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Results for “Predictive Value of Tests”

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PubMed2004

Behavior in degenerative dementias: mood disorders, psychotic symptoms and predictive value of neuropsychological deficits.

We studied mood disorders (MD) and psychotic symptoms (PS) in patients with fronto -temporal dementia (FTD) and Alzheimer's disease (AD) by means of different diagnostic instruments. These were: a subjective scale (subsets of survey psychiatric assessment schedule: SPAS), an objective scale (subsets of neuropsychiatric inventory: NPI) and a projective task (Wartegg completion task: WCT). A general tendency of NPI to over estimate the presence of symptoms compared to SPAS was observed, but distribution and severity of symptoms were quite homogeneous in the two dementia-groups, independently of the diagnostic scales. At variance with the scales, the WCT showed a more severe impairment in FTD than in AD. The regression analysis selected neuropsychological models able to predict behavioral disorders only in FTD, in particular, a planning deficit predicted PS. These data confirm the hypothesis that a damage in the frontal areas constitutes the neurobiological basis of PS in degenerative brain diseases. Furthermore, they suggest that mostly in FTD, behavioral disorders, as well as cognitive deficits, should be considered a direct expression of neural damage.

Aged↗

PubMed2005

The prognostic value of domain-specific cognitive abilities in acute first-ever stroke.

OBJECTIVE: To evaluate the prognostic value of domain-specific cognitive abilities in acute stroke with respect to long-term cognitive and functional outcome in addition to neurologic and demographic predictors. METHODS: The authors evaluated 168 patients within the first 3 weeks after first-ever stroke. The prevalence of neuropsychological impairment was calculated vs 75 matched healthy controls. The authors also recorded demographic data, vascular risk factors, lesion characteristics, and clinical factors at admission. Independent predictor variables associated with long-term cognitive impairment (assessed with a follow-up neuropsychological examination) and functional impairment (assessed with the modified Barthel Index and the Frenchay Activities Index) were identified with stepwise multiple logistic regression. Areas under receiver operator characteristic curves were used to compare the predictive value of three models, i.e., a standard medical model, a purely cognitive model, and a model consisting of both medical and cognitive predictors. RESULTS: Thirty-one percent of patients showed long-term cognitive impairment. Basic and instrumental ADL disturbances remained present in 19% and 24% of patients. Domain-specific cognitive functioning predicted cognitive and functional outcome better than any other variable. Moreover, the prediction of instrumental ADL functioning improved when cognitive predictors were added to the standard medical model (p < 0.05). Impairments in abstract reasoning and executive functioning were independent predictors of long-term cognitive impairment. Inattention and perceptual disorders were more important in predicting long-term functional impairment. CONCLUSION: Domain-specific cognitive abilities in the early phase of stroke are excellent independent predictors of long-term cognitive and functional outcome.

Acute Disease↗

PubMed1999

Use of a water hardness test kit to measure serum calcium concentration in cattle.

OBJECTIVE: To determine whether a commercially available water hardness test kit could be used to measure total serum calcium concentration and diagnose hypocalcemia in dairy cows. DESIGN: Prospective study. ANIMALS: 30 dairy cows from 19 commercial herds. PROCEDURE: Serum calcium concentration was determined using a water hardness test kit and a standard, laboratory-based method. Simple linear regression was used to determine whether there was a linear relationship between results of the 2 methods, and Spearman's rank correlation was used to calculate correlation between measurements. Sensitivity, specificity, and predictive values of using test kit-derived values for diagnosis of hypocalcemia (laboratory value < 8 mg/dl) were calculated. RESULTS: There was a high correlation and significant linear relationship between results of the 2 methods. Sensitivity, specificity, predictive value of a positive test result, and predictive value of a negative test result were 100, 73, 86, and 100%, respectively. Accuracy was improved by using a test kit-derived calcium concentration of 7 mg/dl as the cut-off for determining hypocalcemia. CLINICAL IMPLICATIONS: Results indicate that a commercially available water hardness test kit can be used as a rapid, inexpensive method of estimating serum calcium concentrations and diagnosing hypocalcemia in dairy cattle. However, the test is not practical for cow-side use, because blood samples must be centrifuged to obtain serum for use in the test kit.

Animals↗

PubMedDate not supplied

Factors predicting success in picture naming in Alzheimer's disease and primary progressive aphasia.

The aim of the present study was to determine the predictive value of all important variables in the picture naming performance of 8 patients with probable Alzheimer's disease (AD) and 8 patients with primary progressive aphasia (PPA). The experimental investigation controlled for (i) visual complexity, (ii) name agreement on dominant response, (iii) age of acquisition, (iv) frequency, (v) word length, (vi) concept familiarity, and (vii) category membership. The results of the multiple regression analyses showed that age of acquisition and name agreement were significant for 10/16 subjects. Visual complexity, frequency, familiarity, and category were also significant for four patients respectively. Word length had no effect. These results are at variance with those of series of patients with AD (Gaillard et al., 1998) and with PPA (Lambon Ralph et al., 1998) where concept familiarity was found to be one of the most predictive factors of naming success.

Aged↗

PubMedDate not supplied

Evaluation of serum total IgE in Chinese allergic children using different assays.

Since differences in HLA groups have been found in Chinese populations, as well as differences in the values of total IgE in China, Japan and Thailand, a study has been done in 44 Chinese children, all of them with a history of atopic conditions divided into five groups: asthma, rhinitis, conjunctivitis, allergic bronchitis and atopic dermatitis. 34 of them were positive against D. pteronyssimus, 8 against cats, 3 against dogs and 3 against fish. The only adult patient studied was positive against gramineal plants (all positivities were tested with the prick test). IVT ELISA Screen is performed against 10 allergens, as well as 3 M FAST-Test and 3 M Total IgE FAST Plus Test. The results show that the majority of children had an elevation of the total IgE in the three tests. There is quite a good agreement between FAST and IgE-IVT and a better correlation between IgE-IVT and IgE FAST Plus. The correlation between IgE FAST and IgE FAST Plus was excellent.

Adult↗

PubMedDate not supplied

Excessively high magnetic resonance signal in preterm infants and neuropsychobehavioural follow-up at 2 years.

The diffuse excessive high-signal intensity (DEHSI) findings in the T2 weighted scans of white matter (WM), besides the corresponding low signal in the T1 weighted images, are usually more evident around the periventricular regions. It is not clear whether the DEHSI should be considered as a diffuse WM injury rather than a sign of delayed maturation of the WM. Eighty nine preterm infants at the full-term equivalent age (FEA) were studied using conventional Magnetic Resonance (MR) imaging of the brain. Based on the MR findings, the infants studied were divided into three groups: the control group presenting normal WM, the DEHSI group and the group with other WM lesions. Ten newborns were not included in the statistical analysis because they presented evidence of precedent germinal matrix hemorrhage (GMH-IVH) which cannot be considered as WM lesions. Seventy nine infants were enrolled in a program of neuropsychobehavioural study follow-up until 24 months of age. Each infant was evaluated for those variables which mostly affect the occurrence of neuropsychomotor disability. In the DEHSI infant group, significantly lower mean pH and mean base excess (BE) values were found in comparison to controls, while the mean birth weight (BW) was significantly higher. No significant difference was observed between the mean 1st minute Apgar Score, mean birth gestational age (GA) and assisted ventilation mean duration of controls and DEHSI groups. Finally, no significant difference between the parameters studied was found by comparing the WM lesion infants group to the DEHSI infants one. Our observations, together with follow-up studies, even up to school age, confirm that DEHSI has a clinical significance and cannot be considered as a simple indicator of delayed WM maturation.

Brain↗

PubMed2004

Validation of a modified version of the Gijon's social-familial evaluation scale (SFES): the "Barcelona SFES Version", for patients with cognitive impairment.

The aim was to validate an abbreviated version of the Gijon's social-familial evaluation scale (SFES) (Barcelona-SFES version), on patients with cognitive impairment. A group of 34 patients with cognitive impairment, admitted to an intermediate-long-term-care facility, were analyzed. Mean age was 80.2 +/- 7.4 years. Gijón's SFES was abbreviated and only the first three item groups corresponding to family conditions, social contacts and assistance from the social network were selected. Barcelona-SFES version had a range score between 3 to 15 points, in which low scores identify older patients who live with their family, have good contacts, and participate in community activities. In contrast, high scores identify older persons who live alone and have poor social support and little participation with community activities. Three social risk categories were established according to the Barcelona-SFES score: low social risk (>/= 7 points), intermediate social risk (8-9 points) and high social points). Validation criteria used in the present study were: predictive value of Barcelona-SFES score of post-discharge destination (home or institution), and patient's (or family's) request for a definitive institutionalization in a nursing home. There were 9 patients with low social risk (26.4 %), 8 with intermediate social risk (23.5 %) and 17 with high social risk (50 %). A significant relationship between Barcelona-SFES scores and post-discharge destination was found. Eighty percent of patients discharged to an institution(nursing and residential homes), they had high social risk SFES scores (>/= 10) Also, a significant correlation was found between the number of patients for which a definitive institutionalization request was performed and the Barcelona-SFES scores. Fifteen (88.2 %) of the 18 patients for whom the request was done, were in the high social risk group. The lowest scores from SFES were predictive of home discharge, while the highest scores were predictive of a definitive institutionalization.

Aged↗

PubMedDate not supplied

The significance of thyroid-stimulating hormone and homocysteine in the development of Alzheimer's disease in mild cognitive impairment: a 6-year follow-up study.

Mild cognitive impairment (MCI) represents a transition between normal aging and Alzheimer's disease (AD). The aim of this study was to investigate the predictive value of vitamin B12/folate, homocysteine, standard laboratory parameters, and concomitant diseases for development of AD in persons with an MCI diagnosis. Development of dementia was followed for 6 years in 93 consecutively recruited MCI persons. Information concerning the above factors was obtained from medical journals. Thirty-four percent of participants converted to AD within 6 years. A forward stepwise logistic regression was performed. The odds ratio (OR) for the Mini-Mental State Examination (MMSE) was 0.777; for age, 1.084; and for thyroid stimulating hormone (TSH), 0.287. The OR for homocysteine was 1.287 at 60 years of age and 1.087 at 65 years of age. Lower TSH levels together with the more established factors lower MMSE, higher homocysteine levels, and age were found to be predictive factors of AD. This may have clinical implications with regard to monitoring TSH levels and thyroxin substitution in MCI patients.

Age Factors↗

PubMed1990

Flash visual evoked responses in the early encephalopathy of chronic liver disease.

In recent years many variants of EEG sensory evoked responses have been studied as potential diagnostic aids in the detection and quantification of hepatic encephalopathy (HE). This study assesses the value of the flash visual evoked response (VER). Twenty-six controls and 21 non-encephalopathic and 12 encephalopathic (grade 1/2), biopsy-proven, cirrhotic patients were assessed clinically, psychometrically, and electrophysiologically. Flash VER from three different leads were obtained from each patient. Data from the fronto-occipital leads gave the best differentiation between the subjects. The P2 and N3 peak latencies were significantly increased in the two liver groups and correlated with the mental state and psychometric results. The N3 latency had a 92% specificity and a 50% sensitivity in the detection of grade 1/2 HE. This study suggests that the N3 latency changes may be a good marker of early clinical HE and useful in the longitudinal assessment of individual patients.

Adult↗

PubMed1994

Dental anxiety, optimism-pessimism, and dental experience from childhood to adolescence.

94 adolescents, 58% of the original study group, participated in a 5-yr follow-up questionnaire study to assess the predictive power of self-reported dental anxiety, optimism-pessimism dimension, and previous dental experience on dental anxiety level over the 5-yr period. The mean values on Corah's Dental Anxiety Scale (DAS) and Dental Anxiety Question (DAQ) had increased for the girls and remained stable for the boys. The predictive power of DAS and DAQ on anxiety levels as measured by these same scales 5 yr later was weak to moderate, although statistically significant. The optimism-pessimism dimension and dental treatment experiences did not have any effect on dental anxiety changes from childhood to adolescence. DAS had an independent, weak, but statistically significant negative effect on optimistic disposition over the period. The internal reliability of DAS was high and highly similar results using DAS and DAQ were found. Except for significantly more dental experience in the drop-out group (n = 69) than in the current study group in the first study, there were no statistically significant differences in mean scores between the groups with respect to self-reported and clinical dental anxiety, and optimism. Methodological complications are discussed.

Adolescent↗

PubMedDate not supplied

[The photo test].

INTRODUCTION: The Memory Impairment Screen (MIS) is very useful in the detection of dementia but one of its important shortcomings is that it only evaluates memory and cannot be applied to illiterate subjects. AIM: Our aim was to assess the value of the Photo Test (PT), a new test that combines facilitated memory, denomination and verbal fluency tasks. PATIENTS AND METHODS: Study phase I of the diagnostic test evaluation in which we assessed the sociodemographic variables and results in the Minimental (MMSE), the SPMSQ (Short Portable Mental Status Questionnaire), the clock test (CT) and the PT in 60 subjects above the age of 65 years (30 with mild dementia and 30 without dementia). STATISTICAL ANALYSES: comparison of sociodemographic variables and test results between groups, determination of parameters that are useful in diagnosis and areas below the ROC curve with their respective 95% confidence intervals, linear regression study with 'step-by-step' strategy. RESULTS: There were no differences between groups as regards age, sex, level of schooling or degree of literacy. The PT has a sensitivity of 0.93 (0.76-0.99) and a specificity of 0.8 (0.7-0.9), similar or superior to those of the SPMSQ, MMSE and CT, and its results are not influenced by the level of schooling or literacy. CONCLUSIONS: The psychometric and applicability characteristics of the PT make it an excellent instrument for dementia screening.

Aged↗

PubMedDate not supplied

Diagnostic value of nasal provocation testing and rhinomanometry in allergic rhinitis.

We studied 32 patients, aged 7 to 17 years, with clinical symptoms of perennial allergic rhinitis, isolated (n = 21) or associated with asthma (n = 11), all of them with positive skin test and specific serum IgE for Dermatophagoides pteronyssinus (Dpt). The control group consisted of 10 children aged 7 to 16 years, with no personal or family history of allergy and with negative skin tests and negative specific serum IgE for mites. Total and specific IgE measurements in nasal secretion and nasal provocation testing (NPT) were also performed with increasing concentrations of Dermatophagoides pteronyssinus (Dpt) extracts. The nasal response was evaluated using a clinical score and active anterior rhinomanometry. The levels of total and specific IgE in nasal secretion were higher in patients with allergic rhinitis than in individuals from the control group. The NPT presented a significant correlation with clinical symptoms, skin tests and specific serum IgE. None of the individuals from the control group presented a positive NPT. No generalized reactions or bronchial response at the immediate phase of NPT were observed. The NPT constitutes a safe, dependable investigative procedure of nasal reactivity to a specific allergen, presenting a good sensitivity and specificity when compared to the other methods classically used in allergy studies.

Adolescent↗

PubMed2005

Long-term stability and consistency of EEG event-related (de-)synchronization across different cognitive tasks.

OBJECTIVE: We examined whether task-related band power changes (event-related desynchronization/synchronization; ERD/ERS) that have been linked to individual differences in cognitive ability demonstrate satisfying temporal stability and cross-situational consistency. METHODS: Multi-channel EEG recordings from 29 adults, assessed at three different occasions over 2 years were examined. Between-session correlations and consistency coefficients (Cronbach's alpha) across the three experiments were evaluated for both, spectral power features of the resting EEG and ERD/ERS estimates while the participants performed some cognitive task (i.e. different elementary cognitive tasks that put comparable demands on the participants). RESULTS: ERD/ERS values, while subjects performed a cognitive task, demonstrated satisfactory stability and consistency (i.e. >0.7), whereby the degree of consistency varied as a function of frequency band and brain region. Highest consistency was found for the 8-10 Hz ERD in parieto-occipital recording sites (i.e. >0.9). In resting EEG, mean alpha (gravity) frequency was the most stable EEG feature. CONCLUSIONS: The present data suggest that ERD/ERS phenomena in different narrow frequency bands are rather stable over time and across different situations. The relatively high reproducibility of ERD/ERS promotes the usefulness of this measure in assessing individual differences of physiological activation patterns accompanying cognitive performance. SIGNIFICANCE: This study addresses the issue of reproducibility of EEG in general and ERD/ERS experiments in particular, which is a prerequisite for both basic research and clinical studies.

Adolescent↗

PubMed1997

Vagal regulation of heart rate in the prediction of developmental outcome for very low birth weight preterm infants.

To investigate heart rate and respiratory sinus arrhythmia (RSA) as markers of developmental outcome, infant ECG and 3 year outcome were assessed in 41 very low birth weight (< 1,500 g) infants. Measures of mean heart rate and RSA, and the maturational shifts in their values from 33 to 35 weeks gestational age, were recorded. RSA measures predicted 3 year outcome beyond the effects of birth weight, medical risk, and socioeconomic status. Higher RSA was associated with better social skills, whereas greater RSA maturation was associated with better mental processing and gross motor skills. Lower heart rate was associated with better behavior regulation and social skills, whereas greater maturational decreases were associated with better gross motor skills. Dividing the sample into groups of infants with birth weights less than 1,000 g and those with birth weights over 1,000 g, RSA maturation emerged a strong predictor of mental processing, knowledge base, and gross motor skills in the former. A measure of joint maturation of RSA and heart rate was associated with better behavior regulation at 3 years, as measured by Child Behavior Checklist and Parenting Stress Index scores, for this group. The findings directly respond to the need for physiological variables in the prediction of outcome in high-risk infants.

Arousal↗

PubMed2003

Prognostic significance of white matter changes in a memory clinic population.

Non-specific white matter changes (WMC) can be seen on neuroimaging of the brain in healthy elderly but are more common in dementia. WMC are correlated to specific cognitive deficits and might also contribute to global cognitive decline. The value of WMC as a predictor of cognitive impairment has been incompletely elucidated. We studied the prognostic significance of extensive WMC in a group of patients with memory disturbances, to evaluate if the presence of such changes predicts a poorer outcome. We retrospectively selected a group of 24 patients with prominent WMC on magnetic resonance imaging (MRI) and with different grades of memory impairment. We matched each patient, with regard to age, education, length of follow-up, initial score on the Mini Mental State Examination (MMSE) and initial diagnosis, to a patient without white matter pathology. The matched pairs were evaluated and the decrease in MMSE score after follow-up (range 2-4 years) was used as the outcome measure. Results showed no difference in the decrease in MMSE score at follow-up between patients with or without WMC. In conclusion, the presence of WMC in cognitively impaired patients had no effect on the progression rate of dementia, as measured by MMSE decline.

Aged↗

PubMed1993

Value of Papanicolaou smear in detection of Chlamydia trachomatis infection.

This study was undertaken to assess the value of Papanicolaou smear for the diagnosis of Chlamydia trachomatis infection. The study was both retrospective (groups I and II) and prospective (group III). Group I consisted of 41 smears with cytomorphological changes proposed by Gupta, Kiviat, or Shiina. Group II was a control group, consisting of 30 cytologically normal smears. All these smears were subjected to specific immunofluorescent (IF) staining under identical conditions to confirm the diagnosis. In group III, 40 consecutive duplicate cervical smears were collected from patients attending the Sexually Transmitted Disease Clinic. One smear was routinely examined, and the specific IF staining was done on the other smear. The results in all the three groups were analysed. It was concluded that Papanicolaou smear is not useful in the detection of Chlamydia trachomatis infection.

Adolescent↗

PubMed2007

A three-armed trial of the ThinPrep Imaging System.

We compared the performance of the ThinPrep (TP) Imaging System (TIS) with manual reading of TP slides (TPM) and with manual reading of the paired conventional Pap smear (PS) in terms of sensitivity for and positive predictive value (PPV) of high-grade disease and productivity. The study consisted of 11,416 routine PS and paired TP slides as well as 103 confirmed abnormal TP slides. In terms of sensitivity for the detection of biopsy-confirmed high-grade disease, overall there was no statistically significant difference between TIS-screened TP (TPI) and TPM (81.1% vs. 86.8%). For the routine cases, TPI was significantly more sensitive than PS (73.4% vs. 57.8%). In terms of PPVs for the cytologic prediction of high-grade disease, there was no statistically, significant difference among TPI, TPM, and PS (75.6%, 73.9%, and 84.6%). For cytologic reports of possible high-grade disease, the PPVs were equivalent for TPI (45.0%) and TPM (37.0%) and there was no significant difference in PPVs between TPI and PS (61.3%). For TP slides, TIS screening showed a 27% productivity gain when compared with manual screening and a 54% productivity gain when compared with manual screening of PS slides. Use of TIS showed productivity benefits when compared with TPM and both productivity and sensitivity benefits over use of PS.

Autoanalysis↗

PubMed2003

Cognitive impairment in children with hemoglobin SS sickle cell disease: relationship to MR imaging findings and hematocrit.

BACKGROUND AND PURPOSE: Children with hemoglobin SS sickle cell disease are known to suffer cognitive impairment if they have silent infarct, but recent evidence suggests that patients with hemoglobin SS sickle cell disease may be impaired even if they are free of infarction. We test a hypothesis that cognitive impairment in children with hemoglobin SS sickle cell disease is associated with low hematocrit and MR imaging abnormalities. METHODS: A cohort of 49 patients was examined, all of whom had hemoglobin SS sickle cell disease but no history of clinical stroke. The Wechsler scales, which are standardized and age-adjusted, were used to assess cognitive function. Patients also underwent MR imaging examination of the brain, and hematocrit was measured in a subset of 45 patients. MR images were evaluated by at least two readers, and abnormal imaging findings were evaluated by at least three readers. Any lesion was sufficient to be classified as abnormal, with lesions defined to include lacunar infarction, encephalomalacia, or leukoencephalopathy. Hematocrit data were used if obtained within 3 months of psychometric testing and if there were no confounding events in the patients' charts. Wechsler test scores were then evaluated in relation to imaging findings and hematocrit values. RESULTS: Patients with imaging abnormalities had more cognitive impairment than did patients with normal imaging findings in verbal intelligence quotient (P <.02) and verbal comprehension (P <.01). Patients with low hematocrit had cognitive impairment shown by many performance measures, including full-scale intelligence quotient (P <.006), verbal comprehension (P <.006), and freedom from distractibility (P <.02). Multivariate analysis showed that MR imaging and hematocrit were independent predictors of full-scale intelligence quotient. CONCLUSION: Focal brain injury, revealed by MR imaging, is associated with cognitive impairment, but our data suggest that diffuse brain injury may also contribute to impairment. These findings show that impairment is multifactorial and suggest that chronic brain hypoxia is part of the pathophysiology of sickle cell disease.

Adolescent↗