scholarly journals Diagnostic Performance of Three-Phase Bone Scintigraphy and Digital Infrared Thermography Imaging for Chronic Post-Traumatic Complex Regional Pain Syndrome

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1459
Author(s):  
Miju Cheon ◽  
Hyo Jung Kang ◽  
Kyung Hee Do ◽  
Hee Seung Yang ◽  
Eul Joo Han ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Infrared Thermography ◽  
Bone Scintigraphy ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Uptake Pattern ◽  
Three Phase ◽  
Post Traumatic

This study aimed to evaluate the diagnostic performance of three-phase bone scintigraphy (TPBS) and digital infrared thermography imaging (DITI) in the chronic post-traumatic CRPS and propose new imaging diagnostic criteria that combine the two tests. We retrospectively enrolled 44 patients with suspected symptoms of CRPS from various injuries during obligatory military service. We analyzed the following findings: (1) uptake pattern on TPBS, (2) uptake ratios of affected and unaffected sides in each phase of TPBS, (3) difference in body skin temperature on DITI. New criteria combining the above findings were also evaluated. Eighteen patients were finally defined as CRPS according to the Budapest criteria. Uptake pattern and uptake ratio in blood pool phase on the TPBS were significantly different between CRPS and non-CRPS groups (both p < 0.05). The DITI could not discriminate significantly between the groups (p = 0.334). The diagnostic criteria considering both the pattern analysis and quantitative analysis in TPBS exhibited the highest positive likelihood ratio. On the other hand, the diagnostic criteria combining DITI and TPBS showed the lowest negative likelihood ratio value. TPBS can be useful in diagnosing chronic post-traumatic CRPS. Moreover, we can suggest that different diagnostic criteria be applied depending on the purpose.

Diagnostic Accuracy of Plasma Ghrelin Concentrations in Pediatric Sepsis -associated ARDS: A Single-center Cohort Study

2020 ◽  
Author(s):  
xiu yuan ◽  
Shaojun Li ◽  
Liang Zhou ◽  
yanru LI ◽  
tian tang ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Protective Factor ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Ghrelin Level ◽  
Inflammatory Factors ◽  
Rank Test ◽  
Growth Hormone Secretagogue

Abstract Background: Ghrelin is the endogenous ligand of growth hormone secretagogue receptor 1a (GHSR1a), which can regulate immunity and inflammation. To assess the diagnostic value of plasma ghrelin levels in sepsis-associated pediatric acute respiratory distress syndrome (PARDS).Methods: We recruited patients from the PICU of a third-class teaching hospital who met the diagnostic criteria for sepsis from January 2019 to January 2020. Clinical data, laboratory indicators, plasma ghrelin concentrations, and inflammatory factors of cohort were evaluated in detail, and patients were followed up for 28 days. The area under the receiver-operating characteristic curves (AUROC) was calculated using logistic regression to calculate and positivity cut-offs was tested. Ghrelin's ability to diagnose and differentiate sepsis-associated PARDS were determined. The log-rank test was used to compare the survival curves of different ghrelin level groups.Main results: Sixty-six PICU patients (30 with ARDS, 36 without ARDS) who met the diagnostic criteria of sepsis were recruited. The ghrelin level was significantly higher in the sepsis patients of the ARDS group than in those of the non-ARDS group. The AUROC of ghrelin was 0.708 (95% confidence interval: 0.584–0.833) and the positivity cutoff value was 445 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (–LR) of plasma ghrelin for diagnosis of sepsis with PARDS were 86.7%, 50.0%, 59.1%, 81.8%,1.734, and 0.266, respectively. The survival rate of sepsis patients was significantly improved when the ghrelin level was >445 pg/mL.Conclusions: Ghrelin plasma was higher in sepsis-associated PARDS, and accompanied by the increase of inflammatory factors. The increased plasma ghrelin may be due to the anti-inflammatory response, which may be a protective factor in children with sepsis. Yet, there is no evidence to prove that elevated ghrelin appears to be a promising diagnostic indicator of sepsis-associated PARDS. In addition, the ghrelin levels may be a positive predictor of sepsis.Trial registration: Clinicaltrials, ChiCTR1900023254. Registered 1 December 2018 - Retrospectively registered, http://www.clinicaltrials. gov/ChiCTR1900023254.

scholarly journals Diagnosis of cardiogenic shock without the use of a pulmonary artery catheter

2014 ◽  
Vol 4 (1) ◽  
pp. 88-95 ◽  
Author(s):  
Howard A Cooper ◽  
Amir H Najafi ◽  
Kambiz Ghafourian ◽  
Andre RM Paixao ◽  
Mohamed Aljaabari ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Cardiogenic Shock ◽  
Diagnostic Criteria ◽  
Pulmonary Artery Catheter ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Coronary Care

Background: Current diagnostic criteria for cardiogenic shock (CS) require the use of a pulmonary artery catheter (PAC), which is time-consuming and may cause complications. A set of simple yet accurate noninvasive diagnostic criteria would be of significant utility. Methods: Candidate components for the Noninvasive Parameters for Assessment of Cardiogenic Shock (N-PACS) criteria were required to be objective, readily available, and noninvasive. Variables encompassing hypotension, hypoperfusion, predisposing conditions, and elevated intracardiac filling pressures were optimized versus a PAC-based standard in a retrospective developmental cohort of 122 patients with acute myocardial infarction (AMI). The finalized criteria were validated in a prospective cohort of coronary care unit patients in whom a PAC was placed for clinical indications. Results: According to invasive criteria, CS was present in 32 of 217 consecutive patients undergoing PAC. Compared to the PAC-based standard, the N-PACS criteria had a sensitivity of 96.9% (95% confidence interval (CI) 82.0–99.8), specificity of 90.8% (95% CI 85.5–94.4), positive predictive value of 64.6% (95% CI 49.4–77.4), negative predictive value of 99.4% (95% CI 96.2–100), positive likelihood ratio of 10.5 (95% CI 6.7–16.7), negative likelihood ratio of 0.03 (95% CI 0.00–0.24), and diagnostic odds ratio of 306.4. Results were similar among patients with and without AMI. Conclusion: A simple, echocardiography-based set of noninvasive diagnostic criteria can be used to accurately diagnose CS.

scholarly journals Comparison of contrast-enhanced ultrasound with MRI in the diagnosis of complex cystic renal masses: a meta-analysis

2018 ◽  
Vol 59 (10) ◽  
pp. 1254-1263 ◽  
Author(s):  
Linli Zhou ◽  
Lemin Tang ◽  
Tao Yang ◽  
Wei Chen
Keyword(s):  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Efficacy ◽  
Renal Masses ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

Background The differential diagnosis of cystic renal masses still faces great challenges. There has been no systematically assessment to compare the value of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) in the diagnosis of cystic renal masses. Purpose To perform a meta-analysis to compare the diagnostic efficacy of CEUS with that of MRI for cystic renal masses. Material and Methods A systematic search was performed for literature evaluating the diagnostic performance of CEUS or MRI in cystic renal masses. Quality assessment of diagnostic studies 2 (QUADAS-2) was used to evaluate the quality of each study included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the areas under the summary receiver operating characteristic (AUCs-SROC) curve for CEUS and MRI were calculated, respectively. Results Seventeen studies with 1142 lesions were included. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS /MRI were 0.95/0.92, 0.84/0.91, 5.62/6.74, and 0.09/0.13, respectively. The AUCs-SROC curves for the two methods were 95.66% and 94.65%. The subgroup analysis indicated that the scanning slice thickness may influence the diagnostic efficacy of MRI. Conclusion Both CEUS and MRI have good diagnostic performance for cystic renal masses and can provide the reference for clinicians. CEUS is more sensitive but less specific than MRI.

Diagnostic performance of circulating cell-free DNA for hepatocellular carcinoma: a systematic review and meta-analysis

2021 ◽  
Vol 15 (3) ◽  
pp. 219-239
Author(s):  
Jinmei Zhang ◽  
Yuan Yuan ◽  
Shuxia Gao ◽  
Xue Zhao ◽  
Hong Li
Keyword(s):  
Likelihood Ratio ◽  
Odds Ratio ◽  
Diagnostic Performance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Free Dna ◽  
Sensitivity Specificity

Background: We aimed to assess the diagnostic performance of circulating cell-free DNA (cfDNA) in hepatocellular carcinoma (HCC). Materials & methods: After a systematic literature search bivariate linear mixed models were used to integrate sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio. The area under receiver operating characteristics curves of the included studies was used to estimate the diagnostic value. Results: Thirty-eight articles enrolled in quantitative synthesis. In overall analysis the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under receiver operating characteristics curves for cfDNA in distinguishing HCC patients from healthy controls were 0.54, 0.90, 5.23, 0.51, 10.27 and 0.82, respectively. Conclusion: This study suggests that cfDNA has a promising diagnostic accuracy in detection of HCC.

scholarly journals Diagnostic performance of PET in thyroid cancer with elevated anti-Tg Ab

2018 ◽  
Vol 25 (6) ◽  
pp. 643-652 ◽  
Author(s):  
Seong-Jang Kim ◽  
Sang-Woo Lee ◽  
Kyoungjune Pak ◽  
Sung-Ryul Shim
Keyword(s):  
Thyroid Cancer ◽  
Likelihood Ratio ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Whole Body ◽  
Cochrane Library ◽  
Pet Ct ◽  
Fdg Pet Ct

We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with progressively and/or persistently elevated TgAb levels and negative radioactive iodine whole-body scan (RI-WBS) through a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−). Across 9 studies (515 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.84 (95% CI; 0.77–0.89) a pooled specificity of 0.78 (95% CI; 0.67–0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.8 (95% CI; 2.5–5.7) and negative likelihood ratio (LR−) of 0.21 (95% CI; 0.14–0.30). The pooled diagnostic odds ratio (DOR) was 18 (95% CI; 10–34). The area (AUC) under the hierarchical summary receiver-operating characteristic (HCROC) curve was 0.88 (95% CI: 0.85–0.90). F-18 FDG PET or PET/CT demonstrated moderate sensitivity and specificity for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS.

The Diagnostic Performance of lncRNAs from Blood Specimens in Patients with Hepatocellular Carcinoma: A Meta-Analysis

2020 ◽  
Vol 52 (1) ◽  
pp. 64-73
Author(s):  
Jing-Yi Huang ◽  
Si-Yu Wang ◽  
Yong Lin ◽  
Huo-Chun Yi ◽  
Jian-Jun Niu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Exclusion Process ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Relevant Information ◽  
Diagnostic Odds Ratio ◽  
Linear Regression Method

Abstract Objective Long noncoding RNAs (lncRNAs) are widely involved in the carcinogenesis and development of cancers. We conducted a meta-analysis to evaluate the diagnostic performance of lncRNAs in hepatocellular carcinoma (HCC). Methods After the inclusion and exclusion process, relevant information was extracted. Heterogeneity between studies was evaluated, and data synthesis was conducted by employing a bivariate random-effects model. Results In total, 20 eligible studies were enrolled. The pooled sensitivity and specificity were 0.86 (95% confidence interval [CI], 0.80–0.90) and 0.88 (95% CI, 0.82–0.92), respectively. The pooled positive likelihood ratio, pooled negative likelihood ratio, and pooled diagnostic odds ratio were 7.1 (95% CI, 4.9–10.2), 0.16 (95% CI, 0.11–0.23), and 44 (95% CI, 25–79), respectively. The results of the linear regression method and visual inspection of the Deeks funnel plot did not indicate significant publication bias. Conclusion Our meta-analysis suggested that lncRNAs have high diagnostic performance for HCC and have the potential for clinical application.

Diagnostic performance of ID Screen® MVV-CAEV Indirect Screening ELISA in identifying small ruminant lentiviruses-infected goats

2014 ◽  
Vol 17 (3) ◽  
pp. 501-506 ◽  
Author(s):  
D. Nowicka ◽  
M. Czopowicz ◽  
M. Mickiewicz ◽  
O. Szaluś-Jordanow ◽  
L. Witkowski ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Serum Sample ◽  
Diagnostic Performance ◽  
Small Ruminant ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Sample Collection ◽  
Serum Samples ◽  
Wide Range ◽  
Small Ruminant Lentiviruses

AbstractDiagnostic performance of ID Screen®MVV-CAEV Indirect Screening ELISA in identifying goats infected with small ruminant lentiviruses (SRLV) was evaluated. In total 299 serum samples from the collection of the Laboratory of Veterinary Epidemiology and Economics - 109 truly positive and 190 truly negative - were used. To be enrolled in the study a serum sample had to come from at least 2 year-old goat which had reacted identically in two serological surveys preceding sample collection and was kept in a herd of stable serological status confirmed at least twice during preceding 5 years. Moreover, in seropositive herds at least 20% of goats had to be serologically positive at the moment when the serum sample was collected for the study. The test proved to have high accuracy. Area under curve was 98.8% (95% CI: 97.5%, 100%). Diagnostic performance of the test was almost identical (Youlden’s index of 90%, sensitivity >90% and specificity >95%) within a fairly wide range of cut-off values - between 20% and 60%. At manufacturer’s cut-off of 50% sensitivity and specificity were 91.7% (95% CI: 85.0%, 95.6%) and 98.9% (95% CI: 96.2%, 99.7%), respectively. For this cut-off positive likelihood ratio was 87 (95% CI: 22, 346) and negative likelihood ratio was 0.08 (95% CI: 0.04, 0.16). In conclusion, the results of this study indicate that ID Screen®MVV-CAEV Indirect Screening ELISA is a highly accurate diagnostic test for SRLV infection.

scholarly journals The role of mHLA-DR in the early diagnosis of sepsis patients with severe trauma: a meta-analysis

2021 ◽  
Author(s):  
Guo-sheng Chen ◽  
Da-Lin Wen ◽  
Jin-Chao Qiu ◽  
Qiang Wang ◽  
Guo-Xuan Peng ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Trauma Patients ◽  
Hla Dr ◽  
Post Traumatic

Abstract Background HLA-DR is a common and significant biomarker in sepsis. However, as a biomarker of post-traumatic sepsis, there are few studies. This meta-analysis was conducted to evaluate the value of HLA-DR in the diagnosis of severe traumatic sepsis. Methods We developed a strategy for literature retrieval from the PubMed, MEDLINE, Web of Science,EMBASE, and Cochrane Library databases. All studies published until June 1, 2021, were retrieved. All studies that were included considered HLA-DR in the diagnosis of adult post-traumatic sepsis, and each study calculated the sensitivities and specificities. Results The study included 8 articles involving 639 trauma patients. combined sensitivity was 0.81 (95% CI, 0.75–0.86), the combined specificity was 0.67 (95% CI, 0.62–0.71), the positive likelihood ratio was 2.29 (95% CI, 1.73–3.04), and the negative likelihood ratio was 0.32 (95% CI, 0.23–0.44). The area under the summary receiver operating characteristic curve was 0.84(95% CI, 0.80–0.87), and the Q index was 0.76. The combined diagnostic odds ratio was 9.11 (95% CI, 5.37–15.45). Conclusions The results of this meta-analysis showed that HLA-DR could be considered as a useful biomarker for the early diagnosis of severe traumatic sepsis. Its sensitivity and diagnostic abilities are excellent. However, its specificity is inadequate. Therefore, it should be combined with other clinical indicators to assess post-traumatic sepsis, and cannot be used in the diagnosis of a disease alone.

scholarly journals miRNA-21 may serve as a promising noninvasive marker of glioma with a high diagnostic performance: a pooled analysis of 997 patients

2021 ◽  
Vol 13 ◽  
pp. 175883592098765
Author(s):  
Xinli Zhao ◽  
Zhihong Xiao ◽  
Bin Li ◽  
Hongwei Li ◽  
Bo Yang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Therapeutic Effects ◽  
Study Region ◽  
Meta Regression

Background: Although various serum and tissue biomarkers have been investigated for glioma diagnosis, no gold standard has been identified. miRNA-21 was demonstrated to be a promising biomarker for the diagnosis of various brain tumors, whereas there remains uncertainty concerning whether miRNA-21 could be used as a good clinical diagnostic biomarker for glioma. The current meta-analysis aimed to evaluate the diagnostic accuracy of miRNA-21 as a potent biomarker in adults with suspected glioma. Methods: The Pubmed and Embase databases were searched systematically from inception to January 2020 to identify relevant research reports. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. Summary receiver operating characteristic (SROC) curves were used to evaluate the overall diagnostic performance. Meta-regression and subgroup analyses were conducted to determine the source of heterogeneity and test the robustness of the results. Results: From 5394 citations with 997 subjects that met the inclusion criteria, 11 studies were selected. Summary estimates of the diagnostic performance of miRNA-21 were as follows: sensitivity, 0.83 [95% confidence interval (CI): 0.73–0.89]; specificity, 0.92 (95% CI: 0.85–0.96); PLR, 10.20 (95% CI: 5.10–20.30); NLR, 0.19 (95% CI: 0.12–0.31); and DOR, 54 (95% CI: 19–155). The area under the SROC curve was 0.94 (95% CI: 0.92–0.96). Deeks’s funnel plot revealed no evidence of publication bias ( p = 0.59). Meta-regression analysis suggested that study publication year could attribute to the heterogeneity. Subgroup analysis found miRNA-21 had a constant high diagnostic accuracy across different ethnicity, glioma grade, sample source, and study region. Conclusion: This meta-analysis demonstrated that miRNA-21 has high diagnostic performance and could serve as a promising noninvasive diagnostic marker for glioma. Further large prospective studies are needed to validate its diagnostic value and its prognostic significance and therapeutic effects.

scholarly journals Diagnostic Role of Four-Dimensional Computed Tomography for Preoperative Parathyroid Localization in Patients with Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 664
Author(s):  
Lixin Sun ◽  
Jian Yao ◽  
Pan Hao ◽  
Yuanyuan Yang ◽  
Zhimou Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
4D Ct ◽  
Patient Level ◽  
Lesion Level ◽  
Sensitivity Specificity

We sought to systematically evaluate diagnostic performance of four-dimensional computed tomography (4D-CT) in the localization of hyperfunctioning parathyroid glands (HPGs) in patients with primary hyperparathyroidism (pHPT). We calculated the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratios (DOR) of 4D-CT on a per-lesion level, as well as pooled sensitivity and positive predictive value (PPV) on a per-patient level with 95% confidence intervals (CIs). Additionally, we plotted summary receiver operating characteristic (SROC) curves and evaluated the areas under the curves (AUC). A total of 16 studies were included in the analysis. Their pooled sensitivity, specificity, PLR, NLR, and DOR of 4D-CT on per-lesion level were 75% (95%CI: 66–82%), 85% (95%CI: 50–97%), 4.9 (95%CI: 1.1–21.3), 0.30 (95%CI: 0.19–0.45), and 17 (95%CI: 3–100), respectively, with an AUC of 81% (95%CI: 77–84%). We also observed heterogeneity in sensitivity (I2 = 79%) and specificity (I2 = 94.7%), and obtained a pooled sensitivity of 81% (95%CI: 70–90%) with heterogeneity of 81.9% (p < 0.001) and PPV of 91% (95%CI: 82–98%) with heterogeneity of 80.8% (p < 0.001), based on a per-patient level. Overall, 4D-CT showed moderate sensitivity and specificity for preoperative localization of HPG(s) in patients with pHPT. The diagnostic performance may improve with 4D-CT’s promotion to first-line use on a lesion-based level, further research is needed to confirm the results.

Sign in / Sign up

Export Citation Format

Share Document