Clinical utility of reflex testing with cancer biomarkers to improve diagnostic accuracy of primary Human Papillomavirus screening

2022 ◽  
pp. cebp.0972.2021
Author(s):  
Lauren G Johnson ◽  
Rakiya Saidu ◽  
Cecilia Svanholm-Barrie ◽  
Rosalind Boa ◽  
Jennifer Moodley ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Diagnostic Accuracy ◽  
Clinical Utility ◽  
Cancer Biomarkers ◽  
Reflex Testing

Translation: Beyond Diagnostic Accuracy: The Clinical Utility of Diagnostic Tests

2013 ◽  
Vol 3 (4) ◽  
pp. 269
Author(s):  
Patrick M.M. Bossuyt ◽  
Johannes B. Reitsma ◽  
Kristian Linnet ◽  
Karel G.M. Moons
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Tests ◽  
Clinical Utility

scholarly journals Diagnostic accuracy and clinical utility of a simplified low cost method of counting CD4 cells with flow cytometry in Malawi: diagnostic accuracy study

BMJ ◽  
2007 ◽  
Vol 335 (7612) ◽  
pp. 190-190 ◽  
Author(s):  
Calman A MacLennan ◽  
Michael K P Liu ◽  
Sarah A White ◽  
Joep J G van Oosterhout ◽  
Felanji Simukonda ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Diagnostic Accuracy ◽  
Clinical Utility ◽  
Low Cost ◽  
Diagnostic Accuracy Study ◽  
Cd4 Cells ◽  
Accuracy Study

Clinical Utility of Striational Antibodies in Paraneoplastic and Myasthenia Gravis Paraneoplastic Panels

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012050
Author(s):  
Shahar Shelly ◽  
John R Mills ◽  
Divyansu Dubey ◽  
Andrew McKeon ◽  
Anastasia Zekeridou ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Myasthenia Gravis ◽  
Clinical Utility ◽  
Roc Analysis ◽  
Thymic Cancer ◽  
Diagnostic Characteristics ◽  
Data Platform ◽  
Neurological Phenotype ◽  
Antibody Positivity

Objective:To critically assess the clinical utility of striational antibodies (StrAbs) within paraneoplastic and myasthenia gravis serological evaluations.Methods:All Mayo Clinic patients tested for StrAbs from January 1st 2012-December 31st 2018 utilizing Mayo’s Unified Data Platform (UDP) were reviewed for neurological diagnosis and cancer.Results:38,502 unique paraneoplastic and 1,899 MG patients were tested. In paraneoplastic evaluations, the StrAbs positivity rate was higher in cancer vs without cancer (5% [321/6775] vs 4% [1154/31727]; p<0.0001; OR 1.35; CI=1.19-1.53) but ROC analysis indicated no diagnostic accuracy in cancer (AUC=0.505). No neurological phenotype was significantly associated with StrAbs in the paraneoplastic group. Positivity was more common in all MG cancers compared to paraneoplastic cancers (p<0.0001). In MG evaluations, the StrAbs positivity rate was higher in those with cancer vs without (46% [217/474] vs 26% [372/1425]; p<0.0001; OR 2.39, CI 1.9-2.96) with ROC analysis indicating poor diagnostic accuracy for thymic cancer (AUC 0.634, recommended cutoff=1:60, sensitivity=56%, specificity=71%), with worse accuracy for extrathymic cancers (AUC 0.543). In paraneoplastic or MG evaluations, the value of antibody positivity did not improve cancer predictions. Paraneoplastic evaluated patients were more likely with positive StrAbs to obtain computed tomography (CT) (p=0.0001) with 3% (12/468) cancer found.Conclusion:Despite a statistically significant association with cancer, an expansive review of performance in clinical service demonstrates that StrAbs are neither specific nor sensitive in predicting malignancy or neurological phenotypes. CT imaging is over utilized with positive StrAbs results. Removal of StrAbs from paraneoplastic or MG evaluations will improve the diagnostic characteristics of the current MG test.Classification of Evidence:This study provides Class II evidence that the presence of StrAbs do not accurately identify patients with malignancy or neurological phenotypes.

scholarly journals Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure

2017 ◽  
Vol 29 (10) ◽  
pp. 1585-1593 ◽  
Author(s):  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
David Meagher ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Medical Records ◽  
Clinical Utility ◽  
The Elderly ◽  
Testing Procedure ◽  
Cognitive Tests ◽  
Attention Task ◽  
High Diagnostic Accuracy ◽  
Eye Opening ◽  
Delirium Superimposed On Dementia

ABSTRACTBackground:Detecting delirium superimposed on dementia (DSD) can be challenging because assessment partly relies on cognitive tests that may be abnormal in both conditions. We hypothesized that a combined arousal and attention testing procedure would accurately detect DSD.Methods:Patients aged ≥70 years were recruited from five hospitals across Europe. Delirium was diagnosed by physicians using DSM-5 criteria using information from nurses, carers, and medical records. Dementia was ascertained by the Informant Questionnaire on Cognitive Decline in the Elderly. Arousal was measured using the Observational Scale of Level of Arousal (OSLA), which assesses eye opening, eye contact, posture, movement, and communication. Attention was measured by participants signaling each time an “A” was heard when “S-A-V-E-A-H-A-A-R-T” was read out.Results:The sample included 114 persons (mean age 82 years (SD 7); 54% women). Dementia alone was present in 25% (n = 28), delirium alone in 18% (n = 21), DSD in 27% (n = 31), and neither in 30% (n = 34). Arousal and attention was assessed in n = 109 (96%). Using OSLA, 83% participants were correctly identified as having delirium (sensitivity 85%, specificity 82%, AUROC 0.92). The attention task correctly classified 76% of participants with delirium (sensitivity 90%, specificity 64%, AUROC 0.80). Combining scores correctly classified 91% of participants with delirium (sensitivity 84%, specificity 92%, AUROC 0.94). Diagnostic accuracy remained high in the subgroup with dementia (93% correctly classified, sensitivity 94%, specificity 92%, AUROC 0.98).Conclusions:This combined arousal–attention assessment to detect DSD was brief yet had high diagnostic accuracy. Such an approach could have clinical utility for diagnosing DSD.

scholarly journals Examination of Regression-based Discrepancy Scores for the RBANS in Detecting Cognitive Impairment from an Archival Sample

2018 ◽  
Vol 34 (8) ◽  
pp. 1329-1339 ◽  
Author(s):  
William F Goette ◽  
Andrew L Schmitt
Keyword(s):  
Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Clinical Utility ◽  
Word Reading ◽  
Neuropsychological Test ◽  
Clinical Neuropsychology ◽  
Standard Score ◽  
Neuropsychological Status ◽  
Total Scale Score ◽  
Performance Results

Abstract Objective The purpose of this study was to evaluate the clinical utility of regression-based formulas for the RBANS indexes in screening for cognitive impairment. Method A database of neuropsychological test results was created from archival records in a memory assessment clinic. The sample consisted of 83 individuals (37 males/46 females) with an average age of 70.1 (SD = 9.8) and 14.6 years of education (SD = 2.8). Diagnostic accuracy of regression-based predictions provided by Duff and Ramezani (2015) (Duff, K., & Ramezani, A. (2015). Regression-based normative formulae for the Repeatable Battery for the Assessment of Neuropsychological Status for older adults. Archives of Clinical Neuropsychology, 30, 600–604.) and from regression of WTAR standard score were examined via receiver operator characteristic curves. Preliminary generalizability investigation was completed using two additional datasets. Results The WTAR was found to mediate the relationship between education and all RBANS index scores. The WTAR standard score was also found to contribute uniquely and significantly to the prediction of RBANS performance. Results of diagnostic accuracy analyses showed similar discriminating accuracy for all scores. There was limited support for using the WTAR over demographic variables alone in the estimation of RBANS performance; however, the WTAR was found to be more predictive than education, indicating potential clinical utility to using the word-reading score over just years of attained education. Conclusions Use of these derived Total Scale score variants is recommended for the screening of cognitive impairment, particularly in individuals with superior or poor educational quality. Further research is required to evaluate the utility of these variations in more diverse samples.

Clinical utility of reflex testing using focused next generation sequencing for management of patients with advanced lung adenocarcinoma.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e24199-e24199
Author(s):  
Navid Sadri ◽  
Tyler E Miller ◽  
Michael Yang ◽  
Afshin Dowlati ◽  
Judah D. Friedman ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Lung Adenocarcinoma ◽  
Clinical Utility ◽  
Next Generation ◽  
Reflex Testing ◽  
Generation Sequencing
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