• 제목/요약/키워드: Predictive value of tests

검색결과 113건 처리시간 0.03초

대구지역 응급의료센터에 내원한 급성 콩팥손상 환자의 진단을 위한 호중구 젤라티나제 관련 리포칼린 키트의 유용성 (Usefulness of the Neutrophil Gelatinase-Associated Lipocalin (NGAL) Kit for Acute Kidney Injury Patients at the Emergency Medical Center in Daegu)

  • 이승진;박상욱
    • 대한임상검사과학회지
    • /
    • 제48권2호
    • /
    • pp.49-53
    • /
    • 2016
  • 급성 심 질환 환자는 트로포닌(troponin)과 같은 생물학적 표지자(biomarker)가 등장하면서 진단과 치료에 많은 개선이 있었다. 콩팥 질환에서는 많은 치료약제 개발이 꾸준하게 진전해 왔음에도 불구하고 실제 사망률이나 이환률은 별로 개선되지 않았다. 급성 콩팥 손상 환자를 대상으로 응급의료센터에서 측정한 NGAL의 측정치는 NGAL이 증가할수록 Creatinine이 유의하게 증가 하였다. 그러나, AST, ALT, BUN, Na, K, Cl 과의 상관관계는 통계적으로 유의하지 않았다. NAGL kit와 ELISA의 민감도는 ${\geq}300$ (92.2%), ${\geq}200$ (95.6%), ${\geq}100$ (99.6%), 특이도는 ${\geq}300$ (95.1%), ${\geq}200$ (97.3%), ${\geq}100$ (99.4%)로 조사되었으며 양성예측도는 ${\geq}300$ (93.3%), ${\geq}200$ (93.4%), ${\geq}100$ (99.2%), 음성예측도는 ${\geq}300$ (96.7%), ${\geq}200$ (97.7%), ${\geq}100$ (98.1%)로 조사되었으며, 급성 콩팥 손상의 정도를 평가하는 검사로써 조기 진단 및 예후를 예측함에 있어서 환자의 치료의 결정에 유용하게 이용 될 수 있다. 향후 응급의료센터에서 콩팥 질환 환자의 중증도를 평가하고 치료 방향을 결정하며, 예후를 예측하는데 있어서 NGAL kit 검사가 도움이 될 수 있다고 생각한다.

폐색전증에서 반정량적 Latex 응집법으로 시행한 D-dimer 검사의 유용성에 관한 연구 (Clinical Usefulness of D-dimer Test with Semiquantitative Latex Agglutination Method in Pulmonary Embolism)

  • 김동균;천강일;김양기;이영목;김기업;어수택;김용훈;박춘식;박노진;최태윤
    • Tuberculosis and Respiratory Diseases
    • /
    • 제59권6호
    • /
    • pp.651-655
    • /
    • 2005
  • 연구배경 : D-dimer는 혈장응고 및 섬유소분해계의 활성화 표지자로 알려져 있고 폐색전증은 비특이적인 임상양상과 진단이 어려워 비관혈적인 진단적 필요성이 대두되어 ELISA법에 의한 D-dimer 검사가 알려져 있으나 검사에 대한 소요시간이 길어 현실적으로 적용하기 어려운 단점이 있다. 검사 소요시간이 짧은 latex응집법에 의한 D-dimer 검사가 폐색전증의 선별검사에 유용한지에 대해 알아보고자 하였다. 대상 및 방법 : 흉부 나선형 전산화 단층촬영, 폐관류 및 폐환기검사, 폐동맥조영술 등을 통해 진단된 폐색전증 환자 90명 (I군) 및 폐색전증을 상기의 방법으로 제외가 가능하였던 환자 95명 (II군)을 대상으로 반정량적 latex응집법에 따른 D-dimer 검사 (Stago D-Di, Diagnostica Stago, France)에 대한 후향적 조사를 시행하였다. 결 과: 환자의 성별 및 연령은 I군은 남:녀 = 37:55 및 57세였고 II군은 남:녀 = 50:45 및 52세 였다. D-dimer $500{\mu}g$ 이상을 양성으로 판정하였을때 민감도는 86.7%, 양성예측치 61.4%, 음성예측치 79.3%, 특이도 48.4%였고 확진이 가능하였던 66명과 음성으로 최종 판독되었던 95명에서 D-dimer $500{\mu}g$ 이상을 양성으로 판정하였을때 민감도는 93.9%, 양성예측치 55.9%, 음성예측치 92.0%, 특이도 48.4% 였다. 결 론: 반정량적 latex응집법에 의한 D-dimer 검사는 알려진 ELISA법에 의한 결과보다 민감도 및 음성예측치가 낮으며 혈전의 부하가 많은 경우에는 비교적 양성률이 높게 나타나나 혈전의 부하가 적은 경우 양성률이 낮게 나타날 수 있어 폐색전증 및 심부정맥 혈전증의 선별검사로 적합하지 않았다.

연속적으로 시행한 공장 근로자 건강 검진에서 무증상 간기능 검사 이상자의 임상적 특성 (Clinical Characteristics of Factory Wokers with Asymptomatic Liver Function Test Abnormalities in Serial Health Examination)

  • 김강모;김윤준;이광혁;백도명
    • 한국건강관리협회지
    • /
    • 제3권2호
    • /
    • pp.121-136
    • /
    • 2005
  • Background/Aims The liver funtion tests(LFTs), such as aspartate aminotransferase(AST), alanine amino-transferase(ALT), r -glutamyl transferase( r -GT), have been widely used for screening tests but their low positive predictive value can cause many false positive results. To evaluate the clinical usefulness of these tests, we analyzed serial LFT results of single factory workers and compared the risk factor's in groups divided by the serial LFT results. Methods From June 2001 to October 2001, 1223 consecutive healthy workers in a single factory were enrolled and questionnaire, LFT and liver ultrasonography were performed. Previous LFT results were collected from Annual Health Examination Survey. According to the abnormalities in serial LFT, participants were classified into three groups (abnormal-in-both, alternating normal-in-both) and the risk factors were compared among these groups using multiple logistic regression Results The prevalence of LFT abnormality in a single test was 16.8% but, in serial LFT, only 5% of participants showed consistent abnormality. The risk factors for abnormal-in-both group, compared with alternating group, were liver ultrasonography abnormality such as fatty liver(odds ratio, 2.2; p=0.026) and heavy alcohol intake (more than 210g/week) (odds ratio, 7.2;P=0.064). HBsAg was not significant risk factor for any of the three groups. ConclusionIn factory workers with serial LFT abnormality, alcoholic liver disease could be the principal cause of abnormal LFT. Even if HBsAg were positive in patients with abnormal LFT, there is a possibility of another causes for LFT abnormalities such as alcoholic liver disease and nonalcoholic steatosis or steatohepatitis

  • PDF

Albumin-Bilirubin Score Predicts Tolerability to Adjuvant S-1 Monotherapy after Curative Gastrectomy

  • Miwa, Takashi;Kanda, Mitsuro;Tanaka, Chie;Kobayashi, Daisuke;Hayashi, Masamichi;Yamada, Suguru;Nakayama, Goro;Koike, Masahiko;Kodera, Yasuhiro
    • Journal of Gastric Cancer
    • /
    • 제19권2호
    • /
    • pp.183-192
    • /
    • 2019
  • Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08-20.1; cutoff value, -2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69-7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33-45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.

Comparison of Computed Tomography-based Abdominal Adiposity Indexes as Predictors of Non-alcoholic Fatty Liver Disease Among Middle-aged Korean Men and Women

  • Baek, Jongmin;Jung, Sun Jae;Shim, Jee-Seon;Jeon, Yong Woo;Seo, Eunsun;Kim, Hyeon Chang
    • Journal of Preventive Medicine and Public Health
    • /
    • 제53권4호
    • /
    • pp.256-265
    • /
    • 2020
  • Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes-visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)-were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions: Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.

Fluorescence-in-situ-hybridization in the Surveillance of Urothelial Cancers: Can Use of Cystoscopy or Ureteroscopy be Deferred?

  • Ho, Christopher Chee Kong;Tan, Wei Phin;Pathmanathan, Rajadurai;Tan, Wei Keith;Tan, Hui Meng
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권7호
    • /
    • pp.4057-4059
    • /
    • 2013
  • Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

Predictive Value of Malignancy Risk Indices for Ovarian Masses in Premenopausal and Postmenopausal Women

  • Ertas, Sinem;Vural, Fisun;Tufekci, Ertugrul Can;Ertas, Ahmet Candost;Kose, Gultekin;Aka, Nurettin
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권4호
    • /
    • pp.2177-2183
    • /
    • 2016
  • Background: To evaluate the predictive role of a risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Materials and Methods: A total of 408 patients with adnexal masses managed surgically between January 2010 and February 2014 were included. The risk of malignancy indices (RMI) 1, 2, 3 and 4 were calculated using findings for ultrasonography, menopausal status, and CA125 levels. Histopathologic results were the end point. ROC analysis was used for the sensitivity and the specificity of the models. Results: Some 37.6 % of the cases were malignant in the postmenopausal group while 7.9 % were malignant in the premenopausal group. Pelvic pain was the most common complaint, and the majority of the cases were diagnosed at stage 3. The RMI 1, 2, 3 and 4 yielded percentage sensitivities of 76.1, 79.1, 76.1 and 76.1 and specificities of 91.5, 89.1, 90.6, 88.6, respectively. RMI 1 was the most reliable test in the general population according to AUC levels and Kappa statistics. From ROC analysis results of post/premenopausal women, the RMI 1 (cut off: 200) yielded sensitivities of 84.0/60.9 and specificities of 87.7/92.5. With RMI 2 they were 88.6/60.9 and 80.0/91.0, with RMI 3 84.0/60.9 and 87.7/91.8, and with RMI 4 (cut off:400) 81.8/47.8 and 83.6 /44.0. Although test performance of RMI methods were good in a general population and postmenopausal women, the RMI inter-agreement validity was only moderate or fair in premenopausal women. Conclusions: Our study confirms the effectiveness of RMI algorithms in postmenopausal women. However, more sensitive tests are needed for premenopausal women.

Energy analysis-based core drilling method for the prediction of rock uniaxial compressive strength

  • Qi, Wang;Shuo, Xu;Ke, Gao Hong;Peng, Zhang;Bei, Jiang;Hong, Liu Bo
    • Geomechanics and Engineering
    • /
    • 제23권1호
    • /
    • pp.61-69
    • /
    • 2020
  • The uniaxial compressive strength (UCS) of rock is a basic parameter in underground engineering design. The disadvantages of this commonly employed laboratory testing method are untimely testing, difficulty in performing core testing of broken rock mass and long and complicated onsite testing processes. Therefore, the development of a fast and simple in situ rock UCS testing method for field use is urgent. In this study, a multi-function digital rock drilling and testing system and a digital core bit dedicated to the system are independently developed and employed in digital drilling tests on rock specimens with different strengths. The energy analysis is performed during rock cutting to estimate the energy consumed by the drill bit to remove a unit volume of rock. Two quantitative relationship models of energy analysis-based core drilling parameters (ECD) and rock UCS (ECD-UCS models) are established in this manuscript by the methods of regression analysis and support vector machine (SVM). The predictive abilities of the two models are comparatively analysed. The results show that the mean value of relative difference between the predicted rock UCS values and the UCS values measured by the laboratory uniaxial compression test in the prediction set are 3.76 MPa and 4.30 MPa, respectively, and the standard deviations are 2.08 MPa and 4.14 MPa, respectively. The regression analysis-based ECD-UCS model has a more stable predictive ability. The energy analysis-based rock drilling method for the prediction of UCS is proposed. This method realized the quick and convenient in situ test of rock UCS.

Ensembles of neural network with stochastic optimization algorithms in predicting concrete tensile strength

  • Hu, Juan;Dong, Fenghui;Qiu, Yiqi;Xi, Lei;Majdi, Ali;Ali, H. Elhosiny
    • Steel and Composite Structures
    • /
    • 제45권2호
    • /
    • pp.205-218
    • /
    • 2022
  • Proper calculation of splitting tensile strength (STS) of concrete has been a crucial task, due to the wide use of concrete in the construction sector. Following many recent studies that have proposed various predictive models for this aim, this study suggests and tests the functionality of three hybrid models in predicting the STS from the characteristics of the mixture components including cement compressive strength, cement tensile strength, curing age, the maximum size of the crushed stone, stone powder content, sand fine modulus, water to binder ratio, and the ratio of sand. A multi-layer perceptron (MLP) neural network incorporates invasive weed optimization (IWO), cuttlefish optimization algorithm (CFOA), and electrostatic discharge algorithm (ESDA) which are among the newest optimization techniques. A dataset from the earlier literature is used for exploring and extrapolating the STS behavior. The results acquired from several accuracy criteria demonstrated a nice learning capability for all three hybrid models viz. IWO-MLP, CFOA-MLP, and ESDA-MLP. Also in the prediction phase, the prediction products were in a promising agreement (above 88%) with experimental results. However, a comparative look revealed the ESDA-MLP as the most accurate predictor. Considering mean absolute percentage error (MAPE) index, the error of ESDA-MLP was 9.05%, while the corresponding value for IWO-MLP and CFOA-MLP was 9.17 and 13.97%, respectively. Since the combination of MLP and ESDA can be an effective tool for optimizing the concrete mixture toward a desirable STS, the last part of this study is dedicated to extracting a predictive formula from this model.

낙상예방 활동의 지속적 질 관리 프로세스 확립을 위한 위험 사정도구 평가 (Evaluation of a Fall Risk Assessment Tool to Establish Continuous Quality Improvement Process for Inpatients' Falls)

  • 박인숙;조인숙;김은만;김민경
    • 간호행정학회지
    • /
    • 제17권4호
    • /
    • pp.484-492
    • /
    • 2011
  • Purpose: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. Methods: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital’s Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. Results: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. Conclusion: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.