Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “diagnostic algorithm”

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 1,549 records · Page 86Linked to original sources
PubMed1991

A new algorithm for the diagnosis of polycythemia.

A new algorithm for the diagnostic evaluation of erythrocytosis is presented. This algorithm is based on principles of decision-making analysis and on the pathophysiology of erythrocytosis. The initial task is to identify smokers, because of the high probability that they have "smoker's" polycythemia. The current diagnostic criteria for polycythemia vera may be insufficient when the probability of disease is low but may be too rigorous when the probability of disease is high.

Algorithms↗
PubMedDate not supplied

Bayesian decision making based on measurements containing errors.

The paper presents a Bayesian approach to the construction of diagnostic and prognostic algorithms, based on the use of several diagnostic factors (tests) in combination. With this approach, the simultaneous use of dichotomous, discrete, categoric, and continuous factors is easy and the resulting algorithms are more efficient than those of other known methods. Moreover, each factor value that is available for use is assumed to represent an estimate (the result of an imperfect measurement) of some (unknown) true value. The proposed method of accounting for measurement errors is advantageous as regards efficiency for users of the algorithm (physicians) if the accuracy of the factor-measurement techniques at their disposal differs from that of the constructor of the algorithm (the scientist). The approach is illustrated by an example, and possible error models and methods of collecting statistical data are discussed.

Algorithms↗
PubMed1998

Incisal edge reattachment: literature review and treatment perspectives.

Anterior crown fractures in children and adolescents are a common form of injury, affecting approximately 25% of that population. Common restorative treatments such as composite bonding, laminate veneers, or full-coverage restorations tend to sacrifice healthy tooth structure and challenge dentists to match the adjacent unrestored dentition. Incisal edge fragment reattachment, including the use of current bonding techniques, is a restorative treatment option that offers the advantages of simplicity, immediate esthetics, and conservatism in cases of dental trauma. This article presents a comprehensive literature review on this restorative technique. It also provides diagnostic and treatment algorithms to simplify and clarify the recommended diagnostic and clinical regimens.

Child↗
PubMed1989

[Scientific and technologic aspects of equipping the preventive services department during general mass screening of the population].

The analysis of the screening stage of follow-up medical technology practice has been carried out. The study tackles the problems of selection of medical programmes of mass periodic medical check-ups, definition of diagnostic informative indices and their biometrology, programme algorithmic control with its preliminary diagnostic decisions, wide use of an individual principle of health status assessment and further organization of check-up flows, building up of technical equipment patterns for prophylactic departments. A two-stage system of technical equipment patterns of prophylactic departments in a city polyclinic is discussed. At the first stage the department should be equipped with compact, cheap, easily transported, safe and simple in operation, high-quality autonomous specialized automated diagnostic complexes. The second stage consists in the development of the data bank formation system proceeding from the examination results within the region assigned to the polyclinic.

Algorithms↗
PubMed1990

Determination of near-optimum use of hospital diagnostic resources using the "GENES" genetic algorithm shell.

"GENES", a genetic algorithm shell developed by the authors, was used to optimize allocation of hospital resources for a small set of hypothetical patients. GENES creates a random population of rule sets of the IF..THEN type, which are variable in both the number of rules in each set and in the size of each rule. GENES applies each rule set to a patient data base, ranks the goodness of each set as applied, and uses the mechanisms of population genetics, i.e. mutation, crossover, inversion and survival of the fittest, to create a new, and often improved generation of rule sets. It also allows for the time dependent nature of medical tests, the possibility of injury associated with those tests, and the fact that results may not always be conclusive. Using 10-11 artificially created patients admitted under the diagnosis of possible gall bladder disease, a rule set was obtained which selected a testing strategy from a list of available hospital resources and correctly diagnosed all patients at minimum cost in no more than 3807 generations.

Algorithms↗
PubMed2006

An algorithmic approach to intracranial mass lesions in HIV/AIDS.

We developed a diagnostic and therapeutic algorithm for intracranial mass lesions in patients with HIV/AIDS that obviates the need for neurosurgical intervention. The approach is based upon CD4(+) lymphocyte count, serum toxoplasma immunoglobulin G (IgG) serology, chest X-ray, routine lumbar puncture studies, cerebrospinal fluid (CSF) cytology, CSF adenosine deaminase or Mycobacterium tuberculosis polymerase chain reaction testing, single positron emission-computed tomography (SPECT) scanning for intracranial enhancing lesions, and limited therapeutic trials. Over a 12-month period involving 26 patients, we found that the algorithm correctly identified the aetiology of focal intracranial lesions in all 23 evaluable patients. Costs for SPECT scanning for the entire study cohort were more than offset by the savings achieved by reduced hospital stays for the four patients with lymphoma alone. An algorithmic approach can accurately identify the cause(s) of central nervous system (CNS) mass lesions in HIV-infected patients, and SPECT scanning can replace stereotactic brain biopsy in most cases where opportunistic malignancy is suspected.

AIDS-Related Opportunistic Infections↗
PubMed1996

[The current aspects of diagnosis and expertise in flight personnel with gallstones].

The paper discusses the modern aspects of diagnosis and expertise of pilots suffering from gall-stones. The present-day methods were used to examine 196 pilots of different aviation categories (helicopter in the main). Semiotic signs of different variations of gall-stones are studied, comparative characteristics of diagnostic methods are demonstrated, more effective algorithms of examination are elaborated. It is shown that in the radio-clinical examination the ultrasonic investigation holds the lead in the diagnostic algorithm enabling in the shortest way early and correct detection of concretions in the biliary tracts. Viscous putty-like bile in the gall bladder found during preventive monitoring is an unfavourable sign calling for correction of diet, motor activity and medicamentous therapy.

Aerospace Medicine↗
PubMed2001

[The prevalence of dementia and its main subtypes in subjects older than 65 years: impact of occupation and education. The Toledo Study].

BACKGROUND: To assess the prevalence of dementia and its subtypes in a population with a low level of education, and to determine whether there is any association between occupation, education and dementia. SUBJECTS AND METHOD: Cross-section study of the population, with a sample of 3,214 individuals representative of the population of Toledo, Spain, aged 65 years and older. The Mini-Mental State Examination (MMSE) was used in the first phase of the study to detect those individuals with cognitive deterioration. The second phase consisted of a semi-structured clinical interview and neuropsychological evaluation. Dementia and sub-types of dementia were determined using well-established diagnostic criteria. The process was applied using an algorithm to optimise diagnostic agreement. RESULTS: The overall prevalence of dementia, Alzheimer's disease and vascular dementia amounted to 7.6, 4.6 and 1.8%, respectively. A direct relationship was detected between these three entities and age. The prevalence of dementia was greater in women, illiterate persons and occupations which require less skill. Once adjustment had been made for other socio-demographic variables, only age was associated with the presence of dementia. CONCLUSIONS: The overall prevalence of dementia, Alzheimer's type dementia and vascular dementia increases with age. No clear association was found between education, occupation and dementia.

Aged↗
PubMed2004

Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis.

OBJECTIVES/HYPOTHESIS: Skull base dural lesions and cerebrospinal fluid (CSF) fistulas are potentially vital conditions whose diagnosis can be challenging. The authors' aim was to compose a comprehensive algorithm that combines the most modern diagnostic tools in easily applicable patterns to indicate a possible dural lesion or CSF fistula. STUDY DESIGN: Prospective clinical study. METHODS: The authors collected the data of all patients with suspicion of CSF fistula or dural lesion, or both, between January 1999 and December 2002. Beta-trace protein, beta2-transferrin, and endoscopic and laboratory sodium fluorescein tests; high-resolution computed tomography; and magnetic resonance cisternography were used according to the symptoms and etiological factors. The results of the diagnostic tools that were used and intraoperative findings (in case of an operative treatment) were reviewed. RESULTS: From 1999 to 2002, 236 patients were evaluated because of suspicion of dural lesion or CSF fistula, mostly after head trauma. Pattern I of the algorithm was applied for head trauma in dural lesion or CSF leak assessment, pattern II for postoperative CSF leaks, pattern III for evaluation of spontaneous CSF rhinorrhea, and pattern IV for the assessment of recurrent pneumococcal meningitis related to dural lesions without CSF fistula. By applying the patterns of this algorithm, a dural lesion or CSF leak that was also confirmed intraoperatively was detected in 48 patients. CONCLUSION: The four patterns of the new diagnostic algorithm described in the present study enable physicians to reliably clarify suspicions of dural lesions and CSF fistulas and aim to help them choose the best possible management. Each pattern uses the optimal combination of CSF tests and radiological imaging to reach a synergistic effect for precisely detecting dural lesions or CSF fistulas. Accordingly, this improves surgical decision-making when necessary.

Adolescent↗
PubMed1984

Modular algorithm for tardive dyskinesia diagnosis (MALTD): a demonstration of a methodological concept for diagnostic decision making.

A set of algorithms has been written which assign the Research Diagnoses for Tardive Dyskinesia (RD-TD) to patients evaluated for this neurological syndrome that occurs as a side effect of neuroleptic drug treatment. The approach used in constructing these algorithms does not employ decision tree and flowcharting mechanisms often used in making automated diagnoses. Rather, a modular structure is used where a value is assigned to each independent component relevant to tardive dyskinesia, e.g. presence or absence of a minimal amount of abnormal involuntary movements, length of time of neuroleptic drug-taking. A particular combination of values of these components determines the diagnosis assigned. Advantages of such a modular system structure are that it permits new components to be added, existing components to be deleted, the criterion levels for existing components to be modified, and/or the definition of any of the diagnostic labels to be altered without affecting other components. Although this algorithm was developed specifically for research in tardive dyskinesia, the authors hope that the concepts of the modular structure will apply to the study of other longitudinal data.

Antipsychotic Agents↗
PubMed2006

Elimination of the need for urine studies in the screening algorithm for monoclonal gammopathies by using serum immunofixation and free light chain assays.

OBJECTIVE: To determine the relative diagnostic contribution of urine assays as part of the screening algorithm for monoclonal gammopathies. PATIENTS AND METHODS: We identified 428 patients with a monoclonal gammopathy and monoclonal urinary protein at initial diagnosis of plasma cell dyscrasia who had also undergone serum immunofixation and serum free light chain quantitation within 30 days of diagnosis. The laboratory results for serum protein electrophoresis, serum immunofixation, serum free light chain, urine protein electrophoresis, and urine immunofixation were reviewed. RESULTS: The patients had diagnoses of multiple myeloma, primary amyloid, monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, solitary plasmacytomas, and other less frequently detected monoclonal gammopathies. All 428 had a monoclonal urine protein, 85.7% had an abnormal serum free light chain kappa/lambda ratio, 80.8% had an abnormal serum protein electrophoresis, and 93.5% had an abnormal serum immunofixation result. All 3 serum assays were normal in only 2 patients, 1 of whom had monoclonal gammopathy of undetermined significance (idiopathic Bence Jones proteinuria) and 1 whose urine sample contained an intact monoclonal immunoglobulin but whose serum and subsequent urine samples showed no evidence of a monoclonal gammopathy. CONCLUSION: Discontinuation of urine studies and reliance on a diagnostic algorithm using only serum studies (protein electrophoresis, immunofixation, and free light chain quantitation) missed 2 (0.5%) of the 428 monoclonal gammopathies with urinary monoclonal proteins, and these 2 cases required no medical intervention.

Algorithms↗
PubMed2005

[Evidence based diagnostic procedures for the determination of suspected blunt cervical spine injuries. Development of an algorithm].

BACKGROUND: The aim of this study was to present existing publications, describing various diagnostic procedures as well as considering the evidence supporting them, to develop a recommendation for diagnosis. MATERIAL AND METHODS: We reviewed relevant publications between 1966 and 2004 by a systemic literature search in MEDLINE, EMBASE, National Guideline Clearinghouse, Cochrane Library as well as a manual reference search. Keywords were cervical spine, cervical vertebrae, spinal, spinal cord, injury, trauma, fracture, dislocation, imaging, radiography, flexion, extension, fluoroscopy, computed tomography, computed scanning, and magnetic resonance imaging. The selected search results were then classified into levels of evidence. RESULTS: From among a total of 10,000 publications, 137 relevant publications were stringently reviewed. The level of evidence is on the whole limited due to deficit data; therefore, only class II-III recommendations are possible. We developed an algorithm for the diagnostic approach to suspected trauma of the cervical spine. This clinical algorithm displays the complex diagnosis of cervical spine injury in a clear and logically structured process. CONCLUSIONS: The diagnostic algorithm for cervical spine injury meets the presently required standards and maximizes care for the newly injured. The development, which can be followed using evidence-based medicine, is transparent and therefore aids the decision process when choosing an adequate diagnostic procedure.

Algorithms↗
PubMedDate not supplied

[Nozometric algorithms in stomatology].

The intensive development of medical informatics and cybernetics led to the creating of an impressive mathematical apparatus, associated with algorithmization of medical activities and processes. In that aspect, special attention is paid to the nozometric algorithms, applied in the most responsible medical field--therapeutic-diagnostic process. The existing nozometric algorithms are reviewed, with consideration given to the specificity of the stomatological diagnostics. An algorithm set has been systematized that is recommended for use in the field of stomatology.

Algorithms↗
PubMed2005

Automatic identification of clinical lead dysfunctions.

Implantable cardioverter defibrillators (ICD) lead dysfunctions can cause inappropriate shocks. Current ICDs store lead diagnostics and detected episodes. This stored information with intracardiac electrograms (EGM) and sensed RR interval patterns may characterize the ICD lead performance. The aim of this analysis was to determine the sensitivity and positive predictive value (PPV) of an automatic lead dysfunction identification algorithm. This algorithm uses RR and EGM data to distinguish noncardiac oversensing (OS), for example, due to conductor fracture, and cardiac OS, for example, T-wave OS, from detected episodes. The algorithm also uses lead diagnostics: sensing integrity counter trends (e.g., RR intervals <140 ms), nonsustained tachyarrhythmias episodes with a mean RR <200 ms and impedance trends to identify lead fractures. The PPV was determined using the stored memory from 1,756 ICD patients enrolled in a 13-center long-term lead study with an average follow-up of 18.3 patient-months. Sensitivity was determined in 35 patients who presented with OS or lead fracture-related adverse events confirmed by stored ICD diagnostics. The algorithm sensitivity was 97.1% (34/35). There were 43 additional patients identified by the algorithm without an adverse event. Stored ICD diagnostics confirmed lead dysfunctions in 32 of 43 patients corresponding with an 85.7% PPV (66/77). ICD memory diagnostics and episodes with intracardiac EGM may be used to identify ICD lead dysfunctions with high sensitivity and PPV. This algorithm may be implemented in postprocessing ICD environments (e.g., remote server, programmer) to rapidly identify lead dysfunction prior its clinical manifestation.

Algorithms↗
PubMed1991

Diagnostic modalities in abdominal trauma. Peritoneal lavage, ultrasonography, computed tomography scanning, and arteriography.

Numerous algorithms encompassing the diagnostic studies described above have been published in recent years. For practical purposes, diagnostic peritoneal lavage and CT scanning are the diagnostic studies most commonly used in patients without obvious indications for celiotomy after blunt or penetrating abdominal trauma. Diagnostic peritoneal lavage is invasive, rapidly performed, cheap, and accurate and has a primary role in documenting intra-abdominal bleeding or contamination in hypotensive patients with blunt trauma or selected stable patients with penetrating stab wounds. It misses small and large injuries to the diaphragm and cannot rule out injury to retroperitoneal structures. Computed tomography is noninvasive, time consuming to perform, expensive, and accurate and has a primary role in defining the location and magnitude of intra-abdominal injuries in stable patients with blunt trauma or with penetrating trauma to the flank or back. In many hospitals, it misses gastrointestinal perforations or ruptures. Both studies may be needed in the same stable patient, and both should be available and used in a complementary fashion in the modern trauma center.

Abdominal Injuries↗
PubMedDate not supplied

[Evaluation of the stability of algorithms in data processing by computerized diagnostic cardiocomplex ECG C3T-01].

Evidence is provided for the model of choosing cardiosignal depiction to estimate one of the most important parameters of an outfit operation - stability of the results of electrocardiosignal (ECS) processing. It should be mentioned that despite the fact that the given parameter is not so far generally acknowledged, it reflects accurately enough the operation "reliability" of the automated system. The author bases theoretically the choice of the adaptive piecewise model of ECS. Describes the results of testing real ECS estimated according to 3 different processing algorithms bearing in mind the protection of the latter ones from additive interference of different types. Analogous studies were also carried out with artificial ECS. Analyzing the research findings the author arrives at the conclusion that the up-to-date automated systems are to be equipped with appliances enhancing the computation stability of algorithms of signal processing.

Algorithms↗
PubMed1987

Differential diagnosis of jaundice: applicability of the Copenhagen Pocket Chart proved in Stockholm patients.

This paper shows that an algorithm for differential diagnosis of jaundice developed in Denmark has been successfully transferred for use in a Swedish hospital. The algorithm, which is based on data from nearly 1000 patients, utilises 21 items of information from the medical history, physical examination and blood chemistry. The algorithm recognises four diagnostic groups: benign obstructive jaundice, malignant obstructive jaundice, acute non-obstructive jaundice, and chronic non-obstructive jaundice. To each item of information, a score is attached reflecting its weight of evidence. Summing the scores for the symptoms and signs that are present leads to a probabilistic statement about the diagnosis. Because of missing data in the Swedish patient material, three of the items were excluded from the original algorithm. Corrections were made for differences in the distribution of diseases. In reclassification of 985 Danish patients the modified algorithm's "best bid", i.e. the diagnosis given the highest probability, was correct in 78% of cases. More important, 93% of the cases given a "confident" diagnosis (probability greater than 0.80) were correct. The corresponding figures when the algorithm was applied to Swedish patients were 76% and 93%, respectively. In both series the predicted probabilities were matched by a corresponding proportion of actual diagnostic hits. It is concluded that the algorithm leads to reliable estimates of diagnostic probabilities in jaundice and that the algorithm seems to work well in Sweden also.

Adult↗
PubMed1996

Multiple domain protein diagnostic patterns.

We have implemented an iterative algorithm for the identification of diagnostic patterns from sets of multiple-domain proteins, where domains need not be common to all the proteins in the defining set. Our algorithm was applied to sequences gathered using a variety of methods, including BLAST, common keywords, and common E.C. numbers. In all cases, useful diagnostic patterns were obtained, possessing both high sensitivity and specificity. The patterns were found to correlate in several cases with both functional and structural domains. Patterns generated from a large number of sequence families were analyzed for probable multiple-domain structure.

Algorithms↗