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diagnostic test interpretation

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https://www.readbyqxmd.com/read/27925577/the-role-of-ultrasound-compared-to-biopsy-of-temporal-arteries-in-the-diagnosis-and-treatment-of-giant-cell-arteritis-tabul-a-diagnostic-accuracy-and-cost-effectiveness-study
#1
Raashid Luqmani, Ellen Lee, Surjeet Singh, Mike Gillett, Wolfgang A Schmidt, Mike Bradburn, Bhaskar Dasgupta, Andreas P Diamantopoulos, Wulf Forrester-Barker, William Hamilton, Shauna Masters, Brendan McDonald, Eugene McNally, Colin Pease, Jennifer Piper, John Salmon, Allan Wailoo, Konrad Wolfe, Andrew Hutchings
BACKGROUND: Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. DESIGN: Prospective multicentre cohort study...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27923164/thinking-anxious-feeling-anxious-or-both-cognitive-bias-moderates-the-relationship-between-anxiety-disorder-status-and-sympathetic-arousal-in-youth
#2
Michelle Rozenman, Allison Vreeland, John Piacentini
Cognitive bias and physiological arousal are two putative markers that may underlie youth anxiety. However, data on relationships between cognitive bias and arousal are limited, and typically do not include behavioral measurement of these constructs in order to tap real-time processes. We aimed to examine the relationship between performance-based cognitive bias and sympathetic arousal during stress in clinically anxious and typically-developing youth. The sample included children and adolescents ages 9 to 17 (Mean age=13...
November 17, 2016: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/27922976/intraoperative-frozen-section-of-ovarian-tumors-a-6-year-review-of-performance-and-potential-pitfalls-in-an-australian-tertiary-referral-center
#3
Rhett Morton, Lyndal Anderson, Jonathan Carter, Selvan Pather, Samir A Saidi
OBJECTIVES: Intraoperative frozen section (IFS) offers a rapid test to guide the extent of surgery, which is essential for optimal treatment of ovarian cancer. This study evaluated the diagnostic performance and influence of IFS in the surgical management of ovarian tumors. METHODS: A retrospective review was conducted of IFS of adnexal lesions from 2008 to 2013, with diagnoses classified as benign, borderline, or malignant. The diagnostic performance of IFS was calculated, with a focus on primary epithelial tumors...
December 3, 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#4
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27920237/von-willebrand-disease-a-concise-review-and-update-for-the-practicing-physician
#5
Arjun Swami, Varinder Kaur
von Willebrand disease (vWD) is the most common inherited disorder of hemostasis and comprises a spectrum of heterogeneous subtypes. Significant advances have been made in understanding von Willebrand factor (vWF) gene mutations, resultant physiologic deficits in the vWF peptide, and their correlation to clinical presentation. Diagnostic tests for this disorder are complex, and interpretation requires a thorough understanding of the underlying pathophysiology by the practicing physician. The objective of this review is to summarize our current understanding of pathophysiology, laboratory investigations, and evolving treatment paradigm of vWD with the availability of recombinant von Willebrand factor...
December 5, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#6
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27917572/mannitol-challenge-testing-for-asthma-in-a-community-cohort-of-young-adults
#7
Elisha C White, Nicholas de Klerk, Zoltan Hantos, Monique Priston, Elysia M Hollams, Alan James, Peter D Sly, Patrick G Holt, Graham L Hall
BACKGROUND AND OBJECTIVE: Mannitol challenge testing is an established tool for clinical asthma diagnosis, and can be performed outside of specialized respiratory laboratories. Despite applicability in both clinical and non-clinical populations, with different pre-test asthma probabilities, differences in diagnostic properties have not been well explored. This study aimed to quantify the diagnostic utility of mannitol challenge testing for asthma in a community cohort and a symptomatic wheezing subset of this cohort...
December 5, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27913867/comparison-of-different-concepts-for-interpretation-of-chromosomal-aberrations-in-urothelial-cells-detected-by-fluorescence-in-situ-hybridization
#8
Johannes Mischinger, Lutz Philipp Guttenberg, Jörg Hennenlotter, Georgios Gakis, Stefan Aufderklamm, Steffen Rausch, Eva Neumann, Jens Bedke, Stefan Kruck, Christian Schwentner, Arnulf Stenzl, Tilman Todenhöfer
PURPOSE: Urine fluorescence in situ hybridization (FISH) has become a broadly used marker for noninvasive detection of bladder cancer (BC). However, it has been discussed whether the interpretation algorithm proposed by the manufacturer could be improved. Aim of the present study was to compare alternative evaluation strategies of FISH for detection of BC. METHODS: We included 1048 patients suspicious for BC, who underwent urine FISH examination before cystoscopy (diagnostic cohort)...
December 2, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27905977/spectrum-of-false-positivity-for-the-fourth-generation-human-immunodeficiency-virus-diagnostic-tests
#9
Peter Liu, Patrick Jackson, Nathan Shaw, Scott Heysell
Novel fourth generation screening and confirmatory human immunodeficiency virus (HIV) assays are now commercially available and incorporated into new diagnostic algorithms. We report two cases involving a total of three patients which highlight the spectrum of false positivity for both the Abbott Architect p24 antigen/antibody assay and the confirmatory Multispot antibody differentiation test. We then discuss the mechanisms for false positivity and the associated clinical conditions or laboratory scenarios that may predispose to inaccurate interpretation...
January 5, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27902658/understanding-negative-predictive-value-of-diagnostic-tests-used-in-clinical-practice
#10
Reba A Umberger, Linda A Hatfield, Patricia M Speck
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902616/diagnostic-accuracy-of-tumor-necrosis-factor-alpha-assay-for-tuberculous-pleurisy-a-prisma-compliant-meta-analysis
#11
Min Li, Zhuang Luo, Wenye Zhu, Rana Sami Ullah Khan, Saeed Ummai Ummair, Shaoqing Shi
BACKGROUND: The diagnosis of tuberculous pleurisy is difficult and traditional methods are not always helpful. Many studies have focused on the tumor necrosis factor-alpha (TNF-α) assay in pleural effusion for the diagnosis of tuberculous pleurisy, but the results remain controversial. This meta-analysis was conducted to determine the overall diagnostic accuracy of TNF-α. METHODS: Relevant studies were searched from PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wangfang, and Weipu...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27901552/diagnosis-and-management-of-hyperthyroidism-in-pregnancy-a-review
#12
Jennifer Renae King, Ruben Lachica, Richard H Lee, Martin Montoro, Jorge Mestman
Importance: Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. Objective: To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27894449/ending-a-diagnostic-odyssey-family-education-counseling-and-response-to-eventual-diagnosis
#13
REVIEW
Donald Basel, Julie McCarrier
Genomic sequencing is the diagnostic test of choice for families with undiagnosed or rare diseases seeking an explanation for their child's complex medical concerns. The desire to find answers can easily bias interpretation of sequencing results, and thus the counseling process is designed to facilitate informed decision making and set realistic expectations for possible outcomes. The patient case examples serve to highlight the various challenges and complexities encountered with the clinical application of genomic sequencing and to reflect some of the data that has been accrued during the past 5 years of clinical experience...
February 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/27893647/cervical-spine-mri-in-patients-with-negative-ct-a-prospective-multicenter-study-of-the-research-consortium-of-new-england-centers-for-trauma-reconect
#14
Adrian A Maung, Dirk C Johnson, Kimberly Barre, Thomas Peponis, Thomas Mesar, George C Velmahos, Daniel McGrail, George Kasotakis, Ronald I Gross, Michael S Rosenblatt, Kristen C Sihler, Robert J Winchell, Walter Cholewczynski, Kathryn L Butler, Stephen R Odom, Kimberly A Davis
BACKGROUND: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. While some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT. METHODS: Blunt trauma patients who either were unevaluable or had persistent midline cervicalgia and underwent an MRI of the C-spine after a negative CSCT were enrolled prospectively in 8 Level I and II New England trauma centers...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893164/diagnostic-and-prognostic-value-of-human-prion-detection-in-cerebrospinal-fluid
#15
Aaron Foutz, Brian S Appleby, Clive Hamlin, Xiaoqin Liu, Sheng Yang, Yvonne Cohen, Wei Chen, Janis Blevins, Cameron Fausett, Han Wang, Pierluigi Gambetti, Shulin Zhang, Andrew Hughson, Curtis Tatsuoka, Lawrence B Schonberger, Mark L Cohen, Byron Caughey, Jiri G Safar
Objective-Several prion amplification systems have been proposed for detection of prions in cerebrospinal fluid (CSF), most recently, the measurements of prion seeding activity with second-generation real-time quaking-induced conversion (RT-QuIC). The objective of this study was to investigate the diagnostic performance of the RT-QuIC prion test in the broad phenotypic spectrum of prion diseases. Methods- We performed CSF RT-QuIC testing in 2,141 patients who had rapidly progressive neurological disorders, determined diagnostic sensitivity and specificity in 272 cases which were autopsied, and evaluated the impact of mutations and polymorphisms in the PRNP gene, and Type 1 or Type 2 of human prions on diagnostic performance...
November 28, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27891820/investigating-diagnostic-bias-in-autism-spectrum-conditions-an-item-response-theory-analysis-of-sex-bias-in-the-aq-10
#16
Aja Louise Murray, Carrie Allison, Paula L Smith, Simon Baron-Cohen, Tom Booth, Bonnie Auyeung
Diagnostic bias is a concern in autism spectrum conditions (ASC) where prevalence and presentation differ by sex. To ensure that females with ASC are not under-identified, it is important that ASC screening tools do not systematically underestimate autistic traits in females relative to males. We evaluated whether the AQ-10, a brief screen for ASC recommended by the National Institute of Clinical Excellence in cases of suspected ASC, exhibits such a bias. Using an item response theory approach, we evaluated differential item functioning and differential test functioning...
November 28, 2016: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/27891335/a-comparative-evaluation-of-different-diagnostic-modalities-in-the-diagnosis-of-typhoid-fever-using-a-composite-reference-standard-a-tertiary-hospital-based-study-in-central-india
#17
Veena Maheshwari, Navinchandra Motiram Kaore, Vijay Kumar Ramnani, Sheil Sarda
INTRODUCTION: Enteric fever, caused by Salmonella spp. is a major cause of morbidity and mortality worldwide and endemic in many developing countries including India and other South-East Asian countries. Blood culture is regarded as the gold standard for diagnosis. Currently, the standard serological method is tube agglutination with moderate sensitivity and specificity. Dot blot assay detecting IgM and IgG antibodies to a specific 50kD Outer Membrane Protein (OMP) antigen of Salmonella spp...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891290/a-comparative-study-of-assay-performance-of-commercial-hepatitis-e-virus-enzyme-linked-immunosorbent-assay-kits-in-australian-blood-donor-samples
#18
Ashish C Shrestha, Robert L P Flower, Clive R Seed, Susan L Stramer, Helen M Faddy
Hepatitis E virus (HEV) is transfusion-transmissible and therefore poses a risk to blood transfusion safety. Seroprevalence studies are useful for estimating disease burden and determining risk factors. Considerable variability in the sensitivity of HEV antibody detection assays exists. This study aimed to compare the performances of commercially available HEV enzyme-linked immunosorbent assays (ELISA) in Australian blood donor samples. Plasma samples that tested positive (n = 194) or negative (n = 200) for HEV IgG (Wantai HEV IgG ELISA) were selected...
2016: Journal of Blood Transfusion
https://www.readbyqxmd.com/read/27887717/the-continued-existence-of-significant-disparities-in-the-technical-practices-of-sperm-morphology-assessment-and-the-clinical-implications-results-of-a-french-questionnaire
#19
Nicolas Gatimel, Lucile Mansoux, Jessika Moreau, Jean Parinaud, Roger D Léandri
OBJECTIVE: To investigate current practices for sperm morphology assessment. DESIGN: E-mail survey questionnaire. SETTING: Diagnostic and clinical institutions/laboratories. PATIENT(S): French biologists and clinicians (n = 225). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Answers to 24 questions. RESULT(S): The survey shows that even now in France there is great inconsistency in the use of sperm morphology assessments...
November 22, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27884421/interpreting-the-incremental-cardiopulmonary-exercise-test
#20
REVIEW
Samir Nusair
The incremental cardiopulmonary exercise test (CPET) is an increasingly used diagnostic method that serves to evaluate patients with chief complaint of dyspnea during exercise. Performing maximal symptom-limited CPET can show if the tested subject has a reduced exercise capacity and give clues to the mechanism of such exercise capacity reduction, cardiac, pulmonary, or pulmonary vascular source. In this review, it is suggested that the evaluation of the complex results of CPET should be performed by first determining if myocardial/circulatory insufficiency is present and second if there is gas exchange abnormality...
November 1, 2016: American Journal of Cardiology
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