Articles: sensitivity-specificity.
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In studies of diagnostic accuracy, the performance of an index test is assessed by verifying its results against those of a reference standard. If verification of index-test results by the preferred reference standard can be performed only in a subset of subjects, an alternative reference test could be given to the remainder. ⋯ The Bayesian methods presented in this paper use a single model to (1) acknowledge the different nature of the 2 reference standards and (2) make simultaneous inferences about the population prevalence and the sensitivity, specificity, and predictive values of the index test with respect to both reference tests, in relation to latent disease status. We illustrate this approach using data from a study on the accuracy of the elbow extension test for diagnosis of elbow fractures in patients with elbow injury, using either radiography or follow-up as reference standards.
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Physical examination has been advocated as a primary determinant of ICU-acquired weakness (ICU-AW). The purpose of the study is to investigate ICU-AW development by using Maximum Inspiratory Pressure (MIP) as a surrogate parameter of the standardized method to evaluate patients' peripheral muscle strength. ⋯ MIP estimated using the unidirectional valve method may be a potential surrogate parameter for the assessment of muscle strength compromise, useful for the early detection of ICU-AW.
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J Bronchology Interv Pulmonol · Oct 2010
Performance characteristics of semirigid thoracoscopy in pleural effusions of undetermined etiology.
The utility of the recently introduced semirigid thoracoscopy in undiagnosed pleural effusions is still unclear. ⋯ Semirigid thoracoscopy is a safe, well-tolerated, and efficacious procedure for establishing the diagnosis in pleural effusions of undetermined etiology.
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J Bronchology Interv Pulmonol · Jul 2010
Factors Influencing the Diagnostic Yield of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration.
We describe the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a heterogeneous population of patients with mediastinal lymphadenopathy secondary to suspected cancer (lung and nonlung) or recurrence after cancer therapy in a large academic cancer institute. A review was done of all patients referred for real-time EBUS-TBNA over an 18-month period at our institution. Cytological analysis of EBUS-TBNA aspirates was compared with a reference standard of definitive pathologic tissue diagnosis or a composite of ≥6 months' clinical follow-up with radiographic imaging. ⋯ Other factors, such as airway distortion and calcification, are also associated with less accurate EBUS-TBNA results. In a diverse population of patients with suspected cancer or recurrence, EBUS-TBNA is minimally invasive and highly accurate. Factors such as lymph node size and location influence the result of EBUS-TBNA.
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J Bronchology Interv Pulmonol · Jul 2010
Utility of semirigid thoracoscopy in the diagnosis of pleural effusions: a systematic review.
Pleural effusion of undetermined etiology (PEUE), where blind pleural aspirate/biopsy fails to yield an answer, often needs histologic study for a definitive diagnosis. Several studies have shown the potential utility of medical thoracoscopy (MT) in PEUE; results, however, are not uniform and a majority are available for rigid thoracoscopy. We sought to determine the diagnostic accuracy of the relatively new technique of semirigid thoracoscopy in PEUE through this systematic review. ⋯ Semirigid thoracoscopy seems to be a safe, simple, and accurate tool for undiagnosed pleural effusions. It is well tolerated and is devoid of major complications. Further studies with sound methodology will further help to define the future role of this procedure.