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At least 829 records · Page 46Linked to original sources
PubMed1997

Determination of glomerular filtration rate using technetium-99m-DTPA with differing degrees of renal function.

UNLABELLED: Glomerular filtration rate (GFR) is an important index of renal function. Twenty-four-hour creatinine clearance overestimates GFR in patients with poor renal function. Inulin and iothalamate clearances are accepted reference standards for determining GFR but are expensive and laborious. We have previously reported that GFRs obtained by measuring the disappearance of 99mTc-DTPA from ultrafiltered (protein-free) samples of plasma were virtually identical to those obtained by the iothalamate method. However, the subjects used in that study had normal to only moderately decreased renal function. METHODS: The accuracy of measuring GFR by plasma clearance of 99mTc-DTPA was determined in subjects where renal function varied from normal to severely impaired. In all subjects, GFR was established by clearance of 125I-iothalamate from urine and serum and was used as the standard of reference. RESULTS: For subjects with normal to moderately diminished renal function (GFR > 20 ml/min), the correlation between values of GFR obtained by the DTPA and iothalamate methods was high (n = 18, r = 0.966). The difference between the pairs of GFR values obtained by the two methods was not statistically significant (p > 0.1). In patients with severe renal insufficiency (GFR < 20 ml/min), the correlation between the DTPA and iothalamate methods was poor (n = 11, r = 0.236), and the GFR values obtained by the two methods were statistically different (p < 0.01). CONCLUSION: These results suggest that GFR can be determined accurately by plasma clearance of 99mTc-DTPA in all patients except those with severe renal insufficiency.

Adult↗
PubMedDate not supplied

Determination of total fat in foods and feeds by the caviezel method, based on a gas chromatographic technique.

This peer-verified method specifies a fast, easy, and reliable quantitative method to determine total fat in foods and feeds in compliance with the new definition of fat from the U.S. Food and Drug Administration. The method takes into consideration all fatty acids, from C4 to C24, and when fat is present at 0.3-100%. The validation study included 9 matrixes, with fat levels ranging from 1 to 79%. Sample and internal standard (IS; tridecanoic acid) are added to solvent (n-butyl alcohol). Fat is extracted and simultaneously saponified by potassium hydroxide. The fatty acid potassium salts are converted to fatty acids by adding an acidic aqueous salt solution, which produces a 2-phase system. The upper phase, containing the fatty acids and IS, is injected into the fat determination system. After gas chromatographic separation, the fat content is calculated from IS and fatty acid peak areas. The fat content is automatically converted to triglyceride content with a pre-determined factor. Ten replicates of 9 different food samples, which cover the whole range of different contents in fat, proteins, and carbohydrates, were analyzed by the submitting and the peer laboratories. Repeatability relative standard deviation (RSDr) values ranged from 0.47 to 4.62%. Reproducibility relative standard deviation (RSDR) values ranged from 0.85 to 9.52%. These estimates include between-run variability. The method shows good accuracy. Values for standard reference materials (SRMs) are in agreement with certified values. Regression analysis of the correlation between observed fat and certified value over all matrixes and fat levels indicated good precision and absence of method bias (5 SRMs; 1-30% fat; correlation coefficient, R2 = 99.98%).

Animal Feed↗
PubMedDate not supplied

Determination of calcium by inductively coupled plasma-atomic emission spectrometry, and lead by graphite furnace atomic absorption spectrometry, in calcium supplements after microwave dissolution or dry-ash digestion: method trial.

A 3-laboratory method trial was conducted to evaluate 2 sample digestion procedures and instrumental determination parameters for analysis of calcium and lead in Ca supplements. Calcium supplements were treated by dry-ash digestion or microwave dissolution prior to spectrometric analysis. In each case, Pb was determined by graphite furnace atomic absorption spectrometry and Ca by inductively coupled plasma-atomic emission spectrometry. Blind duplicates of 6 Ca supplement samples were analyzed after each sample treatment procedure. Matrix pairs contained dissimilar Pb levels to cover the analyte range encountered during method development. Calcium content of the Ca supplement samples also reflected the range seen during method development. Stock solutions of Ca and Pb were supplied to collaborators for preparation of quantitation standards to remove a variable external to the method. National Institute of Standards and Technology Standard Reference Material (NIST SRM) 1486, bone meal, was included to assess method accuracy and recovery at NIST certificate Ca and Pb levels for this material (26.58 +/- 0.24% Ca and 1.335 +/- 0.014 micrograms Pb/g). Analyses of the NIST SRM yielded 25.9 +/- 1.1 and 27.2 +/- 2.3% Ca and 1.53 +/- 0.19 and 1.26 +/- 0.19 micrograms Pb/g for dry-ash and microwave procedures, respectively. Statistical analyses of data indicated acceptable repeatability and reproducibility for determination of Pb and Ca in various Ca supplements. With either sample preparation technique, the method is appropriate for determining Pb or Ca in Ca supplements.

Biological Products↗
PubMed1999

An assessment of the Nam Pehchan computer program for the identification of names of south Asian ethnic origin.

BACKGROUND: An assessment was made of the usefulness and accuracy of a computer program for the identification of the south Asian population through the classification of names on a disease register. METHODS: The computer program, Nam Pehchan, was used to classify names as either south Asian or non south Asian. The results were compared with a reference standard, which combined use of the program with visual inspection. The latter was facilitated by a computer-generated dictionary of common non south Asian names. The data set consisted of 356,555 cases of incident cancer (ICD9: 140-208) registered between 1990 and 1992 by Thames, Trent, West Midlands and Yorkshire cancer registries. RESULTS: Nam Pehchan classified 5506 cases as south Asian. Visual inspection identified 2024 false positives (36.8 per cent of all cases identified as south Asian by Nam Pehchan) and 363 false negatives (9.5 per cent of those identified by the reference standard). Compared with the reference standard, Nam Pehchan had a sensitivity of 90.5 per cent and a positive predictive value of 63.2 per cent. CONCLUSION: The Nam Pehchan program quickly identified a high proportion of the names classified as south Asian by the reference standard, but the high false positive rate means that the program alone is not an adequate single strategy. The time-consuming process of inspection of program negatives for large data sets can be substantially reduced by comparison with dictionaries of common non south Asian names.

Asia↗
PubMed1989

Application of theoretical considerations to the analysis of ELISA data.

Solid-phase immunoassays such as the ELISA are in routine use in many areas of biological research. Data from these assays are analyzed in a variety of ways, frequently without taking into account the immunochemical principles of the assay. The Reference Standard Method is often used and is suitable and convenient for obtaining concentration (or activity) values from the antigen-specific ELISA or spRIA, sandwich assays, and inhibition assays. The standard curve required for this method may be obtained by simple linear regression analysis of logarithmic or logitlogarithmic transformed data obtained from titration of the reference standard. The shape of the logarithmic plot of the reference standard provides information on the performance of the assay. Examining data from multiple dilutions of the samples is essential to assure that each titrates with the same slope as does the reference standard; the analysis routine must permit this comparison to be made. ELISANALYSIS is a program for the IBM PC which was developed to perform such analyses. It is presented here as a model, with sufficient information provided for the development of similar analytical routines by interested users. This approach to ELISA data analysis is presented as an alternative to complicated empirical curve-fitting systems and simple endpoint methods, which can be immunochemically misleading or, in some cases, even invalid. The consistent use of the described routines would encourage greater uniformity in the means of data interpretation and thereby enhance our understanding of immunobiology.

Algorithms↗
PubMed2004

Validity of rim area measurements by different reference planes.

PURPOSE: Reference plane description of the neuroretinal rim in scanning laser tomography should correctly represent optic nerve morphology. We evaluated how well rim area analysis by different reference planes agreed with the appearance of rim area in disc images. METHODS: Three expert observers subjectively and repeatedly analyzed rim area in Heidelberg Retina Tomograph (HRT) images so that each optic disc was measured six times in 100 eyes, 50 normal and 50 glaucoma. Rim area was evaluated globally and in 30 degree sectors. Agreement between rim appearance, as subjectively analyzed, and objective analysis by an experimental reference plane, the standard reference plane, and a reference plane fixed 320 microm below the reference ring was assessed in HRT images. RESULTS: Subjective analysis of rim area in HRT images was consistent between expert observers. Their analysis of rim appearance agreed more closely with experimental reference plane analysis than analysis by the standard or 320-microm reference planes; this was true globally and in every region of the nerve (P = 0.000). The experimental reference plane yielded higher estimates of rim area than did the standard or 320-microm reference planes. CONCLUSION: There was closer correspondence between the appearance of the neuroretinal rim in images and description by the experimental reference plane compared with description by the standard and 320-microm reference planes.

Aged↗
PubMed2003

Laboratory evaluations of two toothbrushes for removal of artificial plaque above, around and below the gingival margin.

OBJECTIVE: Two toothbrushes were evaluated with a laboratory method for the ability to remove artificial plaque deposits around interproximal sites (interproximal access efficacy, IAE) at the gingival margin (gingival margin cleaning, GMC), and below simulated gingivae (subgingival access, SA) using clinical toothbrushing motions under wet brushing conditions. METHODOLOGY: The toothbrushes tested were Meridol or an ADA reference standard. The Meridol toothbrush has a flat profile and contains double-tapered filaments. The ADA reference standard also has a flat profile, with traditional end-rounded bristles. Both toothbrushes have a soft texture. Six toothbrushes of each design were evaluated four times for a total of 24 assessments. RESULTS: The Meridol toothbrush had significantly (p < 0.001) higher mean IAE, GMC and SA values compared to the ADA reference standard toothbrush tested. CONCLUSION: From these results, the Meridol toothbrush with tapered bristles is more likely to be effective in clinical studies on plaque removal compared to other manual toothbrushes with rounded bristles in a flat head design, that are similar to the ADA reference standard toothbrush.

Dental Plaque↗
PubMed1997

Polymerase chain reaction for Streptococcus pyogenes used to evaluate an optical immunoassay for the detection of group A streptococci in children with pharyngitis.

BACKGROUND: In evaluations of sensitive rapid tests for group A streptococci such as the optical immunoassay (OIA), some samples are positive by the antigen test but negative by culture. A method is needed for resolving these discrepant results. OBJECTIVE: To develop a PCR-based assay to detect group A streptococci and to use it to establish a reference standard for evaluating an OIA for group A streptococcal antigen. METHODS: A PCR assay that detects a segment of the MF gene of Streptococcus pyogenes was developed for the detection of group A streptococci in throat swabs. Paired swabs were obtained from 200 children with symptomatic pharyngitis and used to perform OIA, agar culture, broth-enhanced culture and PCR. As a reference standard any patient with group A streptococci detected by either culture or PCR was considered to be truly positive. RESULTS: In comparison to agar and broth-enhanced culture procedures, OIA had sensitivities of 82 and 80% and specificities of 87 and 89%, respectively. Eight (44%) of 18 samples that were positive by OIA but negative by culture were positive for group A streptococci by PCR. Compared with the reference standard, sensitivities were OIA 76%, agar culture 79%, broth-enhanced culture 86% and PCR 96%. The specificity of OIA was 92%. CONCLUSIONS: PCR can be used to establish a reference standard for evaluating rapid tests for group A streptococci. With this reference standard OIA was nearly as sensitive as but less specific than agar culture for detection of group A streptococci. Maximum detection requires use of both tests.

Antigens, Bacterial↗
PubMedDate not supplied

Accuracy of administrative data for identifying patients with pneumonia.

The goal of this study was to determine the accuracy and the impact of 5 different claims-based pneumonia definitions. Three International Classification of Diseases, Version 9, (ICD-9), and 2 diagnosis-related group (DRG)-based case identification algorithms were compared against an independent, clinical pneumonia reference standard. Among 10748 patients, 272 (2.5%) had pneumonia verified by the reference standard. The sensitivity of claims-based algorithms ranged from 47.8% to 66.2%. The positive predictive values ranged from 72.6% to 80.8%. Patient-related variables were not significantly different from the reference standard among the 3 ICD-9-based algorithms. DRG-based algorithms had significantly lower hospital admission rates (57% and 65% vs 73.2%), lower 30-day mortality (5.0% and 5.8% vs 10.7%), shorter length of stay (3.9 and 4.1 days vs 5.6 days), and lower costs (USD $4543 and USD $5159 vs USD $8585). Claims-based identification algorithms for defining pneumonia in administrative databases are imprecise. ICD-9-based algorithms did not influence patient variables in our population. Identifying pneumonia patients with DRG codes is significantly less precise.

Aged↗
PubMed2003

Sequence characterization of the protease and partial reverse transcriptase proteins of the NED panel, an international HIV type 1 subtype reference and standards panel.

The NED panel (NIH-ENVA-DOD) was assembled by the Virology Quality Assurance Laboratory for use as an international HIV-1 subtype reference and standards panel. The panel contains 44 minimally cultured strains from diverse geographic areas donated by the Walter Reed Army Institute of Research and F. Brun-Vezinet (Hôpital Bichat-Claude Bernard, Paris, France). The contributors assigned the strains to group M subtypes A (5), B (10), C (6), D (3), E (10), F (5), G (2), H (1), and O (2) before donation. Phylogenetic and recombination analyses of the protease gene and a partial sequence of the reverse transcriptase gene of each seed pool indicated potentially three more recombinants in the panel in addition to the two previously recognized recombinants. Alignments of the amino acids to corresponding regions of pNL4-3 showed protease amino acid sequence identity ranged from 68.5 % (group O) to 95.2 % (subtype B). Reverse transcriptase amino acid identity ranged from 84.5% (group O) to 96.8% (clade B). Codons associated with antiretroviral resistance were primarily wild type and highly conserved among all the clades.

Drug Resistance, Viral↗
PubMed2001

Comparison of magnetic resonance real-time imaging of left ventricular function with conventional magnetic resonance imaging and echocardiography.

This study analyzes the accuracy of a new real-time magnetic resonance imaging (MRI) technique (acquisition duration, 62 ms/image) and echocardiography for the determination of left ventricular (LV) end-diastolic volume, end-systolic volume, ejection fraction, and muscle mass when compared with turbo gradient echo imaging as the reference standard. Thirty-four patients were examined with digital echocardiography, standard, and real-time MRI. A close correlation was found between the results of real-time imaging and the reference standard for end-diastolic volume, end-systolic volume, and ejection fraction (r >0.95), with a lower correlation for LV muscle mass (r = 0.81). Correlations between echocardiography and the reference standard were lower for all parameters. Real-time MRI enables the acquisition of high-quality cine loops of the entire heart in minimal time without electrocardiographic triggering or breath holding. Thus, patient setup and scan time can be reduced considerably. Results are similar to the reference standard and superior to echocardiography for determining LV volumes and ejection fraction. This technique is a valid alternative to current approaches and can form the basis of every cardiac MRI examination.

Adult↗
PubMed2003

Accuracy of cervical transvaginal sonography in predicting preterm birth: a systematic review.

This review investigates the accuracy with which transvaginal cervical sonography predicts spontaneous preterm birth. Published studies were identified without language restrictions through nine different databases and manual searching of bibliographies of known primary and review articles. Studies were selected if they undertook antenatal transvaginal sonographic cervical assessment among a population of pregnant women with known gestational age of delivery. There were 46 primary articles, which included a total of 31,577 women, consisting of 33 studies in asymptomatic and 13 studies in symptomatic women. Data were extracted for the studies' characteristics and quality. Accuracy data were used to form 2 x 2 contingency tables for various cervical length measurements with birth before 32, 34 and 37 weeks' gestation as the reference standards. Data were stratified according to singleton or twin pregnancy, gestational age at testing, cervical length threshold, and the various reference standards, and were pooled to produce summary estimates of likelihood ratios (LRs). Our review showed that transvaginal cervical sonography identifies women who are at higher risk of spontaneous preterm birth, although there was a wide variation amongst studies with respect to gestational age at testing, definition of threshold of abnormality and definition of reference standard. The most commonly reported sub-group was testing of asymptomatic women at < 20 weeks' gestation using a threshold cervical length of 25 mm with spontaneous preterm birth before 34 weeks' gestation as the reference standard. The summary LR+ for this group was 6.29 (95% CI, 3.29-12.02), with corresponding LR- of 0.79 (95% CI, 0.65-0.95). Both cervical length measurement and funneling, whether alone or in combination, appear to be useful (depending on the threshold chosen to define the abnormality) in predicting spontaneous preterm birth in asymptomatic women. For symptomatic women there was a paucity of data, although the degree of funneling appeared to be predictive of spontaneous preterm birth.

Data Collection↗
PubMed1994

Determination of parallelism and nonparallelism in bioassay dilution curves.

There is a lack of consensus among investigators who use a variety of immunoassay techniques (e.g., enzyme-linked immunosorbent assay [ELISA] and radioimmunoassay) regarding the protocols for describing and forming standard reference or calibration curves and interpolating serum antibody concentrations. This confounds the issue of detecting the presence or absence of parallelism between standard reference serum and serially diluted serum sample curves. These curves must be parallel to support the assumption that the antibody-binding characteristics are similar enough to allow the determination of antibody levels in the diluted serum sample. There is no universal and widely adopted strategy for assessing parallelism in bioassays, and without an assurance of parallelism, investigators are not able to calculate reliable estimates for antibody concentrations in serum samples. Furthermore, single-point (dilution) serum assays do not provide information related to parallelism and nonparallelism, and this, too, may lead to considerable error when calculating antibody concentrations. When assay methodology, technique, and precision improve to the extent that standard reference serum and serially diluted serum sample curves are fit with little error, standard analysis of variance techniques are overly sensitive to negligible departures from parallelism. We present a series of guidelines that compose a protocol for assessing parallelism between bioassay dilution curves that are applicable to data derived from ELISAs. These criteria should be applicable, with minor modifications, to most immunoassay experimental situations and, most importantly, are not dependent on the mathematical model used to form the standard reference curve. These guidelines have evolved in our laboratories over the past 4 years during the performance of thousands of ELISAs for antibodies to the capsular polysaccharides of Neisseria meningitidis groups A and C and Haemophilus influenzae type b.

Analysis of Variance↗
PubMed1997

Standardization of Lp(a) measurements.

The standardization of immunoassays for Lp(a) is a major challenge to clinical chemists. In order to establish a reference material acknowledged by the International Federation of Clinical Chemistry, the Center of Disease Control and possibly the World Health Organization, a working group with participants from four continents was put together. With the aid of 34 companies, eight proposed reference materials have been tested in the last 3 years and two of them have been selected for value assignment. A reference method based on dissociation-enhanced lanthanide fluorescence immunoassays was therefore developed which gives linear and parallel response curves by assaying freshly prepared primary reference standards, fresh plasma or serum as well as lyophilized or frozen proposed reference material. For value assignment, four laboratories simultaneously prepare primary reference standards with known isoforms and molecular weights. By assaying the amino acid composition of these primary reference standards, the molar concentration which is the basis of value transfer to the lyophilized proposed reference material can be calculated. In a final step, harmonization of all commercially available Lp(a) kits is to be tested by assaying 50 Lp(a) samples with increasing Lp(a) concentrations and varying isoforms. We hope to be able in the near future to create a basis for comparable results in epidemiological studies in different laboratories and also to help to improve future long-term precision in clinical chemical laboratories.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

Systematic review: noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae.

BACKGROUND: Testing of urine samples is noninvasive and could overcome several barriers to screening for chlamydial and gonococcal infections, but most test samples are obtained directly from the cervix or urethra. PURPOSE: To systematically review studies that assessed the sensitivity and specificity of nucleic acid amplification tests for Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens and to compare test characteristics according to type of assay, site of sample collection, presence of symptoms, disease prevalence, and characteristics of the reference standard. DATA SOURCES: Relevant studies in all languages were identified by searching the MEDLINE database (January 1991 to December 2004) and by hand-searching the references of identified articles and relevant journals. STUDY SELECTION: Studies were selected that evaluated 1 of 3 commercially available nucleic acid amplification tests, included data from tests of both a urine sample and a traditional sample (obtained from the cervix or urethra), and used an appropriate reference standard. DATA EXTRACTION: From 29 eligible studies, 2 investigators independently abstracted data on sample characteristics, reference standard, sensitivity, and specificity. DATA SYNTHESIS: Articles were assessed qualitatively and quantitatively. Summary estimates for men and women were calculated separately for chlamydial and gonococcal infections and were stratified by assay and presence of symptoms. The pooled study specificities of each of the 3 assays exceeded 97% when urine samples were tested, for both chlamydial infection and gonorrhea and in both men and women. The pooled study sensitivities for the polymerase chain reaction, transcription-mediated amplification, and strand displacement amplification assays, respectively, were 83.3%, 92.5%, and 79.9% for chlamydial infections in women; 84.0%, 87.7%, and 93.1% for chlamydial infections in men; and 55.6%, 91.3%, and 84.9% for gonococcal infections in women. The pooled specificity of polymerase chain reaction to gonococcal infections in men was 90.4%. In subgroup analyses, the sensitivity did not vary according to the prevalence of infection or the presence of symptoms but did vary according to the reference standard used. LIMITATIONS: Few published studies present data on the transcription-mediated amplification or strand displacement amplification assays, and few studies report data from asymptomatic patients or low-prevalence groups. CONCLUSIONS: Results of nucleic acid amplification tests for C. trachomatis on urine samples are nearly identical to those obtained on samples collected directly from the cervix or urethra. Although all 3 assays can also be used to test for N. gonorrhoeae, the sensitivity of the polymerase chain reaction assay in women is too low to recommend its routine use to test for gonorrhea in urine specimens.

Cervix Uteri↗
PubMed1999

Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice.

Researchers and clinicians have used numerous methods in their attempts to adequately assess patient compliance (adherence) with medication regimens and to identify noncompliant patients. Large variations have been reported in the extent of noncompliance in individual patients and large populations. In addition, nonadherence has often been poorly defined. Direct measures of adherence include drug assays of blood or urine, use of drug markers with the target medication, and direct observation of the patient receiving the medication. Indirect measures of adherence imply that the medication has been used by the patient; these measures include various forms of self-reporting by the patient, medication measurement (pill count), use of electronic monitoring devices, and review of prescription records and claims. Compliance measures should be assessed on the basis of their validity (sensitivity and specificity or statistical correlation) and the reference standard used. Many early studies used pill counts as a reference standard, but electronic monitoring devices such as the Medication Event Monitoring System have replaced pill counts as the reference standard. The choice of a method for measuring adherence to a medication regimen should be based on the usefulness and reliability of the method in light of the researcher's or clinician's goals. Specific methods may be more applicable to certain situations, depending on the type of adherence being assessed, the precision required, and the intended application of the results.

Clinical Trials as Topic↗
PubMed1997

Obstetric anaesthesia: an approach to improving the standards of services.

There has been considerable discussion about obstetric anaesthesia standards and about the role of peer review in quality improvement. We carried out two postal surveys in 1990 and 1991 in major obstetric departments in Northern England, in order to assess practice and facilities against professionally derived standards, with the aim of stimulating and reviewing change. The reference standards were a local adaptation of those produced by the Obstetric Anaesthetists Association, and covered operating facilities, anaesthetic equipment, management and manpower, training, and protocols. In 1990, considerable variation in practice and facilities was identified with deficiencies in all hospitals. After feedback of the results of the first survey, a further survey conducted in 1991 identified improvement in 23/26 standards. Reference to standards was widely included in business plans and contracts for services. Following further feedback of the second survey and some revision of standards, a third survey was carried out using site visits. This revealed further improvement in 8/26 standards, but apparent deterioration in 11/26. The overall change from the first to the third survey was of apparent improvement in 15/26 standards and deterioration in 6/26. Surveys of practice against professionally derived standards and the targeted feed back of results can lead to improvements in practice and facilities.

Journal Article↗
PubMed2002

MR nerve imaging in a prospective cohort of patients with suspected carpal tunnel syndrome.

OBJECTIVES: To evaluate the reliability and diagnostic accuracy of high-resolution MRI of the median nerve in a prospectively assembled cohort of subjects with clinically suspected carpal tunnel syndrome (CTS). METHODS: The authors prospectively identified 120 subjects with clinically suspected CTS from five Seattle-area clinics. All subjects completed a hand-pain diagram and underwent a standardized nerve conduction study (NCS). The reference standard for determining CTS status was a classic or probable hand pain diagram and NCS with a difference >0.3 ms between the 8-cm median and ulnar peak latencies. Readers graded multiple imaging parameters of the MRI on four-point scales. The authors also performed quantitative measurements of both the median nerve and carpal tunnel cross-sectional areas. NCS and MRI were interpreted without knowledge of the other study or the hand pain diagram. RESULTS: Intrareader reliability was substantial to near perfect (kappa = 0.76 to 0.88). Interreader agreement was lower but still substantial (kappa = 0.60 to 0.67). Sensitivity of MRI was greatest for the overall impression of the images (96%) followed by increased median nerve signal (91%); however, specificities were low (33 to 38%). The length of abnormal signal on T2-weighted images was significantly correlated with nerve conduction latency, and median nerve area was larger at the distal radioulnar joint (15.8 vs 11.8 mm(2)) in patients with CTS. A logistic regression model combining these two MR variables had a receiver operating characteristic area under the curve of 0.85. CONCLUSIONS: The reliability of MRI is high but the diagnostic accuracy is only moderate compared with a research-definition reference standard.

Adult↗