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PubMed2001

Method preferences and test accuracy of antimicrobial susceptibility testing: updates from the College of Amercian Pathologists Microbiology Surveys Program.

OBJECTIVE: To summarize the antimicrobial susceptibility testing results from the College of American Pathologists (CAP) Microbiology Surveys Program for 2000. Specifically, the frequency of tests used and the quantitative and qualitative (susceptibility category) accuracy were assessed. DESIGN: The CAP Microbiology Surveys challenged subscribers in 2000 with 3 well-characterized organisms for antimicrobial susceptibility testing in pure culture. Each laboratory was to use the test method and reporting procedures routinely applied to patient samples. The strains were National Committee for Clinical Laboratory Standards (NCCLS) quality control organisms with precisely defined antimicrobial susceptibility patterns and reproducibility. Results reported by participants (2685-2979/sample) were graded for categorical accuracy and quantitative performance by comparing reported minimal inhibitory concentrations (microg/mL) or zone diameters (mm) against quality control ranges published by the NCCLS. The appropriateness of reported drugs was determined in the context of the type and anatomic location of the infection. RESULTS: The tests most often used varied by the species of the organism and growth characteristics of the isolated strains. Nonfastidious, rapid-growing Surveys unknowns (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853) were most often tested with commercial systems (MicroScan, 42.0%-42.4%; Vitek, 41.5%-43.0%) or with the standardized disk diffusion method (12.8%-13.9%). In contrast, fastidious species, such as Streptococcus pneumoniae (ATCC 49619), were predominantly tested by Etest (40.3%), followed by disk diffusion (27.6%) and MicroScan (23.2%). Categorical accuracy was essentially equal between dilution (98.9%) and diffusion (99.0%) methods. Among the minimal inhibitory concentration methods used to test penicillin against S pneumoniae, Etest method quantitative accuracy (96.3%) was greater than that of MicroScan (92.4%). Quantitative accuracy was greatest for dilution minimal inhibitory concentration methods, with more than 90% of results within NCCLS quality control ranges for nearly all reported antimicrobials. Reevaluations of quality control ranges may be needed for 4 to 7 agents, depending on method. Reporting errors were also detected in 2 areas: (1) reporting results for drugs not active at the site of infection and (2) reporting results for drugs tested with suboptimal methods without published NCCLS interpretive criteria. CONCLUSIONS: Antimicrobial susceptibility testing methods used in US laboratories were dominated by commercial products with relatively high accuracy (qualitative and quantitative). As available methods have become better suited to both fastidious and rapid-growing species, reporting errors have assumed a higher level of concern to the CAP Surveys in an effort to minimize prescription errors.

Anti-Bacterial Agents↗
PubMed2001

Diagnostic accuracy of a stereotaxically guided vacuum-assisted large-core breast biopsy program in Canada.

OBJECTIVE: To assess the accuracy rate associated with 11-gauge vacuum assisted large-core breast biopsy (VALCBB) at our institution. METHODS: 673 consecutive VALCBBs performed between September 1997 and March 2000 were evaluated. For most of the benign VALCBB specimens, accuracy was determined by the stability of the lesions on follow-up mammography. When possible, histological results of specimens obtained from VALCBB and of specimens obtained from surgical excision were compared. Modified accuracy rates were calculated. RESULTS: Of the 673 biopsies, 499 (74%) were benign; for the 315 benign lesions for which complete follow-up information was available, a greater than 99% modified accuracy rate was obtained. The modified accuracy rate for the 174 nonbenign lesions was 95%. Thus, VALCBB yielded an overall modified accuracy for both benign and nonbenign lesions of 97.9%. CONCLUSION: VALCBB provides accurate histological results for biopsy of suspicious lesions of the breast.

Biopsy↗
PubMed2002

On being sad and mistaken: mood effects on the accuracy of thin-slice judgments.

A series of studies explored how sadness impacts the accuracy of social judgments. In Study 1, induced sadness led to reduced accuracy in judgments of teacher effectiveness from brief samples of nonverbal behavior (thin slices). In Study 2, sad participants showed reduced accuracy in judging relationship type from thin slices as well as diminished judgmental efficiency. Study 3 revealed that higher Beck Depression Inventory scores were associated with diminished accuracy on the Profile of Nonverbal Sensitivity. Finally, Study 4 tested the possibility that sadness impairs accuracy by promoting a more deliberative information-processing style. As expected, accuracy was higher among participants in a sad mood condition who completed the judgment task while simultaneously performing a distracting cognitive load task.

Affect↗
PubMed2002

[Diagnostic accuracy of cell-block or tissue-fragment histology and cytology by fine needle lung aspiration].

OBJECTIVE: Study on the diagnostic accuracy and value of cell block and tissue fragment preparations collected from lung fine needle aspiration (FNA). METHODS: A total of 187 FNA (22G) samples from the lungs with matched histological diagnosis were studied. Among them, the diagnosis made by depending on 124 cell block and fragment preparations were analyzed in comparing retrospectively with the diagnosis of 187 cases by smear preparations. RESULTS: (1) Of the 124 cell blocks cases, 89 cases were true positives, 22 cases were true negatives, 13 cases were false negatives and no false positives. Of the 187 smears cases, the figure were 136, 30, 19 and 2 cases respectively. The diagnostic accuracy of cell blocks was 87.3% in sensitivity, 100% in specificity, 89.5% in overall accuracy. The figures for smears were 87.7%, 93.8% and 88.8% respectively. (2) For malignant tumours, the histological typing accuracy of cell blocks was 93.3% (83/89), and to be 67.9% (91/134) by diagnosis depending on the smears (P < 0.01). For the benign lesions, the figures were 86.4% (19/22) and 60% (18/30) respectively (P < 0.05). (3) It was possible to obtain many minisections for further studies from cell blocks. Immunoperoxidase staining on minisections was reliable and agreed with those on the surgical specimens. CONCLUSIONS: The diagnostic accuracy of cell block is high, particularly in histological typing which approaches to that of the diagnosis made depending on the postoperative specimens. A combined use of smears and cell block is recommended which may raise further the diagnostic accuracy.

Adolescent↗
PubMed2002

[CT-guided percutaneous transthoracic aspiration biopsy of chest lesions: factors influencing the diagnostic accuracy].

OBJECTIVE: To investigate the factors influencing the diagnostic accuracy of CT-guided percutaneous transthoracic aspiration biopsy of chest lesions. METHODS: Data of pathology and clinical follow-up of 224 patients who had undergone CT-guided percutaneous transthoracic biopsy were collected. Univariate analysis and multivariate stepwise Logistic regression analysis were made to study the influence of the patient-related factors (sex, age, and presence of emphysema), lesion-related factors (histology, size, location, depth, and presence of cavity discovered by CT), and procedure factor (posture of patient during operation) on the diagnostic accuracy of CT-guided biopsy. RESULTS: (1) One hundred and sixty-five lesions were diagnosed as malignant and 79 lesions as benign. The accuracy rate of CT-guided biopsy was 82.4% (201/244). Univariate analysis showed that the diagnostic accuracy rates of CT-guided biopsy for malignant and benign lesions were 88.5% and 69.6% respectively (chi(2) = 13.096, P < 0.01). The mean diameters of the lesions with correct diagnosis and of those misdiagnosed were 4.0 cm +/- 1.8 cm and 3.1 cm +/- 1.4 cm respectively (F = 8.805, P < 0.01). (2) Multivariate stepwise Logistic regression analysis showed that among the various factors only histology (regression coefficient = 0.320, Wald chi(2) = 7.126, P < 0.01) and size (regression coefficient = 1.114, Wald chi(2) = 4.951, P < 0.05) were significantly associated with diagnostic accuracy. CONCLUSION: Histology and size of lesion are the determining factors for diagnostic accuracy of CT-guided transcutaneous thoracic needle aspiration biopsy.

Adolescent↗
PubMed2003

[Accuracy and precision of X-ray radiosurgery treatment for tumors in eyeball].

BACKGROUND & OBJECTIVE: Localization error in X-ray radiosurgery for tumors in eyeball was common due to the rotation of eyeball. The accuracy and precision of X-ray radiosurgery was studied by fixing the eyeball with micro-vacuo-certo-contacting ophthalmophanto (MVCCOP) to reduce the error in this article. METHODS: CT localization accuracy of X-ray radiosurgery system was measured using special markers in skull phantom. The eyeballs were fixed using MVCCOP, which was designed by the authors, and then the eyeball fixation accuracy and target localization accuracy were measured by comparing the CT localization coordinates and verification coordinates of corresponding points. RESULTS: The mean error of CT localization of BRW head-ring was 0.65 mm and maximum error was 1.09 mm. The mean error of fixation of eyeball using MVCCOP was 0.84 mm and maximal error was 1.17 mm. The accuracy of tumor localization in eyeball was 0.87 mm averagely and 1.19 mm maximally. The mean error of SRS200 was 0.22 mm and maximum error was 0.32 mm. The total error was 1.40 mm and 95 percentile confidence error was 2.12 mm. CONCLUSION: The accuracy and precision of X-ray radiosurgery using MVCCOP has come up to the standard of quality control of stereotactic radiosurgery. This localization method can reduce the localization errors in radiosurgery caused by the rotation of eyeball.

Child↗
PubMed2003

Application of a neural network to improve nodal staging accuracy with 18F-FDG PET in non-small cell lung cancer.

UNLABELLED: We proposed to train a back-propagation artificial neural network (aNN) on a cohort of surgically proven non-small cell lung cancers (NSCLCs) and compare its accuracy with that of a trained (18)F-FDG PET reader. We plan to show that an aNN trained on (18)F-FDG PET- and CT-derived data is more accurate in predicting the true surgicopathologic nodal stage than a human reader. METHODS: One hundred thirty-three NSCLC patients with surgically proven N status treated at the University of Washington Medical Center or the Veterans Affairs Puget Sound Health Care System between February 1998 and September 2002 were used as inputs for the creation of an aNN. From CT of the thorax and (18)F-FDG PET (neck to pelvis) performed before surgery, we extracted the primary tumor size and uptake (maximum pixel SUV [maxSUV]), normal lung and mediastinal uptake, and nodal uptake (maxSUV). Using the same 133 cases, the same output (surgical N status, N(0) to N(3)), and the same software configuration settings, scenarios were created to assess which input parameters were most influential in creating an optimal aNN. To compute this optimal aNN, cases were split randomly 100 times into a training subset of 103 cases and a testing subset of 30 cases having the same proportion of N(0), N(1), N(2), and N(3) cases. N status predicted by the aNN was compared with the proven surgical N status to calculate the aNN accuracy. The N status readings from (18)F-FDG PET were also compared with the surgical N status for the same cases to determine (18)F-FDG PET accuracy. RESULTS: Statistical tests demonstrate that the best aNN accuracy is achieved by using N(1)-N(2)- N(3) nodal maxSUV divided by background uptake, the primary tumor size, and primary tumor maxSUV as inputs. The aNN correctly predicted the N stage in 87.3% of the testing cases compared with 73.5% for the (18)F-FDG PET expert reader. Accuracy of the aNN increased to 94.8% (PET, 89.4%) when comparing N(0) + N(1) with N(2) or N(3) status and to 94.9% (PET, 91.9%) when comparing N(0) + N(1) with N(2) + N(3) status. CONCLUSION: A back-propagation aNN can be trained to predict hilar and mediastinal nodal involvement with greater accuracy than an expert (18)F-FDG PET reader. Such a tool could be used to improve clinical interpretations and for clinical training.

Aged↗
PubMed2004

[The effect of mold temperature on the accuracy of titanium castings].

PURPOSE: To study the effect of mold temperature on the accuracy of titanium castings invested in the ZrP99 investment. METHODS: 30 artificial stone dies simulated the post-tooth and their corresponding complete crown wax patterns were made with a truncated cone-shape standard brass model with round sleeves. They were divided randomly into five groups and each group had six samples. Four group wax patterns were invested in ZrP99 investment as test groups and one group was invested in Titavest-CB investment as control. The test group moulds were cast at the mould temperature 600 degrees centigrade, 450 degrees centigrade, 300 degrees centigrade, 150 degrees centigrade, respectively. Measure the distance separating the gingival margin of the crown and the shoulder of the die in the same way as for the wax pattern. The casting accuracy was represented by the discrepancies derived from the space distance measurements made with wax patterns and cast crowns. t test and one-way ANOVA were used for statistical analysis. RESULTS: Measurement of the casting accuracy indicated that the casting accuracy of the control group was higher than all the test groups. When the mold temperature was lower than 450 degrees centigrade, the accuracy of the castings invested in ZrP99 investment was improved significantly with the mold temperature raised. CONCLUSION: To satisfy the requirement of the clinical practice in the point of the casting accuracy, the mold temperature of ZrP99 investment must be chosen higher than 300 degrees centigrade.

Crowns↗
PubMed1975

The accuracy of diver sound localization by pointing.

The accuracy of human sound localization in 360 degrees of azimuth was determined underwater in a free field. The location indicator was a pointer in the median plane. Accuracy of the response was defined as the mean deviation (MD) from the objective location of a sound source. Maximum accuracy obtained using the present procedure with visual cues was approximately 6 degrees, while maximum accuracy with auditory cues was approximately 11 degrees. Training with visual feedback resulted in a reduction in errors due to the pointing procedure employed, but did not affect localization accuracy. The decrement in accuracy of auditory localization found in the water environment should have no noticeable effect on the ability of divers to find a sound source in the environment.

Adult↗
PubMed2005

Improvement in the accuracy of multiple sequence alignment program MAFFT.

In 2002, we developed and released a rapid multiple sequence alignment program MAFFT that was designed to handle a huge (up to approximately 5,000 sequences) and long data (approximately 2,000 aa or approximately 5,000 nt) in a reasonable time on a standard desktop PC. As for the accuracy, however, the previous versions (v.4 and lower) of MAFFT were outperformed by ProbCons and TCoffee v.2, both of which were released in 2004, in several benchmark tests. Here we report a recent extension of MAFFT that aims to improve the accuracy with as little cost of calculation time as possible. The extended version of MAFFT (v.5) has new iterative refinement options, G-INS-i and L-INS-i (collectively denoted as [GL]-INS-i in this report). These options use a new objective function combining the weighted sum-of-pairs (WSP) score and a score similar to COFFEE derived from all pairwise alignments. We discuss the improvement in accuracy brought by this extension, mainly using two benchmark tests released very recently, BAliBASE v.3 (for protein alignments) and BRAliBASE (for RNA alignments). According to BAliBASE v.3, the overall average accuracy of L-INS-i was higher than those of other methods successively released in 2004, although the difference among the most accurate methods (ProbCons, TCoffee v.2 and new options of MAFFT) was small. The advantage in accuracy of [GL]-INS-i became greater for the alignments consisting of approximately 50-100 sequences. By utilizing this feature of MAFFT, we also examined another possible approach to improve the accuracy by incorporating homolog information collected from database. The [GL]-INS-i options are applicable to aligning up to approximately 200 sequences, although not applicable to thousands of sequences because of time and space complexities.

Amino Acid Sequence↗
PubMedDate not supplied

[Evaluation of pipetting systems. II. Precision and accuracy of precision dispensers].

OBJECTIVE: To evaluate the precision and accuracy of the liquid dispensers being used in our institution. MATERIAL: A total of 15 dispensers (8 micro and 7 macro) of automatic, semiautomatic or manual types were evaluated. They had been in use from 0.5 to 7 years. METHODS: The volume dispensed was established by gravimetry using an analytical balance (Chio JP-160) and deionized distilled water as previously described. The microdispensers were evaluated using volumes of 20 and 100 microL, and the macrodispensers with 1 and 5 mL. Each dispenser was evaluated using 10 replicates: the mean and the CV (coefficient of variation) were calculated with the 10 replicates. The mean was transformed to per cent of the theoretical volume. Thus a 100% ratio of accuracy corresponds to a perfect accuracy. An important methodological aspect was that the 10 dispensing replicates were performed personally by the habitual user of the dispenser. RESULTS: The mean and CV are shown in table 2 for the microdispensers, and in table 3 for the macrodispenser. In the total 25 evaluation in tables 2 and 3 there were 8 instances in which precision was poor (CV above 3%) and also 8 cases of sizable inaccuracy (ratio outside of 100 +/- 5%). In 4 (2 micro and 2 macro) of these 8 inaccuracies, the error ranged from 10% to 22%. A minority was within the specifications of precision and accuracy claimed by the manufacturers of the dispensers with the exception of the manual microdispensers which were within specifications in most instances. We attribute the latter to the lack of a mechanical device in the manual dispensers. CONCLUSIONS: As in a previous evaluation of automatic micropipettes, we detected a high proportion of pipetting systems out of specifications in both precision and accuracy. The magnitude of error in the accuracy of 4 dispensers (10 to 22%) would be catastrophic in methods demanding good pipetting.

Calibration↗
PubMed1986

Regional accuracy of computed tomography of the mediastinum in staging of lung cancer.

To determine the regional accuracy of computed tomography of the mediastinum in staging lung cancer, we compared the results of preoperative computed tomographic staging to pathologic findings in lymph nodes taken at mediastinoscopy and/or thoracotomy in 61 patients. Twenty-two patients had adenocarcinoma, 24 had squamous cell carcinoma, eight had large cell tumors, and seven had small cell cancer or mixed cellular types. Sixteen patients had Stage I, eight had Stage II, and 37 had Stage III disease. Thirteen patients had mediastinoscopy only, and the remaining 48 patients had thoracotomy. Computed tomographic staging of the mediastinum as a whole had an accuracy of 88% with a negative predictive index of 96.1%. In examining the differential regional accuracy within the mediastinum we found results in the aortopulmonary window to be inferior to those of other regions, with an accuracy of 80% and a negative predictive index of 83.3%. The reliability of computed tomographic scan staging varied relative to cell type. The accuracy rate in adenocarcinoma was 94.7% compared to 70.6% in squamous cell carcinoma. Computed tomography is accurate for staging the mediastinum in lung cancer, and this accuracy holds over the regions of the mediastinum except the aortopulmonary window. Computed tomography is more accurate for staging adenocarcinoma than squamous cell cancer.

Adenocarcinoma↗
PubMedDate not supplied

Factors significant in the diagnostic accuracy of lung cytology in bronchial washing and sputum samples. II. Sputum samples.

Some factors influencing the detection of malignant cells in sputum samples were evaluated in 449 consecutive cases of primary lung carcinoma seen between 1959 and 1974. Diagnostic accuracy increased during the years under study; the reasons are discussed. The overall accuracy was 82.8%. Detection of malignant cells was 85% for small-cell carcinoma, squamous-cell carcinoma and large-cell carcinoma, 75% for adenocarcinoma, bronchioloalveolar carcinoma and adenosquamous carcinoma and 64% for the uncommon tumors. Accuracy was 87% for central tumors and 42% for peripheral lesions. Tumors less than 2 cm in diameter yielded only 39% accuracy as compared to 90% for larger tumors. The specificity of diagnosis of cell type in those specimens with malignant cells was 95% for small-cell carcinoma and squamous-cell carcinoma, more than 80% for adenocarcinoma and large-cell carcinoma, 65% for bronchioloalveolar-cell carcinoma and adenosquamous carcinoma and less than 30% for the uncommon tumors. Diagnostic accuracy was optimal in those cases with three or more sputum samples: 83% for those with three samples and 90% for those with five or more samples per case. The use of both sputum and bronchial specimens was complementary and increased the accuracy further. Reasons for unsatisfactory specimens included no deep cough, limited cellular material, excessive blood or leukocytes and drying artifacts; the first two were the most common causes.

Adenocarcinoma↗
PubMed1993

Diagnostic accuracy of pancreatic enzymes evaluated by use of multivariate data analysis.

We analyzed pancreatic enzyme data from 508 patients with suspected pancreatitis by neural network analysis, by an Expert multirule generation protocol, and by receiver-operator characteristic (ROC) curve analysis of a single test result. Neural network analysis showed that use of lipase provided the best means for diagnosing pancreatitis. Diagnostic accuracies achieved by using amylase only, lipase only, and amylase and lipase in combination were 76%, 82%, and 84%, respectively. Use of the Expert rule generation protocol provided a diagnostic accuracy of 92% when rules for single and multiple samplings were combined. ROC curve analysis for initial enzyme activities showed the maximal diagnostic accuracy to be 82% and 85% for amylase and lipase, respectively; use of peak enzyme activities yielded accuracies of 81% and 88%, respectively. The evaluation of laboratory test data should include analysis of the diagnostic accuracy of laboratory tests by multivariate techniques such as neural network analysis or an Expert systems approach. Multivariate analysis should allow for a more realistic assessment of the diagnosis accuracy of laboratory tests because all the available data are included in the evaluation.

Amylases↗
PubMedDate not supplied

Cytologic versus histologic evaluation of needle biopsy of the lung, hilum and mediastinum. Sensitivity, specificity and typing accuracy.

Fine needle aspiration biopsy (FNAB) and punch biopsy (PB) are reliable methods of establishing a morphologic diagnosis in thoracic lesions. However, some reservations exist concerning the diagnostic accuracy of and indications for both methods. Therefore, we evaluated the sensitivity, specificity, typing accuracy and complication rates of both methods. We present a six-year experience with 501 thoracic FNABs and PBs in 482 patients. To examine site-specific differences, we evaluated three different compartments: lung, mediastinum and hilum. In 457 cases the final outcome was known for evaluating the accuracy of the cytologic or histologic diagnoses. FNAB was used most often in lung (81.8%) and hilar lesions (87.3%), whereas PB was used mostly in mediastinal (67.9%) and pleural lesions or if a mesenchymal lesion was suggested radiologically but never in foci below 20 mm in diameter. Our complication rate was 21.3% for FNAB and 4.6% for PB. The most frequent complications were pneumothorax, one hematothorax and intercostal neuralgia. The overall sensitivities of the biopsy methods were equal (FNAB, 98.4%; PB, 98%), but the typing accuracy was better for PB than FNAB (87.2% vs. 83.5%). In the hilum the sensitivities of FNAB and PB were 94.6% and 85.7%, respectively, and for the lungs, 99% and 98.2%. In the mediastinum the sensitivity was 100% for both methods. There were false-positive diagnoses in 5% with FNAB of the lung due to misinterpretation of regenerating epithelium and hamartochondroma and a 0.1% rate of false-negative diagnoses as a result of misplacement of the cannula, leading to inflammation, infarction or scarring. Our data indicate that FNAB is the method of choice in pulmonary and hilar lesions because of the similar diagnostic accuracy. Mediastinal and pleural lesions and presumed mesenchymal tumors should be sampled with PB because the typing accuracy of FNAB is insufficient in these cases.

Adolescent↗
PubMed1995

Accuracy of duplex versus angiography in patients undergoing carotid surgery.

The operative findings of 23 carotid arteries were compared with pre-operative duplex scans and angiography. Both duplex and angiography had a high degree of accuracy in detecting haemodynamically significant lesions of 50-99% (88 and 92%, respectively). Their accuracy, however, in correctly predicting the grade of stenosis was significantly lower; 30 and 48%, respectively (P < 0.001). They each exhibited an accuracy of 70% and 78%, respectively, in the detection of ulceration. Overall, both duplex and angiography displayed an accuracy of 87% in indicating the proper management course. The combination of both investigations increased this accuracy to 94.6%. In severely stenotic lesions, duplex to rule out occlusion was not reliable. On statistical analysis, there was no difference between duplex and angiography in predicting haemodynamically significant lesions of 50-99%, estimating the grade of stenosis, the detection of ulceration, or indicating the proper management course. In most situations, duplex alone equalled the accuracy of angiography in the pre-operative assessment of patients for carotid surgery. For stenotic lesions of > 90%, however, we recommend supplemental angiography to rule out occlusion.

Carotid Arteries↗
PubMed1993

Colposcopic accuracy in a residency training program: defining competency and proficiency.

BACKGROUND: The determination of proficiency in procedural skills has evoked keen interest, but meaningful guidelines are limited by the absence of pertinent clinical data. Colposcopic accuracy is defined as the clinical correlation between a colposcopic impression and a histologic report. The colposcopic accuracy of physicians in a university-based family practice residency colposcopy program was evaluated. METHODS: Demographic information, clinical findings, and laboratory results of patients evaluated by colposcopy were prospectively recorded. Colposcopic accuracy was calculated based on the agreement of the colposcopic impression with the histologic interpretation within one histologic grade. RESULTS: Colposcopic examinations were performed on 282 patients. Histologic evidence of premalignant cervical disease was identified in 115 patients as follows: mild dysplasia, 72; moderate dysplasia, 24; and severe dysplasia, 19. The colposcopic impression agreed within one histologic grade in 188 of 205 patients for a colposcopic accuracy rate of 91.7% (95% CI = 87.1% to 95.1%). CONCLUSIONS: Given an acceptable latitude of clinical correlation between the colposcopic impression and histologic interpretation, the colposcopic accuracy of family physicians compared favorably with that reported by other colposcopists. The more common colposcopic errors were overestimation of low-grade disease and underestimation of high-grade disease. Colposcopic accuracy at an essential minimal proficiency level of 80% should form the basis for assessing specialized perceptual ability and therefore determining colposcopic competency.

Adolescent↗
PubMed1997

The effect of a rapid kit for detection of streptococcal pharyngitis on the accuracy of the physicians' diagnoses.

BACKGROUND: In the last decade, the accuracy of rapid tests for detection of group A streptococcal antigen was evaluated in laboratory and clinical settings, and the tests were suggested as an alternative to the traditional throat culture. METHODS: We evaluated 19 patients with a preliminary diagnosis of nonstreptococcal pharyngitis and 13 patients with a preliminary diagnosis of streptococcal pharyngitis. The physician performed a rapid latex agglutination test (Detect A Strep), took throat culture from all of the patients, reconsidered the preliminary diagnosis, and made a working diagnosis. A clinical score was calculated for each patient during data analysis. The accuracy of the physicians' preliminary diagnoses was compared with the accuracy of the scoring system, with the accuracy of the latex agglutination test, and with the accuracy of the physicians' working diagnoses. RESULTS: The scoring system, the physicians' preliminary diagnoses, the latex agglutination test, and the physicians' working diagnoses correlated significantly with throat culture results (p < or = 0.05). The efficiency of the physicians' preliminary diagnoses was 75% compared with an efficiency of 69% of the clinical scoring system, an efficiency of 66% of the latex agglutination test, and an efficiency of 69% of the physicians' working diagnoses. The physician changed the preliminary diagnosis only for two patients as a result of the latex agglutination test results; ironically, however, the preliminary diagnosis was correct in both of these cases. CONCLUSION: The use of a rapid test for the diagnosis of group A streptococcal antigen under normal working conditions did not improve the accuracy of the physician's diagnosis, so the use of the latex agglutination test in this study was not cost-effective.

Adult↗