroma-II) and a 3-gene expression score was quantified from whole blood using the Xpert-MTB-HR cartridge. We evaluated receiver operating characteristic area under the curve (AUC) and assessed specificity at 90% sensitivity and sensitivity at 70% specificity, consistent with WHO target product profile (TPP) benchmarks.FindingsTwo hundred controls controls and 100 culture- or Xpert-positive tuberculosis cases were included. Half of tuberculosis cases and 11% of controls reported any tuberculosis symptoms. AUC for CRP was 0.79 (95% CI: 0.73-0.84) and for Xpert-MTB-HR was 0.84 (95% CI: 0.79-0.89). At 90% sensitivity, Xpert-MTB-HR had significantly higher specificity (53.0%, 95% CI: 45.0-69.0%) than CRP (28.1%, 95% CI: 20.2-41.8%) (p=0.003). Among individuals with medium or high sputum Xpert semi-quantitative load, sensitivity (at 70% specificity) of CRP (90.3%, 95% CI: 74.2-98.0) and Xpert-MTB-HR (96.8%, 95% CI: 83.3-99.9%) was higher.InterpretationFor active case finding in this high tuberculosis-burden setting, CRP and Xpert-MTB-HR did not meet TPP benchmarks for a triage test. However, Xpert-MTB-HR was highly sensitive in detecting individuals with medium or high sputum bacillary burden.FundingNational Institutes of Health (R01 AI130058 and R01 AI149620) and Brazilian National Council for Scientific and Technological Development (CNPq-404182/2019-4). Xpert-MTB-HR cartridges were provided by Cepheid.

The shortened combined clonidine and arginine test for growth hormone deficiency is practical and specific: a diagnostic accuracy study

2016 ◽  
Vol 29 (3) ◽  
Author(s):  
Reem Al Khalifah ◽  
Lina Moisan ◽  
Helen Bui
Keyword(s):  
Growth Hormone ◽  
Diagnostic Accuracy ◽  
Stimulation Index ◽  
False Positive Rate ◽  
Hormone Deficiency ◽  
Index Test ◽  
Arginine Test ◽  
Positive Rate ◽  
Accuracy Study ◽  
Index Tests

AbstractThe growth hormone (GH) stimulation protocols for clonidine and arginine tests are non-standardized and can be lengthy. We examined the specificity of both tests using a shorter duration of timed samples: 90 min for clonidine and 60 min for arginine.We retrospectively studied all children who had GH stimulation with clonidine and arginine to test for GH deficiency (GHD). We compared the diagnostic accuracy of both reference and new shortened test (index).We reviewed 243 charts (11.4±4.1 years old; 74.5% males). The combined reference test was performed on 159 children, 29 (18.3%) tested positive for GHD on the combined index test, Kappa 0.98, false positive rate 1 (0.8%), specificity 0.99, 95th CI (0.96–1), and p=1.0. The specificity of both the clonidine and arginine single index tests was 0.98%.The shortened clonidine and arginine stimulation index tests have good specificity. This is a viable option for testing children for GHD.

scholarly journals Rapid Salivary Test suitable for a mass screening program to detect SARS-CoV-2: A diagnostic accuracy study

2020 ◽  
Vol 81 (3) ◽  
pp. e75-e78 ◽  
Author(s):  
Lorenzo Azzi ◽  
Andreina Baj ◽  
Tiziana Alberio ◽  
Marta Lualdi ◽  
Giovanni Veronesi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Mass Screening ◽  
Screening Program ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study ◽  
Salivary Test
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