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At least 199 records · Page 11Linked to original sources
PubMed2006

Accuracy of Ein Bild Röntgen Analyse in determining wear in total hip arthroplasty in vitro.

The Ein Bild Röntgen Analyse system is used to radiographically measure femoral head penetration in total hip replacement components. Because determining the accuracy of any wear analysis system is more precise and comparable under in vitro conditions, we used a femoral head migration simulator to assess the accuracy of Ein Bild Röntgen Analyse and determine the effect of magnification factors on accuracy. We used onscreen magnifications of 100% and 200% to measure anteroposterior radiographs, which improved the accuracy of determining femoral head penetration. Improvements averaged 0.056 mm (95% CI +/- 0.013 mm) in the X direction and 0.024 mm (95% CI +/- 0.027 mm) in the Y direction. Femoral head penetration was simulated in 0.25-mm steps from 0-1 mm. Accuracy ranged from 0-0.029 mm (95% CI, 0.035-0.067 mm) for the X direction and from 0.001-0.013 mm (95% CI, 0.046-0.079 mm) for the Y direction. Assuming the worst accuracy combined for the X and Y directions, Ein Bild Röntgen Analyse can accurately detect femoral head penetration greater than 0.128 mm. These results are comparable with reported accuracy values for different systems and suggest that magnification tools should be considered with Ein Bild Röntgen Analyse when measuring wear radiographically.

Arthroplasty, Replacement, Hip↗
PubMed2005

Accuracy of ultrasound biometry in the prediction of macrosomia: a systematic quantitative review.

OBJECTIVE: To determine the accuracy of ultrasonographically estimated fetal weight (EFW) and abdominal circumference (AC) in the prediction of macrosomia. DESIGN: Systematic quantitative review. METHODS: Studies were identified without language restrictions from MEDLINE (1966-2003), EMBASE (1980-2003), Cochrane Library (2003:4), SCISEARCH (1974-2003) and manual searching of bibliographies of known primary and review articles. Studies were selected if accuracy of ultrasonographically EFW or AC was evaluated for predicting macrosomia using birthweight as the reference standard. Data were extracted on study characteristics, quality and accuracy. Data were pooled to produce summary receiver operating characteristic curves (sROC) for studies with various test thresholds. Summary likelihood ratios for positive (LR+) and negative (LR-) test results were generated for an EFW of 4000 g and an AC of 36 cm for predicting birthweight of over 4000 g. MAIN OUTCOME MEASURES: Birthweight over various thresholds. RESULTS: There were 36 primary articles consisting of 63 accuracy studies (51 evaluating the accuracy of EFW, and 12 accuracy of fetal AC), including a total of 19,117 women. The sROC area for EFW was not different from the area for fetal AC (0.87 vs 0.85, P= 0.91). For predicting a birthweight of over 4000 g, the summary LRs were 5.7 (95% CI: 4.3 to 7.6) for a positive test and 0.48 (95% CI: 0.38 to 0.60) for a negative test, using Hadlock's method of ultrasonographically estimating fetal weight. For ultrasound fetal AC of 36 cm, the respective LRs for predicting a birthweight over 4000 g were 6.9 (95% CI: 5.2 to 9.0) and 0.37 (0.30-0.45). CONCLUSION: There is no difference in accuracy between ultrasonographically EFW and AC in the prediction of a macrosomic baby at birth. A positive test result is more accurate for ruling in macrosomia than a negative test result for ruling it out.

Abdomen↗
PubMed2002

The prognostic accuracy of different QT interval measures.

BACKGROUND: The QT intervals accuracy for predicting arrhythmic death varies between studies, possibly due to differences in the selection of the lead used for measurement of the QT interval. The purpose of this study was to analyze the prognostic accuracy of all known ways to select the lead. METHODS AND RESULTS: Three institutions that used different methods for measuring QT intervals provided their QT databases. They included more than 3500 twelve-lead surface ECGs. The data represented low- and high-risk patients of the normal population (survivors vs dead from cardiovascular causes), acute myocardial infarction (survivors versus death from all causes) and remote myocardial infarction (with vs without a history of ventricular arrhythmia). The prognostic accuracy was defined as the area under the Receiver Operator Curve (ROC-area). The most accurate standard leads were I and aVL and the least accurate was AVR. The most accurate precordial lead was V4. The prognostic accuracy of the longest QT interval was higher than for any standard lead. The prognostic accuracy of the mean of the three longest QT intervals was equal to or slightly lower than for the longest QT interval. CONCLUSIONS: The highest prognostic accuracy is obtained with the longest QT interval. The accuracies of the lead selection methods are so different that it can explain a substantial part of the differences between otherwise similar studies in the literature. We recommend the use of the mean value of the three longest QT intervals.

Adult↗
PubMed2005

In vitro accuracy of a novel registration and targeting technique for image-guided template production.

OBJECTIVES: The objective of this study was to evaluate the accuracy of a novel registration and targeting technique for image-guided template production (IGTP) in a preliminary phantom study. MATERIAL AND METHODS: Registration of four standard dental stone casts with integrated target pellets to the corresponding computed tomography (CT) data was performed via a vacuum mouthpiece and an external reference frame (Medical Intelligence GmbH, Germany). Using the Treon navigation system (Medtronic Inc., Minneapolis, MN, USA) a surgical path with the entry in the centre of the dental crown and the target in the centre of the target pellet was planned on the CT data. An aiming device was adjusted according to the planned trajectory and guided drillings into the dental stone casts. The accuracy was evaluated on postoperative 3D-CT data. RESULTS: The mean fiducial registration error as given by the registration software was 0.4 mm. One hundred and twelve navigated drillings showed a mean accuracy [xy] of 0.42+/-0.26 mm (maximum 1 mm). For the z-axis, a mean accuracy [z] of 0.25+/-0.12 mm (maximum 0.6 mm) was found. CONCLUSIONS: Comparing the presented registration technique to existing registration methods in IGTP and burr tracking, no radiographic and registration templates are needed. The procedure is easy and requires only minimal effort. Navigation-controlled drillings could be performed with an accuracy that approaches the intrinsic navigation system's accuracy, a fact that warrants its use for surgical template production. Further accuracy studies of template-guided drillings are necessary before the presented registration technique can be implemented for patient treatment.

Calcium Sulfate↗
PubMedDate not supplied

Accuracy of nurses' diagnoses of psychosocial responses.

PURPOSE: To describe the accuracy of staff nurses' diagnoses or interpretations of the human responses of patients in hospital settings. METHODS: The sample was 62 staff nurses in three hospitals who assessed and diagnosed the psychosocial problems of one to four patients. Two trained raters followed with assessment, diagnosis, and ratings of nurses' accuracy of 153 cases. A seven-point interval scale was used to judge accuracy. FINDINGS: The means of accuracy scores across nurses were significantly different (f = 1.66; p < .05; df = 2.59). A significant percentage of nurses' diagnoses were scored at the two highest levels of accuracy (45.2%), and 12.8% were scored at the three lowest levels of accuracy. According to the expert raters, a high percentage of patients (54.4%) were experiencing fear or anxiety. CONCLUSIONS: More attention needs to be given to the accuracy of nurses' diagnoses of psychosocial responses.

Acute Disease↗
PubMedDate not supplied

Accuracy of data in computer-based patient records.

Data in computer-based patient records (CPRs) have many uses beyond their primary role in patient care, including research and health-system management. Although the accuracy of CPR data directly affects these applications, there has been only sporadic interest in, and no previous review of, data accuracy in CPRs. This paper reviews the published studies of data accuracy in CPRs. These studies report highly variable levels of accuracy. This variability stems from differences in study design, in types of data studied, and in the CPRs themselves. These differences confound interpretation of this literature. We conclude that our knowledge of data accuracy in CPRs is not commensurate with its importance and further studies are needed. We propose methodological guidelines for studying accuracy that address shortcomings of the current literature. As CPR data are used increasingly for research, methods used in research databases to continuously monitor and improve accuracy should be applied to CPRs.

Algorithms↗
PubMed1991

Representation of sensory information in the cricket cercal sensory system. II. Information theoretic calculation of system accuracy and optimal tuning-curve widths of four primary interneurons.

1. Principles of information theory were used to calculate the limit of accuracy achievable by a subset of the wind-sensitive primary interneurons in the cricket cercal sensory system. For these calculations, an ensemble of four neurons was treated as an information channel, which encoded the direction of air-current stimuli for a defined range of air-current velocities. The specific information theoretic parameter that was calculated was the "transin-formation" or "mutual information" between the air-current directions and the neuronal spike trains, which were characterized in the preceding report. Under the assumptions used for these calculations, the ensemble of four interneurons was demonstrated to be capable of encoding between 4.2 and 3.5 bits of information about wind direction. This corresponds to an average directional accuracy of 4.7 and 7.7 degrees, respectively. 2. The same principles were applied to estimate the extent to which any variation in the width of the tuning curves would affect the transfer of information. As the widths of simulated tuning curves were varied, the mean ensemble accuracy showed a clear global maximum. This maximum corresponds to tuning curves widths of 110 degrees wide (at half maximum), which was remarkably close to the actual mean widths of the tuning curves observed in the cricket of 130 degrees. 3. The effect of varying the parametric "spacing" of the tuning curves within the stimulus range was also examined through a series of simulations. The configuration allowing the maximum information transfer corresponded to equal spacing of the tuning curves around the stimulus range (i.e., 90 degrees separation of peak sensitivity points). This theoretically optimum spacing corresponded exactly to the values observed in the experiments presented in the preceding report. 4. These simulations also showed that the degradation in the accuracy resulting from a shift in the tuning-curve spacing would depend on the plasticity of the higher order decoder of directional information. If there were no plasticity in the interneurons making up the higher order decoder, then the accuracy would be degraded by 50% for a mean tuning-curve shift of only 3.5 degrees. However, if the higher order decoding network were capable of being reoptimized to any arbitrary shift in tuning curves, the degradation in attainable accuracy would be much less severe as shifts of up to 10 degrees would result in virtually no degradation in the accuracy. 5. From these results, two general conclusions can be drawn about the coding of specific stimulus parameters by arrays of sensory cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Air↗
PubMed2000

Accuracy of intraoperative frozen-section diagnosis in stage I endometrial adenocarcinoma.

The purpose of our study was to determine if frozen-section diagnosis accurately identified patients suffering from endometrial adenocarcinoma FIGO stage I for surgical staging consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytology, and complete bilateral pelvic lymphadenectomy in moderately differentiated tumors with myometrial invasion. In all poorly differentiated tumors, and in all tumors with deep myometrial invasion (more than 50%) surgical staging included additional para-aortic lymphadenectomy. We performed a retrospective study including 70 patients. Frozen-section diagnosis of myometrial invasion and tumor grade was compared with permanent-section diagnosis. The accuracy rates were determined, and compared with accuracy rates of frozen-section diagnosis in the literature, and a total accuracy rate for 624 patients suffering from stage I endometrial adenocarcinoma was evaluated. In our patient collective, the overall accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade was 80 and 84%, respectively. In the five comparable studies, the mean accuracy rate for myometrial invasion and tumor grade was 89 and 84%, respectively. In combination with the five comparable studies our recent study produced an accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade of 88 and 84% in 624 patients, respectively. Despite an accuracy level of frozen-section diagnosis for myometrial invasion of 80 and 84% for tumor grade in our patient collective, all patients who required surgical staging were accurately identified.

Adenocarcinoma↗
PubMedDate not supplied

Effect of OB/GYN residents' fatigue and training level on the accuracy of fetal weight estimation.

OBJECTIVE: To determine the effect of Ob/Gyn residents' fatigue and training level on the accuracy of their clinical and ultrasonographical estimation of fetal weight (EFW). METHODS: In this study, clinical and ultrasonographical EFWs were performed by various residents. Actual birth weight, gravidity, parity, gestational age, body mass index, presence or absence of diabetes and hypertensive diseases, presentation and amniotic fluid index were recorded. All EFWs were divided into 3 groups according to the hour they were performed. All residents were divided into 4 groups according to their training level. The accuracy of EFW as compared with actual birth weight was then analyzed according to the shift and to the residents' seniority by using the ANOVA test. Multivariate analysis was performed to evaluate the factors that significantly and independently affected the weight evaluation. RESULTS: Statistically significant differences were found between the clinical EFW and the birth weight among the working shifts for birth weights of 2,500 g and more (p = 0.032 and p = 0.035). For clinical EFW, night shifts were the most inaccurate (9.27, 8.05 and 9.78% of error for day, evening and night shift, respectively; p = 0.03). The accuracy of ultrasonographical EFW was not affected by the residents' fatigue level. The residents' training level did not alter the accuracy of either clinical or sonographical EFW. The accuracy of clinical EFW was affected independently by the work shift (p = 0.01), whereas no factor was found to independently effect the accuracy of ultrasonographic EFW. CONCLUSIONS: Ob/Gyn residents' fatigue affects the accuracy of clinical but not ultrasonographical EFWs. Residents' training level does not alter either the clinical or sonographical EFW.

Analysis of Variance↗
PubMed1994

Measuring diagnostic accuracy in the absence of a "gold standard".

OBJECTIVE: As the nation debates issues of national health care reform, psychiatrists seek equal status with other medical colleagues. To defend psychiatry in the national arena, the accuracy of psychiatric diagnoses must be measured. Indexes of accuracy such as sensitivity and specificity provide valuable information, yet they are rarely computed because there is no "gold standard" with which to compare them. The goal of this article is to show how this problem can be overcome and to encourage nosologists to use accuracy statistics in assessing the adequacy of psychiatric diagnoses. METHOD: The authors reviewed the literature on medical decision making to find methodological approaches to assessing diagnostic accuracy in the absence of gold standards. RESULTS: A lack of such standards is not unique to psychiatry and has been addressed with a variety of novel analytic procedures. Although these methods differ in many respects, each recognizes that the conventional 2 x 2 table of interrater agreement does not provide enough data for estimating diagnostic accuracy. After defining the data needed, each method provides a mathematical model that estimates accuracy statistics and the prevalence of a disorder. Most of these methods are variants of latent class analysis. The authors reanalyzed data from one of the reviewed papers to show that similar inferences about accuracy of diagnoses could be drawn from a conventional latent class analysis. CONCLUSIONS: There are potential pitfalls in using latent structure methods, but their cautious use would provide valuable information for psychiatric nosology. These methods supplement, but do not replace, data about outcome, family history, laboratory studies, and other validating criteria in making accurate diagnoses.

Female↗
PubMed1994

Precision and accuracy of Morgan ventilometers at continuous and sinusoidal flows.

The P.K. Morgan Mark II Ventilometer comprises a turbine transducer and a control/readout unit, which contains either a VENTX5A or VENTX6A programme. This equipment is used to measure minute ventilation during oxygen consumption tests. The precision and accuracy of six of these devices (a VENTX5A with two turbines, and two VENTX6As each with two different turbines) were examined during continuous and pulsatile flows; accuracy was affected by the syringe rate during the calibration procedure. The reference standard was a 350 l Collins chain-compensated gasometer. At continuous flows, the two VENTX5A devices showed accuracies of 99.5-100.5% over the range 60-160 l.min-1 whereas those for the four VENTX6As were 99.3-102.1% over the range 60-200 l.min-1. The mean accuracies of sinusoidal flows for the VENTX5A ranged between 96.1-101.3% for minute volumes spanning 15-200 l.min-1; comparable data for the VENTX6As were 95.9-98.9%. These mean accuracies improved to 98.1-101.3% for the VENTX5A at measured minute volumes > 80 l.min-1. Omission of the two lowest tidal volumes (1 and 1.5 l) for the VENTX6As narrowed the range of accuracy to 96.9-98.5%. The coefficients of variation for five trials at each minute ventilation were 0-0.2%. We conclude that, while the P.K. Morgan Mark II Ventilometer has excellent precision, its accuracy is dependent on the calibration syringe rate, minute ventilation and program.

Airway Resistance↗
PubMed2004

An anthropomorphic phantom study of the accuracy of Cyberknife spinal radiosurgery.

OBJECTIVE: Stereotactic radiosurgery requires the highest degree of accuracy in target identification and localization. When targeting paraspinal lesions, the CyberKnife radiosurgical system (Accuray, Inc., Sunnyvale, CA) uses implanted stainless steel fiducials. The purpose of this study was to evaluate the total system for clinically relevant accuracy of this approach. METHODS: The clinically relevant accuracy of the CyberKnife depends on 1) the accuracy of beam delivery, which in turn represents a compilation of robot and camera image-tracking errors, and 2) the inherent accuracy of target localization that stems from computed tomographic imaging and treatment planning. The clinically relevant accuracy was measured at three different CyberKnife facilities using head and torso phantoms loaded with packs of radiochromic film and expressed as a displacement of the dose contours from the treatment planning. RESULTS: The mean clinically relevant error, as measured at three different CyberKnife facilities, was determined to be 0.7 +/- 0.3 mm, which did not vary with computed tomographic slice thickness in a range of 0.625 to 1.5 mm. The average treatment delivery precision was 0.3 +/- 0.1 mm. Fiducial tracking error was less than 0.3 mm for radial translations up to 14 mm and less than 0.7 mm for rotations up to 4.5 degrees. CONCLUSION: For the treatment of relatively stationary spinal lesions targeted with fiducial tracking, the CyberKnife system is capable of submillimeter accuracy.

Humans↗
PubMed2001

Should atypical squamous cells of undetermined significance (ASCUS) be subcategorized? Accuracy analysis of Papanicolaou smears using receiver operating characteristic curves and implications for the ASCUS/squamous intraepithelial lesion ratio.

We correlated all Papanicolaou test diagnoses over a 6-month period with biopsy results and determined accuracy using receiver operating characteristic curves and biopsy as the "gold standard." Accuracies were calculated using all atypical squamous cells of undetermined significance (ASCUS) cases or by eliminating subsets thereof. Retaining the ASCUS category resulted in significantly greater accuracy for the diagnosis of squamous intraepithelial lesion (SIL) on biopsy compared with eliminating it by diagnosing all such cases as negative. Subcategorization significantly improved the accuracy of the test only when all cases were included. The highest accuracy without subcategorization was achieved when ASCUS, favor reactive, cases were diagnosed as negative, but this threshold was significantly less sensitive than including all ASCUS cases. Increasing or decreasing the estimated ASCUS/SIL ratio from 2.4 without subcategorization significantly reduced accuracy. Similar results were obtained when high-grade SIL on biopsy was used as the gold standard. Use of the ASCUS category significantly improves the accuracy of the Papanicolaou test. Eliminating any subset of ASCUS reduces the ASCUS/SIL ratio but also significantly diminishes the sensitivity of the Papanicolaou test.

Female↗
PubMed2004

Accuracy and precision of manual baseline determination.

Vibrational spectra often require baseline removal before further data analysis can be performed. Manual (i.e., user) baseline determination and removal is a common technique used to perform this operation. Currently, little data exists that details the accuracy and precision that can be expected with manual baseline removal techniques. This study addresses this current lack of data. One hundred spectra of varying signal-to-noise ratio (SNR), signal-to-baseline ratio (SBR), baseline slope, and spectral congestion were constructed and baselines were subtracted by 16 volunteers who were categorized as being either experienced or inexperienced in baseline determination. In total, 285 baseline determinations were performed. The general level of accuracy and precision that can be expected for manually determined baselines from spectra of varying SNR, SBR, baseline slope, and spectral congestion is established. Furthermore, the effects of user experience on the accuracy and precision of baseline determination is estimated. The interactions between the above factors in affecting the accuracy and precision of baseline determination is highlighted. Where possible, the functional relationships between accuracy, precision, and the given spectral characteristic are detailed. The results provide users of manual baseline determination useful guidelines in establishing limits of accuracy and precision when performing manual baseline determination, as well as highlighting conditions that confound the accuracy and precision of manual baseline determination.

Algorithms↗
PubMed2005

Case-control and two-gate designs in diagnostic accuracy studies.

BACKGROUND: In some diagnostic accuracy studies, the test results of a series of patients with an established diagnosis are compared with those of a control group. Such case-control designs are intuitively appealing, but they have also been criticized for leading to inflated estimates of accuracy. METHODS: We discuss similarities and differences between diagnostic and etiologic case-control studies, as well as the mechanisms that can lead to variation in estimates of diagnostic accuracy in studies with separate sampling schemes ("gates") for diseased (cases) and nondiseased individuals (controls). RESULTS: Diagnostic accuracy studies are cross-sectional and descriptive in nature. Etiologic case-control studies aim to quantify the effect of potential causal exposures on disease occurrence, which inherently involves a time window between exposure and disease occurrence. Researchers and readers should be aware of spectrum effects in diagnostic case-control studies as a result of the restricted sampling of cases and/or controls, which can lead to changes in estimates of diagnostic accuracy. These spectrum effects may be advantageous in the early investigation of a new diagnostic test, but for an overall evaluation of the clinical performance of a test, case-control studies should closely mimic cross-sectional diagnostic studies. CONCLUSIONS: As the accuracy of a test is likely to vary across subgroups of patients, researchers and clinicians might carefully consider the potential for spectrum effects in all designs and analyses, particularly in diagnostic accuracy studies with differential sampling schemes for diseased (cases) and nondiseased individuals (controls).

Case-Control Studies↗
PubMed2005

Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy.

STUDY OBJECTIVES: To analyze the accuracy of esophageal endoscopic ultrasound (EUS) with real-time, guided fine-needle aspiration (EUS-FNA) with an on-site cytopathologist in patients with (presumed) lung cancer presenting with mediastinal lymphadenopathy (ML) or a suspect left adrenal gland (LAG). DESIGN: A single-center prospective study. PATIENTS: Sixty-seven outpatients with (presumed) lung cancer with ML or a suspect LAG on either CT and/or positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) scan. INTERVENTIONS: All patients underwent EUS-FNA under conscious sedation. A cytopathologist was present during all procedures. MEASUREMENTS: EUS with and without fine-needle aspiration (FNA) as compared to FDG-PET was evaluated for accuracy in diagnosing cancer, safety, and rate of avoidance for further surgery. RESULTS: Of 67 consecutive patients (56 men; median age, 64 years), malignant ML or LAG were found in 47 patients (70.1%). In 20 patients (29.9%) without EUS-FNA proof of malignancy, confirmation was obtained by surgical procedure in 13 patients (sarcoidosis [n = 5], infection [n = 1], lung cancer [n = 7]) or by clinical follow-up in 5 patients suggesting benign disease. Sixty-five patients were included in the calculation of test characteristics. With malignancy as an end point, the accuracy for EUS-FNA was 100%. This was better than EUS without FNA (accuracy, 75.4%; p < 0.001) or FDG-PET (accuracy, 75.0% [n = 28]; p = 0.0011). When using final histopathologic diagnosis as an end point, the accuracy of EUS-FNA was 92.3%, since EUS-FNA was unable to show noncaseating granulomas in those patients with sarcoidosis diagnosed after mediastinoscopy. Related to the presence of the in situ cytopathologist, there were no inconclusive samples. No adverse events were recorded, and 67.7% of surgical interventions were avoided following EUS-FNA. CONCLUSIONS: The accuracy in this series of EUS-FNA with cytopathologist-assisted rapid on-site evaluation is high. The technique is safe and greatly reduces the number of surgical interventions.

Adult↗
PubMed2003

How helpful is pneumatic otoscopy in improving diagnostic accuracy?

BACKGROUND: Pneumatic otoscopy is believed to be helpful in optimally assessing the presence or absence of middle ear effusion (MEE). Although expert clinicians teach the importance of this diagnostic skill to trainees, evidence exists that many pediatric providers do not typically perform pneumatic otoscopy. OBJECTIVE: To determine if the otoscopic accuracy within a group of clinicians improves with the pneumatic assessment when compared with the static assessment using videotaped otoendoscopic examinations (VOEs). METHODS: Residents and faculty from 2 pediatric training programs served as subjects. All viewed a set of 50 video otoscopic examinations of tympanic membranes (TMs) from a validated VOE developed previously for training purposes. The video displays each TM in a static presentation and then in a pneumatic (mobile) presentation, followed by a final static presentation. Each subject first viewed the initial static presentation of each TM and responded "yes/no" to the presence of MEE, and then viewed the pneumatic presentation of the same TM and again responded "yes/no" to the presence of MEE. We compared the accuracy of assessment for both the static and the pneumatic tests. RESULTS: Thirty-four pediatric residents and 6 clinical faculty participated. Accuracy (percent of total test items correct) on the pneumatic test was uniformly greater than accuracy on the static test. The mean absolute improvement in the accuracy from the static test (61%) to the pneumatic test (76%) was 15% (95% confidence interval [CI] = 12%-18%). The mean relative improvement in accuracy from the static test to the pneumatic test was 26% (95% CI = 19%-32%). Higher accuracy on the VOE was associated with greater absolute (r = 0.57) and greater relative (r = 0.47) improvement. The mean relative improvement in sensitivity and specificity from static viewing to pneumatic viewing was 24% (95% CI = 15%-33%) and 42% (95% CI = 27%-58%), respectively. CONCLUSIONS: Using a video otoendoscopic test, we found that accurate identification of both the presence and the absence of MEE improved after pneumatic assessment of TM mobility. Providers who were more accurate at otoscopy, defined by higher video total test scores, benefited more from the pneumatic component than providers with lower scores.

Acoustic Impedance Tests↗
PubMed2005

Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions.

PURPOSE: To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. METHOD: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). RESULTS: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. CONCLUSION: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions.

Anterior Cruciate Ligament Injuries↗