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Muller-Bolla M, Joseph C, Innes N, Aïem E, Lopez S, Juwara L, Velly AM. Improving radiographic diagnosis of pulpo-periodontal complications in primary molars by training: Application in education and clinical research. Eur J Dent Educ 2023; 27:360-367. [PMID: 35543311 DOI: 10.1111/eje.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The objective of this study was to assess an original learning intervention to train students and paediatric dentistry teachers in radiographic diagnostic accuracy of pulpo-periodontal complications in primary molars. MATERIALS AND METHODS The learning intervention was based on 250 different randomly ordered radiographs of primary molars within three quizzes (A, B and C) for 5 sessions (S): quiz A (50 X-rays), B and C (100 X-rays) were, respectively, completed in S1 to assess the extent of agreement with 5 experts' diagnoses, in S2 and S3 (B at days 8 and 23) and in S4 and S5 (C at days 90 and 105). During S1 and at the end of S3 and S5, the participants (48 students and 16 teachers) were informed of correct diagnoses. A satisfaction questionnaire was completed by all the students. Alongside the descriptive analyses, generalised linear mixed model (GLMM) analyses assessed the odds of participants' correct diagnosis over the study duration. RESULTS At S1, the odds of diagnostic accuracy among students were significantly lower than those among the teachers. After receiving feedback at S1, GLMM analyses showed that among all the participants, accuracy improved over time with the odds of correct diagnoses higher in S2-5 than in S1; and there were similar increases across sessions between teachers and students, except in S3, where the improvement among teachers tended to be greater than that among the students. All students were satisfied though one-third reported that quizzes with 100 radiographs felt too long. CONCLUSION The online case-based learning was a good training format for dental education.
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Affiliation(s)
- Michèle Muller-Bolla
- Centre Hospitalier Universitaire de Nice, Department of Paediatric Dentistry, UFR Odontology, University Côte d'Azur, Nice, France
- Laboratory URB2i EA - 4462, University of Paris, Paris, France
| | - Clara Joseph
- Centre Hospitalier Universitaire de Nice, Department of Paediatric Dentistry, UFR Odontology, University Côte d'Azur, Nice, France
- Laboratory MICORALIS EA - 7354, University Côte d'Azur, Nice, France
| | - Nicola Innes
- School of Dentistry, Heath Park, University of Cardiff, Cardiff, UK
| | - Elody Aïem
- Centre Hospitalier Universitaire de Nice, Department of Paediatric Dentistry, UFR Odontology, University Côte d'Azur, Nice, France
- Laboratory MICORALIS EA - 7354, University Côte d'Azur, Nice, France
| | - Serena Lopez
- Faculty of Dentistry, Department of Paediatric Dentistry, Unité d'investigation Clinique en Odontologie (Uic11), Centre de Recherche en Education de Nantes (CREN EA 2661), University and Hospital of Nantes, Nantes, France
| | - Lamin Juwara
- Dental Department of Jewish General Hospital, Faculty of Dentistry, University of McGill, Montréal, QC, Canada
| | - Ana Miriam Velly
- Department of Dentistry, Lady Davis Institute, SMBD Jewish General Hospital, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
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Zhou YS, DU Y, Wu YJ, Ye RX, Wang QZ, Sun C, Zheng QM, Zhou H. [Evaluation of Accuracy and Influencing Factors for Diagnosis of Two Chronic Diseases by Primary Healthcare Providers in Sichuan Rural Areas Based on Standardized Patients]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:213-220. [PMID: 35538755 DOI: 10.3881/j.issn.1000-503x.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective We used standardized patients to evaluate the accuracy and explore the influencing factors of the diagnosis of unstable angina pectoris and type 2 diabetes by primary healthcare providers in Sichuan rural areas,aiming to provide a scientific basis for improving the diagnosis accuracy of primary healthcare providers for the two chronic diseases. Methods A multi-stage stratified random cluster sampling method was adopted to select 100 villages from 50 townships in 5 districts/counties in Zigong city,Sichuan province. General and internal medicine practioners who were on duty on the survey day were enrolled in the survey.Two rounds of data collection were conducted.In the first round,the basic information of providers from township health centers and village clinics was collected.One month after the the first survey,standardized patients were used to collect the information related to the diagnosis of unstable angina pectoris and type 2 diabetes by rural primary providers.Logistic regression was carried out to analyze the factors influencing the diagnosis accuracy. Results A total of 172 rural primary healthcare providers were enrolled in the survey,who completed 186 standardized patient visits and showed the correct diagnosis rate of 48.39%.Specifically,the correct diagnosis rates of unstable angina pectoris and type 2 diabetes were 18.68%(17/91) and 76.84%(73/95),respectively.The providers with medical practitioner qualifications were more likely to make correct diagnosis(OR=4.857,95%CI=1.076-21.933, P=0.040).The providers who involved more necessary consultation and examination items in the diagnosis process had higher probability of correct diagnosis(OR=1.627,95%CI=1.065-2.485, P=0.024).Additionally,the providers were more likely to make a correct diagnosis for type 2 diabetes than for unstable angina pectoris(OR=6.306,95%CI=3.611-11.013, P<0.001). Conclusions The overall diagnosis accuracy of unstable angina pectoris and type 2 diabetes was relatively low among primary healthcare providers in Sichuan rural areas.The training of diagnosis process can be taken as a key for improving providers' practice ability so as to increase the diagnosis accuracy of chronic diseases.
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Affiliation(s)
- Yi-Shan Zhou
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Yan DU
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Yu-Ju Wu
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Rui-Xue Ye
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Qing-Zhi Wang
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Chang Sun
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
| | - Qing-Mei Zheng
- Center for Chronic Disease Prevention,Zigong Center for Disease Control and Prevention,Zigong,Sichuan 643000,China
| | - Huan Zhou
- Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital, Sichuan University,Chengdu 610041,China
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Huang C, Wan WJ, Yao YH, Xia LM, Huang WH. Feasibility of Subtraction Coronary Computed Tomographic Angiography and Influencing Factor Analysis: a Retrospective Study. Curr Med Sci 2021; 41:821-6. [PMID: 34403108 DOI: 10.1007/s11596-021-2413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the feasibility of subtraction coronary computed tomographic (CT) angiography (SubCCTA) to decline calcium artifacts and improve diagnostic accuracy in the presence of coronary calcification and analyze the factors that influence SubCCTA. METHODS A total of 294 patients suspected of having coronary artery diseases underwent coronary computed tomographic angiography (CCTA) and SubCCTA. Coronary stenoses were blindly evaluated by two experienced radiologists, which were compared with invasive coronary angiography (ICA). Multiple statistical indexes were adopted to analyze the value of SubCCTA for the diagnosis of calcium stenoses. RESULTS The diagnosable rate of SubCCTA was 67.2% (n=197), and the non-diagnosable rate was 32.8% (n=97). Using SubCCTA, the false positive rate decreased from 56.5% to 17.4%, and the corresponding diagnostic accuracy was increased from 83.6% to 92.9%. Univariate logistic regression analysis showed that height (OR=1.029, 95% CI=1.001-1.058), weight (OR=1.025, 95% CI=1.004-1.046), left ventricular size (OR=1.018, 95% CI=1.007-1.030), cardiothoracic ratio (OR=39.917, 95% CI=1.244-1281.098), the average heart rate (OR=0.866, 95% CI=0.836-0.896) and heart rate range (OR=0.882, 95% CI=0.853-0.912) might be the factors influencing SubCCTA. CONCLUSION This study suggested that SubCCTA could help improve diagnostic accuracy in the presence of calcium plaques. Moreover, several factors were discovered for the first time to possibly influence SubCCTA, which will be helpful in improving the subtracted image quality.
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Esmailian M, Ataie M, Ahmadi O, Rastegar S, Adibi A. Sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury. J Res Med Sci 2021; 26:14. [PMID: 34084193 PMCID: PMC8106407 DOI: 10.4103/jrms.jrms_264_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/26/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022]
Abstract
Background: This study was performed to determine the sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury in comparison with magnetic resonance imaging (MRI). Materials and Methods: This cross-sectional study was performed on 31 patients with soft-tissue injury or fracture, referring to the MRI imaging center of Alzahra and Kashani Hospitals in Isfahan from October 2018 to March 2019. After an MRI, an ultrasound of the affected ankle was performed for all patients. Sonography and MRI were performed by two radiologists who were blinded to the results of each other's reports. The sensitivity, specificity, positive predictive value, and negative predictive value of sonography were determined. Results: In this study, 31 patients with ankle trauma were studied. The mean age of the patients was 30.73 ± 10.15 years; 32.3% were male and 67.7% were female. The sensitivity of ultrasound relative to MRI to detect damage to the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL) was 66.67%, 50%, and 100%, respectively, and the corresponding specificity was 92.86%, 93.10%, and 93.10%, respectively. According to Kappa test, the agreement between ultrasound and MRI methods for detecting injury to ATFL (κ = 0.51), PTFL (κ = 0.35), and CFL (κ= 0.63) was statistically significant (P < 0.05). Conclusion: Ultrasound is an appropriate modality for the diagnosis of injuries to CFL and ATFL and has shown acceptable results for PTFL. It could be used as an alternative in cases where access to MRI is not available.
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Affiliation(s)
- Mehrdad Esmailian
- Department of Emergency Medicine, Emergency Medicine Research Center, Al-Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Ataie
- Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Ahmadi
- Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirvan Rastegar
- Department of Orthopedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atoosa Adibi
- Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Sadeghi M, Chilana P, Yap J, Tschandl P, Atkins MS. Using content-based image retrieval of dermoscopic images for interpretation and education: A pilot study. Skin Res Technol 2019; 26:503-512. [PMID: 31845429 DOI: 10.1111/srt.12822] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/09/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Dermoscopic content-based image retrieval (CBIR) systems provide a set of visually similar dermoscopic (magnified and illuminated) skin images with a pathology-confirmed diagnosis for a given dermoscopic query image of a skin lesion. Although recent advances in machine learning have spurred novel CBIR algorithms, we have few insights into how end users interact with CBIRs and to what extent CBIRs can be useful for education and image interpretation. MATERIALS AND METHODS We developed an interactive user interface for a CBIR system with dermoscopic images as a decision support tool and investigated users' interactions and decisions with the system. We performed a pilot experiment with 14 non-medically trained users for a given set of annotated dermoscopic images. RESULTS Our pilot showed that the number of correct classifications and users' confidence levels significantly increased with the CBIR interface compared with a non-CBIR interface, although the timing also increased significantly. The users found the CBIR interface of high educational value, engaging and easy to use. CONCLUSION Overall, users became more accurate, found the CBIR approach provided a useful decision aid, and had educational value for learning about skin conditions.
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Affiliation(s)
- Mahya Sadeghi
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Parmit Chilana
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Jordan Yap
- MetaOptima Technology Inc., Vancouver, BC, Canada
| | - Philipp Tschandl
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada.,Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - M Stella Atkins
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada.,School of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Zhang Y, Tang J, Zhou X, Zhu SL, Li LQ. Diagnostic accuracy of midkine for hepatocellular carcinoma: A meta-analysis. Mol Genet Genomic Med 2019; 8:e1071. [PMID: 31777190 PMCID: PMC7005611 DOI: 10.1002/mgg3.1071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/03/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022] Open
Abstract
Background There have been many reports on midkine as a promising marker in the diagnosis of hepatocellular carcinoma (HCC). However, the results are inconsistent and even conflicting. Methods This meta‐analysis was performed to investigate the accuracy of midkine in the diagnosis of HCC. Meta‐DiSc 1.4 software was used to extract data and to calculate the overall sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Data are presented as forest plots and summary receiver operating characteristic (SROC) curve analysis was used to summarize the overall test performance. Results Ten studies with a total of 753 HCC patients and 977 non‐HCC patients were included. The overall pooled diagnostic data were as follows: the pooled sensitivity of 0.86 (95% confidence interval [CI]: 083–0.88), the pooled specificity of 0.75 (95% CI: 0.73–0.78), the pooled PLR of 4.71 (95% CI: 2.80–7.90), the pooled NLR of 0.18 (95% CI: 0.11–0.30), and the pooled DOR of 36.83 (95% CI: 13.56–100.05). The area under curve value was 0.9266 in the overall SROC curve. Conclusion Midkine has moderate diagnostic accuracy for HCC. Due to the design limitations, results inpublished studies should be carefully interpreted. In addition, more well‐designed studies with large sample sizes should be performed to rigorously evaluate the diagnostic accuracy of the MDK.
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Affiliation(s)
- Yu Zhang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Juan Tang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Xiao Zhou
- Department of Breast Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Shao-Liang Zhu
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Le-Qun Li
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
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Abstract
OBJECTIVE We sought to evaluate the accuracy of periostin for the diagnosis of asthma through a systematic review and meta-analysis. METHODS we searched the electronic databases (PubMed, EMBASE, Web of science) to find relevant studies through December 31, 2018. Studies selecting, data extraction and quality assessment were conducted by two researchers independently according to inclusion and exclusion criteria. We used bivariate mixed effects model to conduct the meta-analysis. RESULTS A total of 9 studies including 1448 subjects with asthma were analyzed. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) were 0.68 (95% CI, 0.42-0.86), 0.87 (95% CI, 0.76-0.93) and 13.78 (95% CI, 4.64-40.93) respectively. The area under the summary receiver operating curves (SROC) was 0.87 (95% CI, 0.84-0.90). The Spearman correlation coefficient indicated that no threshold effect existed in the included studies. The study design had statistical significance for sensitivity results (p < 0.001) through regression analysis. Heterogeneity might be caused by non-threshold effect. CONCLUSION Periostin has moderate accuracy in the diagnosis of asthma.
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Affiliation(s)
- Xinyu Jia
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shan Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - TingTing Xu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ningfei Ji
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mao Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Yu W, Cao J, Dai W, Qiu Q, Xiong J. Quantitative PCR Analysis of Gut Disease-Discriminatory Phyla for Determining Shrimp Disease Incidence. Appl Environ Microbiol 2018; 84:e01387-18. [PMID: 30006395 DOI: 10.1128/AEM.01387-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/06/2018] [Indexed: 12/30/2022] Open
Abstract
There is evidence that gut microbial signatures are indicative of host health status. However, few efforts have been devoted to establishing an applicable technique for determining disease incidence by using gut microbial signatures. Herein, we established a quantitative PCR (qPCR)-based approach to detect the relative abundances of gut disease-discriminatory phyla, which in turn afforded independent variables for quantitatively determining the incidence of shrimp disease. Given the temporal dynamics of gut bacterial communities as healthy shrimp aged, we identified disease-discriminatory phyla after ruling out age-discriminatory phyla. The top 10 disease-discriminatory phyla contributed to an overall 93.2% accuracy in diagnosis (n = 103 samples from shrimp that were determined with high confidence to be healthy or that exhibited apparent disease symptoms and subsequent death), with 70% diagnosis accuracy at the disease onset stage, when symptoms or signs of disease were not apparent. 16S rRNA gene-targeted group-specific primers of five disease-discriminatory phyla were then designed according to their compositions within shrimp gut microbiota, and other primers were borrowed from previous studies. The relative abundances of the 10 disease-discriminatory phyla assayed by qPCR exhibited a high consistency (r = 0.946, P < 0.001) with those detected by Illumina sequencing. Notably, using the profiles of disease-discriminatory phyla assayed by qPCR and the corresponding weight coefficients as independent variables, we were able to accurately estimate the incidences of future disease outcome. This work establishes an applicable technique to quantitatively determine the incidence and onset of shrimp disease, which is a valuable attempt to translate scientific research into a practical application.IMPORTANCE Current studies have identified gut microbial signatures of host health using high-throughput sequencing (HTS) techniques. However, HTS is still expensive and time-consuming and requires a high technical ability, thereby impeding its application in routine monitoring in aquaculture. Hence, it is necessary to seek an alternative strategy to overcome these shortcomings. Herein, we establish a qPCR-based approach to detect the relative abundances of gut disease-discriminatory phyla, which in turn afford independent variables to quantitatively determine the incidence and onset of shrimp disease. Notably, there is a high consistency between the accuracies of disease diagnosis achieved by qPCR and HTS. This applicable technique makes important progress toward defining a diseased state in shrimp and toward solving an important animal health management-driven economic problem.
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Li J, Wang T, Jin B, Li W, Wang Z, Zhang H, Song Y, Li N. Diagnosis accuracy of serum glypican-3 level in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Int J Biol Markers 2018; 33:353-363. [PMID: 30071741 DOI: 10.1177/1724600818784409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous studies have evaluated the diagnostic value of serum glypican-3 in patients with hepatocellular carcinoma. However, the results remain inconsistent and even controversial. Thus, the aim of the present meta-analysis was to clarify the diagnostic accuracy of serum glypican-3 for hepatocellular carcinoma. METHODS A meta-analysis including 22 studies was performed with 2325 cases and 2280 controls. Relevant studies were searched in the EMBASE, PubMed, and Web of Science databases, covering relevant papers published until November 1, 2017. The quality of the studies was assessed by revised QUADAS tools. Sensitivity, specificity, and other measures were pooled and determined to evaluate the accuracy of serum glypican-3 in the diagnosis of hepatocellular carcinoma by random-effects models. Summary receiver operating characteristic curve (sROC) analysis was performed to summarize the overall test performance. RESULTS The results showed that the pooled overall diagnostic sensitivity, specificity, and 95% confidence interval (CI) for serum glypican-3 in the diagnosis of hepatocellular carcinoma were 68% (56-79%) and 92% (82-96.0%), respectively. Besides, the summary diagnostic odds ratio and 95% CI for glypican-3 were 23.53 (8.57-64.63). In addition, the area under sROC and 95% CI was 0.87 (0.84-0.90). The major design deficiencies of included studies were differential verification bias, and a lack of clear exclusion and inclusion criteria. CONCLUSIONS The results of this meta-analysis suggested that serum glypican-3 was acceptable as a moderate diagnostic marker in the diagnosis of hepatocellular carcinoma compared with healthy individuals, which could elevate the sensitivity and specificity of diagnosis. Furthermore, more well-designed studies with large sample sizes are needed to show the effectiveness of glypican-3 in the differential diagnosis of hepatocellular carcinoma.
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Affiliation(s)
- Jian Li
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China.,Department of Hepatobiliary Surgery, Hospital Affiliated to Chengde Medical University,Chengde, China
| | - Tiezheng Wang
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Boxun Jin
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Wenlei Li
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zhenshun Wang
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Haitao Zhang
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yunjun Song
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
| | - Ning Li
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, Beijing, China
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Huang L, Zhou JG, Yao WX, Tian X, Lv SP, Zhang TY, Jin SH, Bai YJ, Ma H. Systematic review and meta-analysis of the efficacy of serum neuron-specific enolase for early small cell lung cancer screening. Oncotarget 2017; 8:64358-64372. [PMID: 28969076 PMCID: PMC5610008 DOI: 10.18632/oncotarget.17825] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/11/2017] [Indexed: 11/25/2022] Open
Abstract
We performed a pooled analysis of the efficacy of serum neuron-specific enolase (NSE) levels for early detection of small cell lung cancer (SCLC) in patients with benign lung diseases and healthy individuals. Comprehensive searches of several databases through September 2016 were conducted. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Ultimately, 33 studies containing 9546 samples were included in the review. Pooled sensitivity of NSE for detecting SCLC was 0.688 (95%CI: 0.627-0.743), specificity was 0.921 (95%CI: 0.890-0.944), positive likelihood ratio was 8.744 (95%CI: 6.308-12.121), negative likelihood ratio was 0.339 (95%CI: 0.283- 0.405), diagnostic odds ratio was 25.827 (95%CI: 17.490- 38.136) and area under the curve was 0.88 (95%CI: 0.85- 0.91). Meta-regression indicated that study region was a source of heterogeneity in the sensitivity and joint models, while cut-off level was a source in the joint model. Subgroup analysis showed that enzyme linked immunosorbent assays had the highest sensitivity and radioimmunoassay assays had the highest specificity. The diagnostic performance was better in Europe [sensitivity: 0.740 (95%CI: 0.676-0.795), specificity: 0.932 (95%CI: 0.904-0.953)] than in Asia [sensitivity: 0.590 (95%CI: 0.496- 0.678), specificity: 0.901 (95%CI: 0.819-0.948)]. In Europe, 25 ng/ml is likely the most suitable NSE cut-off level. NSE thus has high diagnostic efficacy when screening for SCLC, though the efficacy differs depending on study region, assay method and cut-off level. In the clinic, NSE measurements should be considered along with clinical symptoms, image results and histopathology.
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Affiliation(s)
- Lang Huang
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Jian-Guo Zhou
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Wen-Xiu Yao
- Department of Oncology, Affiliated Cancer Hospital of Medical School, University of Electronic Science and Technology of China, Sichuan Cancer Hospital and Institute & Cancer, The Second People's Hospital of Sichuan Province, Chengdu 610000, China
| | - Xu Tian
- Chongqing Cancer Hospital and Institute, Chongqing 40030, China
| | - Shui-Ping Lv
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Ting-You Zhang
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Shu-Han Jin
- Department of Cardiology and Endodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Yu-Ju Bai
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Hu Ma
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
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Lopes SC, Cabral AJ, de Sousa B. Community health workers: to train or to restrain? A longitudinal survey to assess the impact of training community health workers in the Bolama Region, Guinea-Bissau. Hum Resour Health 2014; 12:8. [PMID: 24517103 PMCID: PMC3924622 DOI: 10.1186/1478-4491-12-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 01/20/2014] [Indexed: 05/29/2023]
Abstract
BACKGROUND The shortage in human resources for health affects most dramatically developing countries which frequently use community health workers (CHW) as the basis for health programmes and services. The traditional definition refers CHWs as members of the community who are recruited and trained in health prevention and promotion to provide services within their community. In Guinea-Bissau, CHWs play a fundamental role in the diagnosis and treatment of childhood diarrheal diseases - one of the main health problems in the country. METHODS This study is based on 22 CHW, 79% of the total number of CHW in the Sanitary Region of Bolama. The main goal was to assess how training CHW on diarrheal diseases impacted the accuracy of the diagnosis and treatment of these diseases in children under the age of 5 years. Three evaluations were made throughout time - one evaluation before the training and two follow-up evaluations.An observation grid was developed to evaluate the identified signs, symptoms, diagnosis and treatments prescribed by the CHW in consultations to children with a suspicion of diarrhoeal disease. A similar grid was filled by a medical doctor who took the role of the external validation standard.Friedman's variance analysis and Cochran's Q test were performed to compare the accuracy depicted by CHWs in identifying items throughout time. A logistic regression model was also used to check the possible influence of socio-demographic characteristics of CHWs on the accuracy of the diagnosis and treatment prescribed by the CHW. RESULTS The results show that CHWs improve significantly their performance in identifying the correct diagnosis in the first follow-up moment after the training (P = 0.001, n = 22) but, 3 months later, the effectiveness decreases. No statistical evidence was found for the logistic regression models applied. This progressive loss of performance after training may occur because CHWs fail to apply treatment algorithms and guidelines over time. A limited set of socio-demographic characteristics of the CHWs can influence their performance and should not be disregarded when selecting CHW candidates. CONCLUSION The selection, supervision, support and continuous training of CHW are as important as the training provided.
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Affiliation(s)
| | - António J Cabral
- CMDT, Center for Malaria and Tropical Medicine, Lisbon, Portugal
| | - Bruno de Sousa
- Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
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