• Title/Summary/Keyword: Predictive value of tests

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Statistical Methods for Comparing Predictive Values in Medical Diagnosis

  • Chanrim Park;Seo Young Park;Hwa Jung Kim;Hee Jung Shin
    • Korean Journal of Radiology
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    • v.25 no.7
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    • pp.656-661
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    • 2024
  • Evaluating the performance of a binary diagnostic test, including artificial intelligence classification algorithms, involves measuring sensitivity, specificity, positive predictive value, and negative predictive value. Particularly when comparing the performance of two diagnostic tests applied on the same set of patients, these metrics are crucial for identifying the more accurate test. However, comparing predictive values presents statistical challenges because their denominators depend on the test outcomes, unlike the comparison of sensitivities and specificities. This paper reviews existing methods for comparing predictive values and proposes using the permutation test. The permutation test is an intuitive, non-parametric method suitable for datasets with small sample sizes. We demonstrate each method using a dataset from MRI and combined modality of mammography and ultrasound in diagnosing breast cancer.

Estimation of Predictive Value of a Positive Test from a Screening Test

  • Shin, Hyun Chul;Park, Sang Gue;Kim, Yong Hee
    • Communications for Statistical Applications and Methods
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    • v.10 no.2
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    • pp.567-574
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    • 2003
  • The estimation problem of predictive value of a positive test(PVP), which is assessing the accuracy of a screening test is considered. Score methods discussed by Gart and Nam(1988) are proposed for constructing confidence interval for PVP. The simulation studies are conducted in evaluating the proposed methods and existing approximate ones.

Reliability of Stool Antigen Tests: Investigation of the Diagnostic Value of a New Immunochromatographic Helicobacter pylori Approach in Dyspeptic Patients

  • Korkmaz, Huseyin;Findik, Duygu;Ugurluoglu, Ceyha;Terzi, Yuksel
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.657-660
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    • 2015
  • Background: A diagnosis of H. pylori infection can be made by invasive or non-invasive methods. Several noninvasive diagnostic tests based on the detection of H. pylori stool antigen (HpSA) have been developed. The Genx H. pylori stool antigen card test is a new rapid, non-invasive test that is based on monoclonal immunochromatographic assay. The aim of this study was to determine its sensitivity, specificity, and diagnostic accuracy for diagnosing H. pylori infection in adult patients. Materials and Methods: A total of 162 patients were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: Using the reference test, 50.6% of the samples were positive for H. pylori infection. The Genx H. pylori antigen test was positive in 19.7% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the Genx H. pylori antigen test were 51.6%, 96.0%, 88.8%, 76.1%, and 79.0%, respectively. Conclusions: The Genx H. pylori stool antigen card test is a new non-invasive method that is fast and simple to perform but provides less reliable results.

Pseudospectral Model Predictive Control for Exo-atmospheric Guidance

  • Rahman, Tawfiqur;Zhou, Hao;Yang, Liang;Chen, Wanchun
    • International Journal of Aeronautical and Space Sciences
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    • v.16 no.1
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    • pp.64-76
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    • 2015
  • This paper suggests applying pseudospectral model predictive method for exo-atmospheric guidance. The method is a fusion of pseudospectral law and model predictive control, in which a two point boundary value problem is formulated using model predictive approach and solved by applying pseudospectral law. In this work, the method is applied to exo-atmospheric guidance with specific target requirement. The existing exo-atmospheric guidance methods suffice general requirements for guidance, but cannot ensure specific target constraints; whereas, the presented method is able to do so. The proposed guidance law is assessed through simulation of perturbed cases, and the tests suggest that the method is able to operate semi-autonomously under control and thrust vector perturbations.

Estimation of a Nationwide Statistics of Hernia Operation Applying Data Mining Technique to the National Health Insurance Database (데이터마이닝 기법을 이용한 건강보험공단의 수술 통계량 근사치 추정 -허니아 수술을 중심으로-)

  • Kang, Sung-Hong;Seo, Seok-Kyung;Yang, Yeong-Ja;Lee, Ae-Kyung;Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.5
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    • pp.433-437
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    • 2006
  • Objectives: The aim of this study is to develop a methodology for estimating a nationwide statistic for hernia operations with using the claim database of the Korea Health Insurance Cooperation (KHIC). Methods: According to the insurance claim procedures, the claim database was divided into the electronic data interchange database (EDI_DB) and the sheet database (Paper_DB). Although the EDI_DB has operation and management codes showing the facts and kinds of operations, the Paper_DB doesn't. Using the hernia matched management code in the EDI_DB, the cases of hernia surgery were extracted. For drawing the potential cases from the Paper_DB, which doesn't have the code, the predictive model was developed using the data mining technique called SEMMA. The claim sheets of the cases that showed a predictive probability of an operation over the threshold, as was decided by the ROC curve, were identified in order to get the positive predictive value as an index of usefulness for the predictive model. Results: Of the claim databases in 2004, 14,386 cases had hernia related management codes with using the EDI system. For fitting the models with applying the data mining technique, logistic regression was chosen rather than the neural network method or the decision tree method. From the Paper_DB, 1,019 cases were extracted as potential cases. Direct review of the sheets of the extracted cases showed that the positive predictive value was 95.3%. Conclusions: The results suggested that applying the data mining technique to the claim database in the KHIC for estimating the nationwide surgical statistics would be useful from the aspect of execution and cost-effectiveness.

Sensitivity, specificity, and predictive value of cardiac symptoms assessed by emergency medical services providers in the diagnosis of acute myocardial infarction: a multi-center observational study

  • Park, Jeong Ho;Moon, Sung Woo;Kim, Tae Yun;Ro, Young Sun;Cha, Won Chul;Kim, Yu Jin;Shin, Sang Do
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.264-271
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    • 2018
  • Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

A Clinical Observation of Fine Needle Aspiration Cytology in the Neck Mass (경부 종류의 세침 흡인 세포학적 검사에 대한 임상적 고찰)

  • Lim Jong-Hak;Kim Jae-Jun;Lee Dong-Hwa;Hur Kyung-Bal
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.31-36
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    • 1992
  • Neck mass is common neoplasms, but it poses a diagnostic dilemma for the physician. The differential diagnosis include neoplastic, inflammatory and developmental causes. The FNAC is one of the most valuable tests in the initial assessment and differential diagnosis of the neck mass. FNAC was performed with 267 cases of the neck mass, during the period from April, 1988 to October, 1990 at the department of General Surgery, Soon Chun Hyang. University Hospital. Thyroid lesions were excluded from this analysis. Final diagnosis was based on resection histology in 58 cases, and surgical specimens were compared with FNAC. The following results were obtoired ; 1) Of 267 cases, there we re 9 cases(3.4%) of congenital lesion, 74 cases(27.7%) of inflammatory lesion, 40 cases(15.0%) of benign tumor, 12 cases(4.5%) of primary malignant tumor, 37 cases(13.8%) of metastatic tumor, 75cases(28.1%) of reactive hyperplasia, 20 cases(7.5%) of unsatisfactory. In the pathologic classification, inflammatory lesion was the most common. 2) In the 58 cases of excisional biopsy, sensitivity 93.8%, specificity 95.2%, false positive 11.8%, false negative 2.4%, positive predictive value 88.2%, negative predictive value 97.6%, accuracy 94.8%. 3) The most common disease was the tuberculous lymphadenitis (53 cases, 19.8%). sensitivity 57.9%, specificity 100.0%, false positive 0.0%, false negative 17.0%, positive predictive value 100.0%, negative predictive value 83.0%, accuracy 86.2%.

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Clinical Usefulness of 14C-Urea Breath Test for the Diagnosis of H. pylori Infection (H. pylori 감염 진단 시 14C-요소호기검사의 임상적 유용성)

  • Kim, Yoon-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.3
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    • pp.271-276
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    • 2007
  • Helicobacter pylori (H. pylori) infection is common in korea and high incidence at gastric ulcer and duodenal ulcer. $^{14}C-urea$ breath test ($^{14}C-UBT$) is regarded as a highly reliable and non-invasive method for the diagnosis of H. pylori infection. The purpose of this study was to evaluate the diagnositc performance of a new and rapid $^{14}C-UBT$, which was equipped with Geiger-Muller counter and compared the results with those obtained by gastroduodenoscopic biopsies (GBx). One hundred sixty-eight patients (M : F = 118 : 50) underwent $^{14}C-UBT$, rapid urease test (CLO test), and GBx. The results of $^{14}C-UBT$ were classified as positive (>50 cpm), borderline (25$^{14}C-UBT$ or CLO test results with GBx as a glod standard. In the assessment of the presence of H. pylori infection, the $^{14}C-UBT$ global performance yielded positive predictive value, negative predictive value and accuracy of 93.3% and 83.3%, respectively. However, the CLO test had performance yielded positive predictive value, negative predictive value and accuracy of 76.9%, 50.0%, respectively. In this study $^{14}C-UBT$ is a highly accurate, simple and non-invasive method or the diagnosis of follow up H. pylori infection.

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Reliability and Validity of the Side-lying Instability and Prone Instability Tests in Patients with Lumbar Segmental Instability

  • Kim, Bo-Eon;Lee, Kwan-Woo;Park, Dae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.1
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    • pp.1-7
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    • 2021
  • PURPOSE: The purpose of this study is to conduct inter-rater and intra-rater reliability tests in patients with low back pain (LBP) using the prone instability test (PIT) and side-lying instability test (SIT). We have analyzed the Korean version Oswestry disability index (K-ODI) correlations and radiograph finding (RF) for validity. METHODS: Individuals (n = 51) (mean age of 40.27 ± 13.28) with LBP for at least over a week were recruited, together with two participating physical therapist examiners. The measurement consisted of PIT, PST, K-ODI, and RF. Sensitivity (Sn), specificity (Sp), positive predictive value, negative predictive value, prevalence index, agreement %, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa (PABAK) were calculated. The PIT and SIT were compared with RF for validity analysis, while PIT, SIT, K-ODI, and RF were calculated for the correlation analysis. RESULTS: The intra-rater reliability test measured for the PIT (kappa = .79, PABAK = .88) and SIT (kappa = .73, PABAK = .84), and inter-rater reliability test measured for the SIT (kappa = .80, PABAK = .88) showed good agreements. The PIT (Sn = .65, Sp = .63) and SIT validities (Sn = .68, Sp = .70) were compared with RF, showing a significant correlation in PIT and RF (r = .69), SIT and RF (r = .73), and PIT and K-ODI (r = .53). CONCLUSION: The SIT is a more comfortable position test than the PIT in patients. Both PIT and SIT have acceptable reliability and validity.

Design of an Adaptive Robust Nonlinear Predictive Controller (적응성을 가진 강인한 비선형 예측제어기 설계)

  • Park, Gee--Yong;Yoon, Ji-Sup
    • Journal of Institute of Control, Robotics and Systems
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    • v.7 no.12
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    • pp.967-972
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    • 2001
  • In this paper, an adaptive robust nonlinear predictive controller is developed for the continuous time nonlinear systems whose control objective is composed of the system output and its desired value. The basic control law is derived from the continuous time prediction model and its feedback dynamcis shows another from if input and output linearization. In order to cope with the parameter uncertainty, robust control is incorporated into the basic control law and the asymptotic convergence of tracking error to a certain bounded region is guaranteed. For stability and performance improvement within the bounded region, an adaptive control is introduced. Simulation tests for the motion control of an underwater wall-ranging robot confirm the performance improvement and the robustness of this controller.

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