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Bayes theorem diagnosis

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https://www.readbyqxmd.com/read/28673674/is-ct-angiography-of-the-pulmonary-arteries-indicated-in-patients-with-high-clinical-probability-of-pulmonary-embolism
#1
L Martínez Montesinos, J M Plasencia Martínez, J M García Santos
When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography...
June 30, 2017: Radiología
https://www.readbyqxmd.com/read/28657526/useful-of-tokyo-guidelines-in-the-diagnosis-of-acute-cholecystitis-anatomopathologie-correlationship
#2
Christian Janikow, Edgardo Corti, Nicolás Menso, Gastón Moretti, Martín Alé, Martín Sánchez, Paul Eduardo Lada
BACKGROUND: In the year 2007 a group of experts come together to discuss criteria for acute cholecystitis and to establish therapeutic guidelines and states of gravity in this disease. OBJECTIVES: we correlated the criteria of the Tokyo Guidelines 2007 with the anatomopathology study of the surgical specimen. SETTING: Service of Urgencies of the National Clinic Hospital in Córdoba, Argentine. METHODS: We studied 324 patients (120 male and 204 female) older than 15 years and without limits of age with the criteria of acute cholecystitis a cord to the Tokyo guidelines 2007...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28562551/final-diagnoses-and-probability-of-new-reason-for-encounter-at-an-urban-clinic-in-japan-a-4-year-observational-study
#3
Motoharu Fukushi, Yukishige Ishibashi, Naoki Nago
Past clinical data are not currently used to calculate pretest probabilities, as they have not been put into a database in clinical settings. This observational study was designed to determine the initial reasons for utilizing home visits or visits to an outpatient urban clinic in Japan.All family medical clinic outpatients and patients visited by the clinic (total = 11,688) over 1460 days were enrolled.We used a Bayes theorem-based clinical decision support system to analyze codes for initial reason-for-encounter (examination and final diagnosis: pretest probability) and final diagnosis of patients with fever (conditional pretest probability)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28521616/a-10-gene-classifier-for-indeterminate-thyroid-nodules-development-and-multicenter-accuracy-study
#4
Hernán E González, José R Martínez, Sergio Vargas-Salas, Antonieta Solar, Loreto Veliz, Francisco Cruz, Tatiana Arias, Soledad Loyola, Eleonora Horvath, Hernán Tala, Eufrosina Traipe, Manuel Meneses, Luis Marín, Nelson Wohllk, René E Diaz, Jesús Véliz, Pedro Pineda, Patricia Arroyo, Natalia Mena, Milagros Bracamonte, Giovanna Miranda, Elsa Bruce, Soledad Urra
BACKGROUND: In most of the world, diagnostic surgery remains the most frequent approach for indeterminate thyroid cytology. Although several molecular tests are available for testing in centralized commercial laboratories in the United States, there are no available kits for local laboratory testing. The aim of this study was to develop a prototype in vitro diagnostic (IVD) gene classifier for the further characterization of nodules with an indeterminate thyroid cytology. METHODS: In a first stage, the expression of 18 genes was determined by quantitative polymerase chain reaction (qPCR) in a broad histopathological spectrum of 114 fresh-tissue biopsies...
July 11, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27818878/intelligent-framework-for-diagnosis-of-frozen-shoulder-using-cross-sectional-survey-and-case-studies
#5
Humaira Batool, M Usman Akram, Fouzia Batool, Wasi Haider Butt
OBJECTIVES: Frozen shoulder is a disease in which shoulder becomes stiff. Accurate diagnosis of frozen shoulder is helpful in providing economical and effective treatment for patients. This research provides the classification of unstructured data using data mining techniques. Prediction results are validated by K-fold cross-validation method. It also provides accurate diagnosis of frozen shoulder using Naïve Bayesian and Random Forest models. At the end results are presented by performance measure techniques...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27178981/is-omission-of-free-text-records-a-possible-source-of-data-loss-and-bias-in-clinical-practice-research-datalink-studies-a-case-control-study
#6
Sarah J Price, Sal A Stapley, Elizabeth Shephard, Kevin Barraclough, William T Hamilton
OBJECTIVES: To estimate data loss and bias in studies of Clinical Practice Research Datalink (CPRD) data that restrict analyses to Read codes, omitting anything recorded as text. DESIGN: Matched case-control study. SETTING: Patients contributing data to the CPRD. PARTICIPANTS: 4915 bladder and 3635 pancreatic, cancer cases diagnosed between 1 January 2000 and 31 December 2009, matched on age, sex and general practitioner practice to up to 5 controls (bladder: n=21 718; pancreas: n=16 459)...
May 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27146704/planning-clinically-relevant-biomarker-validation-studies-using-the-number-needed-to-treat-concept
#7
Roger S Day
PURPOSE: Despite an explosion of translational research to exploit biomarkers in diagnosis, prediction and prognosis, the impact of biomarkers on clinical practice has been limited. The elusiveness of clinical utility may partly originate when validation studies are planned, from a failure to articulate precisely how the biomarker, if successful, will improve clinical decision-making for patients. Clarifying what performance would suffice if the test is to improve medical care makes it possible to design meaningful validation studies...
May 4, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/26999810/variability-in-pathologists-interpretations-of-individual-breast-biopsy-slides-a-population-perspective
#8
Joann G Elmore, Heidi D Nelson, Margaret S Pepe, Gary M Longton, Anna N A Tosteson, Berta Geller, Tracy Onega, Patricia A Carney, Sara L Jackson, Kimberly H Allison, Donald L Weaver
BACKGROUND: The effect of physician diagnostic variability on accuracy at a population level depends on the prevalence of diagnoses. OBJECTIVE: To estimate how diagnostic variability affects accuracy from the perspective of a U.S. woman aged 50 to 59 years having a breast biopsy. DESIGN: Applied probability using Bayes' theorem. SETTING: B-Path (Breast Pathology) Study comparing pathologists' interpretations of a single biopsy slide versus a reference consensus interpretation from 3 experts...
May 17, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26939066/how-much-overtesting-is-needed-to-safely-exclude-a-diagnosis-a-different-perspective-on-triage-testing-using-bayes-theorem
#9
Jonne J Sikkens, Djoeke G Beekman, Abel Thijs, Patrick M Bossuyt, Yvo M Smulders
Ruling out disease often requires expensive or potentially harmful confirmation testing. For such testing, a less invasive triage test is often used. Intuitively, few negative confirmatory tests suggest success of this approach. However, if negative confirmation tests become too rare, too many disease cases could have been missed. It is therefore important to know how many negative tests are needed to safely exclude a diagnosis. We quantified this relationship using Bayes' theorem, and applied this to the example of pulmonary embolism (PE), for which triage is done with a Clinical Decision Rule (CDR) and D-dimer testing, and CT-angiography (CTA) is the confirmation test...
2016: PloS One
https://www.readbyqxmd.com/read/26875953/competing-risks-model-in-screening-for-preeclampsia-by-maternal%C3%A2-factors-and-biomarkers-at-30-34-weeks-gestation
#10
Andreas Tsiakkas, Youssef Saiid, Alan Wright, David Wright, Kypros H Nicolaides
BACKGROUND: Preeclampsia (PE) affects 2-3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. We have proposed a 2-stage strategy for the identification of pregnancies at high risk of developing PE. The objective of the first stage, at 11-13 weeks' gestation, is a reduction in the prevalence of the disease through pharmacological intervention in the high-risk group. The objective of the second stage, during the second and/or third trimesters, is to improve perinatal outcome through close monitoring of the high-risk group for earlier diagnosis of the clinical signs of the disease and selection of the appropriate, time, place, and method of delivery...
July 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26555449/diagnosis-and-or-classification-of-vasculitis-different
#11
REVIEW
Hasan Yazici, Yusuf Yazici
PURPOSE OF REVIEW: Currently, there are no diagnostic criteria for vasculitides. To this end, there is a current European League Against Rheumatism and American College of Rheumatology initiative for formulating separate classification and diagnostic criteria for different forms of vasculitis. The authors of this review previously disagreed to separate classification and diagnostic criteria. They now expand this disagreement in light of both of more recent information and a reassessment of older communications...
January 2016: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/26506878/serum-level-of-interleukin-17-and-interleukin-35-as-a-biomarker-for-diagnosis-of-thyroid-cancer
#12
Yi Lu, Ye Yuan
OBJECTIVE: The aim of this study was to evaluate the serum level of interleukin-17 (IL-17) and IL-35 in thyroid cancer patients and its diagnostic value as a biomarker. METHODS: Sixty-one thyroid carcinoma patients were recruited from January 2012 to December 2014 in our hospital. Of the 61 included cases, 42 subjects were pathology confirmed with thyroid cancer and other 19 cases were diagnosed with thyroid adenoma. The serum level of IL-17 and IL-35 were compared between the two groups...
October 2015: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/26444024/informativeness-of-early-huntington-disease-signs-about-gene-status
#13
Emily Oster, Shirley W Eberly, E Ray Dorsey, Elise Kayson-Rubin, David Oakes, Ira Shoulson
BACKGROUND: The cohort-level risk of Huntington disease (HD) is related to the age and symptom level of the cohort, but this relationship has not been made precise. OBJECTIVE: To predict the evolving likelihood of carrying the Huntington disease (HD) gene for at-risk adults using age and sign level. METHODS: Using data from adults with early signs and symptoms of HD linked to information on genetic status, we use Bayes' theorem to calculate the probability that an undiagnosed individual of a certain age and sign level has an expanded CAG repeat...
2015: Journal of Huntington's Disease
https://www.readbyqxmd.com/read/26219318/the-challenge-of-medical-diagnosis-a-primer-on-principles-probability-process-and-pitfalls
#14
K S Jacob
Arriving at a medical diagnosis is a complex process, which requires clinical skill. However, the need for clear decisions has to be balanced by an acceptance of the ambiguity of many clinical situations. Complex presentations often require probabilistic inferences rather than presumed diagnostic certainty. The demands, logic and process of clinical diagnosis are highlighted. The multiple aspects of clinical reality and the impact of gold standards, nature of evidence and dichotomous disease/no disease categorization are discussed...
January 2015: National Medical Journal of India
https://www.readbyqxmd.com/read/26148910/the-role-of-latex-agglutination-test-for-the-etiological-diagnosis-of-pleural-effusion-in-children-and-adolescents
#15
Paulo Camargos, Ana Cristina Fonseca, Sérgio Amantéa, Elizabeth Oliveira, Maria das Graças Benfica, Chequer Chamone
INTRODUCTION: The etiological diagnosis of pleural effusion is a difficult task because the diagnostic tools can only establish a definitive etiological diagnosis in at most 76% of cases. OBJECTIVES: To verify the diagnostic accuracy of the latex agglutination test (LAT) for the etiological diagnosis of pleural effusions caused by Streptococcus pneumoniae and Haemophilus influenzae type b. METHODS: After thoracocentesis, paired fresh samples of pleural fluid from 418 children and adolescents were included in this investigation...
May 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/26028484/diagnosis-of-biopsy-verified-usual-interstitial-pneumonia-by-computed-tomography
#16
Vidar Søyseth, Trond Mogens Aaløkken, Georg Mynarek, Anne Naalsund, Erik H Strøm, Helge Scott, Alf Kolbenstvedt
OBJECTIVE: To identify the combination of clinical data and high resolution computed tomography (HRCT) features that best identified biopsy verified usual interstitial pneumonia (UIP). METHODS: The study included 91 patients with a tentative diagnosis of interstitial lung disease. All underwent clinical investigation, surgical lung biopsy and HRCT. Two independent readers assessed the HRCT images for the extent and pattern of abnormality. On the basis of the biopsy result the patients were categorized in three groups: 1) Usual interstitial pneumonia, 2) Other idiopathic interstitial pneumonias (IIPs) and hypersensitivity pneumonitis and 3) Other interstitial lung diseases...
July 2015: Respiratory Medicine
https://www.readbyqxmd.com/read/26005726/points-of-significance-bayes-theorem
#17
Jorge López Puga, Martin Krzywinski, Naomi Altman
No abstract text is available yet for this article.
April 2015: Nature Methods
https://www.readbyqxmd.com/read/25979870/fructosamine-measurement-for-diabetes-mellitus-diagnosis-and-monitoring-a-systematic-review-and-meta-analysis-protocol
#18
REVIEW
Jobert Richie N Nansseu, Joël Fokom-Domgue, Jean Jacques N Noubiap, Eric V Balti, Eugène Sobngwi, André Pascal Kengne
INTRODUCTION: Fructosamine is a marker of glucose control reflecting the average glycaemic level over the preceding 2-3 weeks. Fructosamine has not gained as much popularity as glycated haemoglobin (HbA1c) for diabetes mellitus (DM) control monitoring, and the related underlying reasons remain unclear. We aim to search for and summarise available evidence on the accuracy of fructosamine measurements to diagnose and monitor DM. METHODS AND ANALYSIS: This systematic review will include randomised control trials, controlled before-and-after studies, time series designs, cohort studies, case-control studies and cross-sectional surveys reporting the diagnosis and/or monitoring of DM (type 1 DM, type 2 DM and gestational DM) with fructosamine compared with other measures of glycaemia (fasting glucose, oral glucose tolerance test, random glucose, HbA1c), without any language restriction...
2015: BMJ Open
https://www.readbyqxmd.com/read/25977116/cost-effectiveness-of-coronary-ct-angiography-in-patients-with-chest-pain-comparison-with-myocardial-single-photon-emission-tomography
#19
COMPARATIVE STUDY
Seung-Pyo Lee, Eun Jin Jang, Yong-Jin Kim, Myung-Jin Cha, Sun-Young Park, Hyun Jin Song, Ji Eun Choi, Jung-Im Shim, Jeonghoon Ahn, Hyun Joo Lee
BACKGROUND: Coronary CT angiography (CCTA) has been proven accurate and is incorporated in clinical recommendations for coronary artery disease (CAD) diagnosis workup, but cost-effectiveness data, especially in comparison to other methods such as myocardial single photon emission CT (SPECT) are insufficient. OBJECTIVE: To compare the cost-effectiveness of CCTA and myocardial SPECT in a real-world setting. METHODS: We performed a retrospective cohort study on consecutive patients with suspected CAD and a pretest probability between 10% and 90%...
September 2015: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/25954418/text-classification-towards-detecting-misdiagnosis-of-an-epilepsy-syndrome-in-a-pediatric-population
#20
Ryan Sullivan, Robert Yao, Randa Jarrar, Jeffrey Buchhalter, Graciela Gonzalez
When attempting to identify a specific epilepsy syndrome, physicians are often unable to make or agree upon a diagnosis. This is further complicated by the fact that the current classification and diagnosis of epilepsy requires specialized training and the use of resources not typically available to the average clinician, such as training to recognize specific seizure types and electroencephalography (EEG). Even when training and resources are available, expert epileptologists often find it challenging to identify seizure types and to distinguish between specific epilepsy syndromes...
2014: AMIA ... Annual Symposium Proceedings
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