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At least 55 records · Page 3Linked to original sources
PubMed1986

Construct validity of the DSM-III and RDC classification of melancholia (endogenous depression).

Diagnostic schedules for any psychiatric disorder should represent a coherent concept and demonstrate adequate construct (internal) validity and transferability. Testing fit to latent class models (e.g. by Rasch model fitting test), correspondence to these requirements can be assessed. Based on data from a sample of 173 depressed in-patients, diagnostic schedules for endogenous depression (melancholia) according to DSM-III and RDC are evaluated for their ability to fit the requirements listed above. According to the data presented, the set of DSM-III-criteria for melancholia represents a coherent concept; on the contrary, this is not the case for RDC-criteria. Furthermore, application of the diagnostic algorithm applied to the defining criteria according to DSM-III has been justified; again, this was not the case for the diagnostic algorithm according to RDC. However, a simple linear diagnostic algorithm emerges from our data.

Adult↗
PubMed1989

Noninvasive and angiographic evaluation of coronary artery disease in patients with peripheral vascular disease.

The accuracy of exercise testing for detection of coronary artery disease in a population with a high incidence of claudication was evaluated in 58 consecutive patients with abdominal aortic aneurysms or lower extremity occlusive disease. Each patient was evaluated by history and physical examination, symptom-limited testing with exercise treadmill, arm ergometry and exercise radionuclide ventriculography. An algorithm was designed that retrospectively examined the results of each test in a stepwise fashion to simulate a clinical decision-making process. The results of the clinical examination, each of the exercise tests and the noninvasive diagnostic algorithm were compared with the results of coronary arteriography. The predictive accuracy of the clinical evaluation was 36%, treadmill stress testing 57%, treadmill stress plus arm ergometry 74%, exercise radionuclide ventriculography 57% and the noninvasive diagnostic algorithm 89%. When discriminant analysis was applied to all of the exercise variables, no individual test improved the accuracy of the noninvasive diagnostic algorithm. When the analysis considered only individual variables without the algorithm, the model correctly classified only 67% of the patients. Thus, accurate noninvasive evaluation of coronary artery disease is possible in patients with severe peripheral vascular disease when care is taken to design exercise protocols that allow adequate stress on the cardiovascular system.

Adult↗
PubMed1991

[A computer algorithm for diagnostic assessment with DSM-III in the early course of schizophrenic diseases].

The purpose of the computer algorithm described here is the evaluation of diagnostic criteria according to DSM-III for schizophrenia and schizophreniform disorders. It also dates the first time point of the assessment of these diagnoses. The necessary information comes from a semistructured interview, called IRAOS (Interview for the Retrospective Assessment of the Onset of Schizophrenia). With this interview early indicators of a beginning schizophrenia can be evaluated in their chronological order and their type of course. The algorithm was first used in a sample of patients admitted for the first time with a diagnosis of either schizophrenia or paranoid psychosis. One third of these patients fulfills the DSM-III-criterion of a duration of at least six months. The other patients fulfill criterion B of a schizophreniform disorder. To strengthen the validity of a diagnosis including the criteria A up to E successively, the sample is reduced to 70%. The average time point of the first assessment of the diagnosis by the computer algorithm is about 1.5 years before the index-admission. Together with the IRAOS the computer algorithm allows an operationalized assessment of the real onset of schizophrenia.

Adult↗
PubMedDate not supplied

A clinical algorithm to determine the etiology of brittle diabetes.

Brittle diabetes is a subset of insulin-dependent diabetes mellitus for which multiple causes have been suggested. In its most severe form, brittle diabetes is incapacitating, preventing gainful employment and a normal lifestyle. Although some brittle diabetic individuals will significantly improve by intensive insulin therapy and education, many others remain unable to function normally because of recurrent episodes of hyperglycemia and hypoglycemia. We studied 30 incapacitated brittle diabetic subjects and developed an efficient algorithmic approach to determine the etiology of brittleness. Central to our diagnostic algorithm was the glucose response to 0.1 U/kg insulin administered subcutaneously and intravenously. If this response was normal, then psychosocial evaluations were completed, including psycholinguistic and health psychological testing. Other parameters affecting blood glucose concentration were also assessed, such as gastric motility, counterregulatory hormones, and, most important, patient compliance with prescribed regimens. However, if an "abnormal" glucose response to the insulin challenge tests was observed, the location of the insulin resistance was identified as being subcutaneous, intravascular, or at the peripheral tissue. Using our diagnostic algorithm, the identification of the etiology of brittleness in 29 of the 30 referred patients was possible. Thus, the purpose of an algorithmic approach to diagnosis is not only to avoid unnecessary testing, but also to determine the correct etiology of the brittle diabetes to determine appropriate therapy.

Blood Glucose↗
PubMed1989

Diagnostic criteria for hospitalized acute myocardial infarction: the Minnesota experience.

Standardized diagnostic algorithms are needed for systematic surveillance of hospitalized acute myocardial infarction (AMI). Ambiguities in diagnostic classification are resolvable to the extent that objective information is available in the hospital chart. In this study of diagnostic algorithms, serum cardiac enzyme levels, especially creatine kinase total (CK-TOT) and creatine kinase myocardial band (CK-MB) isoenzyme, were most closely correlated with the physician-reviewer diagnostic assignment used for validation; chest pain and electrocardiographic findings were less closely correlated. In addition, a close relationship was noted between the clinician's diagnostic impression and testing procedures and the final hospital discharge diagnosis. Thus, the algorithm should include discharge diagnosis as a classification element. The algorithm for cases discharged as acute myocardial infarction should be very sensitive, tending to call cases acute myocardial infarction. Other discharge diagnoses may harbour some clinically unrecognized myocardial infarction cases; however, the algorithm for such cases should be restrictive and specific to minimize false positives. These findings indicate optimal ways of combining clinical characteristics to most completely and accurately identify cases of acute myocardial infarction based on hospital records examined in retrospect.

Algorithms↗
PubMed1987

Hematologic values in horses and interpretation of hematologic data.

Normal reference ranges and pertinent background information on equine hematology are presented and briefly discussed. Diagnostic interpretation of hematologic data is discussed and three diagnostic algorithms and two diagnostic tables are provided to facilitate the use of the presented information for diagnosis. Two cases are presented and the information presented in the article is used to interpret the case data.

Animals↗
PubMed1990

[The automated detection of patients with neurotic disturbances in conducting mass prophylactic examinations].

The theory of image recognition was used to design clinico-statistical models of patients with neurotic disorders and healthy persons. 535 patients with neuroses and 204 mentally healthy persons were used as material for investigation. Based on a complex of anamnestic, psychological and clinical characteristics the assessment function developed makes it possible to distribute the examined into groups of a high risk for the disease development and of healthy persons. The diagnostic algorithm ensures proper recognition of patients with neurotic disorders (in 93-95% of cases). The use of the diagnostic algorithm for automated screening of neuroses enables the increased demonstration of the pathology and reduction of expenses for conduction of mass prophylactic screenings.

Algorithms↗
PubMed1991

[Errors and hazards in the surgical treatment of hepatic echinococcosis].

The article analyses the results of operative treatment of 455 patients for hydatid disease of the abdominal organs, in particular the errors and hazards of surgical management of hydatid disease of the liver. Difficulties occur in the differential diagnosis in suppuration of hydatid cysts which had not been operated on, as well as in residual cavities in patients who had undergone surgery for this disease. The authors dwell on the diagnostic algorithm and the surgical tactics depending on the size and location of the hydatid cysts. Some problems of the operative techniques and intraoperative measures for the prevention of recurrences in complicated forms of hepatic hydatid disease are discussed. The suggested diagnostic algorithm and the surgical tactics allowed the authors to reduce diagnostic errors in this pathological condition to 3.5% and surgical mortality rates to 3.07%.

Algorithms↗
PubMed1987

[The choice of surgical intervention in mitral defects].

Under analysis were clinical data and roentgencardiometric parameters in 181 patients with mitral diseases. The most informative roentgencardiometric parameters were established and a quantitative diagnostic algorithm was created with the help of a mathematical method for the choice of the operative procedure. The correct choice was made in 79% of the cases. The diagnostic algorithm developed is thought to be most expedient for use in patients with combined mitral defects. The procedure of quantitation of cardiometric parameters and summing their diagnostic coefficients is simple and not time-taking.

Algorithms↗
PubMed1985

The research diagnostic criteria for endogenous depression and the dexamethasone suppression test: a discriminant function analysis.

Most studies examining the validity of the Research Diagnostic Criteria (RDC) for endogenous depression have been negative. RDC endogenous subtyping is not associated with short- or long-term treatment outcome, family history of affective disorder, or premorbid personality disorder. Studies examining its relationship to the dexamethasone suppression test (DST) are mixed; half report a significant association, and half do not. The RDC endogenous diagnosis may lack validity either because the criteria do not represent, or are not specific to, the endogenous subtype, or the diagnostic algorithm is inappropriate. In the present study, we conduct a discriminant function analysis on the 10 criteria for the endogenous subtype using DST results as the independent variable. We constructed a new diagnostic algorithm and cross-validated it on a second patient sample. In both samples the discriminant function classification was significantly associated with DST results, whereas the RDC algorithm was not.

Adult↗
PubMed1991

Resampling algorithms for diagnostic radiology.

The use of digital image resampling can be highly suitable for diagnostic radiology. It can be applied not only to obtain zoom effects but also to solve various problems related to the comparison of images of different origin (NMR, CT, NM). The mathematical approach to this kind of algorithm, based on rational assumptions, can be very wide and diversified. In this work the principles of the stochastic and of the analytical methods have been analyzed. In particular, a complete mathematical treatment of the integral analytical methods, which are both the most theoretically interesting and analytically complex, has been performed. The practice of these techniques has to be determined each time from the analysis of the specific problem to which they are to be applied in the routine, and after a retrospective analysis of the results obtained.

Algorithms↗
PubMed1990

[Elaboration and use of the methods of computer-assisted diagnosis of cerebrovascular pathology].

The purpose of the work was to analyze the experience with the trial of diagnostic algorithms to specify possibilities of differential diagnosis and forecasting the course or outcome of cerebrovascular diseases. Detailed study of 922 clinico-anatomic cases (547 with hemorrhagic brain stroke, 157 with ischemic, 218 with pseudostroke) enabled revealing differential-diagnostic criteria for the pathological patterns under study bearing in mind disease pathomorphism. Analysis was made of the tabular diagnosis of cerebrovascular pathology and of the experience gained with the trail of diverse diagnostic algorithms for staged diagnosis of brain stroke and pseudostroke, different varieties of cerebral hemorrhages (10 varieties). The results of the use of four algorithms for forecasting hemorrhagic brain stroke were studied and compared. The accuracy of the diagnosis and forecasting amounts from 55 to 82.3% depending on the problem to be solved and the algorithm used. The data show the necessity of the careful providing of the algorithm choice as dependent on the problem raised.

Adult↗