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Test Sensitivity

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21. Understanding medical tests: A new addition to our toolkit addressing sensitivity, specificity, and other core concepts

Understanding medical tests: A new addition to our toolkit addressing sensitivity, specificity, and other core concepts Understanding medical tests-A new addition to our toolkit on sensitivity, specificity and positive predictive value Note to our followers: Our nearly 13-year run of daily publication of new content on HealthNewsReview.org came to a close at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. But all of the 6,000+ articles we (...) have published contain lessons to help you improve your critical thinking about health care interventions. And those will be still be alive on the site for a couple of years. 6093 Posts Menu June 21, 2018 Understanding medical tests: A new addition to our toolkit addressing sensitivity, specificity, and other core concepts Posted By Categories , , Tags Kevin Lomangino is the managing editor of HealthNewsReview.org. He tweets as @KLomangino. Hardly a day goes by without some media outlet making

2018 HealthNewsReview

22. Patient selection for high sensitivity cardiac troponin testing and diagnosis of myocardial infarction: prospective cohort study. (PubMed)

Patient selection for high sensitivity cardiac troponin testing and diagnosis of myocardial infarction: prospective cohort study. Objective To evaluate how selection of patients for high sensitivity cardiac troponin testing affects the diagnosis of myocardial infarction across different healthcare settings.Design Prospective study of three independent consecutive patient populations presenting to emergency departments.Setting Secondary and tertiary care hospitals in the United Kingdom (...) and United States.Participants High sensitivity cardiac troponin I concentrations were measured in 8500 consecutive patients presenting to emergency departments: unselected patients in the UK (n=1054) and two selected populations of patients in whom troponin testing was requested by the attending clinician in the UK (n=5815) and the US (n=1631). The final diagnosis of type 1 or type 2 myocardial infarction or myocardial injury was independently adjudicated.Main outcome measures Positive predictive value

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2017 BMJ

23. S-maup: Statistical test to measure the sensitivity to the modifiable areal unit problem. (PubMed)

S-maup: Statistical test to measure the sensitivity to the modifiable areal unit problem. This work presents a nonparametric statistical test, S-maup, to measure the sensitivity of a spatially intensive variable to the effects of the Modifiable Areal Unit Problem (MAUP). To the best of our knowledge, S-maup is the first statistic of its type and focuses on determining how much the distribution of the variable, at its highest level of spatial disaggregation, will change when it is spatially (...) aggregated. Through a computational experiment, we obtain the basis for the design of the statistical test under the null hypothesis of non-sensitivity to MAUP. We performed an exhaustive simulation study for approaching the empirical distribution of the statistical test, obtaining its critical values, and computing its power and size. The results indicate that, in general, both the statistical size and power improve with increasing sample size. Finally, for illustrative purposes, an empirical

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2018 PLoS ONE

24. Are drug intradermal tests dangerous to explore cross-reactivity and co-sensitization in DRESS? (PubMed)

Are drug intradermal tests dangerous to explore cross-reactivity and co-sensitization in DRESS? Drug Reaction with Eosinophilia and Systemic Symptoms syndrome (DRESS) is a severe Cutaneous Adverse drug Reaction, for which allergological explorations are poorly codified. Patch tests are usually well tolerated, and their sensitivity depends on the tested drug. Due to a potential risk of relapse during the tests, intradermal tests (IDTs) are contra-indicated in severe cutaneous drug adverse (...) reactions 1 . Consequently, results of IDTs in DRESS allergological work-up have been rarely reported. The objective of this retrospective monocentric study was to assess the value and tolerance of drug IDTs in patients who had a DRESS and negative patch tests with the same drugs. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

2019 British Journal of Dermatology

25. Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing: JACC Scientific Expert Panel. (PubMed)

Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing: JACC Scientific Expert Panel. High-sensitivity cardiac troponin (hs-cTn) I or T methods have been in use in certain regions for years but are now increasingly globally adopted, including in the United States. Accordingly, inevitable challenges are created for institutions transitioning from conventional cardiac troponin (cTn) assays. hs-cTn assays have higher analytic precision at lower concentrations, yielding (...) greater clinical sensitivity for myocardial injury and allowing accurate recognition of small changes in troponin concentration (rise or fall) within a short time frame. Although much of the knowledge regarding troponin biology that was applicable with older troponin assays still holds true, considerable education regarding the differences between conventional cTn and hs-cTn is needed before medical systems convert to the newer methods. This includes a basic understanding of how hs-cTn testing differs

2019 Journal of the American College of Cardiology

26. Transfusion of HIV-infected blood products despite highly sensitive nucleic acid testing. (PubMed)

Transfusion of HIV-infected blood products despite highly sensitive nucleic acid testing. In France, the risk of HIV transmission by transfusion was reduced by implementing pooled nucleic acid testing (NAT) in 2001 and individual NAT in 2010. We report here the first case in France of transfusion of human immunodeficiency virus (HIV)-infected blood donated during HIV pre-ramp-up phase that tested individual NAT negative.Blood donations are screened for HIV antibodies and HIV RNA (ProcleixUltrio (...) tested with CTM. Sequencing showed no mismatch between Ultrio primers/probes and the target sequence. HIV transmission was excluded by lookback studies in the recipient of platelets, which had been pathogen reduced, but not in the recipient of RBCs due to premature death.This case demonstrates that the risk of contaminated donations due to the early HIV infection phase going undetected by highly sensitive NAT is real but exceptional. The absence of transmission to the platelets recipient could be due

2019 Transfusion

27. <i>Plasmodium falciparum</i> Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar. (PubMed)

Plasmodium falciparum Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar. Current malaria rapid diagnostic tests (RDTs) contain antibodies against Plasmodium falciparum-specific histidine-rich protein 2 (PfHRP2), Plasmodium lactate dehydrogenase (pLDH), and aldolase in various combinations. Low or high parasite densities/target antigen concentrations may influence the accuracy and sensitivity of PfHRP2-detecting RDTs. We analyzed (...) . Plasmodium falciparum-only infections were predominant (microscopy, 45.7%; LDR-FMA, 52.3%). In all, 16.3% of P. falciparum, 70% of P. vivax, and all of Plasmodium malariae, Plasmodium ovale, and mixed-species infections were submicroscopic. In 423 P. falciparum mono-infections, confirmed by microscopy and LDR-FMA, the parasitemia in those who were positive for both the PfHRP2 and pan-pLDH test bands was significantly higher than that in those who were positive only for the PfHRP2 band (P < 0.0001

2019 American Journal of Tropical Medicine & Hygiene

28. Understanding the role of cutaneous allergy testing in anogenital dermatoses: a retrospective evaluation of contact sensitization in anogenital dermatoses. (PubMed)

Understanding the role of cutaneous allergy testing in anogenital dermatoses: a retrospective evaluation of contact sensitization in anogenital dermatoses. Patients with anogenital symptoms may delay before seeking medical attention. Attempted self-treatment with multiple topical preparations and excessive hygiene measures offer ideal conditions for sensitization. The aim of this study was to identify the common allergens detected on cutaneous allergy testing in patients presenting (...) with anogenital symptoms.A retrospective chart review of patients who underwent cutaneous allergy testing for perianal and/or genital symptoms over a 3-year period, January 2013 to December 2015, n = 99. Information was gathered from medical records, pretesting questionnaires, and cutaneous allergy testing records.At least one relevant allergen(s) was identified in 44/99 (45%) in our cohort, with allergic reactions to fragrances, Myroxylon pereirae, caine mix, sodium metabisulfite, and methylisothiazolinone

2019 International Journal of Dermatology

29. Resident Sensitive Processes of Care: the Impact of Surgical Residents on Inpatient Testing. (PubMed)

Resident Sensitive Processes of Care: the Impact of Surgical Residents on Inpatient Testing. Healthcare value is a national priority, and there are substantial efforts to reduce overuse of low-value testing. Residency training programs and teaching hospitals have been implicated in excessive testing. We evaluated the impact of surgery residents on the frequency of inpatient testing and investigated potential inter-resident variation.Inpatient laboratory and imaging orders placed on general (...) surgery services were extracted from an academic institution from 2014-2016 and linked to National Surgical Quality Improvement Program data. Using negative binomial mixed effects regression with unstructured covariance, we evaluated the frequency of testing orders compared to median utilization, accounting for case, patient, and attending-level variables.111,055 laboratory and 7,360 imaging orders were linked with 2,357 patients. Multivariable analysis demonstrated multiple significant predictors

2019 Journal of the American College of Surgeons

30. Evaluation of in vitro testing strategies for hazard assessment of the skin sensitization potential of "real-life" mixtures: the case of henna-based hair coloring products containing p-phenylenediamine. (PubMed)

Evaluation of in vitro testing strategies for hazard assessment of the skin sensitization potential of "real-life" mixtures: the case of henna-based hair coloring products containing p-phenylenediamine. Allergic contact dermatitis reported to henna-based hair coloring products (HPs) has been associated with adulteration of henna with p-phenylenediamine (PPD).To develop a testing approach based on in vitro techniques that address key events within the skin sensitization adverse outcome pathway (...) to evaluate allergenic potential of HPs.The following in vitro assays were used to test the sensitizing capacity of hair dye ingredients: micro-direct peptide reactivity assay (mDPRA); HaCaT keratinocytes-associated IL-18 assay; U937 cell line activation test (USENS)/IL-8 levels; blood monocyte-derived dendritic cell test; genomic allergen rapid detection (GARD skin). Those techniques with better human concordance were selected to evaluate the allergenic potential of ten HPs.Contrasting to the label's

2019 Contact Dermatitis

31. High-sensitive cardiac Troponin T and exercise stress test for evaluation of angiographically significant coronary disease. (PubMed)

High-sensitive cardiac Troponin T and exercise stress test for evaluation of angiographically significant coronary disease. Exercise stress test (EST) has a moderate precision for diagnosis of CAD and could potentially obtain improved accuracy if adding a reliable cardiac biomarker to the test.We aimed to investigate resting levels and change in hs-cTnT during EST in patients with and without angiographically significant CAD. Moreover, we intended to explore the additive value of hs-cTnT to EST

2019 International journal of cardiology

32. Baroreceptor activity and sensitivity: normal values in children and young adults using the head up tilt test. (PubMed)

Baroreceptor activity and sensitivity: normal values in children and young adults using the head up tilt test. Baroreceptor function in children and adolescents has not been well studied in the current literature, with a lack of agreed upon normal values. The authors hypothesize that there is a significant increase in the baroreceptor activity with a decrease in the sensitivity during the upright phase in comparison to the supine phases of the head upright tilt test (HUTT) protocol.Baroreceptor (...) evaluation was performed using the sequence method in 49 subjects ages 8-21 years, during the 3 phases of HUTT: supine, head up, and post-tilt supine positions. Baroreceptor Effectiveness Index (BEI) and the number and slope of baroreceptor events were recorded.On study of the events and slope values, there was a significant difference between the three phases of the HUTT with regard to the baroreceptor activity and sensitivity. No significant difference was found in BEI.Our study presents normal values

2019 Pediatric Research

33. Testing the Infection Prevalence of <i>Schistosoma mansoni</i> after Mass Drug Administration by Comparing Sensitivity and Specificity of Species-Specific Repeat Fragment Amplification by PCR and Loop-Mediated Isothermal Amplification. (PubMed)

Testing the Infection Prevalence of Schistosoma mansoni after Mass Drug Administration by Comparing Sensitivity and Specificity of Species-Specific Repeat Fragment Amplification by PCR and Loop-Mediated Isothermal Amplification. Schistosomiasis is a blood parasitic disease caused by trematode parasites of the genus Schistosoma. Schistosoma mansoni is one of the main contributors of the disease and 90% of the global burden of schistosomiasis is in Africa. Mass drug administration (MDA (...) ) has been implemented to reduce the disease burden in endemic areas. Because of MDA, the diagnostic sensitivity and specificity for classical diagnostic tests are reduced. In any disease situation, diagnosis is vital in determining asymptomatic, concurrent, current, new, and reinfection cases to evaluate the efficacy of any control program. We have evaluated the positive infection for S. mansoni from filtered urine samples collected from Zambian school children after MDA using loop-mediated

2019 American Journal of Tropical Medicine & Hygiene

34. Discrepancy between batches and impact on the sensitivity of point-of-care circulating cathodic antigen tests for Schistosoma mansoni infection. (PubMed)

Discrepancy between batches and impact on the sensitivity of point-of-care circulating cathodic antigen tests for Schistosoma mansoni infection. The Kato-Katz (KK) technique is the mainstay mapping tool for the diagnosis of Schistosoma mansoni infection, despite showing poor sensitivity in cases of low-intensity infections. As an alternative, a rapid point-of-care circulating cathodic antigen diagnostic test (POC-CCA) has been commercially developed that involves a simple urine assay to detect (...) S. mansoni, rather than a stool-based parasitological examination. Although POC-CCA has proven to be a more sensitive test than KK, it is not yet clear how to interpret discordant results between the two tests, particularly for situations in which the KK result is positive and the POC-CCA result is negative. Thus, the objective of this study was to evaluate the degree of diagnostic variability between different POC-CCA batches with respect to results obtained with KK. For this purpose, we

2019 Acta Tropica

35. Unexpected positive patch-test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre. (PubMed)

Unexpected positive patch-test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre. Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate, with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone mix (SLM) tested in the baseline series.To compile patch test results of subjects affected, and provide potential explanations for this association.53 Freestyle Libre (...) -allergic patients were patch-tested with isobornyl acrylate and/or SLM, and several also with the components of SLM. Chromatographic analyses were performed of the glucose sensor, isobornyl acrylate, and the components of SLM.Thirty-three patients reacted positively to SLM, and 11/27 patients tested positive to alantolactone, in particular. Gas-chromatographic and spectrometric (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, nor in isobornyl acrylate

2019 Contact Dermatitis

36. Diagnostic Accuracy of a High-Sensitivity Cardiac Troponin Assay with a Single Serum Test in the Emergency Department. (PubMed)

Diagnostic Accuracy of a High-Sensitivity Cardiac Troponin Assay with a Single Serum Test in the Emergency Department. We sought to evaluate diagnostic accuracy of a high-sensitivity cardiac troponin I (hs-cTnI) assay for acute coronary syndromes (ACS) in the emergency department (ED). The assay has high precision at low concentrations and can detect cTnI in 96.8% of healthy individuals.In successive prospective multicenter studies ("testing" and "validation"), we included ED patients (...) with suspected ACS. We drew blood for hs-cTnI [Singulex Clarity® cTnI; 99th percentile, 8.67 ng/L; limit of detection (LoD), 0.08 ng/L] on arrival. Patients also underwent hs-cTnT (Roche Elecsys) testing over ≥3h.The primary outcome was an adjudicated diagnosis of ACS, defined as acute myocardial infarction (AMI; prevalent or incident), death, or revascularization within 30 days.The testing and validation studies included 665 and 2470 patients, respectively, of which 94 (14.1%) and 565 (22.9%) had ACS

2019 Clinical Chemistry

37. A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study. (PubMed)

A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study. Childhood socio-economic status (SES) has long been associated with later-life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long-term impact of childhood trauma, abuse, and smoking on later-life oral health. This study fills the gap in the literature by examining how (...) adverse childhood experiences-social, psychological, and behavioral-shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research.Data are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N = 6,427; age > 50). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured

2019 Community Dentistry and Oral Epidemiology

38. Excipient and Dose per Unit Area Affect Sensitivity When Patch Testing With Gold Sodium Thiosulfate. (PubMed)

Excipient and Dose per Unit Area Affect Sensitivity When Patch Testing With Gold Sodium Thiosulfate. Dose/area and reading paradigms for gold patch testing are controversial and not standardized worldwide.The aims of this study were to determine the optimum patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD) and to establish GST HYD safety/efficacy and further characterize normal morphology and time course of GST reactions.Twenty gold-allergic patients were patch tested

2019 Dermatitis : contact, atopic, occupational, drug Controlled trial quality: uncertain

39. Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol. (PubMed)

Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol. Suspected urinary tract infection (UTI) ranks among the most common reasons for antibiotic use in nursing homes. However, diagnosing UTI in this setting is challenging because UTI often presents with non-specific symptomatology. Moreover asymptomatic bacteriuria is common in elderly, which complicates attribution of causality (...) studies suggest their usefulness in supporting UTI diagnosis, their utility has not been studied in elderly populations for this purpose.In a 24-month matched prospective study, 'PROGRESS' will assess and compare the sensitivity of rapid POC measurements of blood CRP and PCT levels to support clinical rules for diagnosing UTI in nursing home residents. The primary outcome measure is sensitivity of the POC tests to identify patients with true UTI based on the predefined definition, as derived from

2019 BMJ open

40. Effect of combined testing of ceramides with high-sensitive troponin T on the detection of acute coronary syndrome in patients with chest pain in China: a prospective observational study. (PubMed)

Effect of combined testing of ceramides with high-sensitive troponin T on the detection of acute coronary syndrome in patients with chest pain in China: a prospective observational study. Ceramides are associated with coronary plaque vulnerability. We aim to investigate the potential diagnostic value of ceramides for acute coronary syndrome (ACS) in Chinese patients with chest pain.Prospective observational survey.Shanghai, China, 2016-2017.A total of 2773 patients with chest pain from four (...) factors and high-sensitivecardiac troponin T. Receiver operating characteristic curve analysis showed a significant improvement in detecting ACS in the multivariable model with ceramides compared with that without (0.865 (0.840 to 0.889) vs 0.808 (0.776 to 0.841), p<0.001).Distinct plasma ceramides are independent diagnostic predictors of ACS among patients with chest pain. Ceramides together with high-sensitive troponin and traditional factors showed great potential in identifying ACS among patients

2019 BMJ open

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