• 제목/요약/키워드: Diagnostic Accuracy

검색결과 1,063건 처리시간 0.031초

Diagnostic Accuracy of the Quidel Sofia Rapid Influenza Fluorescent Immunoassay in Patients with Influenza-like Illness: A Systematic Review and Meta-analysis

  • Lee, Jonghoo;Song, Jae-Uk;Kim, Yee Hyung
    • Tuberculosis and Respiratory Diseases
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    • 제84권3호
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    • pp.226-236
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    • 2021
  • Background: Although the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) is widely used to identify influenza A and B, the diagnostic accuracy of this test remains unclear. Thus, the objective of this study was to determine the diagnostic performance of this test compared to reverse transcriptase-polymerase chain reaction. Methods: A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of this test for identifying influenza A and B were determined using meta-analysis. A sensitivity subgroup analysis was performed to identify potential sources of heterogeneity within selected studies. Results: We identified 17 studies involving 8,334 patients. Pooled sensitivity, specificity, and DOR of the Quidel Sofia rapid influenza FIA for identifying influenza A were 0.78 (95% confidence interval [CI], 0.71-0.83), 0.99 (95% CI, 0.98-0.99), and 251.26 (95% CI, 139.39-452.89), respectively. Pooled sensitivity, specificity, and DOR of this test for identifying influenza B were 0.72 (95% CI, 0.60-0.82), 0.98 (95% CI, 0.96-0.99), and 140.20 (95% CI, 55.92-351.54), respectively. The area under the HSROC for this test for identifying influenza A was similar to that for identifying influenza B. Age was considered a probable source of heterogeneity. Conclusion: Pooled sensitivities of the Quidel Sofia rapid influenza FIA for identifying influenza A and B did not quite meet the target level (≥80%). Thus, caution is needed when interpreting data of this study due to substantial betweenstudy heterogeneity.

Contrast-Enhanced Spectral Mammography Versus Ultrasonography: Diagnostic Performance in Symptomatic Patients with Dense Breasts

  • Zhongfei Lu;Cuijuan Hao;Yan Pan;Ning Mao;Xin Wang;Xundi Yin
    • Korean Journal of Radiology
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    • 제21권4호
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    • pp.442-449
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    • 2020
  • Objective: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) versus ultrasonography (US) in symptomatic patients with dense breasts, while using histology as the gold standard. Materials and Methods: After obtaining approval from the local ethics board, this prospective study collected data from patients with symptomatic breasts who underwent CESM and US examinations from May 1, 2017 to September 30, 2017. We then selected those with dense breasts and pathological results as our sample population. Both CESM and US results were classified by a radiologist through the Breast Imaging Reporting and Data System, and the results were compared with their corresponding histological results. The chi-square test was conducted to compare the diagnostic performance of CESM and US, and the receiver operating characteristic curves for the two imaging modalities were obtained. Results: A total of 131 lesions from 115 patients with dense breasts were included in this study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 93.8%, 88.1%, 88.2%, 93.7%, and 90.8% for CESM, and 90.6%, 82.1%, 82.9%, 90.2%, and 86.3% for US, respectively. The p values for sensitivity, specificity, PPV, NPV, and accuracy were 0.687, 0.388, 0.370, 0.702, and 0.238, respectively. The area under the curve of CESM (0.917) was comparable with that of US (0.884); however, the differences between CESM and US were not statistically significant (p = 0.225). Eight false-positive cases and 4 false-negative cases for breast cancer were found in CESM, while 12 false-positive cases and 6 false-negative cases were found in US. Conclusion: The diagnostic performances of CESM and US are comparable in symptomatic women with dense breasts; however, the routine use of additional US imaging is questionable for lesions that can be detected by CESM.

$^{99m}Tc-MIBI$ 심근 SPECT에서 180도와 360도 데이터 집적의 비교 (Comparison between $180^{\circ}$ and $360^{\circ}$ Data Collection in $^{99m}Tc-MIBI$ Myocardial SPECT)

  • 강건욱;이동수;곽철은;현인영;정준기;이명철;고창순
    • 대한핵의학회지
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    • 제29권4호
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    • pp.478-483
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    • 1995
  • We compared the influences of reconstruction methods using $180^{\circ}$ or $360^{\circ}$ data upon contrasts and discriminating capability and diagnostic accuracy in $^{99m}Tc-MIBI$ stress/rest myocardial SPECT. We reviewed SPECT images reconstructed only with $180^{\circ}$ projection data or with $360^{\circ}$ data in 18 patients and in 11 normal subjects. To compare counts of surface structures and deep structures, we measured ape# posterior wall ratios in 11 normal subjects. To compare the contrasts of images, we measured apex/ventricle ratios. To compare contrasts between normal and diseased myocardial segments, we measured count ratios of defect and normal segments in 4 patients who had single coronary artery diseases. To compare diagnostic accuracy, we scored SPECT images made with $180^{\circ}$ and $360^{\circ}$ data segmentally. Sensitivity and specificity for the diagnosis of coronary artery disease and for the revelation of diseased arteries with both $180^{\circ}$ and $360^{\circ}$ SPECT images. If involved coronary arteries had more narrowing than 50% In coronary angiogram, we considered them as diseased arteries Apex/posterior wall ratios were not different significantly in normal subjects. Apex/ ventricle ratios in normal subjects were different significantly between $180^{\circ}$ and $360^{\circ}$ SPECT images. Defect/normal ratios were different significantly between $180^{\circ}$ and $360^{\circ}$ SPECT images in single vessel disease patients. The overall diagnostic accurracy was the same between $180^{\circ}$ and $360^{\circ}$ data collection. Sensitivity was 94% and specificity was 91% for both types of data collection in this sample population. Sensitivity and specificity of each coronary artery territory were not significantly different between the images made with $180^{\circ}$ and $360^{\circ}$ data. The images made with $180^{\circ}$ data had better contrast between ventricle and myocardium and between hypoperfused and normal myocardium, though no difference was found between the ratios of the myocardial counts of surface and deep structures. However, diagnostic sensitivities of diseased artery territories were not different significantly and so were overall diagnostic accuracy between both methods of making images with $180^{\circ}$ and $360^{\circ}$ data.

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MRI Evaluation of Suspected Pathologic Fracture at the Extremities from Metastasis: Diagnostic Value of Added Diffusion-Weighted Imaging

  • Sun-Young Park;Min Hee Lee;Ji Young Jeon;Hye Won Chung;Sang Hoon Lee;Myung Jin Shin
    • Korean Journal of Radiology
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    • 제20권5호
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    • pp.812-822
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    • 2019
  • Objective: To assess the diagnostic value of combining diffusion-weighted imaging (DWI) with conventional magnetic resonance imaging (MRI) for differentiating between pathologic and traumatic fractures at extremities from metastasis. Materials and Methods: Institutional Review Board approved this retrospective study and informed consent was waived. This study included 49 patients each with pathologic and traumatic fractures at extremities. The patients underwent conventional MRI combined with DWI. For qualitative analysis, two radiologists (R1 and R2) independently reviewed three imaging sets with a crossover design using a 5-point scale and a 3-scale confidence level: DWI plus non-enhanced MRI (NEMR; DW set), NEMR plus contrast-enhanced fat-saturated T1-weighted imaging (CEFST1; CE set), and DWI plus NEMR plus CEFST1 (combined set). McNemar's test was used to compare the diagnostic performances among three sets and perform subgroup analyses (single vs. multiple bone abnormality, absence/presence of extra-osseous mass, and bone enhancement at fracture margin). Results: Compared to the CE set, the combined set showed improved diagnostic accuracy (R1, 84.7 vs. 95.9%; R2, 91.8 vs. 95.9%, p < 0.05) and specificity (R1, 71.4% vs. 93.9%, p < 0.005; R2, 85.7% vs. 98%, p = 0.07), with no difference in sensitivities (p > 0.05). In cases of absent extra-osseous soft tissue mass and present fracture site enhancement, the combined set showed improved accuracy (R1, 82.9-84.4% vs. 95.6-96.3%, p < 0.05; R2, 90.2-91.1% vs. 95.1-95.6%, p < 0.05) and specificity (R1, 68.3-72.9% vs. 92.7-95.8%, p < 0.005; R2, 83.0-85.4% vs. 97.6-98.0%, p = 0.07). Conclusion: Combining DWI with conventional MRI improved the diagnostic accuracy and specificity while retaining sensitivity for differentiating between pathologic and traumatic fractures from metastasis at extremities.

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

  • Jung, Nani;Byun, Hye Jin;Park, Jae Hyun;Kim, Joon Sik;Kim, Hae Won;Ha, Ji Yong
    • Clinical and Experimental Pediatrics
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    • 제61권1호
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    • pp.24-29
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    • 2018
  • Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and ${\beta}-2$ microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever. Methods: A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed. Results: Among 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407. Conclusion: Accuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.

MDCT를 이용한 관상동맥협착 진단의 정확성 평가 (Evaluate the diagnostic accuracy in the assessment of coronary artery stenoses using MDCT)

  • 양원석;신성규;박재홍
    • 한국방사선학회논문지
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    • 제6권4호
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    • pp.275-279
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    • 2012
  • 16MD CT(n=93) and dual source CT(n=100)를 이용해 촬영된 심장 CT 중 그 결과 협착으로 진단되어 심장영화 촬영을 시행한 환자를 대상으로 심장영화 촬영과의 협착 유무에 대한 비교를 하였다. 그 결과 16MDCT의 경우 가장 높은 민감도, 특이도, 양성예측도, 음성예측도는 LAD(73.5%), RCA(74.5%), LAD(66.7%), LCX(75%), LCX(67.7%)로 나타났고, 16Slice MDCT에서 각 관상동맥 혈관별 정확도는 평균67%로 다소 떨어지는 것으로 나타났고, Somatom Definition dual source CT의 경우 평균 정확도 84%로 16Slice MDCT보다는 17%더 높은 정확도를 나타내었다. 관상동맥영역별(segaments) 구분에서는 16Slice MDCT와 Somatom Definition 모두 근위부(proximal)보다는 원위부로 갈수록 더 높은 정확도를 나타내었다. 하지만 그 결과 값이 10% 오차 범위 내에 있어 명확한 차이라 보기는 힘들 것 이다. 또한 Dual source CT의 경우 역시 관상동맥 영역별 구분에서 큰 차이를 보이지 않았다.

협력진료를 통한 혈관종 및 혈관기형 진단 정확도 향상 (Improvement in Diagnostic Accuracy of Hemangioma and Vascular Malformation through Multidisciplinary Clinic)

  • 강경동;배용찬;남수봉;최수종;정도상;김창원
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.758-762
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    • 2010
  • Purpose: It is difficult to provide accurate diagnosis and proper treatment for vascular anomalies, because vascular anomalies have a wide spectrum of lesion with various symptoms. Furthermore, vascular anomalies often require the services of a wide range of specialists. So, many patients have been discouraged by the lack of expertise and treatment options available to them. In this study, we aimed to describe the scope of the Vascular Malformation clinic (VAM clinic), a multidisciplinary clinic for hemangioma and vascular malformation patients and investigate of diagnostic accuracy of VAM clinic. Methods: 68 patients have included in a retrospective, medical record review study in the VAM clinic from may 2002 to august 2009. Data included the types of diagnoses of patients seen in the clinic, locations of lesions, comparison of accuracy of diagnoses at other clinic and initial diagnoses at VAM clinic and types of recommended treatments. Results: Initial diagnosis at VAM clinic showed 94.2% accuracy, while diagnosis at other clinic only showed 12.5% accuracy. Head and neck is most frequently occurred lesions in patients of VAM clinic. And VAM clinic is able to provide various and proper treatments to patients. Conclusion: Hemangiomas and vascular malformations can present with various medical problems. VAM clinic, the multidisciplinary clinic provided accurate diagnoses and proper treatments to patients.

Accuracy of administrative claim data for gastric adenoma after endoscopic resection

  • Ga-Yeong Shin;Hyun Ho Choi;Jae Myung Park;Sang Yoon Kim;Jun Young Park;Donghoon Kang;Yu Kyung Cho;Sung Soo Kim;Myung-Gyu Choi
    • Clinical Endoscopy
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    • 제56권3호
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    • pp.325-332
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    • 2023
  • Background/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas. Methods: Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen. Results: Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers. Conclusions: Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

Evaluation of the Accuracy of the $EasyTest^{TM}$ Malaria Pf/Pan Ag, a Rapid Diagnostic Test, in Uganda

  • Chong, Chom-Kyu;Cho, Pyo Yun;Na, Byoung-Kuk;Ahn, Seong Kyu;Kim, Jin Su;Lee, Jin-Soo;Lee, Sung-Keun;Han, Eun-Taek;Kim, Hak-Yong;Park, Yun-Kyu;Cha, Seok Ho;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • 제52권5호
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    • pp.501-505
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    • 2014
  • In recent years, rapid diagnostic tests (RDTs) have been widely used for malaria detection, primarily because of their simple operation, fast results, and straightforward interpretation. The Asan $EasyTest^{TM}$ Malaria Pf/Pan Ag is one of the most commonly used malaria RDTs in several countries, including Korea and India. In this study, we tested the diagnostic performance of this RDT in Uganda to evaluate its usefulness for field diagnosis of malaria in this country. Microscopic and PCR analyses, and the Asan $EasyTest^{TM}$ Malaria Pf/Pan Ag rapid diagnostic test, were performed on blood samples from 185 individuals with suspected malaria in several villages in Uganda. Compared to the microscopic analysis, the sensitivity of the RDT to detect malaria infection was 95.8% and 83.3% for Plasmodium falciparum and non-P. falciparum, respectively. Although the diagnostic sensitivity of the RDT decreased when parasitemia was ${\leq}500\;parasites/{\mu}l$, it showed 96.8% sensitivity (98.4% for P. falciparum and 93.8% for non-P. falciparum) in blood samples with parasitemia ${\geq}100\;parasites/{\mu}l$. The specificity of the RDT was 97.3% for P. falciparum and 97.3% for non-P. falciparum. These results collectively suggest that the accuracy of the Asan $EasyTest^{TM}$ Malaria Pf/Pan Ag makes it an effective point-of-care diagnostic tool for malaria in Uganda.

의학적 의사결정 도구들에 대한 고찰 : Bayesian analysis and ROC analysis (Medical decision making tools : Bayesian analysis and ROC analysis)

  • 이병도
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.1-5
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    • 2006
  • During the diagnostic process of the various oral and maxillofacial lesions, we should consider the following: 'When should we order diagnostic tests? What tests should be ordered? How should we interpret the results clinically? And how should we use this frequently imperfect information to make optimal medical decisions?' For the clinicians to make proper judgement, several decision making tools are suggested. This article discusses the concept of the diagnostic accuracy (sensitivity and specificity values) with several decision making tools such as decision matrix, ROC analysis and Bayesian analysis. The article also explain the introductory concept of ORAD program.

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