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PubMed1989

[Diagnostic models. 2. Fabrication].

After describing in Part I the preparation of diagnostic cast, the authors describe the Wax Up preparation. Most of the definition of centric relation agree that the position of the mandible is slightly behind its position in centric occlusion. The Hinge axis position is used for mounting the cast on articulator. The final restauration must reconstruct both position and the occlusion should be established in front the centric occlusion. After equilibration anterior guidance is studied and restaured if necessary. After creating the different curve of occlusion, the final Wax Up is settled. The use of the diagnostic cast so obtained will be presented in Part III.

Dental Articulators↗
PubMed2004

[Humor as an additional component of psychological and psychiatric diagnostics in children and adolescents: concept of a humor-diagnostic model].

When looking at humor of children and adolescents from a diagnostic point of view, there exist additional diagnostic possibilities other than the usual assessment methods from child and adolescent psychiatry or psychology. Spontaneous humorous behavior in everyday life and a humorous performance during assessment situations of children can provide a useful basis for further diagnostic considerations. From a developmental point of view it is important to notice what kinds of humor a child is already capable of understanding and of performing towards others. Whilst the actual readiness for cheerfulness contains information concerning the emotional state, the more general readiness for being cheerful renders insight into basic parameters of temperament. To what extent a child uses humor either supportively or destructively, contains information about psychodynamic connections, motivational aspects and active coping strategies. Concerning the diagnostic approach, reports of parents as well as humor tests or hypothesizing methods (e.g. humorous drawings) can be used. Central in using humor as a diagnostic assessment device is the knowledge of humor development and of the relations between psychiatric illnesses and humor.

Adaptation, Psychological↗
PubMed1995

Research review: a computer-based diagnostic model for individual case review.

A previous study found that Iliad, a diagnostic expert system, detects diagnostic errors missed by peer review organization (PRO) review. That study used volunteer physicians from an institution as gold standard reviewers, however. The article discusses a second experiment employing Utah PRO (UPRO) review physicians as gold standards. Iliad was compared with the Unified Clinical Data Set used by the UPRO and was found to detect otherwise unsuspected diagnostic errors. The confirmation rate of Iliad flags was much higher in the earlier study, however. No agreement was found between institution and UPRO physicians, but there was agreement between a unique physician (who was both an institution and UPRO physician) and each of the two groups. Because Iliad screens for potential diagnostic errors to be confirmed or denied by gold standard physician review, the different types of physicians in the two experiments might have been the cause.

Diagnostic Errors↗
PubMed1976

[The use of rating scales for the study of diagnostic models: recognition of the uncertainties in classification principles].

In a cross cultural comparison of diagnostic concepts, we obtained from 45 expert italian psychiatrits symptom rating profiles, in terms of B.P.R.S., of the 12 most used diagnostic categories. While for 11 diagnostic concepts agreement was reasonably good, for cycloïd psychosis the variability of results supported the conclusion that this diagnostic concept is rather non specific among italian psychiatrists.

Cross-Cultural Comparison↗
PubMed1998

Calvarial eosinophilic granuloma: diagnostic models and image feature selection with a neural network.

RATIONALE AND OBJECTIVES: The authors analyzed the accuracy of diagnostic features used by an artificial neural network compared with logistic-regression analysis in the diagnosis with computed tomography (CT) of calvarial eosinophilic granuloma. MATERIALS AND METHODS: Thirty-one of 167 patients with calvarial lesions were found to have eosinophilic granuloma. Clinical and CT data were used for logistic-regression and neural network models. Both models were tested by using the leave-one-out method. The final results of each model were compared by means of the area under the receiver operating characteristic curve (Az). RESULTS: Identification of eosinophilic granuloma was significantly more accurate with the neural network than with logistic regression (Az = 0.9846 +/- 0.0157 [standard deviation] vs 0.9117 +/- 0.0373) (P = .001). The most important diagnostic features identified with the neural network were patient age and marginal sclerosis. For logistic regression, the most important features were age, shape, and lobularity. CONCLUSION: The neural network is a useful tool for analyzing the features of calvarial eosinophilic granuloma. Age and marginal sclerosis are important diagnostic features.

Adolescent↗
PubMed1992

Test selection in jaundice: a comparison between physician behavior and a diagnostic model.

The results of an observational study aimed at a formal assessment of clinicians' test-selection behavior are presented. We first make a proposal for diagnostic test usage in the latter phases of jaundice diagnosis. Next we compute a probabilistic estimate of the patient diagnosis, based on the COMIK algorithm. From the proposal and the probabilistic estimate we can predict the "test-selection behavior" of clinicians. The assessment follows from a tabulation of the predicted behavior against the tests selected by clinicians. It is shown that for most tests, the predictions are consistent with the observed test-selection behavior at a statistically significant level. Discussions of discrepancies between prediction and observation, and reasons for deviations from general guidelines, provide new dimensions for medical education. The methodology applied is a useful tool to improve medical care for the jaundiced patient.

Algorithms↗
PubMedDate not supplied

A sequential diagnostic model for medical questioning.

A medical interview is a very important part of medical treatment since it is conducted when a patient is first admitted to a hospital and treatment is decided afterwards. However, these interviews are not always carried out in sufficient detail because physicians have very heavy work-loads. The development of automated medical questioning equipment which tabulates the answers to questions into a form easily understood by physicians, which enumerates data on doubtful diseases and which indicates pertinent medical examinations may come to the aid of patients and physicians. This paper presents a new diagnostic theory for the design of automated medical questioning equipment. Diagnostic theories can be classified into batch and sequential theories; the authors have investigated the sequential one, because decisions are made using minimal data. The techniques supporting this theory are multi-class recognition systems based on independently designed dual-class recognition systems and Wald's Sequential Probability Ratio Test. To discuss the properties inherent in the present theory, classification of three pattern classes was made. These were normal, hypertension and myocardial infarction classes of patients. The mean error probability of classification was found to be 3.08%.

Diagnosis, Computer-Assisted↗
PubMed1992

Non-Newtonian rheology of leukemic blood and plasma: are n and k parameters of power law model diagnostic?

When discussing the rheological properties of normal and leukemic blood it must be considered that blood is a suspension of cells in aqueous solution which is also known as plasma. Whole blood viscosity and plasma viscosity were determined by Rheometer LS30 which allows measuring whole blood and plasma viscosity in the middle and low shear rate ranges. The measurements of the viscosity showed that whole blood and plasma behave as non-Newtonian power law fluid. The values of n (non-Newtonian index) and k (consistency index) of power law fluid were calculated for both leukemic blood and plasma samples. The importance of this phenomenon for the micro-circulation is discussed.

Adolescent↗
PubMed1993

A diagnostic model for the evaluation of childbirth and parenting education.

A research study examined current issues in childbirth and parenting education in the Australian Capital Territory (ACT). In this article continuing official scepticism about the effectiveness of these programmes, despite evidence of consumer satisfaction and commitment from service providers, is noted. A critical review of the literature reveals the absence of a systematic framework for evaluation of childbirth education programmes. A framework which incorporates a methodology for health education planning and evaluation in a management context is proposed as a means of overcoming this deficiency. This framework enables a focus on the effectiveness of these health services from the perspective of both clients and providers, and identification of strategic measures for improving programme delivery and educational outcomes.

Female↗
PubMed1999

[Radical prostatectomy in prostate adenocarcinoma. Clinical factors influencing the pathological stage. Diagnostic model].

MATERIAL AND METHODS: Study on the efficacy of stage diagnosis, how to support it based on clinical objective data and description of a prognostic model. Analysis of 160 patients diagnosed with localized prostate adenocarcinoma undergoing radical prostatectomy in the Clínica Universitaria de Navarra between 1988-1997. The statistical study used Fisher's or Pearson's tests for the comparison of qualitative variables. A logistic regression multivariate analysis was run to avoid confounding factors in the pathological stage. RESULTS: 85/160 (53%) were correctly staged. Incorrect staging occurred in patients with higher clinical stage (T1-T2a: 25%; T2bc: 65%). The univariate study shows that the pathological stage is significantly correlated to: a) serum PSA levels (15 ng/mL in P2 vr. 25 ng/mL in P3-4), the most suitable cutoff value being 15 ng/mL. b) digital rectal examination and Gleason. Negatively influencing factors in the multivariate study were: PSA greater than 15 ng/mL, Gleason greater than 5 and a T2bc clinical stage. Risk groups: 4 risk groups are established based on the above factors (inclusion in group 1 involves an 8% risk of having P3, 30% in group 2, 56% in group 3 and 84% in group 4). CONCLUSIONS: The clinical factors with influence in the pathological stage are PSA, Gleason and clinical stage. The reliability of the risk groups established based on these factors is remarkable.

Adenocarcinoma↗
PubMed1999

Validation procedures in radiologic diagnostic models. Neural network and logistic regression.

OBJECTIVE: To compare the performance of two predictive radiologic models, logistic regression (LR) and neural network (NN), with five different resampling methods. METHODS: One hundred sixty-seven patients with proven calvarial lesions as the only known disease were enrolled. Clinical and CT data were used for LR and NN models. Both models were developed with cross-validation, leave-one-out, and three different bootstrap algorithms. The final results of each model were compared with error rate and the area under receiver operating characteristic curves (Az). RESULTS: The NN obtained statistically higher Az values than LR with cross-validation. The remaining resampling validation methods did not reveal statistically significant differences between LR and NN rules. CONCLUSIONS: The NN classifier performs better than the one based on LR. This advantage is well detected by three-fold cross-validation but remains unnoticed when leave-one-out or bootstrap algorithms are used.

Adolescent↗
PubMed1993

Elder care. A diagnostic model for failure to thrive.

1. Care of the elderly is often complicated by complex, interacting conditions. Major areas of concern for the elderly are malnutrition, depression, and confusion (in the form of dementia or delirium). Malnutrition has been prevalent in both hospitalized and institutionalized elderly. 2. Failure to thrive (FTT) has long been recognized in pediatric patients as a multifaceted syndrome that is primarily a disorder of nutritional status and physical and mental development. The characteristics of FTT in the elderly are undernutrition, loss of physical and cognitive function, and depression. 3. The redefinition and alteration of terms from the infant model of FTT results in three categories of FTT in the elderly--psychosocial, predisposing, and physical, as opposed to the two categories of FTT in infants--the infant and the environment.

Aged↗