• Title/Summary/Keyword: Positive predictive value

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Estimation of Predictive Value of a Positive Test from a Screening Test

  • Shin, Hyun Chul;Park, Sang Gue;Kim, Yong Hee
    • Communications for Statistical Applications and Methods
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    • v.10 no.2
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    • pp.567-574
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    • 2003
  • The estimation problem of predictive value of a positive test(PVP), which is assessing the accuracy of a screening test is considered. Score methods discussed by Gart and Nam(1988) are proposed for constructing confidence interval for PVP. The simulation studies are conducted in evaluating the proposed methods and existing approximate ones.

Evaluation of Validity of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 타당도 평가)

  • Choi, Heejung;Ok, Jong Sun;An, Soo Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.26-35
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    • 2019
  • Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

  • Miri, Shimasadat;Mehralizadeh, Sandra;Sadri, Donya;Motamedi, Mahmood Reza Kalantar;Soltani, Parisa
    • Imaging Science in Dentistry
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    • v.45 no.3
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    • pp.141-145
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    • 2015
  • Purpose: This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs. Materials and Methods: Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections $5{\mu}m$ in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (${\alpha}=0.05$). Results: Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p<0.05). However, no statistically significant differences were found regarding specificity, positive predictive value, negative predictive value, or accuracy (p>0.05). Conclusion: The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

An Implementation of Classification Method of Osteoporosis using CT images (CT 영상을 이용한 골다공증 분류 방법의 구현)

  • Jung, Sung-Tae
    • Journal of Korea Multimedia Society
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    • v.19 no.1
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    • pp.1-9
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    • 2016
  • In this paper, we propose a method of measuring bone mineral density in a peripheral-type clinical X-ray CT using a phantom, and we propose a method of classifying osteoporosis using bone mineral density and bone structure parameters together. It segments the trabecular bone region and cortical bone region for the six sections of the phantom and calculates the average HU value of the segmented regions. By using these values, it derives an expression converting HU value to bone mineral density. It segments trabecular bone of 1 cm region in the end part of distal radius and extracts the bone mineral density and structural parameters for the trabecular bone region. We extracted bone mineral density and structural parameters for the 18 subjects each of normal and osteoporotic group. We carried out classification experiments using three classification methods; SAD, SVM, ANN. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved in the order of ANN, SVM and SAD. Also, The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved when we use the bone mineral density and structural parameters together.

Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis (후향적 자료분석을 통한 낙상위험 사정도구의 타당도 비교: 종합병원 입원 환자를 중심으로)

  • Kang, Young Ok;Song, Rhayun
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.29-38
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    • 2015
  • Purpose: The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT). Methods: A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools. Results: MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales. Conclusion: The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.

An Improved Estimator of PPV from the Screening Test

  • Park, Sang-Gue;Choi, Ji-Yun
    • Journal of the Korean Data and Information Science Society
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    • v.16 no.2
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    • pp.419-428
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    • 2005
  • The screening test is increasingly being used for predicting future disease in the person screened and has raised concerns about reliability of the result of its procedure. We propose an improved estimator of the confidence interval for the positive predictive value(PPV) in screening test by simply taking inverse sinh transformation comparing to Gastwirth(1987) estimator and show its efficiency through the simulation study.

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Study on the Clinical Validity of Sperm Penetration Assay (Sperm Penetration Assay의 임상적 타당성에 관한 연구)

  • Pang, Myung-Geol;Oh, Sun-Kyung;Shin, Chang-Jae;Kim, Jung-Gu;Moon, Shin-Yong;Chang, Yoon-Seok;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.1-7
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    • 1993
  • The present study was designed to test the validity of the semen analysis(S/A) and the sperm penetration assay(SPA) as a prognostic indicator of male fertility in 123 patients undergoing in vitro fertilization(IVF). We attempted to correlate the traditional semen parameters or the extent of sperm penetration in SPA with the results of human IVF rate or cleavage rate. Poor correlation was found between the results of S/A and human IVF rate(sensitivity, 80.6% ;specificity, 46.7%; positive predictive value, 91.6%;negative predictive value, 25%). Conversely, good correlation was found between the results of SPA and human IVF rate(sensitivity, 100% ; specificity, 80% ;positive predictive value, 97.3% ;negative predictive value, 100%). Our results corroborate the conclusion that SPA can be a valuable tool as a prognostic indicator of male fertilizing ability.

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Comparison of Radiography Findings and Magnetic Resonance Image Findings of Lumbar Spine Instability Patients (요추 불안정 환자에서 단순방사선 소견과 자기공명영상 소견의 비교)

  • Lee, In-Hee;Park, Hee-Joon;Jin, Jong-Sik;Lee, Jyung-Hyun;Kim, Yoon-Nyun
    • The Journal of Korean Physical Therapy
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    • v.19 no.3
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    • pp.41-46
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    • 2007
  • Purpose: This study was to investigate how dose the radiography findings are to magnetic resonance (MR) image findings in the L5-S1 instability patients. The subjects of this study were comprised of eleven males and fifteen females, who had Lumbago and agreed with this research. Methods: Radiography and MR images of Lumbar spine were acquired respectively from subjects in conditions of maximum flexion and extension. The horizontal and angular displacements in lumabosacral spine radiography were used to assess the instability of lumbar spine. MR images were also used to evaluate the intervertebral disc abnormalities and change of bone marrow. Results: The results are as follows. 1. In the case of flexion transitional displacement proposed by Dupuis et al, the specificity and negative predictive value were good accuracy ($0.7{\sim}0.8$), and the negative predictive value was in average. In the case of extension displacement, the negative predictive value was about average ($0.6{\sim}0.7$), but the sensitivity, specificity and positive predictive value were below the poor (<0.6). On the other side, the specificity was about average but other things were below in the case of angular displacement. 2. In the case of flexion transitional displacement proposed by Dupuis et al., compared with the intervertebral disc abnormalities, the negative prediction value was excellent, the sensitivity good, and the specificity about average. In the case of extension, the negative prediction value was about average, but the other things were poor. On the other side the specificity and negative predictive value had good accuracy and the sensitivity and positive prediction value were below average in the case of angular displacement. Conclusion: The above results show that the radiography finding is sufficiently helpful to find the lumbar spine instability as an economic point of view.

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Clinical Usefulness of 14C-Urea Breath Test for the Diagnosis of H. pylori Infection (H. pylori 감염 진단 시 14C-요소호기검사의 임상적 유용성)

  • Kim, Yoon-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.3
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    • pp.271-276
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    • 2007
  • Helicobacter pylori (H. pylori) infection is common in korea and high incidence at gastric ulcer and duodenal ulcer. $^{14}C-urea$ breath test ($^{14}C-UBT$) is regarded as a highly reliable and non-invasive method for the diagnosis of H. pylori infection. The purpose of this study was to evaluate the diagnositc performance of a new and rapid $^{14}C-UBT$, which was equipped with Geiger-Muller counter and compared the results with those obtained by gastroduodenoscopic biopsies (GBx). One hundred sixty-eight patients (M : F = 118 : 50) underwent $^{14}C-UBT$, rapid urease test (CLO test), and GBx. The results of $^{14}C-UBT$ were classified as positive (>50 cpm), borderline (25$^{14}C-UBT$ or CLO test results with GBx as a glod standard. In the assessment of the presence of H. pylori infection, the $^{14}C-UBT$ global performance yielded positive predictive value, negative predictive value and accuracy of 93.3% and 83.3%, respectively. However, the CLO test had performance yielded positive predictive value, negative predictive value and accuracy of 76.9%, 50.0%, respectively. In this study $^{14}C-UBT$ is a highly accurate, simple and non-invasive method or the diagnosis of follow up H. pylori infection.

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