• Title/Summary/Keyword: Accuracy and Agreement of Diagnosis

Search Result 62, Processing Time 0.027 seconds

Study on the Agreement Values of Pulmonary Arterial Hypertension Measured by Cardiac Sonographers (심장초음파 검사자 간의 폐동맥고혈압 진단 측정값 일치도 분석 연구)

  • Seol Hwa KIM;Sundo JUNG
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.55 no.4
    • /
    • pp.269-275
    • /
    • 2023
  • Echocardiography is a non-invasive method that is useful for diagnosing pulmonary arterial hypertension. It is known that echocardiography depends on the experience, education, and knowledge level of the cardiac sonographer. This study aimed to compare the agreement values between cardiac sonographer with different practical experiences in the diagnosis of pulmonary arterial hypertension using echocardiography. Three readers re-evaluated the echocardiography images of 148 patients who were diagnosed with pulmonary arterial hypertension at the S Medical Center from January 1, 2020, to December 31, 2020. The echocardiography values measured by each reader were compared and analyzed. The results of the analysis of discrete variables revealed that the agreement values of the cardiac sonographers showed excellent consistency for both reader 3 and the cardiologist group, indicating that more experience leads to better predictive accuracy for diagnosis of the condition. Furthermore, in terms of continuous variables, all the cardiac sonographer demonstrated good agreement in the measured values of the right atrium, which was easier to assess and clearer than the structurally complex measurements of the right ventricle. This study represents the first analysis in Korea of the agreement values measured by medical technologists who are cardiac sonographers.

Diagnostic Accuracy, Sensitivity, Specificity and Positive Predictive Value of Fine Needle Aspiration Cytology (FNAC) in Intra Oral Tumors

  • Gillani, Munazza;Akhtar, Farhan;Ali, Zafar;Naz, Irum;Atique, Muhammad;Khadim, Muhammad Tahir
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.8
    • /
    • pp.3611-3615
    • /
    • 2012
  • Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

Source Image Based New 3D Rotational Angiography for Differential Diagnosis between the Infundibulum and an Internal Carotid Artery Aneurysm : Pilot Study

  • Jang, Hyeongyu;Jung, Woo Sang;Myoung, Seong Uk;Kim, Jung-Jae;Jang, Chang Ki;Cho, Kwang-Chun
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.5
    • /
    • pp.726-731
    • /
    • 2021
  • Objective : Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum. Methods : Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA). The data were retrospectively and independently reviewed by two neurointerventionists, and the diagnoses based on TOF MRA, S-n3DRA, and DSA were compared. The diagnostic efficacy (interobserver agreement and diagnostic performance) of S-n3DRA was compared with that of TOF MRA. Results : S-n3DRA showed higher interobserver agreement (κ=0.923) than TOF MRA (κ=0.465) and significantly higher accuracy than MRA in distinguishing an aneurysm from an infundibulum (p=0.0039). Conclusion : Compared to MRA, S-n3DRA could provide better screening accuracy and information for distinguishing an aneurysm from an infundibulum. Therefore, S-n3DRA has the potential to reduce the need for DSA.

Accuracy of Bolton analysis measured in laser scanned digital models compared with plaster models (gold standard) and cone-beam computer tomography images

  • Kim, Jooseong;Lagravere, Manuel O.
    • The korean journal of orthodontics
    • /
    • v.46 no.1
    • /
    • pp.13-19
    • /
    • 2016
  • Objective: The aim of this study was to compare the accuracy of Bolton analysis obtained from digital models scanned with the Ortho Insight three-dimensional (3D) laser scanner system to those obtained from cone-beam computed tomography (CBCT) images and traditional plaster models. Methods: CBCT scans and plaster models were obtained from 50 patients. Plaster models were scanned using the Ortho Insight 3D laser scanner; Bolton ratios were calculated with its software. CBCT scans were imported and analyzed using AVIZO software. Plaster models were measured with a digital caliper. Data were analyzed with descriptive statistics and the intraclass correlation coefficient (ICC). Results: Anterior and overall Bolton ratios obtained by the three different modalities exhibited excellent agreement (> 0.970). The mean differences between the scanned digital models and physical models and between the CBCT images and scanned digital models for overall Bolton ratios were $0.41{\pm}0.305%$ and $0.45{\pm}0.456%$, respectively; for anterior Bolton ratios, $0.59{\pm}0.520%$ and $1.01{\pm}0.780%$, respectively. ICC results showed that intraexaminer error reliability was generally excellent (> 0.858 for all three diagnostic modalities), with < 1.45% discrepancy in the Bolton analysis. Conclusions: Laser scanned digital models are highly accurate compared to physical models and CBCT scans for assessing the spatial relationships of dental arches for orthodontic diagnosis.

The discrimination model for the pattern identification diagnosis of the stroke (중풍의 변증 진단을 위한 판별모형)

  • Kang, Byeong-Kab;Kang, Kyung-Won;Park, Sae-Wook;Kim, Bo-Young;Kim, Jeong-Chul;Go, Mi-Mi;Seol, In-Chan;Jo, Hyun-Kyung;Lee, In;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
    • /
    • v.13 no.2 s.20
    • /
    • pp.59-63
    • /
    • 2007
  • The purpose of this study was to diagnosis that what patterns identification using the statistical method. Discriminant analysis using the medical specialist and resident pattern identification agree case in stroke patients within 1 month of onset. The agreement rate of dificiency of Gi(75%), heat-transformation(74%), dampphlegm syndrome(69%), deficiency of Eum(51%) and syndrome of blood stagnation(43%) are respectively 0.75, 0.74, 0.69, 0.51 and 0.43 in medical specialist and using linear discriminant function pattern identification are same. The study of inspection, pulse feeling and palpitation will be continued to evaluate concordance rate. Discrimination model will be make to get higher Accuracy and prediction, it means becomes the help in pattern identification diagnosis objectivity and scientific.

  • PDF

Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.28 no.3
    • /
    • pp.317-325
    • /
    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

  • PDF

Diagnosis of Hirschsprung's Disease of Neonate and Infant (신생아 및 영아기의 허쉬슈프렁병 진단)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, Kyung-Mo;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Kim, Jung-Sun;Goo, Hyun-Woo;Yoon, Chong-Hyun;Kim, Jin-Cheon;Pil, Soo-Young;Kim, In-Koo
    • Advances in pediatric surgery
    • /
    • v.8 no.1
    • /
    • pp.1-5
    • /
    • 2002
  • Diagnosing Hirschsprung's disease is a clinical challenge. Hirschsprung's disease should be considered in any child who has a history of constipation dating back to the newborn period. We examined diagnostic methods and their results retrospectively in 37 neonates and infants who underwent both barium enema and anorectal manometry for the diagnosis of Hirschsprungs disease at Asan Medical Center between January 1999 and April 2001. Two radiologists and a surgeon repeatedly reviewed both of the diagnostic results. In anorectal manometry, thirty-four studies were in agreement with the definitive diagnosis, giving an overall diagnostic accuracy of 91.9 % (neonate; 100 %, infant; 85.7 %). The accuracy and specificity of barium enema was lower than those of anorectal manometry, but sensitivity was higher. There was no significant difference between the two methods. Both studies showed findings consistent with the final diagnosis. However, discordant results needed further evaluation or close observation to diagnose accurately. We conclude that Hirschsprungs disease should not be diagnosed by only one diagnostic method.

  • PDF

A Study on the Factors Affecting Examinee Classification Accuracy under DINA Model : Focused on Examinee Classification Methods (DINA 모형에서 응시생 분류 정확성에 영향을 미치는 요인 탐구 : 응시생 분류방법을 중심으로)

  • Kim, Ji-Hyo
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.14 no.8
    • /
    • pp.3748-3759
    • /
    • 2013
  • The purpose of this study was to examine the classification accuracies of ML, MAP, and EAP methods under DINA model. For this purpose, this study examined the classification accuracies of the classification methods under the various conditions: the number of attributes, the ability distribution of examinees, and test length. To accomplish this purpose, this study used a simulation method. For the simulation study, data was simulated under the various simulation conditions including the number of attributes (K= 5, 7), the ability distribution of examinees (high, middle, low), and test length (J= 15, 30, 45). Additionally, the percent of agreements between true skill patterns(true ${\alpha}$) and skill patterns estimated by the ML, MAP, and EAP methods were calculated. The summary of the main results of this study is as follows: First, When the number of attributes was 5 and 7, the EAP method showed relatively higher average in the percent of exact agreement than the ML and MAP methods. Second, under the same conditions, as the number of attributes increased, the average percent of exact agreement decreased in ML, MAP, and EAP methods. Third, when the prior distribution of examinees ability was different from low to high under the conditions of the same test length, the EAP method showed relatively higher average in the percent of exact agreement than those of the ML and MAP methods. Fourth, the average percent of exact agreement increased in all methods, ML, MAP, and EAP when the test length increased from 15 to 30 and 45 under the conditions of the same the ability distribution of examinees.

Production of Spirometer 'The Spirokit' and Performance Verification through ATS 24/26 Waveform (휴대형 폐기능 검사기 'The Spirokit'의 제작 및 ATS 24/26파형을 통한 성능검증)

  • Byeong-Soo Kim;Jun-Young Song;Myung-Mo Lee
    • Journal of Korean Physical Therapy Science
    • /
    • v.30 no.3
    • /
    • pp.49-58
    • /
    • 2023
  • Background: This study aims to examine the useful- ness of the portable spirometer "The Spirokit" as a clinical diagnostic device through technology introduction, precision test, and correction. Design: Technical note Methods: "The Spirokit" was developed using a propeller-type flow rate and flow rate measurement method using infrared and light detection sensors. The level of agreement between the Pulmonary Waveform Generator and the measured values was checked to determine the precision of "The Spirokit", and the correction equation was included using the Pulmonary Waveform Generator software to correct the error range. The analysis was requested using the ATS 24/26 waveform recognized by the Ministry of Food and Drug Safety and the American Thoracic Society for the values of Forced Voluntary Capacity (FVC), Forced Expiratory Volume in 1second (FEV1), and Peak Expiratory Flow (PEF), which are used as major indicators for pulmonary function tests. All tests were repeated five times to derive an average value, and FVC and FEV1 presented accuracy and PEF presented accuracy as the result values. Results: FVC and FEV1 of 'The Spirokit' developed in this study showed accuracy within ± 3% of the error level in the ATS 24 waveform. The PEF value of 'The Spirokit' showed accuracy within the error level ± 12% of the ATS 26 waveform. Conclusion: Through the results of this study, the precision of 'The Spirokit' as a clinical diagnosis device was identified, and it was confirmed that it can be used as a portable pulmonary function test that can replace a spirometer.

A Homogeneous Immunoassay Method for Detecting Interferon-Gamma in Patients with Latent Tuberculosis Infection

  • Wu, Fei;Wang, Lin;Guo, Qiaomei;Zhao, Mingna;Gu, Hongchen;Xu, Hong;Lou, Jiatao
    • Journal of Microbiology and Biotechnology
    • /
    • v.26 no.3
    • /
    • pp.588-595
    • /
    • 2016
  • IFN-γ release assays (IGRAs) have been developed as viable alternative diagnostic tools for detecting latent tuberculosis infection (LTBI). A customized homogeneous sandwich luminescent oxygen channeling immunoassay (LOCI) was used to quantify IFN-γ levels in IGRAs. Samples were collected from healthy volunteers (n = 40) who were T-Spot-negative and T-Spot-positive patients (n = 32) at rest. Then the amount of IFN-γ in the supernatant of IGRAs was measured by LOCI. The results demonstrated a low background, and high sensitivity, specificity, accuracy, and reproducibility, and a short assay time (only 30 min) with LOCI for IFN-γ. The recovery range was 81.63-102.06%, the coefficients of variation were below 5%, and the limit of detection was 19.0 mIU/ml. Excellent agreement between LOCI IFN-γ and the T-SPOT.TB test was obtained (97.2% agreement, κ = 0.94). The LOCI IFN-γ concentrations were significantly higher in T-Spot-positive patients than in the healthy group (p < 0.001). Moreover, as observed for the comparative LOCI IFN-γ assay, IFN-γ concentrations were related to the numbers of T-SPOT.TB spots. We have established an in vitro blood test for LTBI diagnosis, defined as LOCI IFN-γ. A high level of agreement between the LOCI IFN-γ method and T-SPOT.TB assay was observed in clinical studies that showed the LOCI IFN-γ method could determine LTBI. This study shows acceptable performance characteristics of the LOCI IFN-γ assay to diagnose LTBI.