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At least 1,207 records · Page 67Linked to original sources
PubMed1989

An undetectable source of technical error that could lead to false negative results in enzyme linked immunosorbent assay of antibodies to HIV-1.

Since the institution of routine testing for antibodies to Human Immunodeficiency Virus (HIV) using the enzyme-linked immunosorbent assay (ELISA), the specificity and sensitivity of this assay system has received significant scrutiny. During previous use of this methodology, we have quantified rates of false biological positive results using commercial kit assays in a normal donor population. In this study, we have identified a potential source for false negative results. Using multiple lots of two different commercial ELISA kits, the absorbance readings at the test end point could not differentiate between normal non-reactive donor samples and blanks containing no sample. These results occur using normal donor samples, even though the assays could distinguish between blank wells and the manufacturers' "normal controls", provided with the assay. Our findings suggest that a technical pipetting error is presently undetectable, either visually or by statistical methods, and could permit an untested, potentially HIV-1 positive, unit to be released into the transfusable blood supply. A possible solution is suggested.

Enzyme-Linked Immunosorbent Assay↗
PubMed2003

High dose-rate brachytherapy source localization: positional resolution using a diamond detector.

A potential real-time source position verification process for high dose-rate (HDR) brachytherapy treatment is described. This process is intended to provide immediate confirmation that a treatment is proceeding according to plan, so that corrective action can be taken if necessary. We show that three dosimeters are in principle sufficient and demonstrate the feasibility of the process using a diamond detector and an Ir-192 source. An error analysis including all identified sources of error shows that this detector is capable of locating the distance to the source to within 2 mm for distances up to 12 cm. This positional accuracy is less than the diameter of typical HDR catheters indicating that a diamond detector can be used to accurately determine the distance to the source. The uncertainty in the distance is found to increase with distance.

Algorithms↗
PubMed2001

The influence of electrode location errors on EEG dipole source localization with a realistic head model.

OBJECTIVES: Inaccurate information about the electrode locations on the scalp will introduce errors in electroencephalogram dipole source localization results. The present study uses computer simulations to evaluate such errors in a realistic head model and in the context of noise. METHODS: A realistic head model was constructed from magnetic resonance imaging scans and 29 electrodes placed on the head according to the 10-20 International System. Twenty sets of electrode displacements, with a mean value of 5 mm, were generated and 200 single dipoles evenly located in the brain were used as test sources. The boundary element method was employed for the forward calculation and dipole fitting was carried out at different noise levels. RESULTS: For a noise-free signal, the source localization error due to electrode misplacement is about 5 mm, whereas it is about 2 mm for normal noisy signals. CONCLUSIONS: For realistic head models, dipole estimation error due to electrode misplacement is negligible compared with errors caused by noise.

Artifacts↗
PubMed1998

Stability of finite difference deconvolution II: simulation studies.

Theoretical analysis of the stability of finite difference deconvolution (FDD) indicates that if the cumulative amount function is used to characterize the drug input the method is stable for any sampling schedule for an intravenous unit impulse response function. The analysis also indicates that the method is stable for an oral unit impulse response only for well designed sampling schedules. This article confirms these results through numerical simulation experiments. It is shown that the assumption that the unit impulse response is error-free has an influence on the performance of FDD which is generally of no practical significance, except possibly for the first few points estimated. It is also shown that there is no significant interaction between the statistical error due to data noise and the deterministic algorithm error. The major source of error in practice is likely to be the data noise in the input response function. The simulations confirm that, with the estimated cumulative amount function as the quantity estimated and, with a well designed sampling schedule for the case of an oral unit impulse response, FDD is in practice an accurate and stable method with acceptable precision under a typical error disturbance.

Algorithms↗
PubMed1989

Sources of diagnostic error in fine needle aspiration of the thyroid.

Smears obtained from 795 patients with suspicious thyroid nodules by fine needle aspiration (FNA) of the thyroid gland were seen over a 5-year period at the UCLA Center for the Health Sciences. From 72 patients who underwent subsequent surgical excision of their nodules, inadequate or discrepant FNA diagnoses were noticed in 20 cases (27.8%). These errors could be attributed to inadequate material for diagnosis (n = 6), sampling errors (n = 2), and cytodiagnostic errors (n = 12). If the diagnosis of follicular neoplasm was treated as indeterminate for malignancy, the overall efficiency of FNA was 88.9%. All false-negative diagnoses were related to procedure (i.e., inadequate smears or missed sampling of the lesion). The frequency of inadequate smears, in turn, was strongly related to the type of physician performing the aspiration. The frequency was highest among community-based clinicians (32.4%) and lowest among hospital-based cytopathologists (6.4%). With adequate sampling, the finding of 100% sensitivity in the diagnosis of malignant neoplasms by FNA cytology reaffirms its role as the procedure of choice in the initial screening of thyroid nodules.

Adolescent↗
PubMed2003

Follicular thyroid lesions coexisting with Hashimoto's thyroiditis: incidence and possible sources of diagnostic errors.

Our objectives were to study the types and incidence of thyroid follicular lesions coexisting with Hashimoto's thyroiditis (HT), the pitfalls in their cytodiagnosis, and the effect on management. All cases of HT diagnosed by fine-needle aspiration (FNA) and/or histology over a 7-yr period were retrospectively studied. HT coexisted with follicular adenoma (FA) in 6 cases, follicular variant of papillary carcinoma (FVPC) in 1 case, and goitrous nodule (GN) in 2 cases. The overall incidence rates of thyroid neoplasm and goitrous nodules coexistent with HT were 15% and 3.5%, respectively. A preoperative FNA diagnosis was available in 10 histologically proven cases of HT. A false-positive diagnosis of follicular neoplasm (FN) that led to unnecessary thyroidectomies was given in 3 cases. In 2 of these, the cytological diagnosis was HT with the possibility of coexisting FN, and in the third case, the cytological finding of HT was misinterpreted as FN. The main causes of these diagnostic pitfalls were the presence of hyperplastic follicular cells with nuclear pleomorphism, a paucity of lymphoid cells in burned-out HT, and lack of ones exposure. Nuclear pleomorphism was observed in none of the follicular adenomas. FNA diagnosed accurately the coexisting lesions in 6 cases; 3 FA, 1 FVPC, and 2 GN, but it did not sample HT. In one case, FNA diagnosed correctly both HT and the coexisting FA. Therefore, the presence of a coexistent neoplasm or goitrous nodule reduced the chances of sampling HT by 85.7%, with no false-negative results. Indeed, aspiration on and around the thyroid nodule helps in sampling HT. However, HT may dominate the smear and obscure neoplasia. This can be avoided if the procedure is performed by the pathologist and the aspiration is done on the nodule only. The overlapping cytological features of FN and HT were the main causes of false-positive results. This can be reduced by avoiding the diagnosis of FN in the presence of follicular-cell pleomorphism and/or moderate to excessive numbers of lymphoid cells, provided proper aspiration technique is maintained.

Adenoma↗
PubMed1994

Sources of prediction error when using a Bayesian method to evaluate nortriptyline serum concentrations.

A Bayesian method was used to evaluate nortriptyline (NTP) serum concentrations (Cps) and predict future Cps in two populations: five simulated groups (n = 20 each) with known clearance (CL) and volume of distribution (Vd), and an actual inpatient group (n = 20). The effects of weight, CL, Vd, and magnitude of Cps on absolute prediction error (APE) were evaluated. In simulated groups, Cps after two doses of NTP and for steady-state were calculated for normal, increased, and decreased Vd and CL. In the actual patient group, Cps were measured in the first few days after starting NTP administration and again during maintenance therapy. The first Cps were used in the Bayesian program to estimate CL and Vd to predict the second Cps. In the simulated group, PE and APE differed significantly between normal and decreased values of CL. A large Vd resulted in less of a change in PE or APE in these subjects, but when combined with low CL led to the largest errors. In the actual patient group, PE was -5.9 +/- 19.2 ng/mL and APE was 15.4 +/- 12.6 ng/mL. In these patients, only body weight was correlated with the percent APE (r = 0.607, P = 0.005). The Bayesian method performs well clinically, but increased Vd and decreased CL can lead to higher PE. Clinically, the only factor that predicted higher APE was obesity. This may reflect an effect on Vd, and in these patients, a high APE may occur.

Adult↗
PubMed1993

Heteroduplex formation: a potential source of genotyping error from PCR products.

The formation of heteroduplexes from polymerase chain reaction (PCR) products has recently become a diagnostic tool that is routinely used for the prenatal detection of small deletions or insertions in a number of disease-causing alleles. We present evidence illustrating that heterozygous PCR products can manifest 'invisible' heteroduplexes that can ultimately lead to genotyping errors. Justifications for these 'invisible' heteroduplexes and requisite parameters to optimize their detection are presented.

Amniocentesis↗
PubMed1979

Radiographic examination of the stomach following surgery for pancreatic pseudocyst. A source of diagnostic error.

The radiographic changes in the stomach following drainage procedures for pancreatic pseudocysts are described and illustrated. Principles of modern surgical techniques are reviewed and the occurrence and significance of barium reflux into the cyst are discussed. Contrary to previous statements, it is pointed out that reflux into the cyst may occur following Roux-en-Y cystojejunostomies. Radiographic presentations mimicking peptic ulcers, rigid gastric segments, and pseudodiverticula formation, related to the healing postoperative process, are emphasized.

Diagnostic Errors↗
PubMed1992

Forecast accuracy of Australian subnational population projections.

The authors assess demographic projections made over the last 20 years for Australia. "This paper first considers the role of accuracy amongst other objectives of projection activity. Accepting accuracy as a legitimate goal, we then assess the performance of 48 sets of population projections and forecasts for states and territories of Australia prepared since 1970. Projection accuracy is assessed by reference to length of forecast horizon, population size and rate of growth. We also examine the main sources of forecast error in selected projections for each state and compare the performance of past projections with alternatives based on simple extrapolation of contemporary population trends."

Australia↗
PubMed2002

Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors.

Shoulder magnetic resonance (MR) imaging and MR arthrography are frequently utilized in the evaluation of shoulder pain and instability. The clinical scenario and imaging findings may be confusing to clinicians and radiologists and may present diagnostic challenges for those involved in evaluating and treating shoulder pathology. Often rotator cuff and labral abnormalities may be coexistent, clinical manifestations of denervation syndromes may be confusing to clinicians, and normal anatomic variations, imaging pitfalls, and various artifacts may cause dilemmas for the radiologist. This article will review the most frequently encountered mimickers and pitfalls of MR imaging of the shoulder.

Artifacts↗
PubMed2005

Consistency of epidemiologic estimates.

BACKGROUND: The epidemiology of a disease describes numbers of people becoming incident, being prevalent, recovering, surviving, and dying from the disease or from other causes. As a matter of accounting principle, the inflow, stock, and outflows must be compatible, and if we could observe completely every person involved, the epidemiologic estimates describing the disease would be consistent. Lack of consistency is an indicator for possible measurement error. METHODS: We examined the consistency of estimates of incidence, prevalence, and excess mortality of dementia from the Rotterdam Study. We used the incidence and excess mortality estimates to calculate with a mathematical disease model a predicted prevalence, and compared the predicted to the observed prevalence. RESULTS: Predicted prevalence is in most age groups lower than observed, and the difference between them is significant for some age groups. CONCLUSIONS: The observed discrepancy could be due to overestimates of prevalence or excess mortality, or an underestimate of incidence, or a combination of all three. We conclude from an analysis of possible causes that it is not possible to say which contributes most to the discrepancy. Estimating dementia incidence in an aging cohort presents a dilemma: with a short follow-up border-line incident cases are easily missed, and with longer follow-up measurement problems increase due to the associated aging of the cohort. Checking for consistency is a useful strategy to signal possible measurement error, but some sources of error may be impossible to avoid.

Aged↗
PubMed1976

Resolution problems in echocardiology: a source of interpretation errors.

Resolution is the ability of the echocardiographic system to distinguish closely lying structures. This is usually defined in two directions: laterally (lateral resolution) and in depth (axial resolution). With use of short ultrasonic pulses, axial resolution is not a major problem. By far the more important problem is the limited lateral resolution that results from the finite beam width of current ultrasonic devices. This results in the display of echoes that originate from off-axis structures. How these off-axis or "spurious echoes" affect the display is a function of the way the echographic information is handled. In conventional M-mode tracings, spurious echoes are displayed at a site where there is no directly corresponding anatomic structure, whereas with two-dimensional imaging, these echoes may result in important distortions of structures. The underlying principles are illustrated by a clinical experiment wherein the ball of a Starr-Edwards mitral valve prosthesis serves as a target of known shape and dimensions. These data are used to elucidate some of the problems and potential errors encountered in the interpretation of clinical M-mode recordings of the aorta, mitral valve and the left ventricular endocardium as well as their cross-sectional analysis. They also explain the present limitations of quantification of left ventricular performance from cross-sectional images.

Aorta↗