• Title/Summary/Keyword: Predictive value of tests

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

  • Lee, Seung-Jin;Park, Sangwook
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.49-53
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    • 2016
  • Acute kidney injury (AKI) is a common syndrome resulting in kidney damage and malfunction within a few days or even a few hours. The diagnosis of AKI depends on routine biochemical tests, including serum creatinine, aspartate aminotransferase (AST), alanine aminotransaminase (ALT), blood urea nitrogen (BUN), and electrolytes. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker that shows correlation with the severity of acute infections and kidney injuries. The predictive value in other conventional assays for kidney functions has been reported to cause distraction for AKI syndrome. The aim of this study is to verify the predictive value of plasma NGAL in patients with established AKI. The NGAL kit for checkup demonstrates sensitivity of ${\geq}300$ (92.2%), ${\geq}200$ (95.6%), ${\geq}100$ (99.6%), specificity of ${\geq}300$ (95.1%), ${\geq}200$ (97.3%), ${\geq}100$ (99.4%), positive predictability of ${\geq}300$ (93.3%), ${\geq}200$ (93.4%), ${\geq}100$ (99.2%), and negative predictability of ${\geq}300$ (96.7%), ${\geq}200$ (97.7%), ${\geq}100$ (98.1%), respectively. The plasma NGAL compared with the enzyme-linked immunosorbent assay (ELISA) has been shown to be an early predictive biomarker of AKI. The NGAL kit, recently developed for point-of-care of plasma specimens, is thought to be a useful and reliable biomarker for the early diagnosis of decreased kidney functions.

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

  • Kim, Dong Kyun;Chun, Kang Il;Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki Up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Park, No Jin;Choi, Tae Youn
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.651-655
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    • 2005
  • Background : Diagnosing a pulmonary embolism is difficult because its presenting symptoms are nonspecific and there are limitations with all of the objective tests. The D-dimer is known to be a marker of the lysis of intravascular cross-linked fibrin as a result of the activation of the endogenous fibrinolytic pathways, and the D-dimer assay is these an objective method for diagnosing a pulmonary embolism. This study assessed the benefits of the D-dimer test for diagnosing a pulmonary embolism using semiquantitative latex agglutination. Methods : The latex agglutination results of 185 patients were retrospectively reviewed. The D-dimer test was performed at the time a pulmonary embolism was suspected. Ninety patients(group I) were diagnosis with PE through spiral chest CT or a chest CT angiogram, perfusion/ventilation scans, and/or pulmonary angiogram. Ninety-five patients (group II) were found not to have a pulmonary embolism through the above tests. Results : The male to female ratio and mean age in groups I and II was 37:55, and 57 years old to 50:45 and 52 years old, respectively. When the cut off value for a positive D-dimer assay was set to $500{\mu}g$, the sensitivity, positive predictive value, negative predictive value and specificity was 86.7%, 61.4%, 79.3%, and 48.4%, respectively. Conclusion : The semiquantitative latex agglutination method in the D-dimer test has a lower sensitivity and negative predictive value than the well known ELISA test particularly for small emboli. Therefore, this test is not a suitable screening test for excluding a pulmonary embolism.

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

  • Kim, Gang-Mo;Kim, Yun-Jun;Lee, Gwang-Hyeok;Baek, Do-Myeong
    • Journal of Korea Association of Health Promotion
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    • v.3 no.2
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    • pp.121-136
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    • 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

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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
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    • v.19 no.2
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    • pp.183-192
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    • 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
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    • v.53 no.4
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    • pp.256-265
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    • 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
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    • v.14 no.7
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    • pp.4057-4059
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    • 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
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    • v.17 no.4
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    • pp.2177-2183
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    • 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
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    • v.23 no.1
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    • pp.61-69
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    • 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
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    • v.45 no.2
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    • pp.205-218
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    • 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.

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

  • Park, Ihn-Sook;Cho, In-Sook;Kim, Eun-Man;Kim, Min-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.4
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    • pp.484-492
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    • 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.