scholarly journals The T2-FLAIR Mismatch Sign as an Imaging Indicator of IDH-Mutant, 1p/19q Non-Codeleted Lower Grade Gliomas: A Systematic Review and Diagnostic Accuracy Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1620
Author(s):  
Antonis Adamou ◽  
Eleftherios T. Beltsios ◽  
Panagiotis Papanagiotou
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
False Negative ◽  
Diagnostic Odds Ratio ◽  
Lower Grade ◽  
Mri Scan ◽  
Negative Results ◽  
False Negative Results ◽  
The Brain

The study’s objective was the evaluation of the diagnostic accuracy of the T2-FLAIR mismatch sign in terms of diagnosing IDH-mutant non-codeleted (IDHmut-Noncodel) lower grade gliomas (LGG) of the brain. We searched the MEDLINE, Scopus and Cochrane Central databases. The last database search was performed on 12 April 2021. Studies that met the following were included: MRI scan assessing the presence of T2-FLAIR mismatch sign, and available IDH mutation and 1p/19q codeletion status. The quality of studies was assessed using the QUADAS-2 tool. Twelve studies involving 14 cohorts were included in the quantitative analysis. The diagnostic odds ratio [DOR (95% confidence interval; CI)] was estimated at 34.42 (20.95, 56.56), Pz < 0.01. Pooled sensitivity and specificity (95% CI) were estimated at 40% (31–50%; Pz = 0.05) and 97% (93–99%; Pz < 0.01), respectively. The likelihood ratio (LR; 95% CI) for a positive test was 11.39 (6.10, 21.29; Pz < 0.01) and the LR (95% CI) for a negative test was 0.40 (0.24, 0.65; Pz < 0.01).The T2-FLAIR mismatch sign is a highly specific biomarker for the diagnosis of IDHmut-Noncodel LGGs. However, the test was found positive in some other tumors and had a high number of false negative results. The diagnostic accuracy of the mismatch sign might be improved when combined with further imaging parameters.

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.

scholarly journals Diagnostic accuracy of prostate cancer antigen 3 (PCA3) prior to first prostate biopsy: A systematic review and meta-analysis

2019 ◽  
Vol 14 (5) ◽  
Author(s):  
Sandra Viviana Muñoz Rodríguez ◽  
Herney Andrés García-Perdomo
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Biopsy ◽  
Reference Lists ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Cancer Antigen ◽  
Prostate Cancer Antigen

Introduction: We aimed to determine the diagnostic accuracy of the prostate cancer antigen 3 (PCA3) test before performing the first biopsy compared with prostate biopsy for the diagnosis of prostate cancer. Methods: A systematic search was performed in MEDLINE, EMBASE, CENTRAL, LILACS, reference lists, specialized journals in urology and cancer, and unpublished literature. The population was adults with suspected prostate cancer, and the intervention was the measurement of PCA3 in urine samples for the diagnosis of prostate cancer. The quality of studies was evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The operative characteristics were determined, and a meta-analysis was performed. Results: Nine studies of diagnostic tests were included based on a cutoff value of 35. The following overall values were obtained: the sensitivity was 0.69 (95% confidence interval [CI] 0.61–0.75); specificity was 0.65 (95% CI 0.553–0.733); the diagnostic odds ratio (DOR) was 4.244 (95% CI 3.487–5.166); and the area under the curve was 0.734 (95% CI 0.674–0.805) with a heterogeneity of 0%. Conclusions: Urinary PCA3 has an acceptable diagnostic accuracy, aids in the study of patients with suspected prostate cancer, and can be used as a guide for directing the performance of the first prostate biopsy and decreasing unnecessary biopsies.

scholarly journals False Covid-19 Test Results – Could We Do Things Better? A Personal Opinion

2020 ◽  
Vol 8 (5) ◽  
Author(s):  
Suzanne Lisbeth Ekelund
Keyword(s):  
False Positive ◽  
False Negative ◽  
Test Results ◽  
Negative Results ◽  
False Negative Results ◽  
Personal Opinion ◽  
Potential Problems

This paper describes the problems with false covid-19 test results, both false positive and false negative results. The problems are related to the quality of tests, test sampling and the currently limited follow-up procedures. A test and follow-up strategy that could decrease the potential problems is suggested.

scholarly journals Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari syndrome: systematic review and meta-analysis

2020 ◽  
Vol 93 (1109) ◽  
pp. 20190847 ◽  
Author(s):  
Pankaj Gupta ◽  
Varun Bansal ◽  
Praveen Kumar-M ◽  
Saroj K Sinha ◽  
Jayanta Samanta ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Sensitivity Specificity ◽  
Ct And Mri

Objective: To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS). Methods: We performed a literature search in PubMed, Embase, and Scopus to identify articles reporting the diagnostic accuracy of Doppler ultrasound, CT, and MRI (either alone or in combination) for BCS using catheter venography or surgery as the reference standard. The quality of the included articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: 11 studies were found eligible for inclusion. Pooled sensitivities and specificities of Doppler ultrasound were 89% [95% confidence interval (CI), 81–94%, I2 = 24.7%] and 68% (95% CI, 3–99%, I2 = 95.2%), respectively. Regarding CT, the pooled sensitivities and specificities were 89% (95% CI, 77–95%, I2 = 78.6%) and 72% (95% CI, 21–96%, I2 = 91.4%), respectively. The pooled sensitivities and specificities of MRI were 93% (95% CI, 89–96%, I2 = 10.6%) and 55% (95% CI, 5–96%, I2 = 87.6%), respectively. The pooled DOR for Doppler ultrasound, CT, and MRI were 10.19 (95% CI: 1.5, 69.2), 14.57 (95% CI: 1.13, 187.37), and 20.42 (95% CI: 1.78, 234.65), respectively. The higher DOR of MRI than that of Doppler ultrasound and CT shows the better discriminatory power. The area under the curve for MRI was 90.8% compared with 88.4% for CT and 86.6% for Doppler ultrasound. Conclusion: Doppler ultrasound, CT and MRI had high overall diagnostic accuracy for diagnosis of BCS, but substantial heterogeneity was found. Prospective studies are needed to investigate diagnostic performance of these imaging modalities. Advances in knowledge: MRI and CT have the highest meta-analytic sensitivity and specificity, respectively for the diagnosis of BCS. Also, MRI has the highest area under curve for the diagnosis of BCS.

scholarly journals EUS-Guided FNA for Diagnosis of Pancreatic Cystic Lesions: a Meta-Analysis

2015 ◽  
Vol 36 (3) ◽  
pp. 1197-1209 ◽  
Author(s):  
Qi-Xian Wang ◽  
Jun Xiao ◽  
Matthew Orange ◽  
Hu Zhang ◽  
You-Qing Zhu
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Needle Aspiration ◽  
Cystic Lesions ◽  
Clinical Tool ◽  
Current Standard ◽  
Summary Receiver Operating Characteristic ◽  
Fluid Analysis

Background: Preoperative diagnosis of pancreatic cystic lesions (PCLs) must be reliable as the current standard treatment, major or total pancreatectomy, dramatically affects quality of life. Additionally, early diagnosis of malignancy is essential to an improved prognosis. The diagnostic accuracy of fluid analysis using endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been demonstrated in pancreatic solid lesions. The utility of this technique in the diagnosis of PCLs is still unknown. Methods: A comprehensive search was performed in multiple databases. Studies differentiating benign and malignant PCLs via EUS-FNA were included in this meta-analysis. The quality of diagnostic accuracy studies (QUADAS) was adopted to evaluate the selected studies. Pooled sensitivity, specificity, likelihood ratio, diagnostic odds ratio, and summary receiver operating characteristic (sROC) curve analyses were conducted. Two main classification types of malignancy were characterized and analyzed. We also generated a subgroup analysis of available clinical factors. Publication bias was evaluated by Begg's and Egger's tests. Results: Sixteen studies containing 1024 subjects have been published. The pooled sensitivity for malignant cytology according to classification 1 was 0.51 (95% CI, 0.45-0.58), and pooled specificity was 0.94 (95% CI, 0.92-0.96). When the detected PCLs were identified as classification 2, suspicious malignancy or potential malignancy, sensitivity and specificity were similar, 0.52 (95% CI, 0.46-0.57) and 0.97 (95% CI, 0.95-0.98) respectively. Conclusion: This meta-analysis demonstrates that EUS-FNA is a reliable clinical tool for the diagnosis of PCLs. However, a more accurate algorithm is needed to reduce various biases and to improve the sensitivity of EUS-FNA in the detection of malignant PCLs.

scholarly journals Diagnostic Value of Endoscopic Ultrasound after Neoadjuvant Chemotherapy for Gastric Cancer Restaging: A Meta-Analysis of Diagnostic Test

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 100
Author(s):  
Victor Mihai Sacerdotianu ◽  
Bogdan Silviu Ungureanu ◽  
Sevastita Iordache ◽  
Adina Turcu-Stiolica ◽  
Antonio Facciorusso ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Diagnostic Test ◽  
Endoscopic Ultrasound ◽  
Meta Analysis ◽  
False Negative ◽  
Diagnostic Value ◽  
Significant Heterogeneity ◽  
True Negative ◽  
Negative Results ◽  
False Negative Results

This study aimed to evaluate the diagnostic value of endoscopic ultrasound (EUS) after neoadjuvant therapy (NT) for gastric cancer restaging by meta-analysis. We conducted a systematic search of studies published on PubMed and Web of Science up to 30th August 2021. Assessing the risk of bias in the included studies was done with the QUADAS-2 tool. We used R and Review Manager 5.4.1 for calculations and statistical analysis. To evaluate the diagnostic value of EUS after NT for gastric cancer restaging, we performed a meta-analysis on six studies, with a total of 283 patients, including true-positive, true-negative, false-positive, and false-negative results for T1-T4, N0. EUS as a diagnostic test for GC patients after chemotherapy has a relatively low DOR for the T2 (3.96) and T4 stages (4.79) and a relatively high partial AUC for the T2 (0.85) and T4 (0.71) stages. Our results reveal that the pooled sensitivity for T stages after chemotherapy is rather low (29–56%), except for the T3 stage (71%). A potential limitation of our study was the small number of included studies, but no significant heterogeneity was found between them. Our meta-analysis concludes that EUS is not recommended or is still under debate for GC restaging after NT.

Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature

2012 ◽  
Vol 141 (1) ◽  
pp. 22-32 ◽  
Author(s):  
M. L. SIGNORINI ◽  
J. LOTTERSBERGER ◽  
H. D. TARABLA ◽  
N. B. VANASCO
Keyword(s):  
Direct Method ◽  
Meta Analysis ◽  
False Negative ◽  
Area Under The Curve ◽  
Disease Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stage Of Disease ◽  
Negative Results ◽  
Igm Elisa ◽  
False Negative Results

SUMMARYWe report an evaluation of the accuracy of ELISA for the detection ofLeptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770–0·789) and 0·913 (95% CI 0·908–0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.

scholarly journals Rapid detection of microbial contamination in UHT milk: practical application in dairy industry 

2018 ◽  
Vol 36 (No. 5) ◽  
pp. 357-364
Author(s):  
Martina Kračmarová ◽  
Hana Stiborová ◽  
Šárka Horáčková ◽  
Kateřina Demnerová
Keyword(s):  
Microbial Contamination ◽  
False Negative ◽  
Bacterial Count ◽  
Total Bacterial Count ◽  
Microbial Quality ◽  
Uht Milk ◽  
Negative Results ◽  
False Negative Results ◽  
Dairy Plant

Microbial quality of ultra-high temperature (UHT) milk is usually ascertained by a total bacterial count (TBC) cultivation. But this is time consuming, so there is a tendency to search for faster and simpler methods. We compared three instruments, focusing on shortening the detection time and their suitability for practical use in dairy plants. Two of them, RapiScreen Dairy 1000 and Promilite III, detect microbial contamination by measuring adenosine triphosphate bioluminescence; the third, GreenLight, is based on oxygen consumption analysis. In the laboratory experiments, samples of UHT milk, were spiked with low concentration of microorganisms and then the level of microbial contamination was evaluated using the above-mentioned instruments together with cultivation method as a control. The instruments were also applied in a dairy plant to test 182 real samples. All investigated methods determined microbial quality faster than the TBC, but in some cases false positive and false negative results were obtained. Therefore, precise testing including optimizing pre-incubation time for bacteria enrichment is needed prior to industrial use. 

scholarly journals Evaluation of the quality of functioning of artificial neural network with logic outputs in the diagnosis of diseases of hepatopancreatoduodenal zone

2017 ◽  
Vol 98 (6) ◽  
pp. 928-932 ◽  
Author(s):  
V A Lazarenko ◽  
A E Antonov
Keyword(s):  
Neural Network ◽  
Artificial Neural Network ◽  
False Negative ◽  
Activation Function ◽  
Negative Results ◽  
False Negative Results ◽  
Artificial Neural ◽  
Sensitivity Specificity ◽  
Diagnosis Of Diseases

Aim. To develop a set of information methods to improve the quality of neural network diagnosis of diseases of hepatopancreatoduodenal zone. Methods. The study involved 385 patients with peptic ulcer, cholecystitis and pancreatitis undergoing in-patient treatment in medical organizations of the city of Kursk. For data mining internally developed software «System of Intellectual Analysis and Diagnosis of Diseases» was used which is an environment for the creation, adjustment, training and practical clinical application of an artificial neural network, such as a multilayer perceptron with an activation function - hyperbolic tangent. Results. Hyperbolic tangent (activation function) of the output layer’s neuron takes the value OUT ∈ ℝ ∧ OUT ∈ (-1; 1) which requires an interpretation. For logic network gates, for example, presence/absence of a disease, it can be performed by comparison with an arbitrarily assigned threshold yB ∈ (0; 1). In this approach, the values are interpreted as false (if y ≤-yB), undefined if y ∈ (-yB; yB), or true (if y ≥yB). Network operation control includes calculation of sensitivity, specificity, false positive and false negative results, for which the comparison of arrays of pairs of calculated and empirical values is carried out. In case of artificial neural network use for diagnosing diseases of hepatopancreatoduodenal zone, the optimal mode was achieved assigning yB≈0.3 as a threshold of the output neuron activation function. Conclusion. Assessing the quality of the ability of artificial neural network with logic outputs to diagnose hepatopancreatoduodenal zone diseases, as well as its controlled setting, is most effective by evaluation of sensitivity, specificity, frequency of false positive and false negative results at the threshold value yB≈0.3; the demonstrated sensitivity (83-94.7%) and specificity (83-97.8%) levels are comparable to the traditionally used diagnostic methods.

scholarly journals Expression of CK-19, galectin-3, and HBME-1 in the differentiation of thyroid lesions: Systematic review and DIAGNOSTIC meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21151-e21151
Author(s):  
Leandro Luongo Matos ◽  
Adriana Braz Del Giglio ◽  
Carolina MATSUBAYASHI Ogawa ◽  
Michelle de lima Farah ◽  
Maria Aparecida Silva Pinhal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Gland ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
False Negative ◽  
Diagnostic Odds Ratio ◽  
Cytokeratin 19 ◽  
Benign Lesions ◽  
Galectin 3 ◽  
Thyroid Lesions

e21151 Background: The distinction between malignant and benign lesions of the thyroid gland often requires histological demonstration, once the fine-needle aspiration biopsy method applied pre-operatively has some limitations. In an attempt to improve diagnostic accuracy, markers have been studied by immunocyto- and immunohistochemistry techniques, mainly cytokeratin-19 (CK-19), galectin-3 (Gal-3) and Hector Battifora mesothelial-1 (HBME-1). However, current results remain controversial. The aim of the present article was to establish the diagnostic accuracy of CK-19, Gal-3 and HBME-1 markers, as well as their associations, in the differentiation of malignant and benign thyroid lesions. Methods: A systematic review of MEDLINE’s published articles was performed. After establishing the inclusion and exclusion criteria, 65 articles were selected. The technique of meta-analysis of diagnostic accuracy was employed, and global values of sensitivity, specificity, area under the ROC curve (AUC), and diagnostic odds ratio (dOR) were calculated. Results: The positivity ofCK-19 for the diagnosis of malignant thyroid lesions demonstrated sensitivity of 81% (IC95%: 79-83%), specificity of 73% (IC95%: 70-75%), AUC of 87,5% and dOR of 14,7 (IC95%: 8,2-26,4); for Gal-3, sensitivity of 82% (IC95%: 81-84%), specificity of 81% (IC95%: 79-82%), AUC of 90% and dOR of 23,4 (IC95%: 14,0-39,1); and for HBME-1, sensitivity of 77% (IC95%: 76-79%), specificity of 83% (IC95%: 82-85%), AUC of 92,8% and dOR of 41,0 (IC95%: 21,4-78,4). The association of the three markers determined sensitivity of 85% (IC95%: 78-90%), specificity of 97% (IC95%: 90-99%), AUC of 93,3% and dOR of 95,1 (IC95%: 25,2-359,1). Conclusions: The search for new molecular markers must continue in order to enhance the diagnostic accuracy of the differentiation between malignant and benign lesions of the thyroid gland, since the results found still show persistency of false-negative and false-positive tests.

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