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At least 541 records · Page 30Linked to original sources
PubMed2006

Accuracy comparison of a 16 and 64 multidetector-row computed tomography scanner to image small high-density structures.

OBJECTIVES: The accuracy in imaging small high-density structures is compared for 16 and 64 multidetector-row computed tomography (MDCT) scanners. MATERIALS AND METHODS: Phantom experiments and different quantification methods are used to establish size measurement accuracy, object signal, and image noise, for both MDCT systems. RESULTS: At similar scanning doses, image noise is larger ( approximately 55%) for the 64 MDCT compared with the 16 MDCT, leading to lower signal-to-noise ratios ( approximately 28% for objects <2 mm). Object spread in the xy-plane is similar for both systems; while it is reduced along the z-axis (by approximately 0.18 mm) for the 64 MDCT. Measurement accuracy of the 64 MDCT is not significantly higher (P < 0.05) compared with the 16 MDCT when using a relative-threshold corresponding to 50% of the object maximum attenuation value. However, when using a fixed-threshold, interscanner and interprotocol measurement differences are statistically significant (eg, volume relative errors are reduced by approximately 17% on average for the 64 MDCT). CONCLUSIONS: Measurement accuracy of the 16 and 64 MDCT scanners is not significantly different when using a 50% relative threshold. However, image noise is significantly larger for the 64 MDCT. Compared with a fixed-threshold based method, the 50% relative-threshold strongly reduces interscanner and interprotocol measurement dependency and improves accuracy.

Image Enhancement↗
PubMed2003

Diagnostic accuracy of serological kits for Helicobacter pylori infection with the same assay system but different antigens in a Japanese patient population.

Helicobacter pylori infection is thought to be a causal risk factor for gastric carcinoma. Recently, diagnostic accuracy of serological kits for H. pylori infection that were made in Western countries has been reported to be lower when used among Oriental populations. Diagnostic accuracy of two serological kits [HM-CAP and HM-CAP with antigens extracted from clinically isolated Japanese H. pylori strains (J-HM-CAP)] was investigated in 440 samples from a Japanese patient population by using the (13)C-urea breath test as gold standard. According to the original optimal cut-off value, HM-CAP provided 87.5 % sensitivity and 84.8 % specificity with 86.8 % accuracy and J-HM-CAP provided 95.5 % sensitivity and 81.9 % specificity with 92.3 % accuracy. This study suggests that antigens from HM-CAP are satisfactory for examining a Japanese patient population, but that using local antigens improves accuracy.

Adult↗
PubMed2006

Accuracy and precision of the three-dimensional assessment of the facial surface using a 3-D laser scanner.

Three-dimensional (3-D) recording of the surface of the human body or anatomical areas has gained importance in many medical specialties. Thus, it is important to determine scanner precision and accuracy in defined medical applications and to establish standards for the recording procedure. Here we evaluated the precision and accuracy of 3-D assessment of the facial area with the Minolta Vivid 910 3D Laser Scanner. We also investigated the influence of factors related to the recording procedure and the processing of scanner data on final results. These factors include lighting, alignment of scanner and object, the examiner, and the software used to convert measurements into virtual images. To assess scanner accuracy, we compared scanner data to those obtained by manual measurements on a dummy. Less than 7% of all results with the scanner method were outside a range of error of 2 mm when compared to corresponding reference measurements. Accuracy, thus, proved to be good enough to satisfy requirements for numerous clinical applications. Moreover, the experiments completed with the dummy yielded valuable information for optimizing recording parameters for best results. Thus, under defined conditions, precision and accuracy of surface models of the human face recorded with the Minolta Vivid 910 3D Scanner presumably can also be enhanced. Future studies will involve verification of our findings using test persons. The current findings indicate that the Minolta Vivid 910 3D Scanner might be used with benefit in medicine when recording the 3-D surface structures of the face.

Algorithms↗
PubMed2007

A randomized controlled trial of the diagnostic accuracy of internet-based telepathology compared with conventional microscopy.

AIMS: To compare the diagnostic accuracy of internet-based virtual microscopy with conventional light microscopy, in the context of renal biopsies assessed by participants in the UK National Renal Pathology External Quality Assessment (EQA) Scheme. METHODS AND RESULTS: 'Virtual slides' of current EQA cases were made available over the internet to participants in the scheme. The approach permitted what may reasonably be described as a randomized controlled trial of the diagnostic accuracy of this mode of telepathology, in the context of renal pathology. No significant difference in diagnostic accuracy could be detected between the diagnoses proffered on the basis of virtual slides and conventional slides; but using virtual slides took pathologists considerably longer. CONCLUSIONS: This result provides some encouragement for the implementation of such virtual slide-based telepathology systems. However, in failing to detect a difference, equivalence of diagnostic accuracy has not been proved; nor has the relevance of this result to other fields of histopathology been demonstrated. A decision to implement a diagnostic telepathology system requires consideration of numerous factors beyond diagnostic accuracy, including financial, legal, professional and ethical issues.

Diagnosis↗
PubMed2005

Diagnostic accuracy of the care dependency scale.

AIM: This paper reports an investigation of the diagnostic accuracy of the Care Dependency Scale (CDS). BACKGROUND: Assessment tools can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy can be determined by several techniques as sensitivity, specificity, receiver operating curve analysis and likelihood ratios. METHOD: A cross-sectional design was used with data from 237 patients from two studies. Data were collected using a questionnaire consisting of the CDS and the Barthel Index (BI). The CDS is a relatively new instrument and should be validated by comparison against an established gold standard, in this case the BI. Measures to quantify the validity of diagnostic tests, such as sensitivity, specificity, positive and negative predictive values, prevalence and likelihood ratios were calculated. In addition, the receiver operating characteristics (ROC) curve analysis was used to report the test accuracy of the CDS and to determine an appropriate cut-off point for care dependency detection. FINDINGS: The prevalence in the sample study was very high (84%). The area under the ROC curve for the CDS was 0.81, which indicates moderate diagnostic accuracy. Patients with a CDS sumscore </=68 (rule-out cut-off point) were classified as care dependent, all others as independent. The determination of the appropriate cut-off point was based on sensitivity (0.85) and positive predictive valued (0.90). CONCLUSION: The CDS may be used for to estimate care dependency among hospital patients with various conditions.

Activities of Daily Living↗
PubMed2004

The effect of practical portion size measurement aids on the accuracy of portion size estimates made by young adults.

A barrier to controlling the amount of food consumed may be the difficulty consumers have in accurately estimating portion sizes. Although portion size measurement aids (PSMAs) can improve estimation accuracy, their bulk and/or cost tends to make them impractical for regular use. The purpose of this study was to investigate the effect on portion size estimation accuracy of two practical PSMAs: a 2-D PSMA (life size picture of tennis and golf balls) and 3-D PSMAs (tennis and golf balls). Young adults were randomly assigned to one of two groups and estimated the portion sizes of 36 foods divided into three equal sets. PSMAs were not used to estimate portion sizes in Food Set 1. Study group 1 (n = 57) used the 2-D PSMA and study group 2 (n = 56) used the 3-D PSMAs to estimate the portion sizes in Food Set 2. Neither group used PSMAs to estimate portion sizes in Food Set 3. Repeated measures anova indicated that both groups significantly improved estimation accuracy between Food Sets 1 and 2 and between Foods Sets 1 and 3. Thus, even short-term exposure to practical PSMAs may improve estimation accuracy and these improvements persist when the PSMA is no longer available. However, the accuracy rate for Food Set 2 was only about 60% indicating that a great deal of estimation error remains.

Adolescent↗
PubMed1992

Level of accuracy and degree of precision in attempting to maintain steady levels of biting force.

The primary purpose of this study was to assess the level of accuracy (bias) and degree of precision for a group of 24 normal subjects attempting to maintain a constant biting force at levels of 100 gm, 500 gm, 1000 gm and 2000 gm for a period of 10 s each. Accuracy is defined as the difference between subjects' actual level of biting force and the target value they were trying to achieve. Precision is the level or range of variability demonstrated by the subjects while attempting to bite with a constant level of force. Subjects' performance relative to accuracy and precision was also compared when using the central incisors vs. the first permanent molars. Assessment of bite force was measured using a specially designed strain gauge scale which permitted subjects to visually monitor when their biting force equalled a preset resistance. Each subject was instructed to bite on the end of a plastic sheathed steel beam with enough force to activate the indicator needle on the voltage meter to its central position and to try to maintain a constant level of biting force (by attempting to keep the indicator needle steady in its central position). No significant (P > 0.05) differences were found in mean accuracy in bite force for gender or specific teeth used in the biting task. However, a significant difference (P < 0.0001) in mean accuracy in bite force was found to exist between the target levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Endoscopic ultrasound for esophageal and gastroesophageal junction cancer: Impact of increased use of primary neoadjuvant therapy on preoperative locoregional staging accuracy.

Initial treatment of locally advanced esophageal and gastroesophageal junction (GEJ) malignancies for selected patients at some institutions has recently changed from surgical resection to neoadjuvant therapy. The aim of this study is to evaluate the impact of this change in treatment strategy on both the overall disease profile and locoregional endoscopic ultrasound (EUS) staging accuracy for a cohort of patients managed with primary surgical resection over a 10-year period at our institution. All subjects at our institution who underwent primary esophagectomy from 1993 to 2002 following preoperative EUS for known or suspected esophageal and/or GEJ cancers were identified. Patients with dysplasia alone, prior upper gastrointestinal tract surgery, preoperative neoadjuvant therapy, cancer of the gastric cardia or recurrent malignancy were excluded. EUS findings and staging results were compared to surgical pathology following resection. The impact of the gradually increased use of primary chemoradiation during the second half of the study was assessed. Of the 286 operations performed, 184 subjects were excluded. The remaining 102 underwent primary surgical resection a median of 18 days following EUS staging for adenocarcinoma (88%) or squamous cell carcinoma (12%) of the esophagus (69%) or GEJ (31%). Overall EUS locoregional T and N staging accuracy was 72% and 75% respectively; accuracy for T1, T2, T3 and T4 cancer was 42%, 50%, 88% and 50% respectively. Despite an increased frequency of pathologically confirmed T1 and T2 cancers (P = 0.005) and an insignificant trend toward increased N0 malignancy (P = 0.05) during the second half of the study period, no statistically significant changes in T (P = 0.07) or N (P = 0.82) staging accuracies for EUS or disease characteristics were noted between the first and second half of the study period. Despite both inaccurate radial EUS staging and increased relative use of primary surgery for early cancers, recent increased use of primary neoadjuvant therapy did not change overall disease characteristics and accuracy of locoregional EUS staging of esophageal and GEJ cancers managed with primary surgical resection.

Adenocarcinoma↗
PubMed2005

Accuracy of fetal heart-rate variability interpretation by obstetricians using the criteria of the National Institute of Child Health and Human Development compared with computer-aided interpretation.

AIM: To evaluate the accuracy of fetal heart rate variability interpretation by obstetricians using the criteria of the National Institute of Child Health and Human Development (NICHD), compared with computer-aided analysis as a gold standard. METHODS: One hundred and fourteen panels of fetal heart-rate tracings derived from electrocardiogram via scalp electrodes obtained from women with high-risk pregnancies during the intrapartum period. The tracings were interpreted using computer analysis and recorded as a gold standard. The same tracings were distributed to six observers: three residents in the third year of training and three faculty members. All observers blindly interpreted the fetal heart-rate variability without the knowledge of the computer analysis. The main outcome measures were: (i) the accuracy of fetal heart-rate variability interpretation by obstetricians using the NICHD criteria compared with computer-aided analysis was presented as a percentage value; and (ii) the agreement of fetal heart-rate variability interpretation between the obstetricians and the computer analysis using the NICHD criteria was presented as a kappa-value. RESULT: When using the computer analysis as a gold standard, the accuracy of fetal heart-rate variability interpretation in the residents group was 81.58%, 86.84% and 82.46%, respectively, with a mean of 83.62%, whereas the accuracy of the faculty members was 79.82%, 67.54% and 79.82%, respectively, with a mean of 75.73%. kappa-values, representing the agreement of interpretation, were 0.70, 0.78 and 0.72, with a mean of 0.73 +/- 0.04 among the residents, and 0.67, 0.50 and 0.68, with a mean of 0.62 +/- 0.10 among the faculty members. Agreements in the two groups were not significantly different (Student's t-test, P=0.14). CONCLUSION: Using the NICHD criteria, the accuracy and agreement of fetal heart-rate variability interpretation in the third-year residents and faculty members are substantial. There was no difference between the groups with regard to the agreement of fetal heart-rate variability interpretation.

Arrhythmias, Cardiac↗
PubMed2004

The accuracy of various tests for bacterial vaginosis in predicting preterm birth: a systematic review.

OBJECTIVE: To determine the accuracy with which various types of tests for bacterial vaginosis predict spontaneous preterm birth in pregnant women. DATA SOURCES: Studies were identified without language restrictions through nine different databases, and manual searching of bibliographies of known primary and review articles. STUDY SELECTION AND DATA EXTRACTION: There are four different bacterial vaginosis testing methods: Gram staining tests using either Nugent's or Spiegel's criteria, and gas liquid chromatography are laboratory based, and the fourth method uses clinical (Amsel's) criteria to diagnose bacterial vaginosis. Two reviewers independently selected studies and extracted data on their characteristics, quality and accuracy. Accuracy data were used to form 2 x 2 contingency tables of the bacterial vaginosis test results with spontaneous preterm birth as the reference standard. DATA SYNTHESIS: Data on asymptomatic women and women with symptoms of threatened preterm labour were analysed separately. Data were pooled to produce summary estimates of likelihood ratios for positive (LR+) and negative (LR-) test results for the various types of tests. RESULTS: There were 18 primary articles, involving altogether 17,868 women. There was unexplained heterogeneity in the meta-analyses of the accuracy results, which requires caution in their interpretation. Meta-analyses of studies testing asymptomatic women in the second trimester showed that clinical criteria had a LR+ of 0.98 (95% confidence interval 0.59 to 1.6) and a LR- of 1.00 (0.93 to 1.1), Gram staining (Nugent's criteria) had a LR+ of 1.6 (1.4 to 1.9) and a LR- of 0.9 (0.8 to 0.9), and Gram staining (Spiegel's criteria) had a LR+ of 2.4 (1.4 to 4.9) and a LR- of 0.81 (0.64 to 1.0). Among symptomatic women, Gram staining (Spiegel's criteria) had a LR+ of 1.3 (1.0 to 1.6) and LR- of 0.9 (0.7 to 1.0). CONCLUSION: There was a lack of difference in the accuracy of the various bacterial vaginosis tests for predicting preterm birth in both asymptomatic and symptomatic women of threatened preterm labour.

Bacteriological Techniques↗
PubMed2005

Accuracy of fetal echocardiography in the routine detection of congenital heart disease among unselected and low risk populations: a systematic review.

OBJECTIVE: To determine among unselected and low risk populations the accuracy with which fetal echocardiography during the second trimester detects congenital heart disease. DESIGN: A systematic review of studies that assess the accuracy of fetal echocardiography. SETTING: District General Hospital and Tertiary referral centres. POPULATION: Women during the second trimester attending for ultrasound assessment. METHODS: General bibliographic databases (e.g. MEDLINE, EMBASE) and specialist computerised databases (e.g. Cochrane Library, National Research Register), grey literature, manual searching of reference lists of primary and review articles and personal contact with experts were used to identify studies. Studies were included if fetal echocardiography among unselected or low risk pregnant women was compared against a postnatal reference standard. Data were extracted on quality, study design and characteristics, and accuracy data to construct 2 x 2 tables. Data were synthesised qualitatively, and sensitivity and specificity with 95% confidence intervals were calculated. MAIN OUTCOME MEASURE: Sensitivity and specificity. RESULTS: Five primary studies met the inclusion criteria and comprised 60,901 subjects. One study assessed the accuracy of fetal echocardiography among an unselected population and four studies among low risk populations. All eligible studies found that fetal echocardiography helped to correctly diagnose normal fetus among unselected and low risk populations. Correct diagnosis of babies for congenital heart defects was higher among the unselected population (85%) than among the low risk populations (range from 35% to 86%); however, the potential for ascertainment bias and the choice of reference standard limits the validity of this finding. The variation in sensitivity across studies was not explainable by clinical factors such as scanning regime, operator skill and equipment. CONCLUSIONS: The evidence from this review about the accuracy of fetal echocardiography does not lend support to its routine use among unselected and low risk populations during the second trimester to detect congenital heart disease.

Echocardiography↗
PubMed2006

Ovarian reserve tests for predicting fertility outcomes for assisted reproductive technology: the International Systematic Collaboration of Ovarian Reserve Evaluation protocol for a systematic review of ovarian reserve test accuracy.

BACKGROUND: The presence of a wide range of tests of ovarian reserve suggests that no single test provides a sufficiently accurate result. Many tests are used without reference to an evidence base. So far, individual studies conducted on these tests are too small to give precise estimates of prognostic accuracy. OBJECTIVES: To systematically assess the accuracy of the available tests of ovarian reserve in terms of prediction of fertility outcomes. SEARCH STRATEGY: The search will be conducted using the name of the respective index test being studied (as listed on the MESH database), if more than 2000 citations are listed, 'ovary' and or 'ovarian', 'fertility' and or 'reserve' will be combined with the original search term as required. Studies of the accuracy of tests of ovarian reserve will be obtained without language restrictions from 1980 to 2005 using the following electronic databases and Ovid software: MEDLINE, EMBASE, PUBmed, Biological extracts, Pascal, Cochrane Library (CDSR, DARE, CCTR, HTA), Best Evidence databases, SCISEARCH, Conference Proceedings (ISI Proceedings, Healthstar, Current Contents, Science Citation Index, Cancerlit and Econlit and NHS Economic Evaluation database. The National Research Register, the Medical Research Council's Clinical Trials Register, MEDION, DARE, and the US Clinical Trials register. SELECTION CRITERIA: Studies will be selected if accuracy of tests are compared with a reference standard and include data that can be abstracted into a two-by-two table to calculate sensitivity and specificity. The studies to be included in this review will examine one of the following index 'tests' within a study population of women undergoing assisted reproductive technology: * Clinical variables--age, history of cancelled cycles. * Basal blood tests--follicle-stimulating hormone (FSH), lutenising hormone (LH), FSH:LH ratios, estradiol (E(2)), inhibin A and B, progesterone (P(4)), P(4):E(2) ratios, antimullerian hormone, testosterone, vascular endothelial growth factor, insulin-like growth factor-1:insulin-like growth factor binding protein-1 ratios. * Dynamic tests--clomiphene citrate challenge test, gonadotropin analogue stimulating test, exogenous FSH ovarian reserve test. * Ultrasound tests-antral follicle count, ovarian volume, ovarian stromal peak systolic velocity, including waveform and pulsatility index, ovarian follicular vascularity. * Histology--ovarian biopsy. Data collection and analysis Two independent reviewers will perform quality assessment and data extraction. Prognostic accuracy will be determined by calculating positive and negative likelihood ratios for the following outcomes or reference standards: live birth, ongoing pregnancy, clinical pregnancy, biochemical pregnancy, embryos available for transfer, eggs obtained at oocyte retrieval, cycles cancelled prior to oocyte retrieval. Main results and conclusions N/A.

Data Collection↗
PubMed2005

Moisture effect on polyether and polyvinylsiloxane dimensional accuracy and detail reproduction.

PURPOSE: This investigation evaluated and compared the dimensional accuracy and surface detail reproduction of two hydrophilic polyvinylsiloxane (PVS) and two polyether (PE) impression materials when used under dry and moist conditions. METHODS: Impressions were made of stainless steel dies as described in ANSI/ADA specification no. 19, with two vertical and three horizontal lines inscribed on the die superior surface. Impressions were made under dry and moist conditions (17 impressions per condition for each material). Dimensional accuracy was measured by comparing the average length of the middle horizontal line in each impression with the same line on the metal die using a measuring microscope with an accuracy of 0.001 mm. Surface detail reproduction was evaluated by using criteria similar to ADA specification no. 19: continuous replication of at least two of the three horizontal lines. RESULTS: The mean percent dimensional change and SD values ranged from -0.135% (0.035) to 0.053% (0.031). A two-way analysis of variance (ANOVA) indicated that moisture did not cause significant adverse effects on the dimensional accuracy of any material (p > 0.05); however, significant differences were found between the materials (p < .05). The surface detail evaluation indicated that moisture had a significant effect on detail reproduction of PVS materials (Pearson's Chi square, p < 0.05). Under dry conditions, all materials produced satisfactory detail reproduction 100% of the time; however, under moist conditions, only 29% of Aquasil and Genie Ultra PVS impressions produced satisfactory detail reproduction, while 100% of Permadyne Garant and Impregum Penta Soft PE impressions still met the surface detail criteria. CONCLUSIONS: Although moisture may not adversely affect the dimensional accuracy of either PE or hydrophilic PVS material, the evidence suggests that PE material is more likely to produce impressions with superior detail reproduction in the presence of moisture.

Analysis of Variance↗
PubMed1991

Accuracy of rhythm classification using a data log system in implantable cardioverter defibrillators.

Because the presence or absence of symptoms alone may be insufficient to correctly diagnose the rhythm for which implantable cardioverter defibrillator therapy is delivered, we hypothesized that the addition of data log information available in Telectronics ATP 4210 may improve the accuracy of rhythm classification. With this system the recorded ventricular electrogram cycle length is reported on a beat-to-beat basis immediately before, during, and after the tachyarrhythmia is detected. Using this information recorded from the data log in 32 separate tachyarrhythmia episodes in 20 patients, we compared the sensitivity, specificity, and predictive accuracy of rhythm classification on the basis of symptoms alone, data log alone, and data log combined with symptoms. While classification based on symptoms alone is highly specific (10/10 episodes), it is insensitive and has an overall predictive accuracy of 53%. By contrast, data log is sensitive (90%) and specific (91%) with better predictive accuracy (94%) than symptoms alone (P = 0.002). The addition of symptoms to information on beat-to-beat cycle length from data log resulted in a slight increase in predictive accuracy.

Data Collection↗
PubMed1999

Comparison of Three Different Protocols for Dobutamine Stress Echocardiography: Does the Addition of Atropine Increase Complications, and Does It Improve Diagnostic Accuracy?

The addition of atropine during dobutamine stress echocardiography (DSE) is increasingly used for detecting coronary artery disease (CAD), but its safety and whether it has added diagnostic accuracy have not been well defined. The aim of this study was to retrospectively compare the complication rate and diagnostic accuracy of three different protocols in the same laboratory. DSE was performed in 1090 patients over a 5-year period. The protocol had included (1) 5' stages up to 30 µg/kg/min of dobutamine in the first 184 patients, (2) 3' stages up to 40 µg/kg/min in the next 274 patients, and (3) 3' stages up to 40 µg/kg/min with atropine, when required in the last 632 patients. A large number of patients (n = 938) underwent coronary angiography within 2 weeks, and 524 patients had a significant coronary stenosis (> 50%). In the whole group of 1090 patients, serious complications developed in 5 patients (one acute myocardial infarction, one sustained ventricular tachycardia, and three prolonged ischemia). Although the incidence was low, there were no detectable differences between protocols. Hypotension, which was defined as a >/= 20 mmHg decrease in systolic blood pressure from the baseline, was observed in 68 patients. Premature ventricular contraction was the most common arrhythmia. The complication rate was similar among three protocols. The diagnostic accuracy for detecting CAD was nearly the same among three protocols (30 µg, 86%; 40 µg, 84%; and 40 µg with atropine, 84%), but the prevalence of CAD was higher with the 30-µg protocol (65%) than the 40-µg protocol (55%) or 40-µg-with-atropine protocol (53%, P < 0.01). In 469 patients without a previous myocardial infarction, the prevalence of CAD was the same (38-42%). Sensitivity increased with more aggressive protocols (71%, 76%, and 84%). However, it was associated with the loss of specificity (92%, 92%, and 85%). Thus, the diagnostic accuracy was similar among groups (84%, 85%, and 84%). In conclusion, the addition of atropine during DSE does not increase the rate of complication compared with previous conservative protocols and shows the same diagnostic accuracy with a small increase in sensitivity at the cost of a small and matched decrease in specificity.

Journal Article↗
PubMed2004

Prospective, blinded assessment of factors influencing the accuracy of biliary cytology interpretation.

OBJECTIVES: There is little published data assessing factors that influence the accuracy of biliary cytology. The aim of this study was to (a) prospectively compare interobserver variability among two blinded pathologists interpreting biliary cytology specimens, (b) to describe the predictors of interpathologist agreement, and (c) to characterize the predictors of accurate cytology interpretation. METHODS: In total, 113 consecutive patients undergoing endoscopic retrograde cholangiopancreatography with brushing of suspicious biliary tract strictures were prospectively enrolled to assess routine cytology (RC) accuracy. The initial RC interpretation was performed by the pathologist on duty with the benefit of the patient's clinical information. Subsequent interpretation was performed by two independent pathologists blinded to the patients' clinical details. RESULTS: Of the 113 patients, 67 had malignant strictures and 46 had benign strictures. The sensitivity of RC varied from 9% to 24% (p= 0.02), while the specificity varied from 61% to 100% (p < 0.001). Accuracy varied from 43% to 51% (p= n.s.). The rate of equivocal readings was lowest for the initial interpretation (1.7%), p < 0.0001 versus pathologist 1, p= 0.002 versus pathologist 2. Overall correlation of the blinded pathologists' interpretations was moderate, k= 0.66. Neither cytology accuracy nor interpathologist agreement improved with increasing specimen cellularity. CONCLUSIONS: There is a high rate of interpathologist variation for the biliary cytology interpretation. The knowledge of the patient's clinical information appears to clarify cytology interpretation resulting in fewer equivocal results. We did not detect any reliable predictors of cytology accuracy.

Bile Duct Neoplasms↗
PubMed1997

In vitro accuracy and reproducibility of automated and conventional periodontal probes.

The aim of this study was to investigate the accuracy and reproducibility of experienced and inexperienced examiners using 3 automated periodontal probes (Florida Pocket Probe, Florida Disk Probe, Peri Probe) in comparison with 3 conventional periodontal probes (Marquis, Williams and EN-15 probes). Test blocks of aluminium had 30 holes of diameter 1.10 mm and depths ranging from 2.75 to 10.0 mm. machined with a tolerance of +/- 0.01 mm. 8 experienced examiners and 8 inexperienced examiners were selected to perform duplicate measurements on the blocks over 6 visits using each of the 6 probes. 1 automated and 1 conventional probe were used at each examination. The % accuracy and reproducibility for each of the duplicate measurements was calculated and analysed using Friedman 2-way analysis of variance and the Wilcoxon matched pairs test. On average, all probes showed high reproducibility, with the Florida Disk Probe, the Florida Pocket Probe and the Williams probe ranked best and the other 3 probes were less reproducible. On average, all probes showed a high degree of accuracy, automated probes were ranked best and were significantly better than conventional probes. Experience had little effect on reproducibility, with only the Peri Probe showing significant differences at the 5% level between the groups. Experience appeared to be more important for accuracy, as experienced examiners were more accurate than inexperienced examiners, with significant differences at the 5% level for the EN-15, Florida Disk Probe and Peri Probe. However, inexperienced examiners were significantly more accurate using the Williams probe. This in vitro study has shown that automated probes offer increased accuracy over conventional probes and the Florida Pocket and disk probes compare well with conventional probes for reproducibility.

Adult↗
PubMedDate not supplied

Accuracy of survey radiographic diagnosis of intervertebral disc protrusion in dogs.

To assess the diagnostic accuracy of survey radiography for canine thoracolumbar intervertebral disc protrusion, survey radiographs (lateral and ventrodorsal) of 64 dogs with surgically-confirmed thoracolumbar intervertebral disc protrusion, 51 dogs with negative myelograms and 29 dogs with various spinal conditions other than disc protrusion were reviewed by three independent observers who were unaware of any clinical information. There were marked differences in observer performance for diagnosis of intervertebral disc protrusion, although there were no significant differences in intraobserver diagnostic accuracy for small vs. large dogs. Accuracy of observers for determining sites of intervertebral disc protrusion using survey radiography was in the range 51-61%. All observers had low accuracy for identification of second sites of intervertebral disc protrusion. The most useful radiographic sign, narrowed intervertebral space, had only moderate sensitivity (range 64-69%) and moderate predictive value (range 63-71%) for intervertebral disc protrusion. Vacuum phenomenon was an infrequent but accurate sign of intervertebral disc protrusion. Recognition of multiple radiographic signs of intervertebral disc protrusion at one site was associated with increased accuracy of diagnosis. No observer was accurate enough to justify attempting targeted surgical treatment of intervertebral disc protrusion without myelography.

Animals↗