Articles: sensitivity-specificity.
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Meta Analysis
Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis.
Acute aortic syndrome is a life-threatening emergency condition. Previous systematic reviews of D-dimer diagnostic accuracy for acute aortic syndrome have been contradictory and based on limited data, but recently published studies offer potential for a more definitive overview. We aimed to perform a systematic review and meta-analysis to determine the diagnostic accuracy of D-dimer for diagnosing acute aortic syndrome. ⋯ D-dimer concentration has high sensitivity (96.5%) and moderate specificity (56.2%) for acute aortic syndrome, with some uncertainty around estimates due to risk of bias and heterogeneity. Previous meta-analysis reporting higher specificity may be explained by inclusion of case-control studies that may overestimate accuracy.
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Multiple decision-aiding models are available to help physicians identify acute coronary syndrome (ACS) and accelerate the decision-making process in emergency departments (EDs). This study evaluated the diagnostic performance of the Manchester Acute Coronary Syndrome (MACS) rule and its derivations, enhancing the evidence for their clinical use. A systematic review and meta-analysis was performed. ⋯ Of all the MACS models, T-MACS displayed the highest overall accuracy due to its high sensitivity and significantly superior specificity. T-MACS exhibits very good diagnostic performance in predicting both AMI and MACE. This makes it a highly promising tool for managing patients with acute chest pain.
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Comparative Study
Comparison of the value of ultrasound-guided fine needle aspiration biopsy and contrast-enhanced ultrasound in different sizes of thyroid nodules.
The purpose of this study was to evaluate the diagnostic value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEUS) in the presence of thyroid nodules of different sizes. We retrospectively analyzed 110 patients with surgically operated unimodular thyroid nodules in Yichang City Central Hospital from July 1, 2021, to April 1, 2023, all of whom underwent conventional thyroid ultrasound, CEUS, and US-FNAB, and all of whom were classified according to the size of nodules into <0.5, 0.5 to 1, and ≥1 cm groups. The diagnostic accuracy, sensitivity, and specificity of the 2 methods for benign and malignant nodules were calculated. ⋯ In patients with nodule diameter <0.5 cm, the sensitivities of US-FNAB and CEUS were 74.29% and 100.00%, respectively, and the differences were statistically significant (P < 0.05); in patients with nodule diameter 0.5 to 1 cm, the sensitivities of US-FNAB and CEUS were 79.59% and 95.92%, respectively, and the differences were statistically significant (P < 0.05); among patients with nodule diameters ≥1 cm, the sensitivities of US-FNAB and CEUS were 88.89% and 77.78%, respectively, with no statistically significant difference (P > 0.05). For thyroid nodules ≤1 cm in diameter, the sensitivity of CEUS examination was higher than that of US-FNAB; and CEUS still has good diagnostic accuracy in the diagnosis of benign and malignant thyroid nodules <0.5 cm, CEUS is recommended for thyroid nodules diagnosed negatively by US-FNAB with a diameter of <1 cm; and CEUS should be preferred for thyroid nodules with a diameter of <0.5 cm. CEUS should be preferred for thyroid nodules <0.5 cm in diameter.
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Background and Objectives: The steady spread of dengue virus (DENV) poses a profound public health threat worldwide. Reverse transcription real-time polymerase chain reaction (RT2-PCR) has been increasingly recognized as a reference method for the diagnosis of acute dengue infection. The goal of this study was to assess the diagnostic accuracy of five different RT2-PCR kits for the detection of DENV in a historically processed set of sera samples. ⋯ No false positive results were registered in any assay. The end-point dilution analysis suggested that the RealStar kit had the lowest limit of detection. Conclusions: Available RT2-PCR kits for the detection of DENV are highly specific and generally sensitive and, therefore, their implementation in diagnostic pathways is advisable.
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Ann Acad Med Singap · Sep 2024
Observational StudyInvestigating urinary characteristics and optimal urine white blood cell threshold in paediatric urinary tract infection: A prospective observational study.
While the definitive diagnosis of urinary tract infection (UTI) requires a positive urine culture, the likelihood of UTI can be determined by urinalysis that includes white blood cell (WBC) count. We aimed to determine the optimal urine WBC threshold in urinalysis to predict UTIs in children presenting at the emergency department (ED). ⋯ A urine microscopy WBC threshold of ≥100/μL results in a clinically significant number of missed UTIs. Implementation of various thresholds should consider both the potential missed UTI rate and the required resource utilisation.