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PubMed2003

Differences in endoscopic classification of early colorectal carcinoma between China and Japan: a comparative study.

AIM: To compare the differences in the endoscopic classification of early colorectal carcinoma (CRC) between Japan and China. METHODS: Ten cases of early CRC were included in the study. After reviewing the color pictures of these cases, 5 Japanese endoscopists and 5 Chinese endoscopists made their classificatory diagnosis individually using the current Japanese classification, and indicated their findings on which the diagnosis was based. RESULTS: Some lesions diagnosed by the Japanese endoscopists as IIa or IIa plus IIc, were classified as Is or Isp by the Chinese endoscopists. For superficial lesions consisting of elevation plus central depression, IIa plus depression, IIa plus IIc or IIc plus IIa were classified according to the ratio of elevated area/depressed area. However, international as well as interobserver difference still existed in the classification of such lesions. In addition, most Chinese endoscopists overlooked slightly depressed part on the top of a protruded lesion. Laterally spreading tumor, a special type of IIa, was identified as LST by some Japanese endoscopists. CONCLUSION: Discrepancies on macroscopic classification for early CRC do exist between Japanese and Chinese endoscopists, which are found not only in terminology but also in recognition of some lesions. In order to develop a universal classification, it needs for international communication and cooperation.

Carcinoma↗
PubMed2006

Tumor classification based on DNA copy number aberrations determined using SNP arrays.

High-density single nucleotide polymorphism (SNP) array is a recently introduced technology that genotypes more than 10,000 human SNPs on a single array. It has been shown that SNP arrays can be used to determine not only SNP genotype calls, but also DNA copy number (DCN) aberrations, which are common in solid tumors. In the past, effective cancer classification has been demonstrated using microarray gene expression data, or DCN data derived from comparative genomic hybridization (CGH) arrays. However, the feasibility of cancer classification based on DCN aberrations determined by SNP arrays has not been previously investigated. In this study, we address this issue by applying state-of-the-art classification algorithms and feature selection algorithms to the DCN aberration data derived from a public SNP array dataset. Performance was measured via leave-one-out cross-validation (LOOCV) classification accuracy. Experimental results showed that the maximum accuracy was 73.33%, which is comparable to the maximum accuracy of 76.5% based on CGH-derived DCN data reported previously in the literature. These results suggest that DCN aberration data derived from SNP arrays is useful for etiology-based tumor classification.

Algorithms↗
PubMed1996

Diagnosis of chronic venous disease of the lower extremities: the "CEAP" classification.

OBJECTIVE: To test a new classification of chronic venous disease (CVD)--based on clinical, etiologic, anatomic, and pathophysiologic data (the CEAP system)--in a series of patients by using objective tests to establish all diagnoses. MATERIAL AND METHODS: The CEAP classification was applied to 102 extremities in 70 consecutive patients with CVD. Diagnoses were based on objective testing with continuous-wave Doppler studies, duplex scanning, plethysmography, venous pressure, and phlebography, which were applied selectively (the more invasive methods were reserved for cases of greater severity). RESULTS: Use of this classification provided an organized categorization of the key elements of the venous abnormalities in each case and clarified the interrelationships among the clinical manifestations, cause of the process, and anatomic distribution of involvement. For example, in this series of 102 extremities, 79% had primary venous disease, 18% had secondary disease, and 3% had congenital abnormalities. Ulcers were found in 7% of extremities with primary CVD and 44% with secondary CVD. Of the cases with ulceration, 43% were due to primary incompetence and 57% to postthrombotic disease. Reflux was the pathophysiologic problem in 86% of the total series and in 80% of ulcer cases. Similar relationships can be delineated for cases with varicose veins, edema, or skin changes. Study of the specific facets of the CEAP classification provided precise information about the cause and the effect of venous abnormalities that could be compared with cases in other series. CONCLUSION: Use of the CEAP classification with diagnoses determined by objective testing accurately identifies categories of CVD. The objective date provide a clear description of the abnormalities in each case and may be used for analyses of meaningful relationships between categories of CVD. Adoption of this objective method of classifying CVD will facilitate interinstitutional studies.

Algorithms↗
PubMed1996

A clinical approach to the classification of seizures and epileptic syndromes.

Seizures and epilepsies are heterogeneous. Their classifications are essential for clinicians to achieve a common understanding of the disorders. The diagnosis, treatment, and prognosis of seizure disorders depend on the correct identification of the types of seizures and epilepsy. The two currently accepted classifications are the International Classification of Epileptic Seizures and the International Classification of Epilepsies and Epileptic Syndromes. Both are based on clinical and electrophysiologic data, and both maintain a basic dichotomy between partial (focal, localization-related) and generalized epileptic disorders. Partial seizures are further classified into those that are simple partial, complex partial, and partial with secondary generalization. Generalized seizures are classified predominantly on the basis of their motor manifestations. Epilepsies are divided into idiopathic, cryptogenic, and symptomatic types. The utility and the limitations of these two classifications are discussed. A simplified system that encompasses neuroradiologic advances is offered to enhance the clinical usefulness of classifying epileptic disorders.

Epilepsy↗
PubMed2006

Application of classification and regression trees for sensitivity analysis of the Escherichia coli O157:H7 food safety process risk model.

Microbial food safety process risk models are simplifications of the real world that help risk managers in their efforts to mitigate food safety risks. An important tool in these risk assessment endeavors is sensitivity analysis, a systematic method used to quantify the effect of changes in input variables on model outputs. In this study, a novel sensitivity analysis method called classification and regression trees was applied to safety risk assessment with the use of portions of the Slaughter Module and Preparation Module of the E. coli O157:H7 microbial food safety process risk as an example. Specifically, the classification and regression trees sensitivity analysis method was evaluated on the basis of its ability to address typical characteristics of microbial food safety process risk models such as nonlinearities, interaction, thresholds, and categorical inputs. Moreover, this method was evaluated with respect to identification of high exposure scenarios and corresponding key inputs and critical limits. The results from the classification and regression trees analysis applied to the Slaughter Module confirmed that the process of chilling carcasses is a critical control point. The method identified a cutoff value of a 2.2-log increase in the number of organisms during chilling as a critical value above which high levels of contamination would be expected. When classification and regression trees analysis was applied to the cooking effects part of the Preparation Module, cooking temperature was found to be the most sensitive input, with precooking treatment (i.e., raw product storage conditions) ranked second in importance. This case study demonstrates the capabilities of classification and regression trees analysis as an alternative to other statistically based sensitivity analysis methods, and one that can readily address specific characteristics that are common in microbial food safety process risk models.

Consumer Product Safety↗
PubMedDate not supplied

Classifications of thoracic and lumbar fractures: rationale and supporting data.

Classification systems are generalizations that attempt to identify common attributes within a group to predict behavior or outcome without sacrificing too much detail. Because of the inherent variability of fractures, classifying them can be difficult. To properly apply any of the commonly cited classification schemes for thoracic and lumbar fractures, one must not only know the injury categories described in the original studies but also be familiar with the rationale for developing the classification. Many original reports describing common thoracic and lumbar injury classifications lack a rigorous scientific foundation. They were based largely on the insights of experienced surgeons and researchers. Although the ideal classification for thoracic and lumbar fractures does not exist, it would incorporate neurologic as well as structural factors. Standardization of terminology as related to treatment decisions and prognosis is key to an improved understanding of the clinical behavior of these injuries and identification of optimal treatment options.

Humans↗
PubMed1992

The international classification of impairments, disabilities and handicaps in leprosy-control projects.

The use of a uniform language, which includes definitions of terms, is very important in the field of health care. It is important to have a common language for educational, research and communication purposes. Classifications can play a major role in the development of uniform reporting and registration systems. The purpose of this article is to familiarize leprosy workers with two classifications that are in common use in health care, a classification of diseases and a classification used to describe the overall health status of a person, and to relate the 3 terms that are used in the latter classification, impairments, disabilities and handicaps, to leprosy.

Humans↗
PubMed1993

Concurrent skin and nerve histology in leprosy and its role in the classification of leprosy.

Concurrent skin and nerve histology was evaluated in 60 leprosy patients (25 BT, 28 BL and 7 LL). The twin aims were to study the comparative histology and the usefulness of nerve histology in the classification of the disease. In BT patients, clinical and histological classification was in agreement in 11 (44%) skin and 17 (68%) nerve biopsies. Concurrent skin and nerve histology was in consonance in 14 (56%) BT patients, while in 6 (24%) patients, only nerve histology was helpful in the classification of the disease, the skin histology being non-specific. Nerve histology was classified as BL in 3 (12%) BT patients, the skin histology was non-specific. In the BL group, the histology of 23 (82.4%) nerve biopsies correlated with the clinical classification, in contrast to skin histology which correlated with clinical assessment in 19 (68%) patients only. In the LL patients, the histology of nerve correlated with the clinical classification in 5 patients (71.4%), compared to histology of the skin in 4 (57%) patients only. The GF was higher in the nerves than in the skin throughout the leprosy spectrum (BT, BL, LL); the difference was, however, marginal in BL leprosy. The average bacteriological index (BI) was higher in nerves (4+) compared to that of skin histology and slit skin smears (3+) in BL leprosy. There was, however, no difference in the BI of the slit skin smears, skin and nerve biopsies in lepromatous leprosy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

Limitations of the 1990 American College of Rheumatology classification criteria in the diagnosis of vasculitis.

BACKGROUND: The American College of Rheumatology (ACR) established criteria to discriminate among patients with seven types of vasculitis. Although designated as "classification criteria" for research, these criteria are often used for diagnosis. OBJECTIVE: To examine the operating characteristics of the 1990 ACR classification criteria in the diagnosis of Wegener granulomatosis, giant-cell arteritis, polyarteritis nodosa, and hypersensitivity vasculitis. DESIGN: Prospective cohort study. SETTING: University medical center and Veterans Affairs medical center. PATIENTS: 198 consecutive patients referred to rheumatologists for evaluation of possible vasculitis. MEASUREMENTS: Blinded chart audits were done to classify patients according to the 1990 ACR classification criteria for Wegener granulomatosis, polyarteritis nodosa, giant-cell arteritis, and hypersensitivity vasculitis on the basis of the patients' initial presentation. Chart audits done 2 to 8 months after baseline provided the patients' final diagnoses, which were considered the gold standard, as in the development of the ACR criteria. Test operating characteristics of the ACR classification criteria were calculated according to 2 x 2 tables for the entire cohort and for only the patients with a final diagnosis of vasculitis. RESULTS: Vasculitis was diagnosed in 51 (26%) patients. Thirty-eight (75%) of 51 patients with vasculitis and 31 (21%) of 147 patients without vasculitis met ACR criteria for one or more types of vasculitis. The positive predictive values for the four vasculitides according to ACR criteria were 17% to 29% for the entire cohort and 29% to 75% for only the patients with a final diagnosis of vasculitis. CONCLUSION: The 1990 ACR classification criteria function poorly in the diagnosis of specific vasculitides.

Diagnosis, Differential↗
PubMed1993

[Problems in Papanicolaou classification].

There are several reasons why Papanicolaou classification should not be used for the interpretation of cytologic findings. First, many different classification criteria are sometimes used for a single pathologic condition. Second, inflammatory change or hormonal evaluation are not included in the system. Third, the classification is not compatible for the evaluation of endometrial lesions or chorionic diseases. Fourth, mismanagement of the patient is sometimes encountered when this classification is only used. Instead of Papanicolaou classification, descriptive diagnosis should be used for cytologic interpretation.

Aged↗
PubMed1991

Temporary alien workers seeking classification under the Immigration and Nationality Act--Immigration and Naturalization Service. Final rule.

This final rule implements provisions of the Immigration Act of 1990 (IMMACT). Public Law No. 101-649, November 29, 1990, and the Armed Forces Immigration Adjustment Act of 1991. Public Law No. 102-110, October 1, 1991, as they relate to temporary alien workers seeking nonimmigrant classification and admission to the United States under sections 101(a)(15) (H), (L), (O), and (P) of the Immigration and Nationality Act (Act), 8 U.S.C. 1101. This rule also contains technical amendments which reflect the Service's operating experience under the H and L classifications. This rule will conform Service policy to the intent of Congress as it relates to these classifications, implement new nonimmigrant classifications and requirements established by Public Law 101-649 and Public Law No. 102-110, and clarify for businesses and the general public requirements for classification, admission, and maintenance of status.

Emigration and Immigration↗
PubMed1997

Prognostic factors: classification approaches in patients with lung cancer.

With the proliferation of potential prognostic factors for lung cancer, it is becoming increasingly more difficult to integrate the information provided by these factors into a single accurate prediction of clinical outcome. Here we reviewed five classification methods for their capabilities in classification of 200 patients with lung cancer into distinct prognostic groups using survival outcome as a criteria. The source of patient data for this study is a Lung Tumour Registry from Institute for Lung Diseases, University Clinical Hospital, Belgrade. Almost all developed classification algorithms determined prognostic groups according to biochemical tumour markers LDH and alkaline phosphatase, producing most significant split, instead of commonly used staging variables. The choice of which approach to use for a given classification problem depends not only on statistical properties of method, but also on medical considerations, such as whether more differential findings are given greater weight and the applicability of a classification rule.

Alkaline Phosphatase↗
PubMed1999

[New classification of diabetes by ADA and WHO with special reference to pathogenesis].

New classification of diabetes mellitus was proposed by ADA international committee on the diagnosis and classification and by WHO consultation committee. The classification based on the pathogeneses of diabetes and also on the stages of diseases. Since our knowledge on causes of diabetic syndrome is not yet enough to classify diabetes in genetic bases, the classification had been carried out some sort of mixture of pathogeneses, genetic findings and clinical features of hyperglycemia. Stages of diseases based on the natural course of diabetes mellitus in reference to shortage of insulin effects and degree of chronic hyperglycemia. These two components of classification composed two dimensions of the field that expresses all the pathogeneses and metabolic conditions of all diabetic patients.

Diabetes Mellitus↗
PubMed1999

[Influence of myopic disc shape in a classification program of the Heidelberg retina tomograph].

PURPOSE: We investigated the influence of myopic disc shape on the diagnostic capability of a glaucoma diagnostic software (classification program) of the Heidelberg retina tomograph (HRT). SUBJECTS: 66 eyes of 66 normal subjects and 78 eyes of 78 patients with open-angle glaucoma were studied. The criterion of glaucoma was a visual field defect appearing between Aulhorn classification stage II and stage V regardless of the maximum intraocular pressure value. METHODS: The subjects were divided into eyes with a myopic disc and those with a non-myopic disc on the basis of stereo disc fundus photographs without considering the refractive errors. Agreement between the classification program and the clinical diagnosis was evaluated by the calculation of sensitivity, specificity, and diagnostic precision, and the influence of the disc shape on HRT disc shape parameters was also evaluated. RESULTS: Sensitivity, specificity, and diagnostic precision of the classification program were 83%, 95%, and 89% in the eyes with a non-myopic disc, and 71%, 96%, and 83% in the eyes with a myopic disc, respectively. Rim volume, height variation contour, mean RNFL (retinal nerve fiber layer) thickness, and RNFL cross section area were significantly larger in the eyes with a myopic disc than in those with a non-myopic disc regardless of the clinical diagnosis. CONCLUSION: The classification program should be modified to adjust to a myopia-like disc shape in order to improve the capability of the glaucoma predictive diagnosis.

Female↗
PubMed1999

The International Neuroblastoma Pathology Classification (the Shimada system).

BACKGROUND: The International Neuroblastoma Pathology Committee, which is comprised of six member pathologists, was convened with the objective of proposing a prognostically significant and biologically relevant classification based on morphologic features of neuroblastic tumors (NTs) (i.e., neuroblastoma, ganglioneuroblastoma, and ganglioneuroma). METHODS: A total of 227 cases were reviewed. Consensus diagnoses from morphologic features (criteria described separately) based on five of six or six of six agreements by the reviewer pathologists were used for prognostic analysis. Prognostic effects of morphology, both individual and in combination, taken in conjunction with age (Shimada classification, histologic grade, and risk group), were analyzed. RESULTS: Approximately 99% of cases (224 of 227) had consensus diagnoses for categorization: neuroblastoma (Schwannian stroma-poor), 190 cases; ganglioneuroblastoma, intermixed (Schwannian stroma-rich), 5 cases; ganglioneuroma (Schwannian stroma-dominant) maturing, 1 case; ganglioneuroblastoma, nodular (composite Schwannian stroma-rich/stroma-dominant and stroma-poor), 19 cases; and NT-unclassifiable, 9 cases. For the NTs, subtype (93% consensus: undifferentiated, 6 cases; poorly differentiated, 155 cases; and differentiated, 15 cases), mitosis-karyorrhexis index (90% consensus: low, 94 cases; intermediate, 40 cases; and high, 37 cases), mitotic rate (75% consensus: low, 89 cases; high, 50 cases; and not determined, 4 cases), and calcification (100% consensus: yes, 110 cases and no, 80 cases) were recorded. Statistical analysis demonstrated that the Shimada classification system (90% consensus; 3-year event free survival: 85% for the group with favorable histology and 41% for the group with unfavorable histology; P = 0.31 x 10(-9)) had a significantly stronger prognostic effect than individual features and other combinations. CONCLUSIONS: The International Neuroblastoma Pathology Classification, a system based on a framework of the Shimada classification with minor modifications, is proposed for international use in assessing NTs.

Brain Neoplasms↗
PubMed1976

[Classification and diagnosis of ankle injuries].

A new method for the classification of the injuries of the ankle is recommended by the author. The main types according to his classifixation are the following: pronation-flexion, pronation-extension, supination-extension, supination-flexion and supination-extension types. His classification is compared with Lauge-Hansen's and Weber's classification. Critical analysis of these two last classifications is given. The aim of the author's classification is to render help to the doctors for their every-days' curative work. The characteristic symptoms of the pronation and supination, resp., injuries are described. Attention is drawn to "Weber's lace"--this denomination is proposed by the author, since the first description is due to Weber. On the basis of the author's examinations described in his candidate's dissertation "syndesmolysis trigonum"--pathognostic for syndesmolysis--is dealt with. The "reclined" roentgenograms are dealt with. The so-called pronation reclined roentgenogram visualize the rupture of the deltoid ligament and the syndesmolysis in the same time. The sagittal reclined roentgenogram is dealth with separately, by means of which the "table-drawer" symptom may be produced.

Ankle Injuries↗
PubMed2000

Report of the international consensus development conference on female sexual dysfunction: definitions and classifications.

PURPOSE: Female sexual dysfunction is highly prevalent but not well defined or understood. We evaluated and revised existing definitions and classifications of female sexual dysfunction. MATERIALS AND METHODS: An interdisciplinary consensus conference panel consisting of 19 experts in female sexual dysfunction selected from 5 countries was convened by the Sexual Function Health Council of the American Foundation for Urologic Disease. A modified Delphi method was used to develop consensus definitions and classifications, and build on the existing framework of the International Classification of Diseases-10 and DSM-IV: Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, which were limited to consideration of psychiatric disorders. RESULTS: Classifications were expanded to include psychogenic and organic causes of desire, arousal, orgasm and sexual pain disorders. An essential element of the new diagnostic system is the "personal distress" criterion. In particular, new definitions of sexual arousal and hypoactive sexual desire disorders were developed, and a new category of noncoital sexual pain disorder was added. In addition, a new subtyping system for clinical diagnosis was devised. Guidelines for clinical end points and outcomes were proposed, and important research goals and priorities were identified. CONCLUSIONS: We recommend use of the new female sexual dysfunction diagnostic and classification system based on physiological as well as psychological pathophysiologies, and a personal distress criterion for most diagnostic categories.

Female↗
PubMed2000

Comparison of criteria for the classification of childhood arthritis.

OBJECTIVE: To evaluate the applicability of the ILAR criteria for classification of childhood arthritis in an outpatient pediatric rheumatology clinic population, and to determine the proportion of children who met standard classification criteria, but failed to meet ILAR criteria for specific arthritides, and therefore became unclassifiable. METHODS: We reviewed the charts of 70 consecutive patients who had arthritis for at least 6 months, and attended the clinic between September and November 1997. Sixty-nine patients were categorized according to one of the traditional classifications [ACR for juvenile rheumatoid arthritis (JRA), European Spondylarthropathy Study Group (ESSG) for spondyloarthropathy, Vancouver Criteria for juvenile psoriatic arthritis (JPsA)], and the ILAR classification system. RESULTS: Sixty-one patients (88.4%) were classifiable by the ILAR system; 8 others failed to fulfill ILAR criteria for any specific category, and were assigned to the "other arthritis" category. Of the 29 patients with oligoarticular onset JRA, 6 were unclassified, 5 because of exclusions, and one because he fulfilled criteria for 2 categories. Presence of a family history of psoriasis accounted for most of the exclusions in the oligoarthritis and enthesitis related arthritis categories. All patients with polyarticular onset or systemic onset JRA were classified in the corresponding category in the ILAR system. One 9-year-old patient with spondyloarthropathy was reclassified as "other arthritis" because of exclusions. All 6 children with definite JPsA met ILAR criteria for PsA. Of 4 patients with probable JPsA, only 2 met ILAR criteria for PsA, a third was classified as rheumatoid factor negative polyarthritis, and the fourth was classified as "other arthritis" because of exclusions. CONCLUSION: The ILAR classification criteria applied to a group of children with chronic arthritis classified by traditional criteria results in reassignment of 11.6% of the patients, predominantly in the oligoarticular group. It will be important to determine the role of the presence of a family history of psoriasis in classifying these patients.

Ambulatory Care Facilities↗