• Title/Summary/Keyword: predictive value

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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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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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USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER (구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성)

  • Yu, Min-Gi;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts

  • Yamamoto-Silva, Fernanda Paula;de Oliveira Siqueira, Claudeir Felipe;Silva, Maria Alves Garcia Santos;Fonseca, Rodrigo Borges;Santos, Ananda Amaral;Estrela, Carlos;de Freitas Silva, Brunno Santos
    • Imaging Science in Dentistry
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    • v.48 no.3
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    • pp.177-184
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    • 2018
  • Purpose: This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods: Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups(VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results: The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion: Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.

The effect of metal artifacts on the identification of vertical root fractures using different fields of view in cone-beam computed tomography

  • Moudi, Ehsan;Haghanifar, Sina;Madani, Zahrasadat;Bijani, Ali;Nabavi, Zeynab Sadat
    • Imaging Science in Dentistry
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    • v.45 no.3
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    • pp.147-151
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    • 2015
  • Purpose: The aim of this study was to investigate the effects of metal artifacts on the accurate diagnosis of root fractures using cone-beam computed tomography (CBCT) images with large and small/limited fields of view (FOVs). Materials and Methods: Forty extracted molar and premolar teeth were collected. Access canals were made in all teeth using a rotary system. In half of the teeth, fractures were created by the application of mild pressure with a hammer. The teeth were then randomly put into a wax rim on an acryl base designed in the shape of a mandible. CBCT scans were obtained using a Newtom 5G system with FOVs of $18cm{\times}16cm$ and $6cm{\times}6cm$. A metal pin was then placed into each tooth, and CBCT imaging was again performed using the same fields of view. All scans were evaluated by two oral and maxillofacial radiologists. The specificity, sensitivity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) were calculated. Result: The maximum levels of sensitivity and specificity (100% and 100%, respectively) were observed in small-volume CBCT scans of teeth without pins. The highest negative predictive value was found in the small-volume group without pins, whereas the positive predictive value was 100% in all groups except the large-volume group with pins. Conclusion: The specificity of CBCT decreased with the presence of a pin in the large-volume group, but not in the small-volume group.

Use of ultrasonography for improving reproductive efficiency in cows I. Accuracy of rectal palpation and ultrasonography for determining the presence of a functional corpus luteum in subestrous daitry cows (초음파 진단장치를 이용한 축우의 번식효율증진에 관한 연구 I. 무발정 젖소에서 기능성황체를 평가하기 위한 직장검사와 초음파검사의 진단정확성)

  • Son, Chang-ho;Kang, Byong-kyu;Choi, Han-sun;Kang, Hyun-gu;Oh, Ki-seok;Shin, Chang-rok
    • Korean Journal of Veterinary Research
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    • v.36 no.4
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    • pp.941-948
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    • 1996
  • The accuracy of rectal palpation and ultrasonography for predicting the presence of a functional corpus luteum in subestrous dairy cows was investigated, using the result of a radioimmunoassay for progesterone in plasma. Luteal status (high or low progesterone concentrations) was diagnosed in 820 cows, using rectal palpation and B-mode transrectal ultrasonography, and the results of rectal palpation and ultrasonography were compared in $2{\times}2$ contingency table with plasma progesterone concentrations. A $2{\times}2$ contingency table analysis allowed the calculation of sensitivity, specificity and predictive values for rectal palpation and ultrasonography. The sensitivity, specificity, predictive value of a positive test and predictive value of a negative test were 81.9%, 67.5%, 79.0% and 71.4% for rectal palpation, and 96.3%, 88.8%, 94.5% and 92.4% for ultrasonography, respectively. The percentages of observed agreement and expected agreement between rectal palpation and ultrasonography were 71.8% and 57.1%, respectively. An evaluation of agreement between rectal palpation and ultrasonography, the value of Kappa was 0.34. It was concluded that a ultrasonography was more sensitive and specific than rectal palpation in predicting the presence of a functional corpus luteum. Therefore, ultrasonographic examination is a reliable method for assessing the functional status of ovarian structures in subestrous dairy cows.

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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.

Validation of the Edmonson Psychiatric Fall Risk Assessment Tool for Psychiatric Inpatients: A Retrospective Study (정신건강의학과 입원 환자를 위한 낙상 위험 사정도구 (Edmonson Psychiatric Fall Risk Assessment Tool)의 타당도 평가: 후향적 연구)

  • Kim, Kyung Young;Son, Young Sun;Lee, You Ji;Kim, Ji Eun;Kim, Mi Kyung;YI, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.3
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    • pp.270-276
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    • 2022
  • Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

Actual Energy Consumption Analysis of Temperature Control Strategies for Secondary Side Hot Water District Heating System with an Inverter (인버터시스템 적용 지역난방 시스템의 2차측 공급수 온도 제어방안에 따른 에너지사용량 실증 비교)

  • Cho, Sung-Hwan;Hong, Seong-Ki
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.27 no.4
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    • pp.179-186
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    • 2015
  • In this study, the actual energy consumption of the secondary side District Heating System (DHS) with different hot water supply temperature control methods is compared. The two methods are Outdoor Temperature Reset Control and Outdoor Temperature Predictive Control. While Outdoor Temperature Reset Control has been widely used for energy savings of the secondary side system, the results show that the Outdoor Temperature Predictive Control method saves more energy. In general, the Outdoor Temperature Predictive Control method lowers the supply temperature of hot water, and it reduces standby losses and increases the overall heat transfer value of heated spaces due to more flow into the space. During actual energy consumption monitoring, the Outdoor Temperature predictive Control method saves about 6.6% of energy when compared to the Outdoor Temperature Reset Control method. Also, it is found that at partial load condition, such as during daytime, the fluctuation of hot water supply temperature with Outdoor Temperature Reset Control is more severe than that with Outdoor Temperature Predictive Control. Thus, it proves that Outdoor Temperature Predictive Control is more stable even at partial load conditions.

A Comparative Study on the Predictive Validity among Pressure Ulcer Risk Assessment Scales (욕창발생위험사정도구의 타당도 비교)

  • 이영희;정인숙;전성숙
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.162-169
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    • 2003
  • Purpose: This study was to compare the predictive validity of Norton Scale(1962), Cubbin & Jackson Scale(1991), and Song & Choi Scale(1991). Method: Data were collected three times per week from 48~72hours after admission based on the four pressure sore risk assessment scales and a skin assessment tool for pressure sore on 112 intensive care unit(ICU) patients in a educational hospital Ulsan during Dec, 11, 2000 to Feb, 10, 2001. Four indices of validity and area under the curve(AUC) of receiver operating characteristic(ROC) were calculated. Result: Based on the cut off point presented by the developer, sensitivity, specificity, positive predictive value, negative predictive value were as follows : Norton Scale : 97%, 18%, 35%, 93% respectively; Cubbin & Jackson Scale : 89%, 61%, 51%, 92%, respectively; and Song & Choi Scale : 100%, 18%, 36%, 100% respectively. Area under the curves(AUC) of receiver operating characteristic(ROC) were Norton Scale .737, Cubbin & Jackson Scale .826, Song & Choi Scale .683. Conclusion: The Cubbin & Jackson Scale was found to be the most valid pressure sore risk assessment tool. Further studies on patients with chronic conditions may be helpful to validate this finding.