• Clinical and Experimental Pediatrics
• /
• v.62 no.6
• /
• pp.217-223
• /
• 2019

Purpose: To determine the diagnostic value of eosinopenia and the neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of early onset neonatal sepsis (EONS). Methods: This cross-sectional study was conducted in the Neonatology Ward of R.D. Kandou General Hospital Manado between July and October 2017. Samples were obtained from all neonates meeting the inclusion criteria for EONS. Data were encoded using logistic regression analysis, the point-biserial correlation coefficient, chi-square test, and receiver operating characteristic curve analysis, with a P value <0.05 considered significant. Results: Of 120 neonates who met the inclusion criteria, 73 (60.8%) were males and 47 (39.2%) were females. Ninety (75%) were included in the sepsis group and 30 (25%) in the nonsepsis group. The mean eosinophil count in EONS and non-EONS groups was $169.8{\pm}197.1cells/mm^3$ and $405.7{\pm}288.9cells/mm^3$, respectively, with statistically significant difference (P<0.001). The diagnostic value of eosinopenia in the EONS group (cutoff point: $140cells/mm^3$) showed 60.0% sensitivity and 90.0% specificity. The mean NLR in EONS and non-EONS groups was $2.82{\pm}2.29$ and $0.82{\pm}0.32$, respectively, with statistically significant difference (P<0.001). The diagnostic value of NLR in the EONS group (cutoff point, 1.24) showed 83.3% sensitivity and 93.3% specificity. Conclusion: Eosinopenia has high specificity as a diagnostic marker for EONS and an increased NLR has high sensitivity and specificity as a diagnostic marker for EONS.

• The Korean Journal of Applied Statistics
• /
• v.20 no.3
• /
• pp.515-530
• /
• 2007

Stratum-specific likelihood ratio, which is ratio of the sensitivity to 1-the specificity in each stratum of the test, could be biased if the sensitivity and specificity of diagnostic test are affected by verification bias. Therefore, the optimal cutoff point determined by biased stratum-specific likelihood ratios is incorrect. In this study, we derived adjusted stratum-specific likelihood ratios using the adjusted sensitivity and specificity, and obtained the adjusted optimal cutoff point. The influence of the verification bias on the optimal cutoff point was described through the relation between adjusted and unadjusted stratum-specific likelihood ratios.

• Journal of Environmental Health Sciences
• /
• v.47 no.4
• /
• pp.320-329
• /
• 2021

Background: Smoking exposure may be objectively assessed through specific biomarkers. The most common biomarker for smoking is cotinine concentration in urine, and setting an optimal cut-off point can accurately classify smoking status. Such a cut-off point for Korean adolescents has never been studied. Objectives: The aim of this study was to determine a cut-off point for urinary cotinine concentration for the discrimination of smoking in adolescents. Methods: Participants were adolescents aged 13~18 years who participated in the third cycle of the Korean National Environmental Health Survey. We used urine samples to confirm the level of cotinine concentrations. Smoking status was determined by self-reported questionnaire. We identified the optimal cotinine cut-off point for discriminating smoking status using receiver operating characteristic curve analysis. Results: Of the 904 participants, 28 (3.1%) were smokers, among whom 20 (71.4%) were male. The median urinary cotinine concentrations in smokers was 218 ㎍/L (male: 215 ㎍/L, female: 303 ㎍/L), and that in non-smokers was 1.31 ㎍/L (male: 1.46 ㎍/L, female: 1.18 ㎍/L). We found significant differences in urinary cotinine concentration according to smoking status and sex (p<0.001). Urinary cotinine concentrations performed well for identifying smoking adolescents [area under the curve: 0.954 (male: 0.963, female: 0.908)]. The cut-off that optimally distinguished smokers from non-smokers was 39.85 ㎍/L (sensitivity: 89.3%, specificity: 97.4%). Male [39.85 ㎍/L (sensitivity: 90.0%, specificity: 94.9%)] had a different optimal cut-off point than female [26.26 ㎍/L (sensitivity: 87.5%, specificity: 99.6%)]. Conclusions: This study determined a cut-off point for urinary cotinine of 39.85 ㎍/L (male: 39.85 ㎍/L, female: 26.26 ㎍/L) to distinguish smokers from non-smokers in adolescents.

• Journal of Nutrition and Health
• /
• v.33 no.8
• /
• pp.864-872
• /
• 2000

This study intended to evaluate the validity of the simple nutrition screening test that had been developed with the elderly living in Cheongju as a subject. Nutrition screening score(NSS) and reference standards for nutritional and health status(nutrient intakes, mean adequacy ratio, perceive health, and serum albumin, hematocrit, and hemoglobin) were estimated by using the date obtained in 1996 from the 174 elderly living in Taejon, Statistical analysis showed significant correlations between mean adequacy ratio(MAR) and NSS(r=0.341) and also between NSS and biological indices such as albumin and hematocrit, Around 65-75% of the elderly with perceive health and low level of serum albumin, hemoglobin and hematocrit had NSS$\leq$ll. Sensitivity, specificity, and positive predictive values(PPV) were calculated from the crosstabulation of the three categories of NSS(high, moderate, and low nutritional risk) and low categories MAR(< 0.75, undernutrition;$\geq$0.75, normal) to validate the cut-off point for high or low nutritional risk by NSS. It was suggested that point l1 was appropriate as a criterion to determine high risk of undernutrition, but point 16 was better than 17 as criterion to determine low nutritional risk in the Taejon elderly. When point ll was used as a criterion of high nutritional risk, sensitivity, specificity, and PPV are 59.5, 60.5 and 82.1 respectively. When point 16 was used as a criterion of low nutritional risk, sensitivity, specificity, and PPV are 25.6, 95.4, and 64.7%, respectively. In conclusion, nutrition screening test that had been developed can be a simple, easy, and proper instrument to classify the high risk group of undernutrition. A further validation study seems to be required among other groups of individuals for the screening test to the finalized as a more valid instrument identifying Korean elderly at nutrition and health risk(Korean J Nutrition 33(8) : 864-872, 2000)

• Journal of Veterinary Science
• /
• v.25 no.2
• /
• pp.28.1-28.11
• /
• 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.

• Korean Journal of Acupuncture
• /
• v.29 no.4
• /
• pp.616-622
• /
• 2012

Objectives : The objective of this study was to evaluate the correlation between earlobe crease(ELC) and Hypertension(HTN) in the auricular point diagnosis. Methods : 140 patients who were admitted the Jeongeup City Geriatric Hospital were examined for the presence or absence of ELC and HTN. The one examined the ELC of patients and the other examined the presence of hypertension. The presence of right ELC, left ELC, right or left ELC, and right and left ELC were respectively compared with the presence of HTN. Chi-square test was used to analyze the correlation between ELC and HTN. Results : The presence of right ELC was significantly related to presence of HTN(p=0.001). The sensitivity, specificity, and positive and negative predictability of ELC for diagnosis of HTN were 0.755, 0.524, 0.787, and 0.478. The presence of left ELC was significantly related to presence of HTN(p=0.002). The sensitivity, specificity, and positive and negative predictability of ELC for diagnosis of HTN were 0.745, 0.524, 0.785, and 0.468. The presence of right or left ELC was significantly related to presence of HTN(p<0.001). The sensitivity, specificity, and positive and negative predictability of ELC for diagnosis of HTN were 0.806, 0.500, 0.790, and 0.525. The presence of right and left ELCs was significantly related to presence of HTN (p=0.007). The sensitivity, specificity, and positive and negative predictability of ELC for diagnosis of HTN were 0.694, 0.548, 0.782, and 0.434. Conclusions : These results show that the presence of ELC is significantly associated with hypertension.

• The Korean Journal of Pain
• /
• v.12 no.2
• /
• pp.195-199
• /
• 1999

Background: At present, there is no reliable objective test for the diagnosis of myofascial trigger points (MFTP). We evaluated the usefulness of skin resistance point finder for the diagnosis of MFTP. Methods: 40 subjects with clinical MFTPs at the upper trapezius muscle were included in this study. Using skin resistance point finder (UNIQUE S-2010$^{(R)}$, Seik medical, Korea), we tried to find out the point of low skin resistance. At three different current level, sensitivity and specificity of this method for the diagnosis of clinically identified MFTP was evaluated. Pressure threshold for pain of low skin resistance point was measured using Pressure Threshold Meter$^{(R)}$ (Pain Diagnostics and Thermography, U.S.A.). 3 groups of point detected at different current were compared in mean pressure threshold. Results: Fixed single current of skin resistance point finder showed variable sensitivity and specificity. But, by adjusting current level, skin resistance point finder detected all of 40 clinically identified MFTPs. Although it is partially statistically significant, the mean pressure threshold of points detected at high current was high. Conclusion: Skin resistance finder can be used as objective diagnostic tool of MFTPs. There is possibility that it can be useful in evaluating treatment effect. However, more investigation is necessary.

• Communications for Statistical Applications and Methods
• /
• v.27 no.2
• /
• pp.211-224
• /
• 2020

Sensitivity and specificity are popular measures described by the receiver operating characteristic (ROC) curve. There are also two other measures such as the positive predictive value (PPV) and negative predictive value (NPV); however, the PPV and NPV cannot be represented by the ROC curve. Based on the total operating characteristic (TOC) curve suggested by Pontius and Si (International Journal of Geographical Information Science, 97, 570-583, 2014), explanatory methods are proposed to geometrically describe the PPV and NPV by the TOC curve. It is found that the PPV can be regarded as the slope of the right-angled triangle connecting the origin to a certain point on the TOC curve, while 1 - NPV can be represented as the slope of the right-angled triangle connecting a certain point to the top right corner of the TOC curve. When the neutral zone exists, the PPV and 1-NPV can be described as the slopes of two other right-angled triangles of the TOC curve. Therefore, both the PPV and NPV can be estimated using the TOC curve, whether or not the neutral zone is present.

• Journal of Korean Critical Care Nursing
• /
• v.12 no.2
• /
• pp.26-38
• /
• 2019

Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

• Journal of Korean Clinical Nursing Research
• /
• v.19 no.2
• /
• pp.245-254
• /
• 2013

Purpose: This study was done to examine predictive validity of Critical Care Non-verbal Pain Scale (CNPS) and develop criteria for pain assessment using CNPS with critically ill patients who have communication problems. Methods: Data were collected from intensive care units at three major general hospitals in Seoul and Kyunggi province. During each observation, a nurse assessed pain severity using CNPS ratings (range 0-9) at four treatment stages: at rest, during central catheter dressing change (nonpainful procedure), position change and suctioning (routine painful procedures). Patients also assessed their pain using a self-report 4-point VRS-4. Results: There were significant differences between the four treatment stages except between "at rest" and "nonpainful procedure". Strong correlations were found between CNPS and VRS-4 for "at rest" (r=.552, p<.001), central catheter dressing change (r=.505, p<.001), position change (r=.709, p<.001), and suctioning (r=.662, p<.001). ROC curve analysis of CNPS based on 3 point on VRS-4 showed the cutoff point was 3 for CNPS, the starting point for pain management with 73% sensitivity, 92.2% specificity, 73% positive predictive value, and 92.8% negative predictive value. Conclusion: Results indicate that CNPS is a valid tool for measuring pain in critically ill patients with communication problems and 3 point should be the standardized pain treatment point.