Articles: sensitivity-specificity.
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Multicenter Study Observational Study
Diagnostic value of SAT-TB in smear-negative pulmonary tuberculosis: A diagnostic accuracy study.
This study aimed to evaluate the diagnostic value of rapid simultaneous RNA amplification and testing for tuberculosis (SAT-TB) in smear-negative pulmonary tuberculosis (PTB). We performed a multicenter prospective analysis of 206 patients with smear-negative suspected PTB between December 2018 and March 2022. We collected sputum or bronchoalveolar lavage fluid (BALF) for simultaneous SAT-TB and Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) assays. ⋯ The SAT-TB and Xpert MTB/RIF assays were highly consistent in diagnosing smear-negative PTB. It is a valuable method for early detection, prevention, and managing smear-negative PTB suspects. Meanwhile, the detection efficiency and cost-effectiveness of SAT-TB are more suitable for the rapid diagnosis of smear-negative PTB in low- and middle-income countries.
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Observational Study
Preoperative prediction of microvascular/nerve invasion in locally advanced gastric cancer by differentiation and enhanced CT features.
The purpose of the article is to determine whether differentiation and enhanced CT features can preoperatively predict microvascular/nerve invasion in locally advanced gastric cancer. Retrospective analysis of the CT and pathological data of 325 patients with locally advanced gastric cancer confirmed by pathology in our hospital from July 2011 to August 2023. The patient's age, gender, tumor location, T stage, N stage, TNM stage, differentiation, Lauren classification, as well as tumor thickness, tumor longest diameter, plain CT value, arterial CT value, venous CT value, arterial phase enhancement rate, and venous phase enhancement rate were assessed. ⋯ Multivariate analysis suggested that TNM stage and differentiation were independent risk factors for microvascular/nerve invasion. The receiver operating characteristic analysis showed that the diagnostic efficacy of the combined parameter of TNM stage and differentiation was better than that of the single parameter, in which area under the curve, sensitivity, and specificity were 0.819 (95%CI: 0.770-0.867), 66.7%, and 83.8%, respectively. Differentiation and enhanced CT are helpful in predicting whether microvascular/nerve invasion occurs in locally advanced gastric cancer before operation, especially the combined parameters of TNM stage and differentiation.
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Review Meta Analysis
Bedside-focused transthoracic echocardiography in acute atraumatic thoracic aortic syndrome: a systematic review and meta-analysis of diagnostic accuracy.
The objective of this review was to assess the diagnostic accuracy of bedside-focused transthoracic echocardiography (TTE) in acute atraumatic thoracic aortic syndrome in adults. We performed a systematic review and meta-analysis of publications that described the use of bedside-focused TTE on adults presenting to emergency care settings with suspected atraumatic thoracic aortic syndrome. Studies were identified using keyword and MeSH on relevant databases as well as grey literature, followed by abstract screening and study selection by two independent reviewers. ⋯ For type B dissection, pooled sensitivity was 65% (95% CI, 45-80%) and specificity was 100% (95% CI, 0.69-100%). Regarding indirect TTE signs, pooled sensitivities and specificities were 64% (5.2-98.2%) and 94% (92-96.1%), respectively for aortic valve regurgitation, 92% (54-99.2%) and 87% (62-97%) for thoracic aortic aneurysm and 39% (33.8-45%) and 94% (92-95%) for pericardial effusion. In this systematic review and meta-analysis, bedside-focused TTE has high specificity for type A and B dissection, a moderate to high sensitivity for type A but poor for type B, and unclear diagnostic accuracy for intramural haematoma and penetrating aortic ulcer.
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Meta Analysis
Improving Cancer Probability Estimation in Non-Diagnostic Bronchoscopies: A meta-analysis.
In patients with peripheral pulmonary lesions (PPLs), nondiagnostic bronchoscopy results are not uncommon. The conventional approach to estimate the probability of cancer (pCA) after bronchoscopy relies on dichotomous test assumptions, using prevalence, sensitivity, and specificity to determine negative predictive value. However, bronchoscopy is a multidisease test, raising concerns about the accuracy of dichotomous methods. ⋯ Conventional dichotomous methods for estimating pCA after nondiagnostic bronchoscopies underestimate the likelihood of malignancy. Physicians should opt for the multidisease test approach when interpreting bronchoscopy results.