Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “diagnostics”

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 73 records · Page 4Linked to original sources
PubMed2005

Diagnostic and prognostic utility of an inexpensive rapid on site malaria diagnostic test (ParaHIT f) among ethnic tribal population in areas of high, low and no transmission in central India.

BACKGROUND: Malaria presents a diagnostic challenge in most tropical countries. Rapid detection of the malaria parasite and early treatment of infection still remain the most important goals of disease management. Therefore, performance characteristics of the new indigenous ParaHIT f test (Span diagnostic Ltd, Surat, India) was determined among ethnic tribal population in four districts of different transmission potential in central India to assess whether this rapid diagnostic test (RDT) could be widely applied as a diagnostic tool to control malaria. Beyond diagnosis, the logical utilization of RDTs is to monitor treatment outcome. METHODS: A finger prick blood sample was collected from each clinically suspected case of malaria to prepare blood smear and for testing with the RDT after taking informed consent. The blood smears were read by an experienced technician blinded to the RDT results and clinical status of the subjects. The figures for specificity, sensitivity, accuracy and predictive values were calculated using microscopy as gold standard. RESULTS: The prevalence of malaria infection estimated by RDT in parallel with microscopy provide evidence of the type of high, low or no transmission in the study area. Analysis revealed (pooled data of all four epidemiological settings) that overall sensitivity, specificity and accuracy of the RDT were >90% in areas of different endemicity. While, RDT is useful to confirm the diagnosis of new symptomatic cases of suspected P. falciparum infection, the persistence of parasite antigen leading to false positives even after clearance of asexual parasitaemia has limited its utility as a prognostic tool. CONCLUSION: The study showed that the ParaHIT f test was easy to use, reliable and cheap. Thus this RDT is an appropriate test for the use in the field by paramedical staff when laboratory facilities are not available and thus likely to contribute greatly to an effective control of malaria in resource poor countries.

Adult↗
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↗
PubMed1997

[The Diagnostic Compass; a new contribution to diagnostics].

The Hospital Council has now issued a Diagnostic Compass besides the Pharmacotherapeutic Compass. Its objective is to contribute to a more rational and effective use of diagnostic examinations. The target group comprises physicians involved in using diagnostic tests. The information supplied is based on results of scientific research and don current habits, standards and guidelines. The book has two different approaches: clinical pictures and diagnostic tests. The two volumes are intended to supplement one another.

Diagnostic Techniques and Procedures↗
PubMed1998

Diagnostic accuracy of organ electrodermal diagnostics. A pilot study.

OBJECTIVE: To estimate the diagnostic accuracy as well as the scope of utilisation of a new bio-electronic method of organ diagnostics. DESIGN: Double-blind comparative study of the diagnostic results obtained by means of organ electrodermal diagnostics (OED) and clinical diagnoses, as a criterion standard. SETTING: Department of Surgery, Helen Joseph Hospital, Johannesburg. PATIENTS: 70 pre-selected inpatients of mean age 36 (SD = 7) years with suspected pathology of one (or more) of the following organs: oesophagus, stomach, duodenum, biliary tract, pancreas, colon, kidneys and urinary tract. In total, 276 of the abovementioned internal organs were selected for statistical consideration. MAIN OUTCOME MEASURES: The difference between the so-called basic electrical impedance of the skin and the impedance value established for a particular organ projection area (the skin zone corresponding to a particular internal organ). RESULTS: In total 250 true OED results were obtained from the 276 subjects considered: detection rate 90.6% (95% CI 87.1-94.1%). Established OED sensitivity was 91.8% (95% CI 88.6-95.0%) and OED specificity equalled 89.9% (95% CI 86.4-93.4%). The predictive value for positive OED results was 83.3% (95% CI 78.9-87.7%) and for negative OED results 95.2% (95% CI 92.0-98.4%). The OED results were affected neither by the type nor the aetiology of disease, i.e. OED estimates the actual extent of the pathological process within particular organs but does not explain the cause of pathology directly. No side-effects of the OED examinations were observed. CONCLUSIONS: So-called organ projection areas do exist on the skin surface. The electrical impedance of the projection areas corresponding to diseased organs is increased, relative to that of healthy organ-related skin zones. The difference in impedance is proportional to the intensity of the pathological process. OED, which utilises these electrical phenomena of the skin, may detect diseased organs and estimate the extent of pathological process activity within these organs.

Adult↗
PubMed2005

Aging-related diagnostic variations: need for diagnostic criteria appropriate for elderly psychiatric patients.

It is commonly thought and taught that most psychiatric disorders other than dementia are much less prevalent among the elderly than among younger adults. This perception is based on a relatively small number of published epidemiologic investigations of the incidence and prevalence of mental illnesses in elderly populations. Most of these studies have had a number of methodologic problems, including improper definitions and diagnostic criteria for older persons. A likely consequence of these misconceptions is that clinically significant and potentially treatable mental illnesses might be overlooked, misdiagnosed, and mistreated in elderly patients. Studies in community samples suggest that many older adults who experience clinically significant psychopathology do not fit easily into our existing nomenclature, and yet are disabled. There is a need to develop aging-appropriate diagnostic criteria for major psychiatric disorders. In this article, we discuss the potential causes of this diagnostic confusion. Four specific classes of disorders-mood (specifically depressive) disorders, schizophrenia (and related psychotic disorders), anxiety disorders, and substance use disorders-are discussed as examples. Finally, we suggest some future steps for clarifying this diagnostic confusion.

Age of Onset↗
PubMed2005

[Can US-guided vacuum-assisted biopsies be an alternative to diagnostic surgery in cases of non-diagnostic core needle biopsy?].

PURPOSE: To assess US-guided vacuum-assisted biopsies in the diagnosis of suspicious sonographic breast lesions after non-diagnostic core needle biopsies (CNB). PATIENTS AND METHODS: Retrospective study of 42 females with suspicious breast lesions at US. CNB previously performed were non-diagnostic. Because of the larger sample size, vacuum-assisted biopsies were performed, instead of surgical biopsy. RESULTS: Vacuum-assisted biopsies showed 32 benign lesions. Histologic examination of the CNB showed non-specific fibrous tissue in 43% of cases as opposed to 7.1% for vacuum-assisted biopsies. The latter provided a more specific diagnosis (mainly fibrocystic breast disease). From a total of 4 lesions that were suspicious at CNB, 3 were diagnosed as malignancies after vacuum-assisted biopsy and one case was a "borderline" lesion. Three additional malignant and three additional borderline lesions were diagnosed on vacuum-assisted biopsies. In 11 cases, surgical excision was performed, and all diagnoses from vacuum-assisted biopsies were confirmed at microscopy, except in one case where it was underestimated (ADH versus DCIS). CONCLUSION: US-guided vacuum-assisted biopsy is a reliable technique. Because it provides more tissue than CNB, it can be an alternative to diagnostic surgery after non-diagnostic CNB. Indeed, it allows confirmation of the diagnosis and provides a more specific diagnosis of benign lesions. With regards to malignant and borderline lesions, it avoids the risk of false-negative CNB and overlooking carcinomas.

Adult↗
PubMed2002

Feasibility and diagnostic impact of fluorescence-based diagnostic laparoscopy in hepatocellular carcinoma: a case report.

Fluorescence-based diagnostic techniques are an evolving field in the staging of hepatologic and gastroenterologic malignancies. The method aims at improved accuracy in the detection of locoregional and distant metastases. In hepatocellular carcinoma, detection of metastases is of utmost importance, because advanced tumors preclude curative surgical therapy. We present here our first experience of fluorescence-based diagnostic laparoscopy in a patient with hepatocellular carcinoma. We performed diagnostic laparoscopy in a 76-year-old woman who presented with a tumor of the liver and increased serum levels of alpha-fetoprotein. For photosensitization, 5-aminolevulinic acid (20 mg/kg bodyweight, p.o.) was used 6 hours prior to laparoscopy, which was performed with a prograde 0 degree telescope suitable for fluorescence-based laparoscopy. The D-Light AF system was used as a light source. Laparoscopy was carried out according to common guidelines in the white-light as in the blue-light mode. The main tumor and the satellite metastases clearly showed intense fluorescence compared with unaffected liver parenchyma and other abdominal organs. Fluorescence-based laparoscopy identified several small metastases which had been missed during conventional white-light illumination. Hepatocellular carcinoma was confirmed by the histological examination of several biopsies drawn from suspicious areas. Fluorescence-based laparoscopy provided additional information in the staging of hepatocellular carcinoma. The technique can further improve diagnostic accuracy in the staging of hepatocellular carcinoma, particularly in patients potentially suitable for partial liver resection or transplantation.

Aged↗
PubMed2004

Clinical diagnostic accuracy of otitis media with effusion in children, and significance of myringotomy: diagnostic or therapeutic?

The specific aims of this prospective survey were to determine the accuracy of traditional diagnostic tools, such as pneumatic otoscopy, otomicroscopy, and tympanometry, and evaluate the usefulness of myringotomy as a diagnostic method; also to determine the significance of myringotomy in treating otitis media with effusion (OME). The status of middle ear of 51 children (85 ears) from November 2002 to February 2003 was examined using pneumatic otoscopy, otomicroscopy, and tympanometry, and the presence/absence of middle ear effusion was confirmed by myringotomy. The otomicroscopy was the most sensitive and specific one among three diagnostic tools. But, it had some false positive cases. This study failed to show the therapeutic efficacy of myringotomy. Otomicroscopy seems to have the potential to become the standard for diagnosis of OME and for validation of pneumatic otoscopy in children. However, when otoscopic, otomicroscopic findings and tympanogram of suspected ear show poor correlation, myringotomy can be used to confirm the presence of OME, as the diagnostic modality. As the therapeutic modality, we think that it is proper to limit indications of myringotomy to some selected cases.

Child↗
PubMed2002

Dementia: predictors of diagnostic accuracy and the contribution of diagnostic recommendations.

OBJECTIVES: To explore and quantify the relative contribution of guideline recommendations and other determinants in the family physicianamprsquos diagnostic work-up of patients suspected of dementia. STUDY DESIGN: We prospectively studied 64 family physicians in an Eastern district in the Netherlands who diagnosed dementia according to the national Dutch guidelines in primary care. Their diagnoses were compared with the reference standard embodied by the memory clinic team of the University Medical Center Nijmegen. POPULATION: The physicians evaluated 107 patients older than 55 years suspected of having dementia. OUTCOMES MEASURED: Predictive values of various clinical and demographic parameters were measured in both univariate and multivariate logistic regression analyses. RESULTS: Activities of daily living (ADL) dependency (odds ratio [OR] = 5.3, P =.03), years since symptoms first started (OR = 1.84, P =.03), and the presence of somatic comorbidity (OR = 0.48, P =.02) independently contributed to the prediction of the presence or absence of dementia. The area under the receiver-operating characteristic (ROC) curve for these 3 variables together was 0.79. The ROC area of the family physiciansamprsquo diagnosis to determine the final diagnosis was 0.74. The number of recommendations applied did not additionally contribute to the assessment of the final diagnosis. CONCLUSIONS: The diagnostic accuracy of the family physician was reasonable. For family physicians, ADL dependency is a better predictor of dementia than cognitive impairment. Family physicians should be aware of diagnostic difficulties in patients with somatic comorbidity. We were unable to confirm the diagnostic value of many of the recommendations of dementia guidelines.

Activities of Daily Living↗
PubMed1989

Effect of a computer-assisted general medicine diagnostic consultation service on housestaff diagnostic strategy.

Quick Medical Reference (QMR) is a microcomputer-based decision support system designed to provide diagnostic assistance in the field of internal medicine. In addition to providing plausible diagnostic hypotheses based upon patient specific findings, the program highlights history, physical and laboratory items which are potentially useful in discriminating among the diagnoses under consideration. We have evaluated the impact of a computer-assisted diagnostic consultation service on the diagnostic and management strategy of a housestaff in a university internal medicine training program. Differential diagnoses were obtained before and after the use of the program, and a questionnaire was used to assess the educational value of the service and the effect of the service on the diagnosis and planned management. Over an eight week period, 31 cases were identified which met inclusion criteria. The QMR consultation added a diagnosis to the original list in 14 out of 31 cases. The consultation reordered the diagnosis in an additional 7 cases, and in 8 cases a diagnosis was ruled out by the use of the program. After the use of the program the housestaff reported they would obtain an additional lab test in 10 cases, change the order of planned tests in two cases and eliminate a lab test in one case. The use of the program was rated as helpful educationally in 81% of the cases, and helpful with respect to management in also 81% of the cases.

Diagnosis, Computer-Assisted↗
PubMed1998

Regression modelling of diagnostic likelihood ratios for the evaluation of medical diagnostic tests.

The use of diagnostic likelihood ratios has been advocated in the epidemiologic literature for the past decade. Diagnostic likelihood ratios provide valuable information about the predictive properties of a diagnostic test while having the attractive feature of being independent of the prevalence of disease in the study population. We propose a new regression method that allows for direct assessment of covariate effects on likelihood ratios for binary diagnostic tests. This may be particularly useful in assessing how factors that are under the control of the clinician can be altered to maximize the predictive ability of the test. Similarly, patient characteristics that influence the ability of the test to discriminate between diseased and nondiseased subjects may be identified using the regression model. The regression method is flexible in that it can accommodate clustered data arising from a variety of study designs. We illustrate the method with data from an audiology study.

Audiology↗
PubMed1998

[R. N. Braun diagnostic programs: what prevents the general practitioner from using them? Results of a 1-year-study of indications, acceptance and failure to apply diagnostic programs].

In General Practice, a global measure for quality control has not yet been established. Procedures in this field of health care are usually not evidence based but rely on personal experience. In 1976, the "Diagnostic Protocols" (DP) had been introduced by Robert N. Braun to cover the most frequent and most important uncharacteristic complaints presented to the General Practitioner by the patient. In this study, the authors are showing how often the usage of DP may be useful in the management of cases in General Practice. Additionally, reasons are demonstrated that may lead the Family Physician not to apply DP in certain cases. In 2,084 new cases presented to a General Practitioner within one year (1-12/1994), 19 of 82 existing protocols were used. In every sixth new case (16%), the patient's history and physical examination were analyzed with the help of Diagnostic Protocols. However, their usage would have been beneficial in one of four cases (24.6%). Reasons for declining DP included "No need for further diagnostic investigation" and "Other diagnostic strategy chosen". Shortness of time only played a minor role.

Attitude of Health Personnel↗
PubMed1999

Cobalamin deficiency in general practice. Assessment of the diagnostic utility and cost-benefit analysis of methylmalonic acid determination in relation to current diagnostic strategies.

Diagnosing cobalamin deficiency is often difficult. We investigated the diagnostic strategies that 224 general practitioners used to assess cobalamin status and the criteria on which they based their decisions to supplement patients. From all serum cobalamin analyses carried out at a single laboratory during 1993, individuals with serum cobalamin concentrations <300 pmol/L were identified, and one patient per general practitioner was included. When serum methylmalonic acid (s-MMA) values >0.376 micromol/L were used as the "reference standard" for cobalamin deficiency, the serum cobalamin assay had a diagnostic sensitivity of 0.40 and a specificity of 0.98. With the same reference standard, the diagnostic accuracy of the physicians' decision to supplement patients had the same specificity but a higher sensitivity (0.51). Cost-benefit analysis indicated that measurement of s-MMA can be recommended in patients with serum cobalamin >60-90 pmol/L and <200-220 pmol/L, depending on its diagnostic accuracy.

Adolescent↗
PubMed2026

Molecular Diagnostics for WHO Priority Bacterial Pathogens: A Bibliometric Mapping of Diagnostic Platforms, Resistance Markers, and Antimicrobial Resistance Research Trends.

Antimicrobial resistance (AMR) constrains effective treatment and carries implications for infection control, surveillance, and public health. The World Health Organization (WHO) priority bacterial pathogen framework has intensified the need for diagnostic innovation by redefining research priorities around organisms combining high disease burden with complex resistance profiles. Molecular diagnostics have accordingly moved beyond culture-based workflows, integrating rapid pathogen identification, resistance-marker detection, genomic surveillance, and clinical decision support. The present study conducted a bibliometric mapping of the literature on WHO priority pathogens. Rather than addressing resistance at a general level or a single pathogen or technology, it integrates priority pathogens, molecular platforms, and resistance markers within a single framework, tracing their joint thematic and temporal evolution along an explicit pathogen-platform-marker axis. Scopus-indexed articles and reviews (2000-2025) were retrieved, yielding 1746 publications after screening adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Analyses used Bibliometrix/Biblioshiny, R, and VOSviewer. The literature expanded markedly after 2018, led by China and the United States. Methicillin-resistant Staphylococcus aureus (MRSA), Mycobacterium tuberculosis, Enterococcus faecium, and the Enterobacterales-carbapenemase axis constituted the principal thematic cores, whereas conventional polymerase chain reaction (PCR)/nucleic acid amplification testing (NAAT) and whole-genome sequencing were the dominant platforms. Overall, the field has evolved from pathogen detection into an AMR-centered translational domain encompassing resistance prediction, genomic epidemiology, surveillance, and clinical decision support. Diagnostic development, stewardship, and surveillance depend on hybrid workflows coupling rapid marker-targeted assays with genome-based characterization, delivering actionable resistance within clinically meaningful timeframes, and extending coverage to underrepresented pathogens and platforms.

Humans↗
PubMed2006

Cost-effectiveness of diagnostic tests for toenail onychomycosis: a repeated-measure, single-blinded, cross-sectional evaluation of 7 diagnostic tests.

OBJECTIVE: Our purpose was to estimate and compare the cost-effectiveness of the most commonly used diagnostic tests for onychomycosis: potassium hydroxide preparation (KOH), interpreted both by a dermatologist (KOH-CLINIC) and a laboratory technician (KOH-LAB); KOH with dimethyl sulfoxide (KOH-DMSO) and with chlorazol black E (KOH-CBE), interpreted by a dermatologist; culture using dermatophyte test medium, culture with Mycobiotic and Inhibitory Mold Agar (Cx); and histopathologic analysis using periodic acid-Schiff stain (PAS). METHODS: This was a repeated-measure, blinded, cross-sectional study conducted at the Minneapolis Veterans Affairs Medical Center. Inclusion criteria included: at least one toenail with 25% or more clinical disease, which was defined as subungual debris with onycholysis and/or onychauxis. Exclusion criteria included other nail dystrophies, use of oral antifungal medication for 2 months or longer within the past year, or topical ciclopirox lacquer within 6 weeks of enrollment. The main outcome measure was the cost-effectiveness (Medicare and non-Medicare costs) of 7 diagnostic tests. Sensitivity (at least 3 positive tests) was the unit of effectiveness. RESULTS: Two hundred four participants were enrolled; their average age was 69.5 years and 95.5% were male. PAS was the most sensitive test (98.8%); it was statistically significantly more sensitive than all other diagnostic tests except KOH-CBE (94.3%). Dermatophye test medium was the least sensitive test (57.3%). KOH-CBE was statistically significantly more cost effective than any other test, with the exception of KOH-CLINIC and KOH-LAB. PAS was the least cost effective. LIMITATIONS: Test specificities were not evaluated. CONCLUSION: KOH-CBE should be the test of choice for practitioners confident in interpreting KOH preparations because of its combination of high sensitivity and cost-effectiveness.

Aged↗
PubMed1998

Wrist arthrography after acute trauma to the distal radius: diagnostic accuracy, technique, and sources of diagnostic errors.

RATIONALE AND OBJECTIVES: The objective of this investigation was to determine the diagnostic accuracy of wrist arthrography in the detection of interosseous ligament disruptions and of triangular fibrocartilage complex (TFCC) lesions in patients after acute wrist trauma and to define the sources of diagnostic error of wrist arthrography after recent trauma. METHODS: Twenty-two patients with radial fractures after acute wrist trauma underwent arthrography and arthroscopy of the wrist. Arthrography was performed in a standardized manner by two- or three-compartment injection technique. Subsequently wrist arthroscopy was performed within the same session. Image analysis included the evaluation of interosseous carpal ligaments, the TFCC, and the osseous structures. RESULTS: In 22 patients, 11 injuries of the intrinsic ligaments and the TFCC were diagnosed by arthroscopy, of which 9 had been diagnosed correctly with arthrography before surgery. One scaphoid fracture previously missed on conventional radiographs also could be diagnosed by arthrography. CONCLUSION: Arthrography of the posttraumatic wrist is a valuable tool in the diagnostic evaluation of interosseous carpal ligaments and the TFCC.

Adult↗
PubMedDate not supplied

Mutually exclusive versus co-occurring diagnostic categories: the challenge of diagnostic comorbidity.

Diagnostic comorbidity is the rule rather than the exception in both DSM-IV and ICD-10. Three types of comorbidity include true comorbidity (clinically distinct entities), artifactual comorbidity (a byproduct of the DSM/ICD strategy to split categorical diagnoses) and spurious comorbidity. DSM has established 'mutually exclusive' relationships between disorders to reduce such spurious comorbidity. Four types of mutually exclusive relationships are identified: (1) between disorders that are on different levels of the Kraepelinian-defined hierarchy (e.g., schizophrenia and major depressive disorder); (2) between categories with identical features that are split according to age or duration (schizophrenia and schizophreniform disorder); (3) between categories in which the defining features of one disorder are contained in the definition of more broadly-defined disorder (Asperger's disorder and autistic disorder), and (4) between categories in which the defining features of one disorder are an associated feature of another disorder (e.g., dysthymic disorder and schizophrenia). Although less comorbidity may be desirable to reduce diagnostic complexity, in the absence of knowledge about underlying pathophysiology, the trend in successive editions of the DSM has been to reduce diagnostic hierarchies and increase comorbidity (e.g., elimination of exclusion between panic disorder and major depression in DSM-III-R because of evidence of independence). It is important to understand that comorbidity in psychiatry does not imply the presence of multiple diseases or dysfunctions but rather reflects our current inability to apply Occam's razor (i.e., a single diagnosis to account for all symptoms).

Comorbidity↗
PubMed1996

[Detection of specific toxoplasma class A antibodies: a comparison of diagnostic usefulness of commercially available diagnostic kits].

Diagnostic significance of the presence of specific anti-Toxoplasma gondii IgA antibodies was discussed with particular reference to the cases of congenital toxoplasmosis and infections in pregnant women. Furthermore, the possibilities of testing for anti-Toxoplasma IgA antibodies with commercially available diagnostic kits were presented. From amongst the examined 5 diagnostic kits, Platelia Toxo IgA and ISAGA Plus IgA/IgM showed the highest sensitivity and specificity.

Animals↗