检索结果-南通市图书馆

diagnostic accuracy of ePOS score in predicting DNR labeling after ICU admission:A prospective observational study(ePOS-DNR)

引用

Journal of Intensive Medicine 2024年第2期4卷 216-221页

作者： Omar E.Ramadan Ahmed F.Mady Mohammed A.Al-Odat Ahmed N.Balshi Ahmed W.Aletreby Taisy J.Stephen Sheena R.Diolaso Jennifer Q.Gano Waleed Th.Aletreby Department of Critical Care King Saud Medical CityRiyadhSaudi Arabia Anesthesia Department Faculty of MedicineAin Shams UniversityCairoEgypt Anesthesia Department Faculty of MedicineTanta UniversityTantaEgypt Faculty of Medicine Alexandria UniversityAlexandriaEgypt Nursing Department King Saud Medical CityRiyadhSaudi Arabia

Background Resuscitation can sometimes be futile and making a do-not-resuscitate(DNR)decision is in the best interest of the patient.The electronic poor outcome screening(ePOS)score was developed to predict 6-month poor outcomes of critically ill patients.We explored the diagnostic accuracy of the ePOS score in predicting DNR decisions in the intensive care unit(ICU).Methods This study was conducted at the ICU of a tertiary referral hospital in Saudi Arabia between March and May 2023.Prospectively,we calculated ePOS scores for all eligible consecutive admissions after 48 h in the ICU and recorded the DNR orders.The ability of the score to predict DNR was explored using logistic regression.Youden's ideal cut-off value was calculated using the DeLong method,and different diagnostic accuracy measures were generated with corresponding 95%confidence intervals(CIs).Results We enrolled 857 patients,125 received a DNR order and 732 did not.The average ePOS score of DNR and non-DNR patients was 28.2±10.7 and 15.2±9.7,respectively.ePOS score,as a predictor of DNR order,had an area under receiver operator characteristic(AUROC)curve of 81.8%(95%CI:79.0 to 84.3,P17 was associated with a sensitivity of 87.2(95%CI:80.0 to 92.5,Pdiagnostic odds ratio 12.1(95%CI:7.0 to 20.8,Pdiagnostic test for patients who will be labeled as DNR during their ICU stay.A cut-off score>17 may help guide clinical decisions to withhold or commence resuscitative measures.

关键词： Do-not-resuscitate(DNR) Resuscitation Intensive care unit(ICU) diagnostic accuracy Sensitivity Specificity

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

diagnostic accuracy of Computerized Bowel Sound Analysis with Non-Invasive Devices for Irritable Bowel Syndrome:A Systematic Review and Meta-Analysis

引用

Chinese Medical Sciences Journal 2024年第2期39卷 122-130页

作者： Xia-Xiao Yan Yue-Lun Zhang Yu-Pei Zhang Ying-Yun Yang Dong Wu Department of Gastroenterology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Eight-Year Medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective To assess the diagnostic accuracy of bowel sound analysis for irritable bowel syndrome(IBS)with a systematic review and meta-analysis.Methods We searched MEDLINE,Embase,the Cochrane Library,Web of Science,and IEEE Xplore databases until September 2023.Cross-sectional and case-control studies on diagnostic accuracy of bowel sound analysis for IBS were identified.We estimated the pooled sensitivity,specificity,positive likelihood ratio,negative likeli-hood ratio,and diagnostic odds ratio with a 95% confidence interval(CI),and plotted a summary receiver operat-ing characteristic curve and evaluated the area under the curve.Results Four studies were included.The pooled diagnostic sensitivity,specificity,positive likelihood ratio,nega-tive likelihood ratio,and diagnostic odds ratio were 0.94(95%CI,0.87‒0.97),0.89(95%CI,0.81‒0.94),8.43(95%CI,4.81‒14.78),0.07(95%CI,0.03‒0.15),and 118.86(95%CI,44.18‒319.75),respectively,with an area under the curve of 0.97(95%CI,0.95‒0.98).Conclusions Computerized bowel sound analysis is a promising tool for IBS.However,limited high-quality data make the results'validity and applicability questionable.There is a need for more diagnostic test accuracy studies and better wearable devices for monitoring and analysis of IBS.

关键词： irritable bowel syndrome bowel sound analysis diagnostic accuracy systematic review meta-analysis

来源：

维普期刊数据库博看期刊评论

在线全文

学校读者我要写书评

暂无评论

diagnostic accuracy of the tongue blade test combined with clinical signs to detect maxillary and mandibular fractures in the emergency department

引用

World Journal of Emergency Medicine 2023年第2期14卷 122-127页

作者： Jee Yen Kuck Abdul Muhaimin Noor Azhar Neena Wee Rishya Manikam Emergency Department University of MalayaKuala Lumpur 50603Malaysia

BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging(facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures.RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%.CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures,thus preventing unnecessary radiation exposure.

关键词： Maxillary fractures Mandibular fractures Tongue blade test diagnostic accuracy Clinical decision tool Emergency department

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

diagnostic accuracy of cystoscopic biopsy for tumour grade in outpatients with urothelial carcinoma of the bladder and the risk factors of upgrading

引用

Asian Journal of Urology 2023年第1期10卷 19-26页

作者： Junjie Fan Hua Liang Jinhai Fan Lei Li Guanjun Zhang Xinqi Pei Tao Yang Dalin He Kaijie Wu Department of Urology First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina Department of Urology Baoji Center HospitalBaojiChina Department of Pathology First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina

Objective:To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour(TURBT)and explore the risk factors of upgrading.Methods:The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed.Comparative analysis of the tumour grade of biopsy and operation specimens was performed.Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading.Logistic regression an-alyses were performed to identify the risk factors of upgrading.Results:For the 205 patients,the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639.The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912,respectively.Univariate and multivariate logistic regression analyses showed that older age,tumour multifocality,high neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and low lymphocyte-to-monocyte ratio(LMR)were significantly associated with upgrading(odds ratio ranging from 0.412 to 4.364).The area under the curve of the different multivariate models was improved from 0.752 to 0.821,and decision curve analysis demonstrated a high net benefit when NLR,LMR,and PLR were added.Conclusion:diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer,especially for outpatients with low-grade bladder cancer.Moreover,older age,tumour multifocality,high NLR,PLR,and low LMR are risk factors of upgrading,and systemic inflammatory markers improve the predictive ability.

关键词： Cystoscopic biopsy Bladder cancer diagnostic accuracy Upgrading Systemic inflammatorymarkers

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

diagnostic accuracy of the Apparent Diffusion Coefficient for Microvascular Invasion in Hepatocellular Carcinoma: A Meta-analysis

引用

Journal of Clinical and Translational Hepatology 2022年第4期10卷 642-650页

作者： Yuhui Deng Jisheng Li Hui Xu Ahong Ren Zhenchang Wang Dawei Yang Zhenghan Yang Department of Radiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Medical Imaging Division Heilongjiang Provincial HospitalHarbin Institute of TechnologyHarbinHeilongjiangChina Department of Interventional Radiology Yantai Penglai Traditional Chinese Medicine HospitalYantaiShandongChina

Background and Aims:Microvascular invasion(MVI)is a major risk factor for the early recurrence of hepatocel-lular carcinoma(HCC)and it seriously worsens the prog-nosis.Accurate preoperative evaluation of the presence of MVI could greatly benefit the treatment management and prognosis prediction of HCC patients.The study aim was to evaluate the diagnostic performance of the apparent dif-fusion coefficient(ADC),a quantitative parameter for the preoperative diagnosis MVI in HCC patients.Methods:Original articles about diffusion-weighted imaging(DWI)and/or intravoxel incoherent motion(IVIM)conducted on a 3.0 or 1.5 Tesla magnetic resonance imaging(MRI)system indexed through January 17,2021were collected from MED-LINE/PubMed,Web of Science,EMBASE,and the Cochrane Library.Methodological quality was evaluated using Quality Assessment of diagnostic accuracy Studies 2(QUADAS-2).The pooled sensitivity,specificity,and summary area un-der the receiver operating characteristic curve(AUROC)were calculated,and meta-regression analysis was per-formed using a bivariate random effects model through a meta-analysis.Results:Nine original articles with a total of 988 HCCs were included.Most studies had low bias risk and minimal applicability concerns.The pooled sensitivity,specificity and AUROC of the ADC value were 73%,70%,and 0.78,respectively.The time interval between the index test and the reference standard was identified as a pos-sible source of heterogeneity by subgroup meta-regression analysis.Conclusions:Meta-analysis showed that the ADC value had moderate accuracy for predicting MVI in HCC.The time interval accounted for the heterogeneity.

关键词： Hepatocellular carcinoma Meta-analysis diagnostic accuracy Diffusion-weighted imaging Microvascular invasion

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

diagnostic accuracy of thoracic imaging modalities for the detection of COVID-19

引用

World Journal of Radiology 2022年第2期14卷 47-49页

作者： Haben Dawit Marissa Absi Nayaar Islam Sanam Ebrahimzadeh Matthew D F McInnes Clinical Epidemiology Program Ottawa Hospital Research InstituteOttawa K1E4M9ONCanada Department of Radiology The Ottawa Hospital Research Institute Clinical Epidemiology ProgramOttawa K1H8L6ONCanada

The ongoing coronavirus disease 2019(COVID-19)pandemic continues to present diagnostic challenges.The use of thoracic radiography has been studied as a method to improve the diagnostic accuracy of COVID-19.The‘Living’Cochrane Systematic Review on the diagnostic accuracy of imaging tests for COVID-19 is continuously updated as new information becomes available for study.In the most recent version,published in March 2021,a meta-analysis was done to determine the pooled sensitivity and specificity of chest X-ray(CXR)and lung ultrasound(LUS)for the diagnosis of COVID-19.CXR gave a sensitivity of 80.6%(95%CI:69.1-88.6)and a specificity of 71.5%(95%CI:59.8-80.8).LUS gave a sensitivity rate of 86.4%(95%CI:72.7-93.9)and specificity of 54.6%(95%CI:35.3-72.6).These results differed from the findings reported in the recent article in this journal where they cited the previous versions of the study in which a metaanalysis for CXR and LUS could not be performed.Additionally,the article states that COVID-19 could not be distinguished,using chest computed tomography(CT),from other respiratory diseases.However,the latest review version identifies chest CT as having a specificity of 80.0%(95%CI:74.9-84.3),which is much higher than the previous version which indicated a specificity of 61.1%(95%CI:42.3-77.1).Therefore,CXR,chest CT and LUS have the potential to be used in conjunction with other methods in the diagnosis of COVID-19.

关键词： COVID-19 Chest x-ray Computed tomography Lung ultrasound Specificity and sensitivity diagnostic accuracy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

diagnostic accuracy of dynamic contrast-enhanced magnetic resonance imaging for distinguishing pseudoprogression from glioma recurrence:a meta-analysis

引用

Chinese Medical Journal 2021年第21期134卷 2535-2543页

作者： Jun Qiu Zhen-Chao Tao Ke-Xue Deng Peng Wang Chuan-Yu Chen Fang Xiao Yi Luo Shu-Ya Yuan Hao Chen Huan Huang Department of Radiology The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhui 230036China Department of Radiation Oncology The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhui 230036China

Background:It is crucial to differentiate accurately glioma recurrence and pseudoprogression which have entirely different prognosis and require different treatment strategies.This study aimed to assess the diagnostic accuracy of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)as a tool for distinguishing glioma recurrence and pseudoprogression.Methods:According to particular criteria of inclusion and exclusion,related studies up to May 1,2019,were thoroughly searched from several databases including PubMed,Embase,Cochrane Library,and Chinese biomedical databases.The quality assessment of diagnostic accuracy studies was applied to evaluate the quality of the included studies.By using the"mada"package in R,the heterogeneity,overall sensitivity,specificity,and diagnostic odds ratio were calculated.Moreover,funnel plots were used to visualize and estimate the publication bias in this study.The area under the summary receiver operating characteristic(SROC)curve was computed to display the diagnostic efficiency of DCE-MRI.Results:In the present meta-analysis,a total of 11 studies covering 616 patients were included.The results showed that the pooled sensitivity,specificity,and diagnostic odds ratio were 0.792(95%confidence interval[CI]0.707-0.857),0.779(95%CI 0.715-0.832),and 16.219(97.5%CI 9.123-28.833),respectively.The value of the area under the SROC curve was 0.846.In addition,the SROC curve showed high sensitivities(>0.6)and low false positive rates(diagnostic tool for distinguishing glioma recurrence and pseudoprogression,it was capable of improving diagnostic accuracy.Hence,further investigations combining DCE-MRI with other imaging modalities are required to establish an efficient diagnostic method for glioma patients.

关键词： Meta-analysis Dynamic contrast-enhanced magnetic resonance imaging Pseudoprogression diagnostic accuracy Glioma

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Impact of uncontrolled blood pressure on diagnostic accuracy of coronary flow reserve for detecting significant coronary stenosis in hypertensive patients

引用

Chinese Medical Journal 2013年第5期126卷 839-844页

作者： LI Wei-hong XU Wei-xian LI Zhao-ping LI Cui-ping WANG Xin-yu HE Li-yun ZHAO Wei FENG Xin-heng GAO Wei Department of Cardiology Peking University Third Hospital KeyLaboratory of Cardiovascular Molecular Biology and RegulatoryPeptides Ministry of Health Key Laboratory of MolecularCardiovascular Sciences Ministry of Education Beijing 100191China

Background Impaired coronary flow reserve （CFR） in patients with hypertension may be caused by epicardial coronary stenosis or microvascular dysfunction. Antihypertensive treatment has been shown to improve coronary microvascular dysfunction. The aim of this study was to evaluate the impact of uncontrolled blood pressure （BP） on diagnostic accuracy of CFR for detecting significant coronary stenosis. Methods A total of 98 hypertensive patients scheduled for coronary angiography （CAG） due to chest pain were studied. Of them, 45 patients had uncontrolled BP （defined as the office BP 〉140/90 mmHg （1 mmHg=0.133 kPa） in general hypertensive patients, or ≥130/80 mmHg in hypertensive individuals with diabetes mellitus）, and the remaining 53 patients had well-controlled BP. CFR was measured in the left anterior descending coronary artery （LAD） during adenosine triphosphate-induced hyperemia by non-invasive transthoracic Doppler echocardiography （TTDE） within 48 hours prior to CAG. Significant LAD stenosis was defined as 〉70% luminal narrowing. diagnostic accuracy of CFR for detecting significant coronary stenosis was analyzed with a receiver operating characteristic analysis. Results CFR was significantly lower in patients with uncontrolled BP than in those with well-controlled BP （2.1±0.6 vs. 2.6±0.9, P〈0.01）. Multivariate linear regression analysis of the study showed that the value of CFR was independently associated with the angiographically determined degree of LAD stenosis （β= -0.445, P 〈0.0001） and the presence of uncontrolled BP （β= -0.272, P=0.014）. With a receiver operating characteristic analysis, CFR 〈2.2 was the optimal cut-off value for detecting LAD stenosis in all hypertensive patients （AUC 0.83, 95% CI 0.75-0.91） with a sensitivity of 75%, a specificity of 78%, and an accuracy of 77%. A significant reduction of diagnostic specificity was observed in patients with uncontrolled BP compared with those with well-controlled BP （67% vs. 93%, P=0.031）. Conclusions CFR measurement by TTDE is valuable in the diagn

关键词： coronary flow reserve hypertension uncontrolled blood pressure transthoracic Doppler echocardiography diagnostic accuracy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

diagnostic accuracy of the Malnutrition Screening Tool (MST) in Adult Cancer Patients: a Systematic Literature Review and Meta-Analysis

引用

Journal of Nutritional Oncology 2021年第1期6卷 33-41页

作者： Rena Nakyeyune Xiao Li Ruan Yi Shen Yi Shao Chen Niu Zhao Ping Zang Fen Liu Department of Epidemiology and Health Statistics School of Public HealthBeijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijing 100069China

Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.

关键词： Cancer Malnutrition Nutrition Malnutrition screening Tool Meta-analysis diagnostic accuracy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

diagnostic accuracy and Predictive Value of Clinical Symptoms for the Diagnosis of Mild COVID-19

引用

Journal of Biosciences and Medicines 2021年第6期9卷 137-149页

作者： Vasyl Popovych Ivana Koshel Yulia Haman Vitaly Leschak Ruslan Duplikhin The head of the department of ENT diseases head and neck surgery of Ivano-Frankivsk National Medical University Ivano-Frankivsk Ukraine Department of Therapy and Family Medicine Institute of Postgraduate Education of Ivano-Frankivsk National Medical University Ivano-Frankivsk Ukraine Uzhgorod National University Uzhgorod Ukraine National University of Pharmacy Kharkiv Ukraine

Objective: To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. Methods: We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. Results: Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. Conclusion: The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.

关键词： diagnostic accuracy Predictive Values COVID-19 Symptom

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：