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Diagnostic error

Matthew A Jarrett, Anna Van Meter, Eric A Youngstrom, Dane C Hilton, Thomas H Ollendick
Guidelines exist for the assessment of attention deficit/hyperactivity disorder (ADHD), but they are often unclear as to how a clinician should consider multiple informants, methods, and co-occurring symptoms to reach an overall diagnostic probability for an individual patient. The current study used receiver operating characteristic analyses and evidence-based medicine methods to evaluate the Achenbach System of Empirically Based Assessment measures and the Conners' Continuous Performance Test for ADHD diagnosis in youth...
October 24, 2016: Journal of Clinical Child and Adolescent Psychology
Deepika Savant, Jaya Bajaj, Cecilia Gimenez, Oana C Rafael, Neda Mirzamani, Karen Chau, Melissa Klein, Kasturi Das
BACKGROUND: Urine cytology is the most frequently utilized test to detect urothelial cancer. Secondary bladder neoplasms need to be recognized as this impacts patient management. We report our experience on nonurothelial malignancies (NUM) detected in urine cytology over a 10-year period. METHODS: A 10-year retrospective search for patients with biopsy-proven NUM to the urothelial tract yielded 25 urine samples from 14 patients. Two cytopathologists blinded to the original cytology diagnosis reviewed the cytology and histology slides...
October 24, 2016: Diagnostic Cytopathology
Marco Galli, Emanuele Marzetti
OBJECTIVES: To determine the overall diagnostic accuracy of the McMurray and Joint Line Tenderness (JLT) tests for the detection of meniscal lesions. DESIGN: Secondary analysis of a prospective observational study. SETTING: Orthopedics outpatient clinic, university hospital. PARTICIPANTS: Patients (n=56) with suspected non-acute meniscal lesions who underwent knee arthroscopy. INTERVENTIONS: Not applicable...
October 19, 2016: Archives of Physical Medicine and Rehabilitation
Giuseppe Lippi, Raffick Bowen, Dorothy M Adcock
No abstract text is available yet for this article.
October 19, 2016: Clinical Biochemistry
C H Wong, T R Tan, H Y Heng Hy, T Ramesh, P W Ting, W S Lee, C L Teng, N Sivalingam, K K Tan
INTRODUCTION: Open disclosure is poorly understood in Malaysia but is an ethical and professional responsibility. The objectives of this study were to determine: (1) the perception of parents regarding the severity of medical error in relation to medication use or diagnosis; (2) the preference of parents for information following the medical error and its relation to severity; and (3) the preference of parents with regards to disciplinary action, reporting, and legal action. METHODS: We translated and contextualised a questionnaire developed from a previous study...
August 2016: Medical Journal of Malaysia
Damien Lesenfants, Dina Habbal, Camille Chatelle, Caroline Schnakers, Steven Laureys, Quentin Noirhomme
OBJECTIVE: To propose a new methodology based on single-trial analysis for detecting residual response to command with EMG in patients with disorders of consciousness (DOC), overcoming the issue of trial dependency and decreasing the influence of a patient's fluctuation of vigilance or arousal over time on diagnostic accuracy. METHODS: Forty-five patients with DOC (18 with vegetative/unresponsive wakefulness syndrome [VS/UWS], 22 in a minimally conscious state [MCS], 3 who emerged from MCS [EMCS], and 2 with locked-in syndrome [LIS]) and 20 healthy controls were included in the study...
October 21, 2016: Neurology
Manisha Balwani, Preeti Singh, Anju Seth, Ekta Malik Debnath, Hetanshi Naik, Dana Doheny, Brenden Chen, Makiko Yasuda, Robert J Desnick
Acute Intermittent Porphyria (AIP), an autosomal dominant inborn error of heme metabolism, typically presents in adulthood, most often in women in the reproductive age group. There are limited reports on the clinical presentation in children, and in contrast to the adults, most of the reported pediatric cases are male. While acute abdominal pain is the most common presenting symptom in children, seizures are commonly seen and may precede the diagnosis of AIP. As an example, we report a 9year old developmentally normal pre-pubertal boy who presented with acute abdominal pain, vomiting and constipation followed by hyponatremia, seizures, weakness and neuropathy...
October 15, 2016: Molecular Genetics and Metabolism
Hardeep Singh, Mark L Graber, Timothy P Hofer
Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient...
October 20, 2016: Journal of Patient Safety
Edmund R Glass, Mikhail G Dozmorov
BACKGROUND: The goal of many human disease-oriented studies is to detect molecular mechanisms different between healthy controls and patients. Yet, commonly used gene expression measurements from blood samples suffer from variability of cell composition. This variability hinders the detection of differentially expressed genes and is often ignored. Combined with cell counts, heterogeneous gene expression may provide deeper insights into the gene expression differences on the cell type-specific level...
October 6, 2016: BMC Bioinformatics
Demet Dingoyan, Mike Mösko, Yadigar Imamoğlu, Alessa von Wolff, Jens Strehle, Hans-Ulrich Wittchen, Holger Schulz, Uwe Koch-Gromus, Andreas Heinz, Ulrike Kluge
The Composite International Diagnostic Interview (CIDI), which has been widely applied in epidemiological research, is a standardized, clinically structured interview that enables the diagnosis of mental disorders based on DSM and ICD criteria. The computerized DIA-X CIDI Version 2.8 investigated in this study is an adaptation of the German DIA-X/Munich CIDI, which was translated in a multi-step process into Turkish and used to survey the prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany (N = 662)...
October 21, 2016: International Journal of Methods in Psychiatric Research
Carlos Sardinero-García, Andrés Santiago-Sáez, M Del Carmen Bravo-Llatas, Bernardo Perea-Pérez, M Elena Albarrán-Juan, Elena Labajo-González, Julián Benito-León
OBJECTIVE: To analyse the sentences due to loss of chance that were passed by the Contentious-Administrative Court (i.e., in public medicine), in which both the origin of the disease to be treated and the damages were neurological. METHODS: We analysed the 90 sentences concerning neurological conditions that referred to the concept of loss of chance that were passed in Spain from 2003 (year of the first sentence) until May 2014. FINDINGS: Of the 90 sentences, 52 (57...
October 17, 2016: Gaceta Sanitaria
Sebastian Sippel, Holger Lange, Miguel D Mahecha, Michael Hauhs, Paul Bodesheim, Thomas Kaminski, Fabian Gans, Osvaldo A Rosso
Data analysis and model-data comparisons in the environmental sciences require diagnostic measures that quantify time series dynamics and structure, and are robust to noise in observational data. This paper investigates the temporal dynamics of environmental time series using measures quantifying their information content and complexity. The measures are used to classify natural processes on one hand, and to compare models with observations on the other. The present analysis focuses on the global carbon cycle as an area of research in which model-data integration and comparisons are key to improving our understanding of natural phenomena...
2016: PloS One
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
M V Fedulova, N V Vlasova, A N Shai
The authors report a case of the interstitial disease of the lungs revealed by a histological study that demonstrated intravital diagnostic faults in the patient in question. Moreover, a postmortem diagnostic error occurred; namely, the macroscopic study of the thoracic organs had shown the 0.5 cm long linear rupture of the adhesion in the right lung root region that was considered to be the cause of hemothorax and anemia of the internal organs which supposedly resulted in the patient's death. The definitive diagnosis of interstitial disease of the lungs was established based on the results of the histological study...
2016: Sudebno-meditsinskaia Ekspertiza
Hideki Kato, Keita Sakai, Mizuki Uchiyama, Kentaro Suzuki
The diagnostic reference levels (DRLs) of the general X-ray radiography are defined by the absorbed dose of air at the entrance surface with backscattered radiation from a scattering medium. Generally, the entrance surface dose of the general X-ray radiography is calculated from measured air kerma of primary X-ray multiplied by a backscatter factor (BSF). However, the BSF data employed at present used water for scattering medium, and was calculated based on the water-absorbed dose by incident primary photons and backscattered photons from the scattering medium...
2016: Nihon Hoshasen Gijutsu Gakkai Zasshi
Emily C Edmonds, Joel Eppig, Mark W Bondi, Kelly M Leyden, Bailey Goodwin, Lisa Delano-Wood, Carrie R McDonald
OBJECTIVE: We investigated differences in regional cortical thickness between previously identified empirically derived mild cognitive impairment (MCI) subtypes (amnestic MCI, dysnomic MCI, dysexecutive/mixed MCI, and cluster-derived normal) in order to determine whether these cognitive subtypes would show different patterns of cortical atrophy. METHODS: Participants were 485 individuals diagnosed with MCI and 178 cognitively normal individuals from the Alzheimer's Disease Neuroimaging Initiative...
October 19, 2016: Neurology
Philippe Chouvarine, Lutz Wiehlmann, Patricia Moran Losada, David S DeLuca, Burkhard Tümmler
Ever-increasing affordability of next-generation sequencing makes whole-metagenome sequencing an attractive alternative to traditional 16S rDNA, RFLP, or culturing approaches for the analysis of microbiome samples. The advantage of whole-metagenome sequencing is that it allows direct inference of the metabolic capacity and physiological features of the studied metagenome without reliance on the knowledge of genotypes and phenotypes of the members of the bacterial community. It also makes it possible to overcome problems of 16S rDNA sequencing, such as unknown copy number of the 16S gene and lack of sufficient sequence similarity of the "universal" 16S primers to some of the target 16S genes...
2016: PloS One
E Pagani, A Tarducci, A Borrelli, B Iotti, M Tursi, R Zanatta
Ultrasonographic evaluation of the adrenal glands was performed in 85 dogs, followed by macroscopic and histopathological examination either post-mortem or after adrenalectomy. This retrospective cross-sectional study evaluated the difference between gross and ultrasonographic measurements to determine the diagnostic accuracy of ultrasonography in the evaluation of canine adrenal gland size. The differences were assessed for gland length, thickness at cranial, middle and caudal regions, and surface area. In our sample, ultrasound error accuracy ranged between 0% in measurement of the right adrenal gland surface area and 25...
October 17, 2016: Anatomia, Histologia, Embryologia
Hardeep Singh, Laura Zwaan
No abstract text is available yet for this article.
October 18, 2016: Annals of Internal Medicine
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