WorldWideScience

Sample records for additional diagnostic tests

  1. Diagnostic Testing in Family Practice

    OpenAIRE

    Birtwhistle, R.V.

    1988-01-01

    Laboratory and radiological investigations are central to the diagnosis and management of our patients' health problems. Physicians often order a diagnostic test routinely without giving much thought to the benefits, risks, and costs of the test. The increase in the number and use of diagnostic tests has contributed to the rising cost of health care over the last two decades. By consciously following a process when ordering tests, physicians may improve the effectiveness and efficiency of the...

  2. Diagnosing the Diagnostic Test

    Science.gov (United States)

    Popham, W. James

    2009-01-01

    Scads of pseudodiagnostic tests are peddled by commercial vendors who recognize that desperate educators will do almost anything to dodge an impending accountability cataclysm. And this "almost anything" includes buying tests that promise to help a teacher raise test scores--even if they don't. Accordingly, today's educators need to be aware of…

  3. Diagnostic Testing in Cystic Fibrosis.

    Science.gov (United States)

    Brewington, John; Clancy, J P

    2016-03-01

    Cystic Fibrosis (CF) is a rare, multisystem disease leading to significant morbidity and mortality. CF is caused by defects in the cystic fibrosis transmembrane conductance regulator protein (CFTR), a chloride and bicarbonate transporter. Early diagnosis and access to therapies provides benefits in nutrition, pulmonary health, and cognitive ability. Several screening and diagnostic tests are available to support a diagnosis. We discuss the characteristics of screening and diagnostic tests for CF and guideline-based algorithms using these tools to establish a diagnosis. We discuss classification and management of common "diagnostic dilemmas," including the CFTR-related metabolic syndrome and other CFTR-associated diseases. PMID:26857766

  4. Additional collection devices used in conjunction with the SurePath Liquid-Based Pap Test broom device do not enhance diagnostic utility

    Directory of Open Access Journals (Sweden)

    O'Connor Jason C

    2004-09-01

    Full Text Available Abstract Background We have previously shown that use of an EC brush device in combination with the Rovers Cervex-Brush (SurePath broom offered no significant improvement in EC recovery. Here we determine if use of additional collection devices enhance the diagnostic utility of the SurePath Pap for gynecologic cytology. Methods After informed consent, 37 women ages 18–56 receiving their routine cervical examinations were randomized into four experimental groups. Each group was first sampled with the SurePath broom then immediately re-sampled with an additional collection device or devices. Group 1: Rover endocervix brush (n = 8. Group 2: Medscand CytoBrush Plus GT (n = 7. Group 3: Rover spatula + endocervix brush (n = 11. Group 4: Medscand spatula + CytoBrush Plus GT (n = 11. Results Examination of SurePath broom-collected cytology yielded the following abnormal diagnoses: atypia (n = 2, LSIL (n = 5 and HSIL (n = 3. Comparison of these diagnoses to those obtained from paired samples using the additional collection devices showed that use of a second and or third device yielded no additional abnormal diagnoses. Importantly, use of additional devices did not improve upon the abnormal cell recovery of the SurePath broom and in 4/10 cases under-predicted or did not detect the SurePath broom-collected lesion as confirmed by cervical biopsy. Finally, in 36/37 cases, the SurePath broom successfully recovered ECs. Use of additional devices, in Group 3, augmented EC recovery to 37/37. Conclusions Use of additional collection devices in conjunction with the SurePath broom did not enhance diagnostic utility of the SurePath Pap. A potential but not significant improvement in EC recovery might be seen with the use of three devices.

  5. Appropriateness of diagnostics tests.

    Science.gov (United States)

    Cappelletti, P

    2016-05-01

    The evolution of the concept of 'appropriateness', in the three past decades, from 'no harm' and 'no waste' to 'medical decision-making' and 'determining outcomes' highlights two main points: its foundation is evidence-based medicine, and it is a quality of every phase of the total testing process, not only for the selection of tests. Nevertheless, appropriateness in Laboratory Hematology, as well as in Laboratory Medicine, is an elusive concept: 'Appropriateness' interplays with 'patient's safety', 'healthcare costs', 'clinical decision-making', and 'effectiveness', and the criteria for appropriateness, mainly adherence to clinical guidelines, are often not evidence-based and not always consensus-based. Moreover, practising appropriateness is a complex issue because of the ambiguity of the criteria and targets, the never-ending work of implementing guidelines and their audit, and the uniqueness of the clinical situation of the individual patient. Authors agree on some practical rules: establishing a multidisciplinary and multiprofessional team, choosing carefully clinical targets, finding or building evidences, sharing guidelines with clinicians, choosing adequate tools for changing, working hard on implementation, identifying the 'right' laboratory methods and processes, checking progress indefinitely, providing information, interpretations, and consultations, and promoting feedback and audits. The success depends on the 'right' combination of educational, operative, and reinforcing interventions. Competences in organization, in implementation science, and in interpersonal relationship management are essential as well as knowledge and experience in Hematology, not only in Laboratory Hematology. PMID:27161094

  6. Diagnostic Testing for Female Infertility

    Science.gov (United States)

    ... American Society for Reproductive Medicine Diagnostic Testing for Female Infertility An evaluation of a woman for infertility is ... or suspected male infertility problems Any evaluation for infertility should be ... as well as female partners. The least invasive methods that can detect ...

  7. An Additive Manufacturing Test Artifact

    OpenAIRE

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors meas...

  8. A diagnostic approach to test priorization

    NARCIS (Netherlands)

    Gonzalez-Sanchez, A.; Abreu, R.; Gross, H.; Van Gemund, A.

    2010-01-01

    In development processes with high code production rates testing typically triggers fault diagnosis to localize the detected failures. However, current test prioritization algorithms are tuned for failure detection rate rather than diagnostic information. Consequently, unnecessary diagnostic effort

  9. Progeria Research Foundation Diagnostic Testing Program

    Science.gov (United States)

    ... Testing The PRF Diagnostic Testing Program The Progeria Research Foundation, in association with a CLIA-approved diagnostics lab, ... please contact Dr. Leslie Gordon at The Progeria Research Foundation at info@progeriaresearch.org quick links Donate Now ...

  10. Systematic reviews of diagnostic test accuracy

    DEFF Research Database (Denmark)

    Leeflang, Mariska M G; Deeks, Jonathan J; Gatsonis, Constantine;

    2008-01-01

    More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies......-operating characteristic or the bivariate model for the data analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy studies and difficulties with the interpretation of the results of diagnostic test accuracy research....

  11. An Additive Manufacturing Test Artifact.

    Science.gov (United States)

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system. PMID:26601039

  12. An Additive Manufacturing Test Artifact.

    Science.gov (United States)

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system.

  13. Diagnostic Testing for Degenerative Disc Disease

    OpenAIRE

    Hasz, Michael W.

    2012-01-01

    The diagnostic of degenerative disc disease should be reached with the help of various diagnostic studies. This article briefly review the information gained by the following tests: radiographs, computed tomography, magnetic resonance, and discography. The article explains how each modality provides a piece of the diagnostic puzzle and how discography confirms the origin of the patient's pain.

  14. NCV Flow Diagnostic Test Results

    Science.gov (United States)

    Cappuccio, Mina

    1999-01-01

    There were two objectives for this test. First, was to assess the reasons why there is approximately 1.5 drag counts (cts) discrepancy between measured and computed drag improvement of the Non-linear Cruise Validation (NCV) over the Technology Concept Airplane (TCA) wing body (WB) configurations. The Navier-Stokes (N-S) pre-test predictions from Boeing Commercial Airplane Group (BCAG) show 4.5 drag cts of improvement for NCV over TCA at a lift coefficient (CL) of 0. I at Mach 2.4. The pre-test predictions from Boeing Phantom Works - Long Beach, BPW-LB, show 3.75 drag cts of improvement. BCAG used OVERFLOW and BPW-LB used CFL3D. The first test entry to validate the improvement was held at the NASA Langley Research Center (LARC) UPV;T, test number 1687. The experimental results showed that the drag improvement was only 2.6 cts, not accounting for laminar run and trip drag. This is approximately 1.5 cts less than predicted computationally. In addition to the low Reynolds Number (RN) test, there was a high RN test in the Boeing Supersonic Wind Tunnel (BSWT) of NCV and TCA. BSV@T test 647 showed that the drag improvement of NCV over TCA was also 2.6 cts, but this did account for laminar run and trip drag. Every effort needed to be done to assess if the improvement measured in LaRC UPWT and BSWT was correct. The second objective, once the first objective was met, was to assess the performance increment of NCV over TCA accounting for the associated laminar run and trip drag corrections in LaRC UPWT. We know that the configurations tested have laminar flow on portions of the wing and have trip drag due to the mechanisms used to force the flow to go from laminar to turbulent aft of the transition location.

  15. Validation scheme for diagnostic tests

    International Nuclear Information System (INIS)

    The aim was to develop a scheme for the validation of assays developed in the research laboratory for the successful transfer and implementation in the diagnostic laboratory. Although logistically, temporally and economically challenging, proper validation minimizes the chance of failure and increases the possibility of successful transfer and implementation in the diagnostic laboratory. A properly validated assay, which includes good design, good quality control and good documentation, reduces the chances of liability and increases confidence in the assay both nationally and internationally

  16. How to appraise a diagnostic test.

    Science.gov (United States)

    Manikandan, Ramanitharan; Dorairajan, Lalgudi N

    2011-10-01

    Urologists frequently encounter problems in making a clinical diagnosis whose resolution requires the use of diagnostic tests. With an ever increasing choice of investigations being available, the urologist often has to decide which diagnostic test(s) will best resolve the patient's diagnostic problem. In this article, we aim to help the urologist understand how to critically appraise studies on diagnostic tests and make a rational choice. This article presents the guiding principles in scientifically assessing studies on diagnostic tests by proposing a clinical scenario. The authors describe a standardized protocol to assess the validity of the test and its relevance to the clinical problem that can help the urologist in decision making. The three important issues to be considered when evaluating the validity of the study are to identify how the study population was chosen, how the test was performed and whether there is a comparison to the gold standard test so as to confirm or refute the diagnosis. Then, the urologist would need to know the probability of the test in providing the correct diagnosis in an individual patient in order to decide about its utility in solving the diagnostic dilemma. By performing the steps described in this article, the urologist would be able to critically appraise diagnostic studies and draw meaningful conclusions about the investigations in terms of validity, results and its applicability to the patient's problem. This would provide a scientific basis for using diagnostic tests for improving patient care.

  17. Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

    OpenAIRE

    Calis, M.; Akgun, K; Birtane, M; Karacan, I; Calis, H.; Tuzun, F.

    2000-01-01

    OBJECTIVE—Subacromial impingement syndrome (SIS) is a frequent cause of shoulder pain. The aim of this study was to investigate the diagnostic values of clinical diagnostic tests, in patients with SIS.
METHODS—72 female, 48 male patients with shoulder pain were included in the study. Five had bilateral shoulder pain, so 125 painful shoulders were evaluated. Details were recorded about the patients' ages and sexes, as well as characteristics of pain and related problems. Detailed physical exam...

  18. Systematic reviews of diagnostic test accuracy.

    Science.gov (United States)

    Leeflang, Mariska M G; Deeks, Jonathan J; Gatsonis, Constantine; Bossuyt, Patrick M M

    2008-12-16

    More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies. Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for meta-analysis should take into account the paired nature of the estimates and their dependence on threshold. Authors of these reviews are advised to use the hierarchical summary receiver-operating characteristic or the bivariate model for the data analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy studies and difficulties with the interpretation of the results of diagnostic test accuracy research.

  19. Methodology of diagnostic tests in hepatology

    DEFF Research Database (Denmark)

    Christensen, Erik

    2009-01-01

    The performance of diagnostic tests can be assessed by a number of methods. These include sensitivity, specificity,positive and negative predictive values, likelihood ratios and receiver operating characteristic (ROC) curves. This paper describes the methods and explains which information...... they provide. Sensitivity and specificity provides measures of the diagnostic accuracy of a test in diagnosing the condition. The positive and negative predictive values estimate the probability of the condition from the test-outcome and the condition's prevalence. The likelihood ratios bring together......' and plotting sensitivity as a function of 1-specificity. The ROC-curve can be used to define optimal cut-off values for a test, to assess the diagnostic accuracy of the test, and to compare the usefulness of different tests in the same patients. Under certain conditions it may be possible to utilize a test...

  20. Radiation qualities for tests in diagnostic radiology

    International Nuclear Information System (INIS)

    The paper gives an overview on the essential parameters, which have to be taken into account for designing radiation qualities suitable for tests in diagnostic radiology. It is divided into two sections the first of which is devoted to fields with small amounts of scattered radiation. These fields can be characterized reasonably well by the terms beam attenuation and beam hardening. The two effects occur always simultaneously with a preference towards attenuation for filtering materials of low atomic number and vice versa. The second part is devoted to fields with abundant scattered radiation. In these cases the field diameter and the distance from the exit surface of the phantom are additional important parameters. Possible sources of errors of measurement in such fields are discussed, some recommendations on their usage are given

  1. Hyperaldosteronism: Screening and Diagnostic Tests.

    Science.gov (United States)

    Sabbadin, Chiara; Fallo, Francesco

    2016-06-01

    Primary aldosteronism (PA) is the most common secondary cause of hypertension, accounting for 10 % of hypertensives and 20 % of those with drug-resistant hypertension. Aldosterone excess is associated with the development of adverse cardiovascular, renal and metabolic effects that are partly independent of its effect on blood pressure. Guidelines recommended wider screening for PA in an effort to maximize detection of patients who may benefit from optimal, specific management. All patient groups with increased prevalence of PA, including hypertensive patients with type 2 diabetes mellitus and those with obstructive sleep apnea, should be carefully screened for PA. Screening with aldosterone-to-renin ratio (ARR) is the most practical and informative initial test. Subsequent confirmatory tests are: (1) oral salt loading; (2) saline infusion; (3) captopril challenge and (4) fludrocortisone suppression test. Confirmation of PA can avoid that patients with a false positive ARR would inappropriately undergo costly and harmful lateralization procedures. If confirmatory testing is positive, further investigations are directed toward determining the subtype of PA, as the treatment differs for each subtype. PMID:26971505

  2. Personalized Medicine’s Bottleneck: Diagnostic Test Evidence and Reimbursement

    Directory of Open Access Journals (Sweden)

    Joshua P. Cohen

    2014-04-01

    Full Text Available Background: Personalized medicine is gradually emerging as a transformative field. Thus far, seven co-developed drug-diagnostic combinations have been approved and several dozen post-hoc drug-diagnostic combinations (diagnostic approved after the drug. However, barriers remain, particularly with respect to reimbursement. Purpose, methods: This study analyzes barriers facing uptake of drug-diagnostic combinations. We examine Medicare reimbursement in the U.S. of 10 drug-diagnostic combinations on the basis of a formulary review and a survey. Findings: We found that payers reimburse all 10 drugs, but with variable and relatively high patient co-insurance, as well as imposition of formulary restrictions. Payer reimbursement of companion diagnostics is limited and highly variable. In addition, we found that the body of evidence on the clinical- and cost-effectiveness of therapeutics is thin and even less robust for diagnostics. Conclusions, discussion: The high cost of personalized therapeutics and dearth of evidence concerning the comparative clinical effectiveness of drug-diagnostic combinations appear to contribute to high patient cost sharing, imposition of formulary restrictions, and limited and variable reimbursement of companion diagnostics. Our findings point to the need to increase the evidence base supportive of establishing linkage between diagnostic testing and positive health outcomes.

  3. Diagnostic tests based on human basophils

    DEFF Research Database (Denmark)

    Kleine-Tebbe, Jörg; Erdmann, Stephan; Knol, Edward F;

    2006-01-01

    -maximal responses, termed 'intrinsic sensitivity'. These variables give rise to shifts in the dose-response curves which, in a diagnostic setting where only a single antigen concentration is employed, may produce false-negative data. Thus, in order to meaningfully utilize the current basophil activation tests....... Diagnostic studies using CD63 or CD203c in hymenoptera, food and drug allergy are critically discussed. Basophil-based tests are indicated for allergy testing in selected cases but should only be performed by experienced laboratories.......Human basophils are important tools for studying immediate-type hypersensitivity reactions since they release a variety of mediators (e.g., histamine, leukotriene C4, IL-4 and IL-13) following allergen triggering. Several diagnostic tools have been introduced that measure either leukotriene...

  4. Analysis of the Astronomy Diagnostic Test

    Science.gov (United States)

    Brogt, Erik; Sabers, Darrell; Prather, Edward E.; Deming, Grace L.; Hufnagel, Beth; Slater, Timothy F.

    2007-01-01

    Seventy undergraduate class sections were examined from the database of Astronomy Diagnostic Test (ADT) results of Deming and Hufnagel to determine if course format correlated with ADT normalized gain scores. Normalized gains were calculated for four different classroom scenarios: lecture, lecture with discussion, lecture with lab, and lecture…

  5. Immunochromatographic diagnostic test analysis using Google Glass.

    Science.gov (United States)

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2014-03-25

    We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health.

  6. Evaluation of rapid diagnostic test for influenza

    Directory of Open Access Journals (Sweden)

    Tiziano Allice

    2009-06-01

    Full Text Available In high risk patients such as in eldery, newborns and immunosuppressed subjects, a timely diagnosis of influenza is required for the most appropriate antiviral strategy in order to avoid severe secondary respiratory complications and viral spreading. Influenza is preventable by vaccination and chemoprophylaxis and is treatable by specific antiviral indications. The need for a timely diagnosis has led to the introduction of numerous rapid diagnostic tests.These are mostly antigen detection test giving results within 30 minutes, a clinically relevant time-frame to complement with the use of antiviral medications or chemoprophylaxis strategy. When evaluating performances of rapid test for influenza viruses, it is important to consider the type and quality of specimen to be tested, as well as sensitivity and specificity of the assays. Nasal/nasopharyngeal swabs are the most frequently submitted specimens, but nasal/nasopharingeal aspirates and washs can improve the diagnostic sensitivity of the test. Only some rapid assays can be successful used with broncoalveolar washings. In this review,we evaluated the sensitivity, specificity, reproducibility and feasibility of the most currently licensed rapid tests for influenza virus A and B. A flow-chart for the laboratory diagnosis of influenza with rapid test in combination with confirmatory test is proposed.

  7. Caustic addition system operability test procedure

    International Nuclear Information System (INIS)

    This test procedure provides instructions for performing operational testing of the major components of the 241-AN-107 Caustic Addition System by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E)

  8. Test report - caustic addition system operability test procedure

    International Nuclear Information System (INIS)

    This Operability Test Report documents the test results of test procedure WHC-SD-WM-OTP-167 ''Caustic Addition System Operability Test Procedure''. The Objective of the test was to verify the operability of the 241-AN-107 Caustic Addition System. The objective of the test was met

  9. Evaluation of rapid diagnostic test for influenza

    OpenAIRE

    Tiziano Allice; Valeria Ghisetti

    2009-01-01

    In high risk patients such as in eldery, newborns and immunosuppressed subjects, a timely diagnosis of influenza is required for the most appropriate antiviral strategy in order to avoid severe secondary respiratory complications and viral spreading. Influenza is preventable by vaccination and chemoprophylaxis and is treatable by specific antiviral indications. The need for a timely diagnosis has led to the introduction of numerous rapid diagnostic tests.These are mostly antigen detection tes...

  10. Google glass based immunochromatographic diagnostic test analysis

    Science.gov (United States)

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2015-03-01

    Integration of optical imagers and sensors into recently emerging wearable computational devices allows for simpler and more intuitive methods of integrating biomedical imaging and medical diagnostics tasks into existing infrastructures. Here we demonstrate the ability of one such device, the Google Glass, to perform qualitative and quantitative analysis of immunochromatographic rapid diagnostic tests (RDTs) using a voice-commandable hands-free software-only interface, as an alternative to larger and more bulky desktop or handheld units. Using the built-in camera of Glass to image one or more RDTs (labeled with Quick Response (QR) codes), our Glass software application uploads the captured image and related information (e.g., user name, GPS, etc.) to our servers for remote analysis and storage. After digital analysis of the RDT images, the results are transmitted back to the originating Glass device, and made available through a website in geospatial and tabular representations. We tested this system on qualitative human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) RDTs. For qualitative HIV tests, we demonstrate successful detection and labeling (i.e., yes/no decisions) for up to 6-fold dilution of HIV samples. For quantitative measurements, we activated and imaged PSA concentrations ranging from 0 to 200 ng/mL and generated calibration curves relating the RDT line intensity values to PSA concentration. By providing automated digitization of both qualitative and quantitative test results, this wearable colorimetric diagnostic test reader platform on Google Glass can reduce operator errors caused by poor training, provide real-time spatiotemporal mapping of test results, and assist with remote monitoring of various biomedical conditions.

  11. Testing for additivity with B-splines

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Regression splines are often used for fitting nonparametric functions, and they work especially well for additivity models. In this paper, we consider two simple tests of additivity: an adaptation of Tukey’s one degree of freedom test and a nonparametric version of Rao’s score test. While the Tukey-type test can detect most forms of the local non-additivity at the parametric rate of O(n-1/2), the score test is consistent for all alternative at a nonparametric rate. The asymptotic distribution of these test statistics is derived under both the null and local alternative hypotheses. A simulation study is conducted to compare their finite-sample performances with some existing kernel-based tests. The score test is found to have a good overall performance.

  12. Testing for additivity with B-splines

    Institute of Scientific and Technical Information of China (English)

    Heng-jian CUI; Xu-ming HE; Li LIU

    2007-01-01

    Regression splines are often used for fitting nonparametric functions, and they work especially well for additivity models. In this paper, we consider two simple tests of additivity: an adaptation of Tukey's one degree of freedom test and a nonparametric version of Rao's score test. While the Tukey-type test can detect most forms of the local non-additivity at the parametric rate of O(n-1/2), the score test is consistent for all alternative at a nonparametric rate. The asymptotic distribution of these test statistics is derived under both the null and local alternative hypotheses. A simulation study is conducted to compare their finite-sample performances with some existing kernelbased tests. The score test is found to have a good overall performance.

  13. Additional resource for diabetes diagnostics in animals and humans

    Directory of Open Access Journals (Sweden)

    Vladimir Vitalyevich Drozdov

    2012-09-01

    Full Text Available Veterinary doctors often observe cases of unexplained elevated glucose and ketones in urine of domestic animals without any other signs of diabetes. We studies these effects from the standpoint of the phenomenon of interdependent conditions in animals and humans, described by T.V.Novosadyuk in 2000. She was the first to provide a theoretical and practical foundation for clinical cases of simultaneously developing similar diseases in domestic animals and their owners. During the last 5 years we studied health of humans in families where domestic animals are affected by the laboratory abnormalities described above. In vast majority of cases it has been found out that animal owners have diabetes mellitus of variable severity. At the same time there were no disorders of carbohydrate metabolism in animal owners in 11 cases. We recommended members of these families to undergo a specialized examination. In all of these cases latent diabetes mellitus was found in humans who had especially close relationships with animals. These findings led to initiation of treatment in humans. At the same time animals were treated with a collar with a linen sack attached containing Peganum Harmala 30 globules. Repeated laboratory tests were performed after one month of such treatment. Normalization of laboratory variables was observed in all of the cases. Based on the study results we developed an algorhythm of activities that helps to diagnose early and latent forms of diabetes mellitus in domestic animals and their owners. This algorhythm includes: - test for glucose and/or ketones in animal urine after correction of feeding and care defects. - blood and urine glucose tests in family members of animal owners. In cases of deviations from normal values we recommended them to consult appropriate specialists and begin treatment immediately. - animals are given collars with Peganum Harmala 30 globules in a linen sack attached. - granules are removed when

  14. Systematic tests for position-dependent additive shear bias

    CERN Document Server

    van Uitert, Edo

    2016-01-01

    We present new tests to identify stationary position-dependent additive shear biases in weak gravitational lensing data sets. These tests are important diagnostics for currently ongoing and planned cosmic shear surveys, as such biases induce coherent shear patterns that can mimic and potentially bias the cosmic shear signal. The central idea of these tests is to determine the average ellipticity of all galaxies with shape measurements in a grid in the pixel plane. The distribution of the absolute values of these averaged ellipticities can be compared to randomized catalogues; a difference points to systematics in the data. In addition, we introduce a method to quantify the spatial correlation of the additive bias, which suppresses the contribution from cosmic shear and therefore eases the identification of a position-dependent additive shear bias in the data. We apply these tests to the publicly available shear catalogues from the Canada-France-Hawaii Telescope Lensing Survey (CFHTLenS) and the Kilo Degree Su...

  15. Additional diagnostic value of low dose CT in ventilation/perfusion hybrid SPECT for pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the assistant diagnostic value of low dose CT in patients with pulmonary embolism (PE) based on ventilation/perfusion (V/Q) SPECT imaging. Methods: One hundred and two patients with clinical suspected PE had been enrolled for this retrospective study. The final diagnosis of PE was made according to the 2008 guidelines of European Society of Cardiology (ESC). All patients underwent V/Q SPECT/CT (Hawkeye 4, GE). The imaging findings from low dose CT lung window were used for differential diagnoses of abnormal regions in SPECT imaging. The diagnostic efficiency of V/Q SPECT alone was compared with that of V/Q SPECT combined with low dose CT scan. Crosstabs χ2 test was performed using SPSS 13.0 software. Results: Twenty-nine patients (28.43%, 29/102) were finally diagnosed as PE. V/Q SPECT alone had a sensitivity of 93.10% (27/29), a specificity of 90.41% (66/73), and an accuracy of 91.18% (93/102). With additional diagnostic information from low dose CT, the diagnostic specificity increased to 95.89% (70/73, χ2=1.72, P>0.05), and the accuracy increased to 95.10% (97/102, χ2=1.23, P>0.05) though the sensitivity remained the same. Conclusion: Imaging information from low dose CT in hybrid SPECT/CT may enhance V/Q diagnostic accuracy for PE. (authors)

  16. Mirror fusion test facility plasma diagnostics system

    International Nuclear Information System (INIS)

    During the past 25 years, experiments with several magnetic mirror machines were performed as part of the Magnetic Fusion Energy (MFE) Program at LLL. The latest MFE experiment, the Mirror Fusion Test Facility (MFTF), builds on the advances of earlier machines in initiating, stabilizing, heating, and sustaining plasmas formed with deuterium. The goals of this machine are to increase ion and electron temperatures and show a corresponding increase in containment time, to test theoretical scaling laws of plasma instabilities with increased physical dimensions, and to sustain high-beta plasmas for times that are long compared to the energy containment time. This paper describes the diagnostic system being developed to characterize these plasma parameters

  17. Additional Fault Detection Test Case Prioritization

    Directory of Open Access Journals (Sweden)

    Ritika Jain

    2013-07-01

    Full Text Available Regression testing is used to confirm that previous bugs have been fixed and that new bugs have not been introduced. Thus regression testing is done during maintenance phase and applied whenever a new version of a program is obtained by modifying an existing version. To perform a regression testing a set of new test cases and old test cases that were previously developed by software engineers are reused. This test suite is exhaustive in nature and it may take long time to rerun all test cases. Thus regression testing is too expensive and the number of test cases increases stridently as the software evolves. In present work, an additional fault detection test case prioritization technique is presented that prioritizes test cases in regression test suite based on number of concealed faults detected by test cases. Both noncost cognizant and cost cognizant prioritization of test cases have been performed using proposed technique and efficiency of prioritized suite is assessed using APFD and APFDc metric respectively.

  18. Testing Hammer and Stanton's Reengineering Success Diagnostic

    Directory of Open Access Journals (Sweden)

    Felicity Murphy

    2000-05-01

    Full Text Available Business Process Reengineering (BPR is no longer referenced in academic literature with the regularity that it was in the heady days of the mid-nineties but it is still in use in Australian organisations. We are also changing processes radically as new software is implemented or new electronic markets are embraced and the lessons of reengineering can be applied to these process changes. This study makes three main contributions by: (1 investigating the organisational context prior to the embarkation on projects of major change in Australia, (2 testing the validity of a diagnostic proposed by Hammer and Stanton (1995 to be used when assessing the ability of organisations to succeed at reengineering, and (3 examining the impact of the organisational environment prior to change on the outcome of reengineering projects.

  19. Systematic reviews and meta-analyses of diagnostic test accuracy.

    Science.gov (United States)

    Leeflang, M M G

    2014-02-01

    Systematic reviews of diagnostic test accuracy summarize the accuracy, e.g. the sensitivity and specificity, of diagnostic tests in a systematic and transparent way. The aim of such a review is to investigate whether a test is sufficiently specific or sensitive to fit its role in practice, to compare the accuracy of two or more diagnostic tests, or to investigate where existing variation in results comes from. The search strategy should be broad and preferably fully reported, to enable readers to assess the completeness of it. Included studies usually have a cross-sectional design in which the tests of interest, ideally both the index test and its comparator, are evaluated against the reference standard. They should be a reflection of the situation that the review question refers to. The quality of included studies is assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 checklist, containing items such as a consecutive and all-inclusive patient selection process, blinding of index test and reference standard assessment, a valid reference standard, and complete verification of all included participants. Studies recruiting cases separately from (healthy) controls are regarded as bearing a high risk of bias. For meta-analysis, the bivariate model or the hierarchical summary receiver operating characteristic model is used. These models take into account potential threshold effects and the correlation between sensitivity and specificity. They also allow addition of covariates for investigatation of potential sources of heterogeneity. Finally, the results from the meta-analyses should be explained and interpreted for the reader, to be well understood.

  20. Elementary School-Age Children's Capacity To Choose Positive Diagnostic and Negative Diagnostic Tests.

    Science.gov (United States)

    Samuels, Mark C.; McDonald, John

    2002-01-01

    Two experiments compared 10-year-olds' and adults' ability to choose positive and negative diagnostic tests over positive and negative nondiagnostic tests. Findings indicated that both age groups were more likely to prefer positive diagnostic tests over positive nondiagnostic tests, although only adults showed a significant preference for negative…

  1. A general diagnostic model applied to language testing data.

    Science.gov (United States)

    von Davier, Matthias

    2008-11-01

    Probabilistic models with one or more latent variables are designed to report on a corresponding number of skills or cognitive attributes. Multidimensional skill profiles offer additional information beyond what a single test score can provide, if the reported skills can be identified and distinguished reliably. Many recent approaches to skill profile models are limited to dichotomous data and have made use of computationally intensive estimation methods such as Markov chain Monte Carlo, since standard maximum likelihood (ML) estimation techniques were deemed infeasible. This paper presents a general diagnostic model (GDM) that can be estimated with standard ML techniques and applies to polytomous response variables as well as to skills with two or more proficiency levels. The paper uses one member of a larger class of diagnostic models, a compensatory diagnostic model for dichotomous and partial credit data. Many well-known models, such as univariate and multivariate versions of the Rasch model and the two-parameter logistic item response theory model, the generalized partial credit model, as well as a variety of skill profile models, are special cases of this GDM. In addition to an introduction to this model, the paper presents a parameter recovery study using simulated data and an application to real data from the field test for TOEFL Internet-based testing.

  2. Laboratory tests of sludge-control additives

    Energy Technology Data Exchange (ETDEWEB)

    Tatnall, R.E. [MIC Associates, Inc., Chadds Ford, PA (United States)

    1996-07-01

    Laboratory {open_quotes}jar{close_quotes} tests compared eleven different fuel oil and diesel fuel sludge-control additives. Factors studied included (1) ability to disperse and prevent buildup of sludge deposits on surfaces, (2) ability to protect steel from corrosion, (3) ability to inhibit growth and proliferation of bacteria, and (4) ability to disperse water. Results varied greatly, and it was found that many commercial products do not do what they claim. It is concluded that fuel retailers should not believe manufacturers` claims for their additive products, but rather should test such products themselves to be sure that the benefits of treatment are real. A simplified form of the procedure used here is proposed as one way for dealers to do such testing.

  3. The teratology testing of food additives.

    Science.gov (United States)

    Barrow, Paul C; Spézia, François

    2013-01-01

    The developmental and reproductive toxicity testing (including teratogenicity) of new foods and food additives is performed worldwide according to the guidelines given in the FDA Redbook. These studies are not required for substances that are generally recognized as safe, according to the FDA inventory. The anticipated cumulated human exposure level above which developmental or reproduction studies are required depends on the structure-alert category. For food additives of concern, both developmental (prenatal) and reproduction (multigeneration) studies are required. The developmental studies are performed in two species, usually the rat and the rabbit. The reproduction study is generally performed in the rat. The two rat studies are preferably combined into a single experimental design, if possible. The test methods described in the FDA Redbook are similar to those specified by the OECD for the reproductive toxicity testing of chemicals.

  4. SSME Post Test Diagnostic System: Systems Section

    Science.gov (United States)

    Bickmore, Timothy

    1995-01-01

    An assessment of engine and component health is routinely made after each test firing or flight firing of a Space Shuttle Main Engine (SSME). Currently, this health assessment is done by teams of engineers who manually review sensor data, performance data, and engine and component operating histories. Based on review of information from these various sources, an evaluation is made as to the health of each component of the SSME and the preparedness of the engine for another test or flight. The objective of this project - the SSME Post Test Diagnostic System (PTDS) - is to develop a computer program which automates the analysis of test data from the SSME in order to detect and diagnose anomalies. This report primarily covers work on the Systems Section of the PTDS, which automates the analyses performed by the systems/performance group at the Propulsion Branch of NASA Marshall Space Flight Center (MSFC). This group is responsible for assessing the overall health and performance of the engine, and detecting and diagnosing anomalies which involve multiple components (other groups are responsible for analyzing the behavior of specific components). The PTDS utilizes several advanced software technologies to perform its analyses. Raw test data is analyzed using signal processing routines which detect features in the data, such as spikes, shifts, peaks, and drifts. Component analyses are performed by expert systems, which use 'rules-of-thumb' obtained from interviews with the MSFC data analysts to detect and diagnose anomalies. The systems analysis is performed using case-based reasoning. Results of all analyses are stored in a relational database and displayed via an X-window-based graphical user interface which provides ranked lists of anomalies and observations by engine component, along with supporting data plots for each.

  5. Clonality Testing in Veterinary Medicine: A Review With Diagnostic Guidelines.

    Science.gov (United States)

    Keller, S M; Vernau, W; Moore, P F

    2016-07-01

    The accurate distinction of reactive and neoplastic lymphoid proliferations can present challenges. Given the different prognoses and treatment strategies, a correct diagnosis is crucial. Molecular clonality assays assess rearranged lymphocyte antigen receptor gene diversity and can help differentiate reactive from neoplastic lymphoid proliferations. Molecular clonality assays are commonly used to assess atypical, mixed, or mature lymphoid proliferations; small tissue fragments that lack architecture; and fluid samples. In addition, clonality testing can be utilized to track neoplastic clones over time or across anatomic sites. Molecular clonality assays are not stand-alone tests but useful adjuncts that follow clinical, morphologic, and immunophenotypic assessment. Even though clonality testing provides valuable information in a variety of situations, the complexities and pitfalls of this method, as well as its dependency on the experience of the interpreter, are often understated. In addition, a lack of standardized terminology, laboratory practices, and interpretational guidelines hinders the reproducibility of clonality testing across laboratories in veterinary medicine. The objectives of this review are twofold. First, the review is intended to familiarize the diagnostic pathologist or interested clinician with the concepts, potential pitfalls, and limitations of clonality testing. Second, the review strives to provide a basis for future harmonization of clonality testing in veterinary medicine by providing diagnostic guidelines.

  6. Ultrasonography as a diagnostic method in addition to mammography

    Energy Technology Data Exchange (ETDEWEB)

    Otto, H.; Roer, E.

    1988-05-01

    By using ultrasonography in addition to mammography, experienced diagnosticians essentially enhance the safety of their diagnosis of mammary gland diseases. The same applies to gynecomastia, the condition after plastic surgery, and mastitis.

  7. Ultrasonography as a diagnostic method in addition to mammography

    International Nuclear Information System (INIS)

    By using ultrasonography in addition to mammography, experienced diagnosticians essentially enhance the safety of their diagnosis of mammary gland diseases. The same applies to gynecomastia, the condition after plastic surgery, and mastitis. (orig.)

  8. Test verification and validation for molecular diagnostic assays.

    Science.gov (United States)

    Halling, Kevin C; Schrijver, Iris; Persons, Diane L

    2012-01-01

    With our ever-increasing understanding of the molecular basis of disease, clinical laboratories are implementing a variety of molecular diagnostic tests to aid in the diagnosis of hereditary disorders, detection and monitoring of cancer, determination of prognosis and guidance for cancer therapy, and detection and monitoring of infectious diseases. Before introducing any new test into the clinical laboratory, the performance characteristics of the assay must be "verified," if it is a US Food and Drug Administration (FDA)-approved or FDA-cleared test, or "validated," if it is a laboratory-developed test. Although guidelines exist for how validation and verification studies may be addressed for molecular assays, the specific details of the approach used by individual laboratories is rarely published. Many laboratories, especially those introducing new types of molecular assays, would welcome additional guidance, especially in the form of specific examples, on the process of preparing a new molecular assay for clinical use. PMID:22208481

  9. Results from the Astronomy Diagnostic Test National Project

    Science.gov (United States)

    Deming, G. L.

    2001-12-01

    During 2000 and 2001, the validity and reliability of the Astronomy Diagnostic Test Version 2.0 (ADT 2.0) were formally investigated through the Astronomy Diagnostic Test National Project. The ADT 2.0 was administered as a pre-test to 5346 students and as a post-test to 3842 students. Student test results were collected from 97 classes that ranged in size from 4 to 320 students with 30 states represented. The 68 professors participating in the ADT National Project taught classes at universities (54%), 4-year colleges (27%), and 2-year colleges (19%). The database was analyzed for reliability at the Ontario Institute for Studies in Education. A pre-test value for Cronbach's alpha of 0.65 and post-test value of 0.76 demonstrate an acceptable degree of internal consistency. The average score for the 44 participating professors who completed the ADT as experts was 98%. Face and content validity were established by combining results from the experts with feedback from 60 student interviews. Student results from the National Project yielded an average score of 32.4% for the pre-test and 47.3% for the post-test. There is a gender discrepancy in favor of males that persists in both the pre-test (11% points) and the post-test (12% points) scores. The variations across geographic distribution and institution types were not significant. In addition to the 21 content items, the ADT 2.0 has 12 student background questions enabling instructors to have a better understanding of who takes introductory astronomy. This research was supported by the National Science Foundation through grants REC-0089239 (GD) and DGE-9714489 (BH).

  10. Diagnostic testing managed by hematopathology specialty and other laboratories: costs and patient diagnostic outcomes

    OpenAIRE

    Nicole M Engel-Nitz; Eckert, Benjamin; Song, Rui; Koka, Priyanka; Hulbert, Erin M; McPheeters, Jeffrey; Teitelbaum, April

    2014-01-01

    Background Successful management of patients with hematologic malignancies depends upon accurate and timely diagnosis, which frequently requires integration and interpretation of multiple tests. Our retrospective analysis compared diagnostic uncertainty, resource utilization, and costs for patients with diagnostic bone marrow (BM) tests managed by commercial laboratories. Methods Patients with BM biopsies and suspected hematologic cancer/condition were identified from claims (2005–2011) withi...

  11. Diagnostic value of exercise testing in asbestosis

    International Nuclear Information System (INIS)

    The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease

  12. Feasibility and Testing of Additive Manufactured Components

    Energy Technology Data Exchange (ETDEWEB)

    Dehoff, Ryan R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hummelt, Ed [Eaton Corporation, Milwaukee, WI (United States); Solovyeva, Lyudmila [Eaton Corporation, Milwaukee, WI (United States)

    2016-09-01

    This project focused on demonstrating the ability to fabricate two parts with different geometry: an arc flash interrupter and a hydraulic manifold. Eaton Corporation provided ORNL solid models, information related to tolerances and sensitive parameters of the parts and provided testing and evaluation. ORNL successfully manufactured both components, provided cost models of the manufacturing (materials, labor, time and post processing) and delivered test components for Eaton evaluation. The arc flash suppressor was fabricated using the Renishaw laser powder bed technology in CoCrMo while the manifold was produced from Ti-6Al-4V using the Arcam electron beam melting technology. These manufacturing techniques were selected based on the design and geometrical tolerances required. A full-scale manifold was produced on the Arcam A2 system (nearly 12 inches tall). A portion of the manifold was also produced in the Arcam Q10 system. Although a full scale manifold could not be produced in the system, a full scale manifold is expected to have similar material properties, geometric accuracy, and surface finish as could be fabricated on an Arcam Q20 system that is capable of producing four full scale manifolds in a production environment. In addition to the manifold, mechanical test specimens, geometric tolerance artifacts, and microstructure samples were produced alongside the manifold. The development and demonstration of these two key components helped Eaton understand the impact additive manufacturing can have on many of their existing products. By working within the MDF and leveraging ORNL’s manufacturing and characterization capabilities, the work will ensure the rapid insertion and commercialization of this technology.

  13. Diagnostic criteria and laboratory tests for disseminated intravascular coagulation.

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Hatada, Tuyoshi

    2012-12-01

    Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been established by the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH) and the Japanese Association for Acute Medicine. The diagnostic criteria involving global coagulation tests, such as the Japanese Ministry of Health, Labor and Welfare criteria and the ISTH overt diagnostic criteria, are first-generation DIC diagnostic criteria, those involving global coagulation tests and changes in these tests such as the Japanese Association for Acute Medicine criteria, are second-generation DIC diagnostic criteria, and those including non-overt DIC diagnostic criteria involving global coagulation tests, changes in these tests and hemostatic molecular markers will be the future (third-generation) DIC diagnostic criteria. There are no significant differences in the three diagnostic criteria with respect to predicting poor outcomes. Therefore, the third generation of diagnostic criteria including hemostatic molecular markers is expected to be established. Standardization and the determination of adequate cutoff values should be required for each laboratory test.

  14. Diagnostic Testing at UK Universities: An E-Mail Survey

    Science.gov (United States)

    Gillard, Jonathan; Levi, Margaret; Wilson, Robert

    2010-01-01

    In July 2009, an e-mail survey was sent to various UK universities to gain information regarding current practices concerning mathematics diagnostic testing, and to provide an update from the review "Diagnostic Testing for Mathematics" published by the LTSN MathsTEAM Project in 2003. A total of 38 university departments were contacted and the…

  15. A rapid diagnostic test for schistosomiasis mansoni

    Directory of Open Access Journals (Sweden)

    Clelia Christina Mello-Silva

    2013-12-01

    Full Text Available This article presents an improvement to the Kato-Katz (KK method, making it faster and more efficient for the visualisation of fertile eggs in stool samples. This modified KK method uses sodium acetate formalin as a fixative and reveals the intensity of infection in less than 1 h, reducing the diagnostic time without increasing the cost. This modified method may contribute to future epidemiological studies in both hospitals and the field due to its rapid and precise diagnostic, which allow for immediate treatment.

  16. Causes of false-positive HIV rapid diagnostic test results

    OpenAIRE

    Klarkowski, Derryck; O'Brien, Daniel P.; Shanks, Leslie; Singh, Kasha P

    2014-01-01

    HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undet...

  17. Acute Cholecystitis: The Diagnostic Role for Current Imaging Tests

    OpenAIRE

    Krishnamurthy, Gerbail T.

    1982-01-01

    Acute cholecystitis is a relatively common clinical entity characterized histopathologically by obstruction of the cystic duct due to either edema or stone or both. Thorough clinical assessment and selection of the appropriate diagnostic tests are crucial in making an early diagnosis before surgical treatment. Many diagnostic tests are available for imaging the gallbladder. Hepatobiliary imaging using technetium Tc 99m IDA is the test of choice to either exclude or confirm the diagnosis of ac...

  18. Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study

    NARCIS (Netherlands)

    C.M. Visscher; M. Naeije; A. de Laat; A. Michelotti; M. Nilner; B. Craane; E. Ekberg; M. Farella; F. Lobbezoo

    2009-01-01

    AIMS: To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patient

  19. Optimizing Feedlot Diagnostic Testing Strategies Using Test Characteristics, Disease Prevalence, and Relative Costs of Misdiagnosis.

    Science.gov (United States)

    Theurer, Miles E; White, Brad J; Renter, David G

    2015-11-01

    Diagnostic tests are commonly used by feedlot practitioners and range from clinical observations to more advanced physiologic testing. Diagnostic sensitivity and specificity, estimated prevalence in the population, and the costs of misdiagnoses need to be considered when selecting a diagnostic test strategy and interpreting results. This article describes methods for evaluating diagnostic strategies using economic outcomes to evaluate the most appropriate strategy for the expected situation. The diagnostic sensitivity and specificity, and expected prevalence influence the likelihood of misdiagnosis in a given population, and the estimated direct economic impact can be used to quantify differences among diagnostic strategies.

  20. Diagnostic Testing for Sexually Transmitted Infections

    Science.gov (United States)

    ... medical history, herpes virus blood test and culture. Syphilis Physical examination, including pelvic exam, and thorough medical history, plus one or more of the following blood tests: VDRL (Venereal Disease Research Laboratory) blood test or RPR (Rapid Plasma Reagin) blood test, (FTA-ABS) Fluorescent ...

  1. DIAGNOSTIC ACCURACY OF PROVOCATIVE TESTS IN LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    G Saroja

    2014-12-01

    Full Text Available The aim of the present study was to analyze the diagnostic accuracy of the commonly used provocative tests in the diagnosis of lateral epicondylitis (LE. Cozen’s test, Mills test and Maudsley test are most widely used. Till date no studies have been reported on the diagnostic accuracy of these tests. Musculoskeletal ultrasonography serves as a gold standard tool in the diagnosis of LE. Thirty subjects participated in the study. Baseline measurements of pain severity, elbow joint mobility, hand grip strength and three provocative tests were recorded by the principal investigator. A second investigator accompanied the subjects for musculoskeletal ultrasonography who was blinded of the test results. The thickness of common extensor tendon, echo texture and lateral epicondyle bony contour was measured. The test results of the three provocative tests with ultrasonographic findings were analyzed. The sensitivity for Cozen’s test, Maudsley test and Mills test was found to be 84%, 88% and 53% respectively. The specificity for Cozen’s Maudsley and Mills test was found to be 0%, 0% and 100% respectively. Mills test showed significant area under receiver operator curve (ROC i.e. (0.769, which explains that the test has good diagnostic accuracy. This validation study, concludes that Mills test has an excellent diagnostic value for ruling in LE.

  2. Concordance in diagnostic testing for respiratory pathogens of Bighorn Sheep

    Science.gov (United States)

    Reliable diagnostic tests are essential for disease investigation and management. This is particularly true for diseases of free-ranging wildlife where sampling is logistically difficult precluding retesting. Clinical assays for wildlife diseases frequently vary among laboratories because of lack ...

  3. Self Diagnostic Accelerometer Testing on the C-17 Aircraft

    Science.gov (United States)

    Tokars, Roger P.; Lekki, John D.

    2013-01-01

    The self diagnostic accelerometer (SDA) developed by the NASA Glenn Research Center was tested for the first time in an aircraft engine environment as part of the Vehicle Integrated Propulsion Research (VIPR) program. The VIPR program includes testing multiple critical flight sensor technologies. One such sensor, the accelerometer, measures vibrations to detect faults in the engine. In order to rely upon the accelerometer, the health of the accelerometer must be ensured. The SDA is a sensor system designed to actively determine the accelerometer structural health and attachment condition, in addition to vibration measurements. The SDA uses a signal conditioning unit that sends an electrical chirp to the accelerometer and recognizes changes in the response due to changes in the accelerometer health and attachment condition. To demonstrate the SDAs flight worthiness and robustness, multiple SDAs were mounted and tested on a C-17 aircraft engine. The engine test conditions varied from engine off, to idle, to maximum power. The SDA attachment conditions were varied from fully tight to loose. The newly developed SDA health algorithm described herein uses cross correlation pattern recognition to discriminate a healthy from a faulty SDA. The VIPR test results demonstrate for the first.

  4. Learning Digital Test and Diagnostics via Internet

    Directory of Open Access Journals (Sweden)

    Heinz-Dietrich Wuttke

    2007-02-01

    Full Text Available An environment targeted to e-learning is presented for teaching design and test of electronic systems. The environment consists of a set of Java applets, and of web based access to the hardware equipments, which can be used in the classroom, for learning at home, in laboratory research and training, or for carrying out testing of students during exams. The tools support university courses on digital electronics, computer hardware, testing and design for testability to learn by hands-on exercises how to design digital systems, how to make them testable, how to build self-testing systems, how to generate test patterns, how to analyze the quality of tests, and how to localize faults in hardware. The tasks chosen for hands-on training represent simultaneously research problems, which allow to fostering in students critical thinking, problem solving skills and creativity.

  5. The Astronomy Diagnostic Test National Project: Watch Out FCI!

    Science.gov (United States)

    Zeilik, Michael; Deming, Grace L.; Hufnagel, Beth

    2002-04-01

    With funding from the NSF, a multidisciplinary team at the University of New Mexico transformed “Astro 101” from a mostly descriptive to a highly-focused conceptual course based on cognitive models of adult learning. By 1996, we had developed a mature implementation, which required alternative assessment tools. One of these, an Astronomy Diagnostic Test version 1 (ADT), was based on misconceptions research in astronomy, and demonstrated large and robust gains with hundreds of participants at UNM. To improve the ADT and expand its use, we formed the Consortium for Astronomy Education Research (CAER) to develop ADT version 2, which was released in June 1999. With additional NSF funding, we kicked off the ADT National Project, which has so far included over 5000 students in the pretest and almost 4000 in the posttest. I will present selected results from ADT 1 and 2, which now has a database almost as extensive as that of the Force Concept Inventory (FCI).

  6. The Feasibility of a Diagnostic Media Test System Model.

    Science.gov (United States)

    Rapp, Alfred V.

    Research investigated the feasibility of a diagnostic media test system. Two distinct tests were developed for sixth grade and university populations, each having: 1) a main phase with three specific teaching sequences, one for each media form; 2) test items for each teaching sequence; and 3) a validation phase with one teaching sequence…

  7. Regulating whole exome sequencing as a diagnostic test.

    Science.gov (United States)

    Lapin, Valentina; Mighion, Lindsey C; da Silva, Cristina P; Cuperus, Ymkje; Bean, Lora J H; Hegde, Madhuri R

    2016-06-01

    In the last decade, there has been a flood of new technology in the sequencing arena. The onset of next-generation sequencing (NGS) technology has resulted in the vast increase in genetic diagnostic testing available to the ordering physician. Whole exome sequencing (WES) has become available as a diagnostic test performed in certified clinical laboratories. This has led to increased presence in the diagnostic marketplace, increased consumer awareness, and the question has been raised by various stakeholders to whether there is sufficient stringent regulation of WES and other NGS-based tests. We discuss the various WES services currently available in the marketplace, current regulation of WES as a laboratory developed test, the proposed FDA involvement in its oversight as well as the response of various laboratory groups that provide these diagnostic services. Overall, a rigorous process oversight and assessment of inter-lab reproducibility is strongly warranted for WES as it is used as a diagnostic test, but regulation should be mindful of the excessive administrative burden on academic and smaller diagnostic laboratories.

  8. The DEX/CRH test for major depression: a potentially useful diagnostic test.

    Science.gov (United States)

    Mokhtari, Mohammadreza; Arfken, Cynthia; Boutros, Nash

    2013-07-30

    The dexamethasone/corticotropin-releasing hormone (DEX/CRH) test has been proposed as a potential diagnostic test for major depressive disorder (MDD). A previously proposed four-step approach assesses the stage of development for a biological finding into a clinically useful diagnostic test. Using this approach, we evaluated the progress of the DEX/CRH test using meta-analysis as a part of step 1. A literature review identified 15 studies of the DEX/CRH test in patients with MDD and healthy controls. Meta-analysis estimated the effect size, heterogeneity, and confidence intervals using random effects models. Studies consistent with any step of the four-step approach were identified, and their characteristics were presented. Eleven studies reported significantly higher cortisol levels with the DEX/CRH test in patients with MDD, compared with the healthy controls (step 1). Eight eligible studies were included in meta-analysis, and had an effect size of 1.34 (95% confidence interval: 0.70-1.97). Most studies were step-1 studies (comparison of patients and healthy controls), and no step-4 studies (multicenter trials) were found. This review emphasizes that despite appearing as a promising test, the DEX/CRH has not been adequately studied for the required stages of development into a clinically useful laboratory test. Particularly, additional step-3 and step-4 studies are necessary.

  9. A Diagnostic Test for Apraxia in Stroke Patients : Internal consistency and diagnostic value

    NARCIS (Netherlands)

    van Heugten, C.M.; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C; Kinebanian, A

    1999-01-01

    The internal consistency and the diagnostic value of a test for apraxia in patients having had a stroke are presented. Results indicate that the items of the test form a strong and consistent scale: Cronbach's alpha as well as the results of a Mokken scale analysis present good reliability and good

  10. A diagnostic test for apraxia in stroke patients: internal consistency and diagnostic value.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, F.C.; Kinebanian, A.

    1999-01-01

    The internal consistency and the diagnostic value of a test for apraxia in patients having had a stroke are presented. Results indicate that the items of the test form a strong and consistent scale: Cronbach's alpha as well as the results of a Mokken scale analysis present good reliability and good

  11. Nonparametric reconstruction of the Om diagnostic to test LCDM

    CERN Document Server

    Escamilla-Rivera, Celia

    2015-01-01

    Cosmic acceleration is usually related with the unknown dark energy, which equation of state, w(z), is constrained and numerically confronted with independent astrophysical data. In order to make a diagnostic of w(z), the introduction of a null test of dark energy can be done using a diagnostic function of redshift, Om. In this work we present a nonparametric reconstruction of this diagnostic using the so-called Loess-Simex factory to test the concordance model with the advantage that this approach offers an alternative way to relax the use of priors and find a possible 'w' that reliably describe the data with no previous knowledge of a cosmological model. Our results demonstrate that the method applied to the dynamical Om diagnostic finds a preference for a dark energy model with equation of state w =-2/3, which correspond to a static domain wall network.

  12. Translating biological parameters into clinically useful diagnostic tests.

    Science.gov (United States)

    Arfken, Cynthia L; Carney, Stuart; Boutros, Nash N

    2009-08-01

    Psychiatry has lagged behind other specialties in developing diagnostic laboratory tests for the purpose of confirming or ruling out a diagnosis. Biological research into the pathophysiology of psychiatric disorders has, however, yielded some highly replicable abnormalities that have the potential for development into clinically useful diagnostic tests. To achieve this goal, a process for systematic translation must be developed and implemented. Building on our previous work, we review a proposed process using four clearly defined steps. We conclude that biological parameters currently face challenges in their pathways to becoming diagnostic tests because of both the premature release and premature abandonment of tests. Attention to a systematic translation process aided by these principles may help to avoid these problems.

  13. Diagnostic Path-Oriented Test Data Generation by Hyper Cuboids

    OpenAIRE

    Shahram Moadab; Mohsen Falah Rad

    2014-01-01

    One of the ways of test data generation is using the path-oriented (path-wise) test data generator. This generator takes the program code and test adequacy criteria as input and generates the test data in order to satisfy the adequacy criteria. One of the problems of this generator in test data generation is the lack of attention to generating the diagnostic test data. In this paper a new approach has been proposed for path-oriented test data generation and by utilizing it, test data is gener...

  14. Opportunities for improving pLDH-based malaria diagnostic tests

    Directory of Open Access Journals (Sweden)

    Choi Young

    2011-08-01

    Full Text Available Abstract Background Monoclonal antibodies to Plasmodium lactate dehydrogenase (pLDH have been previously used to format immunochromatographic tests for the diagnosis of malaria. Using pLDH as an antigen has several advantages as a sensitive measure of the presence of parasites within patient blood samples. However, variable results in terms of specificity and sensitivity among different commercially available diagnostic kits have been reported and it has not been clear from these studies whether the performance of an individual test is due simply to how it is engineered or whether it is due to the biochemical nature of the pLDH-antibody reaction itself. Methods A series of systematic studies to determine how various pLDH monoclonal antibodies work in combination was undertaken. Different combinations of anti-pLDH monoclonal antibodies were used in a rapid-test immunochromatographic assay format to determine parameters of sensitivity and specificity with regard to individual Plasmodium species. Results Dramatic differences were found in both species specificity and overall sensitivity depending on which antibody is used on the immunochromatographic strip and which is used on the colorimetric colloidal-gold used for visual detection. Discussion The results demonstrate the feasibility of different test formats for the detection and speciation of malarial infections. In addition, the data will enable the development of a universal rapid test algorithm that may potentially provide a cost-effective strategy to diagnose and manage patients in a wide range of clinical settings. Conclusion These data emphasize that using different anti-pLDH antibody combinations offers a tractable way to optimize immunochromatographic pLDH tests.

  15. University Students' Perspectives on Diagnostic Testing in Mathematics

    Science.gov (United States)

    Ní Fhloinn, Eabhnat; Bhaird, Ciarán Macan; Nolan, Brien

    2014-01-01

    Many universities issue mathematical diagnostic tests to incoming first-year students, covering a range of the basic concepts with which they should be comfortable from secondary school. As far as many lecturers are concerned, the purpose of this test is to determine the students' mathematical knowledge on entry. It should also provide an…

  16. SPS Dipole Multipactor Test and TEWave Diagnostics

    CERN Document Server

    Caspers, F; Edwards, P; Federmann, S; Holz, M; Taborelli, M

    2013-01-01

    Electron cloud accumulation in particle accelerators can be mitigated by coating the vacuum beam pipe with thin films of low secondary electron yield (SEY) material. The SEY of small coated samples are usually measured in the laboratory. To further test the properties of different coating materials, RF-induced multipacting in a coaxial waveguide configuration can be performed. The technique is applied to two main bending dipoles of the SPS, where the RF power is fed through a tungsten wire stretched along the vacuum chamber (6.4 m). A dipole with a bare stainless steel chamber shows a clear power threshold initiating an abrupt rise in reflected power and pressure. The effect is enhanced at RF frequencies corresponding to electron cyclotron resonances for given magnetic fields. Preliminary results show that the dipole with a carbon coated vacuum chamber does not exhibit any pressure rise or reflected RF power up to the maximum available input power. In the case of a large scale coating production this techniqu...

  17. A coproantigen diagnostic test for Strongyloides infection.

    Directory of Open Access Journals (Sweden)

    Alex M Sykes

    Full Text Available Accurate diagnosis of infection with the parasite Strongyloides stercoralis is hampered by the low concentration of larvae in stool, rendering parasitological diagnosis insensitive. Even if the more sensitive agar plate culture method is used repeated stool sampling is necessary to achieve satisfactory sensitivity. In this manuscript we describe the development of a coproantigen ELISA for diagnosis of infection. Polyclonal rabbit antiserum was raised against Strongyloides ratti excretory/secretory (E/S antigen and utilized to develop an antigen capture ELISA. The assay enabled detection of subpatent rodent S. ratti and human S. stercoralis infection. No cross-reactivity was observed with purified E/S from Schistosoma japonicum, the hookworms Ancylostoma caninum, A. ceylanicum, nor with fecal samples collected from rodents harboring Trichuris muris or S. mansoni infection. Strongyloides coproantigens that appear stable when frozen as formalin-extracted fecal supernatants stored at -20 °C remained positive up to 270 days of storage, whereas supernatants stored at 4 °C tested negative. These results indicate that diagnosis of human strongyloidiasis by detection of coproantigen is an approach worthy of further development.

  18. Mixed Portmanteau Test for Diagnostic Checking of Time Series Models

    Directory of Open Access Journals (Sweden)

    Sohail Chand

    2014-01-01

    Full Text Available Model criticism is an important stage of model building and thus goodness of fit tests provides a set of tools for diagnostic checking of the fitted model. Several tests are suggested in literature for diagnostic checking. These tests use autocorrelation or partial autocorrelation in the residuals to criticize the adequacy of fitted model. The main idea underlying these portmanteau tests is to identify if there is any dependence structure which is yet unexplained by the fitted model. In this paper, we suggest mixed portmanteau tests based on autocorrelation and partial autocorrelation functions of the residuals. We derived the asymptotic distribution of the mixture test and studied its size and power using Monte Carlo simulations.

  19. Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection

    OpenAIRE

    Villar Luis A; Bonelo Anilza; Ramirez Meleny; Osorio Lyda; Parra Beatriz

    2010-01-01

    Abstract Background We compared the diagnostic accuracy and reproducibility of commercially available NS1-based dengue tests and explored factors influencing their sensitivities. Methods Paired analysis of 310 samples previously characterized as positive (n = 218) and negative (n = 92) for viral isolation and/or RT-PCR and/or IgM seroconversion. Masked samples were tested by two observers with Platelia™ Dengue NS1 Ag, second generation Pan-E™ Dengue Early ELISA, SD Dengue NS1 Ag ELISA, Dengue...

  20. Classification of chronic orofacial pain using an intravenous diagnostic test

    NARCIS (Netherlands)

    Tjakkes, G. -H. E.; De Bont, L. G. M.; van Wijhe, M.; Stegenga, B.

    2009-01-01

    The aim of this study was to evaluate the ability of a preliminary intravenous diagnostic test to classify chronic orofacial pain patients into different subgroups. Patients with chronic orofacial pain conditions that could not be unambiguously diagnosed. A retrospective evaluation of series of cond

  1. Broadband Liner Optimization for the Source Diagnostic Test Fan

    Science.gov (United States)

    Nark, Douglas M.; Jones, Michael G.

    2012-01-01

    The broadband component of fan noise has grown in relevance with the utilization of increased bypass ratio and advanced fan designs. Thus, while the attenuation of fan tones remains paramount, the ability to simultaneously reduce broadband fan noise levels has become more appealing. This paper describes a broadband acoustic liner optimization study for the scale model Source Diagnostic Test fan. Specifically, in-duct attenuation predictions with a statistical fan source model are used to obtain optimum impedance spectra over a number of flow conditions for three liner locations in the bypass duct. The predicted optimum impedance information is then used with acoustic liner modeling tools to design liners aimed at producing impedance spectra that most closely match the predicted optimum values. Design selection is based on an acceptance criterion that provides the ability to apply increased weighting to specific frequencies and/or operating conditions. Typical tonal liner designs targeting single frequencies at one operating condition are first produced to provide baseline performance information. These are followed by multiple broadband design approaches culminating in a broadband liner targeting the full range of frequencies and operating conditions. The broadband liner is found to satisfy the optimum impedance objectives much better than the tonal liner designs. In addition, the broadband liner is found to provide better attenuation than the tonal designs over the full range of frequencies and operating conditions considered. Thus, the current study successfully establishes a process for the initial design and evaluation of novel broadband liner concepts for complex engine configurations.

  2. Diagnostics of the ITER neutral beam test facility.

    Science.gov (United States)

    Pasqualotto, R; Serianni, G; Sonato, P; Agostini, M; Brombin, M; Croci, G; Dalla Palma, M; De Muri, M; Gazza, E; Gorini, G; Pomaro, N; Rizzolo, A; Spolaore, M; Zaniol, B

    2012-02-01

    The ITER heating neutral beam (HNB) injector, based on negative ions accelerated at 1 MV, will be tested and optimized in the SPIDER source and MITICA full injector prototypes, using a set of diagnostics not available on the ITER HNB. The RF source, where the H(-)∕D(-) production is enhanced by cesium evaporation, will be monitored with thermocouples, electrostatic probes, optical emission spectroscopy, cavity ring down, and laser absorption spectroscopy. The beam is analyzed by cooling water calorimetry, a short pulse instrumented calorimeter, beam emission spectroscopy, visible tomography, and neutron imaging. Design of the diagnostic systems is presented.

  3. Visualizing the impact of prevalence on a diagnostic test

    DEFF Research Database (Denmark)

    Rehling, Michael

    2010-01-01

    The purpose of a diagnostic test is to confirm or rule out disease or to increase or decrease the probability of disease. Only a few tests can separate all patients into those with and without a disease (true positive and true negative test). Usually there will be some false test results (false...... positive and false negative). Traditionally, the four test results are given in a 2 by 2 table, and the terms sensitivity, specificity, and predictive values defined. The influence of the prevalence of the disease in question on the relative distribution of the four test results is not obvious....... This technical note brings a new illustration of the relative distribution of the four test results at prevalence from 0-1. The figure facilitates the understanding of the impact prevalence has on the predictive values of a clinical test....

  4. Chromosome microarrays in diagnostic testing: interpreting the genomic data.

    Science.gov (United States)

    Peters, Greg B; Pertile, Mark D

    2014-01-01

    DNA-based Chromosome MicroArrays (CMAs) are now well established as diagnostic tools in clinical genetics laboratories. Over the last decade, the primary application of CMAs has been the genome-wide detection of a particular class of mutation known as copy number variants (CNVs). Since 2010, CMA testing has been recommended as a first-tier test for detection of CNVs associated with intellectual disability, autism spectrum disorders, and/or multiple congenital anomalies…in the post-natal setting. CNVs are now regarded as pathogenic in 14-18 % of patients referred for these (and related) disorders.Through consideration of clinical examples, and several microarray platforms, we attempt to provide an appreciation of microarray diagnostics, from the initial inspection of the microarray data, to the composing of the patient report. In CMA data interpretation, a major challenge comes from the high frequency of clinically irrelevant CNVs observed within "patient" and "normal" populations. As might be predicted, the more common and clinically insignificant CNVs tend to be the smaller ones resolution, and some miscalling of CNVs is unavoidable. In this, there is no ideal solution, but various strategies for handling noise are available. Even without solutions, consideration of these diagnostic problems per se is informative, as they afford critical insights into the biological and technical underpinnings of CNV discovery. These are indispensable to any clinician or scientist practising within the field of genome diagnostics. PMID:24870134

  5. The impact of new trends in POCTs for companion diagnostics, non-invasive testing and molecular diagnostics.

    Science.gov (United States)

    Huckle, David

    2015-06-01

    Point-of-care diagnostics have been slowly developing over several decades and have taken on a new importance in current healthcare delivery for both diagnostics and development of new drugs. Molecular diagnostics have become a key driver of technology change and opened up new areas in companion diagnostics for use alongside pharmaceuticals and in new clinical approaches such as non-invasive testing. Future areas involving smartphone and other information technology advances, together with new developments in molecular biology, microfluidics and surface chemistry are adding to advances in the market. The focus for point-of-care tests with molecular diagnostic technologies is focused on advancing effective applications. PMID:25990929

  6. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  7. Background review for diagnostic test development for Zika virus infection

    Science.gov (United States)

    Charrel, Rémi N; Leparc-Goffart, Isabelle; Pas, Suzan; de Lamballerie, Xavier; Koopmans, Marion; Reusken, Chantal

    2016-01-01

    Abstract Objective To review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge. Methods We made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain. Findings We identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated. Conclusion An international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs. PMID:27516635

  8. 13CO2-breath tests as diagnostic tools in gastroenterology

    International Nuclear Information System (INIS)

    The diagnostic breath test in gastroenterology and hepatology uses specifically 13C-labelled substrate containing a ''target bond'' which, on enzymatic cleavage, results in the release of a functional group destined to produce labelled 13CO2 as a metabolic end product. Advantages and methodology of the 13CO2 breath tests are presented together with the calculation methods for 13C dose ratios. An example is given with the 13C-octanoic acid breath test to measure gastric emptying of solids. 2 figs., 5 refs

  9. The ethics of testing a test: randomized trials of the health impact of diagnostic tests for infectious diseases.

    Science.gov (United States)

    Dowdy, David W; Gounder, Celine R; Corbett, Elizabeth L; Ngwira, Lucky G; Chaisson, Richard E; Merritt, Maria W

    2012-12-01

    In the last decade, many new rapid diagnostic tests for infectious diseases have been developed. In general, these new tests are developed with the intent to optimize feasibility and population health, not accuracy alone. However, unlike drugs or vaccines, diagnostic tests are evaluated and licensed on the basis of accuracy, not health impact (eg, reduced morbidity or mortality). Thus, these tests are sometimes recommended or scaled up for purposes of improving population health without randomized evidence that they do so. We highlight the importance of randomized trials to evaluate the health impact of novel diagnostics and note that such trials raise distinctive ethical challenges of equipoise, equity, and informed consent. We discuss the distinction between equipoise for patient-important outcomes versus diagnostic accuracy, the equity implications of evaluating health impact of diagnostics under routine conditions, and the importance of offering reasonable choices for informed consent in diagnostic trials.

  10. Performance of Rapid Influenza Diagnostic Testing in Outbreak Settings

    OpenAIRE

    Peci, Adriana; Winter, Anne-Luise; King, Eddie-Chong; Blair, Joanne; Gubbay, Jonathan B.

    2014-01-01

    Rapid influenza diagnostic tests (RIDTs) may be useful during institutional respiratory disease outbreaks to identify influenza and enable antivirals to be rapidly administered to patients and for the prophylactic treatment of those exposed to the virus but not yet symptomatic. The performance of RIDTs at the outbreak level is not well documented in the literature. This study aimed to evaluate the performance of RIDTs in comparison with that of real-time reverse transcription (rRT)-PCR in the...

  11. Diagnostic testing: a key component of high-value care

    Directory of Open Access Journals (Sweden)

    Lucien J. Cardinal

    2016-07-01

    Full Text Available This is the fourth article of a series on fundamental concepts in biostatistics and research. In this article, the author reviews the fundamental concepts in diagnostic testing, sensitivity, and specificity and how they relate to the concept of high-value care. The topics are discussed in common language, with a minimum of jargon and mathematics, and with clinical examples. Emphasis is given to conceptual understanding. A companion article will follow focusing on predictive value and prior probability.

  12. Diagnostic Plots Applied to Well-Tests in Karst Systems

    OpenAIRE

    Maréchal, Jean-Christophe; Ladouche, Bernard; Dewandel, Benoît; Fleury, Perrine; Dörfliger, Nathalie

    2014-01-01

    International audience Pumping tests conducted on wells intersecting karst heterogeneities such as the conduit network are difficult to interpret. Nevertheless, this case can be solved by assimilating the horizontal karst conduit to a finite-conductivity vertical fracture. In this case, several flow patterns corresponding to the respective contributions of karst subsystems (fractured matrix, small conduits and main karst drainage network) can be identified on the diagnostic plot of drawdow...

  13. Diagnostic testing: a key component of high-value care

    OpenAIRE

    Lucien J. Cardinal

    2016-01-01

    This is the fourth article of a series on fundamental concepts in biostatistics and research. In this article, the author reviews the fundamental concepts in diagnostic testing, sensitivity, and specificity and how they relate to the concept of high-value care. The topics are discussed in common language, with a minimum of jargon and mathematics, and with clinical examples. Emphasis is given to conceptual understanding. A companion article will follow focusing on predictive value and prior pr...

  14. DIAGNOSTIC TEST FOR GARCH MODELS BASED ON ABSOLUTE RESIDUAL AUTOCORRELATIONS

    Directory of Open Access Journals (Sweden)

    Farhat Iqbal

    2013-10-01

    Full Text Available In this paper the asymptotic distribution of the absolute residual autocorrelations from generalized autoregressive conditional heteroscedastic (GARCH models is derived. The correct asymptotic standard errors for the absolute residual autocorrelations are also obtained and based on these results, a diagnostic test for checking the adequacy of GARCH-type models are developed. Our results do not depend on the existence of higher moments and is therefore robust under heavy-tailed distributions.

  15. Effects of Concept Map Extraction and a Test-Based Diagnostic Environment on Learning Achievement and Learners' Perceptions

    Science.gov (United States)

    Lin, Yu-Shih; Chang, Yi-Chun; Liew, Keng-Hou; Chu, Chih-Ping

    2016-01-01

    Computerised testing and diagnostics are critical challenges within an e-learning environment, where the learners can assess their learning performance through tests. However, a test result based on only a single score is insufficient information to provide a full picture of learning performance. In addition, because test results implicitly…

  16. Individuals charts and additional tests for changes in spread

    NARCIS (Netherlands)

    Trip, Albert; Wieringa, Jaap E.

    2003-01-01

    Some authors recommend the use of an additional test for detecting increases in the spread, when using a control chart for individual observations. We examine this recommendation both in a practical situation and theoretically. Both studies show that the additional test gives somewhat more power for

  17. Test Procedure - pumping system for caustic addition project

    International Nuclear Information System (INIS)

    This test procedure provides the requirements for sub-system testing and integrated operational testing of the submersible mixer pump and caustic addition equipment by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E)

  18. Diagnostic, predictive, and prenatal testing for facioscapulohumeral muscular dystrophy: diagnostic approach for sporadic and familial cases

    OpenAIRE

    Bakker, E; van der Wielen, M. J R; Voorhoeve, E.; Ippel, P F; Padberg, G.W.A.M.; Frants, R R; Wijmenga, C.

    1996-01-01

    Facioscapulohumeral muscular dystrophy (FSHD) is one of the common inherited neuromuscular disorders. The major gene involved, FSHD1, has been localised to chromosome 4q35. This 4q35 locus, detected by pE13-11 (D4F104S1), shows a mutation frequency of about 10% of the incidence. New mutants are characterised by de novo deletions of tens to hundreds of kilobases of DNA. Although these deletion fragments are very useful as a molecular genetic tool, their use in diagnostic DNA testing is hampere...

  19. Diagnostic Path-Oriented Test Data Generation by Hyper Cuboids

    Directory of Open Access Journals (Sweden)

    Shahram Moadab

    2014-12-01

    Full Text Available One of the ways of test data generation is using the path-oriented (path-wise test data generator. This generator takes the program code and test adequacy criteria as input and generates the test data in order to satisfy the adequacy criteria. One of the problems of this generator in test data generation is the lack of attention to generating the diagnostic test data. In this paper a new approach has been proposed for path-oriented test data generation and by utilizing it, test data is generated automatically realizing the goal of discovering more important errors in the least amount of time. Since that some of the instructions of any programming language are more error-prone, so the paths that contain these instructions are selected for perform test data generation process. Then, the input domains of these paths variables are divided by a divide-and-conquer algorithm to the subdomains. A set of different subdomains is called hypercuboids, and test data will be generated by these hypercuboids. We apply our method in some programs, and compare it with some previous methods. Experimental results show proposed approach outperforms same previous approaches.

  20. A web-based test of residents' skills in diagnostic radiology

    International Nuclear Information System (INIS)

    To develop an objective, Web-based tool for evaluating residents' knowledge of diagnostic radiology. We developed and tested a Web-based evaluation tool (the Diagnostic Radiology Skills Test) that consists of 3 tests, one in each of 3 domains of diagnostic radiology: chest, gastrointestinal, and musculoskeletal imaging. Each test comprises 30 cases representing a range of difficulty in the domain, including normal states, normal variants, typical cases of common diagnoses, and cases with more subtle findings. Cases are presented with a long menu of domain-specific possible diagnoses (response options), each coded for diagnostic appropriateness. Our subjects were 21 residents in postgraduate year (PGY) 2 to 5 and 11 experts in diagnostic radiology. Subjects accessed the tool via a Web site on our Web server. Residents test results were compared for reliability and validity across domain, case, and training level. In addition, results were correlated with commonly used established and objective evaluation tools. The tool demonstrated consistent monotonic improvement in performance with training level. It showed acceptable reliability in discriminating between residents at different performance levels, both within and across training levels (r = 0.53 within level and 0.69 across levels). Test results also had concurrent validity against the American College of Radiology In-Training Examination, a widely accepted objective assessment tool (r = 0.65, P < 0.01), and 2 Objective Structured Clinical Examinations (OSCEs) focusing on diagnostic skills (r = 0.78 and r 0.69, P < 0.01, respectively). Our study demonstrates the feasibility of a Web-based, standardized, objective assessment method for evaluating residents' performance. (author)

  1. DiagTest3Grp: An R Package for Analyzing Diagnostic Tests with Three Ordinal Groups

    Directory of Open Access Journals (Sweden)

    Jingqin Luo

    2012-10-01

    Full Text Available Medical researchers endeavor to identify potentially useful biomarkers to develop marker-based screening assays for disease diagnosis and prevention. Useful summary measures which properly evaluate the discriminative ability of diagnostic markers are critical for this purpose. Literature and existing software, for example, R packages nicely cover summary measures for diagnostic markers used for the binary case (e.g., healthy vs. diseased. An intermediate population at an early disease stage usually exists between the healthy and the fully diseased population in many disease processes. Supporting utilities for three-group diagnostic tests are highly desired and important for identifying patients at the early disease stage for timely treatments. However, application packages which provide summary measures for three ordinal groups are currently lacking. This paper focuses on two summary measures of diagnostic accuracy—volume under the receiver operating characteristic surface and the extended Youden index, with three diagnostic groups. We provide the R package DiagTest3Grp to estimate, under both parametric and nonparametric assumptions, the two summary measures and the associated variances, as well as the optimal cut-points for disease diagnosis. An omnibus test for multiple markers and a Wald test for two markers, on independent or paired samples, are incorporated to compare diagnostic accuracy across biomarkers. Sample size calculation under the normality assumption can be performed in the R package to design future diagnostic studies. A real world application evaluating the diagnostic accuracy of neuropsychological markers for Alzheimer’s disease is used to guide readers through step-by-step implementation of DiagTest3Grp to demonstrate its utility.

  2. Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Giulio Gasparini

    2015-01-01

    Full Text Available Rationale. The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. Objectives. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT compared to polysomnography for the diagnosis of OSA in adult patients. Methods. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5 and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. Measurements and Main Results. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 (p<0.01. The area under the ROC curve (95% CI was the parameter to evaluate the accuracy of the OAAT: it was 0.91 (0.81–1.00 for the diagnosis of OSA (AHI ≥ 5, 0.90 (0.82–0.98 for moderate OSA (AHI ≥ 15, and 0.84 (0.76–0.92 for severe OSA (AHI ≥ 30. Conclusions. The OAAT has shown a high correlation with polysomnography and also a high diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed.

  3. A compliance testing program for diagnostic X-ray equipment

    Energy Technology Data Exchange (ETDEWEB)

    Hutchinson, D.E.; Cobb, B.J.; Jacob, C.S

    1999-01-01

    Compliance testing is nominally that part of a quality assurance program dealing with those aspects of X-ray equipment performance that are subject to radiation control legislation. Quality assurance programs for medical X-ray equipment should be an integral part of the quality culture in health care. However while major hospitals and individual medical centers may implement such programs with some diligence, much X-ray equipment can remain unappraised unless there is a comprehensive regulatory inspection program or some form of compulsion on the equipment owner to implement a testing program. Since the late 1950s all X-ray equipment in the State of Western Australia has been inspected by authorized officers acting on behalf of the Radiological Council, the regulatory authority responsible for administration of the State's Radiation Safety Act. However, economic constraints, coupled with increasing X-ray equipment numbers and a geographically large State have significantly affected the inspection rate. Data available from inspections demonstrate that regular compliance and performance checks are essential in order to ensure proper performance and to minimize unnecessary patient and operator dose. To ensure that diagnostic X-ray equipment complies with accepted standards and performance criteria, the regulatory authority introduced a compulsory compliance testing program for all medical, dental and chiropractic diagnostic X-ray equipment effective from 1 January 1997.

  4. Neutron irradiation tests on diagnostic components at JAERI

    Energy Technology Data Exchange (ETDEWEB)

    Nishitani, T. E-mail: nisitani@naka.jaeri.go.jp; Shikama, T.; Fukao, M.; Reichle, R.; Sugie, T.; Kakuta, T.; Kasai, S.; Snider, R.; Yamamoto, S

    2001-10-01

    As a part of the R and D program of the ITER Engineering Design Activities (EDA), we have carried out irradiation tests on a number of diagnostic components. In this paper the recent results of neutron irradiation tests on diagnostic windows, bolometer substrates and magnetic coils at JAERI are described. UV range transmission losses of a KU-1 quartz glass were measured during 14 MeV neutron irradiation at the Fusion Neutronics Source (FNS) with neutron fluences of up to 7.4x10{sup 19} n/m{sup 2}. Significant transmission losses were observed in the wavelength of 200-300 nm. Mica substrates of bolometers were irradiated at the Japan Material Testing Reactor (JMTR) with neutron fluence between 1x10{sup 22} and 2.2x10{sup 23} n/m{sup 2}. The size expansion was found to be only 0.13% at 2.2x10{sup 23} n/m{sup 2} and 150 deg. C, which gives us the good prospect of the bolometer in the ITER-FEAT application. Magnetic coils made with four kinds of Mineral Insulated (MI) cables have been irradiated in JMTR up to a fast neutron fluence of 1.1x10{sup 24} n/m{sup 2}. Radiation Induced Electrical Motive Force (RIEMF) of several volts was observed between core inductor and sheath of the MI cable.

  5. Epidemiology and diagnostic testing for hemochromatosis and iron overload.

    Science.gov (United States)

    Adams, P C

    2015-05-01

    Hemochromatosis is the most common genetic disease in northern European populations. Body iron stores progressively increase in most patients, which can lead to cirrhosis of the liver, hepatocellular carcinoma, heart failure, arthritis, and pigmentation. Simple blood tests such as the serum ferritin and transferrin saturation are useful to suggest the diagnosis which can be confirmed in most cases with a simple genetic test for the C282Y mutation of the HFE gene. However, these blood tests are often misinterpreted and there are rare patients with iron overload without HFE mutations. A diagnostic approach is presented based on a large referral practice and a population-based study (HEIRS) which screened for iron overload in 101,168 participants.

  6. Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests

    DEFF Research Database (Denmark)

    Korman, J.D.; Volenberg, I.; Balko, J.;

    2008-01-01

    yielded a sensitivity of 94%, specificity of 96%, and a likelihood ratio of 23 for diagnosing fulminant WD. In addition, an AST:ALT ratio >2.2 yielded a sensitivity of 94%, a specificity of 86%, and a likelihood ratio of 7 for diagnosing fulminant WD. Combining the tests provided a diagnostic sensitivity...... a diagnostic sensitivity of 21% and specificity of 84% while, by nephelometry, a sensitivity of 56% and specificity of 63%. Serum copper levels exceeded 200 microg/dL in all ALF-WD patients measured (13/16), but were also elevated in non-WD ALF. An alkaline phosphatase (AP) to total bilirubin (TB) ratio ... and specificity of 100%. CONCLUSION: Conventional WD testing utilizing serum ceruloplasmin and/or serum copper levels are less sensitive and specific in identifying patients with ALF-WD than other available tests. More readily available laboratory tests including alkaline phosphatase, bilirubin and serum...

  7. [Laboratory practices: diagnostics and antibiotics resistance testing of Neisseria gonorrhoeae in Germany].

    Science.gov (United States)

    Loenenbach, Anna; Dudareva-Vizule, S; Buder, S; Sailer, A; Kohl, P K; Bremer, V

    2015-08-01

    Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring. PMID:26112875

  8. Using Three-Tier Diagnostic Test to Assess Students' Misconceptions of States of Matter

    Science.gov (United States)

    Kirbulut, Zubeyde Demet; Geban, Omer

    2014-01-01

    This study involves the development of a three-tier diagnostic test to measure high school students' understanding of states of matter concepts. The States of Matter Diagnostic Test (SMDT) is a 19-item three-tier diagnostic test consisting of three-tier items for assessing students' understanding of states of matter concepts. The SMDT…

  9. 77 FR 71170 - Notice of Public Roundtable on Genetic Diagnostic Testing

    Science.gov (United States)

    2012-11-29

    ... Hearings on Genetic Diagnostic Testing, 77 FR 3748 (Jan. 25, 2012). The Office also provided the public... United States Patent and Trademark Office Notice of Public Roundtable on Genetic Diagnostic Testing... information on independent second opinion genetic diagnostic testing for purposes of preparing a report on...

  10. Fan Noise Source Diagnostic Test: Rotor Alone Aerodynamic Performance Results

    Science.gov (United States)

    Hughes, Christopher E.; Jeracki, Robert J.; Woodward, Richard P.; Miller, Christopher J.

    2005-01-01

    The aerodynamic performance of an isolated fan or rotor alone model was measured in the NASA Glenn Research Center 9- by 15- Foot Low Speed Wind Tunnel as part of the Fan Broadband Source Diagnostic Test conducted at NASA Glenn. The Source Diagnostic Test was conducted to identify the noise sources within a wind tunnel scale model of a turbofan engine and quantify their contribution to the overall system noise level. The fan was part of a 1/5th scale model representation of the bypass stage of a current technology turbofan engine. For the rotor alone testing, the fan and nacelle, including the inlet, external cowl, and fixed area fan exit nozzle, were modeled in the test hardware; the internal outlet guide vanes located behind the fan were removed. Without the outlet guide vanes, the velocity at the nozzle exit changes significantly, thereby affecting the fan performance. As part of the investigation, variations in the fan nozzle area were tested in order to match as closely as possible the rotor alone performance with the fan performance obtained with the outlet guide vanes installed. The fan operating performance was determined using fixed pressure/temperature combination rakes and the corrected weight flow. The performance results indicate that a suitable nozzle exit was achieved to be able to closely match the rotor alone and fan/outlet guide vane configuration performance on the sea level operating line. A small shift in the slope of the sea level operating line was measured, which resulted in a slightly higher rotor alone fan pressure ratio at take-off conditions, matched fan performance at cutback conditions, and a slightly lower rotor alone fan pressure ratio at approach conditions. However, the small differences in fan performance at all fan conditions were considered too small to affect the fan acoustic performance.

  11. Diagnostic testing of the emergency department patient with chest pain.

    Science.gov (United States)

    Zalenski, R J; Shamsa, F H

    1998-07-01

    In evaluating patients with nondiagnostic initial clinical or electrocardiogram (ECG) findings for acute cardiac ischemia, continuous 12-lead ECG monitoring increases the detection of diagnostic ECG findings, including ST-segment elevation, in patients awaiting hospital admission. Rest scanning with technitium-99m sestamibi is able to risk stratify low-moderate risk patients into lower and higher risk groups for cardiac events. Caveats include the reduced sensitivity of scanning of patients who are pain free and the need for follow-up exercise scans for patients free of perfusion defects at rest. Cardiac markers, particularly the troponins, show great promise for the detection of a larger part of the spectrum of acute coronary syndromes in the emergency department, including patients with minimal myocardial damage and higher risk for short-term death and nonfatal acute myocardial infarction. Accelerated diagnostic protocols using serial testing with cardiac markers, ECGs and then provocative testing over a 14-hour period, are feasible, safe, and cost-effective. PMID:10091020

  12. The bone diagnostic instrument III: Testing mouse femora

    Science.gov (United States)

    Randall, Connor; Mathews, Phillip; Yurtsev, Eugene; Sahar, Nadder; Kohn, David; Hansma, Paul

    2009-06-01

    Here we describe modifications that allow the bone diagnostic instrument (BDI) [P. Hansma et al., Rev. Sci. Instrum. 79, 064303 (2008); Rev. Sci. Instrum. 77, 075105 (2006)], developed to test human bone, to test the femora of mice. These modifications include reducing the effective weight of the instrument on the bone, designing and fabricating new probe assemblies to minimize damage to the small bone, developing new testing protocols that involve smaller testing forces, and fabricating a jig for securing the smaller bones for testing. With these modifications, the BDI was used to test the hypothesis that short-term running has greater benefit on the mechanical properties of the femur for young growing mice compared to older, skeletally mature mice. We measured elastic modulus, hardness, and indentation distance increase (IDI), which had previously been shown to be the best discriminators in model systems known to exhibit differences in mechanical properties at the whole bone level. In the young exercised murine femora, the IDI was significantly lower than in young control femora. Since IDI has a relation to postyield properties, these results suggest that exercise during bone development increases post yield mechanical competence. We were also able to measure effects of aging on bone properties with the BDI. There was a significant increase in the IDI, and a significant decrease in the elastic modulus and hardness between the young and old groups. Thus, with the modifications described here, the BDI can take measurements on mouse bones and obtain statistically significant results.

  13. Improvement on Mixograph test through water addition and parameter conversions

    Institute of Scientific and Technical Information of China (English)

    SUN Jia-zhu[1; YANG Wen-long[1; LIU Dong-cheng[1; ZHAO Jun-tao[2; LUO Guang-bin[1; LI Xin[1; LIU Yan-jun[3; GUO Jin-kao[3; ZHANG Ai-min[1

    2015-01-01

    To improve Mixograph testing effect, Farinograph measurements were adopted as a quality standard and changes in water absorption and parameter conversion in Mixograph test were explored. Comparative study showed that increasing water absorption to about 73% and converting original parameters to compound parameters in Mixograph tests significantly increased their predictive power for flour quality. These efforts also enabled the adoption of fixed water addition level in Mixograph test and simplified the test procedure significantly. With the success in parameter conversions, Mixograph test results were successfully described by Farinograph parameters, which allow breeders to compare and exchange test results easily. All these changes optimized the official method of Mixograph test with simplified procedure and enhanced reliability and made the Mixograph being the superior tool for quality assessment in wheat-breeding programs.

  14. Improvement on Mixograph test through water addition and parameter conversions

    Institute of Scientific and Technical Information of China (English)

    SUN Jia-zhu; YANG Wen-long; LIU Dong-cheng; ZHAO Jun-tao; LUO Guang-bin; LI Xin; LIU Yan-jun; GUO Jin-kao; ZHANG Ai-min

    2015-01-01

    To improve Mixograph testing effect, Farinograph measurements were adopted as a quality standard and changes in water absorption and parameter conversion in Mixograph test were explored. Comparative study showed that increasing water absorption to about 73% and converting original parameters to compound parameters in Mixograph tests signiifcantly increased their predictive power for lfour quality. These efforts also enabled the adoption of ifxed water addition level in Mixograph test and simpliifed the test procedure signiifcantly. With the success in parameter conversions, Mixograph test results were successful y described by Farinograph parameters, which al ow breeders to compare and exchange test results easily. Al these changes optimized the ofifcial method of Mixograph test with simpliifed procedure and enhanced reliability and made the Mixograph being the superior tool for quality assessment in wheat-breeding programs.

  15. Test of a new tip material for Langmuir probe diagnostic

    Science.gov (United States)

    Naz, M. Y.; Shukrullah, S.; Ghaffar, A.; Rehman, N. U.; Khan, Y.

    2016-03-01

    The objective of the work is to test a nickel-chrome alloy as a probe tip material for characterization of discharge plasmas. In order to meet the objective, a symmetric triple Langmuir probe diagnostic system and an associated driving circuit are designed and tested in an inductively coupled plasma generated by a 13.56-MHz radio frequency source coupled with an automated impedance match network. This probe is used to measure the electron temperature, electron number density, and ion saturation current as functions of the input power of the radio frequency source and the filling gas pressure. An increasing trend is noticed in the electron temperature and electron number density with an increase in the input power, whilst a decreasing trend is evident in these parameters with an increase in the nitrogen gas pressure. The overall inaccuracies in electron temperature and electron number density measurements are 5-12% and 3-13%, respectively.

  16. Reliability of diagnostic tests in rotator cuff muscle pathology

    Directory of Open Access Journals (Sweden)

    R. Sadenbergh

    2006-02-01

    Full Text Available Background: Several tests to assist it in the diagnoses of rota-tor cuff impairment have been described in the literature but controversystill exists as to the accuracy of these tests. A study was therefore conducted to determine the reliability of the rotator cuff muscle tests (empty can, full can, lift off and external rotation as a diagnostic tool.Methodology: Fifty three patients experiencing shoulder pain were assessedusing manual muscle tests (empty can; full can; lift off and external rotationtests. Both pain and weakness were recorded using numerical scales adapted from tests performed by Itoi et al, (1999. These results were compared to ultrasonic diagnoses made by a surgeon. Informed consent was obtained and anonymity was ensured for all participants.Results: A test was false positive when ultrasonic diagnosis indicated no tear in the muscle (although oedema or calcification may have been present, but the manual muscle test was positive regarding pain and weakness. A test on the other hand was false negative when the ultrasonic diagnosis indicated a muscle tear but the manual muscle tests indicated no pain or muscle weakness. Reliability was tested using sensitivity and specificity tests. The sensitivity of all four tests was high (80%, but the specificity was low (20% to 40%, implying that a large number of false positive diagnoses can be made. The major contributors to the false positive results were sub-acromial sub-deltoid bursitis and a decreased acromio-humeral space. When considering pain alone for a positive result the correlation increased a  little, however, taking both pain and muscle weakness into account, the correlation increased even more.Conclusion: The manual muscle tests were not as reliable as expected, but concurrent pathologies may be the main factor influencing the results of the tests. The combination of muscle strength and pain could be recommendedas criteria for a positive test. The empty can and full can

  17. Performance of rapid influenza diagnostic testing in outbreak settings.

    Science.gov (United States)

    Peci, Adriana; Winter, Anne-Luise; King, Eddie-Chong; Blair, Joanne; Gubbay, Jonathan B

    2014-12-01

    Rapid influenza diagnostic tests (RIDTs) may be useful during institutional respiratory disease outbreaks to identify influenza and enable antivirals to be rapidly administered to patients and for the prophylactic treatment of those exposed to the virus but not yet symptomatic. The performance of RIDTs at the outbreak level is not well documented in the literature. This study aimed to evaluate the performance of RIDTs in comparison with that of real-time reverse transcription (rRT)-PCR in the context of institutional respiratory disease outbreaks. This study included outbreak-related respiratory specimens tested for influenza virus at Public Health Ontario Laboratories by both RIDT and rRT-PCR, from 1 September 2010 to 30 April 2013. At the outbreak level, performance testing of RIDTs compared to rRT-PCR for the detection of any influenza virus type demonstrated an overall sensitivity of 76.5%, a specificity of 99.7%, a positive predictive value (PPV) of 99.5%, and a negative predictive value of 85.3%. Because of their high specificity and PPV, even outside of the influenza season, RIDTs can play a role in screening for influenza virus in outbreaks and instituting antiviral therapy in a timely manner when positive. RIDTs can also be useful in remote settings where molecular virology testing is not easily accessible. Suboptimal sensitivity of RIDTs can be addressed by the use of molecular testing. PMID:25320225

  18. Metagenomic abundance estimation and diagnostic testing on species level

    Science.gov (United States)

    Lindner, Martin S.; Renard, Bernhard Y.

    2013-01-01

    One goal of sequencing-based metagenomic community analysis is the quantitative taxonomic assessment of microbial community compositions. In particular, relative quantification of taxons is of high relevance for metagenomic diagnostics or microbial community comparison. However, the majority of existing approaches quantify at low resolution (e.g. at phylum level), rely on the existence of special genes (e.g. 16S), or have severe problems discerning species with highly similar genome sequences. Yet, problems as metagenomic diagnostics require accurate quantification on species level. We developed Genome Abundance Similarity Correction (GASiC), a method to estimate true genome abundances via read alignment by considering reference genome similarities in a non-negative LASSO approach. We demonstrate GASiC’s superior performance over existing methods on simulated benchmark data as well as on real data. In addition, we present applications to datasets of both bacterial DNA and viral RNA source. We further discuss our approach as an alternative to PCR-based DNA quantification. PMID:22941661

  19. Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection

    Directory of Open Access Journals (Sweden)

    Villar Luis A

    2010-12-01

    Full Text Available Abstract Background We compared the diagnostic accuracy and reproducibility of commercially available NS1-based dengue tests and explored factors influencing their sensitivities. Methods Paired analysis of 310 samples previously characterized as positive (n = 218 and negative (n = 92 for viral isolation and/or RT-PCR and/or IgM seroconversion. Masked samples were tested by two observers with Platelia™ Dengue NS1 Ag, second generation Pan-E™ Dengue Early ELISA, SD Dengue NS1 Ag ELISA, Dengue NS1 Ag STRIP™, and SD BIOLINE™ Dengue Duo (NS1/IgM/IgG. Results SD BIOLINE™ NS1/IgM/IgG had the highest sensitivity (80.7% 95%CI 75-85.7 with likelihood ratios of 7.4 (95%CI 4.1-13.8 and 0.21 (95%CI 0.16-0.28. The ELISA-format tests showed comparable sensitivities; all below 75%. STRIP™ and SD NS1 had even lower sensitivities ( Conclusions The simultaneous detection of NS1/IgM/IgG would be potentially useful for dengue diagnosis in both endemic and non endemic areas. A negative result does not rule out dengue. Further studies are required to assess the performance and impact of early laboratory diagnosis of dengue in the routine clinical setting.

  20. Fan Noise Source Diagnostic Test: Tone Modal Structure Results

    Science.gov (United States)

    Heidelberg, Laurence J.

    2002-01-01

    This investigation is part of a test series that was extremely comprehensive and included aerodynamic and acoustic testing of a fan stage using two different fan rotors and three different stator designs. The test series is known as the Source Diagnostic Test (SDT) and was conducted by NASA Glenn as part of the Advanced Subsonic Technology (AST) Noise Reduction Program. Tone mode measurements of one of the rotors with three different stators were made. The stator designs involve changes in vane count and sweep at constant solidity. The results of both inlet and exhaust tone mode measurements are presented in terms of mode power for both circumferential and radial mode orders. The results show benefits of vane sweep to be large, up to 13 dB in total tone power. At many conditions, the increase in power due to cutting on the rotor/stator interaction is more than offset by vane sweep. The rotor locked mode is shown as an important contributor to tone power when the blade tip speed is near and above Mach one. This is most evident in the inlet when the direct rotor field starts to cut on.

  1. A Novel Automatic Rapid Diagnostic Test Reader Platform.

    Science.gov (United States)

    Ozkan, Haydar; Kayhan, Osman Semih

    2016-01-01

    A novel automatic Rapid Diagnostic Test (RDT) reader platform is designed to analyze and diagnose target disease by using existing consumer cameras of a laptop-computer or a tablet. The RDT reader is useable with numerous lateral immunochromatographic assays and similar biomedical tests. The system has two different components, which are 3D-printed, low-cost, tiny, and compact stand and a decision program named RDT-AutoReader 2.0. The program takes the image of RDT, crops the region of interest (ROI), and extracts the features from the control end test lines to classify the results as invalid, positive, or negative. All related patient's personal information, image of ROI, and the e-report are digitally saved and transferred to the related clinician. Condition of the patient and the progress of the disease can be monitored by using the saved data. The reader platform has been tested by taking image from used cassette RDTs of rotavirus (RtV)/adenovirus (AdV) and lateral flow strip RDTs of Helicobacter pylori (H. pylori) before discarding them. The created RDT reader can also supply real-time statistics of various illnesses by using databases and Internet. This can help to inhibit propagation of contagious diseases and to increase readiness against epidemic diseases worldwide. PMID:27190549

  2. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  3. Reporting Diagnostic Scores in Educational Testing: Temptations, Pitfalls, and Some Solutions

    Science.gov (United States)

    Sinharay, Sandip; Puhan, Gautam; Haberman, Shelby J.

    2010-01-01

    Diagnostic scores are of increasing interest in educational testing due to their potential remedial and instructional benefit. Naturally, the number of educational tests that report diagnostic scores is on the rise, as are the number of research publications on such scores. This article provides a critical evaluation of diagnostic score reporting…

  4. Efficient Noninferiority Testing Procedures for Simultaneously Assessing Sensitivity and Specificity of Two Diagnostic Tests

    Directory of Open Access Journals (Sweden)

    Guogen Shan

    2015-01-01

    Full Text Available Sensitivity and specificity are often used to assess the performance of a diagnostic test with binary outcomes. Wald-type test statistics have been proposed for testing sensitivity and specificity individually. In the presence of a gold standard, simultaneous comparison between two diagnostic tests for noninferiority of sensitivity and specificity based on an asymptotic approach has been studied by Chen et al. (2003. However, the asymptotic approach may suffer from unsatisfactory type I error control as observed from many studies, especially in small to medium sample settings. In this paper, we compare three unconditional approaches for simultaneously testing sensitivity and specificity. They are approaches based on estimation, maximization, and a combination of estimation and maximization. Although the estimation approach does not guarantee type I error, it has satisfactory performance with regard to type I error control. The other two unconditional approaches are exact. The approach based on estimation and maximization is generally more powerful than the approach based on maximization.

  5. Analysis and Interpretation of the Plasma Dynamic Response to Additional Heating Power using different Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Manini, A

    2002-07-01

    development of this work, the Electron Cyclotron Emission system (ECE) of ASDEX Upgrade is crucial since it allows local measurements of the electron temperature with high temporal and spatial resolutions. The analysis and interpretation of perturbative MECH discharges for power deposition localisation using different diagnostics, such as ECE and SXR measurements, are presented. The most important problem is related to the phase locking between the MECH and the sawtooth activity of the plasma, which disturbs both ECE and SXR measurements. Several techniques have been adopted to circumvent this difficulty. In particular, the Singular Value Decomposition (SVD) and the Generalised Singular Value Decomposition (GSVD) have been tested in both TCV and ASDEX Upgrade discharges. However, both methods are incapable of treating the problem correctly, which leads to potential misinterpretation of the results. A new method based on system identification using the SVD (SI-SVD) is developed and applied. This method, within reasonable limits induced by the assumption of linearity, is capable of simultaneously separating the MECH from the sawtooth contributions to both ECE electron temperature measurements and SXR emission measurements. Such a method is in particular applied to a NBI heated ASDEX Upgrade discharge in which MECH is added in order to analyse electron heat transport in a mostly ion-heated plasma. Since the NBI heating is also partly modulated with short pulses, which coincide with the sawtooth crashes to improve their stability, both the MECH and the NBI deposition profiles are determined. Moreover, treating the signals with the SI-SVD procedure enables a study of the plasma dynamic response also at higher MECH harmonic numbers. The procedure is then used to analyse MECH discharges in TCV using different diagnostics. The profiles determined using the ECE and soft X-ray measurements are compared and interpreted, demonstrating in particular that line integrated soft X

  6. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    OpenAIRE

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the te...

  7. RAPID TEST METHOD FOR EVALUATION OF ANTIFREEZE ADDITIVE EFFICIENCY

    Directory of Open Access Journals (Sweden)

    S. V. Gushchin

    2015-01-01

    Full Text Available Usage of chemical additives while executing concrete works at negative temperatures is considered as a convenient and economical method. Range of the used antifreeze additives is rather wide. A great number of new additives are advertised but their characteristics have not been practically studied. Evaluation of the antifreeze additive efficiency is unfortunately rather long process and it does not provide comprehensive data on concrete structure formation processes. Due to this development of rapid and comprehensive methodology for construction companies is urgently required.Freezing processes of antifreeze additive aqueous solutions and hardening of cement paste with them have been investigated in the paper. The paper proposes a methodology for determination of freezing point for aqueous solutions of chemical additives of various applications. Identity of  freezing point for a chemical additive aqueous solution and cement paste with an equal concentration of the additive in the paste pore fluid has been determined while taking  calcium nitrate and sodium formate additives as an example. The paper demonstrates the possibility to evaluate efficiency of antifreeze additive action on the basis of kinetics in temperature changes of the cement paste with additives by its consecutive freezing and defrosting.  A methodology for operational evaluation in the field of chemical additive application for concreting items at negative temperatures has been offered in the paper.  The methodology does not require  deficient and expensive test-equipment. It can be applied at ordinary construction companies and it is comprehensible for personnel of low-qualification.  The paper shows the possibility to develop an original methodology for designing concrete structure which is based on operating efficiency determinations  for single and integrated antifreeze additives.

  8. Birth of the Astronomy Diagnostic Test: Prototest Evolution

    Science.gov (United States)

    Zeilik, M.

    2001-12-01

    In 1992, with funding by the National Science Foundation, a multidisciplinary research team at the University of New Mexico accreted to transform a "traditional Astro 101" course into a conceptually-oriented one. The team consisted of people from astronomy, cognitive psychology, and education. Our aim was to improve the learning environment in a large "lecture" course based on current cognitive models of adult learning. We demanded that our effort be research-based, but found little in the literature to assist us; for example, no field-tested assessment tools that would measure appropiate outcomes had been developed in higher education. From prior research at lower grades, we saw the need of a valid and reliable "misconceptions" test. We also desired to tap into higher level conceptual learning, and so developed concept map assessments to measure acquisition of the "Big Picture" in astronomy. These "misconceptions measures" were protoversions of the Astronomy Diagnostic Test (ADT) that gained in structure and usefulness over four semesters involving hundreds of students. I will outline our methodology to develop the ADT in a bootstrap way, its basis as a learning tool, and its correlation with other assessments (especially the concept maps) and achievement in the UNM "Astro 101" course. This work was supported in part by NSF DUE grants 9253983 and 9981155.

  9. A Note on the Vogelsang Test for Additive Outliers

    DEFF Research Database (Denmark)

    Haldrup, Niels; Sansó, Andreu

    The role of additive outliers in integrated time series has attractedsome attention recently and research shows that outlier detection shouldbe an integral part of unit root testing procedures. Recently, Vogelsang(1999) suggested an iterative procedure for the detection of multiple additiveoutliers...

  10. Design of Test Parts to Characterize Micro Additive Manufacturing Processes

    DEFF Research Database (Denmark)

    Thompson, Mary Kathryn; Mischkot, Michael

    2015-01-01

    The minimum feature size and obtainable tolerances of additive manufacturing processes are linked to the smallest volumetric elements (voxels) that can be created. This work presents the iterative design of a test part to investigate the resolution of AM processes with voxel sizes at the micro...

  11. Testing exclusion restrictions and additive separability in sample selection models

    DEFF Research Database (Denmark)

    Huber, Martin; Mellace, Giovanni

    2014-01-01

    Standard sample selection models with non-randomly censored outcomes assume (i) an exclusion restriction (i.e., a variable affecting selection, but not the outcome) and (ii) additive separability of the errors in the selection process. This paper proposes tests for the joint satisfaction of these......Standard sample selection models with non-randomly censored outcomes assume (i) an exclusion restriction (i.e., a variable affecting selection, but not the outcome) and (ii) additive separability of the errors in the selection process. This paper proposes tests for the joint satisfaction...... of these assumptions by applying the approach of Huber and Mellace (Testing instrument validity for LATE identification based on inequality moment constraints, 2011) (for testing instrument validity under treatment endogeneity) to the sample selection framework. We show that the exclusion restriction and additive...... separability imply two testable inequality constraints that come from both point identifying and bounding the outcome distribution of the subpopulation that is always selected/observed. We apply the tests to two variables for which the exclusion restriction is frequently invoked in female wage regressions: non...

  12. Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy

    OpenAIRE

    Grande, Antonio Jose; Reid, Hamish; Thomas, Emma; Foster, Charlie; Darton, Thomas C

    2016-01-01

    Background Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). Purpose To assess the quality of the evidence supporting the use of the TT and perform a diagnos...

  13. Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy.

    OpenAIRE

    Grande, A.J.; Reid, H; Thomas, E.; Foster, C.; Darton, T.C.

    2016-01-01

    BACKGROUND: Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). PURPOSE: To assess the quality of the evidence supporting the use of the TT and perform a diagn...

  14. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.;

    2007-01-01

    on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R...

  15. A COMPUTERIZED DIAGNOSTIC COMPLEX FOR RELIABILITY TESTING OF ELECTRIC MACHINES

    Directory of Open Access Journals (Sweden)

    O.О. Somka

    2015-06-01

    Full Text Available Purpose. To develop a diagnostic complex meeting the criteria and requirements for carrying out accelerated reliability test and realizing the basic modes of electric machines operation and performance of the posed problems necessary in the process of such test. Methodology. To determine and forecast the indices of electric machines reliability in accordance with the statistic data of repair plants we have conditionally divided them into structural parts that are most likely to fail. We have preliminarily assessed the state of each of these parts, which includes revelation of faults and deviations of technical and geometric parameters. We have determined the analyzed electric machine controlled parameters used for assessment of quantitative characteristics of reliability of these parts and electric machines on the whole. Results. As a result of the research, we have substantiated the structure of a computerized complex for electric machines reliability test. It allows us to change thermal and vibration actions without violation of the physics of the processes of aging and wearing of the basic structural parts and elements material. The above mentioned makes it possible to considerably reduce time spent on carrying out electric machines reliability tests and improve trustworthiness of the data obtained as a result of their performance. Originality. A special feature of determination of the controlled parameters consists in removal of vibration components in the idle mode and after disconnection of the analyzed electric machine from the power supply with the aim of singling out the vibration electromagnetic component, fixing the degree of sparking and bend of the shaft by means of phototechnique and local determination of structural parts temperature provided by corresponding location of thermal sensors. Practical value. We have offered a scheme of location of thermal and vibration sensors, which allows improvement of parameters measuring accuracy

  16. Filtering Medline for a clinical discipline: diagnostic test assessment framework

    Science.gov (United States)

    Iansavichus, Arthur V; Wilczynski, Nancy L; Kastner, Monika; Baier, Leslie A; Shariff, Salimah Z; Rehman, Faisal; Weir, Matthew; McKibbon, K Ann; Haynes, R Brian

    2009-01-01

    Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database. Design Diagnostic test assessment framework with development and validation phases. Setting Sample of 4657 articles published in 2006 from 40 journals. Reviews Each article was manually reviewed, and 19.8% contained information relevant to the discipline of nephrology. The performance of 1 155 087 unique renal filters was compared with the manual review. Main outcome measures Sensitivity, specificity, precision, and accuracy of each filter. Results The best renal filters combined two to 14 terms or phrases and included the terms “kidney” with multiple endings (that is, truncation), “renal replacement therapy”, “renal dialysis”, “kidney function tests”, “renal”, “nephr” truncated, “glomerul” truncated, and “proteinuria”. These filters achieved peak sensitivities of 97.8% and specificities of 98.5%. Performance of filters remained excellent in the validation phase. Conclusions Medline can be filtered for the discipline of nephrology in a reliable manner. Storing these high performance renal filters in PubMed could help clinicians with their everyday searching. Filters can also be developed for other clinical disciplines by using similar methods. PMID:19767336

  17. Toward a Diagnostic Test for Hidden Hearing Loss.

    Science.gov (United States)

    Plack, Christopher J; Léger, Agnès; Prendergast, Garreth; Kluk, Karolina; Guest, Hannah; Munro, Kevin J

    2016-01-01

    Cochlear synaptopathy (or hidden hearing loss), due to noise exposure or aging, has been demonstrated in animal models using histological techniques. However, diagnosis of the condition in individual humans is problematic because of (a) test reliability and (b) lack of a gold standard validation measure. Wave I of the transient-evoked auditory brainstem response is a noninvasive electrophysiological measure of auditory nerve function and has been validated in the animal models. However, in humans, Wave I amplitude shows high variability both between and within individuals. The frequency-following response, a sustained evoked potential reflecting synchronous neural activity in the rostral brainstem, is potentially more robust than auditory brainstem response Wave I. However, the frequency-following response is a measure of central activity and may be dependent on individual differences in central processing. Psychophysical measures are also affected by intersubject variability in central processing. Differential measures may help to reduce intersubject variability due to unrelated factors. A measure can be compared, within an individual, between conditions that are affected differently by cochlear synaptopathy. Validation of the metrics is also an issue. Comparisons with animal models, computational modeling, auditory nerve imaging, and human temporal bone histology are all potential options for validation, but there are technical and practical hurdles and difficulties in interpretation. Despite the obstacles, a diagnostic test for hidden hearing loss is a worthwhile goal, with important implications for clinical practice and health surveillance. PMID:27604783

  18. Diagnostic development and support of MHD test facilities: Technical progress report for the period January, February, March 1985

    International Nuclear Information System (INIS)

    Mississippi State University is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for HRSR support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with MHD Energy Center computers. Additionally, technical support of the diagnostic needs of the national MHD research effort is being provided

  19. Battery Test Facility- Electrochemical Analysis and Diagnostics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrochemical Analysis and Diagnostics Laboratory (EADL) provides battery developers with reliable, independent, and unbiased performance evaluations of their...

  20. Model Checking Vector Addition Systems with one zero-test

    CERN Document Server

    Bonet, Rémi; Leroux, Jérôme; Zeitoun, Marc

    2012-01-01

    We design a variation of the Karp-Miller algorithm to compute, in a forward manner, a finite representation of the cover (i.e., the downward closure of the reachability set) of a vector addition system with one zero-test. This algorithm yields decision procedures for several problems for these systems, open until now, such as place-boundedness or LTL model-checking. The proof techniques to handle the zero-test are based on two new notions of cover: the refined and the filtered cover. The refined cover is a hybrid between the reachability set and the classical cover. It inherits properties of the reachability set: equality of two refined covers is undecidable, even for usual Vector Addition Systems (with no zero-test), but the refined cover of a Vector Addition System is a recursive set. The second notion of cover, called the filtered cover, is the central tool of our algorithms. It inherits properties of the classical cover, and in particular, one can effectively compute a finite representation of this set, e...

  1. The basic and additional immunohistochemical criteria in differential diagnostics of tumors and tumor-like processes of mammary gland

    Directory of Open Access Journals (Sweden)

    Shponka I.S.

    2009-01-01

    Full Text Available Morphological diagnostics of mammary gland neoplasm is complex due to polymorphism of tumors and tumor-like processes. The purpose of our research was to reveal the basic and additional immunohistochemical markers for differential diagnostics of some diseases. We have established that the basic markers for differential diagnostics of adenosis and invasive carcinomas were MSA, α-SMA, S100, collagen IV, р63, Кі-67 and р53, additional - 34βЕ12, СК7, СК8, СК5/6, E-cadgerin. The loss of expression of myoepithelial markers, positive reaction with Кі-67, р53, Her2/neu also matters. Mutually contrary patterns of 34βЕ12 and E-cadgerin expression allow to differentiate ductal or lobular primacy of process. СК7, СК8, 34βЕ12 play a key role in differential diagnostics of carcinosarcomas and sarcomas. myoepithelial markers and basal membrane also give the additional information. At differential diagnostics of carcinoma and malignant tumors of other nature СК7, СК8, E-cadgerin, Her2/neu, ER/PgR, myoepithelial markers were the most important, being typical only for epithelial tumors. At Paget disease the reliable diagnostic criteria are absence of S100 and expression of certain classes СК (more often luminal epithelium СК7, СК8, E-cadgerin, СЕА. Clone AE1/AE3 and revealing СК7 is valuable for diagnostics of micro-metastasises.

  2. Fan Noise Source Diagnostic Test: Vane Unsteady Pressure Results

    Science.gov (United States)

    Envia, Edmane

    2002-01-01

    To investigate the nature of fan outlet guide vane pressure fluctuations and their link to rotor-stator interaction noise, time histories of vane fluctuating pressures were digitally acquired as part of the Fan Noise Source Diagnostic Test. Vane unsteady pressures were measured at seven fan tip speeds for both a radial and a swept vane configuration. Using time-domain averaging and spectral analysis, the blade passing frequency (BPF) harmonic and broadband contents of the vane pressures were individually analyzed. Significant Sound Pressure Level (SPL) reductions were observed for the swept vane relative to the radial vane for the BPF harmonics of vane pressure, but vane broadband reductions due to sweep turned out to be much smaller especially on an average basis. Cross-correlation analysis was used to establish the level of spatial coherence of broadband pressures between different locations on the vane and integral length scales of pressure fluctuations were estimated from these correlations. Two main results of this work are: (1) the average broadband level on the vane (in dB) increases linearly with the fan tip speed for both the radial and swept vanes, and (2) the broadband pressure distribution on the vane is nearly homogeneous and its integral length scale is a monotonically decreasing function of fan tip speed.

  3. Pre-course Results from the Astronomy Diagnostic Test

    Science.gov (United States)

    Hufnagel, Beth; Slater, Timothy; Deming, Grace; Adams, Jeff; Adrian, Rebecca L.; Brick, Christine; Zeilik, Michael

    2000-08-01

    We present selected results from the January 1999 semester pre-course administration of the Astronomy Diagnostic Test (ADT), a research-based, multiple-choice instrument that assesses student knowledge and understanding about selected concepts in astronomy. The ADT is valid for undergraduate non-science majors taking an introductory astronomy course. This paper briefly summarises the development and validation processes, which included pre-course administration to 1557 students in 22 classes attending 17 various post-secondary institutions across the USA in the January 1999 semester. Two interesting results of the ADT's pre-course administration are (1) the average class score of the ADT is about the same (32%) regardless of type of post-secondary institution or class size and (2) there is a significant gender difference, with women scoring an average of 28% and men 38%, with the standard errors both less than 1%. The current version of the ADT (Version 2 dated 21 June 1999) and a comparative by-class database is available to astronomy instructors at the (USA) Association of Astronomy Educators' and the National Institute for Science Education's (NISE) WebPages.

  4. Feasibility of an early Alzheimer's disease immunosignature diagnostic test.

    Science.gov (United States)

    Restrepo, Lucas; Stafford, Phillip; Johnston, Stephen Albert

    2013-01-15

    A practical diagnostic test is needed for early Alzheimer's disease (AD) detection. Immunosignaturing, a technology that employs antibody binding to a random-sequence peptide microarray, generates profiles that distinguish transgenic mice engineered with familial AD mutations (APPswe/PSEN1-dE9) from non-transgenic littermates. It can also detect an AD-like signature in humans. Here, we assess the changes in the immunosignature at different time points of the disease in mice and humans. We also evaluate the accuracy of the late-stage signature as a test to discriminate between young mice with familial AD mutations from non-transgenic littermates. Plasma samples from AD patients were assayed 3-12 months apart, while APPswe/PSEN1-dE9 and non-transgenic controls supplied plasma at monthly intervals until they reached 15 months of age. Microarrays with 10,000 random-sequence peptides were used to compare antibody binding patterns. These patterns gradually changed over the life-span of mice. Strong, characteristic signatures were observed in transgenic mice at early, mid and late stages, but these profiles had minimal overlap. The signature of young transgenic mice had an error rate of 18% at classifying plasma samples from late-stage transgenic mice. Conversely, the late-stage transgenic mice signature discriminated between young transgenic mice and littermates with an error rate of 21%. Less distinctive profiles were recognizable throughout the transgenic mice lifespan, being detectable as early as 2 months. The human signature had minimal change on short-term follow-up. Our results call for a reappraisal of the way incipient AD is studied, as biomarkers seen in late-stages of the disease may not be relevant in earlier stages.

  5. Harmonization of antimicrobial susceptibility testing among veterinary diagnostic laboratories in the five Nordic countries

    DEFF Research Database (Denmark)

    Petersen, A.; Aarestrup, Frank Møller; Hofshagen, Merete;

    2003-01-01

    A total of 100 bacterial strains (25 Escherichia coli, 25 Salmonella enterica, 25 Staphylococcus aureus, and 25 Enterococcus strains) and four reference strains were tested for susceptibility toward 8-12 antimicrobial agents in 12 veterinary diagnostic laboratories in the five Nordic countries...... observed identifying other enterococcal species. This study showed a good performance and agreement in antimicrobial susceptibility testing at the 12 participating laboratories and that surveillance data covering susceptibility test results of E. coli, S. aureus, and Salmonella from animals in the Nordic...... using routine methodology. In addition, the 25 Enterococcus strains were identified to species level. A total of 22,598 (97.2%) out of 23,259 test results were in accordance when the data were categorized as susceptible or resistant. When the reported results were categorized according to the National...

  6. Advances in sodium technology, testing and diagnostics of fast reactors

    International Nuclear Information System (INIS)

    The collection contains a selection of 29 papers from three international specialists' meetings: the CMEA conference ''Control and measuring instruments and diagnostic systems of fast reactors'' held in the GDR in April 1983; the IAEA conference on nuclear power experience held in Austria in September 1982; and the conference ''Problems of technology and corrosion in sodium coolant and protective gas'' held in the GDR in April 1977. Three papers on operating experience with Soviet fast reactors and their safety have a general character; they are followed up by three papers on sodium technology. Five papers deal with the diagnostics of fast sodium cooled reactors and nine papers are devoted to the diagnostics of steam generators. Eight papers relate to detectors for the diagnostics of fast reactors. Safety regulations for work with alkali metals are added. (A.K.)

  7. Latent-class methods to evaluate diagnostics tests for Echinococcus infections in dogs.

    Directory of Open Access Journals (Sweden)

    Sonja Hartnack

    Full Text Available BACKGROUND: The diagnosis of canine echinococcosis can be a challenge in surveillance studies because there is no perfect gold standard that can be used routinely. However, unknown test specificities and sensitivities can be overcome using latent-class analysis with appropriate data. METHODOLOGY: We utilised a set of faecal and purge samples used previously to explore the epidemiology of canine echinococcosis on the Tibetan plateau. Previously only the purge results were reported and analysed in a largely deterministic way. In the present study, additional diagnostic tests of copro-PCR and copro-antigen ELISA were undertaken on the faecal samples. This enabled a Bayesian analysis in a latent-class model to examine the diagnostic performance of a genus specific copro-antigen ELISA, species-specific copro-PCR and arecoline purgation. Potential covariates including co-infection with Taenia, age and sex of the dog were also explored. The dependence structure of these diagnostic tests could also be analysed. PRINCIPLE FINDINGS: The most parsimonious result, indicated by deviance-information criteria, suggested that co-infection with Taenia spp. was a significant covariate with the Echinococcus infection. The copro-PCRs had estimated sensitivities of 89% and 84% respectively for the diagnoses of Echinococcus multilocularis and E. granulosus. The specificities for the copro-PCR were estimated at 93 and 83% respectively. Copro-antigen ELISA had sensitivities of 55 and 57% for the diagnosis of E. multilocularis and E. granulosus and specificities of 71 and 69% respectively. Arecoline purgation with an assumed specificity of 100% had estimated sensitivities of 76% and 85% respectively. SIGNIFICANCE: This study also shows that incorporating diagnostic uncertainty, in other words assuming no perfect gold standard, and including potential covariates like sex or Taenia co-infection into the epidemiological analysis may give different results than if the

  8. Intercomparison of techniques for inspection and diagnostics of heavy water reactor pressure tubes. Additional information

    International Nuclear Information System (INIS)

    The reports from Argentina, Canada, India, Korea and Romania are presented concerning the projects carried out under the Coordinated Research Program (CRP) I3.30.10 of the International Agency for Atomic Energy - Vienna related to 'Intercomparison of Techniques for Pressure Tube Inspection and Diagnostics'

  9. The accuracy of physical diagnostic tests for assessing meniscal lesions of the knee: a meta-analysis.

    NARCIS (Netherlands)

    Scholten, R.J.P.M.; Devillé, W.L.J.M.; Opstelten, W.; Bijl, D.; Plas, C.G. van der; Bouter, L.M.

    2001-01-01

    OBJECTIVE. Our systematic review summarizes the evidence about the accuracy of physical diagnostic tests for assessing meniscal lesions of the knee. SEARCH STRATEGY. We performed a literature search of MEDLINE (1966-1999) and EMBASE 1988- 1999) with additional reference tracking. SELECTION CRITERIA

  10. Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy

    Science.gov (United States)

    Reid, Hamish; Thomas, Emma; Foster, Charlie; Darton, Thomas C.

    2016-01-01

    Background Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). Purpose To assess the quality of the evidence supporting the use of the TT and perform a diagnostic accuracy meta-analysis comparing the TT to antibody response measured by ELISA. Data Sources A comprehensive literature search was conducted in the following databases to April, 2016: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, BIOSIS, Web of Science, SCOPUS. Study Selection Studies comparing the diagnostic accuracy of the tourniquet test with ELISA for the diagnosis of dengue were included. Data Extraction Two independent authors extracted data using a standardized form. Data Synthesis A total of 16 studies with 28,739 participants were included in the meta-analysis. Pooled sensitivity for dengue diagnosis by TT was 58% (95% Confidence Interval (CI), 43%-71%) and the specificity was 71% (95% CI, 60%-80%). In the subgroup analysis sensitivity for non-severe dengue diagnosis was 55% (95% CI, 52%-59%) and the specificity was 63% (95% CI, 60%-66%), whilst sensitivity for dengue hemorrhagic fever diagnosis was 62% (95% CI, 53%-71%) and the specificity was 60% (95% CI, 48%-70%). Receiver-operator characteristics demonstrated a test accuracy (AUC) of 0.70 (95% CI, 0.66–0.74). Conclusion The tourniquet test is widely used in resource poor settings despite currently available evidence demonstrating only a marginal benefit in making a diagnosis of dengue infection alone. Registration The protocol for this systematic review was registered at PROSPERO: CRD42015020323. PMID:27486661

  11. Increasing value in diagnostic research: Publication and reporting of test accuracy studies

    NARCIS (Netherlands)

    D.A. Korevaar

    2016-01-01

    Diagnostic tests form an essential part of daily clinical practice. Unfortunately, most tests are not perfectly accurate; they usually produce a proportion of false positive and false negative results. Diagnostic accuracy studies evaluate a test’s ability to find out whether or not individuals have

  12. Diagnosis of Lumbar Spinal Stenosis An Updated Systematic Review of the Accuracy of Diagnostic Tests

    NARCIS (Netherlands)

    de Schepper, Evelien I. T.; Overdevest, Gijsbert M.; Suri, Pradeep; Peul, Wilco C.; Oei, Edwin H. G.; Koes, Bart W.; Bierma-Zeinstra, Sita M. A.; Luijsterburg, Pim A. J.

    2013-01-01

    Study Design. Systematic review of diagnostic studies. Objective. To update our previous systematic review on the diagnostic accuracy of tests used to diagnose lumbar spinal stenosis. Summary of Background Data. A wide range of clinical, radiological, and electrodiagnostic tests are used to diagnose

  13. Evaluating Frequency, Diagnostic Quality, and Cost of Lyme Borreliosis Testing in Germany: A Retrospective Model Analysis

    Directory of Open Access Journals (Sweden)

    I. Müller

    2012-01-01

    Full Text Available Background. Data on the economic impact of Lyme borreliosis (LB on European health care systems is scarce. This project focused on the epidemiology and costs for laboratory testing in LB patients in Germany. Materials and Methods. We performed a sentinel analysis of epidemiological and medicoeconomic data for 2007 and 2008. Data was provided by a German statutory health insurance (DAK company covering approx. 6.04 million members. In addition, the quality of diagnostic testing for LB in Germany was studied. Results. In 2007 and 2008, the incident diagnosis LB was coded on average for 15,742 out of 6.04 million insured members (0.26%. 20,986 EIAs and 12,558 immunoblots were ordered annually for these patients. For all insured members in the outpatient sector, a total of 174,820 EIAs and 52,280 immunoblots were reimbursed annually to health care providers (cost: 2,600,850€. For Germany, the overall expected cost is estimated at 51,215,105€. However, proficiency testing data questioned test quality and standardization of diagnostic assays used. Conclusion. Findings from this study suggest ongoing issues related to care for LB and may help to improve future LB disease management.

  14. Update on diagnostic value of breath test in gastrointestinal and liver diseases.

    Science.gov (United States)

    Siddiqui, Imran; Ahmed, Sibtain; Abid, Shahab

    2016-08-15

    In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed. PMID:27574563

  15. 31P-MRS of skeletal muscle is not a sensitive diagnostic test for mitochondrial myopathy

    DEFF Research Database (Denmark)

    Jeppesen, Tina Dysgaard; Quistorff, Bjørn; Wibrand, Flemming;

    2007-01-01

    diagnostic criterion for MM but the diagnostic strength of this test has not been compared with that of other commonly used diagnostic procedures for MM. To investigate this, we studied seven patients with single, large-scale deletions-, nine with point mutations of mtDNA and 14 healthy subjects, who were...... as 100%, the sensitivity was low (0-63%) and the diagnostic strength of (31)P-MRS was inferior to the other diagnostic tests for MM. Thus, (31)P-MRS should not be a routine test for MM, but may be an important research tool.......Clinical phenotypes of persons with mitochondrial DNA (mtDNA) mutations vary considerably. Therefore, diagnosing mitochondrial myopathy (MM) patients can be challenging and warrants diagnostic guidelines. (31)phosphorous magnetic resonance spectroscopy ((31)P-MRS) have been included as a minor...

  16. The evaluation of a rapid in situ HIV confirmation test in a programme with a high failure rate of the WHO HIV two-test diagnostic algorithm.

    OpenAIRE

    Derryck B Klarkowski; Wazome, Joseph M.; Kamalini M Lokuge; Leslie Shanks; Mills, Clair F.; Daniel P O'Brien

    2009-01-01

    BACKGROUND: Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF) HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT) (two positive RDTs alone for HIV diagnosis) used in voluntary counselling and testing (VCT) sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-posit...

  17. Fan Noise Source Diagnostic Test: LDV Measured Flow Field Results

    Science.gov (United States)

    Podboy, Gary C.; Krupar, Martin J.; Hughes, Christopher E.; Woodward, Richard P.

    2003-01-01

    Results are presented of an experiment conducted to investigate potential sources of noise in the flow developed by two 22-in. diameter turbofan models. The R4 and M5 rotors that were tested were designed to operate at nominal take-off speeds of 12,657 and 14,064 RPMC, respectively. Both fans were tested with a common set of swept stators installed downstream of the rotors. Detailed measurements of the flows generated by the two were made using a laser Doppler velocimeter system. The wake flows generated by the two rotors are illustrated through a series of contour plots. These show that the two wake flows are quite different, especially in the tip region. These data are used to explain some of the differences in the rotor/stator interaction noise generated by the two fan stages. In addition to these wake data, measurements were also made in the R4 rotor blade passages. These results illustrate the tip flow development within the blade passages, its migration downstream, and (at high rotor speeds) its merging with the blade wake of the adjacent (following) blade. Data also depict the variation of this tip flow with tip clearance. Data obtained within the rotor blade passages at high rotational speeds illustrate the variation of the mean shock position across the different blade passages.

  18. Triple non-invasive diagnostic test for exclusion of common bile ducts stones before laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones.METHODS: All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy from March 2004 to March 2006 were studied retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including:patient's medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test.RESULTS: Twenty-five patients were identified to have common bile duct stones. Lack of history of stones,negative laboratory tests and normal ultrasonography alone was proven to exclude common bile duct stones in some patients. However, a combination of these three components (triple diagnostic), was proven to be the most statistically significant test to exclude common bile duct stones in patients with gallstone disease.CONCLUSION: Using a combination of routinely used diagnostic components as triple diagnostic modality would increase the diagnostic accuracy of common bile duct stones preoperatively. This triple non-invasive test is recommended for excluding common bile duct stones and to identify patients in need for other investigations.

  19. A diagnostic model incorporating P50 sensory gating and neuropsychological tests for schizophrenia.

    Directory of Open Access Journals (Sweden)

    Jia-Chi Shan

    Full Text Available OBJECTIVES: Endophenotypes in schizophrenia research is a contemporary approach to studying this heterogeneous mental illness, and several candidate neurophysiological markers (e.g. P50 sensory gating and neuropsychological tests (e.g. Continuous Performance Test (CPT and Wisconsin Card Sorting Test (WCST have been proposed. However, the clinical utility of a single marker appears to be limited. In the present study, we aimed to construct a diagnostic model incorporating P50 sensory gating with other neuropsychological tests in order to improve the clinical utility. METHODS: We recruited clinically stable outpatients meeting DSM-IV criteria of schizophrenia and age- and gender-matched healthy controls. Participants underwent P50 sensory gating experimental sessions and batteries of neuropsychological tests, including CPT, WCST and Wechsler Adult Intelligence Scale Third Edition (WAIS-III. RESULTS: A total of 106 schizophrenia patients and 74 healthy controls were enrolled. Compared with healthy controls, the patient group had significantly a larger S2 amplitude, and thus poorer P50 gating ratio (gating ratio = S2/S1. In addition, schizophrenia patients had a poorer performance on neuropsychological tests. We then developed a diagnostic model by using multivariable logistic regression analysis to differentiate patients from healthy controls. The final model included the following covariates: abnormal P50 gating (defined as P50 gating ratio >0.4, three subscales derived from the WAIS-III (Arithmetic, Block Design, and Performance IQ, sensitivity index from CPT and smoking status. This model had an adequate accuracy (concordant percentage = 90.4%; c-statistic = 0.904; Hosmer-Lemeshow Goodness-of-Fit Test, p = 0.64>0.05. CONCLUSION: To the best of our knowledge, this is the largest study to date using P50 sensory gating in subjects of Chinese ethnicity and the first to use P50 sensory gating along with other neuropsychological tests

  20. Results of metallographical diagnostic examination of Navy half-watt thermoelectric converters degraded by accelerated tests

    Science.gov (United States)

    Rosell, F. E., Jr.; Rouklove, P. G.

    1977-01-01

    To verify the 15-year reliability of the Navy half-watt radioisotope thermoelectric generator (RTG), bismuth-telluride thermoelectric converters were submitted to testing at high temperatures which accelerated the degradation and caused failure of the converters. Metallographic diagnostic examination of failed units verified failure mechanisms. Results of diagnostic examinations are presented.

  1. Using Meta-Analysis to Inform the Design of Subsequent Studies of Diagnostic Test Accuracy

    Science.gov (United States)

    Hinchliffe, Sally R.; Crowther, Michael J.; Phillips, Robert S.; Sutton, Alex J.

    2013-01-01

    An individual diagnostic accuracy study rarely provides enough information to make conclusive recommendations about the accuracy of a diagnostic test; particularly when the study is small. Meta-analysis methods provide a way of combining information from multiple studies, reducing uncertainty in the result and hopefully providing substantial…

  2. 77 FR 3748 - Request for Comments and Notice of Public Hearings on Genetic Diagnostic Testing

    Science.gov (United States)

    2012-01-25

    ... Patent and Trademark Office Request for Comments and Notice of Public Hearings on Genetic Diagnostic... in gathering information on the genetic diagnostic testing for purposes of preparing a report on the... USPTO invites the public to provide comments and to attend public hearings addressing genetic...

  3. Protease activity measurement in milk as a diagnostic test for clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Koop, G.; Werven, van T.; Roffel, S.; Hogeveen, H.; Nazmi, K.; Bikker, F.J.

    2015-01-01

    Due to the increasing use of automated milking systems, automated detection of clinical mastitis is becoming more important. Various in- or on-line diagnostic tests are in use, but generally suffer from false mastitis alerts. In this study, we explored a new diagnostic approach based on measureme

  4. The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

    Institute of Scientific and Technical Information of China (English)

    Yu-Lei Liu; Ying-Fang Ao; Hui Yan; Guo-Qing Cui

    2016-01-01

    Background:The supraspinatus tendon is the most commonly affected tendon in rotator cufftears.Early detection ofa supraspinatus tear using an accurate physical examination is,therefore,important.However,the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values.Therefore,the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests.Methods:Between November 2012 and January 2014,200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively.The hug-up test,empty can (EC) test,full can (FC) test,Neer impingement sign,and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears,with arthroscopic findings as the gold standard.Muscle strength was precisely quantified using an electronic digital tensiometer.Results:The prevalence of supraspinatus tears was 76.5%.The hug-up test demonstrated the highest sensitivity (94.1%),with a low negative likelihood ratio (NLR,0.08) and comparable specificity (76.6%) compared with the other four tests.The area under the receiver operating characteristic curve for the hug-up test was 0.854,with no statistical difference compared with the EC test (z =1.43 8,P =0.075) or the FC test (z =1.498,P =0.067).The hug-up test showed no statistical difference in terms of detecting different tear patterns according to the position (x2 =0.578,P =0.898) and size (Fisher's exact test,P > 0.999) compared with the arthroscopic examination.The interobserver reproducibility of the hug-up test was high,with a kappa coefficient of 0.823.Conclusions:The hug-up test can accurately detect supraspinatus tears with a high sensitivity,comparable specificity,and low NLR compared with the conventional clinical tests and could,therefore,improve the

  5. Identifying Students' Mathematical Skills from a Multiple-Choice Diagnostic Test Using an Iterative Technique to Minimise False Positives

    Science.gov (United States)

    Manning, S.; Dix, A.

    2008-01-01

    There is anecdotal evidence that a significant number of students studying computing related courses at degree level have difficulty with sub-GCE mathematics. Testing of students' skills is often performed using diagnostic tests and a number of computer-based diagnostic tests exist, which work, essentially, by testing one specific diagnostic skill…

  6. Diagnostics of the SMOS radiometer antenna system at the DTU-ESA spherical near-field antenna test facility

    DEFF Research Database (Denmark)

    Cappellin, Cecilia; Frandsen, A.; Pivnenko, Sergey;

    2007-01-01

    The recently developed Spherical Wave Expansion-to-Plane Wave Expansion (SWE-to-PWE) antenna diagnostics technique is employed in an investigation of the antenna system in the Microwave Imaging Radiometer using Aperture Synthesis (MIRAS) for ESA’s Soil Moisture and Ocean Salinity (SMOS) mission....... The SWE-to-PWE antenna diagnostics technique successfully identifies the sources of the anomalies detected in 2 of the 138 MIRAS antenna farfield patterns that were measured during the on-ground calibration at the DTU-ESA Spherical Near-Field Antenna Test Facility in 2006. In addition to its obvious value...

  7. Hydrogen Balmer beta: The separation between line peaks for plasma electron density diagnostics and self-absorption test

    International Nuclear Information System (INIS)

    We propose a diagnostic technique for the measurement of plasma electron number density, Ne, based on the wavelength separation between peaks, ΔλPS, of hydrogen Balmer beta line, Hβ. In favor of the proposed diagnostic technique we demonstrate high sensitivity of ΔλPS on Ne and low sensitivity on plasma elementary processes and plasma parameters that may distort the line profile. These properties of ΔλPS enable reliable Ne plasma diagnostics in the presence of considerable self-absorption. On the basis of available theoretical data tables for the Hβ line profiles, simple Ne=f(ΔλPS) formulas are proposed. Their validity is experimentally confirmed in a low initial pressure pulsed discharge for the Ne range of (0.2–7)⁎1023 m−3. The agreement of the proposed formulas with another diagnostic technique is well within 10%. In addition, the difference in Ne values obtained from peak separation and from the Hβ line width is successfully used as a self-absorption test for line profile. - Highlights: • Separation between peaks of Hβ line proposed for electron density diagnostics. • Derived formulas for peak separations versus electron density. • Formulas tested in high electron density low pressure pulsed arc. • Applications of formulas in optically thick plasmas proven. • Method for hydrogen Balmer beta line self-absorption testing proposed

  8. Diagnostic test accuracy: methods for systematic review and meta-analysis.

    Science.gov (United States)

    Campbell, Jared M; Klugar, Miloslav; Ding, Sandrine; Carmody, Dennis P; Hakonsen, Sasja J; Jadotte, Yuri T; White, Sarahlouise; Munn, Zachary

    2015-09-01

    Systematic reviews are carried out to provide an answer to a clinical question based on all available evidence (published and unpublished), to critically appraise the quality of studies, and account for and explain variations between the results of studies. The Joanna Briggs Institute specializes in providing methodological guidance for the conduct of systematic reviews and has developed methods and guidance for reviewers conducting systematic reviews of studies of diagnostic test accuracy. Diagnostic tests are used to identify the presence or absence of a condition for the purpose of developing an appropriate treatment plan. Owing to demands for improvements in speed, cost, ease of performance, patient safety, and accuracy, new diagnostic tests are continuously developed, and there are often several tests available for the diagnosis of a particular condition. In order to provide the evidence necessary for clinicians and other healthcare professionals to make informed decisions regarding the optimum test to use, primary studies need to be carried out on the accuracy of diagnostic tests and the results of these studies synthesized through systematic review. The Joanna Briggs Institute and its international collaboration have updated, revised, and developed new guidance for systematic reviews, including systematic reviews of diagnostic test accuracy. This methodological article summarizes that guidance and provides detailed advice on the effective conduct of systematic reviews of diagnostic test accuracy.

  9. DVA as a Diagnostic Test for Vestibulo-Ocular Reflex Function

    Science.gov (United States)

    Wood, Scott J.; Appelbaum, Meghan

    2010-01-01

    The vestibulo-ocular reflex (VOR) stabilizes vision on earth-fixed targets by eliciting eyes movements in response to changes in head position. How well the eyes perform this task can be functionally measured by the dynamic visual acuity (DVA) test. We designed a passive, horizontal DVA test to specifically study the acuity and reaction time when looking in different target locations. Visual acuity was compared among 12 subjects using a standard Landolt C wall chart, a computerized static (no rotation) acuity test and dynamic acuity test while oscillating at 0.8 Hz (+/-60 deg/s). In addition, five trials with yaw oscillation randomly presented a visual target in one of nine different locations with the size and presentation duration of the visual target varying across trials. The results showed a significant difference between the static and dynamic threshold acuities as well as a significant difference between the visual targets presented in the horizontal plane versus those in the vertical plane when comparing accuracy of vision and reaction time of the response. Visual acuity increased proportional to the size of the visual target and increased between 150 and 300 msec duration. We conclude that dynamic visual acuity varies with target location, with acuity optimized for targets in the plane of rotation. This DVA test could be used as a functional diagnostic test for visual-vestibular and neuro-cognitive impairments by assessing both accuracy and reaction time to acquire visual targets.

  10. Self Diagnostic Accelerometer Ground Testing on a C-17 Aircraft Engine

    Science.gov (United States)

    Tokars, Roger P.; Lekki, John D.

    2013-01-01

    The self diagnostic accelerometer (SDA) developed by the NASA Glenn Research Center was tested for the first time in an aircraft engine environment as part of the Vehicle Integrated Propulsion Research (VIPR) program. The VIPR program includes testing multiple critical flight sensor technologies. One such sensor, the accelerometer, measures vibrations to detect faults in the engine. In order to rely upon the accelerometer, the health of the accelerometer must be ensured. Sensor system malfunction is a significant contributor to propulsion in flight shutdowns (IFSD) which can lead to aircraft accidents when the issue is compounded with an inappropriate crew response. The development of the SDA is important for both reducing the IFSD rate, and hence reducing the rate at which this component failure type can put an aircraft in jeopardy, and also as a critical enabling technology for future automated malfunction diagnostic systems. The SDA is a sensor system designed to actively determine the accelerometer structural health and attachment condition, in addition to making vibration measurements. The SDA uses a signal conditioning unit that sends an electrical chirp to the accelerometer and recognizes changes in the response due to changes in the accelerometer health and attachment condition. In an effort toward demonstrating the SDAs flight worthiness and robustness, multiple SDAs were mounted and tested on a C-17 aircraft engine. The engine test conditions varied from engine off, to idle, to maximum power. The two SDA attachment conditions used were fully tight and loose. The newly developed SDA health algorithm described herein uses cross correlation pattern recognition to discriminate a healthy from a faulty SDA. The VIPR test results demonstrate for the first time the robustness of the SDA in an engine environment characterized by high vibration levels.

  11. 40 CFR 85.2231 - On-board diagnostic test equipment requirements.

    Science.gov (United States)

    2010-07-01

    ... with the standard data link connector of vehicles with certified OBD systems. (c) The test system shall... evaluation status of supported monitors (test complete/test not complete) in Mode $01 PID $01, as well as be... 40 Protection of Environment 18 2010-07-01 2010-07-01 false On-board diagnostic test...

  12. Detection of OXA-48-type carbapenemase-producing Enterobacteriaceae in diagnostic laboratories can be enhanced by addition of bicarbonates to cultivation media or reaction buffers.

    Science.gov (United States)

    Studentova, Vendula; Papagiannitsis, Costas C; Izdebski, Radoslaw; Pfeifer, Yvonne; Chudackova, Eva; Bergerova, Tamara; Gniadkowski, Marek; Hrabak, Jaroslav

    2015-03-01

    Carbapenemase-mediated resistance to carbapenems in Enterobacteriaceae has become the main challenge in the treatment and prevention of infections recently. The partially unnoticed spread of OXA-48-type carbapenemase producers is usually assigned to low minimum inhibitory concentrations (MICs) of carbapenems that OXA-48-producing isolates often display. Therefore, there is an urgent need of specific and sensitive methods for isolation and detection of OXA-48 producers in clinical microbiology diagnostics. The influence of bicarbonates on carbapenem MICs against carbapenemase-producing Enterobacteriaceae was tested. We also checked whether the addition of bicarbonates to liquid media supplemented with meropenem may facilitate the selective enrichment of various carbapenemase producers in cultures. Furthermore, the sensitivity of carbapenemase confirmation by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) and spectrophotometric hydrolysis assays upon the addition of NH4HCO3 was examined. The addition of NaHCO3 significantly increased MICs of ertapenem and meropenem for OXA-48 producers. Furthermore, liquid media supplemented with NaHCO3 and meropenem were reliable for the selective enrichment of carbapenemase producers. The presence of NH4HCO3 in buffers used in the spectrophotometric and MALDI-TOF MS carbapenemase detection increased the sensitivity of that assay. Our results demonstrate that bicarbonates in media or reaction buffers can enhance the sensitivity of screening methods and diagnostic tests for carbapenemase producers.

  13. New challenges for BRCA testing: a view from the diagnostic laboratory.

    Science.gov (United States)

    Wallace, Andrew J

    2016-09-01

    Increased demand for BRCA testing is placing pressures on diagnostic laboratories to raise their mutation screening capacity and handle the challenges associated with classifying BRCA sequence variants for clinical significance, for example interpretation of pathogenic mutations or variants of unknown significance, accurate determination of large genomic rearrangements and detection of somatic mutations in DNA extracted from formalin-fixed, paraffin-embedded tumour samples. Many diagnostic laboratories are adopting next-generation sequencing (NGS) technology to increase their screening capacity and reduce processing time and unit costs. However, migration to NGS introduces complexities arising from choice of components of the BRCA testing workflow, such as NGS platform, enrichment method and bioinformatics analysis process. An efficient, cost-effective accurate mutation detection strategy and a standardised, systematic approach to the reporting of BRCA test results is imperative for diagnostic laboratories. This review covers the challenges of BRCA testing from the perspective of a diagnostics laboratory. PMID:27514839

  14. ITER diagnostics: Maintenance and commissioning in the hot cell test bed

    Energy Technology Data Exchange (ETDEWEB)

    Walker, C.I. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany)]. E-mail: walkerc@itereu.de; Barnsley, R. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany); Costley, A.E. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany); Gottfried, R. [Framatome ANP, Paris (France); Haist, B. [Oxford Technologies, 7 Nuffield Way, Abingdon, Oxon (United Kingdom); Itami, K. [ITER Naka Joint Work Site, 801-1 Mukouyama, Naka-shi, Ibaraki-ken 311-0193 (Japan); Kondoh, T. [ITER Naka Joint Work Site, 801-1 Mukouyama, Naka-shi, Ibaraki-ken 311-0193 (Japan); Loesser, G.D. [PPPL, Princeton, NJ (United States); Palmer, J. [EFDA, Boltzmannstrasse 2, 85748 Garching (Germany); Sugie, T. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany); Tesini, A. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany); Vayakis, G. [ITER International Team, Max-Planck-Institut fuer Plasmaphysik, Boltzmannstrasse 2, 85748 Garching (Germany)

    2005-11-15

    In-vessel diagnostic equipment in ITER integrated in six equatorial and 12 upper ports, 16 divertor cassettes and five lower ports is designed to be removed in modules and then repaired, tested and commissioned in the same location at the ITER hot cell. The repair requirements and tests on these components are described along with design features that facilitate repair. The testing establishes the repair strategy, qualifies the refurbishment work and finally checks the mechanical and diagnostic function before the return of the modules. At the hot cell, a dummy port is provided for tests of mechanical and vacuum integrity as well as commissioning of the diagnostic equipment. The scope of the hot cell maintenance and commissioning activities is summarised and an overview of the integration of the diagnostic equipment is given.

  15. Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture.

    NARCIS (Netherlands)

    Nys, S.; Merode, T. van; Bartelds, A.I.M.; Stobberingh, E.E.

    2006-01-01

    Objectives: Urinary tract infections (UTIs) are common bacterial infections encountered in general practice. For the optimal treatment the general practitioner (GP) should rely on the results of diagnostic tests and recent antimicrobial susceptibility of uropathogens. Patients and methods: In total

  16. Optimizing breast cancer follow-up: diagnostic value and costs of additional routine breast ultrasound.

    Science.gov (United States)

    Wojcinski, Sebastian; Farrokh, Andre; Hille, Ursula; Hirschauer, Elke; Schmidt, Werner; Hillemanns, Peter; Degenhardt, Friedrich

    2011-02-01

    A total of 2,546,325 breast cancer survivors are estimated to live in the United States. The organized breast cancer follow-up programs do not generally include breast ultrasound in asymptomatic women. The purpose of our prospective study was to investigate the efficacy of breast ultrasound in detecting previously occult recurrences. A total of 735 eligible patients with a history of breast cancer were recruited. We assessed the same patient population before (routine follow-up program) and after (study follow-up program) the introduction of an additional ultrasound examination. In the routine follow-up program 245 of 735 patients (33.3% [95% confidence-interval (CI): 29.9-36.7]) had an ultrasound due to abnormal local or mammographic findings. 490 of 735 patients (66.7% [95% CI: 63.3-70.1]) were initially considered asymptomatic and received an additional ultrasound exclusively within the study follow-up program. All positive examination results were followed by accelerated core needle biopsy. The routine follow-up program led to a biopsy in 66 of 735 patients (9.0%) revealing a recurrent cancer in 27 cases (3.7%). The study follow-up program with the additional ultrasound led to another 21 biopsies raising the total number of patients who had to undergo a biopsy from 9.0% (95% CI: 6.9-11.1) to 11.8% (95% CI: 9.5-14.2). Finally, we diagnosed a previously occult malignant lesion in an additional six patients following this protocol. Therefore, the rate of detected recurrences rose from 3.7% (95% CI: 2.3-5.0) in the routine follow-up program to 4.5% (95% CI: 3.0-6.0) in the study follow-up program (p = 0.041). Negative side effects were the additional costs (the costs per detected malignancy in the routine follow-up program were $2455.69; the costs for each additionally detected malignancy in the study follow-up program were $7580.30), the higher overall biopsy rate (9.0 vs. 11.8%) and the elevated benign biopsies rate (59.1% vs. 71.4%). Regarding these results, the

  17. The robustness of diagnostic tests for GH deficiency in adults

    DEFF Research Database (Denmark)

    Andersen, Marianne

    2015-01-01

    with recombinant human GH. There is, however, an ongoing debate on how to diagnose GHD, especially in adults. A GH response below the cut-off limit of a GH-stimulation test is required in most cases for establishing GHD in adults. No 'gold standard' GH-stimulation test exists, but some GH stimulation tests may...... be more robust to variations in patient characteristics such as age and gender, as well as to pre-test conditions like heat exposure due to a hot bath or bicycling. However, body mass index (BMI) is negatively associated with GH-responses to all available GH-stimulation tests and glucocorticoid treatment......, including conventional substitution therapy, influences the GH-responses. Recently, the role of IGF-I measurements in the clinical decision making has been discussed. The aim of this review is to discuss the available GH-stimulation tests. In this author's opinion, tests which include growth...

  18. Juvenile retinoschisis: a model for molecular diagnostic testing of X-linked ophthalmic disease.

    OpenAIRE

    Sieving, P A; Yashar, B M; Ayyagari, R

    1999-01-01

    BACKGROUND AND PURPOSE: X-linked juvenile retinoschisis (RS) provides a starting point to define clinical paradigms and understand the limitations of diagnostic molecular testing. The RS phenotype is specific, but the broad severity range is clinically confusing. Molecular diagnostic testing obviates unnecessary examinations for boys at-risk and identifies carrier females who otherwise show no clinical signs. METHODS: The XLRS1 gene has 6 exons of 26-196 base-pair size. Each exon is amplified...

  19. Lacrimination in Sjogren′s syndrome. Is Schirmer′s test really a useful diagnostic tool?

    Directory of Open Access Journals (Sweden)

    Bhadoria D

    1988-01-01

    Full Text Available In the past, Schinier′s test was used as a diagnostic tool in Sjogren′s Syndrome. In this study, a comparison of 100 normal patients with 2l patients with Sjogren′s Syndrome has been made to study its reliability. It has been concluded that Schimer′s test is of a poor diagnostic value in Sjogren′s Syndrome.

  20. Veterinary practitioners’ selection of diagnostic tests for the primary evaluation of colic in the horse

    OpenAIRE

    Curtis, L.; Trewin, I.; England, G. C. W.; Burford, J. H.; Freeman, S. L.

    2015-01-01

    The aim of this study was to survey veterinary practitioners’ selection of diagnostic tests for horses with clinical signs of abdominal pain. A questionnaire was distributed to veterinary surgeons involved in the primary evaluation of horses with abdominal pain, including the respondent's demographics, selection of diagnostic tests and factors affecting decision-making. Data analysis included descriptive analysis, categorisation of free text and simple univariable correlations to explore the ...

  1. Use of California mastitis test, somatic cells count and bacteriological findings in diagnostics of subclinical mastitis

    OpenAIRE

    Varatanović N.; Podžo M.; Mutevelić T.; Podžo K.; Čengić B.; Hodžić A.; Hodžić E.

    2010-01-01

    We have performed diagnostics of sub clinical mastitis in three different cow breeds with comparison of California mastitis test results, somatic cells count at quarter level and with bacteriological findings confirmation in order to justify their appliance in mastitis diagnostics. In total, 90 cows or 360 quarters of mammary gland have been examined. In 63.3 % of the examined cows, with different racial origin, positive reaction to California mastitis test have been established. Usually, pos...

  2. Diagnostic tests for Helicobacter pylori : A prospective evaluation of their accuracy, without selecting a single test as the gold standard

    NARCIS (Netherlands)

    Thijs, J C; van Zwet, A A; Thijs, W J; Oey, H B; Karrenbeld, A; Stellaard, F; Luijt, D S; Meyer, B C; Kleibeuker, J H

    1996-01-01

    OBJECTIVE: To assess the accuracy of six commonly used diagnostic tests for Helicobacter pylori in a prospective study without using any specific test as the gold standard (the patient was regarded as H. pylori-infected if two or more tests, whatever their nature, were positive). METHODS: In 105 out

  3. Novel Diagnostic Tests to Detect Helicobacter pylori Infection: A Pediatric Perspective

    OpenAIRE

    Snyder, John D; van Zanten, Sander Veldhuyzen

    1999-01-01

    Because of the widespread problem of Helicobacter pylori infections, there is an increased need for rapid, reliable and inexpensive diagnostic tests. Five recently developed tests that offer potential advantages because they are less invasive or permit easier acquisition of samples than available tests are assessed. The tests assessed are whole blood, saliva and urine assays that measure systemic antibody response to H pylori, stool tests that measure H pylori antigens and string tests that r...

  4. Noninvasive Diagnostic Tests for Helicobacter Pylori Infection in Children

    OpenAIRE

    Koletzko, Sibylle

    2005-01-01

    Noninvasive tests can be used for the initial diagnosis of Helicobacter pylori infection and to monitor the success of eradication therapy. In populations with a low prevalence of H pylori infection (children living in North America and Europe), a high sensitivity is required to make the test valuable for clinical practice. The 13C-urea breath test has been validated in children of different age groups in a significant number of infected and noninfected children in several countries and, thus...

  5. Colorado Diagnostic Test of English as a Second Language.

    Science.gov (United States)

    Stansfield, Charles

    The testing of non-English dominant children cannot be achieved through written examinations that demand reading proficiency and that fail to ascertain the strengths or weaknesses of individual performance. Nor can an oral proficiency test, involving a lengthy tension-inducing interview and relatively inconclusive scoring, provide the information…

  6. New diagnostic tests for diabetic distal symmetric polyneuropathy.

    Science.gov (United States)

    Papanas, Nikolaos; Ziegler, Dan

    2011-01-01

    Neuropathy needs to be diagnosed early to prevent complications, such as neuropathic pain or the diabetic foot. It is obvious that diagnosis of neuropathy needs to be improved. New peripheral nerve function tests that appear to facilitate diagnosis are now emerging. This review outlines the new tests that have been proposed for the diagnosis of diabetic distal symmetric polyneuropathy, the commonest form of neuropathy in diabetes. New tests are classified into those mainly assessing large-fiber function (tactile circumferential discriminator, steel ball-bearing, and automated nerve conduction study) and those mainly assessing small-fiber function (NeuroQuick and Neuropad). Emerging tests are promising but must be evaluated in prospective studies. Moreover, their cost-effectiveness needs more careful appraisal. The clinician should, therefore, still rely on established modalities to diagnose neuropathy, but wider use of the new tests is expected in the near future. PMID:19896871

  7. Diagnostic Testing for Hemorrhagic Fevers in Pakistan: 2007–2013

    Science.gov (United States)

    Hasan, Zahra; Atkinson, Barry; Jamil, Bushra; Samreen, Azra; Altaf, Lamia; Hewson, Roger

    2014-01-01

    Crimean–Congo hemorrhagic fever virus (CCHFV) and dengue virus (DENV) are endemic to Pakistan. Patients presenting with symptoms of fever, bleeding, and rash cannot be distinguished without appropriate testing. We report data on 354 samples tested for CCHFV at The Aga Khan University Hospital in Pakistan between 2007 and 2013. All samples were tested for the presence of CCHFV RNA. Some samples were also tested for DENV RNA, NS-1 antigen, and/or reactive immunoglobulin M antibodies. Of 354 clinical specimens screened for CCHFV, 52 specimens were positive, with 24 cases in 2013 alone. Most cases were from Sindh and Baluchistan, which border other CCHFV-endemic regions: Iran and Afghanistan. Among CCHFV-negative samples, 168 samples were tested for DENV, and 36% of these samples were found to be DENV-positive. Rapid differentiation of CCHFV and DENV can prevent nosocomial transmission and result in time and cost savings for patients and healthcare workers. PMID:25311694

  8. The furosemide diagnostic test in suspected slow-onset heart failure : popular but not useful

    NARCIS (Netherlands)

    Kelder, Johannes C.; Cramer, Maarten J.; Rutten, Frans H.; Plokker, H. W.; Grobbee, Diederick E.; Hoes, Arno W.

    2011-01-01

    Aims Early, slow-onset heart failure is difficult to diagnose from just signs and symptoms. The physician needs ancillary diagnostic tests. The 'loop-diuretic test' or 'furosemide test', characterized as weight loss and alleviation of symptoms after a short course of a loop-diuretic, could be a cand

  9. How Much Do Our Incoming First Year Students Know?: Diagnostic Testing in Mathematics at Third Level

    Directory of Open Access Journals (Sweden)

    Blathnaid Sheridan

    2013-05-01

    Full Text Available A continuing cause for concern in higher education institutions is the poor core mathematical skills of incoming students. Many institutions now offer mathematics support services such as drop-in centres, online resources and short ‘refresher courses’ in an attempt to alleviate the problem. The majority of third level institutions in Ireland and internationally now make use of diagnostic testing of incoming first year students that both predict subsequent success and select groups for remediation. This project was developed to explore the issues around diagnostic testing and follow-up support for incoming students in the College of Sciences and Health. A large cohort of first year science students was tested and those who failed to achieve 50% on the test were offered support. This support came in the form of peer-assisted student led tutorials during which students had the opportunity to revise basic areas of mathematics. On comparison of the scores on the diagnostic test with the end of module results we have noticed a correlation between students who scored poorly on the diagnostic test and students who failed the Semester 1 mathematics module. The key recommendations arising from this study are; diagnostic testing provides useful information about the cohort as a whole and provides lecturers with information about gaps in the prior knowledge of the group allowing them to take particular care when introducing new topics, diagnostic testing helps to identify those students who are significantly weaker than the rest of the cohort and thus enables them to be targeted with support and attention. Furthermore, by carrying out diagnostic testing over an extended period of time, trends can be observed. This information can then be used by Schools or Departments in an attempt to cope with diversity and ensuring that follow-up support is adequately provided.

  10. Cost Implications of Value-Based Pricing for Companion Diagnostic Tests in Precision Medicine.

    Science.gov (United States)

    Zaric, Gregory S

    2016-07-01

    Many interpretations of personalized medicine, also referred to as precision medicine, include discussions of companion diagnostic tests that allow drugs to be targeted to those individuals who are most likely to benefit or that allow treatment to be designed in a way such that individuals who are unlikely to benefit do not receive treatment. Many authors have commented on the clinical and competitive implications of companion diagnostics, but there has been relatively little formal analysis of the cost implications of companion diagnostics, although cost reduction is often cited as a significant benefit of precision medicine. We investigate the potential impact on costs of precision medicine implemented through the use of companion diagnostics. We develop a framework in which the costs of companion diagnostic tests are determined by considerations of profit maximization and cost effectiveness. We analyze four scenarios that are defined by the incremental cost-effectiveness ratio of the new drug in the absence of a companion diagnostic test. We find that, in most scenarios, precision medicine strategies based on companion diagnostics should be expected to lead to increases in costs in the short term and that costs would fall only in a limited number of situations. PMID:26899833

  11. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    Science.gov (United States)

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K

    2010-06-01

    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  12. Solitary pulmonary nodules and masses: a meta-analysis of the diagnostic utility of alternative imaging tests

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, Paul [University of Michigan Medical Center, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States); University of Michigan Medical Center, Department of Radiology, Ann Arbor (United States); Dwamena, Ben A. [University of Michigan Medical Center, Division of Nuclear Medicine, Ann Arbor, MI (United States); Kelly, Aine Marie [University of Michigan Medical Center, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States); Bernstein, Steven J. [University of Michigan Medical Center, Department of Internal Medicine, Ann Arbor, MI (United States); VA HSR and D Center of Excellence, Ann Arbor, MI (United States); Carlos, Ruth C. [University of Michigan Medical Center, Division of Magnetic Resonance Imaging, Ann Arbor, MI (United States); University of Michigan Medical Center, Department of Radiology, Ann Arbor (United States)

    2008-09-15

    The purpose was to assess the clinical utility of diagnostic tests for identifying malignancy within a solitary pulmonary nodule (SPN), and to create a nomogram or ''look-up'' table using clinical data and non-invasive radiology (positive) test results to estimate post-test probability of malignancy. Studies that examined computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT) for the evaluation of SPN. Two reviewers independently abstracted data and assessed study quality. Study-specific and overall positive likelihood ratios (LRs) for each diagnostic test confirming a diagnosis of malignancy and negative LR for each diagnostic test excluding a diagnosis of malignancy within an SPN were calculated. Forty-four of 242 articles were included. Positive LRs for diagnostic tests were: CT 3.91 (95% confidence interval 2.42, 5.40), MRI 4.57 (3.03, 6.1), PET 5.44 (3.56, 7.32) and SPECT 5.16 (4.03, 6.30). Negative LRs were: CT 0.10 (0.03, 0.16), MRI 0.08 (0.03, 0.12), PET 0.06 (0.02, 0.09) and SPECT 0.06 (0.04, 0.08). Differences in performance for all tests were negligible; therefore, the clinician may confidently use any of the four tests presented in further evaluating an SPN. Given the low cost and prevalence of the technology, SPECT appears to be the leading choice for additional testing in SPN evaluation. (orig.)

  13. Malaria rapid diagnostic test evaluation at private retail pharmacies in Kumasi, Ghana

    Science.gov (United States)

    Audu, Rauf; Anto, Berko Panyin; Koffuor, George Asumeng; Abruquah, Akua Afriyie; Buabeng, Kwame Ohene

    2016-01-01

    Objective: Malaria rapid diagnostic test (MRDT) provides a good alternative to malaria microscopy diagnosis, particularly in resource-constrained settings. This study therefore evaluated MRDT in private retail pharmacies (PRPs) as a critical step in community case malaria management. Methods: In a prospective, cross-over, validation survey at six PRPs in the Ashanti Region of Ghana, 1200 patients presenting with fever in the preceding 48 h were sampled. Fingerstick blood samples were collected for preparation of thick and thin blood films for malaria microscopy. Categorized patients (600 each) went through the processes of MRDT or presumptive diagnosis (PD) of malaria. The malaria disease prevalence of the study area was established. Selectivity (Se), specificity (Sp), positive predictive value (PPV) along with false discovery rate (FDR), and negative predictive value (NPV) along with the false omission rate (FOR), and diagnostic odds ratio (DOR) of MRDT were then calculated. Findings: While 43.0% tested positive using the MRDT, 57.0% tested negative. However, 62.0% MRDT-negative patients in addition to all the MRDT positives were given artemether-lumefantrine. Of those diagnosed by PD, 98.2% were prescribed with an antimalarial (microscopy however confirmed only 70.3% as positive). Se and Sp of the MRDT were 90.68 ± 11.18% and 98.68 ± 1.19%, respectively. Malaria prevalence was estimated to be 43.3%. PPV was 98.0%, FDR was 2.0%, NPV was 98.0%, FOR was 2.0%, and DOR was 2366.43. Conclusion: Results highlighted good performance of MRDTs at PRPs which could inform decision toward its implementation.

  14. A comparison of diagnostic tests for lactose malabsorption - which one is the best?

    Directory of Open Access Journals (Sweden)

    Hovde Øistein

    2009-10-01

    Full Text Available Abstract Background Perceived milk intolerance is a common complaint, and tests for lactose malabsorption (LM are unreliable. This study assesses the agreement between diagnostic tests for LM and describes the diagnostic properties of the tests. Methods Patients above 18 years of age with suspected LM were included. After oral intake of 25 g lactose, a combined test with measurement of serum glucose (s-glucose and hydrogen (H2 and methane (CH4 in expired air was performed and symptoms were recorded. In patients with discrepancies between the results, the combined test was repeated and a gene test for lactose non-persistence was added. The diagnosis of LM was based on an evaluation of all tests. The following tests were compared: Increase in H2, CH4, H2+CH4 and H2+CH4x2 in expired air, increase in s-glucose, and symptoms. The agreement was calculated and the diagnostic properties described. Results Sixty patients were included, seven (12% had LM. The agreement (kappa-values between the methods varied from 0.25 to 0.91. The best test was the lactose breath test with measurement of the increase in H2 + CH4x2 in expired air. With a cut-off level Conclusion The agreement between commonly used methods for the diagnosis of LM was unsatisfactory. A lactose breath test with measurement of H2 + CH4x2 in expired air had the best diagnostic properties.

  15. The Diagnostic Assessment of Hand Elevation Test in Carpal Tunnel Syndrome

    OpenAIRE

    Ma, Hyunjin; Kim, Insoo

    2012-01-01

    Objective The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). Methods We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand e...

  16. Direct transfer of HRPII-magnetic bead complexes to malaria rapid diagnostic tests significantly improves test sensitivity

    OpenAIRE

    Ricks, Keersten M.; Adams, Nicholas M.; Thomas F. Scherr; Haselton, Frederick R.; Wright, David W.

    2016-01-01

    Background The characteristic ease of use, rapid time to result, and low cost of malaria rapid diagnostic tests (RDTs) promote their widespread use at the point-of-care for malaria detection and surveillance. However, in many settings, the success of malaria elimination campaigns depends on point-of-care diagnostics with greater sensitivity than currently available RDTs. To address this need, a sample preparation method was developed to deliver more biomarkers onto a malaria RDT by concentrat...

  17. Large-Scale Spray Releases: Additional Aerosol Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Daniel, Richard C.; Gauglitz, Phillip A.; Burns, Carolyn A.; Fountain, Matthew S.; Shimskey, Rick W.; Billing, Justin M.; Bontha, Jagannadha R.; Kurath, Dean E.; Jenks, Jeromy WJ; MacFarlan, Paul J.; Mahoney, Lenna A.

    2013-08-01

    One of the events postulated in the hazard analysis for the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak event involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids that behave as a Newtonian fluid. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and in processing facilities across the DOE complex. To expand the data set upon which the WTP accident and safety analyses were based, an aerosol spray leak testing program was conducted by Pacific Northwest National Laboratory (PNNL). PNNL’s test program addressed two key technical areas to improve the WTP methodology (Larson and Allen 2010). The first technical area was to quantify the role of slurry particles in small breaches where slurry particles may plug the hole and prevent high-pressure sprays. The results from an effort to address this first technical area can be found in Mahoney et al. (2012a). The second technical area was to determine aerosol droplet size distribution and total droplet volume from prototypic breaches and fluids, including sprays from larger breaches and sprays of slurries for which literature data are mostly absent. To address the second technical area, the testing program collected aerosol generation data at two scales, commonly referred to as small-scale and large-scale testing. The small-scale testing and resultant data are described in Mahoney et al. (2012b), and the large-scale testing and resultant data are presented in Schonewill et al. (2012). In tests at both scales, simulants were used

  18. Power calculation for comparing diagnostic accuracies in a multi-reader, multi-test design.

    Science.gov (United States)

    Kim, Eunhee; Zhang, Zheng; Wang, Youdan; Zeng, Donglin

    2014-12-01

    Receiver operating characteristic (ROC) analysis is widely used to evaluate the performance of diagnostic tests with continuous or ordinal responses. A popular study design for assessing the accuracy of diagnostic tests involves multiple readers interpreting multiple diagnostic test results, called the multi-reader, multi-test design. Although several different approaches to analyzing data from this design exist, few methods have discussed the sample size and power issues. In this article, we develop a power formula to compare the correlated areas under the ROC curves (AUC) in a multi-reader, multi-test design. We present a nonparametric approach to estimate and compare the correlated AUCs by extending DeLong et al.'s (1988, Biometrics 44, 837-845) approach. A power formula is derived based on the asymptotic distribution of the nonparametric AUCs. Simulation studies are conducted to demonstrate the performance of the proposed power formula and an example is provided to illustrate the proposed procedure.

  19. Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test

    DEFF Research Database (Denmark)

    Wang, C.; Turnbull, B.W.; Nielsen, Søren Saxmose;

    2011-01-01

    A Bayesian methodology was developed based on a latent change-point model to evaluate the performance of milk ELISA and fecal culture tests for longitudinal Johne's disease diagnostic data. The situation of no perfect reference test was considered; that is, no “gold standard.” A change......-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute....... An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has...

  20. Comprehensive carrier screening and molecular diagnostic testing for recessive childhood diseases.

    Science.gov (United States)

    Kingsmore, Stephen

    2012-01-01

    Of 7,028 disorders with suspected Mendelian inheritance, 1,139 are recessive and have an established molecular basis. Although individually uncommon, Mendelian diseases collectively account for ~20% of infant mortality and ~18% of pediatric hospitalizations. Molecular diagnostic testing is currently available for only ~300 recessive disorders. Preconception screening, together with genetic counseling of carriers, has resulted in remarkable declines in the incidence of several severe recessive diseases including Tay-Sachs disease and cystic fibrosis. However, extension of preconception screening and molecular diagnostic testing to most recessive disease genes has hitherto been impractical. Recently, we reported a preconception carrier screen / molecular diagnostic test for 448 recessive childhood diseases. The current status of this test is reviewed here. Currently, this reports analytical validity of the comprehensive carrier test. As the clinical validity and clinical utility in the contexts described is ascertained, this article will be updated. PMID:22872815

  1. Addition of bromine as a diagnostic gas to inertial confinement fusion target microspheres

    International Nuclear Information System (INIS)

    Currently, direct fuel rho r measurements on Inertial Confinement Fusion (ICF) targets by neutron activation of the argon tracer gas mixed with the DT fuel would require a 100 fold increase in neutron yield. Bromine, on the other hand, has excellent properties for neutron activation analysis at neutron yields of 10two' to 108, when present at an internal pressure of from 0.1 to 0.2 atmospheres. Bromine addition is accomplished in a 2 furnace system using the dried-gel method of microsphere production. An upper furnace operated at 15000C is separated from a lower furnace by a cooled zone. The lower furnace is filled with bromine gas and operated at approximately 12500C. The upper furnace is the glass production furnace. The cooled zone in between the upper and lower furnace is to prevent the hot bromine gas from rising into the upper furnace. The microspheres pass through the cooled zone and immediately into the 12500C bromine furnace where the bromine permeates into the spheres

  2. Small-Scale Spray Releases: Additional Aerosol Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Schonewill, Philip P.; Gauglitz, Phillip A.; Kimura, Marcia L.; Brown, G. N.; Mahoney, Lenna A.; Tran, Diana N.; Burns, Carolyn A.; Kurath, Dean E.

    2013-08-01

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and across processing facilities in the DOE complex. To expand the data set upon which the WTP accident and safety analyses were based, an aerosol spray leak testing program was conducted by Pacific Northwest National Laboratory (PNNL). PNNL’s test program addressed two key technical areas to improve the WTP methodology (Larson and Allen 2010). The first technical area was to quantify the role of slurry particles in small breaches where slurry particles may plug the hole and prevent high-pressure sprays. The results from an effort to address this first technical area can be found in Mahoney et al. (2012a). The second technical area was to determine aerosol droplet size distribution and total droplet volume from prototypic breaches and fluids, including sprays from larger breaches and sprays of slurries for which literature data are largely absent. To address the second technical area, the testing program collected aerosol generation data at two scales, commonly referred to as small-scale and large-scale. The small-scale testing and resultant data are described in Mahoney et al. (2012b) and the large-scale testing and resultant data are presented in Schonewill et al. (2012). In tests at both scales, simulants were used to mimic the

  3. Potential diagnostic consequences of applying non-invasive prenatal testing

    DEFF Research Database (Denmark)

    Petersen, O B; Vogel, I; Ekelund, C;

    2014-01-01

    OBJECTIVES: Targeted non-invasive prenatal testing (NIPT) tests for trisomies 21, 18 and 13 and sex chromosome aneuploidies and could be an alternative to traditional karyotyping. The aim of this study was to determine the risk of missing other abnormal karyotypes of probable phenotypic...... Fetal Medicine database. Karyotypes were classified according to whether the chromosomal anomaly would have been detected by NIPT and whether it was likely to affect phenotype. RESULTS: cFTS was completed in 193638 pregnancies. 10205 (5.3%) had cytogenetic or molecular analysis performed. Of these, 1122...

  4. Fan Noise Source Diagnostic Test Completed and Documented

    Science.gov (United States)

    Envia, Edmane

    2003-01-01

    The specially organized session offered an international forum to disseminate the results from a year long test that was conducted in 1999 in NASA Glenn Research Center s 9- by 15-Foot Low-Speed Wind Tunnel on a 22-in. scale-model turbofan bypass stage, which was designed to be representative of current aircraft engine technology. The test was a cooperative effort involving Glenn, the NASA Langley Research Center, GE Aircraft Engines, and the Boeing Company. The principal objective of the project was to study the source mechanisms of noise in a modern high-bypass-ratio turbofan engine through detailed aerodynamic and acoustic measurements.

  5. Diagnostic value of postprandial triglyceride testing in healthy subjects

    DEFF Research Database (Denmark)

    Mihas, Constantinos; Kolovou, Genovefa D; Mikhailidis, Dimitri P;

    2011-01-01

    Triglycerides (TGs) are measured in studies evaluating changes in non-fasting lipid profiles after a fat tolerance test (FTT); however, the optimal timing for TG measurements after the oral fat load is unclear. The aim of this study was to evaluate how non-fasting TG levels vary after an oral FTT...

  6. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

  7. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory...

  8. Reliability of Diagnostic Tests for Helicobacter pylori Infection

    Directory of Open Access Journals (Sweden)

    S. Redéen

    2011-01-01

    Full Text Available Introduction. Helicobacter pylori (H. pylori infection is very common worldwide. A reliable diagnosis is crucial for patients with H. pylori-related diseases. At followup, it is important to confirm that eradication therapy has been successful. There is no established gold standard for the diagnosis of H. pylori infection. Material and Methods. A sample of 304 volunteers from the general population was screened for H. pylori infection with serology, 13C-urea breath test (UBT, rapid urease test (RUT on fresh biopsy, culture from biopsy, and histological examination. Culture was used as gold standard. Results. The sensitivity was 0.99 for serology, 0.90 for UBT, 0.90 for RUT, and 0.90 for histological examination. Corresponding specificities were 0.82, 0.99, 0.98, and 0.97, respectively. The accuracy was 0.86 for serology, 0.96 for UBT, 0.95 for RUT, 0.93 for culture, and 0.95 for histology. There was a strong correlation between the results of UBT and the histological scores of H. pylori colonisation as well as between the results of UBT and the scores of RUT. Conclusion. There were only minor differences in accuracy between the three invasive tests for H. pylori infection in this population. RUT may be recommended as the first choice since a result is obtained within hours. The accuracy of UBT was comparable to the invasive tests, and it is recommended for situations when endoscopy is not needed.

  9. Blood lactate diagnostics in exercise testing and training.

    Science.gov (United States)

    Beneke, Ralph; Leithäuser, Renate M; Ochentel, Oliver

    2011-03-01

    A link between lactate and muscular exercise was seen already more than 200 years ago. The blood lactate concentration (BLC) is sensitive to changes in exercise intensity and duration. Multiple BLC threshold concepts define different points on the BLC power curve during various tests with increasing power (INCP). The INCP test results are affected by the increase in power over time. The maximal lactate steady state (MLSS) is measured during a series of prolonged constant power (CP) tests. It detects the highest aerobic power without metabolic energy from continuing net lactate production, which is usually sustainable for 30 to 60 min. BLC threshold and MLSS power are highly correlated with the maximum aerobic power and athletic endurance performance. The idea that training at threshold intensity is particularly effective has no evidence. Three BLC-orientated intensity domains have been established: (1) training up to an intensity at which the BLC clearly exceeds resting BLC, light- and moderate-intensity training focusing on active regeneration or high-volume endurance training (Intensity MLSS). High-performance endurance athletes combining very high training volume with high aerobic power dedicate 70 to 90% of their training to intensity domain 1 (Intensity < Threshold) in order to keep glycogen homeostasis within sustainable limits. PMID:21487146

  10. QUANTITATIVE BUFFY COAT (QBC TEST AND OTHER DIAGNOSTIC TECHNIQUES FOR DIAGNOSIG MALARIA: REVIEW OF LITRATURE

    Directory of Open Access Journals (Sweden)

    Kuladeepa Ananda Vaidya

    2012-06-01

    Full Text Available The technical capability to perform a correct and timely diagnosis of malaria infection in an ill patient is of critical importance since symptoms of complicated malaria may suddenly develop, leading to death of the patient. Even though peripheral blood smear examination is considered as the gold standard technique, tests like Quantitative Buffy Coat (QBC test and Rapid diagnostic tests (RDTs are widely used and more sensitive in detecting malaria parasite. Here we are briefly highlighting the importance of QBC and other useful diagnostic methods for diagnosing malaria. [National J of Med Res 2012; 2(3.000: 386-388

  11. BRAF mutation testing with a rapid, fully integrated molecular diagnostics system

    Science.gov (United States)

    Huang, Helen J.; Falchook, Gerald S.; Devogelaere, Benoit; Kockx, Mark; Bempt, Isabelle Vanden; Reijans, Martin; Naing, Aung; Fu, Siqing; Piha-Paul, Sarina A.; Hong, David S.; Holley, Veronica R.; Tsimberidou, Apostolia M.; Stepanek, Vanda M.; Patel, Sapna P.; Kopetz, E. Scott; Subbiah, Vivek; Wheler, Jennifer J.; Zinner, Ralph G.; Karp, Daniel D.; Luthra, Rajyalakshmi; Roy-Chowdhuri, Sinchita; Sablon, Erwin; Meric-Bernstam, Funda; Maertens, Geert; Kurzrock, Razelle

    2015-01-01

    Fast and accurate diagnostic systems are needed for further implementation of precision therapy of BRAF-mutant and other cancers. The novel IdyllaTM BRAF Mutation Test has high sensitivity and shorter turnaround times compared to other methods. We used Idylla to detect BRAF V600 mutations in archived formalin-fixed paraffin-embedded (FFPE) tumor samples and compared these results with those obtained using the cobas 4800 BRAF V600 Mutation Test or MiSeq deep sequencing system and with those obtained by a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory employing polymerase chain reaction–based sequencing, mass spectrometric detection, or next-generation sequencing. In one set of 60 FFPE tumor samples (15 with BRAF mutations per Idylla), the Idylla and cobas results had an agreement of 97%. Idylla detected BRAF V600 mutations in two additional samples. The Idylla and MiSeq results had 100% concordance. In a separate set of 100 FFPE tumor samples (64 with BRAF mutation per Idylla), the Idylla and CLIA-certified laboratory results demonstrated an agreement of 96% even though the tests were not performed simultaneously and different FFPE blocks had to be used for 9 cases. The IdyllaTM BRAF Mutation Test produced results quickly (sample to results time was about 90 minutes with about 2 minutes of hands on time) and the closed nature of the cartridge eliminates the risk of PCR contamination. In conclusion, our observations demonstrate that the Idylla test is rapid and has high concordance with other routinely used but more complex BRAF mutation–detecting tests. PMID:26330075

  12. Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

    Directory of Open Access Journals (Sweden)

    Luisa Fernanda Duarte

    2014-07-01

    Full Text Available Objective: To compare the diagnostic performance of seven methods to determine Trypanosoma cruzi infection in patients with chronic Chagas disease.Methods: Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105. Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC, positive and negative likelihood ratio, as well as κ quality analysis.Results: The commercial Bioelisa Chagas test showed the highest sensitivity (98%, specificity (100%, and positive and negative predictive values; additionally it had the highest discriminatory power. Otherwise, the amplification of T. cruzi DNA in blood samples showed low values of sensitivity (kinetoplast DNA= 51%, nuclear DNA= 22%, but high values of specificity (100%, and moderate to low discriminatory ability.Conclusion: The comparative analysis among the different methods suggests that the diagnostic strategy of T. cruzi infection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis of T. cruzi infection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease.

  13. Cognitive Diagnostic Models for Tests with Multiple-Choice and Constructed-Response Items

    Science.gov (United States)

    Kuo, Bor-Chen; Chen, Chun-Hua; Yang, Chih-Wei; Mok, Magdalena Mo Ching

    2016-01-01

    Traditionally, teachers evaluate students' abilities via their total test scores. Recently, cognitive diagnostic models (CDMs) have begun to provide information about the presence or absence of students' skills or misconceptions. Nevertheless, CDMs are typically applied to tests with multiple-choice (MC) items, which provide less diagnostic…

  14. An Investigation into the Consequential Validity of a Diagnostic College English Speaking Test

    Science.gov (United States)

    Zhao, Zhongbao

    2013-01-01

    This paper reports the verification of the consequential validity of a Diagnostic College English Speaking Test. A case study was conducted with 28 sophomore students from a national key university in China engaged in seven sets of DCEST tests. The analysis of the DCEST scores of the students in the experiment group indicates that progress has…

  15. Development and Validation of a Diagnostic Grammar Test for Japanese Learners of English

    Science.gov (United States)

    Koizumi, Rie; Sakai, Hideki; Ido, Takahiro; Ota, Hiroshi; Hayama, Megumi; Sato, Masatoshi; Nemoto, Akiko

    2011-01-01

    This article reports on the development and validation of the English Diagnostic Test of Grammar (EDiT Grammar) for Japanese learners of English. From among the many aspects of grammar, this test focuses on the knowledge of basic English noun phrases (NPs), especially their internal structures, because previous research has indicated the…

  16. Evaluating operational specifications of point-of-care diagnostic tests: a standardized scorecard.

    Directory of Open Access Journals (Sweden)

    Jonathan D Lehe

    Full Text Available The expansion of HIV antiretroviral therapy into decentralized rural settings will increasingly require simple point-of-care (POC diagnostic tests that can be used without laboratory infrastructure and technical skills. New POC test devices are becoming available but decisions around which technologies to deploy may be biased without systematic assessment of their suitability for decentralized healthcare settings. To address this, we developed a standardized, quantitative scorecard tool to objectively evaluate the operational characteristics of POC diagnostic devices. The tool scores devices on a scale of 1-5 across 30 weighted characteristics such as ease of use, quality control, electrical requirements, shelf life, portability, cost and service, and provides a cumulative score that ranks products against a set of ideal POC characteristics. The scorecard was tested on 19 devices for POC CD4 T-lymphocyte cell counting, clinical chemistry or hematology testing. Single and multi-parameter devices were assessed in each of test categories. The scores across all devices ranged from 2.78 to 4.40 out of 5. The tool effectively ranked devices within each category (p0.80; p<0.001. Use of this tool enables the systematic evaluation of diagnostic tests to facilitate product selection and investment in appropriate technology. It is particularly relevant for countries and testing programs considering the adoption of new POC diagnostic tests.

  17. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Procedures for preparing egg yolk samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  18. North Carolina Minimum Skills Diagnostic Testing Program. Administrative Information, 1992-93.

    Science.gov (United States)

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability Services/Research.

    Information is presented regarding the administration of the North Carolina Minimum Skills Diagnostic Testing Program. This testing program, mandated by the state's basic education program under the Secondary School Reform Act of 1984, checks the necessity for remediation by determining a student's mastery of specific objectives and diagnoses…

  19. Diagnostic and prognostic implications of exercise testing in coronary artery disease

    NARCIS (Netherlands)

    J.W. Deckers (Jaap)

    1988-01-01

    textabstractThe clinical indications for exercise testing as a diagnostic and prognostic tool in the assessment of patients with ischemic heart disease have gradually evolved since Master introduced the two-step exercise test in 1929 (1). New information from correlations between electrocardiographi

  20. Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast - initial clinical results

    International Nuclear Information System (INIS)

    The purpose of the study was to assess the additional value of magnetic resonance (MR) elastography (MRE) to contrast-enhanced (ce) MR imaging (MRI) for breast lesion characterisation. Fifty-seven suspected breast lesions in 57 patients (mean age 52.4 years) were examined by ce MRI and MRE. All lesions were classified into BI-RADS categories. Viscoelastic parameters, e.g. α0 as an indicator of tissue stiffness, were calculated. Histology of the lesions was correlated with BI-RADS and viscoelastic properties. The positive predictive value (PPV) for malignancy, and the sensitivity and specificity of ce MRI were calculated. Receiver-operating characteristics (ROC) curves were separately calculated for both ce MRI and viscoelastic properties and conjoined to analyse the accuracy of diagnostic performance. The lesions (mean size 27.6 mm) were malignant in 64.9% (n = 37) of cases. The PPV for malignancy was significantly (p ceMRI = 0.93, AUCcombined = 0.96). In this study, the combination of MRE and ce MRI could increase the diagnostic performance of breast MRI. Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results. (orig.)

  1. ADDITIVE TESTING FOR IMPROVED SULFUR RETENTION: PRELIMINARY REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Amoroso, J.; Fox, K.

    2011-09-07

    The Savannah River National Laboratory is collaborating with Alfred University to evaluate the potential for additives in borosilicate glass to improve sulfur retention. This preliminary report provides further background on the incorporation of sulfur in glass and outlines the experiments that are being performed by the collaborators. A simulated waste glass composition has been selected for the experimental studies. The first phase of experimental work will evaluate the impacts of BaO, PbO, and V{sub 2}O{sub 5} at concentrations of 1.0, 2.0, and 5.0 wt % on sulfate retention in simulated high level waste borosilicate glass. The second phase of experimental work will evaluate the effects of time at the melt temperature on sulfur retention. The resulting samples will be characterized to determine the amount of sulfur remaining as well as to identify the formation of any crystalline phases. The results will be used to guide the future selection of frits and glass forming chemicals in vitrifying Department of Energy wastes containing high sulfur concentrations.

  2. Structured approach to design of diagnostic test evaluation studies for chronic progressive infections in animals

    DEFF Research Database (Denmark)

    Nielsen, Søren Saxmose; Toft, Nils; Gardner, Ian Andrew

    2011-01-01

    Diagnostic test evaluations (DTEs) for chronic infections are challenging because a protracted incubation period has to be considered in the design of the DTE, and the adverse effects of infection may be widespread and progressive over an animal's entire life. Frequently, the specific purpose......) than originally intended. The objective of this paper is to outline a structured approach to the design and conduct of a DTE for diagnostic tests used for chronic infections in animals, and intended for different purposes. We describe the process from reflections about test purpose and the underlying...... of the test is not formally considered when a test is evaluated. Therefore, the result is often a DTE where test sensitivity and specificity estimates are biased, either because of problems with establishing the true infection status or because the test detects another aspect of the infection (and analyte...

  3. The indication area of a diagnostic test. Part II-the impact of test dependence, physician's decision strategy, and patient's utility

    NARCIS (Netherlands)

    Stalpers, L.J.; Nelemans, P.J.; Geurts, S.M.; Jansen, E.; Boer, P.; Verbeek, A.L.

    2015-01-01

    OBJECTIVES: Any diagnostic test has an indication area of prior probabilities wherein the gain in diagnostic certainty outweighs its loss. Here, we investigate whether indication area and the maximum diagnostic gain are robust measures if we assume test dependence, alternative physician's heuristics

  4. Venous thromboembolism: Additional diagnostic value and radiation dose of pelvic CT venography in patients with suspected pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Reichert, Miriam, E-mail: Miriam.Reichert@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Henzler, Thomas; Krissak, Radko; Apfaltrer, Paul [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Huck, Kurt [1st Department of Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim (Germany); Buesing, Karen [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Sueselbeck, Tim [1st Department of Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim (Germany); Schoenberg, Stefan O.; Fink, Christian [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany)

    2011-10-15

    Purpose: To assess the additional diagnostic value of indirect CT venography (CTV) of the pelvis and upper thighs performed after pulmonary CT angiography (CTA) for the diagnosis of venous thromboembolism (VTE). Materials and methods: In a retrospective analysis, the radiology information system entries between January 2003 and December 2007 were searched for patients who received pulmonary CTA and additional CTV of the pelvis and upper thighs. Of those patients, the radiology reports were reviewed for the diagnosis of pulmonary embolism (PE) and deep venous thrombosis (DVT) in the pelvic veins and veins of the upper thighs. In cases with an isolated pelvic thrombosis at CTV (i.e. which only had a thrombosis in the pelvic veins but not in the veins of the upper thigh) ultrasound reports were reviewed for the presence of DVT of the legs. The estimated radiation dose was calculated for pulmonary CTA and for CTV of the pelvis. Results: In the defined period 3670 patients were referred to our institution for exclusion of PE. Of those, 642 patients (353 men, 289 women; mean age, 65 {+-} 15 years, age range 18-98 years) underwent combined pulmonary CTA and CTV. Among them, PE was found in 227 patients (35.4%). In patients without PE CTV was negative in all cases. In patients with PE, CTV demonstrated pelvic thrombosis in 24 patients (3.7%) and thrombosis of the upper thighs in 43 patients (6.6%). Of those patients 14 (2.1%) had DVT in the pelvis and upper thighs. In 10 patients (1.5%) CTV showed an isolated pelvic thrombosis. Of those patients ultrasound reports were available in 7 patients, which revealed DVT of the leg veins in 5 cases (1%). Thus, the estimated prevalence of isolated pelvic thrombosis detected only by pelvic CTV ranges between 1-5/642 patients (0.1-0.7%). Radiation dose ranges between 4.8 and 9.7 mSv for additional CTV of the pelvis. Conclusion: CTV of the pelvis performed after pulmonary CTA is of neglectable additional diagnostic value for the

  5. Optimal Sequential Diagnostic Strategy Generation Considering Test Placement Cost for Multimode Systems

    Directory of Open Access Journals (Sweden)

    Shigang Zhang

    2015-10-01

    Full Text Available Sequential fault diagnosis is an approach that realizes fault isolation by executing the optimal test step by step. The strategy used, i.e., the sequential diagnostic strategy, has great influence on diagnostic accuracy and cost. Optimal sequential diagnostic strategy generation is an important step in the process of diagnosis system construction, which has been studied extensively in the literature. However, previous algorithms either are designed for single mode systems or do not consider test placement cost. They are not suitable to solve the sequential diagnostic strategy generation problem considering test placement cost for multimode systems. Therefore, this problem is studied in this paper. A formulation is presented. Two algorithms are proposed, one of which is realized by system transformation and the other is newly designed. Extensive simulations are carried out to test the effectiveness of the algorithms. A real-world system is also presented. All the results show that both of them have the ability to solve the diagnostic strategy generation problem, and they have different characteristics.

  6. Convergent and diagnostic validity of STAVUX, a word and pseudoword spelling test for adults.

    Science.gov (United States)

    Östberg, Per; Backlund, Charlotte; Lindström, Emma

    2016-10-01

    Few comprehensive spelling tests are available in Swedish, and none have been validated in adults with reading and writing disorders. The recently developed STAVUX test includes word and pseudoword spelling subtests with high internal consistency and adult norms stratified by education. This study evaluated the convergent and diagnostic validity of STAVUX in adults with dyslexia. Forty-six adults, 23 with dyslexia and 23 controls, took STAVUX together with a standard word-decoding test and a self-rated measure of spelling skills. STAVUX subtest scores showed moderate to strong correlations with word-decoding scores and predicted self-rated spelling skills. Word and pseudoword subtest scores both predicted dyslexia status. Receiver-operating characteristic (ROC) analysis showed excellent diagnostic discriminability. Sensitivity was 91% and specificity 96%. In conclusion, the results of this study support the convergent and diagnostic validity of STAVUX. PMID:26059176

  7. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course.

  8. Development and testing of a diagnostic system for intelligen distributed control at EBR-2

    International Nuclear Information System (INIS)

    A diagnostic system is under development for demonstration of Intelligent Distributed Control at the Experimental Breeder Reactor (EBR--II). In the first phase of the project a diagnostic system is being developed for the EBR-II steam plant based on the DISYS expert systems approach. Current testing uses recorded plant data and data from simulated plant faults. The dynamical simulation of the EBR-II steam plant uses the Babcock and Wilcox (B ampersand W) Modular Modeling System (MMS). At EBR-II the diagnostic system operates in the UNIX workstation and receives live plant data from the plant Data Acquisition System (DAS). Future work will seek implementation of the steam plant diagnostic in a distributed manner using UNIX based computers and Bailey microprocessor-based control system. 10 refs., 6 figs

  9. Diagnostic performance characteristics of a rapid field test for anthrax in cattle.

    Science.gov (United States)

    Muller, Janine; Gwozdz, Jacek; Hodgeman, Rachel; Ainsworth, Catherine; Kluver, Patrick; Czarnecki, Jill; Warner, Simone; Fegan, Mark

    2015-07-01

    Although diagnosis of anthrax can be made in the field with a peripheral blood smear, and in the laboratory with bacterial culture or molecular based tests, these tests require either considerable experience or specialised equipment. Here we report on the evaluation of the diagnostic sensitivity and specificity of a simple and rapid in-field diagnostic test for anthrax, the anthrax immunochromatographic test (AICT). The AICT detects the protective antigen (PA) component of the anthrax toxin present within the blood of an animal that has died from anthrax. The test provides a result in 15min and offers the advantage of avoiding the necessity for on-site necropsy and subsequent occupational risks and environmental contamination. The specificity of the test was determined by testing samples taken from 622 animals, not infected with Bacillus anthracis. Diagnostic sensitivity was estimated on samples taken from 58 animals, naturally infected with B. anthracis collected over a 10-year period. All samples used to estimate the diagnostic sensitivity and specificity of the AICT were also tested using the gold standard of bacterial culture. The diagnostic specificity of the test was estimated to be 100% (99.4-100%; 95% CI) and the diagnostic sensitivity was estimated to be 93.1% (83.3-98.1%; 95% CI) (Clopper-Pearson method). Four samples produced false negative AICT results. These were among 9 samples, all of which tested positive for B. anthracis by culture, where there was a time delay between collection and testing of >48h and/or the samples were collected from animals that were >48h post-mortem. A statistically significant difference (Ptest) was found between the ability of the AICT to detect PA in samples from culture positive animals tested >48h post-mortem 5 of 9 Se=56% (21-86.3%; 95% CI) (Clopper-Pearson method). Based upon these results a post hoc cut-off for use of the AICT of 48h post-mortem was applied, Se=100% (92.8-100%; 95% CI) and Sp=100% (99.4-100%; 95% CI

  10. Diagnostic performance characteristics of a rapid field test for anthrax in cattle.

    Science.gov (United States)

    Muller, Janine; Gwozdz, Jacek; Hodgeman, Rachel; Ainsworth, Catherine; Kluver, Patrick; Czarnecki, Jill; Warner, Simone; Fegan, Mark

    2015-07-01

    Although diagnosis of anthrax can be made in the field with a peripheral blood smear, and in the laboratory with bacterial culture or molecular based tests, these tests require either considerable experience or specialised equipment. Here we report on the evaluation of the diagnostic sensitivity and specificity of a simple and rapid in-field diagnostic test for anthrax, the anthrax immunochromatographic test (AICT). The AICT detects the protective antigen (PA) component of the anthrax toxin present within the blood of an animal that has died from anthrax. The test provides a result in 15min and offers the advantage of avoiding the necessity for on-site necropsy and subsequent occupational risks and environmental contamination. The specificity of the test was determined by testing samples taken from 622 animals, not infected with Bacillus anthracis. Diagnostic sensitivity was estimated on samples taken from 58 animals, naturally infected with B. anthracis collected over a 10-year period. All samples used to estimate the diagnostic sensitivity and specificity of the AICT were also tested using the gold standard of bacterial culture. The diagnostic specificity of the test was estimated to be 100% (99.4-100%; 95% CI) and the diagnostic sensitivity was estimated to be 93.1% (83.3-98.1%; 95% CI) (Clopper-Pearson method). Four samples produced false negative AICT results. These were among 9 samples, all of which tested positive for B. anthracis by culture, where there was a time delay between collection and testing of >48h and/or the samples were collected from animals that were >48h post-mortem. A statistically significant difference (Ptest) was found between the ability of the AICT to detect PA in samples from culture positive animals tested >48h post-mortem 5 of 9 Se=56% (21-86.3%; 95% CI) (Clopper-Pearson method). Based upon these results a post hoc cut-off for use of the AICT of 48h post-mortem was applied, Se=100% (92.8-100%; 95% CI) and Sp=100% (99.4-100%; 95% CI

  11. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia

    OpenAIRE

    Lyda Osorio; Marcela Uribe; Gloria Ines Ardila; Yaneth Orejuela; Margarita Velasco; Anilza Bonelo; Beatriz Parra

    2015-01-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were ...

  12. The use of the rapid osmotic fragility test as an additional test to diagnose canine immune-mediated haemolytic anaemia

    DEFF Research Database (Denmark)

    Paes, Geert; Paepe, Dominique; Meyer, Evelyne;

    2013-01-01

    Background: Diagnosing canine immune-mediated haemolytic anaemia (IMHA) is often challenging because all currently available tests have their limitations. Dogs with IMHA often have an increased erythrocyte osmotic fragility (OF), a characteristic that is sometimes used in the diagnosis of IMHA....... Since the classic osmotic fragility test (COFT) is time-consuming and requires specialized equipment, an easy and less labour-intensive rapid osmotic fragility test (ROFT) has been used in some countries, but its diagnostic value has not yet been investigated. This study aimed to evaluate erythrocyte...... osmotic fragility in dogs with and without IMHA, to compare results of the classic (COFT) and rapid (ROFT) test and to assess the value of the ROFT as diagnostic test for canine IMHA. Nineteen dogs with IMHA (group 1a), 21 anaemic dogs without IMHA (group 1b), 8 dogs with microcytosis (group 2), 13...

  13. Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test.

    Science.gov (United States)

    Wang, C; Turnbull, B W; Nielsen, S S; Gröhn, Y T

    2011-05-01

    A Bayesian methodology was developed based on a latent change-point model to evaluate the performance of milk ELISA and fecal culture tests for longitudinal Johne's disease diagnostic data. The situation of no perfect reference test was considered; that is, no "gold standard." A change-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute the posterior estimates of the model parameters that provide the basis for inference concerning the accuracy of the diagnostic procedure. Based on the Bayesian approach, the posterior probability distribution of the change-point onset time can be obtained and used as a criterion for infection diagnosis. An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has an area under the receiver operating characteristic curve (AUC) of 0.984, and is superior to the raw ELISA (AUC=0.911) and fecal culture (sensitivity=0.358, specificity=0.980) tests for Johne's disease diagnosis. PMID:21524521

  14. QUANTITATIVE BUFFY COAT (QBC) TEST AND OTHER DIAGNOSTIC TECHNIQUES FOR DIAGNOSIG MALARIA: REVIEW OF LITRATURE

    OpenAIRE

    Kuladeepa Ananda Vaidya; Sukesh K

    2012-01-01

    The technical capability to perform a correct and timely diagnosis of malaria infection in an ill patient is of critical importance since symptoms of complicated malaria may suddenly develop, leading to death of the patient. Even though peripheral blood smear examination is considered as the gold standard technique, tests like Quantitative Buffy Coat (QBC) test and Rapid diagnostic tests (RDTs) are widely used and more sensitive in detecting malaria parasite. Here we are briefly highlighting ...

  15. Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review.

    Science.gov (United States)

    Aslam, Rabeea'h W; Bates, Vickie; Dundar, Yenal; Hounsome, Juliet; Richardson, Marty; Krishan, Ashma; Dickson, Rumona; Boland, Angela; Kotas, Eleanor; Fisher, Joanne; Sikdar, Sudip; Robinson, Louise

    2016-01-01

    were screened and 399 articles were shortlisted for full-text assessment. Sixteen studies were included in the diagnostic accuracy review. No studies were eligible for inclusion in the review of tools for monitoring progressive disease. Eleven automated computerised tests were assessed in the 16 included studies. The overall quality of the studies was good; however, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that meaningful synthesis or statistical analysis was not possible. LIMITATIONS The main limitation of this review is the substantial heterogeneity of the tests assessed in the included studies. As a result, no meta-analyses could be undertaken. CONCLUSION The quantity of information available is insufficient to be able to make recommendations on the clinical use of the computerised tests for diagnosing and monitoring MCI and early dementia progression. The value of these tests also depends on the costs of acquisition, training, administration and scoring. FUTURE WORK Research is required to establish stable cut-off points for automated computerised tests that are used to diagnose patients with MCI or early dementia. Additionally, the costs associated with acquiring and using these tests in clinical practice should be estimated. STUDY REGISTRATION The study is registered as PROSPERO CRD42015025410. FUNDING The National Institute for Health Research Health Technology Assessment programme. PMID:27767932

  16. Appraising and applying evidence about a diagnostic test during a performance-based assessment

    Directory of Open Access Journals (Sweden)

    Franklin Ellen

    2004-10-01

    Full Text Available Abstract Background The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. Methods 4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. Results The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67. Only one out of 28 (3% medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00. Conclusions This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.

  17. A cluster randomised trial introducing rapid diagnostic tests into registered drug shops in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Magnussen, Pascal; Lal, Sham;

    2015-01-01

    the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. METHODS: A cluster-randomized trial...... adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7- 98·4), pDiagnostic testing with mRDTs compared to presumptive treatment of fevers implemented in registered drug shops...... of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive...

  18. Understanding the direction of bias in studies of diagnostic test accuracy.

    Science.gov (United States)

    Kohn, Michael A; Carpenter, Christopher R; Newman, Thomas B

    2013-11-01

    Ordering and interpreting diagnostic tests is a critical part of emergency medicine (EM). In evaluating a study of diagnostic test accuracy, emergency physicians (EPs) need to recognize whether the study uses case-control or cross-sectional sampling and account for common biases. The authors group biases in studies of test accuracy into five categories: incorporation bias, partial verification bias, differential verification bias, imperfect gold standard bias, and spectrum bias. Other named biases are either equivalent to these biases or subtypes within these broader categories. The authors go beyond identifying a bias and predict the direction of its effect on sensitivity and specificity, providing numerical examples from published test accuracy studies. Understanding the direction of a bias may permit useful inferences from even a flawed study of test accuracy.

  19. Assessing the impact of next-generation rapid diagnostic tests on Plasmodium falciparum malaria elimination strategies.

    Science.gov (United States)

    Slater, Hannah C; Ross, Amanda; Ouédraogo, André Lin; White, Lisa J; Nguon, Chea; Walker, Patrick G T; Ngor, Pengby; Aguas, Ricardo; Silal, Sheetal P; Dondorp, Arjen M; La Barre, Paul; Burton, Robert; Sauerwein, Robert W; Drakeley, Chris; Smith, Thomas A; Bousema, Teun; Ghani, Azra C

    2015-12-01

    Mass-screen-and-treat and targeted mass-drug-administration strategies are being considered as a means to interrupt transmission of Plasmodium falciparum malaria. However, the effectiveness of such strategies will depend on the extent to which current and future diagnostics are able to detect those individuals who are infectious to mosquitoes. We estimate the relationship between parasite density and onward infectivity using sensitive quantitative parasite diagnostics and mosquito feeding assays from Burkina Faso. We find that a diagnostic with a lower detection limit of 200 parasites per microlitre would detect 55% of the infectious reservoir (the combined infectivity to mosquitoes of the whole population weighted by how often each individual is bitten) whereas a test with a limit of 20 parasites per microlitre would detect 83% and 2 parasites per microlitre would detect 95% of the infectious reservoir. Using mathematical models, we show that increasing the diagnostic sensitivity from 200 parasites per microlitre (equivalent to microscopy or current rapid diagnostic tests) to 2 parasites per microlitre would increase the number of regions where transmission could be interrupted with a mass-screen-and-treat programme from an entomological inoculation rate below 1 to one of up to 4. The higher sensitivity diagnostic could reduce the number of treatment rounds required to interrupt transmission in areas of lower prevalence. We predict that mass-screen-and-treat with a highly sensitive diagnostic is less effective than mass drug administration owing to the prophylactic protection provided to uninfected individuals by the latter approach. In low-transmission settings such as those in Southeast Asia, we find that a diagnostic tool with a sensitivity of 20 parasites per microlitre may be sufficient for targeted mass drug administration because this diagnostic is predicted to identify a similar village population prevalence compared with that currently detected using

  20. Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

    International Nuclear Information System (INIS)

    The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

  1. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: Relationship with Achievement Criteria.

    Science.gov (United States)

    Fuller, Gerald B.; Wallbrown, Fred H.

    1983-01-01

    Compared the Bender Gestalt (BD) and Minnesota Percepto-Diagnostic Test (MPD) in predicting academic achievement for younger children (N=69). Results suggested that the MPD is more sensitive than the Bender in identifying visual-motor perception areas of achievement performance problems. (LLL)

  2. Introducing rapid diagnostic tests for malaria into registered drug shops in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Clarke, Sîan E; Lal, Sham;

    2015-01-01

    BACKGROUND: Malaria is a major public health problem in Uganda and the current policy recommends introduction of rapid diagnostic tests for malaria (RDTs) to facilitate effective case management. However, provision of RDTs in drug shops potentially raises a new set of issues, such as adherence...

  3. Introducing rapid diagnostic tests for malaria into drug shops in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Magnussen, Pascal; Chandler, Clare Ir;

    2014-01-01

    BACKGROUND: An intervention was designed to introduce rapid diagnostics tests for malaria (mRDTs) into registered drug shops in Uganda to encourage rational and appropriate treatment of malaria with artemisinin-based combination therapy (ACT). We conducted participatory training of drug shop...

  4. Astronomy Diagnostic Test Results Reflect Course Goals and Show Room for Improvement

    Science.gov (United States)

    LoPresto, Michael C.

    2007-01-01

    The results of administering the Astronomy Diagnostic Test (ADT) to introductory astronomy students at Henry Ford Community College over three years have shown gains comparable with national averages. Results have also accurately corresponded to course goals, showing greater gains in topics covered in more detail, and lower gains in topics covered…

  5. A Needs-Based Approach to the Development of a Diagnostic College English Speaking Test

    Science.gov (United States)

    Zhao, Zhongbao

    2014-01-01

    This paper investigated the current situation of oral English teaching, learning, and assessment at the tertiary level in China through needs analysis and explored the implications for the development of a diagnostic speaking test. Through random sampling, the researcher administered both a student questionnaire and a teacher questionnaire to over…

  6. Development and Preparation of Lead-Containing Paint Films and Diagnostic Test Materials

    Science.gov (United States)

    Lead in paint continues to be a threat to children’s health in cities across the United States, which means there is an ongoing need for testing and analysis of paint. This ongoing analytical effort and especially development of new methods continue to drive the need for diagnost...

  7. A Mixed Model Approach to Meta-Analysis of Diagnostic Studies with Binary Test Outcome

    Science.gov (United States)

    Doebler, Philipp; Holling, Heinz; Bohning, Dankmar

    2012-01-01

    We propose 2 related models for the meta-analysis of diagnostic tests. Both models are based on the bivariate normal distribution for transformed sensitivities and false-positive rates. Instead of using the logit as a transformation for these proportions, we employ the "t"[subscript alpha] family of transformations that contains the log, logit,…

  8. Web-Based Two-Tier Diagnostic Test and Remedial Learning Experiment

    Science.gov (United States)

    Lai, Ah-Fur; Chen, Deng-Jyi

    2010-01-01

    Offering a series of diagnosis and individual remedial learning activities for a general class by means of web and multimedia technology can overcome the dilemma of conventional diagnosis and remedial instruction. The study proposes a three-layer conceptual framework and adopts a two-tier diagnostic test theory to develop a web-based two-tier…

  9. Mathematics Diagnostic Testing in Engineering: An International Comparison between Ireland and Portugal

    Science.gov (United States)

    Carr, M.; Fidalgo, C.; Bigotte de Almeida, M. E.; Branco, J. R.; Santos, V.; Murphy, E.; Ní Fhloinn, E.

    2015-01-01

    Concern has been expressed throughout Europe about the significant deficiencies in the basic mathematical skills of many engineering undergraduates. Mathematics diagnostic tests in the UK, Ireland and Portugal have shown these shortcomings, which provide a challenge to those striving to introduce more innovative educational practices into…

  10. Diagnostic Performance Tests for Suspected Scaphoid Fractures Differ with Conventional and Latent Class Analysis

    NARCIS (Netherlands)

    G.A. Buijze; W.H. Mallee; F.J.P. Beeres; T.E. Hanson; W.O. Johnson; D. Ring

    2011-01-01

    Evaluation of the diagnostic performance characteristics of radiographic tests for diagnosing a true fracture among suspected scaphoid fractures is hindered by the lack of a consensus reference standard. Latent class analysis is a statistical method that takes advantage of unobserved, or latent, cla

  11. Medicare Program; Medicare Clinical Diagnostic Laboratory Tests Payment System. Final rule.

    Science.gov (United States)

    2016-06-23

    This final rule implements requirements of section 216 of the Protecting Access to Medicare Act of 2014 (PAMA), which significantly revises the Medicare payment system for clinical diagnostic laboratory tests. This final rule also announces an implementation date of January 1, 2018 for the private payor rate-based fee schedule required by PAMA.

  12. Diagnostic utility of the Key Search Test as a measure of executive functions

    NARCIS (Netherlands)

    Oosterman, J.M.; Molenveld, M.; Olde Rikkert, M.G.M.; Kessels, R.P.C.

    2010-01-01

    Background: Executive function deficits are commonly observed in many clinical populations, highlighting the importance of appropriate diagnostic tools to screen for these deficits. Most neuropsychological tests of executive function, however, are time-consuming and difficult to administer in the ca

  13. Diagnostic utility of the Key Search Test as a measure of executive functions.

    NARCIS (Netherlands)

    Oosterman, J.M.; Molenveld, M.; Olde Rikkert, M.G.M.; Kessels, R.P.C.

    2010-01-01

    BACKGROUND: Executive function deficits are commonly observed in many clinical populations, highlighting the importance of appropriate diagnostic tools to screen for these deficits. Most neuropsychological tests of executive function, however, are time-consuming and difficult to administer in the ca

  14. Sensitive KIT D816V mutation analysis of blood as a diagnostic test in mastocytosis

    DEFF Research Database (Denmark)

    Kielsgaard Kristensen, Thomas; Vestergaard, Hanne; Bindslev-Jensen, Carsten;

    2014-01-01

    The recent progress in sensitive KIT D816V mutation analysis suggests that mutation analysis of peripheral blood (PB) represents a promising diagnostic test in mastocytosis. However, there is a need for systematic assessment of the analytical sensitivity and specificity of the approach in order t...

  15. Effects of a Web-Based Decision Aid Regarding Diagnostic Self-Testing. A Single-Blind Randomized Controlled Trial

    Science.gov (United States)

    Ickenroth, Martine H. P.; Grispen, J. E. J.; de Vries, N. K.; Dinant, G. J.; Ronda, G.; van der Weijden, T.

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized controlled trial was designed. A total of 1259…

  16. Scratching Where They Itch: Evaluation of Feedback on a Diagnostic English Grammar Test for Taiwanese University Students

    Science.gov (United States)

    Yin, Muchun; Sims, James; Cothran, Daniel

    2012-01-01

    Feedback to the test taker is a defining characteristic of diagnostic language testing (Alderson, 2005). This article reports on a study that investigated how much and in what ways students at a Taiwan university perceived the feedback to be useful on an online multiple-choice diagnostic English grammar test, both in general and by students of…

  17. Diagnostic significance of haematological testing in patients presenting at the Emergency Department

    Directory of Open Access Journals (Sweden)

    Giuseppe Lippi

    2012-03-01

    Full Text Available The use of simple and economic tests to rule out diseases of sufficient clinical severity is appealing in emergency department (ED, since it would be effective for contrasting ED overcrowding and decreasing healthcare costs. The aim of this study was to assess the diagnostic performance of simple and economic haematological testing in a large sample of adult patients presenting at the ED of the Academic Hospital of Parma during the year 2010 with the five most frequent acute pathologies (i.e., acute myocardial infarction, renal colic, pneumonia, trauma and pancreatitis. Both leukocyte count and hemoglobin showed a good diagnostic performance (Area Under the Curve [AUC] of 0.85 for leukocyte count and 0.76 for hemoglobin; both p < 0.01. Although the platelet count was significantly increased in all patients groups except pancreatitis, the diagnostic performance did not achieve statistical significance (AUC 0.53; p = 0.07. We also observed an increased RDW in all groups, except in those with trauma and the diagnostic performance was acceptable (AUC 0.705; p < 0.01. The mean platelet volume (MPV was consistently lower in all patients groups and also characterized by an efficient diagnostic performance (AUC 0.76; p < 0.01. This evidence led us to design an arbitrary formula, whereby MPV and hemoglobin were multiplied, and further divided by the leukocyte count, obtaining a remarkable AUC (0.91; p < 0.01. We conclude that simple, rapid and cheap hematological tests might provide relevant clinical information for decision making to busy emergency physicians, and the their combination into an arbitrary formula might further increase the specific diagnostic potential of each of them.

  18. Consensus-based reporting standards for diagnostic test accuracy studies for paratuberculosis in ruminants

    DEFF Research Database (Denmark)

    Gardner, Ian A.; Nielsen, Søren Saxmose; Whittington, Richard;

    2011-01-01

    The Standards for Reporting of Diagnostic Accuracy (STARD) statement (www.stard-statement.org) was developed to encourage complete and transparent reporting of key elements of test accuracy studies in human medicine. The statement was motivated by widespread evidence of bias in test accuracy...... for Reporting of Animal Diagnostic Accuracy Studies for paratuberculosis), should facilitate improved quality of reporting of the design, conduct and results of paratuberculosis test accuracy studies which were identified as “poor” in a review published in 2008 in Veterinary Microbiology...... studies and the finding that incomplete or absent reporting of items in the STARD checklist was associated with overly optimistic estimates of test performance characteristics. Although STARD principles apply broadly, specific guidelines do not exist to account for unique considerations in livestock...

  19. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Hansen, Kristian S.;

    2011-01-01

    ABSTRACT: BACKGROUND: Current Uganda National Malaria treatment guidelines recommend parasitological confirmation either by microscopy or rapid diagnostic test (RDT) before treatment with artemether-lumefantrine (AL). However, the cost-effectiveness of these strategies has not been assessed...... at rural operational primary care centres. METHODS: Three health centres (HCs) were randomized to three diagnostic arms (microscopy, RDT and presumptive diagnosis) in a district of low and another of high malaria transmission intensities in Uganda. Some 22,052 patients presenting with fever at outpatients...

  20. Predictive diagnostic value of the tourniquet test for the diagnosis of dengue infection in adults

    OpenAIRE

    Mayxay, Mayfong; Phetsouvanh, Rattanaphone; Catrin E Moore; Chansamouth, Vilada; Vongsouvath, Manivanh; Sisouphone, Syho; Vongphachanh, Pankham; Thaojaikong, Thaksinaporn; Thongpaseuth, Soulignasack; Phongmany, Simmaly; Keolouangkhot, Valy; Strobel, Michel; Newton, Paul N.

    2011-01-01

    Objective To examine the accuracy of the admission tourniquet test in the diagnosis of dengue infection among Lao adults. Methods Prospective assessment of the predictive diagnostic value of the tourniquet test for the diagnosis of dengue infection, as defined by IgM, IgG and NS1 ELISAs (Panbio Ltd, Australia), among Lao adult inpatients with clinically suspected dengue infection. Results Of 234 patients with clinically suspected dengue infection on admission, 73% were serologically confirmed...

  1. Estimating the True Accuracy of Diagnostic Tests for Dengue Infection Using Bayesian Latent Class Models

    OpenAIRE

    Wirichada Pan-ngum; Blacksell, Stuart D; Yoel Lubell; Sasithon Pukrittayakamee; Bailey, Mark S.; Janaka de Silva, H.; David G Lalloo; Day, Nicholas P. J.; White, Lisa J; Direk Limmathurotsakul

    2013-01-01

    BACKGROUND: Accuracy of rapid diagnostic tests for dengue infection has been repeatedly estimated by comparing those tests with reference assays. We hypothesized that those estimates might be inaccurate if the accuracy of the reference assays is not perfect. Here, we investigated this using statistical modeling. METHODS/PRINCIPAL FINDINGS: Data from a cohort study of 549 patients suspected of dengue infection presenting at Colombo North Teaching Hospital, Ragama, Sri Lanka, that described the...

  2. NS1-based tests with diagnostic utility for confirming dengue infection: a meta-analysis

    OpenAIRE

    Hao Zhang; Wei Li; Junjie Wang; Hongjuan Peng; Xiaoyan Che; Xiaoguang Chen; Yuanping Zhou

    2014-01-01

    Objectives: Non-structural protein 1 (NS1)-based tests may offer a larger window of opportunity for dengue diagnosis and could constitute a very useful diagnostic tool. The aim of this study was to establish the overall accuracy of NS1-based tests for diagnosing dengue infection. Methods: A meta-analysis was conducted including 18 studies published up to October 1, 2012 identified using PubMed, ISI Web of Science, Google Scholar, and the Chinese National Knowledge Infrastructure (CNKI) dat...

  3. Diagnostic value of amino acid consumption test on exocrine pancreatic insufficiency

    Institute of Scientific and Technical Information of China (English)

    Zheng Ming Lei; Dai Yu Li; Jing Li; Qing Wang; Kai He; Shi Lin Zheng; Yong Gui Gan

    2000-01-01

    @@INTRODUCTION Amino acid consumption test (AACT) has a high sensitivity and specificity in evaluating exocrine pancreatic insufficiency[1,2], but its diagnostic value to exocrine pancreatic insufficiency in Chinese has not been well understood. In this study, the oral reagent stimulating pancreatic secretion (O-AACT) was used instead of cerulein (I-AACT) for amido acid consumption test and the dignostic efficiency of O-AACT was evaluated and compared with I-AACT on the exocrine pancreatic insufficiency in Chinese.

  4. Diagnostic value of gastric shake test for hyaline membrane disease in preterm infant

    OpenAIRE

    Mahmood NooriShadkam; Mohammad Hossein Lookzadeh; Mahmood Taghizadeh; Azam Golzar; Zahra NooriShadkam

    2014-01-01

    Background: Hyaline membrane disease (HMD) has remained a common neonatal problem and is a cause of morbidity in infants. The shake test can be used to assess whether surfactant is present in the infant's lungs at birth. Objective: The goal of this study was to determine the usefulness and accuracy of gastric aspirate shake test for the diagnosis of two HMD. Materials and Methods: This was a diagnostic accuracy study carried out on 49 preterm infant born at Shahid Sadoughi hospital in 2...

  5. External Quality Assessment Program for Chlamydia trachomatis Diagnostic Testing by Nucleic Acid Amplification Assays

    OpenAIRE

    Land, Sally; Tabrizi, Sepehr; Gust, Anthony; Johnson, Elizabeth; Garland, Susan; Dax, Elizabeth M.

    2002-01-01

    We report the results from 57 Australian diagnostic laboratories testing two external quality assessment panels using either the Roche Amplicor Chlamydia trachomatis test (R-PCR) or the Abbott LCx Chlamydia trachomatis assay (A-ligase chain reaction [LCR]). Panel samples were either normal urine spiked with Chlamydia trachomatis antigen or clinical urine specimens. There was no significant difference between laboratories or between assays in detection of C. trachomatis-positive clinical sampl...

  6. Diagnostic efficacy of biophysical tests and cerebral-umbilical index when assessing fetal oxygenation

    OpenAIRE

    Čančarević-Đajić Branka; Vilendečić Rade

    2013-01-01

    Introduction. Perinatal morbidity and mortality are the ultimate indicators of antenatal care today, whose responsible task is to assess the respiratory function of the placenta, fetal growth and placental maturation in order to provide conditions for the delivery of a living and viable newborn. The diagnostic procedures of antenatal care tested within this study were the biophysical tests of cardiotocography and the fetal biophysical profile, along with the colour doppler evaluation of...

  7. Advanced Manufacturing Technologies (AMT): Additive Manufactured Hot Fire Planning and Testing in GRC Cell 32 Project

    Science.gov (United States)

    Fikes, John C.

    2014-01-01

    The objective of this project is to hot fire test an additively manufactured thrust chamber assembly TCA (injector and thrust chamber). GRC will install the additively manufactured Inconel 625 injector, two additively manufactured (SLM) water cooled Cu-Cr thrust chamber barrels and one additively manufactured (SLM) water cooled Cu-Cr thrust chamber nozzle on the test stand in Cell 32 and perform hot fire testing of the integrated TCA.

  8. Diagnostic Accuracy of Xpert Test in Tuberculosis Detection: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Kaur, Ravdeep; Kachroo, Kavita; Sharma, Jitendar Kumar; Vatturi, Satyanarayana Murthy; Dang, Amit

    2016-01-01

    Background: World Health Organization (WHO) recommends the use of Xpert MTB/RIF assay for rapid diagnosis of tuberculosis (TB) and detection of rifampicin resistance. This systematic review was done to know about the diagnostic accuracy and cost-effectiveness of the Xpert MTB/RIF assay. Methods: A systematic literature search was conducted in following databases: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, MEDLINE, PUBMED, Scopus, Science Direct and Google Scholar for relevant studies for studies published between 2010 and December 2014. Studies given in the systematic reviews were accessed separately and used for analysis. Selection of studies, data extraction and assessment of quality of included studies was performed independently by two reviewers. Studies evaluating the diagnostic accuracy of Xpert MTB/RIF assay among adult or predominantly adult patients (≥14 years), presumed to have pulmonary TB with or without HIV infection were included in the review. Also, studies that had assessed the diagnostic accuracy of Xpert MTB/RIF assay using sputum and other respiratory specimens were included. Results: The included studies had a low risk of any form of bias, showing that findings are of high scientific validity and credibility. Quantitative analysis of 37 included studies shows that Xpert MTB/RIF is an accurate diagnostic test for TB and detection of rifampicin resistance. Conclusion: Xpert MTB/RIF assay is a robust, sensitive and specific test for accurate diagnosis of tuberculosis as compared to conventional tests like culture and microscopic examination. PMID:27013842

  9. Diagnostic accuracy of xpert test in tuberculosis detection: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ravdeep Kaur

    2016-01-01

    Full Text Available Background: World Health Organization (WHO recommends the use of Xpert MTB/RIF assay for rapid diagnosis of tuberculosis (TB and detection of rifampicin resistance. This systematic review was done to know about the diagnostic accuracy and cost-effectiveness of the Xpert MTB/RIF assay. Methods: A systematic literature search was conducted in following databases: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, MEDLINE, PUBMED, Scopus, Science Direct and Google Scholar for relevant studies for studies published between 2010 and December 2014. Studies given in the systematic reviews were accessed separately and used for analysis. Selection of studies, data extraction and assessment of quality of included studies was performed independently by two reviewers. Studies evaluating the diagnostic accuracy of Xpert MTB/RIF assay among adult or predominantly adult patients (≥14 years, presumed to have pulmonary TB with or without HIV infection were included in the review. Also, studies that had assessed the diagnostic accuracy of Xpert MTB/RIF assay using sputum and other respiratory specimens were included. Results: The included studies had a low risk of any form of bias, showing that findings are of high scientific validity and credibility. Quantitative analysis of 37 included studies shows that Xpert MTB/RIF is an accurate diagnostic test for TB and detection of rifampicin resistance. Conclusion: Xpert MTB/RIF assay is a robust, sensitive and specific test for accurate diagnosis of tuberculosis as compared to conventional tests like culture and microscopic examination.

  10. Safety and Yield of Diagnostic ERCP in Liver Transplant Patients with Abnormal Liver Function Tests

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    Jayapal Ramesh

    2014-01-01

    Full Text Available Background. Abnormal liver enzymes postorthotopic liver transplant (OLT may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patients presenting with abnormal liver function tests in the setting of OLT. Methods. A retrospective review of diagnostic ERCPs in patients with OLT from 2002 to 2013 from a prospectively maintained, IRB approved database. Results. Of the 474 ERCPs performed in OLT patients, 210 (44.3%; 95% CI 39.8–48.8 were performed for abnormal liver function tests during the study period. Majority of patients were Caucasian (83.8%, male (62.4% with median age of 55 years (IQR 48–62 years. Biliary cannulation was successful in 99.6% of cases and findings included stricture in 45 (21.4 %; biliary stones/sludge in 23 (11%; biliary dilation alone in 31 (14.8%; and normal in 91 (43.3%. Three (1.4% patients developed mild, self-limiting pancreatitis; one patient (0.5% developed cholangitis and two (1% had postsphincterotomy bleeding. Multivariate analyses showed significant association between dilated ducts on imaging with a therapeutic outcome. Conclusion. Diagnostic ERCP in OLT patients presenting with liver function test abnormalities is safe and frequently therapeutic.

  11. Real-Time Remote Diagnostic Monitoring Test-bed in JET

    International Nuclear Information System (INIS)

    Based on the remote experimentation concept oriented to long pulse shots, a test-bed system has been implemented in JET. It integrates 2 functionalities. The first one is the real-time monitoring, on remote, of a reflectometer diagnostic, to visualize different data outputs and status information. The second one is the integration of dotJET (Diagnostic Overview Tool for JET), which internally provides at JET an overview about the current diagnostic systems state, in order to monitor, on remote, JET diagnostics status. The architecture of the system is formed by: the data generator components, the data distribution system, an access control service, and the client applications. In the test-bed there are two data generators: the acquisition equipment associated with the reflectometer diagnostic that generates data and status information, and dotJET server that centralize the access to the status information of JET diagnostics. The data distribution system has been implemented using a publishing-subscribing technology that receives data from data generators and redistributes them to client applications. And finally, for monitoring, a client application based on Java Web Start technology, and a dotJET client application have been used. There are 3 interesting results from this project. The first one is the analysis of different aspects (data formats, data frame rate, data resolution, etc) related with remote real-time diagnostic monitoring oriented to long pulse experiments. The second one is the definition and implementation of a flexible enough architecture, to be applied to different types of data generated from other diagnostics, and that fits with remote access requirements; and the third one is to have achieved a secure system, taking into account internal networks and firewalls aspects in JET, and securing the access from remote users. For this last issue, PAPI technology has been used, enabling access control based on user attributes, enabling mobile users to

  12. Improving procedure and results of diagnostic roentgenologic examination of pulmonary emphysema by methods based on lung function tests

    International Nuclear Information System (INIS)

    The article reports a comparative evaluation of examinations in 225 patients intended to show the achievements of a novel procedure based on lung function tests for optimisation of the roentgenologic diagnosis of pulmonary emphysema. The improvements are quantified by discrimination analyses. The approach introduces a novel, additional roentgenological criterion indicating emphysema, called 'Anlagemass', which supplements the usual qualitative and quantitative evaluation of the chest radiograph. A suitable computer code developed for data processing adds advantages in terms of processing time and improved objectiveness of diagnostic evaluation, as compared to existing techniques. The screening results obtained with the method reported ought to be verified by other methods such as bodyplethysmography or CT. (orig.)

  13. Diagnostic Accuracy of PCR Alone and Compared to Urinary Antigen Testing for Detection of Legionella spp.: a Systematic Review.

    Science.gov (United States)

    Avni, Tomer; Bieber, Amir; Green, Hefziba; Steinmetz, Tali; Leibovici, Leonard; Paul, Mical

    2016-02-01

    The diagnosis of Legionnaires' disease (LD) is based on the isolation of Legionella spp., a 4-fold rise in antibodies, a positive urinary antigen (UA), or direct immunofluorescence tests. PCR is not accepted as a diagnostic tool for LD. This systematic review assesses the diagnostic accuracy of PCR in various clinical samples with a direct comparison versus UA. We included prospective or retrospective cohort and case-control studies. Studies were included if they used the Centers for Disease Control and Prevention consensus definition criteria of LD or a similar one, assessed only patients with clinical pneumonia, and reported data for all true-positive, false-positive, true-negative, and false-negative results. Two reviewers abstracted data independently. Risk of bias was assessed using Quadas-2. Summary sensitivity and specificity values were estimated using a bivariate model and reported with a 95% confidence interval (CI). Thirty-eight studies were included. A total of 653 patients had confirmed LD, and 3,593 patients had pneumonia due to other pathogens. The methodological quality of the studies as assessed by the Quadas-2 tool was poor to fair. The summary sensitivity and specificity values for diagnosis of LD in respiratory samples were 97.4% (95% CI, 91.1% to 99.2%) and 98.6% (95% CI, 97.4% to 99.3%), respectively. These results were mainly unchanged by any covariates tested and subgroup analysis. The diagnostic performance of PCR in respiratory samples was much better than that of UA. Compared to UA, PCR in respiratory samples (especially in sputum samples or swabs) revealed a significant advantage in sensitivity and an additional diagnosis of 18% to 30% of LD cases. The diagnostic performance of PCR in respiratory samples was excellent and preferable to that of the UA. Results were independent on the covariate tested. PCR in respiratory samples should be regarded as a valid tool for the diagnosis of LD. PMID:26659202

  14. Reliability of rapid diagnostic tests in diagnosing pregnancy-associated malaria in north-eastern Tanzania

    DEFF Research Database (Denmark)

    Minja, Daniel T.; Schmiegelow, Christentze; Oesterholt, Mayke;

    2012-01-01

    Background: Accurate diagnosis and prompt treatment of pregnancy-associated malaria (PAM) are key aspects in averting adverse pregnancy outcomes. Microscopy is the gold standard in malaria diagnosis, but it has limited detection and availability. When used appropriately, rapid diagnostic tests...... (RDTs) could be an ideal diagnostic complement to microscopy, due to their ease of use and adequate sensitivity in detecting even sub-microscopic infections. Polymerase chain reaction (PCR) is even more sensitive, but it is mainly used for research purposes. The accuracy and reliability of RDTs...... dehydrogenase (pLDH) based RDTs (Parascreen™) or HRP-2 only (Paracheck Pf® and ParaHIT®f), microscopy and nested Plasmodium species diagnostic PCR. Results: From a cohort of 924 pregnant women who completed the follow up, complete RDT and microscopy data was available for 5,555 blood samples and of these 442...

  15. Estimating the true accuracy of diagnostic tests for dengue infection using bayesian latent class models.

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    Wirichada Pan-ngum

    Full Text Available BACKGROUND: Accuracy of rapid diagnostic tests for dengue infection has been repeatedly estimated by comparing those tests with reference assays. We hypothesized that those estimates might be inaccurate if the accuracy of the reference assays is not perfect. Here, we investigated this using statistical modeling. METHODS/PRINCIPAL FINDINGS: Data from a cohort study of 549 patients suspected of dengue infection presenting at Colombo North Teaching Hospital, Ragama, Sri Lanka, that described the application of our reference assay (a combination of Dengue IgM antibody capture ELISA and IgG antibody capture ELISA and of three rapid diagnostic tests (Panbio NS1 antigen, IgM antibody and IgG antibody rapid immunochromatographic cassette tests were re-evaluated using bayesian latent class models (LCMs. The estimated sensitivity and specificity of the reference assay were 62.0% and 99.6%, respectively. Prevalence of dengue infection (24.3%, and sensitivities and specificities of the Panbio NS1 (45.9% and 97.9%, IgM (54.5% and 95.5% and IgG (62.1% and 84.5% estimated by bayesian LCMs were significantly different from those estimated by assuming that the reference assay was perfect. Sensitivity, specificity, PPV and NPV for a combination of NS1, IgM and IgG cassette tests on admission samples were 87.0%, 82.8%, 62.0% and 95.2%, respectively. CONCLUSIONS: Our reference assay is an imperfect gold standard. In our setting, the combination of NS1, IgM and IgG rapid diagnostic tests could be used on admission to rule out dengue infection with a high level of accuracy (NPV 95.2%. Further evaluation of rapid diagnostic tests for dengue infection should include the use of appropriate statistical models.

  16. Additional diagnostic value of tumor markers in cytological fluid for diagnosis of non-small-cell lung cancer

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    Hur Jin

    2012-09-01

    Full Text Available Abstract Background Cytological fluid from a needle aspiration biopsy (NAB is obtained directly from tumor tissue, therefore many biomarker candidates will be present in high concentrations. The aim of this study was to prospectively assess and validate the tumor markers CYFRA 21–1, CEA, and SCC in cytological fluid obtained from NAB samples to determine if they improved the performance of NAB for diagnosing non-small cell lung cancer (NSCLC. Methods A total of 194 patients (M:F = 128:66, mean age 63.7 years with suspected malignant pulmonary lesions were prospectively enrolled and underwent percutaneous NAB. Levels of CYFRA 21–1, CEA, and SCC were measured by immunoassay in serum and cytological fluid obtained during aspiration biopsy. Cut-off values to determined malignancy were 3.3 ng/mL in serum and 15.7 ng/mL in cytological fluid for CYFRA 21–1, 5 ng/mL and 0.6 ng/mL for CEA, and 2 ng/mL and 0.86 ng/mL for SCC. Results Of 194 patients, 139 patients (71.6% had NSCLC and 55 (28.4% had benign lesions. Sensitivity increased significantly for NAB combined with cytological tumor markers compared with NAB alone (CYFRA 21–1: 95% versus 83.5%, p Conclusion Of the tested tumor markers, cytological fluid measurements of CYFRA 21–1 improved the diagnostic performance of NAB for NSCLC.

  17. Evidence Based Medicine; Positive and Negative Likelihood Ratios of Diagnostic Tests

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    Alireza Baratloo

    2015-10-01

    Full Text Available In the previous two parts of educational manuscript series in Emergency, we explained some screening characteristics of diagnostic tests including accuracy, sensitivity, specificity, and positive and negative predictive values. In the 3rd  part we aimed to explain positive and negative likelihood ratio (LR as one of the most reliable performance measures of a diagnostic test. To better understand this characteristic of a test, it is first necessary to fully understand the concept of sensitivity and specificity. So we strongly advise you to review the 1st part of this series again. In short, the likelihood ratios are about the percentage of people with and without a disease but having the same test result. The prevalence of a disease can directly influence screening characteristics of a diagnostic test, especially its sensitivity and specificity. Trying to eliminate this effect, LR was developed. Pre-test probability of a disease multiplied by positive or negative LR can estimate post-test probability. Therefore, LR is the most important characteristic of a test to rule out or rule in a diagnosis. A positive likelihood ratio > 1 means higher probability of the disease to be present in a patient with a positive test. The further from 1, either higher or lower, the stronger the evidence to rule in or rule out the disease, respectively. It is obvious that tests with LR close to one are less practical. On the other hand, LR further from one will have more value for application in medicine. Usually tests with 0.1 < LR > 10 are considered suitable for implication in routine practice.

  18. Decision Making for Borderline Cases in Pass/Fail Clinical Anatomy Courses: The Practical Value of the Standard Error of Measurement and Likelihood Ratio in a Diagnostic Test

    Science.gov (United States)

    Severo, Milton; Silva-Pereira, Fernanda; Ferreira, Maria Amelia

    2013-01-01

    Several studies have shown that the standard error of measurement (SEM) can be used as an additional “safety net” to reduce the frequency of false-positive or false-negative student grading classifications. Practical examinations in clinical anatomy are often used as diagnostic tests to admit students to course final examinations. The aim of this…

  19. Yield of diagnostic tests for opportunistic infections in AIDS: a survey of 33 patients

    DEFF Research Database (Denmark)

    Gøtzsche, P C; Bygbjerg, Ib Christian; Olesen, B;

    1988-01-01

    To examine the therapeutic consequences of diagnostic tests for AIDS-related infections, case records from 33 deceased AIDS patients were reviewed; 23 were autopsied. Determination of serum antibody titres was not important. In particular, there was no relation between titres and isolation....../7 disseminated infections with atypical mycobacteria were only revealed at autopsy, despite numerous cultures in vivo. Liver biopsies were not helpful. Diagnostic procedures for Pneumocystis carinii pneumonia by lung biopsy caused pneumothorax in 3/15 patients; bronchoalveolar lavage or treatment....../prophylaxis without diagnosis could be considered. In 8 autopsies, microscopy was suggestive of cerebral toxoplasmosis, but only 1 patient had presented important clinical symptoms. We suggest a schedule with regular microbiologic and parasitic examinations and few antibody tests, but with more antigen tests....

  20. Diagnostic Tests in Czech for Pupils with a First Language Different from the Language of Schooling

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    Kateřina Vodičková

    2016-01-01

    Full Text Available Mastering a second language, in this case Czech, is crucial for pupils whose first language differs from the language of schooling, so that they can engage more successfully in the educational process. In order to adjust language teaching to pupils’ needs, it is necessary to identify which language skills or individual competences set out within the framework of communicative competence should be developed. For this purpose, a new diagnostic test for lower and upper graders of primary schools was designed. Although it is not a high-stakes test, it is essential that its validity, reliability and practicality are ensured, as well as its positive impact on the teaching process, pupils, teachers, schools and society. The present paper introduces the position of pupils with a first language other than Czech in the Czech Republic. It presents a recently developed diagnostic tool and documents the characteristics of the test, such as validity, reliability, impact and practicality.

  1. Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

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    Marga G A Goris

    Full Text Available BACKGROUND: Diagnosis of leptospirosis by the microscopic agglutination test (MAT or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. METHODOLOGY: During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1(st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. RESULTS: The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1(st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB, but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB. CONCLUSIONS: All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended.

  2. The evaluation of a rapid in situ HIV confirmation test in a programme with a high failure rate of the WHO HIV two-test diagnostic algorithm.

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    Derryck B Klarkowski

    Full Text Available BACKGROUND: Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT (two positive RDTs alone for HIV diagnosis used in voluntary counselling and testing (VCT sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-positive rate of the WHO two-test algorithm compared with our adapted protocol including confirmation testing, and whether weakly reactive compared with strongly reactive rapid test results were more likely to be false positives. METHODOLOGY/PRINCIPAL FINDINGS: 2864 clients presenting to MSF VCT centres in Bukavu during January to May 2006 were tested using Determine HIV-1/2 and UniGold HIV rapid tests in parallel by nurse counsellors. Plasma samples on 229 clients confirmed as double RDT positive by laboratory retesting were further tested using both WB and the Orgenics Immunocomb Combfirm HIV confirmation test (OIC-HIV. Of these, 24 samples were negative or indeterminate by WB representing a false-positive rate of the WHO two-test algorithm of 10.5% (95%CI 6.6-15.2. 17 of the 229 samples were weakly positive on rapid testing and all were negative or indeterminate by WB. The false-positive rate fell to 3.3% (95%CI 1.3-6.7 when only strong-positive rapid test results were considered. Agreement between OIC-HIV and WB was 99.1% (95%CI 96.9-99.9% with no false OIC-HIV positives if stringent criteria for positive OIC-HIV diagnoses were used. CONCLUSIONS: The WHO HIV two-test diagnostic algorithm produced an unacceptably high level of false-positive diagnoses in our setting, especially if results were weakly positive. The most probable causes of the false-positive results were serological cross-reactivity or non-specific immune reactivity. Our findings show that the OIC

  3. Use of a three-band HRP2/pLDH combination rapid diagnostic test increases diagnostic specificity for falciparum malaria in Ugandan children

    OpenAIRE

    Hawkes, Michael; CONROY, Andrea L.; Opoka, Robert O.; Namasopo, Sophie; Liles, W. Conrad; John, Chandy C; Kain, Kevin C

    2014-01-01

    Background Rapid diagnostic tests (RDTs) for malaria provide a practical alternative to light microscopy for malaria diagnosis in resource-limited settings. Three-band RDTs incorporating two parasite antigens may have enhanced diagnostic specificity, relative to two-band RDTs with a single parasite antigen (typically histidine-rich protein 2 [HRP2]). Methods Phase 1: 2,000 children, two months to five years of age, admitted to a referral hospital in Jinja, Uganda, with acute febrile illness w...

  4. Diagnostic value of oral challenge tests with food additives or nickel sulphate

    OpenAIRE

    Carrapatoso, I; Pereira, C.; Faria, E; Geraldes, L; Loureiro, C; Chieira, C

    2008-01-01

    Objectivo: O uso crescente de aditivos na indústria alimentar e farmacêutica tem dificultado o diagnóstico das reacções adversas a estes produtos. O grande desafio é, actualmente, determinar em cada doente a substância a testar. Constituiu objectivo deste trabalho a avaliação do valor diagnóstico das provas de provocação, utilizando cápsulas de aditivos alimentares ou de níquel, em doentes com suspeita, respectivamente, de intolerância alimentar ou de hipersensibilidade ao níquel. Métodos...

  5. Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome

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    Johnsson Ragnar

    2003-05-01

    Full Text Available Abstract Background Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS, with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research. The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests in population-based CTS and determine the properties of the most accurate test. Methods In a population-based study a questionnaire was mailed to a random sample of 3,000 persons. Of 2,466 responders, 262 symptomatic (numbness/tingling in the radial fingers and 125 randomly selected asymptomatic responders underwent clinical and electrophysiologic examinations. A standardized hand diagram was administered to the symptomatic persons. At the clinical examination, the examining surgeon identified 94 symptomatic persons as having clinically certain CTS. Nerve conduction tests were then performed on the symptomatic and the asymptomatic persons by blinded examiners. Analysis with receiver operating characteristic (ROC curves was used to compare the diagnostic accuracy of the nerve conduction tests in distinguishing the persons with clinically certain CTS from the asymptomatic persons. Results No difference was shown in the diagnostic accuracy of median nerve distal motor latency, digit-wrist sensory latency, wrist-palm sensory conduction velocity, and wrist-palm/forearm sensory conduction velocity ratio (area under curve, 0.75–0.76. Median-ulnar digit-wrist sensory latency difference had a significantly higher diagnostic accuracy (area under curve, 0.80. Using the optimal cutoff value of 0.8 ms for abnormal sensory latency difference shown on the ROC curve the sensitivity was 70%, specificity 82%, positive predictive value 19% and negative predictive value 98%. Based on the clinical diagnosis

  6. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

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    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  7. An Overview of Models of Speaking Performance and Its Implications for the Development of Procedural Framework for Diagnostic Speaking Tests

    Science.gov (United States)

    Zhao, Zhongbao

    2013-01-01

    This paper aims at developing a procedural framework for the development and validation of diagnostic speaking tests. The researcher reviews the current available models of speaking performance, analyzes the distinctive features and then points out the implications for the development of a procedural framework for diagnostic speaking tests. On…

  8. Evaluation of a density-based rapid diagnostic test for sickle cell disease in a clinical setting in Zambia.

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    Ashok A Kumar

    Full Text Available Although simple and low-cost interventions for sickle cell disease (SCD exist in many developing countries, child mortality associated with SCD remains high, in part, because of the lack of access to diagnostic tests for SCD. A density-based test using aqueous multiphase systems (SCD-AMPS is a candidate for a low-cost, point-of-care diagnostic for SCD. In this paper, the field evaluation of SCD-AMPS in a large (n = 505 case-control study in Zambia is described. Of the two variations of the SCD-AMPS used, the best system (SCD-AMPS-2 demonstrated a sensitivity of 86% (82-90% and a specificity of 60% (53-67%. Subsequent analysis identified potential sources of false positives that include clotting, variation between batches of SCD-AMPS, and shipping conditions. Importantly, SCD-AMPS-2 was 84% (62-94% sensitive in detecting SCD in children between 6 months and 1 year old. In addition to an evaluation of performance, an assessment of end-user operability was done with health workers in rural clinics in Zambia. These health workers rated the SCD-AMPS tests to be as simple to use as lateral flow tests for malaria and HIV.

  9. Analysis of diagnostic testing of Gladys McCall Well No. 1

    Energy Technology Data Exchange (ETDEWEB)

    Riney, T.D.; Garg, S.K.

    1991-12-01

    Gladys McCall Well No. 1 was flow tested from 1983 to 1987, underwent long-term pressure buildup testing from October 1987 to October 1991, and has recently been re-entered for final diagnostic testing. The combination of a very large, poorly defined reservoir with data from only a single well has required that the testing be carried out over an unusually long time period for an understanding of the pressure maintenance mechanisms to be developed. Ongoing diagnostic testing of the well has been undertaken by DOE to help resolve questions that arose during the analysis of the test data from the eight year depletion and recovery testing. A rather complete summary of the synthesis, correlation and analysis of the earlier test data has recently been published (Riney, 1991.) and is included in this report as an Appendix. Figure 1 (an update of Figure 9 in the Appendix) includes the final pressure buildup data in the comparison with the earlier reservoir simulation model. During October 1991 the Gladys McCall well was flowed twice as part of the diagnostic testing. On October 1 flow was started to clean out the well and to perform a spinner survey to determine the fluid entry distribution across the perforated interval of Sand 8. The spinner log was run on October 2 with the well producing at a constant rate of {approx} 4800 stb/d. Total production during the October 1-2 test period was 5954 stb. The second flow was from October 10 to 14 to obtain downhole pressure transient data to determine if the transmissivity (kh product) of Sand 8 had changed during the four-year shutin period (October 1987 to October 1991). The total production during the four day constant-rate (5958 stb/d) drawdown test of October 10-14 was 23,850 stb. Eaton Operating Co. and Institute of Gas Technology are continuing with the diagnostic testing; entry and pressure measurements in two overlaying sands (2 and 4) are planned. Since neither time nor funds are sufficient to complete the Gladys Mc

  10. Additional diagnostic value of tumor markers in cytological fluid for diagnosis of non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Cytological fluid from a needle aspiration biopsy (NAB) is obtained directly from tumor tissue, therefore many biomarker candidates will be present in high concentrations. The aim of this study was to prospectively assess and validate the tumor markers CYFRA 21–1, CEA, and SCC in cytological fluid obtained from NAB samples to determine if they improved the performance of NAB for diagnosing non-small cell lung cancer (NSCLC). A total of 194 patients (M:F = 128:66, mean age 63.7 years) with suspected malignant pulmonary lesions were prospectively enrolled and underwent percutaneous NAB. Levels of CYFRA 21–1, CEA, and SCC were measured by immunoassay in serum and cytological fluid obtained during aspiration biopsy. Cut-off values to determined malignancy were 3.3 ng/mL in serum and 15.7 ng/mL in cytological fluid for CYFRA 21–1, 5 ng/mL and 0.6 ng/mL for CEA, and 2 ng/mL and 0.86 ng/mL for SCC. Of 194 patients, 139 patients (71.6%) had NSCLC and 55 (28.4%) had benign lesions. Sensitivity increased significantly for NAB combined with cytological tumor markers compared with NAB alone (CYFRA 21–1: 95% versus 83.5%, p < 0.001, CEA: 92.1% versus 83.5%, p = 0.002, SCC: 91.4% versus 83.5%, p = 0.003). Accuracy improved significantly for NAB combined with cytological CYFRA 21–1 compared with NAB alone (95.9% versus 88.1%, p < 0.001). The area under curve (AUC) of NAB with cytological CYFRA 21–1 was significantly larger than for NAB alone (0.966 versus 0.917, p = 0.009). Of the tested tumor markers, cytological fluid measurements of CYFRA 21–1 improved the diagnostic performance of NAB for NSCLC

  11. Post-mortem diagnostics in cases of sepsis. Part 1. Aetiology, epidemiology and microbiological tests

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    Marta Rorat

    2015-03-01

    Full Text Available Clinical practice has an effective methodology of diagnostic procedures to be followed in cases of sepsis. However, there are as yet no corresponding standards of action in post-mortem diagnostics. The scope of examinations is limited to an autopsy and histopathological tests. This situation may lead to errors in medico-legal opinions on the cause of death and in the assessment of appropriateness of medical procedures. In cases of suspected sepsis, medico-legal investigations require obtaining detailed information about the circumstances of death (including symptoms and results of intravital examinations before autopsy is performed, as well as sterile collection of specimens for microbiological tests and interpretation of their results on the basis of knowledge of epidemiology, pathophysiology and clinical progression of sepsis.

  12. Publishing nutrition research: validity, reliability, and diagnostic test assessment in nutrition-related research.

    Science.gov (United States)

    Gleason, Philip M; Harris, Jeffrey; Sheean, Patricia M; Boushey, Carol J; Bruemmer, Barbara

    2010-03-01

    This is the sixth in a series of monographs on research design and analysis. The purpose of this article is to describe and discuss several concepts related to the measurement of nutrition-related characteristics and outcomes, including validity, reliability, and diagnostic tests. The article reviews the methodologic issues related to capturing the various aspects of a given nutrition measure's reliability, including test-retest, inter-item, and interobserver or inter-rater reliability. Similarly, it covers content validity, indicators of absolute vs relative validity, and internal vs external validity. With respect to diagnostic assessment, the article summarizes the concepts of sensitivity and specificity. The hope is that dietetics practitioners will be able to both use high-quality measures of nutrition concepts in their research and recognize these measures in research completed by others.

  13. [Clinical Application of Non-invasive Diagnostic Tests for Liver Fibrosis].

    Science.gov (United States)

    Shin, Jung Woo; Park, Neung Hwa

    2016-07-25

    The diagnostic assessment of liver fibrosis is an important step in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard to assess necroinflammation and fibrosis. However, recent technical advances have introduced numerous serum biomarkers and imaging tools using elastography as noninvasive alternatives to biopsy. Serum markers can be direct or indirect markers of the fibrosis process. The elastography-based studies include transient elastography, acoustic radiation force imaging, supersonic shear wave imaging and magnetic resonance elastography. As accumulation of clinical data shows that noninvasive tests provide prognostic information of clinical relevance, non-invasive diagnostic tools have been incorporated into clinical guidelines and practice. Here, the authors review noninvasive tests for the diagnosis of liver fibrosis. PMID:27443617

  14. Which diagnostic tests are most useful in a chest pain unit protocol?

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    Arnold Jane

    2005-08-01

    Full Text Available Abstract Background The chest pain unit (CPU provides rapid diagnostic assessment for patients with acute, undifferentiated chest pain, using a combination of electrocardiographic (ECG recording, biochemical markers and provocative cardiac testing. We aimed to identify which elements of a CPU protocol were most diagnostically and prognostically useful. Methods The Northern General Hospital CPU uses 2–6 hours of serial ECG / ST segment monitoring, CK-MB(mass on arrival and at least two hours later, troponin T at least six hours after worst pain and exercise treadmill testing. Data were prospectively collected over an eighteen-month period from patients managed on the CPU. Patients discharged after CPU assessment were invited to attend a follow-up appointment 72 hours later for ECG and troponin T measurement. Hospital records of all patients were reviewed to identify adverse cardiac events over the subsequent six months. Diagnostic accuracy of each test was estimated by calculating sensitivity and specificity for: 1 acute coronary syndrome (ACS with clinical myocardial infarction and 2 ACS with myocyte necrosis. Prognostic value was estimated by calculating the relative risk of an adverse cardiac event following a positive result. Results Of the 706 patients, 30 (4.2% were diagnosed as ACS with myocardial infarction, 30 (4.2% as ACS with myocyte necrosis, and 32 (4.5% suffered an adverse cardiac event. Sensitivities for ACS with myocardial infarction and myocyte necrosis respectively were: serial ECG / ST segment monitoring 33% and 23%; CK-MB(mass 96% and 63%; troponin T (using 0.03 ng/ml threshold 96% and 90%. The only test that added useful prognostic information was exercise treadmill testing (relative risk 6 for cardiac death, non-fatal myocardial infarction or arrhythmia over six months. Conclusion Serial ECG / ST monitoring, as used in our protocol, adds little diagnostic or prognostic value in patients with a normal or non-diagnostic

  15. New rapid diagnostic tests for Neisseria meningitidis serogroups A, W135, C, and Y.

    Directory of Open Access Journals (Sweden)

    Suzanne Chanteau

    2006-09-01

    Full Text Available BACKGROUND: Outbreaks of meningococcal meningitis (meningitis caused by Neisseria meningitidis are a major public health concern in the African "meningitis belt," which includes 21 countries from Senegal to Ethiopia. Of the several species that can cause meningitis, N. meningitidis is the most important cause of epidemics in this region. In choosing the appropriate vaccine, accurate N. meningitidis serogroup determination is key. To this end, we developed and evaluated two duplex rapid diagnostic tests (RDTs for detecting N. meningitidis polysaccharide (PS antigens of several important serogroups. METHODS AND FINDINGS: Mouse monoclonal IgG antibodies against N. meningitidis PS A, W135/Y, Y, and C were used to develop two immunochromatography duplex RDTs, RDT1 (to detect serogroups A and W135/Y and RDT2 (to detect serogroups C and Y. Standards for Reporting of Diagnostic Accuracy criteria were used to determine diagnostic accuracy of RDTs on reference strains and cerebrospinal fluid (CSF samples using culture and PCR, respectively, as reference tests. The cutoffs were 10(5 cfu/ml for reference strains and 1 ng/ml for PS. Sensitivities and specificities were 100% for reference strains, and 93.8%-100% for CSF serogroups A, W135, and Y in CSF. For CSF serogroup A, the positive and negative likelihood ratios (+/- 95% confidence intervals [CIs] were 31.867 (16.1-63.1 and 0.065 (0.04-0.104, respectively, and the diagnostic odds ratio (+/- 95% CI was 492.9 (207.2-1,172.5. For CSF serogroups W135 and Y, the positive likelihood ratio was 159.6 (51.7-493.3 Both RDTs were equally reliable at 25 degrees C and 45 degrees C. CONCLUSIONS: These RDTs are important new bedside diagnostic tools for surveillance of meningococcus serogroups A and W135, the two serogroups that are responsible for major epidemics in Africa.

  16. Real-time remote diagnostic monitoring test-bed in JET

    International Nuclear Information System (INIS)

    Based on the remote experimentation concept oriented to long pulse shots, a test-bed system has been implemented in JET. Its main functionality is the real-time monitoring, on remote, of a reflectometer diagnostic, to visualize different data outputs and status information. The architecture of the system is formed by: the data generator components, the data distribution system, an access control service, and the client applications. In the test-bed there is one data generator, which is the acquisition equipment associated with the reflectometer diagnostic that generates data and status information. The data distribution system has been implemented using a publishing-subscribing technology that receives data from data generators and redistributes them to client applications. And finally, for monitoring, a client application based on JAVA Web Start technology has been used. There are three interesting results from this project. The first one is the analysis of different aspects (data formats, data frame rate, data resolution, etc) related with remote real-time diagnostic monitoring oriented to long pulse experiments. The second one is the definition and implementation of an architecture, flexible enough to be applied to different types of data generated from other diagnostics, and that fits with remote access requirements. Finally, the third result is a secure system, taking into account internal networks and firewalls aspects of JET, and securing the access from remote users. For this last issue, PAPI technology has been used, enabling access control based on user attributes, enabling mobile users to monitor diagnostics in real-time, and enabling the integration of this service into the EFDA Federation (Castro et al., 2008 ).

  17. Structured approach to design of diagnostic test evaluation studies for chronic progressive infections in animals.

    Science.gov (United States)

    Nielsen, Søren Saxmose; Toft, Nils; Gardner, Ian Andrew

    2011-05-12

    Diagnostic test evaluations (DTEs) for chronic infections are challenging because a protracted incubation period has to be considered in the design of the DTE, and the adverse effects of infection may be widespread and progressive over an animal's entire life. Frequently, the specific purpose of the test is not formally considered when a test is evaluated. Therefore, the result is often a DTE where test sensitivity and specificity estimates are biased, either because of problems with establishing the true infection status or because the test detects another aspect of the infection (and analyte) than originally intended. The objective of this paper is to outline a structured approach to the design and conduct of a DTE for diagnostic tests used for chronic infections in animals, and intended for different purposes. We describe the process from reflections about test purpose and the underlying target condition through considerations of the pathogenesis, and specification of a practical case definition, which can subsequently be used in the DTE for the specific purpose. The process is illustrated by two examples of Mycobacterium avium subsp. paratuberculosis (MAP) infections in cattle. MAP infections are chronic and can result in different adverse effects at different time points during the incubation period. The description provides input on the process and deductive reasoning which are integral parts to develop a high-quality design of a DTE for chronic infectious diseases.

  18. Temperature and the Field Stability of a Dengue Rapid Diagnostic Test in the Tropics

    OpenAIRE

    Phommasone, Koukeo; Sengvilaipaseuth, Onanong; De Lamballerie, Xavier; Vongsouvath, Manivanh; Phonemixay, Ooyanong; Blacksell, Stuart D; Newton, Paul N.; Dubot-Pérès, Audrey

    2015-01-01

    The global incidence of dengue has increased significantly in recent decades, resulting in a large public health burden in tropical and subtropical countries. Dengue rapid diagnostic tests (RDTs) can provide accurate, rapid accessible diagnosis for patient management and may be easily used by health workers in rural areas. However, in dengue-endemic areas, ambient temperatures are often higher than manufacturer's recommendation. We therefore evaluated the effect of high temperature over time ...

  19. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    Directory of Open Access Journals (Sweden)

    Athanasios Tsalatsanis

    Full Text Available Dual Processing Theories (DPT assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive and type 2 (deliberative. Based on DPT we have derived a Dual Processing Model (DPM to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

  20. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    Science.gov (United States)

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice. PMID:26244571

  1. Data mining approach to the evaluation of diagnostic tests in Wilson disease

    Science.gov (United States)

    Plutecki, Michal M.; Dądalski, Maciej; Socha, Piotr; Mulawka, Jan J.

    2009-06-01

    The purpose of this paper is to figure out a new, better than so-far-known, evaluation method of diagnostic tests in Wilson disease. In order to find the most interesting classification models various data mining techniques were applied to real, suffering from Wilson disease, set of patients. It occurred that a combination of two classification algorithms with its implementations in Weka environment may significantly increase classification ability.

  2. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.

  3. Role of CSF-CRP as a bedside diagnostic test in children with meningitis.

    OpenAIRE

    Piyush Sadat; Snehal Patel; Kruti Shah

    2013-01-01

    Meningitis is a formidable illness with high mortality and morbidity in India. Delay in distinguishing pyogenic meningitis from tuberculous and viral meningitis and delay in starting therapy on one hand and irrational use of antibiotics on the other hand may have irrevocable consequences, so, early diagnosis and appropriate treatment of pyogenic meningitis is very vital to prevent permanent neurological deficits. Detection of C-reative protein in CSF is a bed side rapid diagnostic test to dis...

  4. Performance of Rapid Diagnostic Tests for Plasmodium ovale Malaria in Japanese Travellers

    OpenAIRE

    Tanizaki, Ryutaro; Kato, Yasuyuki; Iwagami, Moritoshi; Kutsuna, Satoshi; Ujiie, Mugen; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Kano, Shigeyuki; Ohmagari, Norio

    2014-01-01

    Background: Rapid diagnostic tests (RDTs) are used widely in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has been described in many previous studies, the low performance of RDT particularly for Plasmodium ovale malaria in traveller has rarely been reported. Methods: This was a retrospective cohort study conducted on Japanese travellers diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. The diagnosis of ...

  5. Experimental comparison of three nondestructive testing diagnostics on pigments and ligands

    Science.gov (United States)

    Giardini-Guidoni, Anna; Vendittelli, M.; Flamini, Chiari; Fantoni, Roberta; Sciuti, S.; Mele, Aldo

    2000-02-01

    Three non destructive testing techniques x-ray fluorescence spectroscopy, laser induced fluorescence and fast luminescence imaging by an intensified charge coupled device have been applied to analyze a few most common painting materials, namely natural and synthetic pigments and resins. A comparison of the experimental results obtained shows the applicability of these three methods and to observe and study an entire oil painting by a mobile station for 'in situ' diagnostics for restoration and conservation.

  6. How Much Do Our Incoming First Year Students Know?: Diagnostic Testing in Mathematics at Third Level

    OpenAIRE

    Blathnaid Sheridan

    2013-01-01

    A continuing cause for concern in higher education institutions is the poor core mathematical skills of incoming students. Many institutions now offer mathematics support services such as drop-in centres, online resources and short ‘refresher courses’ in an attempt to alleviate the problem. The majority of third level institutions in Ireland and internationally now make use of diagnostic testing of incoming first year students that both predict subsequent success and select groups for remedia...

  7. Clinical Performance of an Automated Reader in Interpreting Malaria Rapid Diagnostic Tests in Tanzania.

    OpenAIRE

    Shekalaghe, Seif; Cancino, Marcela; Mavere, Caroline; Juma, Omar; Mohammed, Ali; Abdulla, Salim; Ferro, Santiago

    2013-01-01

    Background Parasitological confirmation of malaria is now recommended in all febrile patients by the World Health Organization (WHO) to reduce inappropriate use of anti-malarial drugs. Widespread implementation of rapid diagnostic tests (RDTs) is regarded as an effective strategy to achieve this goal. However, the quality of diagnosis provided by RDTs in remote rural dispensaries and health centres is not ideal. Feasible RDT quality control programmes in these settings are challenging. Collec...

  8. Novel approach for assessing performance of PCR cyclers used for diagnostic testing

    DEFF Research Database (Denmark)

    Schoder, D.; Schmalwieser, A.; Schauberger, G.;

    2005-01-01

    As part of a large international project for validation and standardization of PCR, the influence of thermocyclers on PCR was tested. Six brand-new, Peltier technology-driven 96-well thermocyclers were subjected to a novel and stringent in-tube (not block) physical testing. The temperature was di...... for laboratories using diagnostic PCR testing.......As part of a large international project for validation and standardization of PCR, the influence of thermocyclers on PCR was tested. Six brand-new, Peltier technology-driven 96-well thermocyclers were subjected to a novel and stringent in-tube (not block) physical testing. The temperature...... was directly monitored in PCR tubes containing 50 mu l of distilled water at 13 different block positions. The certified temperature accuracy of the measurement system was +/- 0.3 degrees C. Finally, the results of the physical testing were compared to those of an amplification efficiency study running an in...

  9. Diagnostic utility of the glucagon stimulation test in comparison to the insulin tolerance test in patients following pituitary surgery

    DEFF Research Database (Denmark)

    Berg, Christian; Meinel, Timo; Lahner, Harald;

    2009-01-01

    OBJECTIVE: The glucagon stimulation test (GST) like the insulin tolerance test (ITT) stimulates both ACTH and GH secretion. However, there are limited data with modern assays on sensitivity and specificity for GST in comparison to ITT. The aim of this study was to evaluate the diagnostic utility......). Receiver-operating characteristic (ROC) analysis was performed to identify the thresholds for GST. RESULTS: In ITT, 18/49 cases were classified as AI. ROC analysis revealed a peak cortisol value >599 nmol/l in GST for adrenal sufficiency with 100% specificity and 32% sensitivity, and a peak cortisol ... alternative test for the assessment of GH reserve, but is a poor test for ACTH reserve. Test-specific cut-offs should be applied to avoid misinterpretation....

  10. Planning for Plume Diagnostics for Ground Testing of J-2X Engines at the SSC

    Science.gov (United States)

    SaintCyr, William W.; Tejwani, Gopal D.; McVay, Gregory P.; Langford, Lester A.; SaintCyr, William W.

    2010-01-01

    John C. Stennis Space Center (SSC) is the premier test facility for liquid rocket engine development and certification for the National Aeronautics and Space Administration (NASA). Therefore, it is no surprise that the SSC will play the most prominent role in the engine development testing and certification for the J-2X engine. The Pratt & Whitney Rocketdyne J-2X engine has been selected by the Constellation Program to power the Ares I Upper Stage Element and the Ares V Earth Departure Stage in NASA s strategy of risk mitigation for hardware development by building on the Apollo program and other lessons learned to deliver a human-rated engine that is on an aggressive development schedule, with first demonstration flight in 2010 and human test flights in 2012. Accordingly, J-2X engine design, development, test, and evaluation is to build upon heritage hardware and apply valuable experience gained from past development and testing efforts. In order to leverage SSC s successful and innovative expertise in the plume diagnostics for the space shuttle main engine (SSME) health monitoring,1-10 this paper will present a blueprint for plume diagnostics for various proposed ground testing activities for J-2X at SSC. Complete description of the SSC s test facilities, supporting infrastructure, and test facilities is available in Ref. 11. The A-1 Test Stand is currently being prepared for testing the J-2X engine at sea level conditions. The A-2 Test Stand is currently being used for testing the SSME and may also be used for testing the J-2X engine at sea level conditions in the future. Very recently, ground-breaking ceremony for the new A-3 rocket engine test stand took place at SSC on August 23, 2007. A-3 is the first large - scale test stand to be built at the SSC since the A and B stands were constructed in the 1960s. The A-3 Test Stand will be used for testing J-2X engines under vacuum conditions simulating high altitude operation at approximately 30,480 m (100,000 ft

  11. Personality Assessment in the Diagnostic Manuals: On Mindfulness, Multiple Methods, and Test Score Discontinuities.

    Science.gov (United States)

    Bornstein, Robert F

    2015-01-01

    Recent controversies have illuminated the strengths and limitations of different frameworks for conceptualizing personality pathology (e.g., trait perspectives, categorical models), and stimulated debate regarding how best to diagnose personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), and in other diagnostic systems (i.e., the International Classification of Diseases, the Psychodynamic Diagnostic Manual). In this article I argue that regardless of how PDs are conceptualized and which diagnostic system is employed, multimethod assessment must play a central role in PD diagnosis. By complementing self-reports with evidence from other domains (e.g., performance-based tests), a broader range of psychological processes are engaged in the patient, and the impact of self-perception and self-presentation biases can be better understood. By providing the assessor with evidence drawn from multiple modalities, some of which provide converging patterns and some of which yield divergent results, a multimethod assessment compels the assessor to engage this evidence more deeply. The mindful processing that ensues can help minimize the deleterious impact of naturally occurring information processing bias and distortion on the part of the clinician (e.g., heuristics, attribution errors), bringing greater clarity to the synthesis and integration of assessment data.

  12. Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: Assessment of the additional diagnostic value of contrast-enhanced ultrasound in the non-cirrhotic liver

    Energy Technology Data Exchange (ETDEWEB)

    Quaia, Emilio, E-mail: quaia@units.it; De Paoli, Luca; Angileri, Roberta; Cabibbo, Biagio; Cova, Maria Assunta

    2014-03-15

    Objective: To assess the additional diagnostic value of contrast-enhanced ultrasound (CEUS) in the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography (CT). Methods: Fifty-five solid hepatic lesions (1–4 cm in diameter) in 46 non-cirrhotic patients (26 female, 20 male; age ± SD, 55 ± 10 years) underwent CEUS after being detected on contrast-enhanced CT which was considered as non-diagnostic after on-site analysis. Two blinded independent readers assessed CT and CEUS scans and were asked to classify retrospectively each lesion as a malignant or benign based on reference diagnostic criteria for the different hepatic lesion histotypes. Diagnostic accuracy and confidence (area – A{sub z} – under ROC curve) were assessed by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging (n = 30 lesions), histology (n = 7 lesions), or US follow-up (n = 18 lesions) as the reference standards. Results: Final diagnoses included 29 hemangiomas, 3 focal nodular hyperplasias, 1 hepatocellular adenoma, and 22 metastases. The additional review of CEUS after CT images improved significantly (P < .05) the diagnostic accuracy (before vs after CEUS review = 49% [20/55] vs 89% [49/55] – reader 1 and 43% [24/55] vs 92% [51/55] – reader 2) and confidence (A{sub z}, 95% Confidence Intervals before vs after CEUS review = .773 [.652–.895] vs .997 [.987–1] – reader 1 and .831 [.724–.938] vs .998 [.992–1] – reader 2). Conclusions: CEUS improved the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced CT by identifying some specific contrast enhancement patterns.

  13. ROLE OF MODERN IMMUNOLOGIC TESTS IN DIAGNOSTICS OF TUBERCULOSIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    P. K. Iablonskiy

    2013-01-01

    Full Text Available Present study has revealed low diagnostic value of Mantoux test with 2 TE in detection of tuberculosis in MBT-infected children, thus requiring implementation of novel methods. Detectable activity of tuberculosis infection among observed children with low tuberculin sensitivity was found in 23.8% of cases, as revealed by Diaskin test, as compared to 42.7% cases in a group with moderate sensitivity to tuberculin. As shown by radiological data it was accompanied by enlargement of intrathoracic lymphatic nodes in 14.3% and 53.0% cases, respectively. The data obtained with Diaskin probe were confirmed by a reference QuantiFERON testing in 95% cases. Parameters of diagnostic value for Diaskin test are two-fold higher than for Mantoux test with 2 TE. Positivity for Diaskin test reflects activity of tuberculosis infection which is accompanied by clear clinical signs in 67.3% cases, and, in 80% cases, it ischaracterized by enlargement of intrathoracic lymphatic nodes as based on radiologic data, thus arranging a risk group for tuberculosis morbidity in children. Appropriate recommendations for these patients include a fullscale phthisiatric assessment and administration of well justified and adequate therapy.

  14. Diagnostic accuracy and optimal use of three tests for tuberculosis in live badgers.

    Directory of Open Access Journals (Sweden)

    Julian A Drewe

    Full Text Available BACKGROUND: Accurate diagnosis of tuberculosis (TB due to infection with Mycobacterium bovis is notoriously difficult in live animals, yet important if we are to understand the epidemiology of TB and devise effective strategies to limit its spread. Currently available tests for diagnosing TB in live Eurasian badgers (Meles meles remain unvalidated against a reliable gold standard. The aim of the present study was to evaluate the diagnostic accuracy and optimal use of three tests for TB in badgers in the absence of a gold standard. METHODOLOGY/PRINCIPAL FINDINGS: A Bayesian approach was used to evaluate the diagnostic accuracy and optimal use of mycobacterial culture, gamma-interferon assay and a commercially available serological test using multiple samples collected from 305 live wild badgers. Although no single test was judged to be sufficiently sensitive and specific to be used as a sole diagnostic method, selective combined use of the three tests allowed guidelines to be formulated that allow a diagnosis to be made for individual animals with an estimated overall accuracy of 93% (range: 75% to 97%. Employing this approach in the study population of badgers resulted in approximately 13 out of 14 animals having their true infection status correctly classified from samples collected on a single capture. CONCLUSIONS/SIGNIFICANCE: This method of interpretation represents a marked improvement on the current procedure for diagnosing M. bovis infection in live badgers. The results should be of use to inform future test and intervention strategies with the aim of reducing the incidence of TB in free-living wild badger populations.

  15. Acceptance test report: Field test of mixer pump for 241-AN-107 caustic addition project

    International Nuclear Information System (INIS)

    The field acceptance test of a 75 HP mixer pump (Hazleton serial number N-20801) installed in Tank 241-AN-107 was conducted from October 1995 thru February 1996. The objectives defined in the acceptance test were successfully met, with two exceptions recorded. The acceptance test encompassed field verification of mixer pump turntable rotation set-up and operation, verification that the pump instrumentation functions within established limits, facilitation of baseline data collection from the mixer pump mounted ultrasonic instrumentation, verification of mixer pump water flush system operation and validation of a procedure for its operation, and several brief test runs (bump) of the mixer pump

  16. Diagnostic Efficacy of Modified Coagglutination Test in the Diagnosis of Human Brucellosis

    Directory of Open Access Journals (Sweden)

    Mohite S.T

    2013-07-01

    Full Text Available Background: Laboratory help is must for thediagnosis of human brucellosis due to proteanclinical manifestations. As culture is hazardous,time consuming and less sensitive, serologicaltests are preferred for the diagnosis. Aggluti-nation tests like Rose Bengal PlateTest (RBPT, Serum Agglutination tests (SAT,2-Mercaptoethanol test (2-ME that are com-monly employed for the diagnosis either lacksensitivity or specificity. Coombs test andBrucellacapt though are sensitive and specific,workout costly. Therefore, modifiedcoagglutination test was developed and its di-agnostic efficacy was evaluated. Aims and Ob-jectives: To develop modified coagglutinationtest for the diagnosis of human brucellosis andcompare it with Coombs test. Materials andMethods: Serum samples collected from 191brucellosis patients and 100 controls were sub-jected to 2-ME, Coombs test and modifiedcoagglutination test (MCOAG. Blood culturewas performed by Castaneda’s method in all thepatients. Results: Significant difference in thepositivity rate was seen between MCOAG and2-ME. The results of MCOAG were compa-rable with Coombs test. Conclusions: Modi-fied coagglutination test is a better option toCoombs test for the serodiagnosis of brucel-losis in resource constrained countries as it issensitive, specific and cost effective.

  17. Clinical applicability of various dengue diagnostic tests in resource-limited endemic settings

    OpenAIRE

    Baijayantimala Mishra; Gupta, Puneet K.; Vandana Dhiman; Sujit K Pujhari; Mirnalini Sharma; Radha K Ratho

    2014-01-01

    Introduction: Dengue is one of the most important arboviral infections caused by one of the four dengue serotypes, 1-4. Objective: To study the applicability of different diagnostic methods in diagnosis of dengue viral infection. Materials and Methods: A total of 2101 blood samples were collected for confirmation of dengue viral infection. All the samples were tested by dengue-specific IgM ELISA, of which 111 were also tested for NS1 antigen detection and 27 acute samples (≤5 days) were furth...

  18. A Pull-in Based Test Mechanism for Device Diagnostic and Process Characterization

    Directory of Open Access Journals (Sweden)

    L. A. Rocha

    2008-01-01

    Full Text Available A test technique for capacitive MEMS accelerometers and electrostatic microactuators, based on the measurement of pull-in voltages and resonance frequency, is described. Using this combination of measurements, one can estimate process-induced variations in the device layout dimensions as well as deviations from nominal value in material properties, which can be used either for testing or device diagnostics purposes. Measurements performed on fabricated devices confirm that the 250 nm overetch observed on SEM images can be correctly estimated using the proposed technique.

  19. Prenatal diagnostic testing of the Noonan syndrome genes in fetuses with abnormal ultrasound findings

    OpenAIRE

    Croonen, Ellen A; Nillesen, Willy M.; Stuurman, Kyra E; Oudesluijs, Gretel; van de Laar, Ingrid M B M; Martens, Liesbeth; Ockeloen, Charlotte; Mathijssen, Inge B.; Schepens, Marga; Ruiterkamp-Versteeg, Martina; Scheffer, Hans; Faas, Brigitte H. W.; Van Der Burgt, Ineke; Helger G Yntema

    2013-01-01

    In recent studies on prenatal testing for Noonan syndrome (NS) in fetuses with an increased nuchal translucency (NT) and a normal karyotype, mutations have been reported in 9–16% of cases. In this study, DNA of 75 fetuses with a normal karyotype and abnormal ultrasound findings was tested in a diagnostic setting for mutations in (a subset of) the four most commonly mutated NS genes. A de novo mutation in either PTPN11, KRAS or RAF1 was detected in 13 fetuses (17.3%). Ultrasound findings were ...

  20. 30 CFR 75.151 - Tests for methane; qualified person; additional requirement.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tests for methane; qualified person; additional... Certified Persons § 75.151 Tests for methane; qualified person; additional requirement. Notwithstanding the... methane unless he demonstrates to the satisfaction of an authorized representative of the Secretary...

  1. The effects of additive outliers on tests for unit roots and cointegration

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); N. Haldrup (Niels)

    1994-01-01

    textabstractThe properties of the univariate Dickey-Fuller test and the Johansen test for the cointegrating rank when there exist additive outlying observations in the time series are examined. The analysis provides analytical as well as numerical evidence that additive outliers may produce spurious

  2. Culture-independent diagnostic testing: have we opened Pandora's box for good?

    Science.gov (United States)

    Janda, J Michael; Abbott, Sharon A

    2014-11-01

    The ability to accurately and quickly identify microbial agents associated with infectious diseases has been a longstanding and continuous goal of diagnostic microbiology laboratories. Over the course of several decades, technology and testing methodologies in this field have gradually evolved from traditional- or classic-based culture and identification approaches to antigen capture systems and more molecular-oriented applications. Recently, these molecular-based applications have signaled a new era in clinical diagnostic microbiology with the commercial introduction of culture-independent diagnostic testing (CIDT) systems. The first major commercial venture into the CIDT arena involves the detection of acute bacterial gastroenteritis. Several commercial products are now on the market globally with at least 4 Food and Drug Administration approved since January of 2013. These new systems offer the direct detection of a variety of enteropathogens quickly without the need for traditional culture. In Greek mythology, Pandora opened a "jar" or "box" out of curiosity thereby releasing all of humanity's evils most notably diseases and plagues according to Hesiod's Theogony. While not ill-intentioned the only thing left in the box was Hope. PMID:25200256

  3. Epidemiology of meningitis with a negative CSF Gram stain: under-utilization of available diagnostic tests.

    Science.gov (United States)

    Nesher, L; Hadi, C M; Salazar, L; Wootton, S H; Garey, K W; Lasco, T; Luce, A M; Hasbun, R

    2016-01-01

    Meningitis with a negative cerebrospinal fluid Gram stain (CSF-GS) poses a diagnostic challenge as more than 50% of patients remain without an aetiology. The introduction of polymerase chain reaction (PCR) and arboviral serologies have increased diagnostic capabilities, yet large scale epidemiological studies evaluating their use in clinical practice are lacking. We conducted a prospective observational study in New Orleans between November 1999 and September 2008 (early era) when PCR was not widely available, and in Houston between November 2008 and June 2013 (modern era), when PCR was commonly used. Patients presenting with meningitis and negative CSF-GS were followed for 4 weeks. All investigations, PCR used, and results were recorded as they became available. In 323 patients enrolled, PCR provided the highest diagnostic yield (24·2%) but was ordered for 128 (39·6%) patients; followed by serology for arboviruses (15%) that was ordered for 100 (31%) of all patients. The yield of blood cultures was (10·3%) and that of CSF cultures was 4%; the yield for all other tests was viral pathogens, 8·3% and 26·3% (P meningitis and a negative CSF-GS, but both tests are being under-utilized.

  4. Diagnostic tests for the detection of human papillomavirus-associated cervical lesions.

    Science.gov (United States)

    Reuschenbach, Miriam; von Knebel Doeberitz, Magnus

    2013-01-01

    Current diagnostic approaches for primary cervical cancer screening, work-up of equivocal or positive screening results or follow- up after treatment of precancerous lesions primarily rely on the morphologic interpretation of squamous epithelial cells (Pap cytology), in some setting accompanied by the detection of human papillomavirus DNA and have largely contributed to remarkable reduction of disease incidence in countries with implemented screening programs. However, these approaches are limited by a poor sensitivity and reproducibility of Pap cytology and low specificity for high grade cervical intraepithelial neoplasia of HPV DNA detection assays. Early detection might be improved by complementing or even replacing these tests by markers which are more directly related to molecular events triggering HPV-induced carcinogenesis and thereby might deliver more accurate diagnostic performance. The delineation of molecular changes which occur during different stages of HPV infections and the identification of changes which induce neoplastic alterations allow for the detection of markers that specifically highlight the transforming stage of the infection where viral oncogenes are overexpressed and therefore allow for a more specific diagnosis of lesions that require treatment. The evaluation of such markers in clinical studies revealed that some indeed show an improved diagnostic performance compared to Pap cytology or HPV DNA tests only.

  5. A four-step approach for developing diagnostic tests in psychiatry.

    Science.gov (United States)

    Boutros, N N; Arfken, C L

    2007-04-01

    A four-step approach for developing diagnostic tests in psychiatry is proposed. Step 1, a biological variable is observed to be deviant from healthy controls in a particular patient population. The demonstration of test retest reliability of the finding using blinding procedures is an essential component of this early step. Step 2, is the demonstration of potential clinical usefulness of the specific finding. The two most important objectives at this step are demonstration of difference between the target patient population and appropriate control groups (these should be groups of patients with diagnoses that commonly appear on the differential diagnostic lists of the target disorder). Estimation of the effect size of the finding could be a reasonable guide to which findings should be considered good candidates for Step 3 studies. During Step 3 the performance characteristics of the test should be established. Specifically, the sensitivity, specificity, positive and negative predictive values of the biological marker should be examined. Step 4 defines the clinical application of the test and helps standardize the technique used in large and multicenter clinical trials. Multicenter trials should pave the road towards standardization of laboratory procedures used to conduct the test, as well as providing data regarding cost effectiveness and impact on both short-term and long-term clinical outcomes.

  6. Diagnostic efficacy of biophysical tests and cerebral-umbilical index when assessing fetal oxygenation

    Directory of Open Access Journals (Sweden)

    Čančarević-Đajić Branka

    2013-01-01

    Full Text Available Introduction. Perinatal morbidity and mortality are the ultimate indicators of antenatal care today, whose responsible task is to assess the respiratory function of the placenta, fetal growth and placental maturation in order to provide conditions for the delivery of a living and viable newborn. The diagnostic procedures of antenatal care tested within this study were the biophysical tests of cardiotocography and the fetal biophysical profile, along with the colour doppler evaluation of the cerebral-umbilical ratio. The objective of this study was to determine the most effective diagnostic procedure when assessing fetal oxygenation. Materials and Methods. The prospective study included 119 pregnant women. They all underwent cardiotocography, biophysical profile and colour doppler evaluation of the cerebral-umbilical ratio. The babies’ umbilical artery blood pH was determined in the first minute upon birth, along with the Apgar score. Results. The results were processed statistically and the most effective diagnostic procedure for the evaluation of fetal oxygenation was selected, after which the rates of perinatal morbidity and mortality were calculated. The findings revealed that cardiotocography was the most sensitive antepartal predictor of fetal acidosis, while the fetal biophysical profile proved the most specific. The rates of perinatal morbidity and of perinatal mortality were 24.37% and 1.68%, respectively. Conclusion. The findings analysis revealed a high statistical significance of both biophysical tests and the cerebral-umbilical ratio evaluation as predictors of the fetal distress syndrome. The analysis of the cerebral-umbilical ratio and biophysical tests showed that the cerebral-umbilical ratio evaluation not only was more sensitive as a parameter compared to biophysical tests but it was also more specific than cardiotocography. Cardiotocography is the most sensitive antepartal predictor of fetal acidosis, followed by the cerebral

  7. Supervisory control and diagnostics system for the mirror fusion test facility: overview and status 1980

    International Nuclear Information System (INIS)

    The Mirror Fusion Test Facility (MFTF) is a complex facility requiring a highly-computerized Supervisory Control and Diagnostics System (SCDS) to monitor and provide control over ten subsystems; three of which require true process control. SCDS will provide physicists with a method of studying machine and plasma behavior by acquiring and processing up to four megabytes of plasma diagnostic information every five minutes. A high degree of availability and throughput is provided by a distributed computer system (nine 32-bit minicomputers on shared memory). Data, distributed across SCDS, is managed by a high-bandwidth Distributed Database Management System. The MFTF operators' control room consoles use color television monitors with touch sensitive screens; this is a totally new approach. The method of handling deviations to normal machine operation and how the operator should be notified and assisted in the resolution of problems has been studied and a system designed

  8. Meta-analysis of diagnostic tests accounting for disease prevalence: a new model using trivariate copulas.

    Science.gov (United States)

    Hoyer, A; Kuss, O

    2015-05-20

    In real life and somewhat contrary to biostatistical textbook knowledge, sensitivity and specificity (and not only predictive values) of diagnostic tests can vary with the underlying prevalence of disease. In meta-analysis of diagnostic studies, accounting for this fact naturally leads to a trivariate expansion of the traditional bivariate logistic regression model with random study effects. In this paper, a new model is proposed using trivariate copulas and beta-binomial marginal distributions for sensitivity, specificity, and prevalence as an expansion of the bivariate model. Two different copulas are used, the trivariate Gaussian copula and a trivariate vine copula based on the bivariate Plackett copula. This model has a closed-form likelihood, so standard software (e.g., SAS PROC NLMIXED) can be used. The results of a simulation study have shown that the copula models perform at least as good but frequently better than the standard model. The methods are illustrated by two examples. PMID:25712874

  9. Meta-analysis of diagnostic tests accounting for disease prevalence: a new model using trivariate copulas.

    Science.gov (United States)

    Hoyer, A; Kuss, O

    2015-05-20

    In real life and somewhat contrary to biostatistical textbook knowledge, sensitivity and specificity (and not only predictive values) of diagnostic tests can vary with the underlying prevalence of disease. In meta-analysis of diagnostic studies, accounting for this fact naturally leads to a trivariate expansion of the traditional bivariate logistic regression model with random study effects. In this paper, a new model is proposed using trivariate copulas and beta-binomial marginal distributions for sensitivity, specificity, and prevalence as an expansion of the bivariate model. Two different copulas are used, the trivariate Gaussian copula and a trivariate vine copula based on the bivariate Plackett copula. This model has a closed-form likelihood, so standard software (e.g., SAS PROC NLMIXED) can be used. The results of a simulation study have shown that the copula models perform at least as good but frequently better than the standard model. The methods are illustrated by two examples.

  10. The Impact of Time-Series Diagnostic Tests on the Writing Ability of Iranian EFL learners

    Directory of Open Access Journals (Sweden)

    Bahareh Molazem Atashgahi

    2014-02-01

    Full Text Available This study aimed to show whether administering a battery of time-series diagnostic tests (screening has any impact on Iranian EFL learners’ writing ability. The study was conducted on the intermediate EFL learners at Islamic Azad University North Tehran branch.  The researcher administered a homogenizing test in order to exclude the exceptional scores, among all the testers, only those whose scores were nearly within one standard deviation above or below the mean were selected as the participants of this study. After the assignment of the participants to the control and experimental groups- 30 students in each group- they were asked to write five-paragraph-essays on two topics. Such a pretest was given to both groups to test their initial writing ability. Once scoring of the students’ writings (five- paragraph essay was finished the two means of the groups were calculated and compared with each other through the t-test analysis. The result demonstrated that there was no statistically significant difference between those two groups regarding the variable under investigation. Four sets of diagnostic tests were given to the experimental group every two weeks and after each test both the result of the exam and suitable feedback regarding students’ errors were given to them by the teacher, while the Current-Traditional Rhetoric method was administered in the control group.In the posttest which was run after giving the treatment and placebo to experimental group and control group respectively, students took another writing test with the same characteristics in administration, topics and scoring as the one in pretest. Thereafter, the significance of the difference between the obtained means of experimental and control groups in the posttest was determined through the t-test.  The result of the t-test analysis indicated a significant difference between the two groups which consequently rejected the null hypothesis of the study.Therefore, any

  11. Generalized requirements and decompositions for the design of test parts for micro additive manufacturing research

    OpenAIRE

    Thompson, Mary Kathryn; Clemmensen, Line Katrine Harder

    2015-01-01

    The design of experimental test parts to characterize micro additive manufacturing (AM) processes is challenging due to the influence of the manufacturing and metrology processes. This work builds on the lessons learned from a case study in the literature to derive generalized requirements and high level decompositions for the design of test parts and the design of experiments to characterize micro additive manufacturing processes. While the test parts and the experiments described are still ...

  12. The modified ultrasound pattern sum score mUPSS as additional diagnostic tool for genetically distinct hereditary neuropathies.

    Science.gov (United States)

    Grimm, Alexander; Rasenack, Maria; Athanasopoulou, Ioanna M; Dammeier, Nele Maria; Lipski, Christina; Wolking, Stefan; Vittore, Debora; Décard, Bernhard F; Axer, Hubertus

    2016-02-01

    The objective of this study is to evaluate the nerve ultrasound characteristics in genetically distinct inherited neuropathies, the value of the modified ultrasound pattern sum score (mUPSS) to differentiate between the subtypes and the correlation of ultrasound with nerve conduction studies (NCS), disease duration and severity. All patients underwent a standardized neurological examination, ultrasound, and NCS. In addition, genetic testing was performed. Consequently, mUPSS was applied, which is a sum-score of cross-sectional areas (CSA) at predefined anatomical points in different nerves. 31 patients were included (10xCharcot-Marie-Tooth (CMT)1a, 3xCMT1b, 3xCMTX, 9xCMT2, 6xHNPP [Hereditary neuropathy with liability to pressure palsies]). Generalized, homogeneous nerve enlargement and significantly increased UPS scores emphasized the diagnosis of demyelinating neuropathy, particularly CMT1a and CMT1b. The amount of enlargement did not depend on disease duration, symptom severity, height and weight. In CMTX the nerves were enlarged, as well, however, only in the roots and lower limbs, most prominent in men. In CMT2 no significant enlargement was detectable. In HNPP the CSA values were increased at entrapped sites, and not elsewhere. However, a distinction from CMT1, which also showed enlarged CSA values at entrapment sites, was only possible by calculating the entrapment ratios and entrapment score. The mUPSS allowed distinction between CMT1a (increased UPS scores, entrapment ratios 1.4), while CMT1b and CMTX showed intermediate UPS types and entrapment ratios neuropathies. The modified UPSS is a quantitative tool, which may provide useful information for diagnosis, differentiation and follow-up evaluation in addition to NCS and molecular testing.

  13. Malaria rapid diagnostic test transport and storage conditions in Burkina Faso, Senegal, Ethiopia and the Philippines

    Directory of Open Access Journals (Sweden)

    Albertini Audrey

    2012-12-01

    Full Text Available Abstract Background As more point of care diagnostics become available, the need to transport and store perishable medical commodities to remote locations increases. As with other diagnostics, malaria rapid diagnostic tests (RDTs must be highly reliable at point of use, but exposure to adverse environmental conditions during distribution has the potential to degrade tests and accuracy. In remote locations, poor quality diagnostics and drugs may have significant negative health impact that is not readily detectable by routine monitoring. This study assessed temperature and humidity throughout supply chains used to transport and store health commodities, such as RDTs. Methods Monitoring devices capable of recording temperature and humidity were deployed to Burkina Faso (8, Senegal (10, Ethiopia (13 and the Philippines (6 over a 13-month period. The devices travelled through government supply chains, usually alongside RDTs, to health facilities where RDTs are stored, distributed and used. The recording period spanned just over a year, in order to avoid any biases related to seasonal temperature variations. Results In the four countries, storage and transport temperatures regularly exceeded 30.0°C; maximum humidity level recorded was above 94% for the four countries. In three of the four countries, temperatures recorded at central storage facilities exceeded pharmaceutical storage standards for over 20% of the time, in another case for a majority of the time; and sometimes exceeded storage temperatures at peripheral sites. Conclusions Malaria RDTs were regularly exposed to temperatures above recommended limits for many commercially-available RDTs and other medical commodities such as drugs, but rarely exceeded the recommended storage limits for particular products in use in these countries. The results underline the need to select RDTs, and other commodities, according to expected field conditions, actively manage the environmental conditions in

  14. Field evaluation of a rapid diagnostic test (Parascreen™ for malaria diagnosis in the Peruvian Amazon

    Directory of Open Access Journals (Sweden)

    Rodriguez Hugo

    2010-06-01

    Full Text Available Abstract Background The rapid diagnostic tests for malaria (RDT constitute a fast and opportune alternative for non-complicated malaria diagnosis in areas where microscopy is not available. The objective of this study was to validate a RDT named Parascreen™ under field conditions in Iquitos, department of Loreto, Peru. Parascreen™ is a RDT that detects the histidine-rich protein 2 (HRP2 antigen from Plasmodium falciparum and lactate deshydrogenase from all Plasmodium species. Methods Parascreen™ was compared with microscopy performed by experts (EM and polymerase chain reaction (PCR using the following indicators: sensitivity (Se, specificity (Sp, positive (PV+ and negative predictive values (PV-, positive (LR+ and negative likehood ratio (LR-. Results 332 patients with suspected non-complicated malaria who attended to the MOH health centres were enrolled between October and December 2006. For P. falciparum malaria, Parascreen™ in comparison with EM, had Se: 53.5%, Sp: 98.7%, PV+: 66.7%, PV-: 97.8%, LR+: 42.27 and LR-: 0.47; and for non-P. falciparum malaria, Se: 77.1%, Sp: 97.6%, PV+: 91.4%, PV-: 92.7%, LR+: 32.0 and LR-: 0.22. The comparison of Parascreen™ with PCR showed, for P. falciparum malaria, Se: 81.8%, Sp: 99.1%, PV+: 75%, PV-: 99.4, LR+: 87.27 and LR-: 0.18; and for non-P. falciparum malaria Se: 76.1%, Sp: 99.2%, PV+: 97.1%, PV-: 92.0%, LR+: 92.51 and LR-: 0.24. Conclusions The study results indicate that Parascreen™ is not a valid and acceptable test for malaria diagnosis under the field conditions found in the Peruvian Amazon. The relative proportion of Plasmodium species, in addition to the genetic characteristics of the parasites in the area, must be considered before applying any RDT, especially after the finding of P. falciparum malaria parasites lacking pfhrp2 gene in this region.

  15. Comparison of diagnostic accuracy of non invasive tests for helicobacter pylori infection in children

    International Nuclear Information System (INIS)

    To compare urea breath and stool antigen in children, with histological diagnosis for Helicobacter pylori (H.pylori) infection. Children between 3 and 15 years of age reporting in pediatric outpatient department with upper gastrointestinal symptoms were included. All the participating children underwent an upper gastrointestinal endoscopy and 3 tests namely: histopathological identification of H. pylori (the traditional gold standard), urea breath test and stool antigen test were carried out on each child. The sensitivity, specificity, and positive predictive values were calculated for each noninvasive test used in the study. A total of 54 patients completed the study with a mean age of 8.2 years. On histological examination, 72% (39) were positive for H. pylori infection. On gross endoscopic examination, only 9 patients had signs of gastritis as compared to 39 histological positives. The sensitivity, specificity and positive predictive value of stool antigen test were: 77%, 73% and 89% respectively whereas the same for urea breath test were: 79%, 80% and 91% respectively. Both the noninvasive tests were found to be sensitive and specific as compared with histological identification, for the diagnosis of H. pylori in our pediatric population. The accuracy of urea breath test was better than the stool antigen test but later was easier to perform and could fulfill the criteria for a rapid bedside diagnostic test. (author)

  16. Diagnostic tests in Raynaud's phenomena in workers exposed to vibration: a comparative study

    DEFF Research Database (Denmark)

    Olsen, N

    1988-01-01

    greater than 0.20). The results indicate that a finger colour test may be as valuable as a FSP(0) test for diagnostic purposes. FSP(A) only indicates if a cold response is exaggerated and does not diagnose RP. The pressure measurements may further be of guidance in evaluating preventive measures......Four objective tests to evaluate Raynaud's phenomena (RP) in workers exposed to handarm vibrations were applied on 23 exposed men with RP (vibration induced white finger 18, primary Raynaud's phenomenon 5), 56 exposed men without RP, and 15 male controls. Finger systolic blood pressure was measured...... by a cuff and strain gauge technique after combined body cooling and finger cooling during five minute ischaemia to 30 degrees, 15 degrees, and 6 degrees C. An attack of RP was detected as a zero pressure, FSP(0) test, whereas a pressure, reduced to a value below the normal 95% confidence limit at 6 degrees...

  17. The Relationship between Students' Reading Performance on Diagnostic Assessments and the Third Grade Reading Achievement Test in Ohio

    Science.gov (United States)

    Hollinger, Jamie L.

    2009-01-01

    The purpose of this correlational study was twofold: to examine the relationship of students' reading performance on six different diagnostic reading assessments and the third grade Ohio Reading Achievement Test; and to assist educators in choosing the diagnostic assessments that best identify students at risk of failing the third grade Ohio…

  18. A Multi-Expert Approach for Developing Testing and Diagnostic Systems Based on the Concept-Effect Model

    Science.gov (United States)

    Panjaburee, Patcharin; Hwang, Gwo-Jen; Triampo, Wannapong; Shih, Bo-Ying

    2010-01-01

    With the popularization of computer and communication technologies, researchers have attempted to develop computer-assisted testing and diagnostic systems to help students improve their learning performance on the Internet. In developing a diagnostic system for detecting students' learning problems, it is difficult for individual teachers to…

  19. Using Combined Diagnostic Test Results to Hindcast Trends of Infection from Cross-Sectional Data.

    Directory of Open Access Journals (Sweden)

    Gustaf Rydevik

    2016-07-01

    Full Text Available Infectious disease surveillance is key to limiting the consequences from infectious pathogens and maintaining animal and public health. Following the detection of a disease outbreak, a response in proportion to the severity of the outbreak is required. It is thus critical to obtain accurate information concerning the origin of the outbreak and its forward trajectory. However, there is often a lack of situational awareness that may lead to over- or under-reaction. There is a widening range of tests available for detecting pathogens, with typically different temporal characteristics, e.g. in terms of when peak test response occurs relative to time of exposure. We have developed a statistical framework that combines response level data from multiple diagnostic tests and is able to 'hindcast' (infer the historical trend of an infectious disease epidemic. Assuming diagnostic test data from a cross-sectional sample of individuals infected with a pathogen during an outbreak, we use a Bayesian Markov Chain Monte Carlo (MCMC approach to estimate time of exposure, and the overall epidemic trend in the population prior to the time of sampling. We evaluate the performance of this statistical framework on simulated data from epidemic trend curves and show that we can recover the parameter values of those trends. We also apply the framework to epidemic trend curves taken from two historical outbreaks: a bluetongue outbreak in cattle, and a whooping cough outbreak in humans. Together, these results show that hindcasting can estimate the time since infection for individuals and provide accurate estimates of epidemic trends, and can be used to distinguish whether an outbreak is increasing or past its peak. We conclude that if temporal characteristics of diagnostics are known, it is possible to recover epidemic trends of both human and animal pathogens from cross-sectional data collected at a single point in time.

  20. Role of CSF-CRP as a bedside diagnostic test in children with meningitis.

    Directory of Open Access Journals (Sweden)

    Piyush Sadat

    2013-01-01

    Full Text Available Meningitis is a formidable illness with high mortality and morbidity in India. Delay in distinguishing pyogenic meningitis from tuberculous and viral meningitis and delay in starting therapy on one hand and irrational use of antibiotics on the other hand may have irrevocable consequences, so, early diagnosis and appropriate treatment of pyogenic meningitis is very vital to prevent permanent neurological deficits. Detection of C-reative protein in CSF is a bed side rapid diagnostic test to distinguish pyogenic from tuberculous and viral meningitis. So, present study was undertaken to study the usefulness of c-reactive protein in CSF as a rapid diagnostic test in differentiating pyogenic from tuberculous and viral meningitis.This study was conducted at Smt Shardaben Hospital from Sept-2008 to Nov-2010. Total 150 cases admitted in paediatric department and neonates admitted to the sick nursery suspected of having meningitis were included. Samples of CSF were taken for bed side diagnostic test of CSF-CRP. The major advantage of this method is rapid two minute reaction time. Our study revealed that out of 150 cases of suspected meningitis 64 (42.66% patient were having meningitis out of which 18 (12% patients were diagnosed as pyogenic meningitis and CSF CRP was positive in 10 (55.55 % patients out of 18 pyogenic meningitis patients and CSF-CRP was negative in all other groups Applying chisquare test, correlation between CSF-CRP positivity and pyoganic meningitis was highly significant (x2 = 31(i.e.> 3.84

  1. Using Combined Diagnostic Test Results to Hindcast Trends of Infection from Cross-Sectional Data

    Science.gov (United States)

    Rydevik, Gustaf; Innocent, Giles T.; Marion, Glenn; White, Piran C. L.; Billinis, Charalambos; Barrow, Paul; Mertens, Peter P. C.; Gavier-Widén, Dolores; Hutchings, Michael R.

    2016-01-01

    Infectious disease surveillance is key to limiting the consequences from infectious pathogens and maintaining animal and public health. Following the detection of a disease outbreak, a response in proportion to the severity of the outbreak is required. It is thus critical to obtain accurate information concerning the origin of the outbreak and its forward trajectory. However, there is often a lack of situational awareness that may lead to over- or under-reaction. There is a widening range of tests available for detecting pathogens, with typically different temporal characteristics, e.g. in terms of when peak test response occurs relative to time of exposure. We have developed a statistical framework that combines response level data from multiple diagnostic tests and is able to ‘hindcast’ (infer the historical trend of) an infectious disease epidemic. Assuming diagnostic test data from a cross-sectional sample of individuals infected with a pathogen during an outbreak, we use a Bayesian Markov Chain Monte Carlo (MCMC) approach to estimate time of exposure, and the overall epidemic trend in the population prior to the time of sampling. We evaluate the performance of this statistical framework on simulated data from epidemic trend curves and show that we can recover the parameter values of those trends. We also apply the framework to epidemic trend curves taken from two historical outbreaks: a bluetongue outbreak in cattle, and a whooping cough outbreak in humans. Together, these results show that hindcasting can estimate the time since infection for individuals and provide accurate estimates of epidemic trends, and can be used to distinguish whether an outbreak is increasing or past its peak. We conclude that if temporal characteristics of diagnostics are known, it is possible to recover epidemic trends of both human and animal pathogens from cross-sectional data collected at a single point in time. PMID:27384712

  2. Comparison of diagnostic tests in distinct well-defined conditions related to dry eye disease.

    Directory of Open Access Journals (Sweden)

    Monica Alves

    Full Text Available PURPOSE: This study compares signs, symptoms and predictive tools used to diagnose dry eye disease (DED and ocular surface disorders in six systemic well-defined and non-overlapping diseases. It is well known that these tests are problematic because of a lack of agreement between them in identifying these conditions. Accordingly, we provide here a comparative clinical profile analysis of these different diseases. METHODS: A spontaneous and continuous sample of patients with Sjögren's syndrome (SS (n=27, graft-versus-host-disease (GVHD (n=28, Graves orbitopathy (n=28, facial palsy (n=8, diabetes mellitus without proliferative retinopathy (n=14 and glaucoma who chronically received topical drugs preserved with benzalkonium chloride (n=20 were enrolled. Evaluation consisted of a comprehensive protocol encompassing: (1 structured questionnaire - Ocular Surface Disease Index (OSDI; (2 tear osmolarity (TearLab Osmolarity System - Ocusense; (3 tear film break-up time (TBUT; (4 fluorescein and lissamine green staining; (5 Schirmer test and (6 severity grading. RESULTS: One hundred and twenty five patients (aged 48.8 years-old ± 14.1, male:female ratio=0.4 were enrolled in the study, along with 24 age and gender matched controls. Higher scores on DED tests were obtained in Sjögren Syndrome (P<0.05, except for tear film osmolarity that was higher in diabetics (P<0.001 and fluorescein staining, that was higher in facial palsy (P<0.001. TFBUT and OSDI correlated better with other tests. The best combination of diagnostic tests for DED was OSDI, TBUT and Schirmer test (sensitivity 100%, specificity 95% and accuracy 99.3%. CONCLUSIONS: DED diagnostic test results present a broad range of variability among different conditions. Vital stainings and TBUT correlated best with one another whereas the best test combination to detect DED was: OSDI/TBUT/Schirmer.

  3. The meaning of diagnostic test results: A spreadsheet for swift data analysis

    International Nuclear Information System (INIS)

    AIMS: To design a spreadsheet program to: (a) analyse rapidly diagnostic test result data produced in local research or reported in the literature; (b) correct reported predictive values for disease prevalence in any population; (c) estimate the post-test probability of disease in individual patients. MATERIALS AND METHODS: Microsoft ExcelTM was used. Section A: a contingency (2 x 2) table was incorporated into the spreadsheet. Formulae for standard calculations [sample size, disease prevalence, sensitivity and specificity with 95% confidence intervals, predictive values and likelihood ratios (LRs)] were linked to this table. The results change automatically when the data in the true or false negative and positive cells are changed. Section B: this estimates predictive values in any population, compensating for altered disease prevalence. Sections C-F: Bayes' theorem was incorporated to generate individual post-test probabilities. The spreadsheet generates 95% confidence intervals, LRs and a table and graph of conditional probabilities once the sensitivity and specificity of the test are entered. The latter shows the expected post-test probability of disease for any pre-test probability when a test of known sensitivity and specificity is positive or negative. RESULTS: This spreadsheet can be used on desktop and palmtop computers. The MS ExcelTM version can be downloaded via the Internet from the URL ftp://radiography.com/pub/Rad-data99.xls CONCLUSION: A spreadsheet is useful for contingency table data analysis and assessment of the clinical meaning of diagnostic test results. MacEneaney, P.M., Malone, D.E. (2000)

  4. The Value of Naproxen Test as a Diagnostic Method to Differentiate Cause of Fever

    Directory of Open Access Journals (Sweden)

    Omer Coskun

    2012-12-01

    Full Text Available Objective: Fever of whatever etiology still remains a perplexing problem to both clinicians and investigators. Increasingly, its role in connective tissue diseases, malignancies and other inflammatory disorders is slowly supplanting the exclusivity of the symptom to just infectious conditions. This study aims to determine the sensitivity of the naproxen test and the diagnostic value in patients with a prolonged febrile illness. Methods: We evaluated twenty patients had been administered the naproxen test. Fever lysis after or within the time frame of drug administration was interpreted as a infectious or an infectious condition. Results: Infectious diseases etiology was detected at 15 patients. 12 and 3 of them responded to naproxen test at the first and second days respectively. Two of non-infectious etiology patients remained unanswered. Conclusion: This study clearly showed that the naproxen test cannot be relied upon to guide diagnostic decision making in patients with fever unknown origin. [TAF Prev Med Bull 2012; 11(6.000: 779-782

  5. [Testing the electric resistance as an objective diagnostic test in dental pulp diseases].

    Science.gov (United States)

    Constantin, I; Severineanu, V; Tudose, N

    1976-01-01

    The authors test by means of a measuring device of high precision the resistence of health or sick human pulpa, comparing it to them of gums, excluding in the same time the sensibility of the patient in question. The authors corroborate the obtained dates with clinical symptomatology and the histopathological photos, discussing the possibility of objective electrical test as an expedient in the diagnosis of pulpa-affections. PMID:137616

  6. Exploring Ways to Provide Diagnostic Feedback with an ESL Placement Test: Cognitive Diagnostic Assessment of L2 Reading Ability

    Science.gov (United States)

    Kim, Ah-Young

    2015-01-01

    Previous research in cognitive diagnostic assessment (CDA) of L2 reading ability has been frequently conducted using large-scale English proficiency exams (e.g., TOEFL, MELAB). Using CDA, it is possible to analyze individual learners' strengths and weaknesses in multiple attributes (i.e., knowledge, skill, strategy) measured at the item level.…

  7. Effect of Two-Tier Diagnostic Tests on Promoting Learners' Conceptual Understanding of Variables in Conducting Scientific Experiments

    Science.gov (United States)

    Çil, Emine

    2015-01-01

    Taking a test generally improves the retention of the material tested. This is a phenomenon commonly referred to as testing effect. The present research investigated whether two-tier diagnostic tests promoted student teachers' conceptual understanding of variables in conducting scientific experiments, which is a scientific process skill. In this…

  8. Testing Diagnostics of Nuclear Activity and Star Formation in Galaxies at z>1

    CERN Document Server

    Trump, Jonathan R; Barro, Guillermo; Koo, David C; Kocevski, Dale D; Juneau, Stephanie; Weiner, Benjamin J; Faber, S M; McLean, Ian S; Yan, Renbin; Perez-Gonzalez, Pablo G; Villar, Victor

    2012-01-01

    We present some of the first science data with the new Keck/MOSFIRE instrument to test the effectiveness of different AGN/SF diagnostics at z~1.5. MOSFIRE spectra were obtained in three H-band multi-slit masks in the GOODS-S field, resulting in two hour exposures of 36 emission-line galaxies. We compare X-ray data with the traditional "BPT" line ratio diagnostics and the alternative mass-excitation and color-excitation diagrams, combining new MOSFIRE infrared data with previous HST/WFC3 infrared spectra (from the 3D-HST survey) and multiwavelength photometry. We demonstrate that a high [OIII]/\\Hb ratio is insufficient as an AGN indicator at z>1. For the four X-ray detected galaxies, the classic BPT diagnostic ([OIII]/Hb vs. [NII]/Ha and [SII]/Ha) remains consistent with X-ray AGN/SF classification. The X-ray data also suggest that "composite" galaxies (with intermediate AGN/SF classification) host bona-fide AGNs. Nearly 2/3 of the z~1.5 emission-line galaxies have nuclear activity detected by either X-rays or...

  9. Application of diagnostic tests for mycoplasmal infections of desert and gopher tortoises with management recommendations

    Science.gov (United States)

    Brown, D.R.; Schumacher, Isabella M.; Mclaughlin, Grace S.; Wendland, L.D.; Brown, Mary E.; Klein, P.A.; Jacobson, E.R.

    2002-01-01

    Mycoplasmosis is a transmissible upper respiratory tract disease that has affected plans for management and conservation of wild desert and gopher tortoises in the United States. Although impact of mycoplasmosis on populations of desert and gopher tortoises is unknown, increased prevalence of seropositive animals as well as field observations of clinically ill tortoises have occurred in association with declining populations. In order to help in the identification of potentially infected animals, three tests have been developed to diagnose mycoplasmal infections of tortoises: 1) direct mycoplasmal culture; 2) detection of mycolplasmal chromosomal DNA by polymerase chain reaction (PCR); and 3) detection of anti-Mycoplasma antibodies in tortoise plasma by enzyme-linked immunosorbent assay (ELISA). Each test provides different, complementary information that collectively can be used to define tortoise mycoplasmal infection status. The types of samples required, the predictive value, interpretation, and cost vary among tests. These assays have been used for epidemiological surveys and in decision making for relocation, repatriation, or captive management of tortoises to minimize the risk of outbreaks of mycoplasmal respiratory disease and spread of the causative agent of this disease. Certain features of mycoplasmal infections of tortoises and other animals create a diagnostic dilemma. Multiple Mycoplasma species can cause respiratory disease with identical clinical presentations. Further, individual strains of a given species may vary with respect to their virulence potential, and some species may be commensals rather than pathogens. Current diagnostic tests may not differentiate among mycoplasmal species or strains or permit determination of pathogenicity of individual isolates. Thus, the information provided by testing is not a simple 'positive' vs. 'negative' issue. While these tests provide much needed information on the exposure of tortoise populations to

  10. Optimizing odor identification testing as quick and accurate diagnostic tool for Parkinson's disease

    Science.gov (United States)

    Mahlknecht, Philipp; Pechlaner, Raimund; Boesveldt, Sanne; Volc, Dieter; Pinter, Bernardette; Reiter, Eva; Müller, Christoph; Krismer, Florian; Berendse, Henk W.; van Hilten, Jacobus J.; Wuschitz, Albert; Schimetta, Wolfgang; Högl, Birgit; Djamshidian, Atbin; Nocker, Michael; Göbel, Georg; Gasperi, Arno; Kiechl, Stefan; Willeit, Johann; Poewe, Werner

    2016-01-01

    ABSTRACT Introduction The aim of this study was to evaluate odor identification testing as a quick, cheap, and reliable tool to identify PD. Methods Odor identification with the 16‐item Sniffin' Sticks test (SS‐16) was assessed in a total of 646 PD patients and 606 controls from three European centers (A, B, and C), as well as 75 patients with atypical parkinsonism or essential tremor and in a prospective cohort of 24 patients with idiopathic rapid eye movement sleep behavior disorder (center A). Reduced odor sets most discriminative for PD were determined in a discovery cohort derived from a random split of PD patients and controls from center A using L1‐regularized logistic regression. Diagnostic accuracy was assessed in the rest of the patients/controls as validation cohorts. Results Olfactory performance was lower in PD patients compared with controls and non‐PD patients in all cohorts (each P 3 years of disease duration were excluded from analysis. All 8 incident PD cases among patients with idiopathic rapid eye movement sleep behavior disorder were predicted with the SS‐16 and the SS‐8 (sensitivity, 100%; positive predictive value, 61.5%). Conclusions Odor identification testing provides excellent diagnostic accuracy in the distinction of PD patients from controls and diagnostic mimics. A reduced set of eight odors could be used as a quick tool in the workup of patients presenting with parkinsonism and for PD risk indication. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society PMID:27159493

  11. Clinical Evaluation of Rapid Diagnostic Test Kit for Scrub Typhus with Improved Performance

    Science.gov (United States)

    2016-01-01

    Diagnosis of scrub typhus is challenging due to its more than twenty serotypes and the similar clinical symptoms with other acute febrile illnesses including leptospirosis, murine typhus and hemorrhagic fever with renal syndrome. Accuracy and rapidity of a diagnostic test to Orientia tsutsugamushi is an important step to diagnose this disease. To discriminate scrub typhus from other diseases, the improved ImmuneMed Scrub Typhus Rapid Diagnostic Test (RDT) was evaluated in Korea and Sri Lanka. The sensitivity at the base of each IgM and IgG indirect immunofluorescent assay (IFA) in Korean patients was 98.6% and 97.1%, and the specificity was 98.2% and 97.7% respectively. The sensitivity and specificity for retrospective diagnosis at the base of IFA in Sri Lanka was 92.1% and 96.1%. ImmuneMed RDT was not reactive to any serum from seventeen diseases including hemorrhagic fever with renal syndrome (n = 48), leptospirosis (n = 23), and murine typhus (n = 48). ImmuneMed RDT shows superior sensitivity (98.6% and 97.1%) compared with SD Bioline RDT (84.4% at IgM and 83.3% at IgG) in Korea. The retrospective diagnosis of ImmuneMed RDT exhibits 94.0% identity with enzyme-linked Immunosorbent assay (ELISA) using South India patient serum samples. These results suggest that this RDT can replace other diagnostic tests and is applicable for global diagnosis of scrub typhus. This rapid and accurate diagnosis will be beneficial for diagnosing and managing scrub typhus. PMID:27478327

  12. Is there a pathological alpha angle for hip impingement? A diagnostic test study.

    Science.gov (United States)

    Barrientos, Cristián; Barahona, Maximiliano; Diaz, Jorge; Brañes, Julian; Chaparro, Felipe; Hinzpeter, Jaime

    2016-08-01

    The normal value of alpha angle is controversial. The aim of this study was to compare the alpha angle in asymptomatic volunteers versus patients who had undergone surgery for symptomatic cam-type femoroacetabular impingement (FAI) and determine a diagnostic cut-off value for symptomatic cam impingement. This is a diagnostic test study. Cases were defined as those patients who had undergone surgery for symptomatic cam or mixed type FAI. Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason. In both groups, the alpha angle was measured in an oblique axial CT reconstruction of the femoral neck. A logistic regression model was first estimated and a receiver operating characteristics (ROC) curve was then calculated. The diagnostic cut-off value selected was the one that maximizes sensitivity and specificity. Data were analysed from 38 consecutive cases of cam or mixed FAI and 101 controls. The average alpha angle was 67°(±12°) among cases and 48°°(±5°) among controls. An odds ratio of 1.28 [1.18-1.39] was obtained. A ROC curve of 0.96 [0.93-0.99] was calculated, and using an alpha angle of 57° as the diagnostic cut-off value, provided a sensitivity of 92% and a specificity of 95%. If a patient complains of hip pain and an alpha angle of 57° is found in CT, strongly suggest that cam impingement is causing the pain.

  13. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Task 5 Full-Scale Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Gary Blythe; MariJon Owens

    2007-12-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project is to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate whether the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project is conducting pilot- and full-scale tests of the additives in wet FGD absorbers. The tests are intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power has provided the Texas lignite/PRB co-fired test site for pilot FGD tests and cost sharing. Southern Company has provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation is providing the TMT-15 additive, and the Nalco Company is providing the Nalco 8034 additive. Both companies are also supplying technical support to the test program as in-kind cost sharing. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6

  14. Summary receiver operating characteristics (SROC) and hierarchical SROC models for analysis of diagnostic test evaluations of antibody ELISAs for paratuberculosis.

    Science.gov (United States)

    Toft, Nils; Nielsen, Søren S

    2009-11-15

    Critical, systematic reviews of available diagnostic test evaluations are a meticulous approach to synthesize evidence about a diagnostic test. However, often the review finds that data quality is poor due to deficiencies in design and reporting of the test evaluations and formal statistical comparisons are discouraged. Even when only simple summary measures are appropriate, the strong correlation between sensitivity and specificity and their dependence on differences in diagnostic threshold across studies, creates the need for tools to summarise properties of the diagnostic test under investigation. This study presents summary receiver operating characteristics (SROC) analysis as a means to synthesize information from diagnostic test evaluation studies. Using data from a review of diagnostic tests for ante mortem diagnosis of paratuberculosis as an illustration, SROC and hierarchical SROC (HSROC) analysis were used to estimate overall diagnostic accuracies of antibody ELISAs for bovine paratuberculosis while accounting for covariates: the target condition (infectious or infected) used in the test evaluation (one for the evaluation of Se and one for Sp); and the type of test (serum vs. milk). The methods gave comparable results (regarding the estimated diagnostic log odds ratio), considering the small sample size and the quality of data. The SROC analysis found a difference in the performance of tests when the target condition for evaluation of Se was infected rather than infectious, suggesting that ELISAs are not suitable for detecting infected cattle. However, the SROC model does not take differences in sample size between study units into account, whereas the HSROC allows for both between and within study variation. Considering the small sample size, more credibility should be given to the results of the HSROC. For both methods the area under the (H)SROC curve was calculated and results were comparable. The conclusion is that while the SROC is simpler and easier

  15. [Diagnostic value of the procalcitonine test in purulent-septic complications of chest traumas].

    Science.gov (United States)

    Vadachkoriia, V K; Gogishvili, Sh G; Shapatava, K K

    2007-04-01

    The aim of the present work was to assess the value of the semi-quantitative procalcitonine test (PCT) in diagnosis of purulent-septic complications of chest traumas, efficacy of the therapy carried out, and outcome prognosis. For this, 71 patients with chest traumas were enrolled in the study. Concentrations of PCT were assessed in dynamics using an immunochromatographic, semi-quantitative quick test. Semi-quantitative quick PCT test is highly sensitive diagnostic marker that can be used for the assessment of a chest trauma, infectious-septic complication severity, and efficiency of the therapy indicated. Thus, it can be successfully used for monitoring trauma therapy. PCT sensitivity during first 12 hrs of infectious-septic complication development is 2-3-times higher than that of routine methods for laboratory diagnostics, and even more sensitive that IL-6 and CRT, when we are dealing with combined chest traumas. PCT concentration increase is 4-times more frequent in gram-positive bacterial processes than in gram-negative ones. This has to be taken into account, when appropriate antibacterial treatment is selected for restricted infectious-septic complications. PMID:17525495

  16. Synthesis of evidence of diagnostic tests and preventive programs identifying pre-diabetes type

    Directory of Open Access Journals (Sweden)

    Dagmar Tučková

    2015-09-01

    Full Text Available Introduction: Type 2 diabetes mellitus (T2D has become the main type of diabetes in children and it is expected that in countries with high income diabetes it is projected to be one of the leading causes of death by 2030. Another fact is that programs and tests diagnosing pre-diabetes type 2 (T2P-DMC are missing. Methods: The aim of the paper is to present the steps for the synthesis of the evidence within the brand new type of the systematic review (SR: SR of diagnostic test accuracy (DTA. Using the acronym PIRD it was developed a review question, search strategy and inclusion and exclusion criteria. Results: The initial search was done in two databases (MedLine and Cinahl with 2 025 results. The second search after the improvement of the sensitivity and the specificity was done in 15 databases with 3 681 results. Conclusion: This methodological paper introduces how to conduct the systematic review protocols of diagnostic test accuracy on the example of T2P-DMC.

  17. Comparative feasibility of implementing rapid diagnostic test and microscopy for parasitological diagnosis of malaria in Uganda

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Nuwaha, Fred

    2011-01-01

    -based diagnosis for uncomplicated malaria in rural health centres (HCs) was investigated with a view to recommending measures for scaling up the policy. METHODS: Thirty HCs were randomized to implement parasite-based diagnosis based on rapid diagnostic tests [RDTs] (n=10), blood microscopy (n=10) and presumptive...... waiting time. Clinicaltrials.gov: NCT00565071. RESULTS: 102,087 outpatients were enrolled. Patients were more likely to be tested in the RDT 44,565 (96.6%) than in microscopy arm 19,545 (60.9%) [RR: 1.59]. RDTs reduced patient waiting time compared to microscopy and were more convenient to health workers...... and patients. Majority 23,804 (99.7%) in presumptive arm were prescribed AL. All (100%) of patients who tested positive for malaria in RDT and microscopy arms were prescribed anti-malarials. Parasitological-based diagnosis significantly reduced AL prescription in RDT arm [RR: 0.62] and microscopy arm [RR: 0...

  18. Diagnostic potential of ancillary molecular testing in differentiation of benign and malignant thyroid nodules.

    Science.gov (United States)

    Bhatia, Parisha; Deniwar, Ahmed; Friedlander, Paul; Aslam, Rizwan; Kandil, Emad

    2015-03-01

    Fine needle aspiration (FNA) cytology, being the mainstay to diagnose thyroid nodules, does not provide definitive results in a subset of patients. The use of molecular markers testing has been described as a useful aid in differentiation of thyroid nodules that present with an indeterminate cytodiagnosis. Molecular tests, such as the Afirma gene classifier, mutational assay and immunohistochemical markers have been increasingly used to further increase the accuracy and defer unnecessary surgeries for benign thyroid nodules. However, in light of the current literature, their emerging roles in clinical practice are limited due to financial and technical limitations. Nevertheless, their synergistic implementation can predict the risk of malignancy and yield an accurate diagnosis. This review discusses the clinical utility of various molecular tests done on FNA indeterminate nodules to avoid diagnostic thyroidectomies and warrant the need of future multi-Institutional studies. PMID:25750270

  19. Effect of incubation temperature on the diagnostic sensitivity of the glanders complement fixation test.

    Science.gov (United States)

    Khan, I; Wieler, L H; Saqib, M; Melzer, F; Santana, V L D A; Neubauer, H; Elschner, M C

    2014-12-01

    The complement fixation test (CFT) is the only serological test prescribed by the World Organisation for Animal Health (OIE) for the diagnosis of glanders in international trading of equids. However, false-positive reactions have caused financial losses to the animal owners in the past, and false-negative tests have resulted in the introduction of glanders into healthy equine populations in previously glanders-free areas. Both warm (incubation at 37°C for 1 h) and cold (overnight incubation at 4°C) procedures are recommended by the OIE for serodiagnosis of glanders. In a comparison of the sensitivity and specificity of the two techniques, using the United States Department of Agriculture antigen, warm CFT was found to be significantly less sensitive (56.8%; p glanders but a lower diagnostic specificity has to be accepted. The immunoblot was used as the gold standard.

  20. Gamma radiation grafted polymers for immobilization of Brucella antigen in diagnostic test studies

    Science.gov (United States)

    Docters, E. H.; Smolko, E. E.; Suarez, C. E.

    The radiation grafting process has a wide field of industrial applications, and in the recent years the immobilization of biocomponents in grafted polymeric materials obtained by means of ionizing radiations is a new and important contribution to biotechnology. In the present work, gamma preirradiation grafting method was employed to produce acrylics hydrogels onto polyethylene (PE), polyvinyl chloride (PVC) and polystyrene (PS). Two monomers were used to graft the previously mentioned polymers: methacrylic acid (MAAc) and acrylamide (AAm), and several working conditions were considered as influencing the degree of grafting. All this grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA).

  1. Rapid Immunoglobulin M-Based Dengue Diagnostic Test Using Surface Plasmon Resonance Biosensor

    OpenAIRE

    Peyman Jahanshahi; Erfan Zalnezhad; Shamala Devi Sekaran; Faisal Rafiq Mahamd Adikan

    2014-01-01

    Surface plasmon resonance (SPR) is a medical diagnosis technique with high sensitivity and specificity. In this research, a new method based on SPR is proposed for rapid, 10-minute detection of the anti-dengue virus in human serum samples. This novel technique, known as rapid immunoglobulin M (IgM)-based dengue diagnostic test, can be utilized quickly and easily at the point of care. Four dengue virus serotypes were used as ligands on a biochip. According to the results, a serum volume of onl...

  2. Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Sørensen, Morten Togo; Gozalov, Aydin;

    2015-01-01

    INTRODUCTION: We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases...... (ICD-11 beta) is almost exclusively based on the ICHD-3 beta classification structure although slightly abbreviated. We compared sensitivity and specificity to ICHD-2 criteria, and evaluated the needs for revision. METHODS: Clinical characteristics were systematically and prospectively collected from...

  3. Field Testing of a Wet FGD Additive for Enhanced Mercury Control

    Energy Technology Data Exchange (ETDEWEB)

    Gary Blythe; MariJon Owens

    2007-12-31

    This document is the final report for DOE-NETL Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project has been to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project was intended to demonstrate whether such additives can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project involved pilot- and full-scale tests of the additives in wet FGD absorbers. The tests were intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power provided the Texas lignite/PRB co-fired test site for pilot FGD tests and project cost sharing. Southern Company provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested, and project cost sharing. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation provided the TMT-15 additive, and the Nalco Company provided the Nalco 8034 additive. Both companies also supplied technical support to the test program as in-kind cost sharing. The project was conducted in six tasks. Of the six tasks, Task 1 involved project planning and Task

  4. Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India.

    Science.gov (United States)

    Vyas, S; Puwar, B; Patel, V; Bhatt, G; Kulkarni, S; Fancy, M

    2014-05-01

    Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis. This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria (SD Bioline Malaria Ag P.f/Pan) versus blood smear examination as the gold standard. All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears. A total of 677 cases with fever were examined; 135 (20.0%) tested positive by rapid diagnostic test and 86 (12.7%) by blood smear. The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%. For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%. The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting.

  5. TDLAS Test-stand Diagnostics Development for Velocity, Temperature, Efficiency, and Erosion for Space Shuttle Main Engines Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose here to develop tunable diode laser spectroscopy as a diagnostic for the Space Shuttle main engines during test stand operations. These engines represent...

  6. Diagnostic and prognostic value of ST segment depression limited to the recovery phase of exercise stress test

    OpenAIRE

    Lanza, G A; Mustilli, M; Sestito, A; Infusino, F; Sgueglia, G A; Crea, F

    2004-01-01

    Objectives: To investigate the diagnostic and prognostic value of ST segment depression limited to the recovery phase of an exercise stress test, as compared with that of ST segment depression appearing during exercise.

  7. Cognitive Reserve in Alzheimer's Dementia: Diagnostic Accuracy of a Testing-the-Limits Paradigm.

    Science.gov (United States)

    Küster, Olivia C; Kösel, Jonas; Spohn, Stephanie; Schurig, Niklas; Tumani, Hayrettin; von Arnim, Christine A F; Uttner, Ingo

    2016-03-29

    Individuals with higher cognitive reserve are more able to cope with pathological brain alterations, potentially due to the application of more efficient cognitive strategies. The extent to which an individual's cognitive performance can be increased by advantageous conditions differs substantially between patients with Alzheimer's dementia (AD) and healthy older adults and can be assessed with the Testing-the-Limits (TtL) approach. Thus, TtL has been proposed as a tool for the early diagnosis of AD. Here, we report the diagnostic accuracy of a memory TtL paradigm to discriminate between AD patients and controls. The TtL paradigm was administered to 57 patients with clinically diagnosed AD and 94 controls. It consisted of a pre-test condition, representing baseline cognitive performance, the presentation of an encoding strategy, and two subsequent post-test conditions, representing learning potential. Receiver operating characteristic (ROC) curves were analyzed for each condition in order to receive optimal cutoff points along with their sensitivity and specificity and to compare the diagnostic accuracy of the conditions. Differentiation between AD patients and controls, indicated by the area under the ROC curve, increased significantly for the TtL post-test and total error scores compared to the pre-test score. The combined error score in the two post-tests could differentiate between AD patients and controls with a sensitivity of 0.93 and a specificity of 0.80. The presented approach can be carried out in 25 minutes and thus constitutes a time- and cost-effective way to diagnose AD with high accuracy. PMID:27031485

  8. Using patient management as a surrogate for patient health outcomes in diagnostic test evaluation

    Directory of Open Access Journals (Sweden)

    Staub Lukas P

    2012-02-01

    Full Text Available Abstract Background Before a new test is introduced in clinical practice, evidence is needed to demonstrate that its use will lead to improvements in patient health outcomes. Studies reporting test accuracy may not be sufficient, and clinical trials of tests that measure patient health outcomes are rarely feasible. Therefore, the consequences of testing on patient management are often investigated as an intermediate step in the pathway. There is a lack of guidance on the interpretation of this evidence, and patient management studies often neglect a discussion of the limitations of measuring patient management as a surrogate for health outcomes. Methods We discuss the rationale for measuring patient management, describe the common study designs and provide guidance about how this evidence should be reported. Results Interpretation of patient management studies relies on the condition that patient management is a valid surrogate for downstream patient benefits. This condition presupposes two critical assumptions: the test improves diagnostic accuracy; and the measured changes in patient management improve patient health outcomes. The validity of this evidence depends on the certainty around these critical assumptions and the ability of the study design to minimise bias. Three common designs are test RCTs that measure patient management as a primary endpoint, diagnostic before-after studies that compare planned patient management before and after testing, and accuracy studies that are extended to report on the actual treatment or further tests received following a positive and negative test result. Conclusions Patient management can be measured as a surrogate outcome for test evaluation if its limitations are recognised. The potential consequences of a positive and negative test result on patient management should be pre-specified and the potential patient benefits of these management changes clearly stated. Randomised comparisons will provide

  9. Treatment guided by rapid diagnostic tests for malaria in Tanzanian children: safety and alternative bacterial diagnoses

    Directory of Open Access Journals (Sweden)

    Sykes Alma

    2011-10-01

    Full Text Available Abstract Background WHO guidelines for the treatment of young children with suspected malaria have recently changed from presumptive treatment to anti-malarial treatment guided by a blood slide or malaria rapid diagnostic test (RDT. However, there is limited evidence of the safety of this policy in routine outpatient settings in Africa. Methods Children 3-59 months of age with a non-severe febrile illness and no obvious cause were enrolled over a period of one year in a malaria endemic area of Tanzania. Treatment was determined by the results of a clinical examination and RDT result, and blood culture and serum lactate were also collected. RDT-negative children were followed up over 14 days. Results Over the course of one year, 965 children were enrolled; 158 (16.4% were RDT-positive and treated with artemether-lumefantrine and 807 (83.4% were RDT-negative and treated with non-anti-malarial medicines. Compared with RDT-positives, RDT-negative children were on average younger with a lower axillary temperature and more likely to have a history of cough or difficulty in breathing. Six (0.6% children became RDT-positive after enrolment, all of whom were PCR-negative for Plasmodium falciparum DNA at enrolment. In addition, 12 (1.2% children were admitted to hospital, one with possible malaria, none of whom died. A bacterial pathogen was identified in 9/965 (0.9% children, eight of whom were RDT-negative and one was RDT-positive, but slide-negative. Excluding three children with Salmonella typhi, all of the children with bacteraemia were ≤12 months of age. Compared to double-read research slide results RDTs had a sensitivity of 97.8% (95%CI 96.9-98.7 and specificity of 96.3% (95%CI 96.3-98.4. Conclusions Use of RDTs to direct the use of anti-malarial drugs in young children did not result in any missed diagnoses of malaria although new infections soon after a consultation with a negative RDT result may undermine confidence in results. Invasive

  10. The diagnostic value of endoscopy and Helicobacter pylori tests for peptic ulcer patients in late post-treatment setting

    Directory of Open Access Journals (Sweden)

    Kull Ingrid

    2004-10-01

    Full Text Available Abstract Background Guidelines for management of peptic ulcer patients after the treatment are largely directed to detection of H. pylori infection using only non-invasive tests. We compared the diagnostic value of non-invasive and endoscopy based H. pylori tests in a late post-treatment setting. Methods Altogether 34 patients with dyspeptic complaints were referred for gastroscopy 5 years after the treatment of peptic ulcer using a one-week triple therapy scheme. The endoscopic and histologic findings were evaluated according to the Sydney classification. Bacteriological, PCR and cytological investigations and 13C-UBT tests were performed. Results Seventeen patients were defined H. pylori positive by 13C-UBT test, PCR and histological examination. On endoscopy, peptic ulcer persisted in 4 H. pylori positive cases. Among the 6 cases with erosions of the gastric mucosa, only two patients were H. pylori positive. Mucosal atrophy and intestinal metaplasia were revealed both in the H. pylori positive and H. pylori negative cases. Bacteriological examination revealed three clarithromycin resistant H. pylori strains. Cytology failed to prove validity for diagnosing H. pylori in a post-treatment setting. Conclusions In a late post-treatment setting, patients with dyspepsia should not be monitored only by non-invasive investigation methods; it is also justified to use the classical histological evaluation of H. pylori colonisation, PCR and bacteriology as they have shown good concordance with 13C-UBT. Moreover, endoscopy and histological investigation of a gastric biopsy have proved to be the methods with an additional diagnostic value, providing the physician with information about inflammatory, atrophic and metaplastic lesions of the stomach in dyspeptic H. pylori positive and negative patients. Bacteriological methods are suggested for detecting the putative antimicrobial resistance of H. pylori, aimed at successful eradication of infection in

  11. Survey of physicians' perspectives and knowledge about diagnostic tests for bloodstream infections.

    Directory of Open Access Journals (Sweden)

    Rosemary C She

    Full Text Available Physicians rely on blood culture to diagnose bloodstream infections (BSI despite its limitations. As new technologies emerge for rapid BSI diagnosis, optimization of their application to patient care requires an understanding of clinicians' perspectives on BSI diagnosis and how a rapid test would influence medical decisions.We administered a 26-question survey to practitioners in infectious diseases/microbiology, critical care, internal medicine, and hematology/oncology services in USA and Germany about current standards in diagnosing and treating BSI and a hypothetical rapid BSI test.Responses from 242 providers had roughly equal representation across specialties. For suspected BSI patients, 78% of practitioners would administer empiric broad spectrum antibiotics although they estimated, on average, that 31% of patients received incorrect antibiotics while awaiting blood culture results. The ability of blood culture to rule in or rule out infection was very/extremely acceptable in 67% and 36%, respectively. Given rapid test results, 60-87% of practitioners would narrow the spectrum of antimicrobial therapy depending on the microorganism detected, with significantly higher percentages when resistance determinants were also tested. Over half of respondents felt a rapid test would be very/extremely influential on clinical practice.Limitations of blood culture were perceived as a barrier to patient care. A rapid test to diagnose BSI would impact clinical practice, but the extent of impact may be limited by prevailing attitudes and practices. Opportunities exist for interventions to influence practitioners' behaviors in BSI management particularly with emergence of newer diagnostic tests.

  12. A test strategy for the assessment of additive attributed toxicity of tobacco products.

    Science.gov (United States)

    Kienhuis, Anne S; Staal, Yvonne C M; Soeteman-Hernández, Lya G; van de Nobelen, Suzanne; Talhout, Reinskje

    2016-08-01

    The new EU Tobacco Product Directive (TPD) prohibits tobacco products containing additives that are toxic in unburnt form or that increase overall toxicity of the product. This paper proposes a strategy to assess additive attributed toxicity in the context of the TPD. Literature was searched on toxicity testing strategies for regulatory purposes from tobacco industry and governmental institutes. Although mainly traditional in vivo testing strategies have been applied to assess toxicity of unburnt additives and increases in overall toxicity of tobacco products due to additives, in vitro tests combined with toxicogenomics and validated using biomarkers of exposure and disease are most promising in this respect. As such, tests are needed that are sensitive enough to assess additive attributed toxicity above the overall toxicity of tobacco products, which can associate assay outcomes to human risk and exposure. In conclusion, new, sensitive in vitro assays are needed to conclude whether comparable testing allows for assessment of small changes in overall toxicity attributed to additives. A more pragmatic approach for implementation on a short-term is mandated lowering of toxic emission components. Combined with risk assessment, this approach allows assessment of effectiveness of harm reduction strategies, including banning or reducing of additives.

  13. COMPARATIVE EFFICIENCY OF SOME INDIRECT DIAGNOSTIC TESTS FOR THE DETECTION OF SUB-CLINICAL MASTITIS IN COWS AND BUFFALOES

    OpenAIRE

    M. IQBAL, M. AMJED1, M. A. KHAN, M. S. QURESHI1 AND U. SADIQUE1

    2006-01-01

    The present study was undertaken to compare five laboratory diagnostic tests for sub-clinical mastitis in cattle and buffaloes and to compute cost, time taken by each test and its ranking for availability, adoptability, interpretability and sensitivity. There were 352 cases with each test type viz. California Mastitis Test (CMT), White Side Test (WST), White Side + Dye (WSTD), Surf Test and Surf + Dye, and 880 cases with each species type (cattle and buffaloes). Result scores (1760 ) for sub...

  14. The Conversion of CESR to Operate as the Test Accelerator, CesrTA, Part 4: Superconducting Wiggler Diagnostics

    CERN Document Server

    Billing, M G; Liu, X; Li, Y; Sabol, D; Smith, E N; Strohman, C R; Palmer, M A; Munson, D V

    2016-01-01

    Cornell's electron/positron storage ring (CESR) was modified over a series of accelerator shutdowns beginning in May 2008, which substantially improves its capability for research and development for particle accelerators. CESR's energy span from 1.8 to 5.6 GeV with both electrons and positrons makes it appropriate for the study of a wide spectrum of accelerator physics issues and instrumentation related to present light sources and future lepton damping rings. Additionally a number of these are also relevant for the beam physics of proton accelerators. This paper, the last in a series of four, describes the vacuum system modifications of the superconducting wigglers to accommodate the diagnostic instrumentation for the study of electron cloud (EC) behavior within wigglers. Earlier papers provided an overview of the accelerator physics program, the general modifications of CESR, the modifications of the vacuum system necessary for the conversion of CESR to the test accelerator, CesrTA, enhanced to study such ...

  15. Development of three-tier heat, temperature and internal energy diagnostic test

    Science.gov (United States)

    Gurcay, Deniz; Gulbas, Etna

    2015-05-01

    Background:Misconceptions are major obstacles to learning physics, and the concepts of heat and temperature are some of the common misconceptions that are encountered in daily life. Therefore, it is important to develop valid and reliable tools to determine students' misconceptions about basic thermodynamics concepts. Three-tier tests are effective assessment tools to determine misconceptions in physics. Although a limited number of three-tier tests about heat and temperature are discussed in the literature, no reports discuss three-tier tests that simultaneously consider heat, temperature and internal energy. Purpose:The aim of this study is to develop a valid and reliable three-tier test to determine students' misconceptions about heat, temperature and internal energy. Sample:The sample consists of 462 11th-grade Anatolian high school students. Of the participants, 46.8% were female and 53.2% were male. Design and methods:This research takes the form of a survey study. Initially, a multiple-choice test was developed. To each multiple-choice question was added one open-ended question asking the students to explain their answers. This test was then administered to 259 high school students and the data were analyzed both quantitatively and qualitatively. The students' answers for each open-ended question were analyzed and used to create the choices for the second-tier questions of the test. Depending on those results, a three-tier Heat, Temperature and Internal Energy Diagnostic Test (HTIEDT) was developed by adding a second-tier and certainty response index to each item. This three-tier test was administered to the sample of 462 high school students. Results:The Cronbach alpha reliability for the test was estimated for correct and misconception scores as .75 and .68, respectively. The results of the study suggested that HTIEDT could be used as a valid and reliable test in determining misconceptions about heat, temperature and internal energy concepts.

  16. On-line tests of organic additives for the inhibition of the precipitation of silica from hypersaline geothermal brine IV. Final tests of candidate additives

    Energy Technology Data Exchange (ETDEWEB)

    Harrar, J.E.; Locke, F.E.; Otto, C.H. Jr.; Lorensen, L.E.; Frey, W.P.; Snell, E.O.

    1980-02-01

    The Lawrence Livermore Laboratory Brine Treatment Test System at Niland, Imperial Valley, California, has been used to evaluate a number of cationic polymers and surfactants as scale control agents. An initial group of compounds was narrowed to four on the basis of their activity as silica precipitation inhibitors. Three of these and certain combinations of compounds were then given a 40-h test to determine their effectiveness in retarding scales formed at 220, 125, and 90/sup 0/C. The best single compound was Corcat P-18 (Cordova Chemical Co. polyethylene imine, M.W. approx. = 1800). It had no effect on the scale at 220/sup 0/C, but it reduced the scales at 125 and 90/sup 0/C by factors of 4 and 18, respectively, and it also has activity as a corrosion inhibitor. Other promising compounds are PAE HCl (Dynapol poly(aminoethylene, HCl salt)), which also somewhat reduces the 220/sup 0/C scale; Ethoquad 18/25 (Armak methyl polyoxyethylene(15) octadecylammonium chloride); and Mirapol A-15 (a Miranol Chemical polydiquaternary compound). The best additive formulation for the brines of the Salton Sea Geothermal Field appears to be a mixture of one of these silica precipitation inhibitors with a small amount of hydrochloric acid and a phosphonate crystalline deposit inhibitor. Speculations are presented as to the mechanism of inhibition of silica precipitation and recommendations for further testing of these additives.

  17. Shear transfer across a single crack in reinforced concrete: Additional detailed tests

    NARCIS (Netherlands)

    Frénay, J.W.; Liqui Lung, G.; Pruijssers, A.F.

    1986-01-01

    This report gives information on additional detailed tests concerning shear transfer across a single reinforced crack in concrete. The bond characteristics of 8mm diameter deformed reinforcing bars have been investigated by means of pull-out tests. The bars were embedded in concrete over a length of

  18. 30 CFR 77.102 - Tests for methane; oxygen deficiency; qualified person, additional requirement.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tests for methane; oxygen deficiency; qualified... methane; oxygen deficiency; qualified person, additional requirement. Notwithstanding the provisions of § 77.101, on and after December 30, 1971, no person shall be a qualified person for testing for...

  19. Diagnostic test accuracy of glutamate dehydrogenase for Clostridium difficile: Systematic review and meta-analysis.

    Science.gov (United States)

    Arimoto, Jun; Horita, Nobuyuki; Kato, Shingo; Fuyuki, Akiko; Higurashi, Takuma; Ohkubo, Hidenori; Endo, Hiroki; Takashi, Nonaka; Kaneko, Takeshi; Nakajima, Atsushi

    2016-01-01

    We performed this systematic review and meta-analysis to assess the diagnostic accuracy of detecting glutamate dehydrogenase (GDH) for Clostridium difficile infection (CDI) based on the hierarchical model. Two investigators electrically searched four databases. Reference tests were stool cell cytotoxicity neutralization assay (CCNA) and stool toxigenic culture (TC). To assess the overall accuracy, we calculated the diagnostic odds ratio (DOR) using a DerSimonian-Laird random-model and area the under hierarchical summary receiver operating characteristics (AUC) using Holling's proportional hazard models. The summary estimate of the sensitivity and the specificity were obtained using the bivariate model. According to 42 reports consisting of 3055 reference positive comparisons, and 26188 reference negative comparisons, the DOR was 115 (95%CI: 77-172, I(2) = 12.0%) and the AUC was 0.970 (95%CI: 0.958-0.982). The summary estimate of sensitivity and specificity were 0.911 (95%CI: 0.871-0.940) and 0.912 (95%CI: 0.892-0.928). The positive and negative likelihood ratios were 10.4 (95%CI 8.4-12.7) and 0.098 (95%CI 0.066-0.142), respectively. Detecting GDH for the diagnosis of CDI had both high sensitivity and specificity. Considering its low cost and prevalence, it is appropriate for a screening test for CDI. PMID:27418431

  20. Diagnostic test accuracy of glutamate dehydrogenase for Clostridium difficile: Systematic review and meta-analysis.

    Science.gov (United States)

    Arimoto, Jun; Horita, Nobuyuki; Kato, Shingo; Fuyuki, Akiko; Higurashi, Takuma; Ohkubo, Hidenori; Endo, Hiroki; Takashi, Nonaka; Kaneko, Takeshi; Nakajima, Atsushi

    2016-07-15

    We performed this systematic review and meta-analysis to assess the diagnostic accuracy of detecting glutamate dehydrogenase (GDH) for Clostridium difficile infection (CDI) based on the hierarchical model. Two investigators electrically searched four databases. Reference tests were stool cell cytotoxicity neutralization assay (CCNA) and stool toxigenic culture (TC). To assess the overall accuracy, we calculated the diagnostic odds ratio (DOR) using a DerSimonian-Laird random-model and area the under hierarchical summary receiver operating characteristics (AUC) using Holling's proportional hazard models. The summary estimate of the sensitivity and the specificity were obtained using the bivariate model. According to 42 reports consisting of 3055 reference positive comparisons, and 26188 reference negative comparisons, the DOR was 115 (95%CI: 77-172, I(2) = 12.0%) and the AUC was 0.970 (95%CI: 0.958-0.982). The summary estimate of sensitivity and specificity were 0.911 (95%CI: 0.871-0.940) and 0.912 (95%CI: 0.892-0.928). The positive and negative likelihood ratios were 10.4 (95%CI 8.4-12.7) and 0.098 (95%CI 0.066-0.142), respectively. Detecting GDH for the diagnosis of CDI had both high sensitivity and specificity. Considering its low cost and prevalence, it is appropriate for a screening test for CDI.

  1. New frontiers for diagnostic testing: taking advantage of forces changing health care.

    Science.gov (United States)

    Allawi, S J; Hill, B T; Shah, N R

    1998-01-01

    The transformation of the health-care industry holds great economic potential for laboratory diagnostic testing providers who understand the five market forces driving change and who are shaping their own roles in the emerging market. Because of these trends, provider-based laboratories (PBLs) are competing with independent laboratories (ILs) for the latter's traditional client base--outpatients and nonpatients. PBLs will continue to service acute care patients while becoming more IL-like in logistics, sales, customer service, and marketing. Forced to compete on price, ILs have engaged in mega-mergers and will try to break into acute care via joint ventures. The ILs will need to choose their markets carefully, solidly integrate with parent organizations, and find ways to be profit centers. Consumers' demands also are forcing change. Consumers want accurate, legible bills and simplified eligibility determination and registration. They want an emphasis on prevention and wellness, which means that diagnostic testing must address early identification and monitoring of high-risk groups. To realize cost-efficiencies under whole-life capitation, laboratory networks must be part of a completely integrated health-care system. The laboratory of the future will be multicentered, without walls, and with quick access to information through technology. PMID:10178702

  2. Interleukin (IL)-1A and IL-6: Applications to the predictive diagnostic testing of radiation pneumonitis

    International Nuclear Information System (INIS)

    Purpose: To explore the application of interleukin (IL)-1α and IL-6 measurements in the predictive diagnostic testing for symptomatic radiation pneumonitis (RP). Methods and materials: In a prospective protocol investigating RP and cytokines, IL-1α and IL-6 values were analyzed by enzyme-linked immunosorbent assay from serial weekly blood samples of patients receiving chest radiation. We analyzed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) over selected threshold values for both cytokines in the application to diagnostic testing. Results: The average coefficient of variation was 51% of the weekly mean IL-1α level and 39% of the weekly mean IL-6 value. Interleukin 1α and IL-6 became positively correlated with time. Specificity for both cytokines was better than sensitivity. IL-6 globally outperformed IL-1α in predicting RP, with higher PPV and NPV. Conclusions: Our data demonstrate the feasibility of applying IL-1α and IL-6 measurements of blood specimens to predict RP. Interleukin-6 measurements offer stronger positive predictive value than IL-1α. This application might be further explored in a larger sample of patients

  3. Indicators of allogenic interactions of lymphocytes in spouses as additional diagnostic and prognostic criteria of immune forms of reproductive failures

    Directory of Open Access Journals (Sweden)

    Belenkova O.V.

    2013-12-01

    Full Text Available Research objective: to search new laboratory approaches to the diagnostics of immune forms of reproductive failures. Materials and methods. Retrospective research a case — control of 54 married couples with idiopathic reproductive failures (in the anamnesis — 3 and more spontaneously interrupted pregnancy in the 4-8th weeks and 47 married couples having two and more children has been conducted. Results. It has been revealed that at the immune form of reproductive failures increase of cells of level A- mononuclear cells, expression of HLDR takes place that promotes tolerance cancellation to allogenic germs and to immune interruption of pregnancy. At reproductive failures female au-toserum positively influences activation of T-lymphocyte (CD3 +/HLADR + that may lead to the death of half- allogenic germ. Conclusion. Level of expression of CD3 and HLADR on CD45 + of mixed allogenic mononuclear cells of spouses may serve as a diagnostic significant criterion for revealing immune reasons of reproductive failures.

  4. Monocyte Activation in Immunopathology: Cellular Test for Development of Diagnostics and Therapy

    Directory of Open Access Journals (Sweden)

    Ekaterina A. Ivanova

    2016-01-01

    Full Text Available Several highly prevalent human diseases are associated with immunopathology. Alterations in the immune system are found in such life-threatening disorders as cancer and atherosclerosis. Monocyte activation followed by macrophage polarization is an important step in normal immune response to pathogens and other relevant stimuli. Depending on the nature of the activation signal, macrophages can acquire pro- or anti-inflammatory phenotypes that are characterized by the expression of distinct patterns of secreted cytokines and surface antigens. This process is disturbed in immunopathologies resulting in abnormal monocyte activation and/or bias of macrophage polarization towards one or the other phenotype. Such alterations could be used as important diagnostic markers and also as possible targets for the development of immunomodulating therapy. Recently developed cellular tests are designed to analyze the phenotype and activity of living cells circulating in patient’s bloodstream. Monocyte/macrophage activation test is a successful example of cellular test relevant for atherosclerosis and oncopathology. This test demonstrated changes in macrophage activation in subclinical atherosclerosis and breast cancer and could also be used for screening a panel of natural agents with immunomodulatory activity. Further development of cellular tests will allow broadening the scope of their clinical implication. Such tests may become useful tools for drug research and therapy optimization.

  5. Diagnostic Accuracy of Clinical Tests for Morton's Neuroma Compared With Ultrasonography.

    Science.gov (United States)

    Mahadevan, Devendra; Venkatesan, Muralidharan; Bhatt, Raj; Bhatia, Maneesh

    2015-01-01

    The aim of the present study was to assess the diagnostic accuracy of 7 clinical tests for Morton's neuroma (MN) compared with ultrasonography (US). Forty patients (54 feet) were diagnosed with MN using predetermined clinical criteria. These patients were subsequently referred for US, which was performed by a single, experienced musculoskeletal radiologist. The clinical test results were compared against the US findings. MN was confirmed on US at the site of clinical diagnosis in 53 feet (98%). The operational characteristics of the clinical tests performed were as follows: thumb index finger squeeze (96% sensitivity, 96% accuracy), Mulder's click (61% sensitivity, 62% accuracy), foot squeeze (41% sensitivity, 41% accuracy), plantar percussion (37% sensitivity, 36% accuracy), dorsal percussion (33% sensitivity, 26% accuracy), and light touch and pin prick (26% sensitivity, 25% accuracy). No correlation was found between the size of MN on US and the positive clinical tests, except for Mulder's click. The size of MN was significantly larger in patients with a positive Mulder's click (10.9 versus 8.5 mm, p = .016). The clinical assessment was comparable to US in diagnosing MN. The thumb index finger squeeze test was the most sensitive screening test for the clinical diagnosis of MN. PMID:25432459

  6. Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome.

    Science.gov (United States)

    Borg, K; Lindblom, U

    1988-12-01

    The initial sensory symptoms of carpal tunnel syndrome (CTS) are usually intermittent and the clinical neurological examination is often normal. The aim of the present study was to determine the rate of impairment of different somatosensory modalities in CTS by means of the following tests: vibrametry, tactile pulses, von Frey hairs, two-point discrimination (2-PD), graphesthesia and warm and cold perception thresholds. The material consisted of 33 hands with CTS from 22 patients. Each of the first 3 tests was abnormal with elevated thresholds in 17 CTS hands (52%), 2-PD was abnormal in 10 hands (30%), graphesthesia in 8 hands (24%), and warm and cold thresholds in only 5 hands (15%). There was an overlap so that at least one test was abnormal in 27 of the 33 CTS hands (82%). Thus, impairment of sensibility can be demonstrated in a majority of patients with CTS if more than one test is applied. Vibrametry and von Frey hairs are recommended instead of the commonly used 2-PD, since abnormality was more often revealed and since they are equally easy to apply. No individual test was sensitive enough to qualify as a diagnostic criterion when it was applied with the hand in resting position. A significant increase in both sensitivity and specificity can be expected for any test if it is combined with provocation, such as wrist flexion, as has been demonstrated for vibrametry.

  7. Hypertrophic cardiomyopathy: Can the noninvasive diagnostic testing identify high risk patients?

    Institute of Scientific and Technical Information of China (English)

    Li; Zhang; Obinna; Mmagu; Liwen; Liu; Dayuan; Li; Yuxin; Fan; Adrian; Baranchuk; Peter; R; Kowey

    2014-01-01

    Hypertrophic cardiomyopathy(HCM) is the most common cause of sudden cardiac death(SCD) in the young, particularly among athletes. Identifying high risk individuals is very important for SCD prevention. The purpose of this review is to stress that noninvasive diagnostic testing is important for risk assessment. Extreme left ventricular hypertrophy and documented ventricular tachycardia and fibrillation increase the risk of SCD. Fragmented QRS and T wave inversion in multiple leads are more common in high risk patients. Cardiac magnetic resonance imaging provides complete visualization of the left ventricular chamber, allowing precise localization of the distribution of hypertrophy and measurement of wall thickness and cardiac mass. Moreover, with late gadolinium enhancement, patchy myocardial fibrosis within the area of hypertrophy can be detected, which is also helpful in risk stratification. Genetic testing is encouraged in all cases, especially in those with a family history of HCM and SCD.

  8. The diagnostic accuracy of serological tests for Lyme borreliosis in Europe

    DEFF Research Database (Denmark)

    Leeflang, M M G; Ang, C W; Berkhout, J;

    2016-01-01

    BACKGROUND: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe....... METHODS: We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist...... % CI 40 % to 61 %); neuroborreliosis 77 % (95 % CI 67 % to 85 %); acrodermatitis chronica atrophicans 97 % (95 % CI 94 % to 99 %); unspecified Lyme borreliosis 73 % (95 % CI 53 % to 87 %). Specificity was around 95 % in studies with healthy controls, but around 80 % in cross-sectional studies. Two...

  9. Generalized requirements and decompositions for the design of test parts for micro additive manufacturing research

    DEFF Research Database (Denmark)

    Thompson, Mary Kathryn; Clemmensen, Line Katrine Harder

    2015-01-01

    The design of experimental test parts to characterize micro additive manufacturing (AM) processes is challenging due to the influence of the manufacturing and metrology processes. This work builds on the lessons learned from a case study in the literature to derive generalized requirements and high...... level decompositions for the design of test parts and the design of experiments to characterize micro additive manufacturing processes. While the test parts and the experiments described are still work in progress, the generic requirements derived from them can serve as a starting point for the design...

  10. Comparison of the Minnesota Percepto-Diagnostic Test-Revised and Bender-Gestalt in Predicting Achievement.

    Science.gov (United States)

    Fuller, Gerald B.; Vance, Booney

    1993-01-01

    Investigated whether Minnesota Percepto-Diagnostic Test-Revised (MPD-R) or Bender-Gestalt Test (BG) would more accurately predict achievement at first-, third-, and fifth-grade levels. Administered both tests to 84 children in counterbalanced order. Results indicated that MPD-R was better predictor of achievement than BG, especially at first- and…

  11. Development and Application of a Three-Tier Diagnostic Test to Assess Secondary Students' Understanding of Waves

    Science.gov (United States)

    Caleon, Imelda; Subramaniam, R.

    2010-01-01

    This study focused on the development and application of a three-tier multiple-choice diagnostic test (or three-tier test) on the nature and propagation of waves. A question in a three-tier test comprises the "content tier", which measures content knowledge; the "reason tier", which measures explanatory knowledge; and the "confidence tier", which…

  12. Use of diagnostic self-tests on body materials among Internet users in the Netherlands : prevalence and correlates of use

    NARCIS (Netherlands)

    Ronda, G.; Portegijs, P.; Dinant, G.J.; Buntinx, F.; Norg, R.; Weijden, T.T. van der

    2009-01-01

    BACKGROUND: A range of self-tests on body materials has become available to the general public, but the extent of their use has hardly been studied. This study examined how many people use diagnostic self-tests on body materials such as blood or urine, as well as the type of tests that are used, and

  13. Diagnostic automated testing system for automotive ECU%汽车ECU诊断自动化测试系统

    Institute of Scientific and Technical Information of China (English)

    张永刚; 刘志峰

    2015-01-01

    The importance of developing and testing of automotive diagnostic function is rising,since the complexity of automotive electric and electronic systems are growing.This issue introduced a diagnostic automated testing system for automotive ECU(Electronic Control Unit),which tests the diagnostic protocol and diagnostic function automatically,significant increasing the efficiency and accuracy of diagnostic testing, also increasing the coverage and reproducibility of diagnostic testing.%汽车电子电器复杂度的提高使得汽车诊断功能的开发和测试愈加重要。本文介绍了一种汽车ECU(Electronic Control Unit)诊断自动化测试系统,可以实现ECU诊断协议及诊断功能的自动化测试,大幅提高诊断测试效率和精度,增加诊断测试的覆盖度和可重复性。

  14. Diagnostic test of predicted height model in Indonesian elderly: a study in an urban area

    Directory of Open Access Journals (Sweden)

    Fatmah Fatmah

    2010-08-01

    Full Text Available Aim In an anthropometric assessment, elderly are frequently unable to measure their height due to mobility and skeletal deformities. An alternative is to use a surrogate value of stature from arm span, knee height, and sitting height. The equations developed for predicting height in Indonesian elderly using these three predictors. The equations put in the nutritional assessment card (NSA of older people. Before the card which is the first new technology in Indonesia will be applied in the community, it should be tested. The study aimed was to conduct diagnostic test of predicted height model in the card compared to actual height.Methods Model validation towards 400 healthy elderly conducted in Jakarta City with cross-sectional design. The study was the second validation test of the model besides Depok City representing semi urban area which was undertaken as the first study.Result Male elderly had higher mean age, height, weight, arm span, knee height, and sitting height as compared to female elderly. The highest correlation between knee height and standing height was similar in women (r = 0.80; P < 0.001 and men (r = 0.78; P < 0.001, and followed by arm span and sitting height. Knee height had the lowest difference with standing height in men (3.13 cm and women (2.79 cm. Knee height had the biggest sensitivity (92.2%, and the highest specificity on sitting height (91.2%.Conclusion Stature prediction equation based on knee-height, arm span, and sitting height are applicable for nutritional status assessment in Indonesian elderly. (Med J Indones 2010;19:199-204Key words: diagnostic test, elderly, predicted height model

  15. Hybrid Residual Flexibility/Mass-Additive Method for Structural Dynamic Testing

    Science.gov (United States)

    Tinker, M. L.

    2003-01-01

    A large fixture was designed and constructed for modal vibration testing of International Space Station elements. This fixed-base test fixture, which weighs thousands of pounds and is anchored to a massive concrete floor, initially utilized spherical bearings and pendulum mechanisms to simulate Shuttle orbiter boundary constraints for launch of the hardware. Many difficulties were encountered during a checkout test of the common module prototype structure, mainly due to undesirable friction and excessive clearances in the test-article-to-fixture interface bearings. Measured mode shapes and frequencies were not representative of orbiter-constrained modes due to the friction and clearance effects in the bearings. As a result, a major redesign effort for the interface mechanisms was undertaken. The total cost of the fixture design, construction and checkout, and redesign was over $2 million. Because of the problems experienced with fixed-base testing, alternative free-suspension methods were studied, including the residual flexibility and mass-additive approaches. Free-suspension structural dynamics test methods utilize soft elastic bungee cords and overhead frame suspension systems that are less complex and much less expensive than fixed-base systems. The cost of free-suspension fixturing is on the order of tens of thousands of dollars as opposed to millions, for large fixed-base fixturing. In addition, free-suspension test configurations are portable, allowing modal tests to be done at sites without modal test facilities. For example, a mass-additive modal test of the ASTRO-1 Shuttle payload was done at the Kennedy Space Center launch site. In this Technical Memorandum, the mass-additive and residual flexibility test methods are described in detail. A discussion of a hybrid approach that combines the best characteristics of each method follows and is the focus of the study.

  16. Diagnostic value of the commercial MycoDotTM test in the diagnosis of active pulmonary tuberculosis in Nepalese population

    Directory of Open Access Journals (Sweden)

    Anil Chander

    2012-10-01

    Full Text Available Background: A rapid, technically non-demanding and inexpensive diagnostic test is needed to improve the early detection and better management of active pulmonary tuberculosis especially in resource limited areas. Objective: To assess the diagnostic value and usefulness of the commercially available MycoDotTM (DynaGen Inc., Cambridge, MA, USA in the diagnosis of active pulmonary tuberculosis in Nepalese population. Materials and Methods: A prospective study was done from January 2008 to August 2008 on a group of 120 sputum smear positive adult patient group aged 17 to 78 years, confirmed cases of active pulmonary tuberculosis (with TB were enrolled and sera samples collected from them. The second group comprised of 105 healthy controls with no history of pulmonary tuberculosis (without TB and sera samples collected from them. The MycoDotTM serologic test was done on the sera samples collected from both the study groups according to the manufacturer’s instructions. Results: Of the sera collected from 120 sputum smear positive cases (with TB group, 48 sera specimens were MycoDotTM test positive (sensitivity = 40%; 95% CI 31.68–48.94. Healthy controls (without-TB group – 8 sera samples were found to be positive by the MycoDotTM test and the remaining 97 sera samples tested negative by this serologic test (specificity = 92.38%; 95% CI 85.68–96.09. The value for % false positive was 7.61% and for % false negative was 60%. The positive predictive value and the negative predictive value was 85.71% (95% CI 73.22–93.20 and 57.4% (95% CI 49.56–64.88, respectively. Conclusion: The MycoDotTM test with its rapidity (completed within 20 min, easy – to – perform format and no expensive instrumentation required – had high specificity but a relatively low sensitivity in the study group subjects and thus could be used only as an additional test in the diagnosis of active pulmonary tuberculosis and to be interpreted judiciously alongwith clinical

  17. Leukotriene D4 nasal provocation test: Rationale, methodology and diagnostic value

    Science.gov (United States)

    ZHU, ZHENG; XIE, YANQING; GUAN, WEIJIE; GAO, YI; XIA, SHU; LIANG, JIANXIN; ZHENG, JINPING

    2016-01-01

    Cysteinyl leukotrienes (LT) play a vital role in the pathogenesis of allergic rhinitis (AR), but few studies have investigated the nasal mucosal physiological response to LTs in AR patients. The aim of the present study was to establish the methodology and investigate the diagnostic value and safety of a leukotriene D4 (LTD4) nasal provocation test. LTD4 nasal provocation tests were performed in 26 AR patients and 16 normal control subjects. Nasal airway responsiveness was assessed by calculating the concentration of LTD4 required to cause a 60% increase in nasal airway resistance (PC60NAR-LTD4), which was measured using rhinomanometry and a composite symptom score. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of LTD4 nasal provocation test, and adverse events were recorded. The study protocol was registered with the U.S. National Institutes of Health (https://clinicaltrials.gov/ct2/show/NCT01963741). PC60NAR-LTD4 in AR was significantly lower compared with that of normal controls [8.36 (IQR, 10.00) vs. 17.00 (IQR, 0.00) µg/ml, P=0.005]. Composite symptom score was higher in AR as compared with normal controls (1.19±0.94 vs. 0.12±0.50, P<0.001). The symptom scores included sneezing (0.12±0.34 vs. 0.00±0.00, P=0.149), rhinorrhea (0.79±0.66 vs. 0.06±0.25, P<0.001) and chemosis or itching of the eyes (0.06±0.25 vs. 0.21±0.42, P=0.216). High diagnostic value was indicated by the ROC [AUC: 0.822, 95%CI (0.665, 0.961)]. No serious adverse events were observed. Thus, the present results indicate that AR patients exhibited nasal hyperactivity to LTD4, and the established procedure of LTD4 nasal provocation testing is effective and safe for use in the diagnosis of AR. PMID:27347089

  18. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia.

    Science.gov (United States)

    Osorio, Lyda; Uribe, Marcela; Ardila, Gloria Ines; Orejuela, Yaneth; Velasco, Margarita; Bonelo, Anilza; Parra, Beatriz

    2015-06-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were identified using contingency tables, nonparametric tests and logistic regression. A total of 778 subjects were diagnosed with dengue by the treating physician, of whom 386 (49.5%) were tested for dengue. Another 491 dengue tests were ordered in subjects whose primary diagnosis was not dengue. Severe dengue classification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergency consultation (OR 1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5) were independently associated with ordering of dengue tests. Dengue tests were used both to rule in and rule out diagnosis. The latter use is not justified by the sensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appear to depend on a combination of factors, including physician and institutional preferences, as well as other patient and epidemiological factors.

  19. Thiopurine S-methyltransferase testing for averting drug toxicity: a meta-analysis of diagnostic test accuracy.

    Science.gov (United States)

    Zur, R M; Roy, L M; Ito, S; Beyene, J; Carew, C; Ungar, W J

    2016-08-01

    Thiopurine S-methyltransferase (TPMT) deficiency increases the risk of serious adverse events in persons receiving thiopurines. The objective was to synthesize reported sensitivity and specificity of TPMT phenotyping and genotyping using a latent class hierarchical summary receiver operating characteristic meta-analysis. In 27 studies, pooled sensitivity and specificity of phenotyping for deficient individuals was 75.9% (95% credible interval (CrI), 58.3-87.0%) and 98.9% (96.3-100%), respectively. For genotype tests evaluating TPMT*2 and TPMT*3, sensitivity and specificity was 90.4% (79.1-99.4%) and 100.0% (99.9-100%), respectively. For individuals with deficient or intermediate activity, phenotype sensitivity and specificity was 91.3% (86.4-95.5%) and 92.6% (86.5-96.6%), respectively. For genotype tests evaluating TPMT*2 and TPMT*3, sensitivity and specificity was 88.9% (81.6-97.5%) and 99.2% (98.4-99.9%), respectively. Genotyping has higher sensitivity as long as TPMT*2 and TPMT*3 are tested. Both approaches display high specificity. Latent class meta-analysis is a useful method for synthesizing diagnostic test performance data for clinical practice guidelines.The Pharmacogenomics Journal advance online publication, 24 May 2016; doi:10.1038/tpj.2016.37. PMID:27217052

  20. Comparison of Serological and Biopsy Diagnostic Tests for Helicobacter Pylori in Dyspeptic Patients

    Directory of Open Access Journals (Sweden)

    Hamid Vahedi

    2015-04-01

    Full Text Available Introduction: Helicobacter pylori infection is a major cause of chronic gastritis, peptic ulcers and gastric cancer in humans. By using inexpensive laboratory methods for diagnosis of H. pylori infection several complications can be prevented. This study compared two methods including, histology and serology tests for diagnosis of H. pylori in patients with dyspepsia which has been conducted in 2012. Methods: 395 patients with dyspepsia which referred to Imam Hossein hospital of Shahroud were participated in this study. All patients undergoing endoscopic procedures and 6 standard biopsy specimens were taken for histological examination. Giemsa stain used for histological detection of H. pylori in gastric biopsy specimens serology. H. pylori IgG ELISA method was also performed to measure IgG titers against H. pylori. Data were statistically analyzed and the sensitivity, specificity, positive and negative predictive values were calculated. Results: From 395 patients with dyspepsia, serological test were positive in 212 patients (53.7%, histological test were positive in 316 (80% patients including 178 male patients (56.3% and 138 female patients sensitivity and specificity were 63.9%, and 87.3% respectively. Moreover positive predictive value was 95.3% and negative predictive value was 37.7%. Conclusion: Due to the high specificity and the relative sensitivity of serological tests as well as simplicity, speed and low cost of these testin comparison with other diagnostic methods these tests could be, recommended for screening.

  1. Typhidot (IgM as a reliable and rapid diagnostic test for typhoid fever

    Directory of Open Access Journals (Sweden)

    Sushma Krishna

    2011-01-01

    Full Text Available Introduction: Typhoid fever still continues to be a major public health problem, particularly in developing countries. A simple, reliable, affordable, and rapid diagnostic test has been a long-felt need of the clinicians. We, therefore, prospectively evaluated the sensitivity and specificity of Typhidot (IgM, a serological test to identify IgM antibodies against Salmonella typhi. Materials and Methods: The study was carried out in the Department of Microbiology, Apollo Hospital, Bangalore between January 2009 and March 2009 on a total of 186 samples from clinically suspected febrile patients. Blood culture as well as Typhidot test was performed for each of the cases. Results: Out of 61 clinically diagnosed typhoid fever, 50 were blood culture positive for S. typhi all 50 were Typhidot (IgM positive and 11 were missed out on both. The sensitivity, specificity, positive and negative predictive values of the test using blood culture as gold standard were 100%, 95.5%, 89.2%, and 100%, respectively for typhoid fever. Conclusion: Typhidot (IgM test is rapid, easy to perform, and reliable for diagnosing typhoid fever, and useful for small, less equipped laboratories as well as for the laboratories with better facilities in typhoid endemic countries.

  2. Evaluation of a rapid diagnostic test for yaws infection in a community surveillance setting.

    Directory of Open Access Journals (Sweden)

    Michael Marks

    2014-09-01

    Full Text Available Yaws is a non-venereal treponemal infection caused by Treponema pallidum ssp. pertenue. The WHO has launched a worldwide control programme, which aims to eradicate yaws by 2020. The development of a rapid diagnostic test (RDT for serological diagnosis in the isolated communities affected by yaws is a key requirement for the successful implementation of the WHO strategy. We conducted a study to evaluate the utility of the DPP test in screening for yaws, utilizing samples collected as part of a community prevalence survey conducted in the Solomon Islands. 415 serum samples were tested using both traditional syphilis serology (TPPA and quantitative RPR and the Chembio DPP Syphilis Screen and Confirm RDT. We calculated the sensitivity and specificity of the RDT as compared to gold standard serology. The sensitivity of the RDT against TPPA was 58.5% and the specificity was 97.6%. The sensitivity of the RDT against RPR was 41.7% and the specificity was 95.2%. The sensitivity of the DPP was strongly related to the RPR titre with a sensitivity of 92.0% for an RPR titre of >1/16. Wider access to DPP testing would improve our understanding of worldwide yaws case reporting and the test may play a key role in assessing patients presenting with yaws like lesions in a post-mass drug administration (MDA setting.

  3. Evaluation of a rapid diagnostic test for yaws infection in a community surveillance setting.

    Science.gov (United States)

    Marks, Michael; Goncalves, Adriana; Vahi, Ventis; Sokana, Oliver; Puiahi, Elliot; Zhang, Zaixing; Dalipanda, Tenneth; Bottomley, Christian; Mabey, David; Solomon, Anthony W

    2014-09-01

    Yaws is a non-venereal treponemal infection caused by Treponema pallidum ssp. pertenue. The WHO has launched a worldwide control programme, which aims to eradicate yaws by 2020. The development of a rapid diagnostic test (RDT) for serological diagnosis in the isolated communities affected by yaws is a key requirement for the successful implementation of the WHO strategy. We conducted a study to evaluate the utility of the DPP test in screening for yaws, utilizing samples collected as part of a community prevalence survey conducted in the Solomon Islands. 415 serum samples were tested using both traditional syphilis serology (TPPA and quantitative RPR) and the Chembio DPP Syphilis Screen and Confirm RDT. We calculated the sensitivity and specificity of the RDT as compared to gold standard serology. The sensitivity of the RDT against TPPA was 58.5% and the specificity was 97.6%. The sensitivity of the RDT against RPR was 41.7% and the specificity was 95.2%. The sensitivity of the DPP was strongly related to the RPR titre with a sensitivity of 92.0% for an RPR titre of >1/16. Wider access to DPP testing would improve our understanding of worldwide yaws case reporting and the test may play a key role in assessing patients presenting with yaws like lesions in a post-mass drug administration (MDA) setting. PMID:25211018

  4. Diagnostic Accuracy of Computer based Tests for Attention-Deficit Hyperactivity Disorder: A Receiver-Operating Characteristic Analysis

    Directory of Open Access Journals (Sweden)

    Thomas Dreisörner

    2011-05-01

    Full Text Available Objectives: Attention-Deficit Hyperactivity Disorder (ADHD is one of the most common neurobehavioral diagnosis affecting children today. Guidelines of child psychiatry encourage clinicians to employ clinical interviews and questionnaires, learning and performance tests and behavior observation in making the diagnosis. Special attention tests can be conducted additionally. Computer-based attention tests constitute a promising method to do so as they appeal to children. In clinical practise in Germany two test batteries are commonly used: “Testbatterie zur Aufmerksamkeitsprüfung” (TAP and “Testbatterie zur Aufmerksamkeitsprüfung für Kinder” (KITAP. The latter having been adapted to the motivational needs of children. This study aims at examining the diagnostic accuracy of the TAP and KITAP. Methods: ROC-analysis of TAP- and KITAP parameters and logistic regressions were conducted in a sample of 24 children with and without ADHD. Results: Both TAP and KITAP proved to differentiate between children with and without ADHD. TAP parameters possessed a higher discriminating power for ADHD. In logistic regression analysis TAP parameters led to an amount of variance of 32.5% (KITAP: 21.6% and correct classification rate of 75% (KITAP: 72.9%. Adding KITAP parameters did not improve the amount of variance significantly whereas adding TAP parameters to the KITAP data did result in a significant increase. Conclusion: These findings suggest that TAP and KITAP could serve as useful additional test instruments to help identify cases likely to meet criteria for ADHD in clinical settings. For individual diagnosis TAP and KITAP lack cut-off criteria and substantial classification rates.

  5. Mycobacterium tuberculosis pili (MTP), a putative biomarker for a tuberculosis diagnostic test.

    Science.gov (United States)

    Naidoo, Natasha; Ramsugit, Saiyur; Pillay, Manormoney

    2014-05-01

    Novel biomarkers are urgently needed for point of care TB diagnostics. In this study, we investigated the potential of the pilin subunit protein encoded by the mtp gene as a diagnostic biomarker. BLAST analysis of the mtp gene on published genome databases, and amplicon sequencing were performed in Mycobacterium tuberculosis Complex (MTBC) strains and other organisms. The protein secondary structure of the amino acid sequences of non-tuberculous Mycobacteria that partially aligned with the mtp sequence was analysed with PredictProtein software. The mtp gene and corresponding amino acid sequence of MTBC were 100% homologous with H37Rv, in contrast to the partial alignment of the non-tuberculous Mycobacteria. The mtp gene was present in all 91 clinical isolates of MTBC. Except for 2 strains with point mutations, the sequence was 100% conserved among the clinical strains. The mtp gene could not be amplified in all non-tuberculous Mycobacteria and respiratory organisms. The predicted MTP protein structure of Mycobacterium avium, Mycobacterium ulcerans and Mycobacterium abscessus differed significantly from that of the M. tuberculosis, which was similar to Mycobacterium marinum. The absence of the mtp gene in non-tuberculous Mycobacteria and other respiratory bacteria suggests that its encoded product, the pilin subunit protein of M. tuberculosis may be a suitable marker for a point of care TB test.

  6. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E;

    2015-01-01

    BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

  7. Ten years experience in acceptance testing of diagnostic radiology equipment in Hungary

    International Nuclear Information System (INIS)

    The EURATOM directive for the radiation protection of patients, which declares the mandatory evaluation of the performance of diagnostic X-ray machines, took effect in 1997. In Hungary, this became a harmonized act, the 31/2001. (X. 3.) decree of the Minister of Health. The most highlighted segment of the evaluation of technical performance is acceptance testing. The NRIRR Department of Radiohygiene performs acceptance tests since 2002. From then on we have performed more than 400 examinations on different modalities such as radiographic, fluoroscopic, DSA, mammographic, CT and dental panoramic X-rays. The tests were performed according to IEC = EN = MSZ EN international, European and at the same time Hungarian standards. This presentation discusses our experience and gives a comprehensive overview of the examinations by the evaluation of the measurement data. Our results show the importance of testing, done independently from the manufacturer and installer: in est. 25 % of the cases overall we have found inadequacies which required remedial action on the part of the service

  8. Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications.

    Science.gov (United States)

    Di Francia, Raffaele; Berretta, Massimiliano; Catapano, Oriana; Canzoniero, Lorella M T; Formisano, Luigi

    2011-07-01

    Abstract Genetic testing of drug response represents an important goal for targeted therapy. In particular, 5-fluorouracil (5-FU) is the backbone of several chemotherapic protocols for treatment of solid tumors. Unfortunately, in some patients, 5-FU is toxic and causes gastrointestinal and hematologic lesions leading to the suspension of therapy. Some adverse drug responses can be predicted by pharmacogenomics. Recently, several polymorphic traits of different genes involved with 5-FU biotransformation have been reported. Many methods have been used for qualitative and quantitative assessment of the mutational status of these genes, without a precise cost-effectiveness analysis. This article reviews recent findings on the seven germline polymorphic traits of four genes involved in the biotransformation of the 5-FU. In particular, we analyze the most common platforms used to identify the specific genetic alterations and their relative costs. Genotyping can be performed either by custom service laboratories or academic reference laboratories by using either the commercial kits (when available) or "in house" tests. By random selection of 20 certified laboratories out of a total of 71, we estimate that the cost of the analysis/single trait is on average €120.00 as custom genotyping service. "In house" validated tests by PCR-based platforms cost approximately €20.00 per single polimorphism. On the basis of this information, the lab manager can evaluate the advantage and limitations, in terms of costs and applicability, of the most appropriate methods for diagnostics of 5-FU pharmacogenomics tests.

  9. Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics.

    Science.gov (United States)

    Mahr, Cynthia V; Dengl, Markus; Nestler, Ulf; Reiss-Zimmermann, Martin; Eichner, Gerrit; Preuß, Matthias; Meixensberger, Jürgen

    2016-09-01

    OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after shunt insertion (specificity 93%, sensitivity 67%). Resistance to outflow of CSF (ROut) > 12 mm Hg/ml/min was false negative in 21% of patients. Intracranial pulsatility parameters yielded different results in various parameters (correlation coefficient between pulse amplitude and ICP, slow wave amplitude, and mean ICP) but did not correlate to outcome. In multiple linear regression analysis, a calculation of presurgical MMSE versus the value after ELD, ROut, and ICP amplitude quotient during LIFT was significantly associated with outcome (p = 0.04). CONCLUSIONS Despite a multitude of invasive tests, presurgical clinical testing and response to ELD yielded the best prediction for improvement of symptoms following surgery. The complication rate of invasive testing was 5.4%. Multiple and simple linear regression analyses indicated that outcome can only be predicted by a combination of parameters, in accordance with a multifactorial pathogenesis of iNPH. PMID:26824377

  10. A Three-Tier Diagnostic Test to Assess Pre-Service Teachers' Misconceptions about Global Warming, Greenhouse Effect, Ozone Layer Depletion, and Acid Rain

    Science.gov (United States)

    Arslan, Harika Ozge; Cigdemoglu, Ceyhan; Moseley, Christine

    2012-01-01

    This study describes the development and validation of a three-tier multiple-choice diagnostic test, the atmosphere-related environmental problems diagnostic test (AREPDiT), to reveal common misconceptions of global warming (GW), greenhouse effect (GE), ozone layer depletion (OLD), and acid rain (AR). The development of a two-tier diagnostic test…

  11. Instructions for additional qualitative scoring of the initial-letter Word-association Test.

    Science.gov (United States)

    Zivković, M

    1994-04-01

    An additional scoring method is based on grouping test-words according to whether the same sign is given by subjects to the test-words. In this way five test-word categories are formed, Eros (test-words with double plus signs), demi-Eros (single plus sign), demi-Thanatos (single minus), Thanatos (double minus), and Deviant (+/- and theta signs). The next step in scoring is to count the number of test-words in a given scoring category whose meanings do not conform. The greater the discrepancy between the test-word category and its meaning, the less well adapted is the subject. Several illustrative protocols are discussed. PMID:8022674

  12. Overview of the Beam diagnostics in the Medaustron Accelerator:Design choices and test Beam commissioning

    CERN Document Server

    Osmic, F; Gyorgy, A; Kerschbaum, A; Repovz, M; Schwarz, S; Neustadt, W; Burtin, G

    2012-01-01

    The MedAustron centre is a synchrotron based accelerator complex for cancer treatment and clinical and non-clinical research with protons and light ions, currently under construction in Wiener Neustadt, Austria. The accelerator complex is based on the CERN-PIMMS study [1] and its technical implementation by the Italian CNAO foundation in Pavia [2]. The MedAustron beam diagnostics system is based on sixteen different monitor types (153 devices in total) and will allow measuring all relevant beam parameters from the source to the irradiation rooms. The monitors will have to cope with large intensities and energy ranges. Currently, one ion source, the low energy beam transfer line and the RFQ are being commissioned in the Injector Test Stand (ITS) at CERN. This paper gives an overview of all beam monitors foreseen for the MedAustron accelerator, elaborates some of the design choices and reports the first beam commissioning results from the ITS.

  13. A Diagnostic Test for Determining the Location of the GeV Emission in Powerful Blazars

    Science.gov (United States)

    Dotson, Amanda; Georganopoulos, Markos; Kazanas, Demosthenes; Perlman, Eric

    2011-01-01

    An issue currently under debate in the literature is how far from the black hole is the Fermi-observed GeV emission of powerful blazars emitted. Here we present a clear diagnostic tool for testing whether the Ge V emission site is located within the sub-pc broad emission line (BLR) region or further out in the few pc scale molecular torus (MT) environment. Within the BLR the scatteri takes place at the onset of the Klein-Nishina regime, causing the electron cooling time to become almost energy independent and as a result, the variation of high-energy emission is expected to be achromatic. Contrarily, if the emission site is located outside the BLR, the expected GeY variability is energy-dependent and with amplitude increasing with energy. We demonstrate this using time-dependent numerical simulations of blazar variability.

  14. On-ground tests of LISA PathFinder thermal diagnostics system

    CERN Document Server

    Lobo, A; Ramos-Castro, J; Sanjuan, J; Lobo, Alberto; Nofrarias, Miquel; Ramos-Castro, Juan; Sanjuan, Josep

    2006-01-01

    Thermal conditions in the LTP, the LISA Technology Package, are required to be very stable, and in such environment precision temperature measurements are also required for various diagnostics objectives. A sensitive temperature gauging system for the LTP is being developed at IEEC, which includes a set of thermistors and associated electronics. In this paper we discuss the derived requirements applying to the temperature sensing system, and address the problem of how to create in the laboratory a thermally quiet environment, suitable to perform meaningful on-ground tests of the system. The concept is a two layer spherical body, with a central aluminium core for sensor implantation surrounded by a layer of polyurethane. We construct the insulator transfer function, which relates the temperature at the core with the laboratory ambient temperature, and evaluate the losses caused by heat leakage through connecting wires. The results of the analysis indicate that, in spite of the very demanding stability conditio...

  15. An Analysis Of Tensile Test Results to Assess the Innovation Risk for an Additive Manufacturing Technology

    OpenAIRE

    Adamczak Stanisław; Bochnia Jerzy; Kaczmarska Bożena

    2015-01-01

    The aim of this study was to assess the innovation risk for an additive manufacturing process. The analysis was based on the results of static tensile tests obtained for specimens made of photocured resin. The assessment involved analyzing the measurement uncertainty by applying the FMEA method. The structure of the causes and effects of the discrepancies was illustrated using the Ishikawa diagram. The risk priority numbers were calculated. The uncertainty of the tensile test measurement was ...

  16. Project Rio Blanco definition plan. Additional formation evaluation and production testing

    International Nuclear Information System (INIS)

    Since the multiple Rio Blanco detonation three reentry wells have been drilled for test purposes: RB-E-01 (Emplacement Well); RB-AR-2 (Alternate Reentry Well); and RB-U-4 (Formation Evaluation Well). Additional testing in all these wells is now required to resolve some remaining technical questions. A plan describing the procedures, methods, responsibilities, and scheduling of the field operations is presented

  17. Latent class analysis of diagnostic tests for adenovirus, Bordetella pertussis and influenza virus infections in German adults with longer lasting coughs.

    Science.gov (United States)

    Sobotzki, C; Riffelmann, M; Kennerknecht, N; Hülsse, C; Littmann, M; White, A; Von Kries, R; Wirsing VON König, C H

    2016-03-01

    Laboratory tests in adult outpatients with longer lasting coughs to identify a potential causal pathogen are rarely performed, and there is no gold standard for these diagnostic tests. While the diagnostic validity of serological tests for pertussis is well established their potential contribution for diagnosing adenovirus and influenza virus A and B infections is unclear. A sentinel study into the population-based incidence of longer lasting coughs in adults was done in Rostock (former East Germany) and Krefeld (former West Germany). A total of 971 outpatients who consulted general practitioners or internists were included. Inclusion criteria were coughing for ⩾1 week and no chronic respiratory diseases. We evaluated the performance of polymerase chain reaction (PCR) as well as IgG and IgA serology, applying a latent class model for diagnosing infections with adenovirus, B. pertussis, and influenza virus A and B. The adult outpatients first sought medical attention when they had been coughing for a median of 3 weeks. In this situation, direct detection of infectious agents by PCR had a low sensitivity. Modelling showed that additional serological tests equally improved sensitivity and specificity for diagnosis for adenovirus, B. pertussis and influenza virus A and B infections. The combination of serology and PCR may improve the overall performance of diagnostic tests for B. pertussis and also for adenovirus, and influenza virus A and B infections.

  18. The diagnostic sensitivity of dengue rapid test assays is significantly enhanced by using a combined antigen and antibody testing approach.

    Directory of Open Access Journals (Sweden)

    Scott R Fry

    2011-06-01

    Full Text Available BACKGROUND: Serological tests for IgM and IgG are routinely used in clinical laboratories for the rapid diagnosis of dengue and can differentiate between primary and secondary infections. Dengue virus non-structural protein 1 (NS1 has been identified as an early marker for acute dengue, and is typically present between days 1-9 post-onset of illness but following seroconversion it can be difficult to detect in serum. AIMS: To evaluate the performance of a newly developed Panbio® Dengue Early Rapid test for NS1 and determine if it can improve diagnostic sensitivity when used in combination with a commercial IgM/IgG rapid test. METHODOLOGY: The clinical performance of the Dengue Early Rapid was evaluated in a retrospective study in Vietnam with 198 acute laboratory-confirmed positive and 100 negative samples. The performance of the Dengue Early Rapid in combination with the IgM/IgG Rapid test was also evaluated in Malaysia with 263 laboratory-confirmed positive and 30 negative samples. KEY RESULTS: In Vietnam the sensitivity and specificity of the test was 69.2% (95% CI: 62.8% to 75.6% and 96% (95% CI: 92.2% to 99.8 respectively. In Malaysia the performance was similar with 68.9% sensitivity (95% CI: 61.8% to 76.1% and 96.7% specificity (95% CI: 82.8% to 99.9% compared to RT-PCR. Importantly, when the Dengue Early Rapid test was used in combination with the IgM/IgG test the sensitivity increased to 93.0%. When the two tests were compared at each day post-onset of illness there was clear differentiation between the antigen and antibody markers. CONCLUSIONS: This study highlights that using dengue NS1 antigen detection in combination with anti-glycoprotein E IgM and IgG serology can significantly increase the sensitivity of acute dengue diagnosis and extends the possible window of detection to include very early acute samples and enhances the clinical utility of rapid immunochromatographic testing for dengue.

  19. Evaluation of diagnostic tests for Wuchereria bancrofti infection in Brazilian schoolchildren

    Directory of Open Access Journals (Sweden)

    Paula Oliveira

    2014-06-01

    Full Text Available Introduction Since the launch of the Global Programme to Eliminate Lymphatic Filariasis, more than 70% of the endemic countries have implemented mass drug administration (MDA to interrupt disease transmission. The monitoring of filarial infection in sentinel populations, particularly schoolchildren, is recommended to assess the impact of MDA. A key issue is choosing the appropriate tools for these initial assessments (to define the best intervention and for monitoring transmission. Methods This study compared the pre-MDA performance of five diagnostic methods, namely, thick film test, Knott's technique, filtration, Og4C3-ELISA, and the AD12-ICT card test, in schoolchildren from Brazil. Venous and capillary blood samples were collected between 11 pm and 1 am. The microfilarial loads were analyzed with a negative binomial regression, and the prevalence and associated 95% confidence intervals were estimated for all methods. The accuracies of the AD12-ICT card and Og4C3-ELISA tests were assessed against the combination of parasitological test results. Results A total of 805 schoolchildren were examined. The overall and stratified prevalence by age group and gender detected by Og4C3-ELISA and AD12-ICT were markedly higher than the prevalence estimated by the parasitological methods. The sensitivity of the AD12-ICT card and Og4C3-ELISA tests was approximately 100%, and the positive likelihood ratios were above 6. The specificity of the Og4C3-ELISA was higher than that of the AD12-ICT at different prevalence levels. Conclusions The ICT card test should be the recommended tool for monitoring school-age populations living in areas with ongoing or completed MDA.

  20. A comparative laboratory diagnosis of malaria:microscopy versus rapid diagnostic test kits

    Institute of Scientific and Technical Information of China (English)

    Azikiwe CCA; Ifezulike CC; Siminialayi IM; Amazu LU; Enye JC; Nwakwunite OE

    2012-01-01

    Objective: To compare the two methods of rapid diagnostic tests (RDTs) and microscopy in the diagnosis of malaria. Methods: RDTs and microscopy were carried out to diagnose malaria. Percentage malaria parasitaemia was calculated on thin films and all non-acute cases of plasmodiasis with less than 0.001% malaria parasitaemia were regarded as negative. Results were simply presented as percentage positive of the total number of patients under study. The results of RDTs were compared to those of microscopy while those of RDTs based on antigen were compared to those of RDTs based on antibody. Patients' follow-up was made for all cases. Results:All the 200 patients under present study tested positive to RDTs based on malaria antibodies (serum) method (100%). 128 out of 200 tested positive to RDTs based on malaria antigen (whole blood) method (64%), while 118 out of 200 patients under present study tested positive to visual microscopy of Lieshman and diluted Giemsa (59%). All patients that tested positive to microscopy also tested positive to RDTs based on antigen. All patients on the second day of follow-up were non-febrile and had antimalaria drugs. Conclusions: We conclude based on the present study that the RDTs based on malaria antigen (whole blood) method is as specific as the traditional microscopy and even appears more sensitive than microscopy. The RDTs based on antibody (serum) method is unspecific thus it should not be encouraged. It is most likely that Africa being an endemic region, formation of certain levels of malaria antibody may not be uncommon. The present study also supports the opinion that a good number of febrile cases is not due to malaria. We support WHO’s report on cost effectiveness of RDTs but, recommend that only the antigen based method should possibly, be adopted in Africa and other malaria endemic regions of the world.

  1. Male Partners’ Involvement Towards Prenatal Screening And Diagnostic Testing For Down Syndrome

    Directory of Open Access Journals (Sweden)

    Niken Kusumaningrum

    2015-03-01

    Full Text Available Introduction: Now, male partners’ involvement in prenatal screening and diagnostic testing for Down syndrome is becoming increasingly recognized as well to ensure that parents are well informed of the risks and benefits of screening. The aim of study was to understand the degree of male partners’ involvement during pregnancy in Singapore population. Methods: A cross-sectional survey of male partners’ attending prenatal counseling was performed. The instrument used to measure the level of involvement is a self-assessment questionnaire that identifies the role of male partners with a Likert scale. Descriptive statistics was used to analyze data gained. Result: A total of 107 participants completed the questionnaire. Sixty-seven percent of male partners were found to have a highlevel of involvement while 32.7% was found to have a medium level of involvement. Most of them stated that women can pursue prenatal testing without their permission. Male partners found it more important for them to accompany their spouse to amniocentesis or CVS than to the Down syndrome screening test. When participants were asked about how much information about Down syndrome they sought prior to the appointment, how much discussion they had with their spouse about Down syndrome testing, and about whether they or their spouse should be the first person to receive test results, most stated that they were undecided. Conclusion: These results revealed that male partners were very well involved in the Down syndrome testing during pregnancy and future studies should assess possible underlying factors that influence male partners’ involvement.

  2. A rapid, sensitive and reliable diagnostic test for scrub typhus in China

    Directory of Open Access Journals (Sweden)

    Zhang Lijuan

    2011-01-01

    Full Text Available Purpose: To evaluate the performances for detection of IgM and IgG antibodies to Orientia. tsutsugamushi (Ot using a gold conjugate-based rapid diagnostic test (RDT. Materials and Methods: The RDT employing mixture recombinant 56-kDa proteins of O. tsutsugamushi and the mIFA assay was performed on 33 patients from Fujian and Yunnan province respectively and 94 positive sera (36 from Hainan province and 58 from Jiangsu province from convalescent stages of the patients with scrub typhus respectively and 82 negative sera from healthy farmers from Anhui province and Beijing City respectively in 2009. A comparison of the RDT and mIFA assay was performed by using the c2 test and the P level of ≤0.05 was considered to be significant. Results: Among these 94 positive sera from convalescent stages of the illness and 82 sera from control farmers, the specificity of RDT was 100% for both IgM and IgG tests. In 33 cases with scrub typhus, 5 cases were positively detected earlier by RDT than by mIFA for the IgM test, and 2 cases were positive for the IgG test. The sensitivities of RDT were 93.9% and 90.9% for IgM and IgG, respectively. Considering IgM and IgG together, the sensitivity was 100%. The geometric mean titre (GMT of IFA and the RDT assay in diluted sera from confirmed cases were 1:37 versus 1:113 respectively (P<0.001 for IgM test and 1:99 versus 1:279 respectively (P<0.016 for IgG. Conclusions: The RDT was more sensitive than the traditional IFA for the early diagnosis of scrub typhus and was particularly suitable for use in rural areas.

  3. Laboratory demonstration of a prozone-like effect in HRP2-detecting malaria rapid diagnostic tests: implications for clinical management

    OpenAIRE

    McCarthy James S; Cheng Qin; Belizario Vicente; Alcantara Sheila; Baker Joanne; Luchavez Jennifer; Bell David

    2011-01-01

    Abstract Background Malaria rapid diagnostic tests (RDTs) are now widely used for prompt on-site diagnosis in remote endemic areas where reliable microscopy is absent. Aberrant results, whereby negative test results occur at high parasite densities, have been variously reported for over a decade and have led to questions regarding the reliability of the tests in clinical use. Methods In the first trial, serial dilutions of recombinant HRP2 antigen were tested on an HRP2-detectiing RDT. In a s...

  4. Performance of rapid influenza diagnostic tests (QuickVue) for Influenza A and B Infection in India

    OpenAIRE

    Koul, P A; Mir, H; Bhat, M.A.; U H Khan; M.M. Khan; Chadha, M S; Lal, R.B.

    2015-01-01

    Background: Rapid point-of-care (POC) tests provide an economical alternative for rapid diagnosis and treatment of influenza, especially in public health emergency situations. Objectives: To test the performance of a rapid influenza diagnostic test, QuickVue (Quidel) as a POC test against a real-time polymerase chain reaction (RT-PCR) assay for detection of influenza A and B in a developing country setting. Study Design: In a prospective observational design, 600 patients with influenza-like ...

  5. Formative Assessment in Teacher Education: The Development of a Diagnostic Language Test for Trainee Teachers of German

    Science.gov (United States)

    Richards, Brian J.

    2008-01-01

    This article describes the development and validation of a diagnostic test of German and its integration in a programme of formative assessment during a one-year initial teacher-training course. The test focuses on linguistic aspects that cause difficulty for trainee teachers of German as a foreign language and assesses implicit and explicit…

  6. Exploring Secondary Students' Conceptions about Fire Using a Two-Tier, True/False, Easy-to-Use Diagnostic Test

    Science.gov (United States)

    Potvin, Patrice; Skelling-Desmeules, Yannick; Sy, Ousmane

    2015-01-01

    This article describes the design of a misconception diagnostic test about fire-related phenomena. It proposes a new test format in which a certainty-measuring tier has been integrated into each of the true/false response choices. This format is argued to be easier for teachers to use than the increasingly popular three-tier format. First, we…

  7. Estimation of Sensitivity and Specificity of Three Conditionally Dependent Diagnostic Tests in the Absence of a Gold Standard

    NARCIS (Netherlands)

    Engel, B.; Swildens, B.; Stegeman, J.A.; Buist, W.G.; Jong, de M.

    2006-01-01

    This article presents a model to evaluate the accuracy of diagnostic tests. Data from three tests for the detection of EF-positive Streptococcus suis serotype 2 strains in sows were analyzed. The data were collected in a field study in the absence of a gold standard, that is, the true disease status

  8. Excluding venous thromboembolism using point of care D-dimer tests in outpatients: a diagnostic meta-analysis

    NARCIS (Netherlands)

    G.J. Geersing; K.J.M. Janssen; R. Oudega; L. Bax; A.W. Hoes; J.B. Reitsma; K.G.M. Moons

    2009-01-01

    Objective To review the evidence on the diagnostic accuracy of the currently available point of care D-dimer tests for excluding venous thromboembolism. Design Systematic review of research on the accuracy of point of care D-dimer tests, using bivariate regression to examine sources of variation and

  9. Diagnostic Value of the 13C Methacetin Breath Test in Various Stages of Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Hamizah Razlan

    2011-01-01

    Full Text Available The accuracy of the 13C-methacetin breath test (13C-MBT in differentiating between various stages of liver disease is not clear. A cross-sectional study of Asian patients was conducted to examine the predictive value of the 13C-MBT in various stages of chronic liver diseases. Diagnostic accuracy of the breath test was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve analysis. Seventy-seven patients (47 men/30 women, mean age 50±16 years were recruited. Forty-seven patients had liver cirrhosis (Child Pugh A = 11, Child Pugh B = 15, and Child Pugh C = 21, 21 had fibrosis, and 9 had chronic inflammation. The sensitivity and positive predictive value for liver fibrosis, cirrhosis (all stages, Child-Pugh A, Child-Pugh B, and Child-Pugh C were 65% and 56%, 89% and 89%, 67% and 42%, 40% and 40%, and 50% and 77%, respectively. Area under curve values for fibrosis was 0.62 (0.39–0.86, whilst that for cirrhosis (all stages was 0.95 (0.91–0.99. The 13C-methacetin breath test has a poor predictive value for liver fibrosis but accurately determines advanced cirrhosis.

  10. Prior probability (the pretest best guess) affects predictive values of diagnostic tests.

    Science.gov (United States)

    Erb, Hollis N

    2011-06-01

    Authors who publish evaluations of dichotomous (yes/no) diagnostic tests often include the predictive values of their test at a single prior probability (eg, the prevalence of the target disease within the evaluation data set). The objectives of this technical note are to demonstrate why single-probability predictive values are misleading and to show a better way to display positive predictive values (PPV) and negative predictive values (NPV) for a newly evaluated test. Secondly, this technical note will show readers how to calculate predictive values from only sensitivity and specificity for any desired prior probability. As prior probability increases from 0% to 100%, PPV increases from 0% to 100%, but NPV goes in the opposite direction (drops from 100% to 0%). Because prior probabilities vary so greatly across situations, predictive values should be provided in publications for the full range of potential prior probabilities (if provided at all). This is easily done with a 2-curve graph displaying the predictive values (y-axis) against the prior probability (x-axis).

  11. Theoretical foundations for on-ground tests of LISA PathFinder thermal diagnostics

    CERN Document Server

    Lobo, A; Ramos-Castro, J; Sanjuan, J; Lobo, Alberto; Nofrarias, Miquel; Ramos-Castro, Juan; Sanjuan, Josep

    2006-01-01

    This paper reports on the methods and results of a theoretical analysis to design an insulator which must provide a thermally quiet environment to test on ground delicate temperature sensors and associated electronics. These will fly on board ESA's LISA PathFinder (LPF) mission as part of the thermal diagnostics subsystem of the LISA Test-flight Package (LTP). We evaluate the heat transfer function (in frequency domain) of a central body of good thermal conductivity surrounded by a layer of a very poorly conducting substrate. This is applied to assess the materials and dimensions necessary to meet temperature stability requirements in the metal core, where sensors will be implanted for test. The analysis is extended to evaluate the losses caused by heat leakage through connecting wires, linking the sensors with the electronics in a box outside the insulator. The results indicate that, in spite of the very demanding stability conditions, a sphere of outer diameter of the order one metre is sufficient.

  12. 75 FR 2122 - Additional Guidance Regarding Application of Current Procedures for Testing Energy Consumption of...

    Science.gov (United States)

    2010-01-14

    ...) standard HRF-1-1979 (HRF-1). See Appendix A1, section 2.2; 47 FR 34517 (Aug. 10, 1982). HRF-1 specifies... Additional Guidance Regarding Application of Current Procedures for Testing Energy Consumption of... procedures to measure the energy consumption of certain consumer products. See 42 U.S.C. 6293, 6295(r)....

  13. Field and laboratory comparative evaluation of rapid malaria diagnostic tests versus traditional and molecular techniques in India

    Directory of Open Access Journals (Sweden)

    Bharti Praveen K

    2010-07-01

    Full Text Available Abstract Background Malaria presents a diagnostic challenge in most tropical countries. Microscopy remains the gold standard for diagnosing malaria infections in clinical practice and research. However, microscopy is labour intensive, requires significant skills and time, which causes therapeutic delays. The objective of obtaining result quickly from the examination of blood samples from patients with suspected malaria is now made possible with the introduction of rapid malaria diagnostic tests (RDTs. Several RDTs are available, which are fast, reliable and simple to use and can detect Plasmodium falciparum and non-falciparum infections or both. A study was conducted in tribal areas of central India to measure the overall performance of several RDTs for diagnosis of P. falciparum and non-falciparum infections in comparison with traditional and molecular techniques. Such data will be used to guide procurement decisions of policy makers and programme managers. Methods Five commercially available RDTs were tested simultaneously in field in parallel with peripheral blood smears in outbreak-affected areas. The evaluation is designed to provide comparative data on the performance of each RDT. In addition, molecular method i.e. polymerase chain reaction (PCR was also carried out to compare all three methods. Results A total of 372 patients with a clinical suspicion of malaria from Bajag Primary Health Centre (PHC of district Dindori and Satanwada PHC of district Shivpuri attending the field clinics of Regional Medical Research Centre were included in the study. The analysis revealed that the First Response Malaria Antigen pLDH/HRP2 combo test was 94.7% sensitive (95% CI 89.5-97.7 and 69.9% specific (95% CI 63.6-75.6 for P. falciparum. However, for non-falciparum infections (Plasmodium vivax the test was 84.2% sensitive (95% CI 72.1-92.5 and 96.5% specific (95% CI 93.8-98.2. The Parascreen represented a good alternative. All other RDTs were relatively

  14. Buffer substitution in malaria rapid diagnostic tests causes false-positive results

    Directory of Open Access Journals (Sweden)

    Van den Ende Jef

    2010-07-01

    Full Text Available Abstract Background Malaria rapid diagnostic tests (RDTs are kits that generally include 20 to 25 test strips or cassettes, but only a single buffer vial. In field settings, laboratory staff occasionally uses saline, distilled water (liquids for parenteral drugs dilution or tap water as substitutes for the RDT kit's buffer to compensate for the loss of a diluent bottle. The present study assessed the effect of buffer substitution on the RDT results. Methods Twenty-seven RDT brands were run with EDTA-blood samples of five malaria-free subjects, who were negative for rheumatoid factor and antinuclear antibodies. Saline, distilled water and tap water were used as substitute liquids. RDTs were also run with distilled water, without adding blood. Results were compared to those obtained with the RDT kit's buffer and Plasmodium positive samples. Results Only eight cassettes (in four RDT brands showed no control line and were considered invalid. Visible test lines occurred for at least one malaria-free sample and one of the substitutes in 20/27 (74% RDT brands (saline: n = 16; distilled water: n = 17; and tap water: n = 20, and in 15 RDTs which were run with distilled water only. They occurred for all Plasmodium antigens and RDT formats (two-, three- and four-band RDTs. Clearance of the background of the strip was excellent except for saline. The aspects (colour, intensity and crispness of the control and the false-positive test lines were similar to those obtained with the RDT kits' buffer and Plasmodium positive samples. Conclusion Replacement of the RDT kit's dedicated buffer by saline, distilled water and tap water can cause false-positive test results.

  15. A False Positive Dengue Fever Rapid Diagnostic Test Result in a Case of Acute Parvovirus B19 Infection.

    Science.gov (United States)

    Izumida, Toshihide; Sakata, Hidenao; Nakamura, Masahiko; Hayashibara, Yumiko; Inasaki, Noriko; Inahata, Ryo; Hasegawa, Sumiyo; Takizawa, Takenori; Kaya, Hiroyasu

    2016-01-01

    An outbreak of dengue fever occurred in Japan in August 2014. We herein report the case of a 63-year-old man who presented with a persistent fever in September 2014. Acute parvovirus B19 infection led to a false positive finding of dengue fever on a rapid diagnostic test (Panbio Dengue Duo Cassette(TM)). To the best of our knowledge, there are no previous reports of a false positive result for dengue IgM with the dengue rapid diagnostic test. We believe that epidemiological information on the prevalence of parvovirus B19 is useful for guiding the interpretation of a positive result with the dengue rapid diagnostic test. PMID:27181552

  16. Implementation and Operational Research: What Happens After a Negative Test for Tuberculosis? Evaluating Adherence to TB Diagnostic Algorithms in South African Primary Health Clinics

    OpenAIRE

    McCarthy, K. M.; Grant, A. D.; Chihota, V.; Ginindza, S; Mvusi, L.; Churchyard, G.J.; Fielding, K.L.

    2016-01-01

    Introduction and Background: Diagnostic tests for tuberculosis (TB) using sputum have suboptimal sensitivity among HIV-positive persons. We assessed health care worker adherence to TB diagnostic algorithms after negative sputum test results. Methods: The XTEND (Xpert for TB—Evaluating a New Diagnostic) trial compared outcomes among people tested for TB in primary care clinics using Xpert MTB/RIF vs. smear microscopy as the initial test. We analyzed data from XTEND participants who were HIV po...

  17. Evaluation of the diagnostic value of the tourniquet test in predicting severe dengue cases in a population from Belo Horizonte, State of Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Alice Costa Antunes

    2013-09-01

    Full Text Available Introduction Dengue is prevalent in many tropical and sub-tropical regions. The clinical diagnosis of dengue is still complex, and not much data are available. This work aimed at assessing the diagnostic accuracy of the tourniquet test in patients with suspected dengue infection and its positivity in different classifications of this disease as reported to the Information System for Notifiable Disease in Belo Horizonte, State of Minas Gerais, Brazil between 2001 and 2006. Methods Cross-section analysis of the diagnostic accuracy of the tourniquet test for dengue, using IgM-anti-DENV ELISA as a gold standard. Results We selected 9,836 suspected cases, of which 41.1% were confirmed to be dengue. Classic dengue was present in 95.8%, dengue with complications in 2.5% and dengue hemorrhagic fever in 1.7%. The tourniquet test was positive in 16.9% of classic dengue cases, 61.7% of dengue cases with complications and 82.9% of cases of dengue hemorrhagic fever. The sensitivity and specificity of the tourniquet test were 19.1% and 86.4%, respectively. Conclusions A positive tourniquet test can be a valuable tool to support diagnosis of dengue where laboratory tests are not available. However, the absence of a positive test should not be read as the absence of infection. In addition, the tourniquet test was demonstrated to be an indicator of dengue severity.

  18. Estimating diagnostic test accuracies for Brachyspira hyodysenteriae accounting for the complexities of population structure in food animals.

    Directory of Open Access Journals (Sweden)

    Sonja Hartnack

    Full Text Available For swine dysentery, which is caused by Brachyspira hyodysenteriae infection and is an economically important disease in intensive pig production systems worldwide, a perfect or error-free diagnostic test ("gold standard" is not available. In the absence of a gold standard, Bayesian latent class modelling is a well-established methodology for robust diagnostic test evaluation. In contrast to risk factor studies in food animals, where adjustment for within group correlations is both usual and required for good statistical practice, diagnostic test evaluation studies rarely take such clustering aspects into account, which can result in misleading results. The aim of the present study was to estimate test accuracies of a PCR originally designed for use as a confirmatory test, displaying a high diagnostic specificity, and cultural examination for B. hyodysenteriae. This estimation was conducted based on results of 239 samples from 103 herds originating from routine diagnostic sampling. Using Bayesian latent class modelling comprising of a hierarchical beta-binomial approach (which allowed prevalence across individual herds to vary as herd level random effect, robust estimates for the sensitivities of PCR and culture, as well as for the specificity of PCR, were obtained. The estimated diagnostic sensitivity of PCR (95% CI and culture were 73.2% (62.3; 82.9 and 88.6% (74.9; 99.3, respectively. The estimated specificity of the PCR was 96.2% (90.9; 99.8. For test evaluation studies, a Bayesian latent class approach is well suited for addressing the considerable complexities of population structure in food animals.

  19. Estimating diagnostic test accuracies for Brachyspira hyodysenteriae accounting for the complexities of population structure in food animals.

    Science.gov (United States)

    Hartnack, Sonja; Nathues, Christina; Nathues, Heiko; Grosse Beilage, Elisabeth; Lewis, Fraser Iain

    2014-01-01

    For swine dysentery, which is caused by Brachyspira hyodysenteriae infection and is an economically important disease in intensive pig production systems worldwide, a perfect or error-free diagnostic test ("gold standard") is not available. In the absence of a gold standard, Bayesian latent class modelling is a well-established methodology for robust diagnostic test evaluation. In contrast to risk factor studies in food animals, where adjustment for within group correlations is both usual and required for good statistical practice, diagnostic test evaluation studies rarely take such clustering aspects into account, which can result in misleading results. The aim of the present study was to estimate test accuracies of a PCR originally designed for use as a confirmatory test, displaying a high diagnostic specificity, and cultural examination for B. hyodysenteriae. This estimation was conducted based on results of 239 samples from 103 herds originating from routine diagnostic sampling. Using Bayesian latent class modelling comprising of a hierarchical beta-binomial approach (which allowed prevalence across individual herds to vary as herd level random effect), robust estimates for the sensitivities of PCR and culture, as well as for the specificity of PCR, were obtained. The estimated diagnostic sensitivity of PCR (95% CI) and culture were 73.2% (62.3; 82.9) and 88.6% (74.9; 99.3), respectively. The estimated specificity of the PCR was 96.2% (90.9; 99.8). For test evaluation studies, a Bayesian latent class approach is well suited for addressing the considerable complexities of population structure in food animals.

  20. Diagnostic value of scratch-chamber test, skin prick test, histamine release and specific IgE in birch-allergic patients with oral allergy syndrome to apple

    DEFF Research Database (Denmark)

    Osterballe, M; Scheller, R; Stahl Skov, P;

    2003-01-01

    BACKGROUND: The aim of the study was to examine the diagnostic value of skin prick test (SPT), scratch-chamber test (SCT), histamine release (HR) and specific immunoglobulin E (IgE) in birch-allergic patients with oral allergy syndrome to apple. METHODS: Ten birch-allergic patients with oral...

  1. Diagnostic test of endometrial cytobrush in cases of perimenopausal and postmenopausal hemorrhage

    Directory of Open Access Journals (Sweden)

    Andrijono Andrijono

    2005-06-01

    Full Text Available Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypical hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The group that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes in endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was to evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was a diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology was performed with a modification of cytubrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its deposits were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the process was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them were examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curetage specimens as gold standard. During the period of study 45 study samples were collected, among which 12 (26.66% were endometrial adenocarcinoma, 6 (13.33% with atypical hyperplasia, 11 (24.44% with non-atypical hyperplasia, 15 (33.33% were samples without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%, and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. It was concluded that cytological examination of the endometriurn with cytobrush could be employed as a screening method in the abnormalities of endometrial thickness, with

  2. [Largest outbreak of legionellosis associated with spa baths: comparison of diagnostic tests].

    Science.gov (United States)

    Kawano, Kimiko; Okada, Mika; Kura, Fumiaki; Amemura-Maekawa, Junko; Watanabe, Haruo

    2007-03-01

    In July 2002, a large outbreak of legionellosis occurred in a bathhouse with spa facilities in Miyazaki Prefecture. Among the visitors, 295, including suspected cases had pneumonia and/or symptoms of fever, coughing, etc. Of these, 37% were hospitalized and 7 died. Clinical samples from 95 mainly inpatients were collected and microbiologically tested at our laboratory. Legionella pneumophila serogroup (SG) 1 was isolated from 3 of 24 in sputum culture, and none of the 3 had been treated effectively with antibiotics at sputa collection. L. pneumophila antigen in urine was detected by using enzyme immunoassay and/or immunochromatographic kits in 23 of 75 patients. Serum antibodies to L. pneumophila SG1 and Legionella dumoffii were detected in 5 each of 66 patients--9 cases including a case at mixed infection-by microplate agglutination test and/or indirect immunofluorescence assay. At our laboratory, 32 were diagnosed with legionellosis. In this outbreak, 14 were diagnosed at other laboratories, resulting in 46 confirmed cases. Urine antigen was detected more frequently by Binax NOW immunochromatographic assay than by Biotest EIA-31% versus 16% of cases tested. Both assays detected urine antigen only in samples collected within 4 weeks after onset. Antigen concentration in urine enhanced sensitivity-58% and 51%-and extended the period of antigen detection beyond 5 weeks. Both antibody titers to L. pneumophila SG1 and L. dumoffii in more than 90% of sera collected within 3 weeks after onset were or = 1:128 within 3 weeks was 1.6%, during 4 to 6 weeks less than 10%, and after 7 weeks or more 8 to 25%. After an administrative report was published, L. pneumophila DNA in sputa was detected in 5 of 17 patients by nested PCR, resulting in extra 3 cases. Altogether, urinary antigen detection and PCR were more effective in laboratory diagnostic tests than culture and serology. Culture combined with molecular epidemiology is critical, however, for confirming the source of

  3. Fan Noise Source Diagnostic Test Computation of Rotor Wake Turbulence Noise

    Science.gov (United States)

    Nallasamy, M.; Envia, E.; Thorp, S. A.; Shabbir, A.

    2002-01-01

    An important source mechanism of fan broadband noise is the interaction of rotor wake turbulence with the fan outlet guide vanes. A broadband noise model that utilizes computed rotor flow turbulence from a RANS code is used to predict fan broadband noise spectra. The noise model is employed to examine the broadband noise characteristics of the 22-inch Source Diagnostic Test fan rig for which broadband noise data were obtained in wind tunnel tests at the NASA Glenn Research Center. A 9-case matrix of three outlet guide vane configurations at three representative fan tip speeds are considered. For all cases inlet and exhaust acoustic power spectra are computed and compared with the measured spectra where possible. In general, the acoustic power levels and shape of the predicted spectra are in good agreement with the measured data. The predicted spectra show the experimentally observed trends with fan tip speed, vane count, and vane sweep. The results also demonstrate the validity of using CFD-based turbulence information for fan broadband noise calculations.

  4. Evaluation of a rapid diagnostic test for assessing the burden of malaria at delivery in India.

    Science.gov (United States)

    Singh, Neeru; Saxena, Ajay; Awadhia, S B; Shrivastava, Rita; Singh, M P

    2005-11-01

    All pregnant women who came for delivery at a district hospital in Mandla and a civil hospital in Maihar were screened for Plasmodium falciparum (placental parasitemia using a rapid test and microscopy and peripheral and umbilical cord parasitemia using microscopy alone). Two rapid diagnostic tests (RDTs), Paracheck Pf and ParaHITf, were used. At Mandla, the sensitivity and specificity of the Paracheck Pf for P. falciparum were 93% and 84%, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) were 50% and 99%, respectively. At Maihar, the sensitivity and specificity of the ParaHITf for P. falciparum were 87.5% and 97%, respectively. The PPVs and NPVs were 75.4% and 98.7%, respectively. Placental infection was significantly associated with low birth weight. The RDTs for the identification of P. falciparum were more sensitive in placental blood than the placental blood smear by microscopy. Thus, the RDTs should be useful for rapid assessment of malaria at delivery. PMID:16282293

  5. Does Stereotype Threat Affect Post-Course Scores on the Astronomy Diagnostic Test?

    Science.gov (United States)

    Deming, G. L.; Hufnagel, B.; Landato, J. M.; Hodari, A. K.

    2003-12-01

    During the 1990s, Claude Steele and others demonstrated that women mathematics students under-performed while men over-performed on selected GRE questions when told that the exam could differentiate by gender. Stereotype threat is triggered for these women when they fear someone else may negatively stereotype them, and therefore, their performance is affected. In a limited study involving 229 students, we investigated the effect of stereotype threat on performance on the Astronomy Diagnostic Test (ADT). The ADT was administered as a pre-test in four introductory astronomy classes intended for non-science majors. The same professors taught pairs of classes at the University of Maryland, a large research institution, and W. R. Harper College, a small liberal arts school. The classes were treated the same until the final day before the post-course ADT was given. One "threatened" class at each campus was told that gender mattered so they should be sure to include it on the ADT. The "control" classes were told that gender does not matter. The results show no stereotype threat effect on the women in these introductory classes. The university men did slightly over-perform at low statistical significance. As Steele suggested, students must identify with a subject in order to strongly invoke a stereotype threat. This research was supported in part by the National Science Foundation through grants REC-0089239 to GLD, DGE-97014489 to BH, and DGE-9714452 for AKH.

  6. Methods specification for diagnostic test accuracy studies in fine-needle aspiration cytology: a survey of reporting practice.

    Science.gov (United States)

    Schmidt, Robert L; Factor, Rachel E; Affolter, Kajsa E; Cook, Joshua B; Hall, Brian J; Narra, Krishna K; Witt, Benjamin L; Wilson, Andrew R; Layfield, Lester J

    2012-01-01

    Diagnostic test accuracy (DTA) studies on fine-needle aspiration cytology (FNAC) often show considerable variability in diagnostic accuracy between study centers. Many factors affect the accuracy of FNAC. A complete description of the testing parameters would help make valid comparisons between studies and determine causes of performance variation. We investigated the manner in which test conditions are specified in FNAC DTA studies to determine which parameters are most commonly specified and the frequency with which they are specified and to see whether there is significant variability in reporting practice. We identified 17 frequently reported test parameters and found significant variation in the reporting of these test specifications across studies. On average, studies reported 5 of the 17 items that would be required to specify the test conditions completely. A more complete and standardized reporting of methods, perhaps by means of a checklist, would improve the interpretation of FNAC DTA studies.

  7. The pectoralis minor length test: a study of the intra-rater reliability and diagnostic accuracy in subjects with and without shoulder symptoms

    Directory of Open Access Journals (Sweden)

    Valentine Rachel E

    2007-07-01

    Full Text Available Abstract Background Postural abnormality and muscle imbalance are thought to contribute to pain and a loss of normal function in the upper body. A shortened pectoralis minor muscle is commonly identified as part of this imbalance. Clinical tests have been recommended to test for shortening of this muscle. The aim of this study was to evaluate the intra-rater reliability and diagnostic accuracy of the pectoralis minor length test. Methods Measurements were made in 45 subjects with and 45 subjects without shoulder symptoms. Measurements were made with the subjects lying in supine. In this position the linear distance from the treatment table to the posterior aspect of the acromion was measured on two occasions (separated by a minimum of 30 minutes and additional data collection on other subjects to reduce bias by one rater. The reliability of the measurements was analyzed using intraclass correlation coefficients (ICC, 95% confidence intervals (CI and standard error of measurement (SEM. The diagnostic accuracy of the test was investigated by determining the sensitivity, specificity, positive and negative likelihood ratios of the test against a 'gold standard' reference. The assessor remained 'blinded' to data input and the measurements were staggered to reduce examiner bias. Results The pectoralis minor length test was found to have excellent intra-rater reliability for dominant and non-dominant side of the subjects without symptoms, and for the painfree and painful side of the subjects with symptoms. The values calculated for the sensitivity, specificity, positive and negative likelihood ratios suggest this test performed in the manner investigated in this study and recommended in the literature, lacks diagnostic accuracy. Conclusion The findings of this study suggest that although the pectoralis minor length test demonstrates acceptable clinical reliability, its lack of specificity suggests that clinicians using this test to inform the clinical

  8. Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever.

    Science.gov (United States)

    Pal, Subhamoy; Dauner, Allison L; Valks, Andrea; Forshey, Brett M; Long, Kanya C; Thaisomboonsuk, Butsaya; Sierra, Gloria; Picos, Victor; Talmage, Sara; Morrison, Amy C; Halsey, Eric S; Comach, Guillermo; Yasuda, Chadwick; Loeffelholz, Michael; Jarman, Richard G; Fernandez, Stefan; An, Ung Sam; Kochel, Tadeusz J; Jasper, Louis E; Wu, Shuenn-Jue L

    2015-04-01

    We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks.

  9. Serum IgA responses against pertussis proteins in infected and Dutch wP or aP vaccinated children: an additional role in pertussis diagnostics.

    Directory of Open Access Journals (Sweden)

    Lotte H Hendrikx

    Full Text Available BACKGROUND: Whooping cough is a respiratory disease caused by Bordetella pertussis, which induces mucosal IgA antibodies that appear to be relevant in protection. Serum IgA responses are measured after pertussis infection and might provide an additional role in pertussis diagnostics. However, the possible interfering role for pertussis vaccinations in the induction of serum IgA antibodies is largely unknown. METHODS/PRINCIPAL FINDINGS: We compared serum IgA responses in healthy vaccinated children between 1 and 10 years of age with those in children who despite vaccinations recently were infected with Bordetella pertussis. All children have been vaccinated at 2, 3, 4 and 11 months of age with either the Dutch whole-cell pertussis (wP vaccine or an acellular pertussis (aP vaccine and additionally received an aP booster vaccination at 4 years of age. Serum IgA responses to pertussis toxin (PT, filamentous heamagglutinin (FHA and pertactin (Prn were measured with a fluorescent multiplex bead-based immuno-assay. An ELISPOT-assay was used for the detection of IgA-memory B-cells specific to these antigens. Serum IgA levels to all pertussis vaccine antigens were significantly higher in infected children compared with healthy children. High correlations between anti-PT, anti-FHA or anti-Prn IgA and IgG levels were found in infected children and to some degree in wP primed children, but not at all in aP primed children. Highest numbers of IgA-pertussis-specific memory B-cells were observed after infection and generally comparable numbers were found after wP and aP vaccination. CONCLUSIONS: This study provides new insight in the diagnostic role for serum IgA responses against PT in vaccinated children. Since aP vaccines induce high serum IgG levels that interfere with pertussis diagnostics, serum IgA-PT levels will provide an additional diagnostic role. High levels of serum IgA for PT proved specific for recent pertussis infection with reasonable

  10. Performace Test and Engine Emission on Acid Oleic Oxygenated as Additives Petrol

    OpenAIRE

    Irfan Wahyudi; Abdul Amir Hassan Kadhum; Yusoff Ali

    2010-01-01

    The objective of this study is to investigate the effect of oxygenated oleic acid additives in standard petrol on the engine performance and the exhaust emissions. The 4-stroke 1.5 litre engine was used on the engine test bed coupled to eddy current electric dynamometer which is also connected to CADET V12 control system and exhaust gas analyser IMR2000/2000P. The oxygenated oleic acid additives used for this experiment is fixed at 0.2% by volume due to limited quantity available. Two types...

  11. An Analysis Of Tensile Test Results to Assess the Innovation Risk for an Additive Manufacturing Technology

    Directory of Open Access Journals (Sweden)

    Adamczak Stanisław

    2015-03-01

    Full Text Available The aim of this study was to assess the innovation risk for an additive manufacturing process. The analysis was based on the results of static tensile tests obtained for specimens made of photocured resin. The assessment involved analyzing the measurement uncertainty by applying the FMEA method. The structure of the causes and effects of the discrepancies was illustrated using the Ishikawa diagram. The risk priority numbers were calculated. The uncertainty of the tensile test measurement was determined for three printing orientations. The results suggest that the material used to fabricate the tensile specimens shows clear anisotropy of the properties in relation to the printing direction.

  12. Carbon dioxide test as an additional clinical measure of treatment response in panic disorder

    OpenAIRE

    Valença Alexandre M; Nardi Antonio Egidio; Nascimento Isabella; Zin Walter A.; Versiani Márcio

    2002-01-01

    OBJECTIVE: We aim to determine if a treatment with a dose of clonazepam - 2 mg/day, for 6 weeks, blocks spontaneous panic attacks and the ones induced by the inhalation of 35% carbon dioxide (CO2) in panic disorder (PD) patients. The CO2 challenge-test may be a useful addition tool for measuring the pharmacological response during the initial phase (6 weeks) in the treatment of PD. METHOD: Eighteen PD patients drug free for a week participated in a carbon dioxide challenge test. Fourteen had ...

  13. Value of Routine Dengue Diagnostic Tests in Urine and Saliva Specimens.

    Directory of Open Access Journals (Sweden)

    Anne-Claire Andries

    2015-09-01

    Full Text Available Dengue laboratory diagnosis is essentially based on detection of the virus, its components or antibodies directed against the virus in blood samples. Blood, however, may be difficult to draw in some patients, especially in children, and sampling during outbreak investigations or epidemiological studies may face logistical challenges or limited compliance to invasive procedures from subjects. The aim of this study was to assess the possibility of using saliva and urine samples instead of blood for dengue diagnosis.Serial plasma, urine and saliva samples were collected at several time-points between the day of admission to hospital until three months after the onset of fever in children with confirmed dengue disease. Quantitative RT-PCR, NS1 antigen capture and ELISA serology for anti-DENV antibody (IgG, IgM and IgA detection were performed in parallel on the three body fluids. RT-PCR and NS1 tests demonstrated an overall sensitivity of 85.4%/63.4%, 41.6%/14.5% and 39%/28.3%, in plasma, urine and saliva specimens, respectively. When urine and saliva samples were collected at the same time-points and tested concurrently, the diagnostic sensitivity of RNA and NS1 detection assays was 69.1% and 34.4%, respectively. IgG/IgA detection assays had an overall sensitivity of 54.4%/37.4%, 38.5%/26.8% and 52.9%/28.6% in plasma, urine and saliva specimens, respectively. IgM were detected in 38.1% and 36% of the plasma and saliva samples but never in urine.Although the performances of the different diagnostic methods were not as good in saliva and urine as in plasma specimens, the results obtained by qRT-PCR and by anti-DENV antibody ELISA could well justify the use of these two body fluids to detect dengue infection in situations when the collection of blood specimens is not possible.

  14. Additive Manufacturing/Diagnostics via the High Frequency Induction Heating of Metal Powders: The Determination of the Power Transfer Factor for Fine Metallic Spheres

    Energy Technology Data Exchange (ETDEWEB)

    Rios, Orlando [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Radhakrishnan, Balasubramaniam [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Caravias, George [Grid Logic, Inc., Lapeer, MI (United States); Holcomb, Matthew [Grid Logic, Inc., Lapeer, MI (United States)

    2015-03-11

    Grid Logic Inc. is developing a method for sintering and melting fine metallic powders for additive manufacturing using spatially-compact, high-frequency magnetic fields called Micro-Induction Sintering (MIS). One of the challenges in advancing MIS technology for additive manufacturing is in understanding the power transfer to the particles in a powder bed. This knowledge is important to achieving efficient power transfer, control, and selective particle heating during the MIS process needed for commercialization of the technology. The project s work provided a rigorous physics-based model for induction heating of fine spherical particles as a function of frequency and particle size. This simulation improved upon Grid Logic s earlier models and provides guidance that will make the MIS technology more effective. The project model will be incorporated into Grid Logic s power control circuit of the MIS 3D printer product and its diagnostics technology to optimize the sintering process for part quality and energy efficiency.

  15. Evaluation of the diagnostic accuracy of prototype rapid tests for human African trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    Jeremy M Sternberg

    2014-12-01

    Full Text Available Diagnosis of human African trypanosomiasis (HAT remains a challenge both for active screening, which is critical in control of the disease, and in the point-of-care scenario where early and accurate diagnosis is essential. Recently, the first field deployment of a lateral flow rapid diagnostic test (RDT for HAT, "SD BIOLINE HAT" has taken place. In this study, we evaluated the performance of "SD BIOLINE HAT" and two new prototype RDTs.The performance of "SD BIOLINE HAT" and 2 prototype RDTs was tested using archived plasma from 250 Trypanosoma brucei gambiense patients, and 250 endemic controls. As well as comparison of the sensitivity and specificity of each device, the performance of individual antigens was assessed and the hypothetical performance of novel antigen combinations extrapolated. Neither of the prototype devices were inferior in sensitivity or specificity to "SD BIOLINE HAT" (sensitivity 0.82±0.01, specificity 0.97±0.01, 95% CI at the 5% margins, while one of the devices (BBI had significantly superior sensitivity (0.88±0.03. Analysis of the performance of individual antigens was used to model new antigen combinations to be explored in development of the next generation of HAT RDTs. The modelling showed that an RDT using two recombinant antigens (rLiTat1.5 and rISG65 would give a performance similar to the best devices in this study, and would also offer the most robust performance under deteriorating field conditions.Both "SD BIOLINE HAT" and the prototype devices performed comparably well to one another and also to the published performance range of the card agglutination test for trypanosomiasis in sensitivity and specificity. The performance of individual antigens enabled us to predict that an all-recombinant antigen RDT can be developed with an accuracy equivalent to " SD BIOLINE HAT." Such an RDT would have advantages in simplified manufacture, lower unit cost and assured reproducibility.

  16. Are faces processed like words? A diagnostic test for recognition by parts.

    Science.gov (United States)

    Martelli, Marialuisa; Majaj, Najib J; Pelli, Denis G

    2005-02-04

    Do we identify an object as a whole or by its parts? This simple question has been surprisingly hard to answer. It has been suggested that faces are recognized as wholes and words are recognized by parts. Here we answer the question by applying a test for crowding. In crowding, a target is harder to identify in the presence of nearby flankers. Previous work has described crowding between objects. We show that crowding also occurs between the parts of an object. Such internal crowding severely impairs perception, identification, and fMRI face-area activation. We apply a diagnostic test for crowding to a word and a face, and we find that the critical spacing of the parts required for recognition is proportional to distance from fixation and independent of size and kind. The critical spacing defines an isolation field around the target. Some objects can be recognized only when each part is isolated from the rest of the object by the critical spacing. In that case, recognition is by parts. Recognition is holistic if the observer can recognize the object even when the whole object fits within a critical spacing. Such an object has only one part. Multiple parts within an isolation field will crowd each other and spoil recognition. To assess the robustness of the crowding test, we manipulated familiarity through inversion and the face- and word-superiority effects. We find that threshold contrast for word and face identification is the product of two factors: familiarity and crowding. Familiarity increases sensitivity by a factor of x1.5, independent of eccentricity, while crowding attenuates sensitivity more and more as eccentricity increases. Our findings show that observers process words and faces in much the same way: The effects of familiarity and crowding do not distinguish between them. Words and faces are both recognized by parts, and their parts -- letters and facial features -- are recognized holistically. We propose that internal crowding be taken as the

  17. EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS).

    Science.gov (United States)

    Dench, Rosalie; Sulistyo, Fransiska; Fahroni, Agus; Philippa, Joost

    2015-12-01

    The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the

  18. Formulation and Testing of Paraffin-Based Solid Fuels Containing Energetic Additives for Hybrid Rockets

    Science.gov (United States)

    Larson, Daniel B.; Boyer, Eric; Wachs,Trevor; Kuo, Kenneth K.; Story, George

    2012-01-01

    Many approaches have been considered in an effort to improve the regression rate of solid fuels for hybrid rocket applications. One promising method is to use a fuel with a fast burning rate such as paraffin wax; however, additional performance increases to the fuel regression rate are necessary to make the fuel a viable candidate to replace current launch propulsion systems. The addition of energetic and/or nano-sized particles is one way to increase mass-burning rates of the solid fuels and increase the overall performance of the hybrid rocket motor.1,2 Several paraffin-based fuel grains with various energetic additives (e.g., lithium aluminum hydride (LiAlH4) have been cast in an attempt to improve regression rates. There are two major advantages to introducing LiAlH4 additive into the solid fuel matrix: 1) the increased characteristic velocity, 2) decreased dependency of Isp on oxidizer-to-fuel ratio. The testing and characterization of these solid-fuel grains have shown that continued work is necessary to eliminate unburned/unreacted fuel in downstream sections of the test apparatus.3 Changes to the fuel matrix include higher melting point wax and smaller energetic additive particles. The reduction in particle size through various methods can result in more homogeneous grain structure. The higher melting point wax can serve to reduce the melt-layer thickness, allowing the LiAlH4 particles to react closer to the burning surface, thus increasing the heat feedback rate and fuel regression rate. In addition to the formulation of LiAlH4 and paraffin wax solid-fuel grains, liquid additives of triethylaluminum and diisobutylaluminum hydride will be included in this study. Another promising fuel formulation consideration is to incorporate a small percentage of RDX as an additive to paraffin. A novel casting technique will be used by dissolving RDX in a solvent to crystallize the energetic additive. After dissolving the RDX in a solvent chosen for its compatibility

  19. Improvements are needed in reporting of accuracy studies for diagnostic tests used for detection of finfish pathogens.

    Science.gov (United States)

    Gardner, Ian A; Burnley, Timothy; Caraguel, Charles

    2014-12-01

    Indices of test accuracy, such as diagnostic sensitivity and specificity, are important considerations in test selection for a defined purpose (e.g., screening or confirmation) and affect the interpretation of test results. Many biomedical journals recommend that authors clearly and transparently report test accuracy studies following the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines ( www.stard-statement.org ). This allows readers to evaluate overall study validity and assess potential bias in diagnostic sensitivity and specificity estimates. The purpose of the present study was to evaluate the reporting quality of studies evaluating test accuracy for finfish diseases using the 25 items in the STARD checklist. Based on a database search, 11 studies that included estimates of diagnostic accuracy were identified for independent evaluation by three reviewers. For each study, STARD checklist items were scored as "yes," "no," or "not applicable." Only 10 of the 25 items were consistently reported in most (≥80%) papers, and reporting of the other items was highly variable (mostly between 30% and 60%). Three items ("number, training, and expertise of readers and testers"; "time interval between index tests and reference standard"; and "handling of indeterminate results, missing data, and outliers of the index tests") were reported in less than 10% of papers. Two items ("time interval between index tests and reference standard" and "adverse effects from testing") were considered minimally relevant to fish health because test samples usually are collected postmortem. Modification of STARD to fit finfish studies should increase use by authors and thereby improve the overall reporting quality regardless of how the study was designed. Furthermore, the use of STARD may lead to the improved design of future studies.

  20. Improvements are needed in reporting of accuracy studies for diagnostic tests used for detection of finfish pathogens.

    Science.gov (United States)

    Gardner, Ian A; Burnley, Timothy; Caraguel, Charles

    2014-12-01

    Indices of test accuracy, such as diagnostic sensitivity and specificity, are important considerations in test selection for a defined purpose (e.g., screening or confirmation) and affect the interpretation of test results. Many biomedical journals recommend that authors clearly and transparently report test accuracy studies following the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines ( www.stard-statement.org ). This allows readers to evaluate overall study validity and assess potential bias in diagnostic sensitivity and specificity estimates. The purpose of the present study was to evaluate the reporting quality of studies evaluating test accuracy for finfish diseases using the 25 items in the STARD checklist. Based on a database search, 11 studies that included estimates of diagnostic accuracy were identified for independent evaluation by three reviewers. For each study, STARD checklist items were scored as "yes," "no," or "not applicable." Only 10 of the 25 items were consistently reported in most (≥80%) papers, and reporting of the other items was highly variable (mostly between 30% and 60%). Three items ("number, training, and expertise of readers and testers"; "time interval between index tests and reference standard"; and "handling of indeterminate results, missing data, and outliers of the index tests") were reported in less than 10% of papers. Two items ("time interval between index tests and reference standard" and "adverse effects from testing") were considered minimally relevant to fish health because test samples usually are collected postmortem. Modification of STARD to fit finfish studies should increase use by authors and thereby improve the overall reporting quality regardless of how the study was designed. Furthermore, the use of STARD may lead to the improved design of future studies. PMID:25252270

  1. Cable Diagnostic Focused Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  2. A Genetically Optimized Predictive System for Success in General Chemistry Using a Diagnostic Algebra Test

    Science.gov (United States)

    Cooper, Cameron I.; Pearson, Paul T.

    2012-02-01

    In higher education, many high-enrollment introductory courses have evolved into "gatekeeper" courses due to their high failure rates. These courses prevent many students from attaining their educational goals and often become graduation roadblocks. At the authors' home institution, general chemistry has become a gatekeeper course in which approximately 25% of students do not pass. This failure rate in chemistry is common, and often higher, at many other institutions of higher education, and mathematical deficiencies are perceived to be a large contributing factor. This paper details the development of a highly accurate predictive system that identifies students at the beginning of the semester who are "at-risk" for earning a grade of C- or below in chemistry. The predictive accuracy of this system is maximized by using a genetically optimized neural network to analyze the results of a diagnostic algebra test designed for a specific population. Once at-risk students have been identified, they can be helped to improve their chances of success using techniques such as concurrent support courses, online tutorials, "just-in-time" instructional aides, study skills, motivational interviewing, and/or peer mentoring.

  3. The stationarity paradigm revisited: Hypothesis testing using diagnostics, summary metrics, and DREAM(ABC)

    Science.gov (United States)

    Sadegh, Mojtaba; Vrugt, Jasper A.; Xu, Chonggang; Volpi, Elena

    2015-11-01

    Many watershed models used within the hydrologic research community assume (by default) stationary conditions, that is, the key watershed properties that control water flow are considered to be time invariant. This assumption is rather convenient and pragmatic and opens up the wide arsenal of (multivariate) statistical and nonlinear optimization methods for inference of the (temporally fixed) model parameters. Several contributions to the hydrologic literature have brought into question the continued usefulness of this stationary paradigm for hydrologic modeling. This paper builds on the likelihood-free diagnostics approach of Vrugt and Sadegh and uses a diverse set of hydrologic summary metrics to test the stationary hypothesis and detect changes in the watersheds response to hydroclimatic forcing. Models with fixed parameter values cannot simulate adequately temporal variations in the summary statistics of the observed catchment data, and consequently, the DREAM(ABC) algorithm cannot find solutions that sufficiently honor the observed metrics. We demonstrate that the presented methodology is able to differentiate successfully between watersheds that are classified as stationary and those that have undergone significant changes in land use, urbanization, and/or hydroclimatic conditions, and thus are deemed nonstationary.

  4. An assessment of various blood collection and transfer methods used for malaria rapid diagnostic tests

    Directory of Open Access Journals (Sweden)

    Baik Fred

    2007-11-01

    Full Text Available Abstract Background Four blood collection and transfer devices commonly used for malaria rapid diagnostic tests (RDTs were assessed for their consistency, accuracy and ease of use in the hands of laboratory technicians and village health workers. Methods Laboratory technicians and village health workers collected blood from a finger prick using each device in random order, and deposited the blood either on filter paper or into a suitable casette-type RDT. Consistency and accuracy of volume delivered was determined by comparing the measurements of the resulting blood spots/heights with the measurements of laboratory-prepared pipetted standard volumes. The effect of varying blood volumes on RDT sensitivity and ease of use was also observed. Results There was high variability in blood volume collected by the devices, with the straw and the loop, the most preferred devices, usually transferring volumes greater than intended, while the glass capillary tube and the plastic pipette transferring less volume than intended or none at all. Varying the blood volume delivered to RDTs indicated that this variation is critical to RDT sensitivity only when the transferred volume is very low. Conclusion None of the blood transfer devices assessed performed consistently well. Adequate training on their use is clearly necessary, with more development efforts for improved designs to be used by remote health workers, in mind.

  5. Costs of genetic testing: Supporting Brazilian Public Policies for the incorporating of molecular diagnostic technologies

    Directory of Open Access Journals (Sweden)

    Rosane Paixão Schlatter

    2015-09-01

    Full Text Available This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%, microsatellite instability analysis (181%, gene rearrangement analysis by multiplex ligation probe amplification (412%, non-labeled sequencing (173%, and quantitation of nucleic acids (169%. These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System.

  6. Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections

    Directory of Open Access Journals (Sweden)

    Pilar Toledano-Sierra

    2015-01-01

    Full Text Available Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics.

  7. Testing Expert-Based versus Student-Based Cognitive Models for a Grade 3 Diagnostic Mathematics Assessment

    Science.gov (United States)

    Roduta Roberts, Mary; Alves, Cecilia B.; Chu, Man-Wai; Thompson, Margaret; Bahry, Louise M.; Gotzmann, Andrea

    2014-01-01

    The purpose of this study was to evaluate the adequacy of three cognitive models, one developed by content experts and two generated from student verbal reports for explaining examinee performance on a grade 3 diagnostic mathematics test. For this study, the items were developed to directly measure the attributes in the cognitive model. The…

  8. The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections

    DEFF Research Database (Denmark)

    Williams, John E; Cairns, Matthew; Njie, Fanta;

    2016-01-01

    BACKGROUND: Intermittent screening and treatment in pregnancy (ISTp) is a potential strategy for the control of malaria during pregnancy. However, the frequency and consequences of malaria infections missed by a rapid diagnostic test (RDT) for malaria are a concern.METHODS: Primigravidae...

  9. 9 CFR 93.204 - Import permits for poultry and for poultry test specimens for diagnostic purposes; and...

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Import permits for poultry and for poultry test specimens for diagnostic purposes; and reservation fees for space at quarantine facilities... SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND...

  10. The diagnostic accuracy and outcomes after coronary computed tomography angiography vs. conventional functional testing in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Ortner, Nino; Nørgaard, Bjarne L;

    2014-01-01

    AIMS: To systematically review and perform a meta-analysis of the diagnostic accuracy and post-test outcomes of conventional exercise electrocardiography (XECG) and single-photon emission computed tomography (SPECT) compared with coronary computed tomography angiography (coronary CTA) in patients...

  11. Diagnostic test for prenatal identification of Down's syndrome and mental retardation and gene therapy therefor

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Desmond J. (Oakland, CA); Rubin, Edward M. (Berkeley, CA)

    2000-01-01

    A a diagnostic test useful for prenatal identification of Down syndrome and mental retardation. A method for gene therapy for correction and treatment of Down syndrome. DYRK gene involved in the ability to learn. A method for diagnosing Down's syndrome and mental retardation and an assay therefor. A pharmaceutical composition for treatment of Down's syndrome mental retardation.

  12. Quality control in diagnostic molecular pathology in the Netherlands; proficiency testing for patient identification in tissue samples.

    NARCIS (Netherlands)

    Thunnissen, F.B.J.M.; Tilanus, M.G.J.; Ligtenberg, M.J.L.; Nederlof, P.M.; Dinjens, W.N.; Meulemans, E.; Brule, A.J. van den; Noesel, C.J. van; Leeuw, W. de; Schuuring, E.

    2004-01-01

    AIMS: To describe the evolution of proficiency testing for molecular diagnostic pathology with respect to determining unambiguously the patient identity of tissue samples by microsatellite analysis. METHOD: Four rounds of quality control exchanges of samples from different patients were sent with th

  13. Chromosomal microarray analysis as a first-tier clinical diagnostic test: Estonian experience.

    Science.gov (United States)

    Zilina, Olga; Teek, Rita; Tammur, Pille; Kuuse, Kati; Yakoreva, Maria; Vaidla, Eve; Mölter-Väär, Triin; Reimand, Tiia; Kurg, Ants; Ounap, Katrin

    2014-03-01

    Chromosomal microarray analysis (CMA) is now established as the first-tier cytogenetic diagnostic test for fast and accurate detection of chromosomal abnormalities in patients with developmental delay/intellectual disability (DD/ID), multiple congenital anomalies (MCA), and autism spectrum disorders (ASD). We present our experience with using CMA for postnatal and prenatal diagnosis in Estonian patients during 2009-2012. Since 2011, CMA is on the official service list of the Estonian Health Insurance Fund and is performed as the first-tier cytogenetic test for patients with DD/ID, MCA or ASD. A total of 1191 patients were analyzed, including postnatal (1072 [90%] patients and 59 [5%] family members) and prenatal referrals (60 [5%] fetuses). Abnormal results were reported in 298 (25%) patients, with a total of 351 findings (1-3 per individual): 147 (42%) deletions, 106 (30%) duplications, 89 (25%) long contiguous stretches of homozygosity (LCSH) events (>5 Mb), and nine (3%) aneuploidies. Of all findings, 143 (41%) were defined as pathogenic or likely pathogenic; for another 143 findings (41%), most of which were LCSH, the clinical significance remained unknown, while 61 (18%) reported findings can now be reclassified as benign or likely benign. Clinically relevant findings were detected in 126 (11%) patients. However, the proportion of variants of unknown clinical significance was quite high (41% of all findings). It seems that our ability to detect chromosomal abnormalities has far outpaced our ability to understand their role in disease. Thus, the interpretation of CMA findings remains a rather difficult task requiring a close collaboration between clinicians and cytogeneticists.

  14. Can Rapid Diagnostic Testing for Malaria Increase Adherence to Artemether-Lumefantrine?: A Randomized Controlled Trial in Uganda.

    Science.gov (United States)

    Saran, Indrani; Yavuz, Elif; Kasozi, Howard; Cohen, Jessica

    2016-04-01

    Most patients with suspected malaria do not receive diagnostic confirmation before beginning antimalarial treatment. We investigated the extent to which uncertainty about malaria diagnosis contributes to patient nonadherence to artemether-lumefantrine (AL) treatment through a randomized controlled trial in central Uganda. Among 1,525 patients purchasing a course of AL at private drug shops, we randomly offered 37.6% a free malaria rapid diagnostic test (RDT) and then assessed adherence through home visits 3 days later. Of these subjects, 68.4% tested positive for malaria and 65.8% adhered overall. Patients who tested positive did not have significantly higher odds of adherence than those who were not offered the test (adjusted odds ratio [OR]: 1.07, 95% confidence interval [CI]: 0.734-1.57,P= 0.719). Patients who received a positive malaria test had 0.488 fewer pills remaining than those not offered the test (95% CI: -1.02 to 0.043,P= 0.072). We found that patients who felt relatively healthy by the second day of treatment had lower odds of completing treatment (adjusted OR: 0.532, 95% CI: 0.394-0.719,P< 0.001). Our results suggest that diagnostic testing may not improve artemisinin-based combination therapy adherence unless efforts are made to persuade patients to continue taking the full course of drugs even if symptoms have resolved. PMID:26928828

  15. Sensitivity and Specificity of a New Vertical Flow Rapid Diagnostic Test for the Serodiagnosis of Human Leptospirosis.

    Directory of Open Access Journals (Sweden)

    Cyrille Goarant

    2013-06-01

    Full Text Available Background : Leptospirosis is a growing public health concern in many tropical and subtropical countries. However, its diagnosis is difficult because of non-specific symptoms and concurrent other endemic febrile diseases. In many regions, the laboratory diagnosis is not available due to a lack of preparedness and simple diagnostic assay or difficult access to reference laboratories. Yet, an early antibiotic treatment is decisive to the outcome. The need for Rapid Diagnostic Tests (RDTs for bedside diagnosis of leptospirosis has been recognized. We developed a vertical flow immunochromatography strip RDT detecting anti-Leptospira human IgM and evaluated it in patients from New Caledonia, France, and French West Indies. Methodology/Principal Findings : Whole killed Leptospira fainei cells were used as antigen for the test line and purified human IgM as the control line. The mobile phase was made of gold particles conjugated with goat anti-human IgM. Standards for Reporting of Diagnostic Accuracy criteria were used to assess the performance of this RDT. The Microscopic Agglutination Test (MAT was used as the gold standard with a cut-off titer of ≥400. The sensitivity was 89.8% and the specificity 93.7%. Positive and negative Likelihood Ratios of 14.18 and 0.108 respectively, and a Diagnostic Odds Ratio of 130.737 confirmed its usefulness. This RDT had satisfactory reproducibility, repeatability, thermal tolerance and shelf-life. The comparison with MAT evidenced the earliness of the RDT to detect seroconversion. When compared with other RDT, the Vertical Flow RDT developed displayed good diagnostic performances.This RDT might be used as a point of care diagnostic tool in limited resources countries. An evaluation in field conditions and in other epidemiological contexts should be considered to assess its validity over a wider range of serogroups or when facing different endemic pathogens. It might prove useful in endemic contexts or outbreak

  16. The diagnostic value of three sacroiliac joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Arnbak, B; Jurik, A G; Jensen, R K;

    2016-01-01

    OBJECTIVES: The aim of the current study was to investigate the diagnostic value of three sacroiliac (SI) joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging (MRI) and stratified by gender. METHOD: Patients without clinical signs of nerve root compression were...... was 33 (range 18-40) years and 241 (53%) were women. The prevalence of SI joints with sacroiliitis was 5%. In the whole study group, only the thigh trust test was associated with sacroiliitis, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.58 [95% confidence interval (CI) 0......-79), and specificity 81% (95% CI 77-85)]. In women, no significant associations were observed between the SI joint tests and sacroiliitis. CONCLUSIONS: Only in men were the SI joint tests found to be associated with sacroiliitis identified by MRI. Although, the diagnostic value was relatively low, the results indicate...

  17. Quantitative analysis of genomic DNA degradation in whole blood under various storage conditions for molecular diagnostic testing.

    Science.gov (United States)

    Permenter, Jessalyn; Ishwar, Arjun; Rounsavall, Angie; Smith, Maddie; Faske, Jennifer; Sailey, Charles J; Alfaro, Maria P

    2015-12-01

    Proper storage of whole blood is crucial for isolating nucleic acids from leukocytes and to ensure adequate performance of downstream assays in the molecular diagnostic laboratory. Short-term and long-term storage recommendations are lacking for successful isolation of genomic DNA (gDNA). Container type (EDTA or heparin), temperature (4 °C and room temperature) and time (1-130 days) were assessed as criterion for sample acceptance policies. The percentage of integrated area (%Ti) between 150 and 10,000 bp from the 2200 TapeStation electropherogram was calculated to measure gDNA degradation. Refrigerated EDTA samples yielded gDNA with low %Ti (high quality). Heparinized samples stored at room temperature yielded gDNA of worst quality. Downstream analysis demonstrated that the quality of the gDNA correlated with the quality of the data; samples with high %Ti generated significantly lower levels of high molecular weight amplicons. Recommendations from these analyses include storing blood samples intended for nucleic acid isolation in EDTA tubes at 4 °C for long term storage (>10 days). gDNA should be extracted within 3 days when blood is stored at room temperature regardless of the container. Finally, refrigerated heparinized samples should not be stored longer than 9 days if expecting high quality gDNA isolates. Laboratories should consider many factors, in addition to the results obtained herein, to update their policies for sample acceptance for gDNA extraction intended for molecular genetic testing.

  18. The conversion of CESR to operate as the Test Accelerator, CesrTA. Part 3: electron cloud diagnostics

    Science.gov (United States)

    Billing, M. G.; Conway, J. V.; Crittenden, J. A.; Greenwald, S.; Li, Y.; Meller, R. E.; Strohman, C. R.; Sikora, J. P.; Calvey, J. R.; Palmer, M. A.

    2016-04-01

    Cornell's electron/positron storage ring (CESR) was modified over a series of accelerator shutdowns beginning in May 2008, which substantially improves its capability for research and development for particle accelerators. CESR's energy span from 1.8 to 5.6 GeV with both electrons and positrons makes it ideal for the study of a wide spectrum of accelerator physics issues and instrumentation related to present light sources and future lepton damping rings. Additionally a number of these are also relevant for the beam physics of proton accelerators. This paper is the third in a series of four describing the conversion of CESR to the test accelerator, CESRTA. The first two papers discuss the overall plan for the conversion of the storage ring to an instrument capable of studying advanced accelerator physics issues [1] and the details of the vacuum system upgrades [2]. This paper focusses on the necessary development of new instrumentation, situated in four dedicated experimental regions, capable of studying such phenomena as electron clouds (ECs) and methods to mitigate EC effects. The fourth paper in this series describes the vacuum system modifications of the superconducting wigglers to accommodate the diagnostic instrumentation for the study of EC behavior within wigglers. While the initial studies of CESRTA focussed on questions related to the International Linear Collider damping ring design, CESRTA is a very versatile storage ring, capable of studying a wide range of accelerator physics and instrumentation questions.

  19. Real-Time Remote Diagnostic Monitoring test-bed in JET

    International Nuclear Information System (INIS)

    The main objective of DiagKG8B is to monitor online and on remote a diagnostic in JET and this solution is ready to be used on other fusion devices. Important remote monitoring concepts are formalized in a data monitoring protocol: frame, delays, monitoring data solution, frame rate. The modular architecture is in 3 parts: diagnostic, data distribution and monitoring applications. DiagKG8B is scalable and long pulse oriented. The system is secure and compatible in a multi-organisation environment. This solution could easily evolve to remote monitoring infrastructure for integrating new diagnostics. This document is made of the presentation transparencies. (A.C.)

  20. Utility of Different Electrocardiographical Leads during Diagnostic Ajmaline Test for Suspected Brugada Syndrome

    Directory of Open Access Journals (Sweden)

    Batchvarov V. N.

    2009-12-01

    Full Text Available In order to compare the value of different leads and lead combinations to detect the signature Brugada type ECG pattern, we analysed digital 10-second, 15-lead ECGs (12 standard leads + leads V1 to V3 from 3rd intercostal (i.c. space, V1h to V3h acquired during diagnostic Ajmaline testing in 128 patients (80 men, age 37±15 years with suspected Brugada syndrome (BS (patient group, 15-lead resting ECGs of 108 healthy subjects (53 men, age 31.9±10.5 years (control group A and standard 12-lead resting ECGs of 229 healthy subjects (111 men, age 33±4 years (control group B. Bipolar leads between V2 (positive pole and V4 or V5 (leads V2-4V2-5 were derived by subtracting leads V4 and V5 from V2 (custom-made program. The 6 peripheral, 6 right precordial leads (V1 to V3, V1h to V3h and leads V2-4 and V2-5 of the patients group, leads V1h to V3h of control group A, and leads V2-4 and V2-5 of control group B were analysed for the presence of type 1 Brugada pattern. There were 21 (16.4% positive and 107 (83.6% negative Ajmaline tests. In 7 positive tests (33%, type 1 pattern appeared only in leads V1h to V3h, whereas in 14 tests 67% it appeared in both V1 to V3 and V1h to V3h. Lead V2 displayed type 1 pattern during 10 positive tests; in all of them, plus 10 other positive tests type 1 was also noted in lead V2h (n=20, 95.2%. In all 10 cases, in which lead V2 exhibited type 1 pattern (n=10, lead V2-4 and/or V2-5 also exhibited type 1-like pattern. During 7 positive tests, in which lead V2h but not V2 exhibited type 1 pattern, lead V2-4 and/or V2-5 also demonstrated type 1 pattern. Type 1 pattern was observed in leads V3 and V3h during 1 (5% and 5 (24% positive tests, in 0 ECGs (0% in control group A and in 1 ECG (0.4% in control group B. In conclusion, the "high" V1 and V2 leads (3rd i.c. space detect more sensitively Brugada type 1 pattern than the standard V1 and V2 leads (4th i.c. space; leads V3 and V3h are not essential for the diagnosis of BS

  1. Field evaluation of five rapid diagnostic tests for screening of HIV-1 infections in rural Rakai, Uganda

    OpenAIRE

    Kagulire, S. C.; Opendi, P; Stamper, P. D.; Nakavuma, J L; Mills, L. A.; Makumbi, F.; Gray, R H; Shott, J P; Serwadda, D; Reynolds, S.J.

    2011-01-01

    The performance characteristics of HIV rapid diagnostic tests (RDTs) vary by test and by population. We assessed five commercial RDTs in Uganda where all but one RDT (Determine; Abbott Laboratories, Germany) performed close to manufacturer’s expectations. Determine had low specificity (85.2%, positive predictive value 67.3%) due to false-positive results with weak-positive bands. Properly trained staff, good quality control programmes and validation of RDTs with laboratories having confirmato...

  2. Bench-top validation testing of selected immunological and molecular Renibacterium salmoninarum diagnostic assays by comparison with quantitative bacteriological culture

    Science.gov (United States)

    Elliott, D.G.; Applegate, L.J.; Murray, A.L.; Purcell, M.K.; McKibben, C.L.

    2013-01-01

    No gold standard assay exhibiting error-free classification of results has been identified for detection of Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease. Validation of diagnostic assays for R. salmoninarum has been hindered by its unique characteristics and biology, and difficulties in locating suitable populations of reference test animals. Infection status of fish in test populations is often unknown, and it is commonly assumed that the assay yielding the most positive results has the highest diagnostic accuracy, without consideration of misclassification of results. In this research, quantification of R. salmoninarum in samples by bacteriological culture provided a standardized measure of viable bacteria to evaluate analytical performance characteristics (sensitivity, specificity and repeatability) of non-culture assays in three matrices (phosphate-buffered saline, ovarian fluid and kidney tissue). Non-culture assays included polyclonal enzyme-linked immunosorbent assay (ELISA), direct smear fluorescent antibody technique (FAT), membrane-filtration FAT, nested polymerase chain reaction (nested PCR) and three real-time quantitative PCR assays. Injection challenge of specific pathogen-free Chinook salmon, Oncorhynchus tshawytscha (Walbaum), with R. salmoninarum was used to estimate diagnostic sensitivity and specificity. Results did not identify a single assay demonstrating the highest analytical and diagnostic performance characteristics, but revealed strengths and weaknesses of each test.

  3. Bench-top validation testing of selected immunological and molecular Renibacterium salmoninarum diagnostic assays by comparison with quantitative bacteriological culture.

    Science.gov (United States)

    Elliott, D G; Applegate, L J; Murray, A L; Purcell, M K; McKibben, C L

    2013-09-01

    No gold standard assay exhibiting error-free classification of results has been identified for detection of Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease. Validation of diagnostic assays for R. salmoninarum has been hindered by its unique characteristics and biology, and difficulties in locating suitable populations of reference test animals. Infection status of fish in test populations is often unknown, and it is commonly assumed that the assay yielding the most positive results has the highest diagnostic accuracy, without consideration of misclassification of results. In this research, quantification of R. salmoninarum in samples by bacteriological culture provided a standardized measure of viable bacteria to evaluate analytical performance characteristics (sensitivity, specificity and repeatability) of non-culture assays in three matrices (phosphate-buffered saline, ovarian fluid and kidney tissue). Non-culture assays included polyclonal enzyme-linked immunosorbent assay (ELISA), direct smear fluorescent antibody technique (FAT), membrane-filtration FAT, nested polymerase chain reaction (nested PCR) and three real-time quantitative PCR assays. Injection challenge of specific pathogen-free Chinook salmon, Oncorhynchus tshawytscha (Walbaum), with R. salmoninarum was used to estimate diagnostic sensitivity and specificity. Results did not identify a single assay demonstrating the highest analytical and diagnostic performance characteristics, but revealed strengths and weaknesses of each test.

  4. Compositions, Functions, and Testing of Friction Brake Materials and Their Additives

    Energy Technology Data Exchange (ETDEWEB)

    Blau, PJ

    2001-10-22

    The purpose of this report is to present a survey of commercial brake materials and additives, and to indicate their typical properties and functions, especially as regards their use in heavy trucks. Most truck pad and shoe materials described here were designed to wear against cast iron. Brake material test methods are also briefly described. This report does not address issues associated with the fabrication and manufacturing of brake materials. Since there are literally thousands of brake material additives, and their combinations are nearly limitless, it is impractical to list them all here. Rather, an attempt has been made to capture the primary constituents and their functions. An Appendix contains thermo-physical properties of some current and potential brake materials.

  5. Dried Plasmodium falciparum-infected samples as positive controls for malaria rapid diagnostic tests

    Directory of Open Access Journals (Sweden)

    Aidoo Michael

    2012-07-01

    Full Text Available Abstract Background Rapid diagnostic tests (RDTs are central to fulfilling the WHO’s recommendation for parasitologic confirmation of all suspected cases of malaria. RDT performance may be compromised when exposed to the high temperature conditions typical of most malaria endemic regions. However, a systematic method to monitor RDT quality and performance in endemic countries is lacking at the present time. Current methods to monitor RDT performance in the field include comparing results from RDTs to diagnoses made by light microscopy and observing health workers perform tests. These methods are not substitutes for direct quality control. In this study, the suitability of dried Plasmodium falciparum-infected blood as quality control samples for malaria RDTs was evaluated. Methods Three cultured strains of P. falciparum at 200 and 2,000 parasites/μl were tested on 10 brands of RDT. After baseline testing to determine initial reactivity, aliquots of parasite-infected blood were air dried, stored at 35°C, room temperature (~25°C or 4°C for one, four and 12 weeks and were then tested on the 10 RDTs after rehydration. Extended stability testing of dried blood stored at 4°C was done using P. falciparum strain 3D7 at 1,000 and 2,000 parasites/μl. Results All dried blood samples at 2,000 parasites/μl retained reactivity (100% sensitivity at all three temperatures and time points for all nine RDT brands that detect histidine-rich protein-2 (HRP2. The dried blood samples with 200 parasites/μl were detected by six of the nine HRP2-based RDTs at all storage temperatures and time points. The sensitivity for two of the three remaining HRP2-based RDTs was 100% up to four weeks of storage at all temperatures but dropped to 87.5% at week 12. Of the four RDTs that detect plasmodium lactate dehydrogenase (pLDH in a pan-specific manner, alone or in combination with HRP2, the detection of pLDH in samples with 2,000 parasites/μL was 100% for two RDTs and

  6. Quantitative kHz to MHz Frame Rate Flow Diagnostics for Aerodynamic Ground Test Facilities Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed Phase I SBIR program will study the feasibility of building next-generation burst-mode laser diagnostics that will enable unparalleled planar imaging...

  7. A Laser-Based Diagnostic Suite for Hypersonic Test Facilities Project

    Data.gov (United States)

    National Aeronautics and Space Administration — In this SBIR effort, Los Gatos Research (LGR) proposes to develop a suite of laser-based diagnostics for the study of reactive and non-reactive hypersonic flows....

  8. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham;

    2016-01-01

    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children ...-randomized trials were conducted in two contrasting areas of moderate-to-high and low malaria transmission in rural Uganda. Each trial examined the effectiveness of mRDTs in the management of malaria and targeting of ACTs by CHWs comparing two diagnostic approaches: (i) presumptive clinical diagnosis of malaria...... sensitivity of current mRDTs in patients with low parasite density are a concern. For community-based treatment in areas of low transmission and/or non-immune populations, presumptive treatment of all fevers as malaria may be advisable, until more sensitive diagnostic assays, suitable for routine use by CHWs...

  9. Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

    Directory of Open Access Journals (Sweden)

    Waiswa Peter

    2010-07-01

    Full Text Available Abstract Background Many malarious countries plan to introduce artemisinin combination therapy (ACT at community level using community health workers (CHWs for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs. Methods The study was conducted in Iganga district using 10 focus group discussions (FGDs with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs. Results CMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred. Conclusion Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical

  10. Application and testing of additive manufacturing for mirrors and precision structures

    Science.gov (United States)

    Sweeney, Michael; Acreman, Martyn; Vettese, Tom; Myatt, Ray; Thompson, Mike

    2015-09-01

    Additive Manufacturing (aka AM, and 3-D printing) is widely touted in the media as the foundation for the next industrial revolution. Beneath the hype, AM does indeed offer profound advantages in lead-time, dramatically reduced consumption of expensive raw materials, while enabling new and innovative design forms that cannot be produced by other means. General Dynamics and their industry partners have begun to embrace this technology for mirrors and precision structures used in the aerospace, defense, and precision optical instrumentation industries. Aggressively lightweighted, open and closed back test mirror designs, 75-150 mm in size, were first produced by AM from several different materials. Subsequent optical finishing and test experiments have exceeded expectations for density, surface finish, dimensional stability and isotropy of thermal expansion on the optical scale of measurement. Materials currently under examination include aluminum, titanium, beryllium, aluminum beryllium, Inconel 625, stainless steel/bronze, and PEKK polymer.

  11. Technological advances in diagnostic testing for von Willebrand disease: new approaches and challenges.

    Science.gov (United States)

    Hayward, C P M; Moffat, K A; Graf, L

    2014-06-01

    Diagnostic tests for von Willebrand disease (VWD) are important for the assessment of VWD, which is a commonly encountered bleeding disorder worldwide. Technical innovations have been applied to improve the precision and lower limit of detection of von Willebrand factor (VWF) assays, including the ristocetin cofactor activity assay (VWF:RCo) that uses the antibiotic ristocetin to induce plasma VWF binding to glycoprotein (GP) IbIXV on target platelets. VWF-collagen-binding assays, depending on the type of collagen used, can improve the detection of forms of VWD with high molecular weight VWF multimer loss, although the best method is debatable. A number of innovations have been applied to VWF:RCo (which is commonly performed on an aggregometer), including replacing the target platelets with immobilized GPIbα, and quantification by an enzyme-linked immunosorbent assay (ELISA), immunoturbidimetric, or chemiluminescent end-point. Some common polymorphisms in the VWF gene that do not cause bleeding are associated with falsely low VWF activity by ristocetin-dependent methods. To overcome the need for ristocetin, some new VWF activity assays use gain-of-function GPIbα mutants that bind VWF without the need for ristocetin, with an improved precision and lower limit of detection than measuring VWF:RCo by aggregometry. ELISA of VWF binding to mutated GPIbα shows promise as a method to identify gain-of-function defects from type 2B VWD. The performance characteristics of many new VWF activity assays suggest that the detection of VWD, and monitoring of VWD therapy, by clinical laboratories could be improved through adopting newer generation VWF assays.

  12. Combustion Control and Diagnostics Sensor Testing in a Thermal Barrier Coated Combustor

    Energy Technology Data Exchange (ETDEWEB)

    Chorpening, B.T.; Dukes, M.G.; Robey, E.H.; Thornton, J.D.

    2007-05-01

    The combustion control and diagnostics sensor (CCADS) continues to be developed as an in-situ combustion sensor, with immediate application to natural gas fired turbines. In-situ combustion monitoring is also expected to benefit advanced power plants of the future, fueled by coal-derived syngas, liquified natural gas (LNG), hydrogen, or hydrogen blend fuels. The in-situ monitoring that CCADS provides can enable the optimal operation of advanced, fuel-flexible turbines for minimal pollutant emissions and maximum efficiency over the full operating range of an advanced turbine. Previous work has demonstrated CCADS as a useful sensor for in-situ monitoring of natural gas combustion, including detection of important combustion events such as flashback and lean blowoff, in experimental combustors without thermal barrier coatings (TBC). Since typical TBC materials are electrical insulators at room temperature, and CCADS operation requires conduction of electrical current to the walls of the combustor, a TBC on the combustion liner was identified as a potential barrier to CCADS operation in commercial application. This paper reports on CCADS experiments in a turbulent lean premixed combustor with a yttria-stabilized zirconia (YSZ) thermal barrier coating on the combustor wall. The tests were conducted at 0.1 MPa (1 atm), with a 15V excitation voltage on the CCADS electrodes. The results confirm that for a typical thermal barrier coating, CCADS operates properly, and the total measured average resistance is close to that of an uncoated combustor. This result is consistent with previous materials studies that found the electrical resistance of typical TBC materials considerably decreases at combustor operating temperatures.

  13. Allergic bronchopulmonary aspergillosis in Italian cystic fibrosis patients: Prevalence and percentage of positive tests in the employed diagnostic criteria

    International Nuclear Information System (INIS)

    The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients is difficult to determine because the data in the literature are not homogeneous or comparable. ABPA and CF have similar clinical symptoms which make diagnosis difficult and underestimate the real dimensions of the problem. We conducted an epidemiological study on 3089 Italian CF patients to determine the prevalence of ABPA in Italy and verify the percentage of positive tests in the employed diagnostic criteria. Our results indicate that the prevalence of ABPA in Italian CF patients is 6.18%, mainly in adolescents and young adults. ABPA is diagnosed using clinical symptoms (presence of episodic bronchial obstructions or typical radiographic features) and on the basis of other criteria which can only be partially fulfilled in paediatric patients. Among the diagnostic tests the most sensitive are the total IgE (84.5%), specific IgE anti-Aspergillus fumigatus (81.6%) and the prick test (68.3%). In the absence of clinical symptoms and gold standard diagnostic tests, serological positivity and/or the skin test are not sufficient evidence to confirm the presence of ABPA

  14. Turn-amplitude analysis as a diagnostic test for myofascial syndrome in patients with chronic pelvic pain

    Science.gov (United States)

    Itza, Fernando; Zarza, Daniel; Salinas, Jesus; Teba, Fernando; Ximenez, Carmen

    2015-01-01

    BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF) is a common disease in the context of chronic pelvic pain (CPP); however, there is currently no gold-standard test to diagnose it. OBJECTIVE: To validate the turns-amplitude analysis (TAA) as a diagnostic test for MPSPF in patients with CPP. METHODS: A case-control study was performed, and patients were consecutively sampled within a specified period of time. A total of 128 patients were included: 64 patients with CPP (32 men and 32 women) and 64 control patients (32 men and 32 women). The same operator conducted all tests. Electromyography of the TAA is based on the collection of motor unit potentials that measure the number of changes in the signal and the mean amplitude of the changes. The electromyogram transfers the data to a graphical point cloud, which enables the patient’s results to be compared with the results of the healthy subjects. RESULTS: In patients and control subjects, the sensitivity and specificity of the proposed diagnostic test showed a marked clinical significance: the sensitivity was 83%, and the specificity was 100%. A positive predictive value of 1 (95% CI 1 to 1) and a negative predictive value of 0.85 (95% CI 0.77 to 0.93) were observed. CONCLUSION: TAA is a reliable diagnostic test to detect MPSPF. Further studies are needed to reproduce these results. PMID:25848846

  15. Diagnostic accuracy of point-of-care tests for hepatitis C virus infection: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mehnaaz Sultan Khuroo

    Full Text Available Point-of-care tests provide a plausible diagnostic strategy for hepatitis C infection in economically impoverished areas. However, their utility depends upon the overall performance of individual tests.A literature search was conducted using the metasearch engine Mettā, a query interface for retrieving articles from five leading medical databases. Studies were included if they employed point-of-care tests to detect antibodies of hepatitis C virus and compared the results with reference tests. Two reviewers performed a quality assessment of the studies and extracted data for estimating test accuracy.Thirty studies that had evaluated 30 tests fulfilled the inclusion criteria. The overall pooled sensitivity, specificity, positive likelihood-ratio, negative likelihood-ratio and diagnostic odds ratio for all tests were 97.4% (95% CI: 95.9-98.4, 99.5% (99.2-99.7, 80.17 (55.35-116.14, 0.03 (0.02-0.04, and 3032.85 (1595.86-5763.78, respectively. This suggested a high pooled accuracy for all studies. We found substantial heterogeneity between studies, but none of the subgroups investigated could account for the heterogeneity. Genotype diversity of HCV had no or minimal influence on test performance. Of the seven tests evaluated in the meta-regression model, OraQuick had the highest test sensitivity and specificity and showed better performance than a third generation enzyme immunoassay in seroconversion panels. The next highest test sensitivities and specificities were from TriDot and SDBioline, followed by Genedia and Chembio. The Spot and Multiplo tests produced poor test sensitivities but high test specificities. Nine of the remaining 23 tests produced poor test sensitivities and specificities and/or showed poor performances in seroconversion panels, while 14 tests had high test performances with diagnostic odds ratios ranging from 590.70 to 28822.20.Performances varied widely among individual point-of-care tests for diagnosis of hepatitis C virus

  16. Diagnostic laboratory testing for Charcot Marie Tooth disease (CMT): the spectrum of gene defects in Norwegian patients with CMT and its implications for future genetic test strategies

    OpenAIRE

    Østern, Rune André Helland; Fagerheim, Toril; Hjellnes, Helene; Nygård, Bjørn; Mellgren, Svein Ivar; Nilssen, Øivind

    2013-01-01

    Background Current genetic test algorithms for Charcot Marie Tooth (CMT) disease are based on family details and comprehensive clinical and neurophysiological data gathered under ideal conditions for clinical assessment. However, in a diagnostic laboratory setting relying on external test requisitions and patient samples, such conditions are not always met. Our objective was therefore to perform a retrospective evaluation of the data given in laboratory request forms and to assess their quali...

  17. Comparison of the diagnostic accuracy of a rapid immunochromatographic test and the rapid plasma reagin test for antenatal syphilis screening in Mozambique.

    OpenAIRE

    Montoya, Pablo J.; Lukehart, Sheila A.; Brentlinger, Paula E.; Blanco, Ana J.; Floriano, Florencia; Sairosse, Josefa; Gloyd, Stephen

    2006-01-01

    OBJECTIVE: Programmes to control syphilis in developing countries are hampered by a lack of laboratory services, delayed diagnosis, and doubts about current screening methods. We aimed to compare the diagnostic accuracy of an immunochromatographic strip (ICS) test and the rapid plasma reagin (RPR) test with the combined gold standard (RPR, Treponema pallidum haemagglutination assay and direct immunofluorescence stain done at a reference laboratory) for the detection of syphilis in pregnancy. ...

  18. Diagnosis of dengue infection using various diagnostic tests in the early stage of illness.

    Science.gov (United States)

    Lolekha, Rangsima; Chokephaibulkit, Kulkanya; Yoksan, Sutee; Vanprapar, Nirun; Phongsamart, Wanatpreeya; Chearskul, Sanay

    2004-06-01

    In order to elucidate the usefulness of various tests in the early course of dengue infection, in terms of diagnosis and correlation with clinical severity, blood specimens were collected every 48 hours on 3 occasions from patients with clinical suspicion of dengue infection with fever for less than 4 days. Viral isolation was attempted by mosquito inoculation (MI), tissue culture inoculation (TC), and reverse transcriptase polymerase chain reaction (RT-PCR). Antibodies were detected by hemagglutination inhibition test (HI), an in-house-ELISA (IH-ELISA), and an ELISA by MRL diagnostics Clinical data were collected from the time of enrollment to complete recovery. Of the 40 patients enrolled, 31 were diagnosed as dengue infection and confirmed by either serology or viral isolation. Of these, 12 had primary infection and 19 had secondary infection. Dengue fever occurred in 9 cases. Dengue viruses were isolated from 28 out of 31 patients, and dengue hemorrhagic fever was diagnosed in 22 patients. Viral serotypes identified by viral isolation, and RT-PCR were concordant: DEN1 was isolated in 8, DEN2 in 13, DEN3 in 5, and DEN4 in 2 patients. Viral isolation yielded positive results on blood collected before the 5th day of fever. MI was more sensitive than TC. RT-PCR was less sensitive than viral isolation during the early days of fever, but became more sensitive after the 5th day of fever. RT-PCR was able to detect virus up to day 7-8 of fever, even after defervescence, and in the presence of antibody. During the febrile stage, serological diagnosis on blood samples taken 48 hours apart was carried out by HI, IH-ELISA, and MRL-ELISA, facilitating diagnosis in 3 (10%), 21 (67%), and 27 (87%) of patients, respectively. All of the patients with secondary infection were diagnosed by MRL-ELISA before defervescence. By the 8th day of fever, a serological diagnosis aided to diagnose in 9 (29%), 29 (93%), and 31 (100%) of patients by HI, IH-ELISA, and MRL-ELISA, respectively

  19. A Fully Non-Metallic Gas Turbine Engine Enabled by Additive Manufacturing Part I: System Analysis, Component Identification, Additive Manufacturing, and Testing of Polymer Composites

    Science.gov (United States)

    Grady, Joseph E.; Haller, William J.; Poinsatte, Philip E.; Halbig, Michael C.; Schnulo, Sydney L.; Singh, Mrityunjay; Weir, Don; Wali, Natalie; Vinup, Michael; Jones, Michael G.; Patterson, Clark; Santelle, Tom; Mehl, Jeremy

    2015-01-01

    The research and development activities reported in this publication were carried out under NASA Aeronautics Research Institute (NARI) funded project entitled "A Fully Nonmetallic Gas Turbine Engine Enabled by Additive Manufacturing." The objective of the project was to conduct evaluation of emerging materials and manufacturing technologies that will enable fully nonmetallic gas turbine engines. The results of the activities are described in three part report. The first part of the report contains the data and analysis of engine system trade studies, which were carried out to estimate reduction in engine emissions and fuel burn enabled due to advanced materials and manufacturing processes. A number of key engine components were identified in which advanced materials and additive manufacturing processes would provide the most significant benefits to engine operation. The technical scope of activities included an assessment of the feasibility of using additive manufacturing technologies to fabricate gas turbine engine components from polymer and ceramic matrix composites, which were accomplished by fabricating prototype engine components and testing them in simulated engine operating conditions. The manufacturing process parameters were developed and optimized for polymer and ceramic composites (described in detail in the second and third part of the report). A number of prototype components (inlet guide vane (IGV), acoustic liners, engine access door) were additively manufactured using high temperature polymer materials. Ceramic matrix composite components included turbine nozzle components. In addition, IGVs and acoustic liners were tested in simulated engine conditions in test rigs. The test results are reported and discussed in detail.

  20. A clearing house for diagnostic testing: the solution to ensure access to and use of patented genetic inventions?

    Science.gov (United States)

    van Zimmeren, Esther; Verbeure, Birgit; Matthijs, Gert; Van Overwalle, Geertrui

    2006-01-01

    In genetic diagnostics, the emergence of a so-called "patent thicket" is imminent. Such an overlapping set of patent rights may have restrictive effects on further research and development of diagnostic tests, and the provision of clinical diagnostic services. Currently, two models that may facilitate access to and use of patented genetic inventions are attracting much debate in various national and international fora: patent pools and clearing houses. In this article, we explore the concept of clearing houses. Several types of clearing houses are identified. First, we describe and discuss two types that would provide access to information on the patented inventions: the information clearing house and the technology exchange clearing house. Second, three types of clearing houses are analysed that not only offer access to information but also provide an instrument to facilitate the use of the patented inventions: the open access clearing house, the standardized licences clearing house and the royalty collection clearing house. A royalty collection clearing house for genetic diagnostic testing would be the most comprehensive as it would serve several functions: identifying patents and patent claims essential to diagnostic testing, matching licensees with licensors, developing and supplying standardized licences, collecting royalties, monitoring whether users respect licensing conditions, and providing dispute resolution services such as mediation and arbitration. In this way, it might function as an effective model for users to facilitate access to and use of the patented inventions. However, it remains to be seen whether patent holders with a strong patent portfolio will be convinced by the advantages of the royalty collection clearing house and be willing to participate. PMID:16710543