scholarly journals Lung Ultrasound Is More Sensitive for Hospitalized Consolidated Pneumonia Diagnosis Compared to CXR in Children

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 659
Author(s):  
Ioana Mihaiela Ciuca ◽  
Mihaela Dediu ◽  
Monica Steluta Marc ◽  
Mirabela Lukic ◽  
Delia Ioana Horhat ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Lung Ultrasound ◽  
Clinical Suspicion ◽  
Cohen’S Kappa ◽  
Perfect Agreement ◽  
Kappa Test ◽  
Cohen's Kappa ◽  
Child Pneumonia ◽  
Chest X Ray ◽  
Pneumonia Diagnosis

Background: Pneumonia is the leading cause of death among children; thus, a correct early diagnosis would be ideal. The imagistic diagnosis still uses chest X-ray (CXR), but lung ultrasound (LUS) proves to be reliable for pneumonia diagnosis. The aim of our study was to evaluate the sensitivity and specificity of LUS compared to CXR in consolidated pneumonia. Methods: Children with clinical suspicion of bacterial pneumonia were screened by LUS for pneumonia, followed by CXR. The agreement relation between LUS and CXR regarding the detection of consolidation was evaluated by Cohen’s kappa test. Results: A total of 128 patients with clinical suspicion of pneumonia were evaluated; 74 of them were confirmed by imagery and biological inflammatory markers. The highest frequency of pneumonia was in the 0–3 years age group (37.83%). Statistical estimation of the agreement between LUS and CXR in detection of the consolidation found an almost perfect agreement, with a Cohen’s kappa coefficient of K = 0.89 ± 0.04 SD, p = 0.000. Sensitivity of LUS was superior to CXR in detection of consolidations. Conclusion: Lung ultrasound is a reliable method for the detection of pneumonia consolidation in hospitalized children, with sensitivity and specificity superior to CXR. LUS should be used for rapid and safe evaluation of child pneumonia.

Validity of participants’ self-reported diagnosis for a work absence due to a mental health problem compared with physician-certified diagnosis for the same work absence among 709 Canadian workers

2020 ◽  
pp. oemed-2020-106658
Author(s):  
Mahée Gilbert-Ouimet ◽  
Xavier Trudel ◽  
Karine Aubé ◽  
Ruth Ndjaboue ◽  
Caroline S Duchaine ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problem ◽  
Sensitivity And Specificity ◽  
Health Problem ◽  
High Specificity ◽  
Work Absence ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Kappa Value ◽  
Total Agreement

ObjectivesThis study assesses the validity of a self-reported mental health problem (MHP) diagnosis as the reason for a work absence of 5 days or more compared with a physician-certified MHP diagnosis related to the same work absence. The potential modifying effect of absence duration on validity is also examined.MethodsA total of 709 participants (1031 sickness absence episodes) were selected and interviewed. Total per cent agreement, Cohen’s kappa, sensitivity and specificity values were calculated using the physician-certified MHP diagnosis related to a given work absence as the reference standard. Stratified analyses of total agreement, sensitivity and specificity values were also examined by duration of work absence (5–20 workdays,>20 workdays).ResultsTotal agreement value for self-reported MHP was 90%. Cohen’s kappa value was substantial (0.74). Sensitivity was 77% and specificity was 95%. Absences of more than 20 workdays had a better sensitivity than absences of shorter duration. A high specificity was observed for both short and longer absence episodes.ConclusionThis study showed high specificity and good sensitivity of self-reported MHP diagnosis compared with physician-certified MHP diagnosis for the same work absence. Absences of longer durations had a better sensitivity.

scholarly journals Kesesuaian Hasil Pemeriksaan RT PCR, RDT NS1, dan RDT IgM Pasien Penyakit Dengue

2016 ◽  
Vol 2 (2) ◽  
pp. 56
Author(s):  
Paisal Paisal ◽  
Mukhlis Zuardi ◽  
Reni Herman
Keyword(s):  
Mortality Rate ◽  
Rt Pcr ◽  
Laboratory Examination ◽  
Cohen’S Kappa ◽  
Dengue Disease ◽  
Kappa Test ◽  
Cohen's Kappa ◽  
The World ◽  
Aceh Province ◽  
Test Result

<p style="text-align: justify;">The incidence of dengue disease in the world is estimated at 390 million cases per year. In Indonesia, during 2013 there were 35-40 cases per 100.000 population, with a mortality rate of 0.73%. This study aimed to determine the suitability and the percentage of RT-PCR, RDT NS1, and RDT IgM detection examination. Samples were obtained from hospitals in Aceh province during 2012. The research samples reached 100 collected samples, it was only 82 samples that fulfill the analysis criteria. Cohen’s Kappa test result showed there was moderate suitability between RT-PCR and RDT NS1 (K=0,404, p = 0,000), and weak suitability between RT-PCR began RDT IgM (K=0,139, p = 0,046). While the percentage of detection for RT-PCR, RDT NS1, dan RDT IgM were 16%, 10%, and 60%. RDT IgM is the best alternative for laboratory examination in the hospital.

scholarly journals Flow Cytometry in Detecting Resistant E. Coli Strains

2017 ◽  
Vol 5 (5) ◽  
pp. 592-594
Author(s):  
Lyudmila Akhmaltdinova ◽  
Alyona Lavrinenko ◽  
Ilya Belyayev
Keyword(s):  
Flow Cytometry ◽  
Fluorescent Dyes ◽  
Antibiotic Sensitivity ◽  
Relative Accuracy ◽  
Diagnostic Methods ◽  
Cohen’S Kappa ◽  
E Coli ◽  
Kappa Test ◽  
Cohen's Kappa ◽  
Relative Specificity

Antibacterial drugs are the most consumed group of drugs in the modern hospitals. Standard methods of antibiotic sensitivity are labour and time-consuming, taking up to 24 hours after the pure culture is isolated (the analysis typically lasts up to 72 hours). Working out express diagnostic methods is of importance, and studies are made in various directions. Flow cytometry in detecting resistant E.coli strains was used. Flow cytometry fluorescent dyes were used to stain viable and dead cells. For method validation, relative accuracy, relative susceptibility, relative specificity and Cohen’s kappa test were determined compared to the delusion test. Cytometry method showed acceptable results on the model of E.coli. Relative accuracy comprised 88.8%, sensitivity - 85.7%, specificity was 88.8%, Cohen’s kappa test showed value 0.524, which is a medium agreement between the measurements by different methods.

scholarly journals Evaluation of the similarity between drought indices by correlation analysis and Cohen's Kappa test in a Mediterranean area

2021 ◽  
Author(s):  
L. Vergni ◽  
F. Todisco ◽  
B. Di Lena
Keyword(s):  
Correlation Analysis ◽  
Pearson Correlation ◽  
Central Italy ◽  
Meteorological Drought ◽  
Drought Indices ◽  
Drought Severity ◽  
Cohen’S Kappa ◽  
Kappa Test ◽  
Cohen's Kappa ◽  
Standardised Precipitation Index

AbstractIn the literature, numerous papers report comparative analyses of drought indices. In these types of studies, the similarity between drought indices is usually evaluated using the Pearson correlation coefficient, r, calculated between corresponding severity time series. However, it is well known that the correlation does not describe the strength of agreement between two variables. Two drought indices can exhibit a high degree of correlation but can, at the same time, disagree substantially, for example, if one index is consistently higher than the other. From an operational point of view, two indices can be considered in agreement when they indicate the same severity category for a given period (e.g. moderate drought). In this work, we compared six meteorological drought indices based on both correlation analysis and Cohen's Kappa test. This test is typically used in medical or social sciences to obtain a quantitative assessment of the degree of agreement between different methods or analysts. The indices considered are five timescale-dependent indices, i.e. the Percent of Normal Index, the Deciles Index, the Percentile Index, the Rainfall Anomaly Index, and the Standardised Precipitation Index, computed at the 1-, 3-, and 6-month timescales, and the Effective Drought Index, a relatively new index, which has a self-defined timescale. The indices were calculated for 15 stations in the Abruzzo region (central Italy) during 1951–2018. We found that the strength of agreement depends on both the criteria of drought severity classification and the different indices' calculation method. The Cohen's Kappa test indicates a prevailing moderate or fair agreement among the indices considered, despite the generally very high correlation between the corresponding severity times series. The results demonstrate that the Cohen's Kappa test is more effective than the correlation analysis in discriminating the actual strength of agreement/disagreement between drought indices.

scholarly journals Performance of real-time PCR and immunofluorescence assay for diagnosis of Pneumocystis pneumonia in real-world clinical practice

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244023
Author(s):  
Darunee Chotiprasitsakul ◽  
Pataraporn Pewloungsawat ◽  
Chavachol Setthaudom ◽  
Pitak Santanirand ◽  
Prapaporn Pornsuriyasak
Keyword(s):  
Real Time ◽  
Sensitivity And Specificity ◽  
Real World ◽  
Real Time Pcr ◽  
Pneumocystis Pneumonia ◽  
Immunofluorescence Assay ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Highly Sensitive ◽  
Sensitivity Specificity

Background PCR is more sensitive than immunofluorescence assay (IFA) for detection of Pneumocystis jirovecii. However, PCR cannot always distinguish infection from colonization. This study aimed to compare the performance of real-time PCR and IFA for diagnosis of P. jirovecii pneumonia (PJP) in a real-world clinical setting. Methods A retrospective cohort study was conducted at a 1,300-bed hospital between April 2017 and December 2018. Patients whose respiratory sample (bronchoalveolar lavage or sputum) were tested by both Pneumocystis PCR and IFA were included. Diagnosis of PJP was classified based on multicomponent criteria. Sensitivity, specificity, 95% confidence intervals (CI), and Cohen's kappa coefficient were calculated. Results There were 222 eligible patients. The sensitivity and specificity of PCR was 91.9% (95% CI, 84.0%–96.7%) and 89.7% (95% CI, 83.3%–94.3%), respectively. The sensitivity and specificity of IFA was 7.0% (95% CI, 2.6%–14.6%) and 99.2% (95% CI, 95.6%–100.0%), respectively. The percent agreement between PCR and IFA was 56.7% (Cohen's kappa -0.02). Among discordant PCR-positive and IFA-negative samples, 78% were collected after PJP treatment. Clinical management would have changed in 14% of patients using diagnostic information, mainly based on PCR results. Conclusions PCR is highly sensitive compared with IFA for detection of PJP. Combining clinical, and radiological features with PCR is useful for diagnosis of PJP, particularly when respiratory specimens cannot be promptly collected before initiation of PJP treatment.

scholarly journals Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results

2019 ◽  
Vol 14 ◽  
Author(s):  
Andrea Smargiassi ◽  
Riccardo Inchingolo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
Stefania Lopatriello ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Rater Agreement ◽  
Pleural Effusions ◽  
Cohen’S Kappa ◽  
Chest Ultrasonography ◽  
X Ray ◽  
Cohen's Kappa ◽  
Diaphragm Position ◽  
Chest X Ray ◽  
Ionizing Radiations

Background: Chest Ultrasonography (chest US) has shown good sensibility in detecting pneumothorax, pleural effusions and peripheral consolidations and it can be performed bedside. Objectives: The aim of the study was to analyze agreement between chest US and chest X-ray in patients who have undergone thoracic surgery and discuss cases of discordance. Methods: Patients undergoing thoracic surgery were retrospectively selected. Patients underwent routinely Chest X-ray (CXR) during the first 48 h after surgery. Chest US have been routinely performed in all selected patients in the same date of CXR. Chest US operators were blind to both reports and images of CXR. Ultrasonographic findings regarding pneumothorax (PNX), subcutaneous emphysema (SCE), lung consolidations (LC), pleural effusions (PE) and hemi-diaphragm position were collected and compared to corresponding CXR findings. Inter-rater agreement between two techniques was determined by Cohen’s kappa-coefficient. Results: Twenty-four patients were selected. Inter-rater agreement showed a moderate magnitude for PNX (Cohen’s Kappa 0.5), a slight/fair magnitude for SCE (Cohen’s Kappa 0.21), a fair magnitude for PE (Cohen’s Kappa 0.39), no agreement for LCs (Cohen’s Kappa 0.06), high levels of agreement for position of hemi-diaphragm (Cohen’s Kappa 0.7). Conclusion: Analysis of agreement between chest X-ray and chest US showed that ultrasonography is able to detect important findings for surgeons. Limitations and advantages have been found for both chest X-ray and chest US. Knowing the limits of each one is important to really justify and optimize the use of ionizing radiations.

scholarly journals Using Video Recording in Evaluating Skills of Medical Students in the Performance of the Orthopedic Examination

2021 ◽  
Vol 55 (3) ◽  
Author(s):  
Jose Ma D. Bautista ◽  
Peter B. Bernardo ◽  
Mark Anthony R. Ruanto
Keyword(s):  
Clinical Skills ◽  
Video Recording ◽  
Kappa Coefficient ◽  
Cohen’S Kappa ◽  
Perfect Agreement ◽  
Rater Reliability ◽  
Video Recordings ◽  
Cohen's Kappa ◽  
Improve Reliability ◽  
Cohen’S Kappa Coefficient

Objective. The study aims to assess the similarity between the results of the evaluation of students during an Objective Structured Clinical Examination (OSCE) and a video recording of the same OSCE (VOSCE). Methods. All Orthopedic surgeon preceptors in the actual OSCE were recruited to the study. Video recordings of the students taking the OSCE were collected and later reviewed and re-evaluated by the same preceptor after at least four weeks. The grades of actual OSCE and VOSCE were collected and analyzed using Cohen’s kappa coefficient. Results. High variability of intra-rater reliability was observed in different preceptors and station (slight agreement to perfect agreement). Overall intra-rater reliability between actual and video OSCE showed moderate agreement with Cohen’s kappa coefficient equal to 0.43 (n-219). Conclusion. Video OSCE is a reliable tool in assessing student clinical skills and knowledge in the musculoskeletal examination. Some factors have been suggested to further improve reliability.

scholarly journals Spinal Instability Neoplastic Score (SINS): Reliability Among Spine Fellows and Resident Physicians in Orthopedic Surgery and Neurosurgery

2017 ◽  
Vol 7 (8) ◽  
pp. 744-748 ◽  
Author(s):  
Shandy Fox ◽  
Michael Spiess ◽  
Luke Hnenny ◽  
Daryl. R. Fourney
Keyword(s):  
Bone Quality ◽  
Vertebral Body ◽  
Bone Lesion ◽  
Spinal Instability ◽  
Kappa Statistics ◽  
Educational Tool ◽  
Intraobserver Agreement ◽  
Cohen’S Kappa ◽  
Perfect Agreement ◽  
Cohen's Kappa

Study Design: Reliability analysis. Objectives: The Spinal Instability Neoplastic Score (SINS) was developed for assessing patients with spinal neoplasia. It identifies patients who may benefit from surgical consultation or intervention. It also acts as a prognostic tool for surgical decision making. Reliability of SINS has been established for spine surgeons, radiologists, and radiation oncologists, but not yet among spine surgery trainees. The purpose of our study is to determine the reliability of SINS among spine residents and fellows, and its role as an educational tool. Methods: Twenty-three residents and 2 spine fellows independently scored 30 de-identified spine tumor cases on 2 occasions, at least 6 weeks apart. Intraclass correlation coefficient (ICC) measured interobserver and intraobserver agreement for total SINS scores. Fleiss’s kappa and Cohen’s kappa analysis evaluated interobserver and intraobserver agreement of 6 component subscores (location, pain, bone lesion quality, spinal alignment, vertebral body collapse, and posterolateral involvement of spinal elements). Results: Total SINS scores showed near perfect interobserver (0.990) and intraobserver (0.907) agreement. Fleiss’s kappa statistics revealed near perfect agreement for location; substantial for pain; moderate for alignment, vertebral body collapse, and posterolateral involvement; and fair for bone quality (0.948, 0.739, 0.427, 0.550, 0.435, and 0.382). Cohen’s kappa statistics revealed near perfect agreement for location and pain, substantial for alignment and vertebral body collapse, and moderate for bone quality and posterolateral involvement (0.954, 0.814, 0.610, 0.671, 0.576, and 0.561, respectively). Conclusions: The SINS is a reliable and valuable educational tool for spine fellows and residents learning to judge spinal instability.

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