جستجوی مقالات مرتبط با کلیدواژه "predictive value" در نشریات گروه "پزشکی"

Early diagnosis of COVID-19 can have an important role in the decrease of mortality of patients. Symptoms such as fever and cough are the first diagnostic information. Due to the importance of early diagnosis of COVID-19, the current study aimed to assess the diagnostic value of different symptoms in detecting COVID-19 cases.

In the current cross-sectional study, 392 COVID-19 patients were confirmed based on RT-PCR (Reverse transcription-polymerase chain reaction) using nose and throat swab specimens and or Chest CT scan compatible with COVID-19 infection. The diagnostic value of symptoms in detecting COVID-19 was measured using the sensitivity, specificity, false alarm rate, likelihood ratio, and area under the receiver operating characteristics (ROC) curve (AUC).

The highest sensitivity and lowest false negative in the detection of COVID-19 cases were seen in Dyspnea and cough with a sensitivity of 0.59 (95%CI: 0.51-0.66) and 0.57 (95%CI: 0.49-0.65) respectively. In terms of specificity, the Loss of consciousness with specificity 0.95 (95%CI: 0.92-0.98) had the best performance so this symptom had the lowest false positive in the detection of COVID-19 cases. The most positive likelihood ratio (LR+) was seen in cough (LR+:1.41) and fever (LR+:1.21), respectively. The most positive predictive value (PPV) was seen in cough (PPV: 0.49 (95%CI: 0.41- 0.56)), and fever (PPV: 0.45(95%CI: 0.37-0.53)) respectively.

Early symptoms among patients tested for SARS-CoV-2 identified those general non-respiratory symptoms were strongly associated with test positivity.

 Sepsis, a deadly infection causing organ failure and Systemic Inflammatory Response Syndrome (SIRS), is detected early in hospitalization using the SIRS criteria, while sequential organ failure (SOFA) assesses organ failure severity. A systematic review and meta-analysis was evaluated to investigate the predictive value of the SIRS criteria and the SOFA system for mortality in early hospitalization of sepsis patients.

 Inclusion criteria were full reports in peer-reviewed journals with data on sepsis assessment using SOFA and SIRS, and their relationship with outcomes. For quality assessment, we considered study population, sepsis diagnosis criteria, and outcomes. The area under the curve (AUC) of these criteria was extracted for separate meta-analysis and forest plots.

 Twelve studies met the inclusion criteria. The studies included an average of 56.1% males and a mean age of 61.9 (±6.1) among 32,979 patients. The pooled AUC was 0.67 (95% CI: 0.60-0.73) for SIRS and 0.79 (95% CI: 0.73-0.84) for SOFA. Significant heterogeneity between studies was indicated by an I2 above 50%, leading to a meta-regression analysis. This analysis, with age and patient number as moderators, revealed age as the major cause of heterogeneity in comparing the predictive value of the SOFA score with SIRS regarding the in-hospital mortality of sepsis patients (P<0.05).

 The SOFA score outperformed the SIRS criteria in predicting mortality, emphasizing the need for a holistic approach that combines clinical judgment and other diagnostic tools for better patient management and outcomes.

Hypertensive intracerebral hemorrhage (HICH) is a spontaneous cerebrovascular disease occuring in the brain parenchyma.

To characterize the predictive role of miR-155-5p and BDNF in the prognosis of HICH.

All patients with HICH who underwent CT-guided minimally invasive surgery were classified into the good and poor prognosis groups using the modified Rankin Scale (mRS). The level of miR-155-5p was determined by qRT-PCR, and the level of brain-derived neurotrophic factor (BDNF) in serum was determined by ELISA. The relationship between miR-155-5p and BDNF was tested by Pearson correlation and luciferase reporter assay. The logistic regression method was used to determine the risk factors. The ROC curve was drawn to explain the predictive role of miR-155-5p, BDNF, or their combination.

A high level of miR-155-5p and a lower level of BDNF were observed in the poor prognosis group. BDNF level was negatively related to the level of miR-155-5p. BDNF is a target of miR-155-5p. BDNF and miR-155-5p were associated with prognosis. BDNF, miR-155-5p or their combination were predictive biomarkers for the prognosis of HICH.

BDNF and miR-155-5p were associated with the outcome of HICH patients.

The diagnostic value of spirometry in the evaluation of pulmonary function is known; however, the predictive potential of this method has always been undervalued. In the present systematic review, we aimed to collect all available data to analyze whether spirometry can be used in screening programs to predict future pulmonary diseases.

A database search was performed in Ovid, Science Direct, PubMed, Scopus, Web of Science, Embase, and Google Scholar using “spirometry” and “predictive value” as the main search terms.

After excluding irrelevant articles, 19 related studies were selected, and data extraction was performed. The results of the included literature showed that spirometry is a safe and reliable method for the evaluation of pulmonary function. It was also reported that spirometry can provide useful information, which can be complementary to other methods of evaluation.

Findings showed that spirometry is a valid and non-invasive method of assessment for the diagnosis of respiratory diseases such as asthma and airway obstruction. Moreover, spirometric parameters may help to predict future pulmonary conditions, at least in children.

Klotho allele status is associated with increased risk of cardiovascular diseases, diabetes and hypertension.

To determine if serum klotho level was lower among diabetic and hypertensive patients compared to control group. Patients and

This was a cross-sectional study of 90 participants. Thirty pure diabetic patients and 30 participants with pure hypertension were compared with the healthy control group. Multiple logistic regressions were used to examine the association between serum klotho and diabetes and hypertension. We also tested the cut off point of serum klotho to predict hypertension and diabetes by using ROC (receiver operating characteristic) curve.

The level of serum klotho was significantly lower in diabetic and hypertensive patients. Participants with higher klotho were less likely to have diabetes and hypertension [OR: 0.48, 95% CI (0.22-0.81)] even after adjustment for covariates. ROC curve for diabetes and hypertension indicated 0.8 area under the curve which was statistically significant.

This study found that serum klotho was associated with lower odds of diabetes and hypertension. Further longitudinal studies are necessary to confirm this finding.

Although laparoscopic cholecystectomy (LC) is the gold standard approach for gallbladder diseases, this sometimes may face difficulties and require conversion to open surgery. The preoperative ultrasonographic study may provide information about the probability of difficult LC, but the data in this term are uncertain. We assessed the value of preoperative ultrasonographic findings for the prediction of LC’s difficulty.

The current prospective clinical trial was conducted on 150 patients who were candidates for LC due to symptomatic gallstone. All of the patients underwent ultrasonography study preoperatively, and then, LC was performed. The surgeon completed a checklist regarding the easy or difficult surgical criteria. Finally, the values of ultrasonographic findings for the prediction of LC difficulty were evaluated.

Among the 150 included patients, 80 had easy LC and 70 had difficult LC. Statistically significant differences were found between the two groups of easy and difficult LC regarding gallbladder wall thickness (P = 0.008), stone impaction (P = 0.009), and gallbladder flow (P = 0.04). The area under the curve (standard error [SE]) for the thickness of the gallbladder wall, flow in the gallbladder wall, and stone impaction was 0.598 ± 0.048, 0.543 ± 0.047, and 0.554 ± 0.047, respectively (P < 0.05). The highest specificity was for gallbladder wall flow (100%). Binary logistic regression showed that stone impaction had predictive value for determining difficult LC (odds ratio = 3.10; 95% confidence interval: 1.03–9.30; P = 0.04).

Although a significant difference was observed between two groups in terms of impacted stone, flow in the gallbladder wall, and thickness of the gallbladder wall, only stone impaction had predictive value for determining difficult LC.

Constipation is a common disorder in pediatrics, although the underlying pathogenesis is not fully understood. The current study aimed at evaluating the efficacy of different colonic transit time (CTT) indices for differentiating normal from nonnormal sensation in children with chronic functional constipation identified by anorectal manometry (ARM).

In this cross‑sectional study, 47 children with chronic idiopathic constipation, aged 5–15 years, were studied. The total and segmental CTTs were estimated by administering multiple radiopaque markers for 6 days and performing a single abdominal radiograph on day 7. Anorectal function was evaluated using manometry with an Arhan probe. The predictive value of CTT indices was evaluated by receiver operating characteristic curve analysis. Area under the curve (AUC) along with 95% confidence interval (CI) as well as sensitivity and specificity was calculated.

The mean age of the participants was 8.30 ± 2.99 years, with a mean constipation duration of 2.90 ± 0.46; 28 children were identified with nonnormal sensation. The mean values of CTT indices were statistically significantly longer in the nonnormal sensation patients than that in the normal group (P < 0.001). In addition, the mean values of manometry parameters were statistically significantly higher in nonnormal sensation patients than that in normal group (P < 0.01). Among CTT indices, rectosigmoid CTT (AUC [95% CI] =0.999 [0.99–1]; P < 0.001) with sensitivity = 100% and specificity = 94.7% and total CTT (AUC [95% CI] =0.972 [0.93–1] P < 0.001) with sensitivity = 82.3% and specificity = 100% had the highest predictive values for differentiating nonnormal from normal sensation patients.

CTT is a simple and noninvasive technique for classifying patients with constipation. It can be used for identifying children suffering from chronic constipation with nonnormal sensation reliably, instead of ARM. Colonic inertia may be a manifestation of global motility dysfunction. Children with delayed distal colonic transits are more likely to have abnormal defecation dynamics.

Acute appendicitis is the most common nonobstetric surgical problem in pregnancy. Common signs and symptoms of appendicitis are less reliable during pregnancy due to physiological changes; thus, the role of imaging becomes prominent. Thus, in the present study, we aimed at assessing the accuracy of sonography in diagnosing acute appendicitis during pregnancy.

In this prospective analytic study, among 1000 patients diagnosed and treated as acute appendicitis, clinical and sonographic findings of 58 consecutive pregnant patients, who underwent appendectomy, were recorded and analyzed. All surgically resected samples were evaluated and confirmed through histological evaluation. Sonographic criteria were utilized to judge the results for appendicitis. Diagnostic test performance characteristics (sensitivity, specificity, predictive values, and likelihood ratios) were calculated.

The mean age of the patients was 27.1±4.9 years, and the most common clinical symptom was right lower quadrant pain. There was no significant difference in the mean leukocyte count between the appendicitis group and normal appendix group (p=0.768). Left shift was also unrelated with the appendix pathology (p= 0.549). The sensitivity, specificity, predictive values (positive and negative), and likelihood ratios (positive and negative) were 80%, 75%, 91.4%, 52.9%, 3.2, and 0.26, respectively during all trimesters of pregnancy.

Ultrasonography is the initially preferred imaging modality in pregnant women suspected of having acute appendicitis with an acceptable sensitivity; however, application of other imaging modalities such as CT scan or MRI is recommended after inconclusive ultrasonography results.

To determine the predictive and diagnostic value of thorax trauma severity score (TTSS) in a population of thoracic trauma patients admitted to a secondary level trauma center.
A Retrospective analysis of patients admitted over a period of two years with IDC-9 codes related to thoracic trauma was undertaken. The association of TTSS with complications and mortality was evaluated. We also determined the predictive value of TTSS using receiver operating characteristic curve (ROC).
238 patients with thoracic trauma, mostly middle-aged (62.2 ± 15 years), were included. The main mechanisms of injury were falls and traffic accidents. Thirty-three patients had important extra-thoracic injuries, but only 9 presented an ISS> 15. The average ISS was 3 ± 5; Morbidity was 2.5% and mortality was 2.1% as a result of thoracic injury and these patients had significantly higherTTSS values. Each score component was analyzed separately, showing significant association with complications and mortality. The area under the curve for TTSS was significant for predicting complications (0.848) and mortality (0.856) values. TTSS with a cut off value of 8 points had a sensitivity of 66% and specificity of 94% to predict complications and 80% sensitivity and 94% specificity for predicting mortality.
The TTSS is an appropriate and feasible tool to predict the development of complications or mortality in a population of mostly mild thoracic trauma.

To evaluate the feasibility of screening for retinopathy of prematurity (ROP) by assessing the pupillary response to mydriatics.
This observational case series included 134 eyes of 67 premature infants with birth weight less than 2,000 grams and gestational age less than 33 weeks. A composite eye drop composed of phenylephrine 1%, tetracaine and tropicamide 0.5% was applied 3 times within 5‑minute intervals and pupil diameters were measured. The eyes were examined by experienced ROP specialists using an indirect ophthalmoscope. Zone and stage of ROP, presence of plus disease and need for treatment were recorded. The relationship between the pupillary response to mydriatics, and presence and severity of ROP was evaluated. Logistic regression was used for statistical analysis.
According to receiver operating characteristic (ROC) curve analysis, final pupil diameter after mydriatic administration was found the most accurate factor among other factors to recognize ROP zone I from zones II and III (Area under ROC: 0.92 [95%CI: 0.85‑0.98]). The best cutoff value for final pupil diameter was 5.6 mm, because it could differentiate involvement of zone I from zones II and III with sensitivity of 80% and specificity of 100%.
Response of the pupil to mydriatic eye drops may be useful as a less invasive method for rough estimation of ROP in high risk babies who need emergent attention; however, it cannot be considered as a screening test due to its low sensitivity.

Colorectal cancer is one of the most important causes of morbidity and mortality in the world. It has been suggested that tissue inhibitor of metalloproteinase-1 (TIMP-1) plays a particular role in cancer promotion. The objective of the present study was to compare the effect of repeated measurement of carcinoembryonic antigen (CEA) and TIMP-1 plasma levels in a follow-up response to chemotherapy treatment in patients with unresectable metastatic colorectal cancer by surgery. All consecutive patients between 18 and 75 years old in both genders with rectal adenocarcinoma who referred to Sayed Al-Shohada Medical Center, during 6 months of study period enrolled in the study. Level of CEA and TIMP-1 were assessed before and after two cycles of chemotherapy. Furthermore, patients underwent computed tomography scan to assess response to chemotherapy. The sensitivity, specificity, and areas under the receiver operating characteristic curves (AUC) calculated for baseline level of CEA and TIMP. The mean age of the studied patients was 52.7 } 7.5 years, 12 patients (48%) were male. Response to chemotherapy after two cycles was 80%. In patients who responded to chemotherapy level of TIMP after treatment was significantly decreased compared to before treatment (P < 0.0001). Before and after treatment in patients who responded to chemotherapy the level of TIMP was significantly lower than who did not response to chemotherapy (P < 0.05). The critical values for the prediction response to chemotherapy for CEA was >63 (AUC: 0.54) and for TIMP was? 8823 (AUC: 0.68). The present study has identified a strong significant association between high plasma TIMP-1 levels and short survival in patients with colorectal cancer. In addition, results demonstrated that the TIMP-1 provides stronger prognostic information than CEA.

Serum uric acid (SUA) is considered a marker for natural progression of chronic heart failure (CHF) mediated cardiovascular remodelling. CHF associates with declining of circulating mononuclear progenitor cells (MPCs). The objective of this study was to evaluate the interrelationship between SUA concentrations and proangiogenic MPCs in ischemic CHF patients. The study population was structured retrospectively after determining the coronary artery disease (CAD) by contrast-enhanced spiral computed tomography angiography in 126 subjects with symptomatic ischemic mild-to-severe CHF and 128 CAD subjects without CHF. Baseline biomarkers were measured in all patients. Cox proportional multivariate hazard ratio was calculated for predictors of MPCs declining in both CHF and non-CHF patient population predictors of MPCs declining in CHF subjects were examined in stepwise logistic regression. C-statistics, integrated discrimination indices (IDI) and net-reclassification improvement were utilized for prediction performance analyses. Cox proportional adjusted hazard ratio analyses for CD14+CD309+ and CD14+CD309+Tie2+ MPCs by SUA has shown that the higher quartiles (Q3 and Q4) of SUA compared to the lower quartiles (Q1 and Q2) are associated with increased risks of depletion of both CD14+CD309+ and CD14+CD309+Tie2+ MPCs. The addition of Q4 SUA to the ABC model improved the relative IDI by 13.8% for depletion of CD14+CD309+ MPCs and by 14.5% for depletion of CD14+CD309+Tie2+ MPCs. Circulating levels of proangiogenic MPCs are declined progressively depending on the levels of SUA in the HF subjects with CHF. We suggest that even mild elevations of SUA might be used to predict of relative depletion of proangiogenic MPCs among chronic HF patients.

Suicide is the third cause of mortality in America, second leading cause of death in developed countries, and one of the major health problems. Self-harm is self-inflicted damage to one’s self with or without suicidal intent. In the present study, the predictive factors of suicide attempt and non-suicidal self-harm were evaluated in patients referred to emergency department (ED) with these problem. The total number of 45 patients with suicide attempt or self-harm admitted to ED were included. Clinical symptoms, thoughts and behaviors of suicidal, and non-suicidal self-harm in these patients were evaluated at baseline. Suicidality, suicidal intent and ideation, non-suicidal self-injury, social withdrawal, disruptive behavior, and poor family functions were evaluated at admission time. Brief clinical visits were scheduled for the twelfth weeks. In the twelfth week, patients returned for their final visit to determine their maintenance treatment. Finally data were analyzed using chi-squared and multiple logistic regression. Forty five patients were included in the study (56.1% female). The mean age of patients was 23.3±10.2 years (range: 15-75; 33.3% married). Significant association of suicide and self-injury was presented at the baseline and in the month before attempting (p=0.001). The most important predictive factors of suicide and self-harm based on univariate analysis were depression (suicidal and non-suicidal items of Hamilton depression rating scale), anxiety, hopelessness, younger age, history of non-suicidal self-harm and female gender (p<0.05). The participants’ quality of life analysis showed a significant higher quality in physical component summary (p=0.002), mental component summary (p=0.001), and general health (p=0.001) at follow up period. At the time of admission in ED, suicide attempt and non-suicidal self-harm are subsequent clinical markers for the patient attempting suicide again. The most independent predictive factors of suicide attempt and self-harm were poor family function, hopelessness, non-suicidality items of Hamilton depression rating scale, history of non-suicidal self-harm, and anxiety disorders.

Chorionic Villous Sampling (CVS) is a diagnostic method for determining genetic disorders. The present study aimed to determine the negative predictive value of the CVS in the diagnosis of major thalassemia in genetic laboratory of Dastgheib Hospital, Shiraz, Iran. The present research was an evaluation diagnostic test conducted on 372 records of embryos examined through CVS in the genetic lab in 2010 and definitely diagnosed by electrophoresis after birth in 2012. The sensitivity and positive predictive value of the test were assessed for minor thalassemia. The negative predictive value and the specificity of this test were determined, as well. A total of 3 embryos (0.8%) were aborted due to testing. In this study, the sensitivity and specificity were 94.8% and 80.4%, respectively. Also, the negative predictive values for diagnosis of major and minor thalassemia were 100% and 89.2%, respectively. No relationships were found between the gestational age and the test results. The results of this study showed that CVS genetic testing in genetic laboratory of Dastgheib Hospital was valid and had a high diagnostic value. Thus, minor couples can undergo this test with relative safety in order to prevent major thalassemia.

SCORE, OST and ORAI risk assessment tools could reduce the cost burden of BMD tests by selecting the high risk patients to osteoporosis. In this study we compared the ability of these risk assessment measures to assess probability of the osteoporosis among post-menopausal women. 211 post-menopausal women aged 45-88 years enrolled into the study. All of the patients underwent BMD test and divided into two groups according to T-Score level. 43 patients (20.4%) had T-Score ≤-2.5 (osteoporotic) (group-1) and 168 (70.6%) patients had T-Score of > -2.5 (non-osteoporotic). Among 168 nonosteoporotic cases, 88 had -2.5≤T-Score≤-2 in at least one bony area. These 88 cases in addition to the 43 cases with -2.5≤T-Score considered as high risk group to osteoporosis (group 2). Afterward, SCORE, OST and ORAI risk scores were calculated and sensitivity, specificity, likelihood ratio, accuracy index and area under the curve of each tool were determined in both groups and then compared with each other. SCORE had the highest sensitivity compared with others in both groups (95% and 88.2% respectively). Moreover, it had the highest diagnostic odds ratio and negative predictive value between the three methods. OST had the highest likelihood ratio and specificity in both groups (71.4% and 75.4%). There was significant difference between the sensitivity and specificity of the tests (p= 0.004 and 0.027). OST with the highest specificity and positive LR had a special role in determining the osteoporotic patients and SCORE with the highest sensitivity and negative predictive value had an exceptional role in exclusion of the non- osteoporotic individuals. However, considering the area under the curve, there was no significant difference among these three methods in determining osteoporosis.