• Title/Summary/Keyword: Diagnostic specificity

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Aberrant Methylation of Genes in Sputum Samples as Diagnostic Biomarkers for Non-small Cell Lung Cancer: a Meta-analysis

  • Wang, Xu;Ling, Li;Su, Hong;Cheng, Jian;Jin, Liu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4467-4474
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    • 2014
  • Background: We aimed to comprehensively review the evidence for using sputum DNA to detect non-small cell lung cancer (NSCLC). Materials and Methods: We searched PubMed, Science Direct, Web of Science, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang, Vip Databases and Google Scholar from 2003 to 2013. The meta-analysis was carried out using a random-effect model with sensitivity, specificity, diagnostic odd ratios (DOR), summary receiver operating characteristic curves (ROC curves), area under the curve (AUC), and 95% confidence intervals (CI) as effect measurements. Results: There were twenty-two studies meeting the inclusion criteria for the meta-analysis. Combined sensitivity and specificity were 0.62 (95%CI: 0.59-0.65) and 0.73 (95%CI: 0.70-0.75), respectively. The DOR was 10.3 (95%CI: 5.88-18.1) and the AUC was 0.78. Conclusions: The overall accuracy of the test was currently not strong enough for the detection of NSCLC for clinical application. Dscovery and evaluation of additional biomarkers with improved sensitivity and specificity from studies rated high quality deserve further attention.

Reliability and Accuracy of Infrared Temperature: A Systematic Review (적외선 체온의 진단 정확도 평가 연구: 체계적 문헌고찰)

  • Park, Seong-Hi
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.668-680
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    • 2014
  • Purpose: The aim of this study was to investigate the accuracy of infrared temperature measurements compared to axillary temperature in order to detect fever in patients. Methods: Studies published between 1946 and 2012 from periodicals indexed in Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected using the following key words: "infrared thermometer". QUADAS-II was utilized to assess the internal validity of the diagnostic studies. Selected studies were analyzed through a meta-analysis using MetaDisc 1.4. Results: Twenty-one diagnostic studies with high methodological quality were included representing 3,623 subjects in total. Results of the meta-analysis showed that the pooled sensitivity, specificity, and area under the curve (AUC) of infrared tympanic thermometers were 0.73 (95% CI 0.70~0.75), 0.92 (95% CI 0.91~0.92), and 0.90, respectively. For axillary temperature readings, the pooled sensitivity was 0.67 (95% CI 0.62~0.73), the pooled specificity was 0.87 (95% CI 0.85~0.90), and the AUC was 0.80. Conclusion: Infrared tympanic temperature can predict axillary temperature in normothermic and in febrile patients with an acceptable level of diagnostic accuracy. However, further research is necessary to substantiate this finding in patients with hyperthermia.

The Diagnostic Performance of the Length of Tumor Capsular Contact on MRI for Detecting Prostate Cancer Extraprostatic Extension: A Systematic Review and Meta-Analysis

  • Tae-Hyung Kim;Sungmin Woo;Sangwon Han;Chong Hyun Suh;Soleen Ghafoor;Hedvig Hricak;Hebert Alberto Vargas
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.684-694
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    • 2020
  • Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

Implementation of point-of-care platforms for rapid detection of porcine circovirus type 2

  • Chiao-Hsu Ke;Mao-Yuan Du;Wang-Ju Hsieh;Chiu-Chiao Lin;James Mingjuh Ting;Ming-Tang Chiou;Chao-Nan Lin
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.28.1-28.11
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    • 2024
  • Background: Porcine circovirus type 2 (PCV2) infection is ubiquitous around the world. Diagnosis of the porcine circovirus-associated disease requires clinic-pathological elements together with the quantification of viral loads. Furthermore, given pig farms in regions lacking access to sufficient laboratory equipment, developing diagnostic devices with high accuracy, accessibility, and affordability is a necessity. Objectives: This study aims to investigate two newly developed diagnostic tools that may satisfy these criteria. Methods: We collected 250 specimens, including 170 PCV2-positive and 80 PCV2-negative samples. The standard diagnosis and cycle threshold (Ct) values were determined by quantitative polymerase chain reaction (qPCR). Then, two point-of-care (POC) diagnostic platforms, convective polymerase chain reaction (cPCR, qualitative assay: positive or negative results are shown) and EZtargex (quantitative assay: Ct values are shown), were examined and analyzed. Results: The sensitivity and specificity of cPCR were 88.23% and 100%, respectively; the sensitivity and specificity of EZtargex were 87.65% and 100%, respectively. These assays also showed excellent concordance compared with the qPCR assay (κ = 0.828 for cPCR and κ = 0.820 for EZtargex). The statistical analysis showed a great diagnostic power of the EZtargex assay to discriminate between samples with different levels of positivity. Conclusions: The two point-of-care diagnostic platforms are accurate, rapid, convenient and require little training for PCV2 diagnosis. These POC platforms can discriminate viral loads to predict the clinical status of the animals. The current study provided evidence that these diagnostics were applicable with high sensitivity and specificity in the diagnosis of PCV2 infection in the field.

Sample Size Requirements in Diagnostic Test Performance Studies (진단검사의 특성 추정을 위한 표본크기)

  • Pak, Son-Il;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.73-77
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    • 2015
  • There has been increasing attention on sample size requirements in peer reviewed medical literatures. Accordingly, a statistically-valid sample size determination has been described for a variety of medical situations including diagnostic test accuracy studies. If the sample is too small, the estimate is too inaccurate to be useful. On the other hand, a very large sample size would yield the estimate with more accurate than required but may be costly and inefficient. Choosing the optimal sample size depends on statistical considerations, such as the desired precision, statistical power, confidence level and prevalence of disease, and non-statistical considerations, such as resources, cost and sample availability. In a previous paper (J Vet Clin 2012; 29: 68-77) we briefly described the statistical theory behind sample size calculations and provided practical methods of calculating sample size in different situations for different research purposes. This review describes how to calculate sample sizes when assessing diagnostic test performance such as sensitivity and specificity alone. Also included in this paper are tables and formulae to help researchers for designing diagnostic test studies and calculating sample size in studies evaluating test performance. For complex studies clinicians are encouraged to consult a statistician to help in the design and analysis for an accurate determination of the sample size.

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

  • Lee Byung-Do
    • Imaging Science in Dentistry
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    • v.36 no.1
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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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Comparative Efficacy of Four Imaging Instruments for Breast Cancer Screening

  • Mehnati, Parinaz;Tirtash, Maede Jafari
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6177-6186
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    • 2015
  • Sensitivity and specificity are the two most important indicators in selection of medical imaging devices for cancer screening. Breast images taken by conventional or digital mammography, ultrasound, MRI and optical mammography were collected from 2,143,852 patients. They were then studied and compared for sensitivity and specificity results. Optical mammography had the highest sensitivity (p<0.001 and p<0.006) except with MRI. Digital mammography had the highest specificity for breast cancer imaging. A comparison of specificity between digital mammography and optical mammography was significant (p<0.021). If two or more breast diagnostic imaging tests are requested the overall sensitivity and specificity will increase. In this literature review study patients at high-risk of breast cancer were studied beside normal or sensitive women. The image modality performance of each breast test was compared for each.

Diagnostic Value of Human Epididymis Protein 4 Compared with Mesothelin for Ovarian Cancer: a Systematic Review and Meta-analysis

  • Lin, Jia-Ying;Qin, Jin-Bao;Li, Xiao-Yan;Dong, Ping;Yin, Bing-De
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5427-5432
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    • 2012
  • Background and Purpose: Ovarian cancer is the leading cause of death among gynecologic cancers because of the lack of effective early detection methods. Accuracies of the human epididymis protein 4 (HE4) and mesothelin in detecting ovarian cancer have never been systematically assessed. The current systematic review aimed to tackle this issue. Methods: MEDLINE, EMBASE, and Cochrane databases were searched (September 1995-November 2011) for studies on the diagnostic performances of HE4 and mesothelin in differentiating ovarian cancer from other benign gynecologic diseases. QUADAS items were used to evaluate the qualities of the studies. Meta-DiSc software was used to handle data from the included studies and to examine heterogeneity. All included studies for diagnostic performance were combined with sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratios (DORs) with 95% confidence intervals (CIs), summary receiver operating characteristic (SROC) curves, and areas under the SROC curves (AUC). Results: A total of 18 studies and 3,865 patients were eligible for the final analysis. The pooled sensitivity estimates for HE4 (74.4%) were significantly higher than those for mesothelin (49.3%). The pooled specificity estimates for mesothelin (94.5%) were higher than those for HE4 (85.8%). The pooled DOR estimates for HE4 (26.22) were higher than those for mesothelin (24.01). The SROC curve for HE4 showed better diagnostic accuracy than that for mesothelin. The PLR and NLR of HE4 were 6.33 (95% CI: 3.58 to 11.18) and 0.27 (95% CI: 0.21 to 0.34), respectively. The PLR and NLR for mesothelin were 11.0 (95% CI: 6.21 to 19.59) and 0.51 (95% CI: 0.42 to 0.62), respectively. The combination of the two tumor markers or their combination with CA-125 increased sensitivity and specificity to different extents. Conclusion: The diagnostic accuracy of HE4 in differentiating ovarian cancer from other benign gynecologic diseases is better than that of soluble mesothelin-related protein. Combinations of two or more tumor markers show more sensitivity and specificity.

Diagnostic Significance of Comprehensive Attention Test in Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 종합주의력검사의 진단적 유용성)

  • Seo, Jong-Man;Lee, Jung-Sun;Kim, Seong-Yoon;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.4
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    • pp.246-252
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    • 2011
  • Background : The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). Method : A total of 110 children and adolescents with ADHD (mean age : 11.2${\pm}$2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0${\pm}$2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. Results : The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). Conclusions : The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

Monoclonal Antibody-Based Dipstick Assay: A Reliable Field Applicable Technique for Diagnosis of Schistosoma mansoni Infection Using Human Serum and Urine Samples

  • Demerdash, Zeinab;Mohamed, Salwa;Hendawy, Mohamed;Rabia, Ibrahim;Attia, Mohy;Shaker, Zeinab;Diab, Tarek M.
    • Parasites, Hosts and Diseases
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    • v.51 no.1
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    • pp.93-98
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    • 2013
  • A field applicable diagnostic technique, the dipstick assay, was evaluated for its sensitivity and specificity in diagnosing human Schistosoma mansoni infection. A monoclonal antibody (mAb) against S. mansoni adult worm tegumental antigen (AWTA) was employed in dipstick and sandwich ELISA for detection of circulating schistosome antigen (CSA) in both serum and urine samples. Based on clinical and parasitological examinations, 60 S. mansoni-infected patients, 30 patients infected with parasites other than schistosomiasis, and 30 uninfected healthy individuals were selected. The sensitivity and specificity of dipstick assay in urine samples were 86.7% and 90.0%, respectively, compared to 90.0% sensitivity and 91.7% specificity of sandwich ELISA. In serum samples, the sensitivity and specificity were 88.3% and 91.7% for dipstick assay vs. 91.7% and 95.0% for sandwich ELISA, respectively. The diagnostic efficacy of dipstick assay in urine and serum samples was 88.3% and 90.0%, while it was 90.8% and 93.3% for sandwich ELISA, respectively. The diagnostic indices of dipstick assay and ELISA either in serum or in urine were statistically comparable (P>0.05). In conclusion, the dipstick assay offers an alternative simple, rapid, non-invasive technique in detecting CSA or complement to stool examinations especially in field studies.