• Title/Summary/Keyword: sensitivity and specificity

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Evaluation of Validity of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 타당도 평가)

  • Choi, Heejung;Ok, Jong Sun;An, Soo Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.26-35
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    • 2019
  • Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

Evaluation of sonography and skin test in diagnosis of clonorchiasis at the Hyongsan-gang (River) area (형산강 유역 포항 통합시 근로자들에 있어서 간흡충 감염상 및 초음파검사와 피내반응검사의 정확도)

  • 이현경
    • Parasites, Hosts and Diseases
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    • v.33 no.2
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    • pp.117-124
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    • 1995
  • This study was performed to evaluate diagnostic sensitivity and specificity of sonography on clonorchiasis. During the 9 months from March to November 1994, sonography skin test, stool examination, and medical examination were performed to 609 volunteers of Pohang which is located along the Hyongsan-gang (Rivers and is one of well-known endemic areas of clonorchiasis. The sensitivity of sonography was either 21% if the intrahepatic ducts dilatation was assumed to be the only positive anding or 52% if the periductal echogenicity was also included as one of positive findings. The sensitivity of skin test was 62%. The sensitivity was 46% if the diagnostic criteria were arbitrarily assumed as being positive in skin test and having either sonographic findings. The sonographic finding of fusiform, non-shadowing, weakly echogenic foci in gallbladder or in billiaiy tree indicating the flukes or aggregates of flukes was not obvious in this study. The specificity of sonography was either 95% if the intrahepatic ducts dilatation was assumed to be the only positive finding or 82% if the periductal echogenicity was also included as one of positive findings. The specificity of skin test was 52%. The specificity was 90% if the diagnostic criteria was arbitrarily assumed as being positive in skin test and having either sonographic findings.

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Highly Sensitive PNA Array Platform Technology for Single Nucleotide Mismatch Discrimination

  • Choi, Jae-Jin;Jang, Min-Jeong;Kim, Ji-Hyun;Park, Hee-Kyung
    • Journal of Microbiology and Biotechnology
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    • v.20 no.2
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    • pp.287-293
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    • 2010
  • Reliable discrimination of a single nucleotide mismatch was demonstrated using arrays with peptide nucleic acid (PNA) probes. The newly developed PNA probes immobilization method and hybridization conditions for PNA arrays gave excellent specificity and sensitivity. In addition we compared the specificity, sensitivity, and stability obtained with the PNA and DNA arrays in discriminating single nucleotide mismatches. The PNA arrays had superior perfect match-to-mismatch signal ratios and sensitivities. The relative signal intensities of mismatch PNA probes ranged from 1.6% to 12.1% of the perfect-match PNA probes. These results demonstrated that the PNA arrays were 2.0 to 37.3 times more specific and about 10 times more sensitive than DNA arrays. The PNA array showed the same specificity and sensitivity after 12-month storage at room temperature.

Diagnostic value of various screening tests in neonatal sepsis (신생아 패혈증의 다양한 선별검사들의 진단적 가치)

  • Je, Hyun Gon;Jeoung, Young Mi;Jeong, Soo Jin
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1167-1173
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    • 2006
  • Purpose : To evaluate various sepsis screening tests, individually and in combination, to formulate a guideline for the diagnosis of neonatal sepsis. Methods : The study was a retrospective cohort study. It took place at the neonatal intensive care unit of the Paediatric Department, Il Sin Christian Hospital, Busan, Korea, over a period of 68 months from 1st, April, 2001 to 31st, December, 2005. This study evaluated 100 neonates having clinical features of sepsis and 100 normal asymptomatic neonates and used screening tests including C-reactive protein (CRP), total leukocyte count (TLC), absolute neutrophil count (ANC), immature neutrophils to total neutrophil count ratio (I/T ratio), thrombocytopenia, degenerative changes in the neutrophils and gastric aspirate cytology (GAC) for the diagnosis of neontal sepsis. Results : The sensitivity of CRP and ANC was high. CRP had 86 percent sensitivity for group-A (proven sepsis) and 74 percent sensitivity for group-B (probable sepsis) and 94 percent specificity for group-A, B. ANC had sensitivity of 72 percent for group-A and 62 percent for group-B and 86 percent specificity for group-A, B. For group-A, sensitivity, specificity of GAC for polymorphs was 74 percent and 94 percent respectively. As for sensitivity, specificity of platelet count for group-A was 64 percent and 89 percent respecively. The sensitivity, specificity and predictive values (PV) of the individual tests and different test combinations were also calculated for group-A and B. Conclusion : For the detection of culture negative cases in neonatal sepsis, screening tests including CRP, TLC, ANC, thrombocytopenia, cytoplasmic vacuolization in the neutrophils and GAC for polymorphs have high sensitivity. A combination of three tests has higher sensitivity.

ROC Analysis of Acid Demineralized Artificial Caries (인공치아 우식병소 진단의 ROC 분석)

  • Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.27 no.2
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    • pp.7-13
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    • 1997
  • 조직학적으로 유용성이 입증된 산탈회법을 이용한 인접면 비교적 초기 치아 우식의 병소를 형성하여 진단율을 조사하였다. 산 용액을 이용하여 20개 인접면 치아우식을 20개 소구치에 형성하였고, 37개 인접면 치아우식을 30개 대구치에 형성하였다. 건전한 소구치 20개, 대구치 30개를 포함하여 총 96개 치아를 4개씩 나누어 24개의 블록을 형성하였고, 각각 2개 블록의 교합면을 교합시켜서, 교익촬영을 하였다. 촬영 결과를 36명의 치과의사들이인접면 치아우식의 유무를 기록하고, 동시에 및 ROC 분석을 위한 5 개 범주의 판독 기준으로 판독하여 기록하였다. 인접면 치아우식증 유, 무만으로 판독한 결과 진단의 sensitivity는 0.71, specificity는 0.78 이였다. ROC 분석 한 결과의 곡선도표 아래부분의 평균 면적은 약 0.806 이였다. 치아우식증 유무만으로 진단한 결과는 특정한 sensitivity와 specificity 만을 나타내지만, ROC 분석 결과는 주관적 진단 기준과 구별되는 고유의 진단 능력을 표시하는 1-specificity(False Positive)의 변화에 따른 sensitivity(True Positive)의 변화를 연속적으로 나타내어 주었다.

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Diagnostic value of eosinopenia and neutrophil to lymphocyte ratio on early onset neonatal sepsis

  • Wilar, Rocky
    • Clinical and Experimental Pediatrics
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    • v.62 no.6
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    • pp.217-223
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    • 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.

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

  • Kim, Eun Joo;Lim, Ji Young;Kim, Geun Myun;Lee, Mi Kyung
    • Child Health Nursing Research
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    • v.25 no.1
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    • pp.56-64
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    • 2019
  • Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

Performance Comparison of 3 Different Isolation Media of Cronobacter sakazakii (Cronobacter sakazakii 분리배지의 성능 비교)

  • Kim, Hyun-Jung;Koo, Min-Seon;Oh, Se-Wook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.5
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    • pp.764-768
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    • 2010
  • Three different isolation media for Cronobacter sakazakii have been recommended by Korea Food and Drug Administration from 2007. Performance comparison test was carried out between recommended Cronobacter sakazakii isolation medium. Chromogenic Enterobacter sakazakii agar (CESA) and Enterobacter sakazakii agar (ESA) produce more distinctive colonies having characteristic colors and appearance than Violet red bile glucose agar (VRBGA). The sensitivity and specificity of 3 different isolation media was checked. All 3 tested media showed 100% sensitivity when tested with 30 different Cronobacter sakazakii. The CESA and ESA showed 100% specificity when tested with Enterobacteriaceae except Cronobacter sakazakii, However, VRBGA did not show any specificity, showing inadequate selectivity compared to applicable Cronobacter sakazakii isolation medium. Artificially inoculated Cronobacter sakazakii to milk powder was easily recovered with 3 different isolation media and they all showed almost the same recovery activity.

The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology

  • Cha, Hyunseo;Pyo, Ju Yeon;Hong, Soon Won
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.404-410
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    • 2018
  • Background: Fine-needle aspiration cytology serves as a safe, economical tool in evaluating thyroid nodules. However, about 30% of the samples are categorized as indeterminate. Hence, many immunocytochemistry markers have been studied, but there has not been a single outstanding marker. We studied the efficacy of CD56 with human bone marrow endothelial cell marker-1 (HBME-1) in diagnosis in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) category III. Methods: We reviewed ThinPrep liquid-based cytology (LBC) samples with Papanicolaou stain from July 1 to December 31, 2016 (2,195 cases) and selected TBSRTC category III cases (n=363). Twenty-six cases were histologically confirmed as benign (six cases, 23%) or malignant (20 cases, 77%); we stained 26 LBC slides with HBME-1 and CD56 through the cell transfer method. For evaluation of reactivity of immunocytochemistry, we chose atypical follicular cell clusters. Results: CD56 was not reactive in 18 of 20 cases (90%) of malignant nodules and showed cytoplasmic positivity in five of six cases (83%) of benign nodules. CD56 showed high sensitivity (90.0%) and relatively low specificity (83.3%) in detecting malignancy (p=.004). HBME-1 was reactive in 17 of 20 cases (85%) of malignant nodules and was not reactive in five of six cases (83%) of benign nodules. HBME-1 showed slightly lower sensitivity (85.0%) than CD56. The specificity in detecting malignancy by HBME-1 was similar to that of CD56 (83.3%, p=.008). CD56 and HBME-1 tests combined showed lower sensitivity (75.0% vs 90%) and higher specificity (93.8% vs 83.3%) in detecting malignancy compared to using CD56 alone. Conclusions: Using CD56 alone showed relatively low specificity despite high sensitivity for detecting malignancy. Combining CD56 with HBME-1 could increase the specificity. Thus, we suggest that CD56 could be a useful preoperative marker for differential diagnosis of TBSRTC category III samples.

Circulating Levels of Adipocytokines as Potential Biomarkers for Early Detection of Colorectal Carcinoma in Egyptian Patients

  • Zekri, Abdel-Rahman N;Bakr, Yasser Mabrouk;Ezzat, Maali Mohamed;Zakaria, Mohamed Serag Eldeen;Elbaz, Tamer Mahmoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6923-6928
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    • 2015
  • Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.