Biomedical subjects

Catherine M Jones

Publications and source records attributed to Catherine M Jones.

9 recordsLinked to original sources

PubMed2007

Multi-detector computed tomography in coronary artery bypass graft assessment: a meta-analysis.

Multi-detector computed tomography (MDCT) has become an alternative to coronary angiography in diagnosis of graft occlusion and stenosis after coronary artery bypass. A literature search was performed for studies comparing angiography to 8-slice, 16-slice, and 64-slice MDCT in the assessment of coronary grafts. In assessing occlusion, 14 studies produced pooled sensitivity of 97.6%, specificity of 98.5%, diagnostic odds ratio of 934.2, area under the curve of 0.996, and Q* of 0.977. Ninety-six percent of all grafts were visualized for occlusion assessment. Beta blockers, symptomatic status, and postoperative period did not significantly affect diagnostic performance. Stenosis assessment produced sensitivity of 88.7% and specificity of 97.4%. Eighty-eight percent of patent grafts could be assessed for stenosis. The diagnostic accuracy of MDCT approaches angiography for diagnosing graft occlusion and stenosis in patients with venous and arterial coronary bypass grafts. Our findings show that cardiac surgeons will need to interpret MDCT images of both native and grafted vessels soon in preparation for primary or re-do coronary bypass grafting procedures.

Coronary Angiography↗

PubMed2006

Differences in cue use and spatial memory in men and women.

Men and women differ in their ability to solve spatial problems. There are two possible proximate explanations for this: (i) men and women differ in the kind (and value) of information they use and/or (ii) their cognitive abilities differ with respect to spatial problems. Using a simple computerized task which could be solved either by choosing an object based on what it looked like, or by its location, we found that the women relied on the object's visual features to solve the task, while the men used both visual and location information. There were no differences between the sexes in memory for the visual features of the objects, but women were poorer than men at remembering the locations of objects.

Adult↗

PubMed2006

Multi-slice computed tomography in coronary artery disease.

Multi-slice computed tomography technology is emerging as a realistic investigation in patients with suspected disease in native, stented or grafted coronary arteries. A non-invasive diagnostic tool is desirable as these patients are at high risk for complications of invasive angiography. A 64-slice CT may achieve the desired diagnostic accuracy, and overcome the limitations of spatial resolution, respiratory motion, artifacts from calcification and stents, and radiation dose considerations to produce reliable image quality. These advances, as well as the capacity for integrated functional cardiac assessment, may change the referral patterns in patients who have had previous bypass surgery or percutaneous intervention. This review outlines the debated issues about 64-slice cardiac CT in patients before and after coronary artery bypass surgery, as well as coronary stenting and functional assessment. A review of the recent literature on native coronary artery and bypass graft assessment by multi-slice CT is also performed.

Calcinosis↗

PubMed2005

Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts?

The amount of literature published over the past decade comparing coronary angiography with transthoracic Doppler echocardiography assessment of internal thoracic artery graft patency after CABG is substantial. There has been no review of the available literature, and conflicting reports of diagnostic accuracy have prevented routine use of transthoracic Doppler in graft patency assessment. Thus, this article reviews the available literature on diagnostic accuracy of transthoracic Doppler echocardiography of coronary bypass grafts. Relevant studies were identified and meta-analysis of diagnostic accuracy was performed. Study quality was assessed. Quantitative data synthesis included calculation of sensitivity, specificity, summary receiver operating characteristic curve analysis, pooled analysis and meta-regression of accuracy against study quality, publication date, angina, probe frequency and diagnostic criteria. Twenty studies of 929 patients produced 26 results included for analysis. Grafts were not visualized in 93 (10%) patients. Pooled sensitivity (85%) and specificity (94%) and diagnostic odds ratio (100.7) were high. SROC analysis showed an area under the curve of 0.96. Heterogeneity of results was due to variations in diagnostic criteria and study size. Subgroup analysis showed best performance in patients with postoperative angina (p = 0.014). Study quality did not affect results. Diastolic fraction less than 0.5 (sensitivity 89%, specificity 94%) was shown to be the best criterion for prediction of stenosis. Performance was lower using peak diastolic to systolic velocity ratio less than 1 (sensitivity 85%, specificity 86%). Transthoracic Doppler echography is effective in first-line assessment of left internal thoracic artery graft patency. It shows high specificity, prevents invasive investigations and improves in patients with postoperative angina. TDE is best used in combination with other non-invasive tests due to its inability to visualize the graft. The potential for use in postoperative coronary bypass patients is high.

Adult↗

PubMed2005

Is virtual bronchoscopy an efficient diagnostic tool for the thoracic surgeon?

Virtual bronchoscopy has emerged over the past decade as a potentially complementary investigation to conventional bronchoscopy in the diagnosis, grading, and monitoring of pulmonary disease. A meta-analysis reporting on the use of virtual bronchoscopy has not yet been performed. The primary aim of this study is to evaluate its diagnostic accuracy compared to the gold standard investigation of conventional bronchoscopy (fiberoptic or rigid). Quantitative data synthesis included the calculation of independent sensitivity and specificity, construction of summary receiver operating characteristic curves, pooled analysis, and sensitivity analysis. Seventeen studies were identified comprising 459 patients. The calculated pooled sensitivity was 84% (95% CI, 78% to 89%), specificity 75% (95% CI, 62% to 85%) and area under the curve was 0.92, which shows good diagnostic performance. Meta-analysis confirms virtual bronchoscopy is very discriminating in the evaluation of patients with significant airway stenosis that is due to a wide spectrum of pathologic conditions. It can potentially have a beneficial role in selected thoracic patients (with bronchoesophageal fistulas, postlung transplantation, anastomoses, and suspected foreign body aspiration).

Area Under Curve↗

PubMed2005

Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests.

The number of studies in the literature using summary receiver operating characteristic (SROC) analysis of diagnostic accuracy is rising. The SROC is useful in many such meta-analyses, but is often poorly understood by clinicians, and its use can be inappropriate. The academic literature on this topic is not always easy to comprehend. Interpretation is therefore difficult. This report aims to explain the concept of SROC analysis, its advantages, disadvantages, indications, and interpretation for the cardiothoracic surgeon. We use a practical approach to show how SROC analysis can be applied to meta-analysis of diagnostic accuracy by using a contrived dataset of studies on virtual bronchoscopy in the diagnosis of airway lesions.

Airway Obstruction↗

PubMed2005

Do technical parameters affect the diagnostic accuracy of virtual bronchoscopy in patients with suspected airways stenosis?

PURPOSE: Virtual bronchoscopy has gained popularity over the past decade as an alternative investigation to conventional bronchoscopy in the diagnosis, grading and monitoring of airway disease. The effect of technical parameters on diagnostic outcome from virtual bronchoscopy has not been determined. This meta-analysis aims to estimate accuracy of virtual compared to conventional bronchoscopy in patients with suspected airway stenosis, and evaluate the influence of technical parameters. MATERIALS AND METHODS: A MEDLINE search was used to identify relevant published studies. The primary endpoint was the "correct diagnosis" of stenotic lesions on virtual compared to conventional bronchoscopy. Secondary endpoints included the effects of the technical parameters (pitch, collimation, reconstruction interval, rendering method, and scanner type), and date of publication on the diagnostic accuracy of virtual bronchoscopy. RESULTS: Thirteen studies containing 454 patients were identified. Meta-analysis showed good overall diagnostic performance with 85% calculated pooled sensitivity (95% CI 77-91%), 87% specificity (95% CI 81-92%) and area under the curve (AUC) of 0.947. Subgroups included collimation of 3mm or more (AUC 0.948), pitch of 1 (AUC 0.955), surface rendering technique (AUC 0.935), and reconstruction interval of more than 1.25 mm (AUC 0.914). There was no significant difference in accuracy accounting for publication date, scanner type or any of the above variables. Weighted regression analysis confirmed none of these variables could significantly account for study heterogeneity. CONCLUSION: Virtual bronchoscopy performs well in the investigation of patients with suspected airway stenosis. Overall sensitivity and specificity and diagnostic odds ratio for diagnosis of airway stenosis were high. The effects of pitch, collimation, reconstruction interval, rendering technique, scanner type, and publication date on diagnostic accuracy were not significant.

Airway Obstruction↗

PubMed2003

The evolution of sex differences in spatial ability.

It is widely believed that male mammals have better spatial ability than females. A large number of evolutionary hypotheses have been proposed to explain these differences, but few species have been tested. The authors critically review the proposed evolutionary explanations for sex differences in spatial cognition and conclude that most of the hypotheses are either logically flawed or, as yet, have no substantial support. Few of the data exclusively support or exclude any current hypotheses. The hypothesis with the strongest support proposes that range size was the selection pressure that acted to increase spatial ability. The authors suggest ways in which these hypotheses could be tested by presenting explicit predictions and suggesting suitable test species or conditions.

Animals↗

PubMed2002

Animal learning and memory: an integration of cognition and ecology.

A wonderfully lucid framework for the ways to understand animal behaviour is that represented by the four 'whys' proposed by Tinbergen (1963). For much of the past three decades, however, these four avenues have been pursued more or less in parallel. Functional questions, for example, have been addressed by behavioural ecologists, mechanistic questions by psychologists and ethologists, ontogenetic questions by developmental biologists and neuroscientists and phylogenetic questions by evolutionary biologists. More recently, the value of integration between these differing views has become apparent. In this brief review, we concentrate especially on current attempts to integrate mechanistic and functional approaches. Most of our understanding of learning and memory in animals comes from the psychological literature, which tends to use only rats or pigeons, and more occasionally primates, as subjects. The underlying psychological assumption is of general processes that are similar across species and contexts rather than a range of specific abilities. However, this does not seem to be entirely true as several learned behaviours have been described that are specific to particular species or contexts. The first conspicuous exception to the generalist assumption was the demonstration of long delay taste aversion learning in rats (Garcia et al., 1955), in which it was shown that a stimulus need not be temporally contiguous with a response for the animal to make an association between food and illness. Subsequently, a number of other examples, such as imprinting and song learning in birds (e.g., Bolhuis and Honey, 1998; Catchpole and Slater, 1995; Horn, 1998), have been thoroughly researched. Even in these cases, however, it has been typical for only a few species to be studied (domestic chicks provide the 'model' imprinting species and canaries and zebra finches the song learning 'models'). As a result, a great deal is understood about the neural underpinnings and development of the behaviour, but substantially less is understood about interspecific variation and whether variation in behaviour is correlated with variation in neural processing (see review by Tramontin and Brenowitz, 2000 but see ten Cate and Vos, 1999).

Journal Article↗