Articles: sensitivity-specificity.
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Critical care medicine · Sep 2014
Review Meta AnalysisLactate Clearance Is a Useful Biomarker for the Prediction of All-Cause Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis.
Lactate clearance has been widely investigated for its prognostic value in critically ill patients. However, the results are conflicting. The present study aimed to explore the diagnostic accuracy of lactate clearance in predicting mortality in critically or acutely ill patients. ⋯ Our study demonstrates that lactate clearance is predictive of lower mortality rate in critically ill patients, and its diagnostic performance is optimal for clinical utility.
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We assess the sensitivity and specificity of xanthochromia as adjudicated by visual inspection and spectrophotometry at predicting the presence of cerebral aneurysm in patients with suspected subarachnoid hemorrhage who have a normal computed tomography (CT) head scan result. ⋯ The heterogeneity in the underlying studies, combined with significant overlap in pooled confidence limits, makes it impossible to provide a definite conclusion about the diagnostic accuracy of spectrophotometry versus visual inspection.
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Cerebral vasospasm is a potentially devastating complication in patients with aneurysmal subarachnoid hemorrhage. The purpose of this article is to review the use of computed tomogram (CT) angiography and CT perfusion in the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage and also assess their use in guiding treatment decisions. ⋯ Computed tomogram angiography can directly visualize arterial narrowing and CT perfusion is able to evaluate differences in perfusion parameters after aneurysmal subarachnoid hemorrhage with high sensitivity and specificity. CT perfusion is better at predicting which patients require endovascular treatment.
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Review Meta Analysis
The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis.
Acute mesenteric ischemia is an infrequent cause of abdominal pain in emergency department (ED) patients; however, mortality for this condition is high. Rapid diagnosis and surgery are key to survival, but presenting signs are often vague or variable, and there is no pathognomonic laboratory screening test. A systematic review and meta-analysis of the available literature was performed to determine diagnostic test characteristics of patient symptoms, objective signs, laboratory studies, and diagnostic modalities to help rule in or out the diagnosis of acute mesenteric ischemia in the ED. ⋯ The quality of the overall literature base for mesenteric ischemia is varied. Signs, symptoms, and laboratory testing are insufficiently diagnostic for the condition. Only CT angiography had adequate accuracy to establish the diagnosis of acute mesenteric ischemia in lieu of laparotomy.
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Intensive care medicine · Sep 2011
Review Meta AnalysisSeverity assessment tools to guide ICU admission in community-acquired pneumonia: systematic review and meta-analysis.
The aim of this meta-analysis was to determine if severity assessment tools can be used to guide decisions regarding intensive care unit (ICU) admission of patients with community-acquired pneumonia. ⋯ Large variations exist in the use of ICU resources between different studies and different healthcare systems. Scoring systems designed to predict 30-day mortality perform less well when ICU admission is taken into account. Further studies of dedicated ICU admission scores are required.