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Molinaro, Annette M. "Diagnostic tests: how to estimate the positive predictive value." Neuro-Oncology Practice 2, no. 4 (2015): 162–66. http://dx.doi.org/10.1093/nop/npv030.
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Abstract When a patient receives a positive test result from a diagnostic test they assume they have the disease. However, the positive predictive value (PPV), ie the probability that they have the disease given a positive test result, is rarely equal to one. To assist their patients, doctors must explain the chance that they do in fact have the disease. However, physicians frequently miscalculate the PPV as the sensitivity and/or misinterpret the PPV, which results in increased anxiety in patients and generates unnecessary tests and consultations. The reasons for this miscalculation as well as three ways to calculate the PPV are reviewed here.
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Arad, Banafsheh, Abolfazl Mahyar, Mahmoud Vandaie, and Sonia Oveisi. "Prediction of Vesicoureteral Reflux by Ultrasonography and Renal Scan in Children." Global Pediatric Health 9 (January 2022): 2333794X2211078. http://dx.doi.org/10.1177/2333794x221107826.
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Background. In recent studies, renal ultrasonography and dimercapto-succinic acid (DMSA) scan have a role in predicting vesicoureteral reflux in children with febrile urinary tract infection (UTI). Materials and Methods. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were defined for ultrasonography and DMSA scan to predict vesicoureteral reflux in 70 children with febrile UTI. Results. Renal ultrasonography sensitivity, specificity, PPV, NPV, PLR, and NLR for vesicourethral reflux prediction was 0.57, 0, 1, 0, 0.57, and 0.47 and sensitivity, specificity, PPV, NPV, PLR, and NLR of DMSA scan for predicting vesicourethral reflux was 0.75, 0.9, 0.33, 0.98, 7.5, and 0.27, respectively. Conclusions. Ultrasonography cannot predict the presence of VUR, but DMSA scan has a good sensitivity in this context. Therefore, by observation of DMSA scan results, it can be decided whether to perform VCUG or not.
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Gunashekar, Satheesh, Ashutosh Kaushal, Ajit Kumar, Priyanka Gupta, Namrata Gupta, and Pooja C.S. "Comparison between perfusion index, pleth variability index, and pulse pressure variability for prediction of hypotension during major abdominal surgery under general anaesthesia: A prospective observational study." Indian Journal of Anaesthesia 68, no. 4 (2024): 360–65. http://dx.doi.org/10.4103/ija.ija_706_23.
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Background and Aims: Short-term hypotension after general anaesthesia can negatively impact surgical outcomes. This study compared the predictive potential of the pleth variability index (PVI), pulse pressure variability (PPV), and perfusion index (PI) for anaesthesia-induced hypotension. This study’s primary objective was to evaluate the predictive potential of PI, PVI, and PPV for hypotension. Methods: This observational study included 140 adult patients undergoing major abdominal surgery under general anaesthesia. Mean arterial pressure, heart rate, PVI, PPV, and PI were collected at 1-min intervals up to 20 min post anaesthesia induction. Hypotension was assessed at 5-min and 15-min intervals. Receiver operating characteristic (ROC) curves were plotted to determine the diagnostic performance and best cut-off for continuous variables in predicting a dichotomous outcome. Statistical significance was kept at P < 0.05. Results: Hypotension prevalence within 5 and 15 min of anaesthesia induction was 36.4% and 45%, respectively. A PI cut-off of <3.5 had an area under the ROC curve (AUROC) of 0.647 (P = 0.004) for a 5-min hypotension prediction. The PVI’s AUROC was 0.717 (P = 0.001) at cut-off >11.5, while PPV’s AUROC was 0.742 (P = 0.001) at cut-off >12.5. At 15 min, PVI’s AUROC was 0.615 (95% confidence interval 0.521–0.708, P = 0.020), with 54.9% positive predictive value and 65.2% negative predictive value. Conclusion: PVI, PPV, and PI predicted hypotension within 5 min after general anaesthesia induction. PVI had comparatively higher accuracy, sensitivity, specificity, and positive predictive value than PI and PPV when predicting hypotension at 15 min.
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Abdurrahman Al Hakim Sampurna Putra S, Ravenalla. "NILAI SENSITIVITAS, SPESIFISITAS, POSITIVE PREDICTIVE VALUE DAN NEGATIVE PREDICTIVE VALUE SPHYGMOMANOMETER DIGITAL PADA SKRINING HIPERTENSI." Jurnal Kedokteran Universitas Palangka Raya 9, no. 1 (2021): 1210–18. http://dx.doi.org/10.37304/jkupr.v9i1.2859.
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Berdasarkan data hipertensi terlihat bahwa hipertensi sendiri masih merupakan momok bagi kesehatan penduduk Indonesia. Pada tahun 2012 data PTM menunjukkan terdapat 554.771 kasus Hipertensi Esensial di Jawa Tengah. Data PTM Kabupaten Purbalingga khususnya untuk tahun 2012 menunjukkan bahwa kasus Hipertensi Esensial merupakan PTM dengan kasus terbanyak dengan total 7.440 kasus dan Hipertensi lainnya 3.616 kasus. Penelitian ini bertujuan untuk melakukan deteksi dini penderita hipertensi di Kecamatan Purbalingga Kabupaten Purbalingga, mengetahui sensitivitas, spesifisitas, PPV dan NPV dari sphygmomanometer digital yang digunakan. Penelitian ini merupakan uji diagnostic pada skrining hipertensi. Sasaran skrining adalah orang yang tinggal di wilayah kerja Puskesmas Purbalingga dengan umur di atas 30 tahun. Dasar perhitungan jumlah sampel mengacu kepada besar rumus besar sampel dari Burderer. Alat yang digunakan adalah sphygmomanometer digital serta sphygmomanometer air raksa (sebagai gold standart) sesuai dengan prosedur yang sudah ditentukan. Dari Hasil skrining menggunakan tensimeter air raksa didapatkan 53 responden menderita hipertensi, menggunakan tensimeter digital didapatkan 48 responden menderita hipertensi. Hasil skrining hipertensi di Puskesmas Purbalingga menunjukkan bahwa tensimeter digital yang digunakan memiliki sensitifitas 90,6%, spesifitas 100%,PPV 100% dan NPV 87,2%. Hal ini menunjukkan hasil yang tidak terlalu berbeda dibandingkan sphygmomanometer air raksa yang merupakan gold standart untuk pengukuran hipertensi
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Pillai, Raji, Charles Handorf, and William David Henner. "Treatment implications for immunohistochemistry-based diagnoses with low positive predictive value." Journal of Clinical Oncology 31, no. 15_suppl (2013): e22033-e22033. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e22033.
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e22033 Background: In a recent study (Handorf, C. et al., Am. J. Surg. Pathol., in press), the accuracy of tumor diagnoses using immunohistochemistry (IHC) (83%) was directly compared to accuracy of gene expression profiling (GEP) (89%). However, in clinical practice, IHC is more commonly used initially and GEP is used secondarily in difficult-to-diagnose cases. For this reason, it is important to identify which IHC-based diagnoses have a low positive predictive value (PPV) and therefore might benefit from the addition of GEP or other diagnostic procedures. Methods: The direct comparison study included 157 metastatic tumors of known origin that represented 15 possible tumor types. A panel of four board-certified anatomic pathologists was blinded to the primary site and each pathologist used IHC to render final tumor diagnoses. 472 specimen reviews and diagnoses were performed. The fraction correct (PPV) for the diagnoses rendered for each of the 15 tumor types in the study were compared. Results: The PPV for each of the 15 tissue types diagnoses was either: low (gastric, 29%; pancreatic, 31%; non-small cell lung, 55%), moderate (prostate, renal, hepatocellular, ovarian and colorectal, 85-90%) or high (bladder, breast, testicular germ cell, non-Hodgkin’s lymphoma, melanoma, sarcoma and thyroid, 94-100%). Among the 90 diagnoses of tissues with low PPVs (gastric, pancreatic and non-small lung cancer) there were 59 incorrect diagnoses. For 23 of those 59 diagnoses, the actual tumor type is treatable for prolonged survival including: breast (N=11), colorectal (N=6), ovarian (N=3) and prostate (N=3) cancer. Conclusions: The PPV for IHC-based diagnoses of primary site varies substantially depending of the type of tissue diagnosed. Pathologists should consider the likely PPV of their IHC-based diagnoses of primary site when considering the use of GEP or other methods to refine their diagnosis. For many of the IHC-based primary site diagnoses with low PPVs, the correct primary site diagnosis may allow treatment for prolonged survival.
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Yeo, Seungsoo. "Exploring the Importance of Positive Predictive Value and Prevalence Rate in Learning Disability Diagnosis." Korean Journal of Special Education 59, no. 4 (2025): 21–40. https://doi.org/10.15861/kjse.2025.59.4.21.
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The main purpose of this study was to analyze the importance of Positive Predictive Value (PPV) in the diagnosis of learning disabilities and the impact of prevalence rates on diagnostic accuracy. In the context of learning disability diagnosis, PPV represents the proportion of students diagnosed as positive who truly have a learning disability, serving as a critical indicator of diagnostic reliability. The study revealed that in environments with extremely low prevalence rates, such as South Korea, even diagnostic tools with high sensitivity and specificity exhibited significantly low PPV, severely undermining the effectiveness of learning disability diagnoses. Conversely, as prevalence rates increased, PPV improved dramatically, with a simulated prevalence rate of 10% resulting in a PPV of 67.9%. This study highlights the pivotal role of prevalence rates in determining diagnostic accuracy and underscores the need for policy reforms and additional evaluation procedures to address the challenges posed by low prevalence rates.
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Carter, Gregory, Allison Milner, Katie McGill, Jane Pirkis, Nav Kapur, and Matthew J. Spittal. "Predicting suicidal behaviours using clinical instruments: Systematic review and meta-analysis of positive predictive values for risk scales." British Journal of Psychiatry 210, no. 6 (2017): 387–95. http://dx.doi.org/10.1192/bjp.bp.116.182717.
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BackgroundPrediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as ‘high risk’ to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).AimsTo identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.MethodA systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.ResultsFor all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9–7.9%), self-harm 26.3% (95% CI 21.8–31.3%) and self-harm plus suicide 35.9% (95% CI 25.8–47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3–22.3%) for high-quality studies, 32.5% (95% CI 26.1–39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5–35.6%) for psychiatric in-patients.ConclusionsNo ‘high-risk’ classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.
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Budhram, Adrian, Ryan G. Taylor, Jeff Fuller, Jorge G. Burneo, J. David Knox, and Stephen H. Pasternak. "The Predictive Value of Endpoint Quaking-Induced Conversion in Creutzfeldt-Jakob Disease." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 5 (2019): 595–98. http://dx.doi.org/10.1017/cjn.2019.72.
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ABSTRACT:Creutzfeldt-Jakob disease (CJD) is a fatal neurological illness for which accurate diagnosis is paramount. Real-time quaking-induced conversion (RT-QuIC) is a prion-specific assay with high sensitivity and specificity for CJD. The Canadian endpoint quaking-induced conversion (EP-QuIC) test is similar, but unlike RT-QuIC there is little data regarding its diagnostic utility in clinical practice. In this exploratory predictive value analysis of EP-QuIC in CJD, the negative predictive value (NPV) and positive predictive value (PPV) was 100% and 83%, respectively, with one false-positive result identified. Re-testing this sample with an optimized EP-QuIC protocol eliminated this false-positive result, leading to a PPV of 100%.
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Teoh, Deanna, Gwiwon Nam, Shalini Kulasingam, and Rachel I. Vogel. "4223 Changes in positive predictive value of cervical cytology following HPV vaccination." Journal of Clinical and Translational Science 4, s1 (2020): 24–25. http://dx.doi.org/10.1017/cts.2020.113.
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OBJECTIVES/GOALS: To determine if current U.S. HPV vaccination rates have decreased dysplasia prevalence enough to decrease the positive predictive value (PPV) of abnormal cervical cytology. METHODS/STUDY POPULATION: This retrospective cohort study comprised a chart review of all patients 21-35 years of age who had at least 1 Pap test result within MHealth/Fairview 2016-2018. HPV vaccination data, cervical cancer screening data and dysplasia results were abstracted. Vaccinated was defined as receiving at least 1 dose of HPV vaccine, with subgroup analyses performed for those completing vaccination per ACIP guidelines and by age of initiation dichotomized as 21+ years versus <21 years. RESULTS/ANTICIPATED RESULTS: 49,764 patients meeting study criteria were identified. Among the entire study population, 10% had abnormal cytology results during the study period. Among the 4,928 patients with abnormal cytology, PPV for CIN2+ was lower among vaccinated individuals (13% vs. 18%; p < 0.0001). Among vaccinated individuals, PPV was lower among those completing vaccination (12% vs. 16% for incomplete vaccination; p = 0.04) and among those initiating vaccination at <21 years of age (9% vs 26% for 21+y; p < 0.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: Among a population with low HPV vaccine coverage, the decrease in dysplasia prevalence among vaccinated individuals is resulting in a subsequent decrease in PPV of cervical cytology, particularly in those initiating vaccination prior to 21 years of age and among those completing the series. Confirmation of these results will call for changes in screening strategies for vaccinated individuals. CONFLICT OF INTEREST DESCRIPTION: Acelity: Industry grant for an investigator-initiated industry-sponsored clinical trial. Tesaro: Site PI for industry-sponsored clinical trial. NOTE: Funding from the industries above are unrelated to the research presented in the abstract.
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Pambet, Mathilde, Fanny Sirodot, Bruno Pereira, et al. "Benefits of Premaquick® Combined Detection of IL-6/Total IGFBP-1/Native IGFBP-1 to Predict Preterm Delivery." Journal of Clinical Medicine 12, no. 17 (2023): 5707. http://dx.doi.org/10.3390/jcm12175707.
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We conducted a prospective double-blind study to compare two vaginal diagnostic methods in singleton pregnancies with threatened preterm labor (TPL) at the University Hospital of Clermont-Ferrand (France) from August 2018 to December 2020. Our main objective was to compare the diagnostic capacity at admission, in terms of positive predictive value (PPV) and negative predictive value (NPV), of Premaquick® (combined detection of IL-6/total IGFBP-1/native IGFBP-1) and QuikCheck fFN™ (fetal fibronectin) for delivery within 7 days in cases of TPL. We included 193 patients. Premaquick® had a sensitivity close to 89%, equivalent to QuikCheck fFN™, but a higher statistical specificity of 49.5% against 38.6% for QuikCheck fFN™. We found no superiority of Premaquick® over QuickCheck fFN™ in terms of PPV (6.6% vs. 7.9%), with NPV being equivalent in predicting childbirth within 7 days in cases of TPL (98.6% vs. 98.9%). Nevertheless, the combination of positive native and total IGFBP-1 and the combination of all three positive markers were associated with a higher PPV. Our results, though non-significant, support this combined multiple-biomarker approach to improve testing in terms of predictive values.
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Dickman, Jeffrey S., Reem M. Haddad, and Andrew Racette. "Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi." Dermatology Research and Practice 2020 (January 29, 2020): 1–4. http://dx.doi.org/10.1155/2020/6716145.
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Dysplastic nevi (DN) are common and controversial and the best choice for management of DN after diagnosis is not always clear. The presence of positive margins found on diagnostic biopsy is used by many dermatologists when deciding whether to re-excise these lesions. In order to quantify the predictive value of positive margins in diagnostic biopsies of DN, we performed a review and analysis of the concordance between the histological findings of biopsies and their subsequent excisions. A total of 122 pathology reports from diagnostic biopsies of DN with nevus cells present at the tissue margin were reviewed. Within this sample, 68 total postbiopsy excisions had been performed. The excisional pathology reports were reviewed for the presence of residual or recurrent nevus cells. Residual nevus cells were reported in 29 of 63 available excisional pathology reports illustrating a positive predictive value (PPV) of positive margins in diagnostic biopsies of DN of 46.0%. We present this value along with PPVs from the very few existing similar studies. The quantified predictive value of positive margins in diagnostic biopsies is useful information for providers who must make decisions regarding the best treatment options for patients with DN. The low PPV of positive margins lends further evidence that DN of moderate severity or less may simply be monitored.
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Kutluhan, Musab Ali, Selman Ünal, Serhan Eren, et al. "Predictive features of pre-operative computed tomography and magnetic resonance imaging for advanced disease in renal cell carcinoma." Archivio Italiano di Urologia e Andrologia 94, no. 1 (2022): 1–6. http://dx.doi.org/10.4081/aiua.2022.1.1.
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Objective: We evaluated predictive features of pre-operative computed tomography and magnetic resonance imaging for advanced disease in renal cell carcinoma. Materials and methods: 92 patients with pathologically confirmed diagnosis of renal cell carcinoma were included in our study. Patients were divided into two groups according to preoperative imaging as computed tomography (CT) (55 patients) and magnetic resonance imaging (MRI) (37 patients). Within the imaging groups, the patients were divided into two groups according to pathological tumor stage: 1-2 (pT1-2) versus ≥ pT3a. It was evaluated whether there was a difference between the two groups in terms of the presence of pre-operative imaging (CT and MRI) features. Predictive value of these features for ≥ pT3a disease was evaluated both for CT and MRI.Results: The cut-off value for the Gerota’s fascia thickness in predicting ≥ pT3a disease was calculated as 0.205 cm. Positive predictive value (PPV) for Gerota's fascia thickness was 52.4% (31.0-73.7) and 66.7% (40.0-93.3) for CT and MRI respectively. The PPV value for renal capsule invasion was 75.0% (53.8-96.2) and 90.0% (71.4-108.6) for CT and MRI respectively. PPV of perirenal fat invasion for CT and MRI was 69.2% (44.1-94.3) and 81.8% (59.0-104.6) respectively. Conclusion: Renal capsular invasion and perirenal fat invasion are reliable signs for locally advanced (≥ pT3a) renal cell carcinoma both in CT and MRI. Gerota’s fascia thickness has relatively low PPV value for prediction of locally advanced disease. Presence of enlarged collateral vessels, tumor necrosis, perinephric stranding are not reliable signs. For all predictors MRI seems more reliable than CT.
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Engelhard, Matthew M., Ricardo Henao, Samuel I. Berchuck, et al. "Predictive Value of Early Autism Detection Models Based on Electronic Health Record Data Collected Before Age 1 Year." JAMA Network Open 6, no. 2 (2023): e2254303. http://dx.doi.org/10.1001/jamanetworkopen.2022.54303.
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ImportanceAutism detection early in childhood is critical to ensure that autistic children and their families have access to early behavioral support. Early correlates of autism documented in electronic health records (EHRs) during routine care could allow passive, predictive model-based monitoring to improve the accuracy of early detection.ObjectiveTo quantify the predictive value of early autism detection models based on EHR data collected before age 1 year.Design, Setting, and ParticipantsThis retrospective diagnostic study used EHR data from children seen within the Duke University Health System before age 30 days between January 2006 and December 2020. These data were used to train and evaluate L2-regularized Cox proportional hazards models predicting later autism diagnosis based on data collected from birth up to the time of prediction (ages 30-360 days). Statistical analyses were performed between August 1, 2020, and April 1, 2022.Main Outcomes and MeasuresPrediction performance was quantified in terms of sensitivity, specificity, and positive predictive value (PPV) at clinically relevant model operating thresholds.ResultsData from 45 080 children, including 924 (1.5%) meeting autism criteria, were included in this study. Model-based autism detection at age 30 days achieved 45.5% sensitivity and 23.0% PPV at 90.0% specificity. Detection by age 360 days achieved 59.8% sensitivity and 17.6% PPV at 81.5% specificity and 38.8% sensitivity and 31.0% PPV at 94.3% specificity.Conclusions and RelevanceIn this diagnostic study of an autism screening test, EHR-based autism detection achieved clinically meaningful accuracy by age 30 days, improving by age 1 year. This automated approach could be integrated with caregiver surveys to improve the accuracy of early autism screening.
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Shiu, Shang-Ying, and Constantine Gatsonis. "The predictive receiver operating characteristic curve for the joint assessment of the positive and negative predictive values." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 366, no. 1874 (2008): 2313–33. http://dx.doi.org/10.1098/rsta.2008.0043.
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Binary test outcomes typically result from dichotomizing a continuous test variable, observable or latent. The effect of the threshold for test positivity on test sensitivity and specificity has been studied extensively in receiver operating characteristic (ROC) analysis. However, considerably less attention has been given to the study of the effect of the positivity threshold on the predictive value of a test. In this paper we present methods for the joint study of the positive (PPV) and negative predictive values (NPV) of diagnostic tests. We define the predictive receiver operating characteristic (PROC) curve that consists of all possible pairs of PPV and NPV as the threshold for test positivity varies. Unlike the simple trade-off between sensitivity and specificity exhibited in the ROC curve, the PROC curve displays what is often a complex interplay between PPV and NPV as the positivity threshold changes. We study the monotonicity and other geometric properties of the PROC curve and propose summary measures for the predictive performance of tests. We also formulate and discuss regression models for the estimation of the effects of covariates.
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Bräuer, Anselm, Sebastian Gassner, Jochim Koch, Daniel Heise, and Michael Quintel. "Retrospective Validation of New Simulation Software to Prevent Perioperative Hypothermia in Major Urologic Abdominal Surgery." ISRN Anesthesiology 2011 (December 8, 2011): 1–7. http://dx.doi.org/10.5402/2011/620905.
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Background. Perioperative hypothermia is still a major problem. Therefore, it would be useful to predict which warming method would prevent perioperative hypothermia in a particular patient. Methods. The simulation software “ThermoSim Vers. 5.07” was validated using the data of two prospective, randomized, and controlled studies. The diagnostic effectiveness was assessed by calculating sensitivity and specificity, positive predictive value (PPV), and negative predictive value (NPV) in the detection of perioperative hypothermia. Results. Sensitivity of the software was 100% (Study 1) and 94% (Study 2), specificity was 67% (Study 1) and 38% (Study 2), PPV was 60% (Study 1) and 50% (Study 2), and NPV was 100% (Study 1) and 90% (Study 2). Conclusions. The software is helpful in predicting which warming method is necessary to prevent perioperative hypothermia. Thermal treatment based on the prediction of the software will lead to some overtreatment, but will prevent perioperative hypothermia reliably.
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Kim, Sinyoung, Jong-Han Lee, Jun Yong Choi, June Myung Kim, and Hyon-Suk Kim. "False-Positive Rate of a “Fourth-Generation” HIV Antigen/Antibody Combination Assay in an Area of Low HIV Prevalence." Clinical and Vaccine Immunology 17, no. 10 (2010): 1642–44. http://dx.doi.org/10.1128/cvi.00258-10.
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ABSTRACT We retrospectively analyzed the performance of the Architect HIV antigen/antibody (Ag/Ab) combination assay in a tertiary health care center with a situation of low HIV prevalence. The specificity and positive predictive value (PPV) were 99.78% and 31.21%, respectively. However, the specificity and PPV could increase to 99.99% and 89.70% using an arbitrary cutoff value.
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Madhuri, H., M. Aruna Devi, and G. Sravani. "Diagnostic Performance of Grayscale Ultrasonography in the Evaluation of Mass-forming Breast Lesions." Annals of African Medicine 23, no. 4 (2024): 529–34. http://dx.doi.org/10.4103/aam.aam_101_23.
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In our study, we evaluated the diagnostic performance of grayscale ultrasonography (USG) in risk stratification of mass-forming breast lesions. Our study included 90 cases, in which 88 were females and 2 cases were male with age ranging from 16 to 73 years. Out of 90 lesions, 51 (58%) lesions were benign and 39 (39%) lesions were malignant. High-resolution USG done in all 90 lesions revealed sensitivity (90.2%), specificity (74.36%), positive predictive value (PPV) (82.14%), negative predictive value (NPV) (85.29%), and accuracy (83.33%). Calculated weighted kappa value 0.665, indicating better level of agreement in predicting malignant lesions compared to gold standard. Our study revealed that USG is sensitive and specific test in detecting malignant lesions with high PPV and NPV; the calculated weighted kappa value was 0.665, indicating better level of agreement in predicting malignant lesions compared to gold standard.
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Anang Tribowo, Alie Solahuddin, Lady Kavotiner, Theodorus, and Vidya Hestika. "Ferning, Schimer I and Tear Break Up Time (TBUT) Accuracy Test in Post-Operative Cataract Patient with Extra Capsular Cataract Extraction (ECCE) Technique." Bioscientia Medicina : Journal of Biomedicine and Translational Research 5, no. 2 (2021): 279–85. http://dx.doi.org/10.32539/bsm.v5i2.219.
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A B S T R A C TObjective: To determine the accuracy of the Ferning, Schimer I and TBUT test incataract patients after cataract surgery with the ECCE technique at the EyePolyclinic at Mohammad Hoesin Hospital Palembang and the Special Eye HospitalPalembang Methods: Diagnostic test was undertaken at the Eye Polyclinic atMohammad Hoesin Hospital Palembang and the Special Eye Hospital Palembangfrom May 2019 to January 2020. There were 42 postoperative cataract patients whomet the inclusion criteria. Ferning, Schimer I and TBUT tests were performed beforesurgery and one month after surgery. Data analysis using SPSS version 22.0 (SPSS,Inc Chicago, Illinois). Results: Fourty two samples of postoperative cataract surgerywith ECCE technique obtained by female sex (57,1%) with a mean age of cataractpatients of approximately 58.09 years. The accuracy of Schimer I and TBUT is 0.952with 100% sensitivity, 50% specificity, 95% positive predictive value (PPV) and 100%negative predictive value (NPV), the accuracy of TBUT and Ferning is 0.881 with90.2% sensitivity, 0% specificity , positive predictive value (PPV) 97.4% and negativepredictive value (NPV) 0% while the accuracy of Ferning and Schimer I was 0.928with a sensitivity of 97.5%, specificity of 0%, positive predictive value (PPV) of 95.1%and negative predictive value (NPV) 0%. Conclusion: Schimer I test is more accurateto use as a predictor of dry eye in postoperative cataract patients than Ferning andTBUT
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Cernea, Claudio R., Lenine Brandão, Flávio Hojaij, et al. "S152 – Injury Predictive Value of Nerve Monitoring in Thyroidectomy." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (2008): P127. http://dx.doi.org/10.1016/j.otohns.2008.05.326.
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Objectives 1) To evaluate the efficacy of a nerve monitoring(NM) system in a series of patients submitted to thyroidectomy; 2) To critically analyze the negative-predictive-value(NPV) and positive-predictive-value(PPV) of the method. Methods NIM® system efficacy was prospectively analyzed in 447 patients submitted to thyroidectomy between 2001 and 2008(366 female/81 male; 420 Caucasian/47 non-Caucasian; 11- to 82-years-old, median: 43 year-old). There were 421 total thyroidectomies and 21 partial thyroidectomies leading to 868 nerves at risk. The gold standard to evaluate inferior laryngeal nerve function was early postoperative videolaryngoscopy, which was repeated after 4 to 6 months in all patients with abnormal endoscopic findings. Results At the early evaluation, 858 nerves (98.8%) presented normal videolaryngoscopic features postoperatively. 10 paretic/paralyzed nerves (1.2%) were detected (2 unexpected unilateral paresis, 1 unexpected bilateral paresis, 1 unexpected unilateral paralysis, 2 unexpected bilateral paralysis and 1 expected unilateral paralysis). At the late videolaryngoscopy, only 2 permanent nerve paralysis were noted (0.2%), with an ultimate result of 99.8% functioning nerves. NM showed absent or markedly reduced electrical activity at the end of the operations in 25/858 nerves (2.9%), including all 10 endoscopically compromised nerves, with 15 false-negative nerves. There were no false-positive nerves. Therefore, NPV was 40.0% and PPV was 100%. Conclusions In the present series, NM had a very high PPV, but a low NPV for the detection of recurrent nerve injury.
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Muir, Matthew, Sarah Prinsloo, Kyle Noll, Vinodh Kumar, Jeffrey Traylor, and Sujit Prabhu. "NIMG-37. FUNCTIONAL MRI AND DTI TRACTOGRAPHY AS ADJUNCTS TO IMPROVE THE PREDICTIVE VALUE OF TMS FOR CORTICAL LANGUAGE SITES." Neuro-Oncology 25, Supplement_5 (2023): v193—v194. http://dx.doi.org/10.1093/neuonc/noad179.0733.
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Abstract Surgeons must maximize the extent of resection while minimizing postoperative neurological morbidity in patients with eloquent gliomas. Transcranial magnetic stimulation (TMS) has emerged as a novel non-invasive technique to map the functional language cortex. However, multiple studies have documented the plethora of false positives that decrease the predictive value of TMS for intraoperative functional sites. Here we hypothesize that diffusion tensor imaging (DTI) tractography and functional magnetic resonance imaging (fMRI) can serve as adjuncts to identify true positive TMS preoperatively and increase the positive predictive value (PPV). We used a distortion correction algorithm to overlay the postoperative MRI with the preoperative surgical plan and correlated the resection versus preservation of certain structures with functional outcomes measured by pre to postoperative change in the Western Aphasia Battery (WAB) score in a cohort of 61 patients with language eloquent gliomas. We found that the resection of TMS points alone does not correlate with aphasic surgical deficits. We then seeded DTI tractography with TMS points and investigated the effect of progressively increasing fractional anisotropic (FA) thresholds. We found that the resection of TMS points with connecting white matter tracts identified at the 50%, 75%, and 85% FA thresholds strongly correlated with surgical deficits. (r=.38, p=.002; r=.61, p&lt; .001, r=.54, p&lt; .001) The PPV increased with increasing FA thresholds. The highest PPV was 50% at the 75% and 85% FA thresholds while the highest negative predictive value was 98% at the 75% FA threshold. We then combined fMRI with TMS and DTI tractography by only using fMRI-colocalized TMS points for tractography seeding. The PPV increased to 63% but the correlation coefficient with aphasic deficits stayed at .61. This study shows that adjunctive modalities can significantly increase the predictive value of TMS for preoperatively identifying true positive cortical sites of language function.
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Moussa, M., A. Shaaban, M. Attia, et al. "Prognostic value of the middle cerebral to umbilical artery Doppler ratio in the prediction of outcomes in post-term pregnancy." Voprosy ginekologii, akušerstva i perinatologii 22, no. 1 (2023): 12–18. http://dx.doi.org/10.20953/1726-1678-2023-1-12-18.
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Objective. To evaluate the diagnostic value of the middle cerebral artery to umbilical artery Doppler ratio (MCA/UA ratio) in predicting poor perinatal outcomes in post-term pregnancies. Patients and methods. This study included patients diagnosed with post-term pregnancy who were admitted to the maternity hospitals in Ain Shams University and Al-Azhar University between January 2019 and December 2021. All patients underwent color Doppler velocimetry and were divided into two groups based on the MCA/UA ratio values: group A (n = 100) – MCA/UA ratio <1, and group B (n = 100) – MCA/UA ratio ≥1. Outcome factors were admission to the neonatal intensive care unit, an Apgar score of less than 7 at 5 minutes, gestational age at delivery, birth weight, and intrauterine growth restriction. Results. The MCA/UA resistance index ratio (MCA-RI/UA-RI) with a cut-off value of 0.88 was found to be the most sensitive parameter in the prediction of adverse prenatal outcomes: sensitivity – 89%, specificity – 71%, positive predictive value (PPV) – 72%, negative predictive value (NPV) – 71%. All parameters combined showed a 93% sensitivity, 92% specificity, 92% PPV, and 89% NPV. Conclusion. To enhance obstetric outcomes and prevent unnecessary treatment and perinatal death, cerebroplacental ratio appears to be a helpful indication in predicting poor neonatal outcomes in post-term pregnancy. Key words: Doppler velocimetry, middle cerebral to umbilical artery ratio, post-term pregnancy
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Nicosia, Luca, Anna Carla Bozzini, Giulia Signorelli, et al. "Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management." Healthcare 11, no. 4 (2023): 511. http://dx.doi.org/10.3390/healthcare11040511.
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The aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast lesions that underwent CESM and histological assessment were included. All the lesions were scored using a 4-point qualitative scale according to the degree of contrast enhancement at the CESM examination. The histological results were considered the gold standard. In the first analysis, enhancement degree scores of 2 and 3 were considered predictive of malignity. The sensitivity (SE) and positive predictive value (PPV) were significative lower for patients with lesions with microcalcifications without other radiological findings (SE = 53.3% vs. 82.2%, p-value < 0.001 and PPV = 84.2% vs. 95.2%, p-value = 0.049, respectively). On the contrary, the specificity (SP) and negative predictive value (NPV) were significative higher among lesions with microcalcifications without other radiological findings (SP = 95.8% vs. 84.2%, p-value = 0.026 and NPV = 82.9% vs. 55.2%, p-value < 0.001, respectively). In a second analysis, degree scores of 1, 2, and 3 were considered predictive of malignity. The SE (80.0% vs. 96.8%, p-value < 0.001) and PPV (70.6% vs. 88.3%, p-value: 0.005) were significantly lower among lesions with microcalcifications without other radiological findings, while the SP (85.9% vs. 50.9%, p-value < 0.001) was higher. The enhancement of microcalcifications has low sensitivity in predicting malignancy. However, in certain controversial cases, the absence of CESM enhancement due to its high negative predictive value can help to reduce the number of biopsies for benign lesions
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Hagelberg, Jon, Bernd Pape, Jaakko Heikkinen, Janne Nurminen, Kimmo Mattila, and Jussi Hirvonen. "Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value." PLOS ONE 17, no. 10 (2022): e0276544. http://dx.doi.org/10.1371/journal.pone.0276544.
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Objectives To review the diagnostic accuracy of contrast-enhanced computed tomography (CT) in differentiating abscesses from cellulitis in patients with neck infections, using surgical findings as the reference standard. Materials and methods Previous studies in the last 32 years were searched from PubMed and Embase. Because of partial verification bias (only positive abscess findings are usually verified surgically), sensitivity and specificity estimates are unreliable, and we focused on positive predictive value (PPV). For all studies, PPV was calculated as the proportion of true positives out of all positives on imaging. To estimate pooled PPV, we used both the median with an interquartile range and a model-based estimate. For narrative purposes, we reviewed the utility of common morphological CT criteria for abscesses, such as central hypodensity, the size of the collection, bulging, rim enhancement, and presence of air, as well as sensitivity and specificity values reported by the original reports. Results 23 studies were found reporting 1453 patients, 14 studies in children (771 patients), two in adults (137 patients), and seven including all ages (545 patients). PPV ranged from 0.67 to 0.97 in individual studies, had a median of 0.84 (0.79–0.87), and a model-based pooled estimate of 0.83 (95% confidence interval 0.80–0.85). Most morphological CT criteria had considerable overlap between abscesses and cellulitis. Conclusions The pooled estimate of PPV is 0.83 for diagnosing neck abscesses with CT. False positives may be due to limited soft tissue contrast resolution. Overall, none of the morphological criteria seem to be highly accurate for differentiation between abscess and cellulitis.
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Tayab, Md Abu, Md Ariful Hoq, and Masuma Begum. "Cut off Value of Red Cell Distribution Width (RDW) in Screening and Diagnosis of Iron Deficiency Anemia and b Thalassemia Trait." Dhaka Shishu (Children) Hospital Journal 37, no. 1 (2022): 51–58. http://dx.doi.org/10.3329/dshj.v37i1.59117.
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Background: The most concerning consequences of iron deficiency in children are the alterations of cognitive, motor, and behavioral performance. Persistent neurocognitive changes despite iron repletion have increased the importance of prevention and early detection of iron deficiency.
 Objectives: To evaluate the cut off value of red cell distribution width (RWD) in the screening and diagnosis of iron deficiency anemia (IDA) and â thalassemia trait (BTT).
 Methods: It is a cross sectional study performed at Dhaka Shishu (Children) Hospital from July 2006 to July 2008. Total 52 patients, age ranged from 1-12 years were included in the study. Among them 27 cases were IDA and 25 cases were BTT. Complete blood count (CBC), serum ferritin and hemoglobin (HB) electrophoresis were measured. The sensitivity, specificity, positive and negative predictive value of differential and cutoff value for RDW discrimination index in differentiation between IDA and BTT were performed.
 Results: Age ranged from 1-12 years. In IDA group male were found 16(59%), female were 11(41%) and in BTT group male were 15(60%), female were 10(40%). The Hb% value in IDA group was significantly (p<0.0001) lower than value for BTT. An elevation of RBC distribution width (>14.6) in IDA had a sensitivity of 81%, specificity of 84%, positive predictive value (PPV) of 85% and negative predictive value (NPV) of 81%; value of RBC distribution width (<14.6) in BTT had a sensitivity of 84%, specificity of 81%, positive predictive value (PPV) of 81% and negative predictive value (NPV) of 85%. An elevation of RBC distribution width (>16) had a sensitivity of 67%, specificity of 92%, and positive predictive value (PPV) of 90% in distinguishing iron deficiency anemia from thalassemia trait. Moreover, eleven (11) of 27 patients with iron deficiency had RBC distribution width values greater than 18 compared to one (1) of the patients with thalassemia trait. An elevation of RBC distribution width ³18 specificity of 96% and positive predictive value (PPV) of 92%.
 Conclusion: The rersult of the study, in patients with microcytic hypochromic anemia, RDW value e³14.6% and Hb level< 10gm/dl, iron deficiency is the most likely diagnosis. RDW value (>16) is a reliable diagnostic tool in differentiation between IDA and BTT. Red cell distribution width (RDW) above 16% is the best index of IDA.
 DS (Child) H J 2021; 37(1): 51-58
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Zohdy, Youssef M., Tomas Garzon-Muvdi, and Yasmine A. Ashram. "1246 The Impact of Latency Variations on the Predictive Value of Facial Nerve Proximal-to-distal Amplitude Ratio During Vestibular Schwannoma Surgery." Neurosurgery 70, Supplement_1 (2024): 197. http://dx.doi.org/10.1227/neu.0000000000002809_1246.
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INTRODUCTION: Intraoperative facial nerve (FN) electromyographic (EMG) monitoring is now considered an essential part of vestibular schwannoma (VS) surgery and is used for both intraoperative monitoring and postoperative outcome prediction. METHODS: Forty-eight patients underwent FN stimulation at the brainstem (proximal) and the internal acoustic meatus (distal) using a current intensity of 2 mA. The proximal latency and the P/D amplitude ratio were assessed. House-Brackmann grades I-II indicated good FN function; and grades III-VI were considered fair/poor function. A P/D amplitude ratio >0.6 was used as a cutoff to indicate good FN function, while a ratio of =0.6 indicated fair/poor FN function. RESULTS: The P/D amplitude ratio was measured for all patients, and the calculated sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were 85.2%, 85.7%, 88.5%, and 81.8% respectively. Then the CMAPs from the mentalis muscle were classified based on their proximal latency into: Group I (<6 msec); group II (6-8 msec); and group III (>8 msec). The SE, SP, PPV, and NPV became 90.5%, 90.9%, 95%, and 83.3% respectively in group II. In group I, SE and NPV increased whereas, SP and PPV decreased. While in group III, SP and PPV increased, whereas SE and NPV decreased. CONCLUSIONS: At a latency between 6-8msec, the P/D amplitude ratio was predictive of outcome with high SE and SP. When the latency was <6 msec or >8 msec, the same predictive ability was not observed. Knowing the impact of latency variations of P/D amplitude ratio measurement is important for a better understanding of the ability and limitations of this method in predicting postoperative FN function.
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Aithmia, Dr Rashmi, Dr Monika Pangotra, and Dr Sindhu Sharma. "IAC Yokohama Reporting of Breast Cytology to Assess Risk of Malignancy and Predictive Values." Saudi Journal of Pathology and Microbiology 7, no. 7 (2022): 267–71. http://dx.doi.org/10.36348/sjpm.2022.v07i07.003.
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Background: IAC Yokohama system has 5 categories that may be stratified by their risk of malignancy (ROM) and supply guidance within a management algorithm for every category. The main objectives were to categorize the Breast FNAC samples according to new system of reporting and to assess the Risk of malignancy (ROM), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy for all categories. Material and Methods: A total of 174 cases were prospectively studied over a period of one year from 1st November 2019 to 31st October 2020 in GMC, Jammu. All the FNAC received was reported routinely according to the newly proposed Yokohama system of reporting breast cytology. The ROM, sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of Breast FNAC were calculated. Results: ROM is 0% for category 1, 2.27% for category 2, 50% for category 3, 50% for category 4 and 100% for category 5. Sensitivity, specificity, and diagnostic accuracy were, respectively, 100%, 100% and 99.11% for category A (only C5 category cases considered positive test results), 88.2%, 93.6%, and 93.6% for category B, (both C4 and C5 categories considered positive test results), and 94.1%, 91.48%, and 92.1% for category C (C3, C4, and C5 category cases grouped as positive test results). PPV and NPV were also calculated. Conclusion: Categorization of the Breast FNAB cytology according to IAC Yokohama system of reporting helps pathologist in the diagnostic clarity and guides clinician in the appropriate patient management.
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Kerola, Anne M., Annukka Pietikäinen, Julia Barantseva, Annaleena Pajander, and Arno Hänninen. "Predictive value of myositis antibodies: role of semiquantitative classification and positivity for more than one autoantibody." RMD Open 11, no. 1 (2025): e005007. https://doi.org/10.1136/rmdopen-2024-005007.
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ObjectivesWe assessed the positive predictive value (PPV) of 17 myositis antibodies for having a diagnosis of myositis and other myositis-spectrum conditions (interstitial lung disease (ILD), connective tissue diseases (CTD), malignancy) and evaluated the impact of semiquantitative classification and antibody overlap on the PPVs.Materials and methodsWe retrospectively identified 1068 individuals ≥18 years who tested positive for ≥1 antibody in the EUROLINE myositis line blot assay or positive for anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) in an ELISA-based test between 2015 and 2020 in 15 out of the 20 hospital districts in Finland. We extracted clinical diagnoses from the Care Register for Health Care between January 2013 and June 2022.ResultsThe PPV for a myositis diagnosis (ever during data collection) was highest for anti-HMGCR antibodies (94%), followed by anti-MDA5, anti-Jo-1 and anti-TIF1-γ (49–54%). Regarding other myositis antibodies, 18–42% of cases had myositis. Anti-synthetase antibodies, anti-MDA5, anti-PM-Scl100, anti-SAE1 and anti-Ro52 had a PPV for ILD of 25–47%. A PPV for CTD was highest for anti-Ro52 (57%). The PPV for malignancy was highest for anti-TIF1-γ (38%), followed by anti-PL-7 (32%). Stronger antibody band intensity was associated with higher PPVs for myositis and CTD but not for ILD or malignancies. Simultaneous positivity for ≥2 antibodies compared with single antibody was associated with higher PPVs for myositis, CTD and ILD.ConclusionThe PPV of myositis antibodies for diagnoses of myositis or other myositis spectrum diseases vary considerably between individual autoantibodies. Higher PPVs can be expected with stronger band intensities and with the presence of ≥2 overlapping myositis antibodies.
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Vorgučin, Ivana, Nada Naumović, Jovan Vlaški, Dragan Katanić, and Georgios Konstantinidis. "Predictive values of metabolic syndrome in children." Open Medicine 6, no. 4 (2011): 379–85. http://dx.doi.org/10.2478/s11536-011-0032-2.
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AbstractMetabolic syndrome is a clinical term encompassing risk factors (obesity, insulin resistance, dyslipidemia and hypertension), which yield an increased risk for the development of diabetes mellitus type 2 and cardiovascular disorders in adolescence. Two sets of criteria for diagnosing metabolic syndrome were applied, the criteria for adults, specifically adapted for children, and the criteria defined by the International Diabetes Federation (IDF). A reliability analysis was conducted; sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of applying certain criteria of both definitions of metabolic syndrome. Metabolic syndrome in adolescents was diagnosed much more frequently using the specific criteria (41%) in comparison to the IDF criteria (22%). Using the specific criteria for children and adolescents, it was established that the HDL cholesterol was the most specific and had the largest PPV. Using the IDF criteria for diagnosing metabolic syndrome, the reliability analysis established that the highest PPV was recorded with the elevated level of triglycerides. The specific criteria have been found to be more efficient in diagnosing metabolic syndrome in adolescents. The highest predictive value was displayed by dyslipidemic disorders, hypertriglyceridemia and hypo HDL cholesterolemia.
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Muhammad, Jan, Muhammad Asad, Muhammad Farhan, Abdullah Shah, Siraj Muneer Kakakhel, and Muhammad Mehroz. "A Comparative Study of Ripasa Score and Alvarado Score in Diagnosis of Acute Appendicitis." Biological and Clinical Sciences Research Journal 6, no. 2 (2025): 114–17. https://doi.org/10.54112/bcsrj.v6i2.1582.
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Among the most frequent causes of right iliac fossa pain is acute appendicitis. Developed to lower the likelihood of negative appendectomy are several scoring systems for diagnosing acute appendicitis. Objective: This study was motivated by a comparison of the RIPSA score with the Alvarado score based on histology reports for the diagnosis of acute appendicitis. Methods: Between November 2023 and June 2024, the emergency general surgery department at Lady Reading Hospital, Peshawar, conducted a prospective cross-sectional study. Based on histopathology data, both scoring methods were applied to the same patient and assessed for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy. Alvarado achieved a score of 7.5, which coincided with RIPASA's cut-off value of 7.5.Results: The study included a total of 194 patients. With values of 97.42% and 86.08%, respectively, the RIPASA score demonstrates a higher diagnostic accuracy than the Alvarado score. For RIPASA, sensitivity, specificity, PPV, and NPV came at 98.86%, 84.21%, 98.3%, and 88.89%, respectively. By contrast, Alvarado had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 96.89%, 33.33%, 87.64%, and 68.75%, respectively. Conclusion: Then the RIPASA scoring system shows better sensitivity, specificity, and diagnostic accuracy than the Alvarado scoring system.
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Elgendy, Hatem, Ahmed Tarek, and Moahmed Shahat. "A prospective cross-sectional study for prediction of fetal macrosomia using sonographic measurement of placental thickness and umbilical cord cross-section area." Hellenic Journal of Obstetrics and Gynecology 24, no. 1 (2025): 22–30. https://doi.org/10.33574/hjog.0581.
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Background: Macrosomia is an obstetric problem with maternal and neonatal adverse outcomes that are associated with a high rate of perinatal morbidity and mortality. The aim is to assess the accuracy of predicting fetal macrosomia by measuring the cross-sectional area of the umbilical cord and the central placental thickness at cord insertion by ultrasound. Design: A prospective cross-sectional study was performed at Banha University Hospital among 60 patients coming into labor from January to June 2024. Method: Trans-Abdominal Sonography was done to measure fetal biparietal diameter, femur length, abdominal circumference, the central placental thickness (PT) at cord insertion in mm, mean umbilical cord cross-sectional area (UCA), and ultrasonically estimated fetal weight. Mode of delivery, use of instrumentation, actual fetal weight, shoulder dystocia, Apgar scoring, and neonatal outcome were recorded. Results: The incidence of macrosomic babies was 13.3%. There was a high statistical difference between (the macrocosmic group and the average group) regarding PT and UCA in favor of the macrosomic group (P<0.001). The ROC curves for PT for the prediction of macrosomia indicate that the best cutoff value for PT was 46 mm (at which Sensitivity was 87.5%, Specificity 88.5%, Positive predictive value (PPV) 53.8%, Negative predictive value (NPV) 97.9% and Accuracy 88.3%). The area under the curve was 0.91 [95%CI. (0.88-0.96)]. ROC curves for UCA for prediction of macrosomia indicate that the best cutoff value for UCA was 2.40 cm2 (at which Sensitivity was 87.5%, Specificity 78.8%, Positive predictive value (PPV) 38.9%, Negative predictive value (NPV) 97.6% and Accuracy 80%). The area under the curve was 0.89 [95%CI. (0.86-0.94)]. Conclusion: The sonographic measurement of placental thickness and umbilical cord cross‐section area are good predictors for macrosomia.
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Podugu, Amareshwar, Peter Junwoo Lee, Amit Bhatt, Jordan Holmes, Rocio Lopez, and Tyler Stevens. "Positive Predictive Value (PPV) of ICD-9 Discharge Diagnosis of Acute Pancreatitis (AP)." American Journal of Gastroenterology 107 (October 2012): S104. http://dx.doi.org/10.14309/00000434-201210001-00242.
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Vijayaraghavan, Gopal R., Adrienne Newburg, and Srinivasan Vedantham. "Positive Predictive Value of Tomosynthesis-guided Biopsies of Architectural Distortions Seen on Digital Breast Tomosynthesis and without an Ultrasound Correlate." Journal of Clinical Imaging Science 9 (November 18, 2019): 53. http://dx.doi.org/10.25259/jcis_134_2019.
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Objective: The objective of the study was to determine the positive predictive value (PPV) of architectural distortions (AD) observed on digital breast tomosynthesis (DBT) and without an ultrasound (US) correlate. Materials and Methods: In this single-institution, retrospective study, patients who underwent DBT-guided biopsies of AD without any associated findings on digital mammography (DM) or DBT, and without a correlate on targeted US exam, over a 14-month period were included in this study. All patients had DM and DBT and targeted US exams. The PPV was computed along with the exact 95% confidence limits (CL) using simple binomial proportions, with histopathology as the reference standard. Results: A total of 45 ADs in 45 patients met the inclusion criteria. Histopathology indicated 6/45 (PPV: 13.3%, CL: 5.1–26.8%), ADs were malignant, including one high-risk lesion that was upgraded at surgery. ADs were appreciated only on DBT in 12/45 (26.7%) patients, and on both DBT and DM in 33/45 (73.3%) patients, and the corresponding PPV was 25% (3/12, CL: 5.5–57.2%) and 9.1% (3/33, CL: 1.9–24.3%), respectively. In all analyses, the observed PPV significantly exceeded the 2% probability of malignancy for Breast Imaging Reporting and Data System-3 diagnostic categories (P < 0.004). Conclusions: The PPV of malignancy in DBT detected AD without an US correlate in our series of 45 cases was 6/45 (13.3%). In the absence of an US correlate, the PPV of AD is lower than that mentioned in prior literature but exceeds the 2% threshold to justify DBT-guided biopsy.
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Zou, Jian-Fang, Qiming Guo, Hua Shao, et al. "A Positive Babinski Reflex Predicts Delayed Neuropsychiatric Sequelae in Chinese Patients with Carbon Monoxide Poisoning." BioMed Research International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/814736.
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As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS) of carbon monoxide poisoning (COP) has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1–79.6), specificity = 88.6% (95% CI: 83.7–92.1), positive predictive value (PPV) = 20.0% (95% CI: 9.1–37.5), and negative predictive value (NPV) = 97.3% (95% CI: 94.0–98.9). The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544–0.880). A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.
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Morales, Juan F., Sara Chuguransky, Lucas N. Alberca, et al. "Positive Predictive Value Surfaces as a Complementary Tool to Assess the Performance of Virtual Screening Methods." Mini-Reviews in Medicinal Chemistry 20, no. 14 (2020): 1447–60. http://dx.doi.org/10.2174/1871525718666200219130229.
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Background: Since their introduction in the virtual screening field, Receiver Operating Characteristic (ROC) curve-derived metrics have been widely used for benchmarking of computational methods and algorithms intended for virtual screening applications. Whereas in classification problems, the ratio between sensitivity and specificity for a given score value is very informative, a practical concern in virtual screening campaigns is to predict the actual probability that a predicted hit will prove truly active when submitted to experimental testing (in other words, the Positive Predictive Value - PPV). Estimation of such probability is however, obstructed due to its dependency on the yield of actives of the screened library, which cannot be known a priori. Objective: To explore the use of PPV surfaces derived from simulated ranking experiments (retrospective virtual screening) as a complementary tool to ROC curves, for both benchmarking and optimization of score cutoff values. Methods: The utility of the proposed approach is assessed in retrospective virtual screening experiments with four datasets used to infer QSAR classifiers: inhibitors of Trypanosoma cruzi trypanothione synthetase; inhibitors of Trypanosoma brucei N-myristoyltransferase; inhibitors of GABA transaminase and anticonvulsant activity in the 6 Hz seizure model. Results: Besides illustrating the utility of PPV surfaces to compare the performance of machine learning models for virtual screening applications and to select an adequate score threshold, our results also suggest that ensemble learning provides models with better predictivity and more robust behavior. Conclusion: PPV surfaces are valuable tools to assess virtual screening tools and choose score thresholds to be applied in prospective in silico screens. Ensemble learning approaches seem to consistently lead to improved predictivity and robustness.
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Nuchanat, Piyanop, and Komsing Methavigul. "Predictive model for left main coronary artery or triple vessel disease in patients with chronic coronary syndromes." Asian Biomedicine 18, no. 4 (2024): 180–85. http://dx.doi.org/10.2478/abm-2024-0024.
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Abstract Background Data about prediction of left main coronary artery disease (LMCAD)/three-vessel disease (TVD) in patients with chronic coronary syndromes (CCS) are lacking. Objectives This study aimed to develop a model for predicting patients at risk of LMCAD/TVD. Methods This study used retrospective data from patients with CCS scheduled for invasive coronary angiography (ICA) and who were retrospectively recruited between January 2018 and December 2020. Predictors were obtained and analyzed by using logistic regression analysis, and generated the prediction score. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. The cut-off value and area under the curve (AUC) were analyzed by using the receiver operating characteristic (ROC) curve. Results We recruited 162 patients with CCS. There were 75 patients in the non-LMCAD/TVD and 87 patients in the LMCAD/TVD groups. After the multivariate analysis, new onset of heart failure (HF) or left ventricular systolic dysfunction (LVSD) and suspected CAD, ST elevation (STE) in aVR, STE in V1 and lateral ST depression (STD) were associated with increased risk of LMCAD/TVD. Based on these 4 predictors, the prediction score was created. The cut-off value of the prediction score by using ROC curve analysis was 3.0. The sensitivity, specificity, PPV, and NPV were 71.26%, 86.67%, 86.11%, and 72.22%, respectively, with an AUC of 0.855. Conclusions The CCS patients with new onset of HF or LVSD and suspected CAD, STE in aVR, and STE in V1 and lateral STD were associated with increased risk of LMCAD/TVD. The novel prediction score could predict LMCAD/TVD in those patients with acceptable sensitivity, specificity, PPV, and NPV.
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Sofouli, Georgia Anna, Asimina Tsintoni, Sotirios Fouzas, Aggeliki Vervenioti, Despoina Gkentzi, and Gabriel Dimitriou. "Early Diagnosis of Late-Onset Neonatal Sepsis Using a Sepsis Prediction Score." Microorganisms 11, no. 2 (2023): 235. http://dx.doi.org/10.3390/microorganisms11020235.
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Sepsis represents a common cause of morbidity in the Neonatal Intensive Care Unit (NICU). Our objective was to assess the value of clinical and laboratory parameters in predicting septicemia (positive blood culture) in NICU infants. In the first part of the present study (derivation cohort) we retrospectively reviewed the clinical files of 120 neonates with symptoms of suspected sepsis and identified clinical and laboratory parameters associated with proven sepsis on the day the blood culture was taken, as well as 24 h and 48 h earlier. These parameters were combined into a sepsis prediction score (SPS). Subsequently (validation study), we prospectively validated the performance of the SPS in a cohort of 145 neonates. The identified parameters were: temperature instability, platelet count < 150,000/mm3, feeding volume decrease > 20%, changes in blood glucose > 50%, CRP > 1 mg/dL, circulatory and respiratory deterioration. In the retrospective cohort, on the day the blood culture was obtained, a SPS ≥ 3 could predict sepsis with 82.54% sensitivity, 85.96% specificity, 5.88 PLR (Positive Likelihood Ratio), 0.20 NLR (Negative Likelihood Ratio), 86.67% PPV (Positive Predictive Value), 81.67% NPV (Negative Predictive Value) and 84.17% accuracy. In the prospective cohort, on the day the blood culture was obtained, a SPS ≥ 3 could predict sepsis with 76.60% sensitivity, 72.55% specificity, 2.79 PLR, 0.32 NLR, 83.72% PPV, 62.71% NPV and 75.17% accuracy. We concluded that this combination of clinical and laboratory parameters may assist in the prediction of septicemia in NICUs.
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Uebel, Linnea, Indy Kromodikoro, Nils Nyhlin, and Michiel van Nieuwenhoven. "Colorectal Cancer Fast Tracks: Cancer Yield and the Predictive Value of Entry Criteria." Cancers 15, no. 19 (2023): 4778. http://dx.doi.org/10.3390/cancers15194778.
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Background: Fast-track pathways for diagnosing colorectal cancer (CRC) have been implemented in several European countries. In Sweden, a substantial number of CRC are diagnosed via the Swedish Standardized Course of Care for colorectal cancer (SCC-CRC). We evaluated the SCC-CRC in terms of CRC yield, and predictive values and odds ratios (OR) for the entry criteria. Methods: We retrospectively analyzed all 2539 patients referred for SCC-CRC colonoscopy between September 2016 and December 2020. Entry criteria and colonoscopy outcomes were analyzed. Results: CRC yield was 16.4%. Highest positive predictive values (PPVs) were seen for abnormal radiology (PPV 30.5%, OR 4.7 (95% CI 3.4–6.4) p < 0.001), abnormal rectal examination (PPV 28%, OR 3.6 (95% CI 2.7–4.8) p < 0.001), and anemia (PPV 24.8%, OR 2.2 (95% CI 1.5–3.1) p < 0.001). Some entry criteria showed no significant risk increase, i.e., visible blood in stool/rectal bleeding, change in bowel habits, and the combination of changed bowel habits plus anemia. A positive fecal immunochemical test (FIT), although not part of the SCC-CRC, showed the highest OR: 9.9 (95% CI 4.5–21.7) p < 0.001) and PPV of 18.8%. Conclusions: CRC yield from the SCC-CRC is slightly higher compared to other European fast tracks. A number of entry criteria showed no benefit towards assessing CRC risk. FIT testing should be included in CRC fast tracks to increase diagnostic efficacy.
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Ellem, Justin A., Tom Olma, and Matthew V. N. O'Sullivan. "Rapid Detection of Methicillin-Resistant Staphylococcus aureus and Methicillin-Susceptible S. aureus Directly from Positive Blood Cultures by Use of the BD Max StaphSR Assay." Journal of Clinical Microbiology 53, no. 12 (2015): 3900–3904. http://dx.doi.org/10.1128/jcm.02155-15.
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The BD Max StaphSR assay is an automated qualitativein vitrodiagnostic test for the direct detection and differentiation of methicillin-susceptibleStaphylococcus aureus(MSSA) and methicillin-resistantS. aureus(MRSA). A total of 460 specimens were tested, and the results were compared with standard culture-based identification. MRSA was detected in 48 samples (sensitivity of 100%; positive predictive value [PPV] of 100%). MSSA was detected in 112 samples (sensitivity of 99.1%; PPV of 100%), and 299 samples containing coagulase-negative staphylococcus and nonstaphylococcal species were negative by the BD Max StaphSR assay (specificity of 100%; negative predictive value [NPV] of 99.7 to 100%).
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Kumar, Maddala Surya, Varghese Zachariah K, and Chakravarthy Joel J. "Airway assessment: Predictors for difficult intubation – A prospective observational study." Indian Journal of Clinical Anaesthesia 10, no. 1 (2023): 11–20. http://dx.doi.org/10.18231/j.ijca.2023.003.
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Airway management remains an important challenge in the contemporary practice of anaesthesia and preoperative airway assessment facilitates appropriate preparation when difficulty with intubation or ventilation is anticipated prior to induction of anaesthesia.: Aim: To study the important predictors for difficult laryngeal intubation. To determine the predictors of difficult laryngeal intubation. Secondary: To determine the most significant predictor for difficult intubation and to determine the incidence of unanticipated difficult intubation.This single centre prospective observational study done in Bangalore Baptist hospital (after obtaining clearance from ethical committee) included adult patients posted for elective surgeries who received general anaesthesia. Patients of either gender in the 18 – 65 year age group, with an American Society of Anaesthesiologists physical status classification of I or II, who required endotracheal intubation for general anaesthesia. The sample size was 413 with confidence level 95%. In our study the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Mallampati class were found to be 75.8%, 78.06%, 37.90%, 94.80% respectively. The sensitivity, specificity, PPV and NPV of mouth opening were found to be 33.87%, 81.19%, 24.13%, 87.42% respectively. The sensitivity, specificity, PPV and NPV of upper lip bite test found to be 27.41%, 96.29%, 56.66%, 88.25% respectively. The sensitivity, specificity, PPV and NPV of neck extension found to be 54.83%, 92.59%, 56.66%, 92.06% respectively. The sensitivity, specificity, PPV and NPV of BMI found to be 53.22%, 75.49%, 27.73%, 90.13% respectively. The incidence of difficult intubation was 15%.:In conclusion, no single predictor is sufficient for prediction of difficult intubation on its own. All the studied bedside tests are poor to moderate predictors of difficult intubation. All the tests showed poor positive predictive values and high negative predictive values which suggests that they can be more useful predictors of easy intubation than difficult intubation.
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Agathis, Alexandra Z., Michael Miller, and Celia M. Divino. "National Trends in Diagnostic Imaging for Appendicitis: A Cross-Sectional Analysis Using NSQIP." American Surgeon 85, no. 6 (2019): 625–30. http://dx.doi.org/10.1177/000313481908500627.
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Prior studies elucidate a high predictive value of imaging to diagnose appendicitis in small, regional cohorts. This cross-sectional study uniquely analyzes diagnostic imaging in a national appendectomy population. Using the 2016 ACS NSQIP database, positive predictive values (PPVs) for CT, ultrasound (US), and MRI were evaluated using chi-squared tests. Univariate and multivariate analyses considered patient-specific factors. Imaging was performed in 94.63 per cent of 11,841 appendectomy cases; most frequently via CT (78.69%), then combination CT and US (7.52%), US (7.15%), and MRI (0.30%). CT PPV was higher in overweight (98.70%) versus underweight patients (94.85%) ( P = 0.01). Gender and age did not impact CT PPV. Imaging from a referral site did not change CTor US PPV. Our study describes imaging frequencies and confirms high PPV. We found imaging equally predictive in women of childbearing age and elderly individuals compared with the general population. Furthermore, repeat scanning is unnecessary with prior positive imaging at outside sites.
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Vincent, Laura, Clémentine Jankowski, Marion Cortet, et al. "HER2-positive breast cancer: Combined 18F-FDG PET and CGFL/Curie nomogram to predict pathologic complete response after preoperative chemotherapy with trastuzumab." Journal of Clinical Oncology 37, no. 15_suppl (2019): e12095-e12095. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12095.
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e12095 Background: The aim of this study was to compare the value of 18F-fluorodesoxyglucose positron emission tomography (18F-FDG PET/CT) with CGFL/Curie nomogram to predict a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in women with human epidermal growth factor 2 (HER2)-positive breast cancer treated by trastuzumab. Methods: Fifty-one women with HER2-positive breast cancer treated with trastuzumab plus taxane-based NAC, were retrospectively included from January 2005 to December 2015. For 18F-FDG PET/CT, the analyzed predictor was the maximum standardized uptake value of the primary tumor and axillary nodes after the first course of NAC (PET2.SUVmax). pCR was defined by no residual infiltrative tumor but in situ tumor was accepted. Accuracy of CGFL/Curie nomogram and PET2.SUVmax was evaluated measuring sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). For each predictor, receiver operating characteristic (ROC) curve was created. To evaluate the correlation between predictors, the Spearman coefficient was calculated. Combined prediction was evaluated testing predictor’s associations. Results: For CGFL/Curie nomogram’s performances, Se, Sp, PPV and NPV were respectively: 76% (CI95%: 58-90%), 57% (CI95%: 43-66%), 55% (CI95%: 42-65), 77% (CI95%: 59-90%). For PET2.SUVmax’s performances, Se, Sp, PPV and NPV were respectively: 67% (CI95%: 48-81%), 77% (CI95%: 64-97%), 67% (CI95%: 48-82%), 77% (CI95%: 64-87%). ROC curves for these predictors were similar; the areas under the curve were 0.6 (CI95%: 0.56-0.64) for PET2.SUVmax and 0.55 (CI95%: 0.50-0.59) for CGFL/Curie nomogram. Spearman coefficient was 0.23. Combined prediction was more efficient with Se at 80%, VPN at 76%, Sp at 78% and VPP at 81 %. Conclusions: CGFL/Curie nomogram and PET2.SUVmax were two efficient predictors of pCR in patients with HER2-positive breast cancer. Combined prediction has an improved accuracy.
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Treneva, M. S. "ALLERGIC DISEASES PRIMARY PREVENTION IN CHILDREN: POSITIVE PREDICTIVE VALUE AND HIGH SPECIFICITY OF INFORMATION ON ALLERGIC DISEASES IN MALE RELATIVES." Russian Journal of Allergy 7, no. 6 (2010): 34–37. http://dx.doi.org/10.36691/rja896.
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Background. Сhildren allergic diseases primary prevention could be advanced with exploration of positive predictive value (PPV), negative predictive value (NPV), sensitivity (Se) and specificity (Sp) of information on allergic diseases in a wide range of relatives. Methods. retrospective analytic cross-sectional study. 1974 relatives of 212 children with allergic diseases and 137 controls were questioned. Couples of children equally aged were grouped in «×2»tables for each relativetype. Se was calculated as relative' allergic disease probability in child with allergic disease. Sp was calculated as negative allergic disease relative' probability in negative allergic disease children. PPV was calculated as a probability of allergic diseased children in positive allergic disease relatives; NPV -as a probability of negative allergic diseased children in negative allergic disease relatives. Results. PPV was of high quantity in male relatives -father' father (86%), male cousins (80%), mother' father (77%), mother' brother (73%), father of a child (72%). Mother' PPV was under 65%. Sp of all relatives was of good quantity. The top levels belong to male relatives -father' father (97%), fathermother (94%), father' brother (91%), male cousins (91%), mother' brother (89%). NPV of all relatives was useless for clinical practitioner. Se was low in all relatives. Mother' Se was on top with 67%. So, male relatives'allergic disease importance is confirmed by high PPV and high Sp in grandfathers, uncles, male cousins. Conclusion. high PPV and high Sp of information on allergic disease in male relatives combine prognostic valid and specific risk criterion for allergic diseases in children. A child should be set for a primary prevention of allergic disease in case of allergic disease in grandfathers, or uncles, or male cousins, or child' father.
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Mason, B. W., E. D. Edwards, A. Oliver, and C. V. E. Powell. "Cohort study to test the predictability of the NHS Institute for Innovation and Improvement Paediatric Early Warning System." Archives of Disease in Childhood 101, no. 6 (2016): 552–55. http://dx.doi.org/10.1136/archdischild-2015-308465.
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ObjectiveTo test the predictability of the National Health Service Institute for Innovation and Improvement (NHSIII) Paediatric Early Warning System (PEWS) score to identify children at risk of developing critical illness.DesignCohort study.SettingAdmissions to all paediatric wards at the University Hospital of Wales between 1 December 2005 and 30 November 2006.Outcome measuresUnscheduled paediatric high dependency unit (PHDU) admission, paediatric intensive care unit (PICU) admission and death.ResultsThere were 9075 clinical observations from 1000 children. An NHSIII PEWS score of 2 or more, which triggers review, has a sensitivity of 73.2% (95% CI 62.2% to 82.4%), specificity of 75.2% (95% CI 74.3% to 76.1%), positive predictive value (PPV) of 2.6% (95% CI 2.0% to 3.4%), negative predictive value of 99.7% (95% CI 99.5% to 99.8%) and positive likelihood ratio of 3.0 (95% CI 2.6 to 3.4) for predicting PHDU admission, PICU admission or death. Six (37.5%) of the 16 children with an adverse outcome did not have an abnormal NHSIII PEWS score. The area under the receiver operating characteristic curve for the NHSIII PEWS score was 0.83 (95% CI 0.77 to 0.88).ConclusionsThe NHSIII PEWS has a low PPV and its full implementation would result in a large number of false positive triggers. The issue with PEWS scores or triggers is neither their sensitivity nor children with high scores which require clinical interventions who are not ‘false positives’; but their low specificity and low PPV arising from the large number of children with low but raised scores.
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Lee, Taehyoung, Jen Hoogenes, Ian Wright, Edward D. Matsumoto, and Bobby Shayegan. "Utility of preoperative 3 Tesla pelvic phased-array multiparametric magnetic resonance imaging in prediction of extracapsular extension and seminal vesicle invasion of prostate cancer and its impact on surgical margin status: Experience at a Canadian academic tertiary care centre." Canadian Urological Association Journal 11, no. 5 (2017): 174. http://dx.doi.org/10.5489/cuaj.4211.
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Introduction: To evaluate the utility of 3 Tesla (3T) pelvic phased-array (PPA) multiparametric magnetic resonance imaging (mpMRI) to predict extracapsular extension (ECE) and seminal vesicle invasion (SVI) and its subsequent effect on radical prostatectomy (RP) surgical margin status.Methods: A retrospective evaluation was conducted of RP patients who underwent preoperative 3T PPA mpMRI (without endorectal coil) based on clinical probability of adverse pathological features. Frequencies, specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of mpMRI in predicting the status of ECE and SVI were calculated.Results: Forty-eight consecutive patients were included. Sensitivity, specificity, PPV, and NPV for 3T PPA mpMRI using T2-weighted sequences with diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging to predict ECE was 39%, 56%, 45%, and 50%, respectively, while SVI prediction was 33%, 95%, 50%, and 91%, respectively. Twelve of the 28 cases predicted as being negative for ECE had positive margins, while two of the 20 cases predicted to be positive for ECE had positive margins. Imaging predicted four cases would have SVI, yet two had positive margins, while of the 44 cases predicted as being negative for SVI, four had positive margins.Conclusions: These findings at our centre suggest that the use of 3T PPA mpMRI using T2-weighted sequences with DWI and DCE in predicting pathological ECE and SVI is of questionable benefit. These mpMRI reports may result in closer dissection of neurovascular bundles and subsequent positive surgical margins. Caution should be exercised when basing intraoperative decisions on mpMRI findings.
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Sumanta, Kumar Mishra, Kumar Panda Sumit, Ballav Jagdev Jagat, and Kumar Mishra Pabitra. "Incidence of False Positive Pelvic Lymph node in Carcinoma Urinary Bladder- A Single Centre Experience." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 308–11. https://doi.org/10.5281/zenodo.11625374.
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<strong>Background:</strong> To assess the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in cervical cancer patients. <strong>Methods:</strong> This study enrolled 31 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and underwent CT, MRI, and PET/CT prior to surgery between December 2019 and March 2023. LN metastases were defined by an LN diameter 1.0 cm and/or the presence of central necrosis on CT, an LN diameter 1.0 cm on MRI, and a focally increased FDG uptake on PET/CT. For pelvic LN metastases, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. <strong>Results:</strong> The sensitivity, specificity, PPV, NPV, and accuracy for detecting pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3%, respectively, for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. PET/CT and CT had a higher sensitivity than MRI (p=0.004 and p=0.013, respectively). MRI had a higher specificity than PET/CT and CT (p=0.002 and p=0.001, respectively). The difference between PET/CT and CT in terms of specificity was not statistically significant (p=0.167). <strong>Conclusion:</strong> These findings indicate that preoperative CT, MRI, and PET/CT exhibited low to moderate sensitivity and positive predictive value, and moderate to high specificity, negative predictive value, and accuracy. To anticipate pelvic LN metastases, additional efforts are required to enhance the sensitivity of imaging techniques.
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Lesmana, Gema Putra, Reno Rudiman, and Rani Septrina. "Accuracy of D-Dimer Levels and C-reactive Protein in Predicting Perforation of Acute Appendicitis." Jurnal llmu Bedah Indonesia 48, no. 1 (2020): 59–69. http://dx.doi.org/10.46800/jibi-ikabi.v48i1.57.
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Introduction: D-Dimer as the primary product of fibrin degradation, was found to be increased in appendicitis patients. CRP still gives different results in predicting perforated appendicitis. The purpose of this study is to find out the accuracy of D-Dimer and CRP in predicting appendicitis perforation at the Central General Hospital Dr. Hasan Sadikin Bandung 2019.
 Method: This study used prospective observational design with cross-sectional approach. The subject were taken from the Emergency Department (ED) patient between September 2018-September 2019 who met the inclusion criteria. Preoperative D-Dimer and CRP serum were measured and the results of the surgery were noted. Chi-Square test was conducted and the data were analyzed using SPSS Version 22.0 for windows at a 95% confidence level. The value is significant if p <0.05.
 Results: The sample included in this study were 41 patients, with 24 perforated appendicitis patients. The average age of patients was 34.8 ± 13.8. The majority of patients were male, 24 patients ( 58.5%). Area for ROC curve for D-Dimer is 0.929, with a cut-off point of 0.51 mg / l for sensitivity perforation appendicitis 95.8%, specificity 76.5%, positive predictive value (PPV) 85.2%, negative predictive value (NPV) 92.9% and accuracy 87.8%. For CRP with a cut-off point at 18.84 for sensitivity perforation appendicitis 58.3%, specificity 94.1%, positive predictive value (PPV) 93.3%, negative predictive value (NPV) 61.5% with an accuracy of 73.2%.
 Conclusion: D-dimer and CRP level can be used in predicting perforation of appendicitis.
 (ISSN 2723-7494 J Bedah Indonesia. 2020;48:3-14)
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Vandromme, Marianne J., Russell L. Griffin, Gerald Mcgwin, Jordan A. Weinberg, Loring W. Rue, and Jeffrey D. Kerby. "Prospective Identification of Patients at Risk for Massive Transfusion: An Imprecise Endeavor." American Surgeon 77, no. 2 (2011): 155–61. http://dx.doi.org/10.1177/000313481107700212.
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Most retrospective studies evaluating fresh-frozen plasma:packed red blood cell ratios in trauma patients requiring massive transfusion (MT) are limited by survival bias. As prospective resource-intensive studies are being designed to better evaluate resuscitation strategies, it is imperative that patients with a high likelihood of MT are identified early. The objective of this study was to develop a predictive model for MT in civilian trauma patients. Patients admitted to the University of Alabama at Birmingham Trauma Center from January 2005 to December 2007 were selected. Admission clinical measurements, including blood lactate 5 mMol/L or greater, heart rate greater than 105 beats/min, international normalized ratio greater than 1.5, hemoglobin 11g/dL or less, and systolic blood pressure less than 110 mmHg, were used to create a predictive model. Sensitivity (Sens), specificity (Spec), positive predictive value (PPV), and negative predictive value (NPV) were calculated for all possible combinations of clinical measurements as well as each measure individually. A total of 6638 patients were identified, of whom 158 (2.4%) received MT. The best-fit predictive model included three or more positive clinical measures (Sens: 53%, Spec: 98%, PPV: 33%, NPV: 99%). There was increased PPV when all clinical measurements were positive (Sens: 9%, Spec: 100%, PPV: 86%, NPV: 98%). All combinations or clinical measures alone yielded lower predictive probability. Using these emergency department clinical measures, a predictive model to successfully identify civilian trauma patients at risk for MT was not able to be constructed. Given prospective identification of patients at risk for MT remains an imprecise undertaking, appropriate resources to support these efforts will need to be allocated for the completion of these studies.
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de Koekkoek-Doll, Petra K., Sander Roberti, Michiel W. van den Brekel, et al. "Value of Assessing Peripheral Vascularization with Micro-Flow Imaging, Resistive Index and Absent Hilum Sign as Predictor for Malignancy in Lymph Nodes in Head and Neck Squamous Cell Carcinoma." Cancers 13, no. 20 (2021): 5071. http://dx.doi.org/10.3390/cancers13205071.
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Ultrasound-guided fine needle aspiration cytology (USgFNAC) is commonly used for nodal staging in head and neck squamous cell cancer (HNSCC). Peripheral vascularity is a described feature for node metastasis. Micro-flow imaging (MFI) is a new sensitive technique to evaluate micro-vascularization. Our goal is to assess the additional value of MFI to detect malignancy in lymph nodes. A total of 102 patients with HNSCC were included prospectively. USgFNAC was performed with the Philips eL18–4 transducer. Cytological results served as a reference standard to evaluate the prediction of cytological malignancy depending on ultrasound features such as resistive index (RI), absence of fatty hilum sign, and peripheral vascularization. Results were obtained for all US examinations and for the subgroup of clinically node-negative neck (cN0). USgFNAC was performed in 211 nodes. Peripheral vascularization had a positive predictive value (PPV) of 83% (cN0: 50%) and the absence of a fatty hilum had a PPV of 82% (cN0 50%) The combination of peripheral vascularization and absent fatty hilum had a PPV of 94% (cN0: 72%). RI (threshold: 0.705) had a PPV of 61% (cN0: RI-threshold 0.615, PPV 20%), whereas the PPV of short axis diameter (threshold of 6.5mm) was 59% for all patients and 19% in cN0 necks (threshold of 4 mm). Peripheral vascularization assessed by MFI and absent hilum has a high predictive value for cytological malignancy in neck metastases. Next to size, both features should be used as additional selection criteria for USgFNAC.
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Mercedes Picarelli, Maria, Henrique Luiz Staub, and Luiz Carlos Bodanese. "Platelet Indexes and Disease Activity in Juvenile Idiopathic Arthritis." Journal of Clinical Pediatrics 11, no. 1 (2025): 1–4. https://doi.org/10.52338/jocp.2025.4855.
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Objective: To test correlation between mean platelet volume (MPV), immature platelet fraction (IPF) with disease activity in a group of juvenile idiopathic arthritis (JIA) patients defined by JADAS 71. Determinate sensitivity, specificity, positive and negative predictive value. Methods: A cross-sectional study included JIA patients with oligoarticular and polyarticular rheumatoid factor negative subtypes, with disease defined activity by JADAS 71. Other subtypes and patients with acute infection, neoplastic diseases, macrophage activation syndrome, other thrombocytopenias, other inflammatory diseases, and use of antiplatelet and anticoagulant medications were excluded. All blood parameters were processed in a SYSMEX XN 1000 haematology analyser. Results: Twenty-five active and 21 inactive JIA disease patients were included. Oligoarticular subtype were 76%, 73,9% were female sex and 95,6% were caucasian. The median age was 10,30 [4,77 – 14] years and the median disease duration was 57 months [ 24 – 90,7]. The median JADAS 71 was 1,35 [ 0 – 10,25] with active disease above 1. There was no correlation between MPV and JADAS 71(rho = 0,204 e p = 0,185). There was no correlation between IPF and JADAS 71 (rho = 0,192 e p = 207). Sensitivity was 13% and specificity was 4,80%. Positive predictive value (PPV) was 75% and negative predictive value (PNV) was 50%. Sensitivity was 4,22%, and specificity was 0,0%, PPV was 36,8% and PNV was 100%. Conclusions: MPV and IPF had no correlation with JADAS 71 in a group of JIA patients Keywords : Juvenile idiopathic arthritis, mean platelet volume, immature platelet fraction, JADAS-71
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Shenoy, Krithika Damodar, and Suchetha S. Rao. "Positive predictive value of pulse oximetry in the screening of critical congenital heart defects in term neonates." International Journal of Contemporary Pediatrics 4, no. 3 (2017): 832. http://dx.doi.org/10.18203/2349-3291.ijcp20171523.
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Background: Critical congenital heart defects (CCHD) are associated with poor patient outcome due to delay in diagnosis. Clinical examination alone has low positive predictive value (PPV). Pulse oximetry examination is suggested as supplemental screening tool. Aim of this study was to screen term neonates for CCHD by clinical and pulse oximetry evaluations and estimate their PPV separately and combined.Methods:Cross-sectional study of 278 term neonates weighing ≥2500g excluding those with antenatal diagnosis of congenital heart defects and/or requiring intensive care. Sample size calculated using EpiInfo version 7 taking 20,000 as population size, 7% expected frequency, 5% confidence limits and 99.9% confidence level. Ethical clearance and informed consent obtained. Clinical examination was performed within 24 hours of life followed by pre-ductal and post-ductal oxygen saturation (SpO2) recording, using standardized hand-held probe, between 24-48 hours. Neonates categorized as screen positive or negative based on an adapted algorithm. Screen positives were confirmed by echocardiography. SPSS version 16 was used for statistical analysis.Results: Mean age at clinical examination was 7.72 ± 0.32 hours during which none screened positive. Mean age at SpO2 screening was 31.93 ± 0.32 hours and a single non-syndromic, acyanotic male newborn, weighing 2550g screened positive. He was found to have severe pulmonary outflow obstruction, with ductus-dependent flow on echocardiography. PPV for pulse oximetry screening alone was 100%.Conclusions:Ductus dependent lesions missed on clinical examination may be picked up by pulse oximetry screening. Echocardiography may be used selectively to confirm diagnosis on screen positive.