Articles: sensitivity-specificity.
-
Health Technol Assess · Jun 2009
ReviewSensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making.
To determine how we define good practice in sensitivity analysis in general and probabilistic sensitivity analysis (PSA) in particular, and to what extent it has been adhered to in the independent economic evaluations undertaken for the National Institute for Health and Clinical Excellence (NICE) over recent years; to establish what policy impact sensitivity analysis has in the context of NICE, and policy-makers' views on sensitivity analysis and uncertainty, and what use is made of sensitivity analysis in policy decision-making. ⋯ The review and the policy impact assessment focused exclusively on documentary evidence, excluding other sources that might have revealed further insights on this issue. In seeking to address parameter uncertainty, both deterministic and probabilistic sensitivity analyses should be used. It is evident that some cost-effectiveness work, especially around the sensitivity analysis components, represents a challenge in making it accessible to those making decisions. This speaks to the training agenda for those sitting on such decision-making bodies, and to the importance of clear presentation of analyses by the academic community.
-
Review
Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis.
Several studies and systematic reviews have reported results that indicate that sensitivity and specificity may vary with prevalence. ⋯ Sensitivity and specificity may vary in different clinical populations, and prevalence is a marker for such differences. Clinicians are advised to base their decisions on studies that most closely match their own clinical situation, using prevalence to guide the detection of differences in study population or study design.
-
Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Monitoring retroperitoneal bleeding model of piglets by electrical impedance tomography.
To investigate continuous monitoring capacity of electrical impedance tomography (EIT) for retroperitoneal bleeding, studies were carried out on six anesthetized piglet's bleeding model produced by injecting anticoagulated blood into renal region. For each subject, total blood of about 200 ml was injected within time periods ranging from tens of minutes to several hours. ⋯ EIT images were reconstructed by dynamic back-projection algorithm. The results showed that impedance changes caused by bleeding could be revealed by EIT images.
-
Controlled Clinical Trial
Diagnostic accuracy of N-terminal pro-brain natriuretic peptide in the evaluation of postoperative left ventricular diastolic dysfunction.
We compared the diagnostic accuracy of N-terminal prohormone brain natriuretic peptide (NT-proBNP) with that of echocardiography in the evaluation of left ventricular diastolic dysfunction after coronary artery bypass grafting. Thirty patients were studied prospectively. Patients who had recent myocardial infarction, unstable angina pectoris, or low ejection fraction with systolic dysfunction were excluded. ⋯ The NT-proBNP had 87.5% sensitivity and 55% specificity, whereas E/Ea had 87.5% sensitivity and 86.4% specificity. Plasma NT-proBNP levels are significantly related to mitral E/Ea ratio, which is a predictor of diastolic stage. Therefore, elevated NT-proBNP levels may indicate the time for a Doppler echocardiographic evaluation and identify a subgroup of patients at high risk who need closer monitoring during the early postoperative period.
-
BMC emergency medicine · Jan 2007
The utility of B-type natriuretic peptide in the diagnosis of heart failure in the emergency department: a systematic review.
Dyspnea is a common chief complaint in the emergency department (ED); differentiating heart failure (HF) from other causes can be challenging. Brain Natriuretic Peptide (BNP) is a new diagnostic test for HF for use in dyspneic patients in the ED. The purpose of this study is to systematically review the accuracy of BNP in the emergency diagnosis of HF. ⋯ Our analysis suggests that BNP has moderate accuracy in detecting HF in the ED. Our results suggest utilizing a BNP of less than 100 pg/ml to rule out HF and a BNP of greater than 400 pg/ml to diagnose HF. Many studies were of marginal quality, and all included patients with varying degrees of diagnostic uncertainty. Further studies focusing on patients with diagnostic uncertainty will clarify the real-world utility of BNP in the emergency management of dyspnea.