• Title/Summary/Keyword: Cut-off value

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Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

Epidemiological Cut-off Values Generated for Disc Diffusion Data from Photobacterium damselae (Photobacterium damselae의 디스크 확산법 결과에 대한 Epidemiological Cut-off Value의 결정)

  • Kwon, Mun-Gyeong;Lim, Yun-Jin;Kim, Myoung-Sug;Seo, Jung-Soo;Kim, Do-Hyung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.49 no.6
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    • pp.838-844
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    • 2016
  • In this study, epidemiological cut-off values were estimated for 44 Photobacterium damselae isolates, since clinical breakpoints have not been established for this pathogenic bacterium. The susceptibility of the isolates to 10 antibiotics was evaluated using internationally standardized disc diffusion protocols. Normalized resistance interpretation was used to generate statistically valid epidemiological cut-off values for the susceptibility data. There were not enough strains exhibiting full sensitivity to ampicillin and amoxicillin to allow analysis of these antibiotics. Because there were only a marginally sufficient number of strains exhibiting full sensitivity to oxytetracycline, the cut-off value generated provided only a provisional estimate. The valid wild-type cut-off values were <13, 13, 9, 22, 25, 27, and 28 mm for gentamicin, cephalexin, erythromycin, oxolinic acid, flumequine, florfenicol, and sulfamethoxazole/trimethoprim, respectively. The application of these cut-off values should greatly facilitate the rational selection of antibiotics for use in commercial fish farms.

Clinically Significant Cut-off Value of the KS-15 for the Risk of Metabolic Syndrome: Using the Korean Medicine Daejeon Citizen Cohort (KDCC) Study (대전시민코호트 자료를 활용한 대사증후군에 임상적으로 유의한 KS-15의 사상체질 판별 기준)

  • Eun Kyoung, Ahn;Siwoo, Lee;Ji-Eun, Park
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.4
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    • pp.27-37
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    • 2022
  • Objectives The purpose of this study is to propose a method to more specifically identify Sasang constitutional risk factors of metabolic syndromes by adjusting the cut-off value of Korea Sasang Constitutional Diagnostic Questionnaire (KS-15). Methods Data of 1997 participants in Korean medicine Daejeon Citizen Cohort study (KDCC) were analyzed. Metabolic syndrome was defined according to the NCEP-ATP III, lifestyle information, and hematologic information including KS-15 and demographic characteristics were used as covariates. Results The 179 subjects with metabolic syndrome accounted for 9.0% of the total. As a result of determining the Sasang constitution for the KS-15 response based on the cut-off values (approximate 0.33), 0.5, and 0.6 of the constitutional score, when performed at the 0.6 cut-off model, the odds ratio of TE was 2.46 which showed a statistically significantly higher risk than the borderline group. For the accuracy of the model and the Area under the curve (AUC), the model accuracy based on the original cut-off of the KS-15 was 0.902 and AUC was 0.737. The accuracy of the model with cut-off of 0.5 and with of 0.6 were 0.904 and 0.902, respectively, and the AUCs were 0.687 and 0.741, respectively. Conclusion In this study, we confirmed that it is effective to increase the cut-off value of KS-15 to 0.6 in the metabolic syndrome risk model. It is expected that this could increase the accuracy of identifying high-risk groups for metabolic syndrome.

Femoral Condyle Cut-off Sign - New Indirect Sign of Radiologic Finding in Knee with Discoid Lateral Meniscus - (대퇴 외과 절삭 징후(cut-off sign) - 원판형 외측 반월상 연골 예에서 나타나는 새로운 단순 방사선 소견 -)

  • Ha Chul-Won;Sung Ki-Sun;Park Jae-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.215-219
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    • 2003
  • Purpose : To report the 'condylar cut-off sign', a new radiographic sign in knees with discoid lateral meniscus and to report the sensitivity, specificity, positive predictive value and negative predictive value of the sign to elucidate the diagnostic significance of the sign for discoid meniscus. Materials and Methods : Fifty knees with complete discoid lateral meniscus and fifty normal knees formed the basis of this study. All of them were arthroscopically confirmed fer the discoid or normal lateral meniscus. The authors developed a method to measure the length of the medial and lateral condylar were compare and analyzed. Results : Tile average ratio was 0.716 in the discoid meniscus group, and 0.902 in the normal group. The stastistical analysis by the T-test revealed the t-value -11.13(p<0.0001). Stastistical analysis by chi-square test using cut point 0.8, also showed significant difference between the two groups, with $76\%$ sensitivity, $100\%$ specificity, $100\%$ positive predictive predictive value and $81\%$ negative predictive value. The 'condylar cut-off sign' was readily detectable in all cases of discoid lateral meniscus, suggesting that the cut off sign could serve as a simple and reliable radiographic sign fur the diagnosis of discoid meniscus. Conclusion : The condylar cut-off sign on the Tunnel view of simple radiography of the knee can serve as a good sign for the diagnosis of discoid lateral meniscus, with $100\%$ positive predictive value.

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Assessment of Ki-67 for Predicting Effective Prognosis in Breast Cancer Subtypes

  • Park, Sangjung;Park, Sunyoung;Kim, Jungho;Ahn, Sungwoo;Park, Kwang Hwa;Lee, Hyeyoung
    • Biomedical Science Letters
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    • v.24 no.1
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    • pp.9-14
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    • 2018
  • Ki-67 has been widely performed and become an important biomarker in worldwide clinics, but the standard cut off value of Ki-67 index in breast cancer is still controversy. The objective study was to understand the Ki-67 in breast cancer subtypes and to investigate relative risk of breast cancer subtypes according to Ki-67 cut off value in Korean breast cancer. Immunohistochemical staining (IHC) for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 index was examined from 123 breast cancer patients. Ki-67 index was significantly overexpressed in PR, ER, and HER2 hormone negative groups. Ki-67 index in Triple negative and HER2 subtypes was shown significantly higher than that in Luminal A and Luminal B subtype. Then, we compared the relative risk of each subtype according to 14% and 20% Ki-67 cut off value, which were applied in most clinics. Especially, 20% Ki-67 cut off value in HER2 and Triple negative subtypes was shown 8.41 fold and 2.83 fold higher relative risk than this in Luminal A subtype. Moreover, Ki-67 index in HER2 2+ or 3+ status showed significantly overexpressed than this in HER2 1+ status. At the 20% Ki-67 cut off value, HER2 1+ or 2+ status and 3+ status showed significant difference. Therefore, the 20% Ki-67 cut off value will be useful as a precise prognostic management and helpful for interpreting diverse outcomes of other subtypes in breast cancer patients.

Determination of cut-off value by receiver operating characteristic curve of norquetiapine and 9-hydroxyrisperidone concentrations in urine measured by LC-MS/MS

  • Kim, Seon Yeong;Shin, Dong Won;Kim, Jin Young
    • Analytical Science and Technology
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    • v.34 no.2
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    • pp.78-86
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    • 2021
  • The objective of this study was to investigate urinary cut-off concentrations of quetiapine and risperidone for distinction between normal and abnormal/non-takers who were being placed on probation. Liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was employed for determination of antipsychotic drugs in urine from mentally disordered probationers. The optimal cut-off values of antipsychotic drugs were calculated using receiver operating characteristic (ROC) curve analysis. The sensitivity and specificity of the method for the detection of antipsychotic drugs in urine were subsequently evaluated. The area under the ROC curve (AUC) was 0.927 for norquetiapine and 0.791 for 9-hydroxyrisperidone, respectively. These antipsychotic drugs are classified readily in the ROC curve analysis. The cut-off values for distinguishing regular and irregular/non-takers were 39.1 ng/mL for norquetiapine and 67.9 ng/mL for 9-hydroxyrisperidone, respectively. The results of this study suggest the cut-off values of quetiapine and risperidone were highly useful to distinguish regular takers from irregular/non-takers.

Determining Optimal Cut-off Score for the Braden Scale on Assessment of Pressure Injury for Tertiary Hospital Inpatients (상급종합병원 입원환자의 욕창발생 위험예측을 위한 Braden Scale의 타당도 검증)

  • Park, Sook Hyun;Choi, hyeyeon;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.24-33
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    • 2023
  • Purpose : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484-0.579). The sensitivity was 56.6% (45.5-67.7%) and the specificity was 69.7% (66.0-73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p < .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

Development Cut-off Value for Yin-deficiency Questionnaire and Diagnostic Ability of Yin-deficiency in Xerostomia (구강건조증 환자에서 음허 측정 설문지 절단점 개발 및 진단능 평가)

  • Jang, Seung-Won;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.483-497
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    • 2014
  • Objectives: The aims of study were developing cut-off value of Yin-deficiency questionnaire (YDQ) for diagnosis of Yin-deficiency (YD) and compare diagnostic ability between YDQ and Yin-deficiency scale score (YDS) in xerostomia patients. Methods: We recruited 58 xerostomia patients. They were diagnosed YD or non-YD by 3 Korean medicine doctors (KMD). We assessed YD using YDQ and YDS. We evaluated xerostomia using VAS, Dry Mouth Symptom Questionnaire (DMSQ), Salivary Flow Rate (SFR), oral moisture on buccal mucosa and tongue surface (OMB and OMT). We surveyed tongue coatings using Winkel Tongue Coating Index (WTCI). Results: We diagnosed 23 patients YD and 35 patients non-YD. There were no significant differences of age, sex and body mass index between the YD and non-YD groups. Using receiver operating characteristic curve analysis, the optimal cut-off value of YDQ was defined as 304. Sensitivity, specificity and Youden index of YDQ were 86.96%, 71.43% and 1.5839 respectively. Using Cohen's coefficient of agreement, we found that degree of agreement between KMD and YDQ diagnosis was moderate (${\kappa}$=0.524, p<0.001). Using Pearson's correlation analysis, we found concurrent validity of YDQ and YDS were significant correlated. Using area under curve value, we found diagnostic ability between YDQ and YDS were not significantly different (p=0.505), but there were more strong correlations between DMSQ-symptoms and YDQ (r=0.731, p<0.001) than correlations between DMSQ-symptoms and YDS (r=0.418, p<0.01). Conclusions: The cut-off value of YDQ can diagnose YD in xerostomia and diagnostic ability of YDQ in xerostomia is better than YDS.

Determination of epidemiological tetracycline MIC cut-off value for Vibrio ichthyoenteri

  • Han, Hyun-Ja;Kim, Do-Hyung;Lee, Deok-Chan;Won, Kyoung-Mi;Lee, Soon-Jeong;Cho, Mi-Young;Jee, Bo-Young;Kim, Jin-Woo
    • Journal of fish pathology
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    • v.24 no.2
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    • pp.95-102
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    • 2011
  • Normalized resistance interpretation (NRI) analysis for tetracycline was applied to generate information on the epidemiological cut-off value for Vibrio ichthyoenteri isolated from diseased olive flounder (Paralichthys olivaceus) larvae. Thus, 42 strains of V. ichthyoenteri were used to determine minimum inhibitory concentration (MIC) values of tetracycline using Etest. Also, 11 tetracycline resistance related genes were investigated by PCR method. Most tetracycline-resistant strains harbored both tetB and tetM with a few exceptions. NRI-derived mean and 2 SD above the mean of theoretical normal distributions of susceptible isolates were 0.33 mg/L and 1.66 mg/L, respectively. The epidemiological cut-off value for V. ichthyoenteri from the calculations could be set to S ${\leq}$ 2 mg/L. Of the 42 strains, 15 were classified as non-wild type (NWT), and MIC values of the NWT strains vary regardless of tetB and tetM detection, suggesting that there may be other mechanisms involved in tetracycline resistance in this Vibrio species.

Circulating Levels of Adipocytokines as Potential Biomarkers for Early Detection of Colorectal Carcinoma in Egyptian Patients

  • Zekri, Abdel-Rahman N;Bakr, Yasser Mabrouk;Ezzat, Maali Mohamed;Zakaria, Mohamed Serag Eldeen;Elbaz, Tamer Mahmoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6923-6928
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    • 2015
  • Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.