[Computed tomography of the liver. Study methods--diagnostic criteria--diagnostic efficiency--indications].
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Carcinoma, Hepatocellular↗
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Intellectual disabilities, depressive episode, diagnostic criteria and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD).
BACKGROUND: Depressive episode is one of the most common types of psychiatric illness that occurs in adults with intellectual disabilities. METHODS: A comprehensive literature search was undertaken using Medline, PsychLIT and hand-searching of key journals. This paper reviews the evidence and integrates findings, to report how evidence relates to the development of the new Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC-LD] depressive episode criteria. RESULTS: This area is better researched than many others, providing evidence on clinical symptomatology and presentation. In view of the lack of utility of standard diagnostic criteria developed for use with the general population, and set within the historical context, there are clearly identified reasons for the introduction of DC-LD. The depressive episode category has been informed by the evidence, and field trials showed excellent validity compared with the gold standard of learning disabilities psychiatric assessment. CONCLUSIONS: The DC-LD depressive episode category may improve clinical diagnosis and facilitate research. Its usefulness and limitations are yet to be determined in detail.
Adult↗
[Diagnostic criteria and diagnostic considerations for hypertension in the elderly].
Hypertension in the elderly consists mostly of essential hypertension, and its pathophysiology differs in many ways from that of essential hypertension in the young or middle-aged. No special diagnostic criteria for hypertension in the elderly were stated in ESH/ESC JNC 7 guidelines, that is, the criteria is systolic pressure of 140 mmHg and greater or diastolic pressure of 90mmHg and greater as in general adults. As the diagnostic considerations for hypertension in the elderly, we should pay much attention to medical history taking, measurement of blood pressure, discrepancy on auscultation, pseudohypertension, fluctuation of blood pressure, and diagnosis of secondary hypertension.
Aged↗
[Angiographic evaluation of mitral valve prolapse: my diagnostic criteria].
Diagnostic method of mitral valve prolapse (MVP) by left ventriculography was proposed. The results of the study are summarized as follows: 1) MVP was assessed by the dislocation of the mitral leaflets from their coaptation site. Diagnosis by left ventriculography was made by the characteristic "hook-like" finding at the coaptation site in the lateral view of the long axial oblique projection (LAP). MVP was classified into three groups by the degree of dislocation. 2) One hundred and twenty-eight patients with secundum atrial septal defect were examined. The diagnosis of MVP was agreed between cineangiography and real-time two-dimensional echocardiography in all the cases except two. On the other hand, by the right anterior oblique view, the diagnostic accuracy was at most 93%. 3) Cineangiographic diagnosis of MVP should be made by the tangential view to the mitral annulus. As to this point, RAO view has various problems and in the previous reports there seems to be some misinterpretations about the prolapse of this valve. For this tangential view, the lateral view of LAP is so useful that MVP must be assessed by this view.
Cineangiography↗
Diagnostic criteria for Rett syndrome. The Rett Syndrome Diagnostic Criteria Work Group.
Diagnostic criteria for Rett syndrome (RS) were developed by representatives of the International Rett Syndrome Association and the Centers for Disease Control for use in future clinical and epidemiological studies. Necessary criteria are: normal prenatal and perinatal period; normal psychomotor development through the first 6 months of life; normal head circumference at birth, with subsequent deceleration of head growth; loss of purposeful hand skills; severely impaired expressive and receptive language; apparent severe mental retardation; and gait apraxia and truncal apraxia/ataxia. Supportive criteria include breathing dysfunction, seizures, spasticity, scoliosis, and growth retardation. The diagnosis of RS is considered tentative until 2 to 5 years of age. The differential diagnosis includes other disorders associated with mental retardation, cerebral palsy, and seizure disorders. These diagnostic criteria for RS should foster reliable communication among investigators and enhance the epidemiological and clinical research of this important disorder.
Child↗
From classification criteria to diagnostic criteria for rheumatoid arthritis.
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Arthritis, Rheumatoid↗
[Diagnostic criteria for psychiatric research: RDC (Research Diagnostic Criteria). French translation and adaptation by M. Ansseau].
This article represents the French translation of the Research Diagnostic Criteria, a set of operational criteria for 24 psychiatric disorders developed by researchers at the New York State Psychiatric Institute and Columbia University (New York) to permit the selection of homogeneous samples of patients presenting with a defined psychiatric illness. The Research Diagnostic Criteria are especially focussed on depressive disorders, defining the major depressive disorder, which comprises 10 non exclusive subtypes. These criteria currently represent the most widely used nosologic system for clinical research in psychiatry, allowing for comparison of results and facilitation of replication by different research teams.
Affective Disorders, Psychotic↗
How to improve recognition and diagnosis of depressive syndromes using international diagnostic criteria.
International diagnostic criteria for depression have been elaborated in order to standardize and to facilitate diagnostic assessment. The findings of the present survey suggest that general practitioners (GPs) do accurately assess the individual depressive symptoms required to fulfill international diagnostic criteria for depressive syndromes. Training GPs to use these diagnostic criteria may be a way of improving recognition and diagnosis of depression in general practice.
Adolescent↗
A psychometric evaluation of the DSM-IV pathological gambling diagnostic criteria.
Specific diagnostic criteria for pathological gambling (PG) have been available for 25 years, since the publication of DSM-III. Little research has examined the psychometric performance of the diagnostic criteria. The goal of the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project was to examine the sensitivity, specificity and predictive values of the DSM-IV PG criteria for psychiatric outpatients who screened positive for a gambling problem. A total of 1709 psychiatric outpatients were evaluated with a semistructured diagnostic interview for PG. Of all patients 88 screened positive for PG, 40 of whom met DSM-IV diagnostic criteria for a lifetime history of PG. All ten DSM-IV criteria were significantly more frequent in the PG group. The sensitivity of the criteria ranged from 25.0% to 90.0% (mean = 67.8%), whereas specificity ranged from 62.5% to 100% (mean = 81.9%). Positive predictive values ranged from 64.1% to 100% (mean = 78.9%), and negative predictive values ranged from 61.5% to 90.7% (mean = 77.1%). Guidelines are recommended for determining whether a diagnostic criterion should be retained as part of the set of diagnostic criteria, and our results suggested that two of the DSM-IV PG criteria are candidates for elimination (criterion 8--commitment of illegal acts; criterion 10--reliance on others for financial assistance to relieve a desperate financial problem).
Adult↗
Validation of the U.K. diagnostic criteria for atopic dermatitis in a population setting. U.K. Diagnostic Criteria for Atopic Dermatitis Working Party.
One reason why so little is known about the epidemiology of atopic dermatitis (AD) is lack of suitable diagnostic criteria. A simple list of diagnostic criteria for AD for use in epidemiological studies has recently been developed by a U.K. working party. These have performed well in hospital validation studies of subjects with skin diseases. This study sought to validate the newly proposed criteria for AD in a population setting by conducting a cross-sectional survey of 695 schoolchildren aged 3-11 years in three randomly selected primary schools in West Lambeth, London. As a point prevalence measure, the U.K. criteria had a sensitivity of 70%, a specificity of 93%, and a positive predictive value of 47% when compared with a dermatologist's examination findings. Subsequent analysis suggested that most children classified as false positives had suffered from AD in the last year, but were inactive at the time of examination. When adjusted for these cases, the sensitivity and specificity increased to 80 and 97%, respectively, corresponding to positive and negative predictive values of 80 and 97%, respectively. The U.K. diagnostic criteria for AD appear to work well as a 1-year period prevalence measure in London schoolchildren. Further validation in adults and other countries are needed.
Child↗
Munchausen Syndrome by Proxy: medical diagnostic criteria.
Medical diagnostic criteria for Munchausen Syndrome by Proxy are presented. The strength of the known facts may vary from case to case, and thus there may be different degrees of diagnostic conviction. Therefore, diagnostic criteria for a definitive diagnosis, and a possible diagnosis of Munchausen Syndrome by Proxy are provided. Because the gathering of evidence in a case may, ultimately, diminish or exclude the diagnosis of Munchausen Syndrome by Proxy, diagnostic criteria for the inconclusive determination and the definitely excluded diagnosis are also enunciated.
Child↗
Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria".
New diagnostic criteria for multiple sclerosis integrating magnetic resonance image assessment with clinical and other paraclinical methods were introduced in 2001. The "McDonald Criteria" have been extensively assessed and used since 2001. New evidence and consensus now strengthen the role of these criteria in the multiple sclerosis diagnostic workup to demonstrate dissemination of lesions in time, to clarify the use of spinal cord lesions, and to simplify diagnosis of primary progressive disease. The 2005 Revisions to the McDonald Diagnostic Criteria for MS should simplify and speed diagnosis, whereas maintaining adequate sensitivity and specificity.
Humans↗
[Analysis of diagnostic criteria in ankylosing spondylitis. I. Diagnostic criteria of ankylosing spondylitis. Patients and methods].
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Diagnosis, Differential↗
Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): diagnostic criteria of the International Society of Thrombosis and Hemostasis and of the Japanese Ministry of Health and Welfare for overt DIC.
We compared the criteria set by the International Society of Thrombosis and Hemostasis (ISTH) for the diagnosis of disseminated intravascular coagulation (DIC) with the criteria of the Japanese Ministry of Health and Welfare (JMHW) set for the diagnosis of overt DIC. We studied 1,284 Japanese patients with DIC. The rate of agreement in the diagnosis of DIC by the two diagnostic systems was 67.4%. In addition, only 2.0% of non-DIC patients by JMHW criteria were diagnosed with overt DIC by ISTH criteria, suggesting that ISTH for overt DIC includes typical cases of DIC. The concordance of diagnosis for DIC by ISTH and JMHW was significantly high in patients with trauma or acute promyelocytic leukemia. About 70% of DIC or overt DIC patients had more than 1 point in the scoring system for prothrombin time, but >50% of those patients had 0 point for plasma fibrinogen level. Abnormal fibrin and fibrinogen degradation product (FDP) levels and platelet counts were observed in >88% of DIC and overt DIC patients but were observed in >50% of non-DIC patients, indicating that these parameters are sensitive markers but not specific markers for the diagnosis of DIC. Considered together, our results suggest that the diagnostic criteria for DIC and overt DIC could be improved by changing the cut-off values of the global coagulation tests.
Blood Coagulation Tests↗
Prevalence of undiagnosed diabetes in three American Indian populations. A comparison of the 1997 American Diabetes Association diagnostic criteria and the 1985 World Health Organization diagnostic criteria: the Strong Heart Study.
OBJECTIVE: In 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus of the American Diabetes Association (ADA) recommended three new sets of criteria for the diagnosis of diabetes that were different from those established by the World Health Organization (WHO) in 1985. One of these three methods was based on a fasting plasma glucose value only. This article compares ADA criteria with WHO criteria by applying them to three subgroups of American Indians in the Strong Heart Study who had no known diabetes. RESEARCH DESIGN AND METHODS: The Strong Heart Study is a prospective epidemiological study of vascular disease in three American Indian populations aged 45-74 years. During the baseline examination from 1988 to 1991, participants without diagnosed diabetes underwent a fasting glucose test and a 2-h oral glucose tolerance test. These values were used to compare the ADA and WHO diagnostic criteria. RESULTS: By using fasting and 2-h glucose values, prevalence rates of undiagnosed diabetes were 15.9% according to WHO criteria and 14.4% according to ADA criteria. The overall agreement rate was 65%, and the weighted kappa statistic was 0.474, which indicates moderate agreement. The age-specific analysis showed that, among participants between 45 and 54 years of age, the prevalence rates of undiagnosed diabetes were 13.4% according to WHO criteria and 12.7% according to ADA criteria. Among those aged 55-74 years, the rates were 18.7% according to WHO criteria and 16.3% according to ADA criteria. Thus, the difference in the prevalence rates when using WHO and ADA criteria, although generally small in this population, was three times higher in the older group (2.4%) than the difference in the younger group (0.7%). CONCLUSIONS: The Strong Heart Study found that prevalence rates of undiagnosed diabetes determined by ADA criteria and WHO criteria were similar in its American Indian population. The data suggest that the difference between the two criteria may increase as age increases. Longitudinal data will be needed to evaluate further the utility of the two criteria.
Aged↗
Chronic pancreatitis. The problems of diagnostic criteria.
The diagnostic criteria for chronic pancreatitis proposed by the Japan Pancreas Society (JPS) classified chronic pancreatitis into (i) definite; (ii) probable, and (iii) possible chronic pancreatitis, excluding obstructive, inflammatory (autoimmune) and tumor-forming pancreatitis from the definition of chronic pancreatitis. In the JPS Criteria, imaging studies, pancreatic function tests, and histological findings are independent of each other, and thus the diagnosis of chronic pancreatitis is made if one of the criteria is satisfied, regardless of the etiology of the chronic pancreatitis. The current diagnostic criteria for chronic pancreatitis depend on abnormalities of the duct system, such as low bicarbonate output, dilation of main pancreatic duct and duct branches, and calculi in the ducts by imaging studies. We revealed that the difference between reversible and irreversible pancreatitis in experimental animals is dependent on the degree of damage of the duct epithelium where pancreas progenitor cells exist. Thus, chronic pancreatitis diagnosed by the current criteria based on abnormalities of the duct system is irreversible. In contrast, the epithelium of the ducts is usually preserved in obstructive and autoimmune pancreatitis in that both structural and functional changes recover almost completely when the obstruction is removed or the inflammatory changes disappear following steroid administration. Even in chronic pancreatitis defined as irreversible, there must be a reversible stage during its clinical course. There is a need to develop biological markers and/or imaging procedure to detect chronic pancreatitis at its reversible stage.
Animals↗
CSF pleocytosis and expansion of spinal lesions in Japanese multiple sclerosis with special reference to the new diagnostic criteria.
New diagnostic criteria for multiple sclerosis (MS) were recently proposed from the international panel on the diagnosis of MS, and they include exclusion criteria, such as lesions extending over more than two vertebral segments on spinal MRI and CSF pleocytosis of more than 50/mm3. We reviewed the clinical features of 158 patients who satisfied the diagnostic criteria for MS except for having the above atypical paraclinical findings. All patients exhibited two or more clinical attacks and objective clinical evidence of multiple lesions without any evidence of other disorders. Thirty-three (20.9%) patients had one or both atypical paraclinical findings. Twenty-one out of the 33 patients were classified as having optico-spinal MS (OSMS), and the other 12 as non-OSMS patients with atypical large expanding or destructive cerebral, cerebellar or brainstem lesions on MRI as well as one or both atypical paraclinical findings. Based on this heterogeneity in clinical findings in MS, there is an urgent need to develop a common general concept of the "MS" syndromes, and the ethnic-related heterogeneity should be considered in the revised criteria for the diagnosis of MS.
Adolescent↗
[Study on Japan Rheumatism Association diagnostic criteria for early rheumatoid arthritis. 1. Application of the American Rheumatism Association diagnostic criteria to Japanese patients with early rheumatoid arthritis].
The Clinical Research Committee of the Japan Rheumatism Association is planning to formulate the diagnostic criteria for early rheumatoid arthritis (RA). We have analysed 123 contemporaneously and consecutively registered patients with early RA and 61 control subjects with rheumatic diseases other than RA (non-RA). As the first step of the works, these 184 patients were applied to the criteria of ARA in 1985 and 1987 for the sensitivity, specificity and accuracy of each items. Consequently, we found that the two ARA criteria were not sufficiently sensitive as the diagnostic criteria for patients studied in this work. Therefore it would be necessary to formulate a new diagnostic criteria for the patients with early rheumatoid arthritis.
Adult↗