Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “diagnostic accuracy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Diagnostic accuracy of endoscopy with brushing cytology and biopsy in upper gastrointestinal lesions.

Because of the high rate of diagnostic error with routine barium X-ray studies in detection of upper gastroesophageal lesions, a prospective investigation was undertaken to evaluate endoscopy together with brushing cytology and biopsy. Ninety-nine patients with recurrent upper gastrointestinal symptoms were examined during a two year period. Thirty-seven patients had cancer and 62 had benign ulcers as diagnosed by cytology and histopathology. All patients with diagnosis of carcinoma were correctly diagnosed by a combination of the above studies as proven by subsequent surgical exploration of all 37 patients. In the benign group, 23 patients were confirmed by exploratory laparotomy and 16 patients by following up for at least 2 years with upper GI series and/or endoscopy. The highest degree of accuracy in the diagnosis of cancer was achieved by cytology alone (92% of cases) and lowest by barium study of upper gastrointestinal tract (84% of cases). Although the accuracy of endoscopy in detecting cancer of the upper gastrointestinal tract was 86 per cent, 15 per cent of benign ulcers were falsely called neoplastic by this technique. It is concluded that endoscopy with brushing cytology and biopsy is an effective diagnostic tool in distinguishing benign lesions from malignant neoplasms and can be performed with little risk to the patient.

Biopsy↗
PubMed1975

[The diagnostic significance of immunoglobulin determination in chronic liver diseases. I. Differential diagnostic accuracy of immunoglobulin changes and enzyme activities (author's transl)].

715 patients with hepatobiliary diseases came for examination, who because of the morphological findings are classified in diagnostic groups. The immunoglobulin measurements of IGG, IGA, IGM were determined and assessed in combination with enzymatic investigations of GOT, GPT, AP and GGTP. Typical group-specific changes were only found in primary biliary liver diseases and toxic cirrhoses of the liver, all acute or chronic inflammatory liver diseases could not be separated and by inference from the final diagnosis showed great errors in classification. Data on the raised mean levels of immunoglobulins in the individual diagnostic groups were demonstrable, but the range limits were so widely scattered that their differential diagnostic valence is of no consequence. Immunoglobulins may appear to be of interest for the observation of the course of liver diseases, but they are unsuitable for diagnostic purposes.

Acute Disease↗
PubMed1978

Diagnostic accuracy of CT in circumscript liver disease.

To evaluate the accuracy of CT in diagnosing circumscript liver disease, CT findings in 105 patients were compared to the results of invasive diagnostic procedures (laparoscopy, laparotomy, and autopsy). In all patients at least one of these procedures was performed in addition to CT. CT proved to be a valuable noninvasive method in detecting and differentiating circumscript liver lesions such us metastases, primary liver tumors, solitary cysts and polycystic disease, abscesses, and echinococciasis. The 10% rate of false positive and false negative diagnoses indicates the limitations of the method.

Autopsy↗
PubMed1977

New approach to interpretation of technetium-99m pyrophosphate scintigraphy in detection of acute myocardial infarction: clinical assessment of diagnostic accuracy.

A modified classification for interpreting technetium-99m pyrophosphate scintigrams defines the 2+ diffuse pattern of tracer uptake as equlvocal rather than positive for acute myocardial infarction. Results of scintigraphy using this classification were compared with results of standard diagnostic tests for myocardial infarction in 235 patients admitted to a coronary care unit with acute chest pain. Of 81 patients with acute transmural infarction by standard clinical, electrocardiographic and serum enzyme criteria, 76 had a positive, 5 an equivocal and none a negative scintigram. Of 18 with acute nontransmural infarction by standard criteria, 7 had a positive, 9 an equivocal and 2 a negative scintigram. This it was uncommon for a patient with acute myocardial infarction, transmural or nontransmural, to have a definitely negative technetium-99m pyrophosphate study. Ten patients had equivocal evidence of infarction by standard criteria. Of the remaining 126 patients with no evidence of acute myocardial infarction by standard criteria, 87 had a negative, 35 an equivocal and 4 a definitely positive scintigram. Thus the definitely positive scintigraphic pattern was relatively highly specific for acute myocardial infarction. If the 2+ pattern had been considered positive, the specificity of the technique would have been greatly decreased. Computer processing strengthened observer certainty of the visual impression but changed the scintigraphic evaluation in only eight cases. Thus, use of an equivocal pattern renders technetium-99m pyrophosphate imaging both an extremely sensitive and specific method for detecting acute myocardial infarction.

Acute Disease↗
PubMed1979

Improved diagnostic accuracy of a modified oral pancreatic function test.

The oral pancreatic function test (PFT) depends upon urinary recovery of p-aminobenzoic acid (PABA) released by chymotrypsin hydrolysis of orally administered N-benzoyl-L-tyrosyl-p-aminobenzoid acid. The diagnostic value of the test is limited because falsely abnormal results frequently occur in patients with bowel or liver disease in whom PABA recovery is impaired by abnormal absorption or hepatic conjugation, even though pancreatic function is normal. To overcome this problem, we have modified the oral PFT to correct for impaired PABA absorption and conjugation. Results of the oral PFT have been compared with urinary recovery of an equivalent dose of free PABA in order to derive a PABA excretion index (PEI). When the modified oral PFT is used, the PEI clearly distinguished patients with pancreatic disease from normal subjects. In patients with small-bowel or liver disease and normal exocrine pancreatic function, the PEI results were similar to those of normal subjects, although a previous oral PFT had been falsey abnormal. The modified test can therefore distinguish abnormal results due to pancreatic disease from the falsely abnormal results found in liver and small-bowel disease.

4-Aminobenzoic Acid↗
PubMed1975

Diagnostic accuracy of an ultrasonic multiple transducer cardiac imaging system.

Eighty patients with various forms of heart disease were studied with the use of a newly developed ultrasonic system having 20 transducers arranged in a linear array. This system allows visualization of the heart in two dimensions in real time. All 15 patients with the mitral valve prolapse syndrome, 13 patients with mitral stenosis, five patients with pericardial effusion, four patients with atrial septal defect, and one patient with left ventricular dyssynergy were properly recognized with this system. One of five patients with hypertrophic myopathy and one of four patients with congestive myopathy were not recognized with this system. Criteria for the recognition of these system. Criteria for the recognition of these conditions are presented as well as the probable cause for false-positive and false-negative diagnoses in this series. Since only qualitative criteria were used, it was not possible to differentiate patients with coronary artery disease or patients with left ventricular volume overload from patients without cardiac pathology. The accuracy of this new system was judged against the clinical examination, conventional echocardiography, cardiac catheterization, and left ventricular angiography. It is assumed that the criteria for diagnosis developed during this study will be supplemented and the equipment improved in the future; however, the ease of operation of this system and the relative accuracy of diagnosis at this stage of its development are extremely interesting. It presents an excellent opportunity to obtain additional information about the cardiac patient without using invasive procedures and without risk.

Cardiomegaly↗
PubMed1979

Diagnostic accuracy in presenile dementia.

A follow-up study of patients diagnosed as suffering from presenile dementia has revealed a high incidence of erroneous diagnoses. Of 52 patients discharged from hospital with this diagnosis, information was obtained 5-15 years later on 51. Eighteen were alive and the diagnosis was rejected in 16 (31 per cent). Possible reasons for the mistaken diagnoses are discussed.

Aged↗
PubMedDate not supplied

Cerebrospinal fluid cytology: diagnostic accuracy and comparison of different techniques.

Cytologic examination of cerebrospinal fluid was performed in 1,021 patients, using Nuclepore and Millipore filter techniques. Positive findings were obtained in 89 cases, including 40 with primary central nervous system tumors, 24 with metastatic tumors and 25 with leukemic or lymphomatous involvement. When correlated with histologic findings, the overall detection rate was 32.2 per cent for primary tumors, 53.3 per cent for metastatic tumors and 65.8 per cent for leukemia and lymphoma. Highest degree of accuracy in the primary tumor group was achieved with medulloblastoma (61.9 per cent). Among metastatic tumors, those originating in the lung (70 per cent) and breast (83 per cent) were the one most often detected. Comparison of the two filter techniques indicated a slightly higher detection rate when the Millipore filter was used. The reasons for this are not entirely clear, but increased cellular yield with the Millipore filter may be an important factor. The cytocentrifuge method was found to be generally inferior to either of the filter techniques in quality of cell preservation. Our findings indicate that diagnostic usefulness of cerebrospinal cytology depends on collection and preparation methods as well as the anatomic distribution and biologic behavior of the lesions.

Cerebrospinal Fluid↗
PubMed1979

Detection of intracolonic lesion by barium contrast enema. The importance of adequate colon preparation to diagnostic accuracy.

Frequently, the clinical significance of the barium contrast enema is minimal because of inadequate colon preparation prior to examination. The frequency of false-positive routine barium enemas was 17% in 230 consecutive patients who underwent colonoscopy for removal of specific radiographically identified polypoid colon lesions. Initial barium enema inaccuracies were documented with postendoscopic air-contrast radiography in colons that were endoscopically proved to be mechanically clean following a two-day colon preparation. These results suggest that more emphasis on a two-day colon preparation, before the initial barium contrast enema, would substantially reduce the frequency of false-positive interpretations.

Barium Sulfate↗
PubMed1978

[Diagnostic accuracy of fiber endoscopy in esophageal and gastric carcinoma. Attempt at error analysis].

A retrospective analysis was performed in 332 cases with cancer of the upper gastrointestinal tract. A limit of one month was set for delayed and missed bioptically verified endoscopic diagnosis. Malignant cycle in ulcerated lesions and the size of elevated processes were the probable causes of delayed diagnosis in 7 out of 37 cases with early cancer. In advanced gastric cancer missed diagnosis was probably caused by the indication for endoscopy made too late in an unknown number of cases or patient's refusal to undergo controls. However, failure of the endoscopist to recognize a malignant process must be considered too. The percentage of endoscopist's mistakes was below 2% in our series.

Aged↗
PubMed1978

Cancer of the pancreas: diagnostic accuracy and survival statistics.

We have reviewed the natural history, reliability of diagnosis, and survivorship of 100 patients with adenocarcinoma of the pancreas, in the context of a thorough review of the literature on survival after therapy for adenocarcinoma of the pancreas. There is 40--62.5% error in the histologic confirmation of the diagnosis of pancreatic cancer. The error by inspection and palpation alone at the time of surgery may be as great as 25%. The absolute 5 year survival rate calculated from 61 clinical studies representing approximately 15,000 patients is 0.4%. The best series in the current literature has only 3% 5 year rate based upon the total population of pancreatic cancer patients. 12.3% of 5 year survivors from the world literature did not have curative surgery. This study shows the necessity for standardization of reporting methods. The same patients and survivors should not be used repeatedly in different reports. Some authors who claim the most effective palliation by pancreatic resection have the highest mortality rates.

Adenocarcinoma↗
PubMed2026

Diagnostic Accuracy of Circulating Tumor DNA to Predict Retroperitoneal Histology in Patients Treated With Retroperitoneal Lymph Node Dissection for Testicular Germ Tumor.

Testicular germ cell tumor (GCT) has survival rates exceeding 90% and thus contemporary research has focused on reducing morbidity. While chemotherapy is efficacious, long-term effects are significant. Primary retroperitoneal lymphadenectomy (P-RPLND) has been offered, and postchemotherapy lymphadenectomy (PC-RPLND) is considered, based on residual node size, to reduce overtreatment. A significant number of patients have necrosis in the retroperitoneum and are thus overtreated. Circulating tumor DNA (ctDNA) may be used to determine which patients would benefit from RPLND. This retrospective analysis sought to determine the performance of ctDNA to detect retroperitoneal GCT only, teratoma only, and GCT/teratoma. All patients had a ctDNA obtained preoperatively and at 3, 6, and 12 months postoperatively. Ninety-two patients underwent P or PC-RPLND. The sensitivity, specificity, and positive predictive values (PPVs) and negative predictive values (NPVs) for detecting active GCT/teratoma in the entire cohort were 60%, 87%, 96%, and 30%, respectively. For GCT only these were 85%, 75%, 73%, and 86%. For teratoma only, these were 31%, 34%, 23%, and 43%. These findings indicate that patients with a positive ctDNA likely harbor active GCT and/or teratoma, as suggested by a PPV of 96%. Future studies may use whole-genome ctDNA assays to improve detection of teratoma and incorporate ctDNA into surveillance protocols.

Humans↗