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PubMed2002

Variability of trail making test, symbol digit test and line trait test in normal people. A normative study taking into account age-dependent decline and sociobiological variables.

BACKGROUND AND AIMS: The influence of sociobiological variables and aging on the variability of the Trail Making Tests (TMT), the Symbol Digit Substituting Test (SDT), and the Line Trait Test (LTT) in the general healthy populations are not well known. Even less is known about the reliability at re-testing. This study aimed at determining the reference range of these tests, taking into account sociobiological variables and age, and the re-testing effect. METHODS: We studied 300 healthy subjects from 20 to 80 years of age. The sample was derived by the pooling of two samples stratified by age and sex: a randomized sample of 161 subjects collected from the city registers of Padova, and a convenience sample of 139 subjects collected in 20 towns (mainly rural) of Northern Italy. After normalization, data were assayed for the influence of age, education, job, and gender. RESULTS: Age was found to be a significant independent predictor for all the tests, education for all but the LTT, job only for the TMT-B and a geometrical version of the same test (TMT-G) which was proved to be highly correlated with the TMT-B (r=0.80, p<0.01). Job and the interaction age x education level influenced the difference TMT-B minus TMT-A. From the predicting equations, the normative data and the formulas to obtain Z scores for each test were derived. Reliability was lowest for LTT errors (CV=67%), highest for the SDT (13%), whereas the TMT obtained intermediate values (22-33%, depending on the test). CONCLUSIONS: This study provides the most reliable normative data range for the TMT, SDT and LTT to date because it considers important demographic variables such as age, education and job.

Adult↗

PubMedDate not supplied

Comparing normal hearing and hearing-impaired subject's performance on the Northwestern Auditory Test Number 6, California Consonant Test, and Pascoe's High-Frequency Word Test.

The Northwestern Auditory Test No. 6, the California Consonant Test, and Pascoe's High-Frequency Test were presented to two groups of listeners. One group consisted of 12 patients with normal hearing up to 2 kHz accompanied by a high-frequency loss. The second group consisted of persons with normal hearing. There were significant differences between the two groups of listeners in overall discrimination scores, among the four intensity levels (10, 20, 30, 40 dB) and the three speech discrimination tests. When the data from the hearing-impaired subjects were analyzed, it was found that these individuals obtained higher scores on the NU 6 material at 20, 30, and 40 dB SL when compared with the California Consonant Test and Pascoe's test. The results from the Newmann-Kuel multicomparison test indicated no statistical significance between the results of the California test and Pascoe's test; however, the distribution of scores at 40 dB was different. Results of this study suggested that the NU 6 test was not sufficiently sensitive to detect consonant confusions in individuals with high-frequency hearing loss.

Adult↗

PubMed1974

Specificity of the indirect haemagglutination test with Plasmodium falciparum test cells. Comparison of indirect haemagglutination and fluorescent antibody tests on African sera.

The specificity of the indirect haemagglutination (IHA) test with Plasmodium falciparum placental antigen-sensitized test cells was examined with sera from healthy blood donors and from patients with diseases other than malaria. Only 1 nonspecific antibody reaction was seen in more than 700 tests. A comparison of IHA titres and indirect fluorescent antibody (IFA) titres with IgG and IgM conjugates on 503 sera from inhabitants of Mto Wa Mbu in Tanzania showed in successive age groups an increasing number of seropositive reactors with both tests. The increase in the proportion of positive reactions and in the mean titre levels started earlier but was more gradual in the IFA test than in the IHA test. Parasite carriers had higher antibody levels than people without an apparent parasitaemia. Parasite carriers in the younger age groups especially were more frequently seronegative in the IHA test than in the IFA test with anti-IgG conjugates. The reactivity of the IHA test with P. falciparum (Palo Alto/Aotus) antigen was higher than that with P. falciparum placental antigen and was thus closer to that of the IFA test with IgG conjugates.

Adolescent↗

PubMed1991

[The diagnostic value of a new whole blood histamine release test using paper disc-coupled antigens--results compared with intracutaneous test, RAST, and eye test].

We have developed a novel histamine release test (HR) using whole blood and antigen-coupled RAST paper discs, for the screening of allergens rather in a short time with a small amount of blood. Histamine was determined by a RIA kit. In order to evaluate the diagnostic value, the results of the test were compared with those of RAST, intracutaneous tests, and eye tests in 45 allergic patients. HR correlates better with RAST than intracutaneous test in almost all antigens. The closest positive correlation with the other tests was seen in mite allergen, followed by pollen, foods and mould spores in that order. When the HR was positive for house dust, 100% of the patients were also positive for the eye test, which is reported to closely correlate with bronchial provocation tests. HR seemed to be a useful test not only for the screening but also for the determination of pathogenic allergens.

Adolescent↗

PubMed1994

Pituitary function tests: comparison of ACTH and 11-deoxy-cortisol responses in the metyrapone test and with the insulin hypoglycemia test.

PURPOSE: To compare the sensitivity of ACTH and 11-deoxy-cortisol (comp. S) responses in the short metyrapone test and the latter with the insulin hypoglycemia test. METHODS: Retrospective evaluation of 115 short metyrapone tests and comparison of 18 pairs of metyrapone and insulin tests. 20 healthy controls and 95 patients with confirmed pituitary disease were studied. All hormones were measured by sensitive radioimmunoassays. RESULTS: In patients with pituitary disease not requiring hydrocortisone substitution (n = 70), the ACTH response in the metyrapone test was subnormal in 47 cases (< 33 pmol/L), the comp. S response (< 200 nmol/L) in 21 cases only. Comparison of the relationship between ACTH and comp. S with an ACTH-cortisol dose-response curve obtained in normal subjects shows that subnormal ACTH responses after metyrapone in the range between 13 and 33 pmol/L still generate normal comp. S responses. The results of the metyrapone test correlated significantly with those of the insulin test. CONCLUSIONS: Measuring plasma ACTH in the scope of the metyrapone test makes the test more sensitive to detect secondary adrenal insufficiency than with steroid measurements alone. Results of the metyrapone test correlate significantly with the cortisol response to insulin hypoglycemia.

Adrenocorticotropic Hormone↗

PubMed1983

[The peritoneal sperm migration test (PSM-test) following fractional artificial insemination during laparoscopic fertility testing].

The peritoneal sperm migration test following fractional artificial insemination during diagnostic laparoscopy was carried out in the context of fertility investigation in 78 women age 25 to age 40. 35 cases had a positive PSM test, 43 had a negative PSM test. The results were correlated to the phase of menstrual cycle, the semen analysis and the tubal patency test. The test showed the best results when it was done in the preovulatory phase in conjunction with a normal semen analysis and a normal tubal patency test. In 2 cases with severe oligospermia and in two cases with bilateral tubal occlusion the test was still positive. The test is of clinical importance and can be done without increased risk during any laparoscopy for infertility. Valuable conclusion about the migration of sperms through the uterus and the tubes in the individual couple can be obtained. This is of prognostic importance. The test shows in addition to mechanical tubal patency by chromopertubation the functional or physiologic tubal permeability. Negative PSM tests are relatively frequent and are caused by tubal, uterine or sperm factors.

Adult↗

PubMed2002

To test or not to test: are Hispanic men at highest risk for HIV getting tested?

This study examined how HIV testing history and future testing intentions were related to sexual risk and perceptions of risk in a community sample of 1,052 Hispanic men. This sample is noteworthy in its diverse representation of Hispanics, its high ratio of participants born outside the USA, and its inclusion of heterosexuals and men who have sex with men (MSM). We used area-based sampling to recruit participants at public venues. Data were collected via anonymous, structured interviews from December 1999 to February 2001. Lifetime testing rates were high (76%), but only 45% had been tested in the last 12 months. Results indicate that men at highest risk-those who were MSM, had more partners and had STDs-were more likely to have been tested, and to have been tested recently, than men with lower risk. Being MSM and having been previously tested predicted future testing intentions. Inconsistent condom users with more than five partners were less likely to intend to be tested than men with more than five partners who used condoms consistently. Studying men who have successfully routinized HIV prevention practices (including testing) will assist in the development of interventions for those who remain at risk.

Adolescent↗

PubMed1998

The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction.

Isokinetic measurements and functional tests are often used to assess function following knee ligament reconstruction using the opposite limb as a control. However, the question of whether the uninvolved leg may serve as a reference on functional tests has not been adequately answered. In particular, the one-legged rebound vertical jump has not been used to assess functional levels following surgery of the cruciate ligament. The purposes of this study were: 1) to determine whether the uninvolved leg is within normal range of an age- and weight-matched group, 2) to determine differences between the involved and uninvolved leg in patients after anterior cruciate ligament reconstruction, 3) to examine the relationship between knee extensor strength and four functional performance tests, and 4) to determine if the one-legged rebound vertical jump yields more information in the assessment of knee function than the other functional tests with respect to two time-frames. Fifty healthy subjects (group A, mean age = 28.1 years) and 55 anterior cruciate ligament patients (groups B and C) participated in dynamometric measurement, one-legged and two-legged vertical jump, and the single- and the triple-hop test. Mean time for testing was 13 weeks following surgery for group B (N = 30, mean age = 27.8 years) and 54 weeks following surgery for group C (N = 25, mean age = 29.9 years). Pearson product moment correlation coefficients between peak torque and single and triple hop were r = .45, r = .48, r = .51, and r = .55 for groups B and C, respectively. Pearson product moment correlation coefficients between peak torque and the height of the vertical jump was r = .51 for group C. Results for group A revealed limb symmetry indices of 95% or more on all functional performance and isokinetic tests. In group B, all patients showed a limb symmetry index of less than 85% on all tests. In group C, the index for the vertical jump was the only functional test that fell below the level of 85%. Regardless of whether the dominant or nondominant leg is involved, the uninvolved leg can be used adequately as a reference guide for outcome from rehabilitation using these measurements. The one-legged vertical jump test is capable of detecting functional limitations of the lower limb following knee ligament reconstruction up to 54 weeks postoperatively.

Adult↗

PubMed1991

[Evaluation of two quantitative tests for salivary secretion--the chewing gum test and the Saxon test in normal subjects and in patients with Sjögren's syndrome].

A cooperative multicenter study was performed to evaluate two salivary secretion methods-the chewing gum test and the Saxon test by a crossover method. Twenty healthy volunteers and 27 patients with Sjögren's syndrome were examined. In healthy controls the amount of saliva collected per minute was larger in the Saxon test. Both tests revealed a significant decrease of salivary secretion in patients with Sjögren's syndrome, but the amount of saliva per minute was also larger in Saxon test. By repeated trials of both tests a notable increase of saliva was always observed at the second trial. Since this phenomenon may be due to the learning effect of the tests, one should perform at least one practice before starting formal tests. Saxon test could be performed in a patient having dental prostheses who was unable to masticate chewing gum. The Saxon test, thus, may be an efficient method, to evaluate the salivary secretory function.

Adult↗

PubMed1980

The sensitivity and specificity of an agglutination test for antibodies to streptococcal extracellular antigens: a quantitative analysis and comparison of the Streptozyme test with the anti-streptolysin O and anti-deoxyribonuclease B tests.

As a part of studies of streptococcal infections of the upper respiratory tract, sera from 142 individuals (mean age 11.9 years) with signs and symptoms on tonsillitis or pharyngitis and their family contacts were studied to quantitatively evaluate the sensitivity and specificity of the Streptozyme test. We also compared this agglutination test for streptococcal extracellular antibodies with the antistreptolysin O and antideoxyribonuclease B tests. Using different lots of Streptozyme reagent we found evidence suggesting variation in the strength of the reagent from lot to lot. Evaluation of the group specificity of the Streptozyme test suggests that it may not be specific for antibodies to extracellular products of group A streptococci, since a response to this test was seen in individuals with only non-group A strains isolated from their upper respiratory tracts. In patients with group A streptococci isolated from the upper respiratory tract, the quantitative sensitivity of the antibody response as measured by the Streptozyme test is comparable to, but no greater than, the ASO or anti-DNase B tests. Our analysis of upper limits of normal for the Streptozyme test in the study population indicates that previous recommendations for values for elevated titers are too low, especially for predominantly pediatric populations, so that previous reports of patients demonstrating an antibody response to Streptozyme-measured antibodies may include a significant number of patients with "normal" levels. This study indicates the need for both further documentation of standardization of the reagents used in this agglutination test and additional quantitative studies of the response measured by Streptozyme.

Adolescent↗

PubMed1985

Comparison of measles antihemolysin test, enzyme-linked immunosorbent assay, and hemagglutination inhibition test with neutralization test for determination of immune status.

Sera were collected from 238 high-school students in Prince Edward Island for the determination of immune status before an anticipated measles outbreak. In addition, history of vaccination status and measles infection was obtained. In the subsequent outbreak, 28 students did contract measles. Specificity for hemagglutination inhibition (HI), antihemolysin (AH), and enzyme-linked immunosorbent assay (ELISA) was 100%, compared with the neutralization test. Corresponding sensitivity values for the tests were 66.0% (HI), 99.5% (AH), and 99.0% (ELISA). Predictive values for susceptibility were 26.9% (HI), 77.8% (AH), 75.7% (ELISA), 80% (neutralization), and 41.4% as determined by history of infection or vaccination. The predictive value for immunity as determined by history of previous infection or vaccination was 91.8%, compared with 100% for the four serological tests. No false-positive results were seen with any of these tests. Compared with the neutralization test, the HI test had 69 false-negative results, the AH had 1, and the ELISA test had 2. The AH and ELISA tests provided sensitive and specific alternatives to the commonly used HI test for immune status determination.

Adolescent↗

PubMed1986

IgG levels after treatment with antigen vials based on the scratch testing, intradermal testing, modified RAST testing.

In this study, there were three groups of patients--each group consisting of four patients. The first group had been skin tested by the scratch method, the second group was skin tested by the end point titration intradermal method, and the third group had been tested for inhalant allergy by the modified RAST technique. All of them had multiple treatment vials made, dependent on the type of testing they had, and the vials all included the ten inhalants that were tested for. All patients had been treated for a year with weekly immunotherapy injections. Specific IgG levels, blocking antibody levels to the ten inhalant allergens, were determined. The results were that the patients who had been scratch tested had the lowest levels of specific IgG blocking antibody--while both intradermal end point titration and modified RAST testing had much higher elevations of blocking IgG antibody, with the RAST having the highest. It is concluded that, since the treatment vials prepared after scratch testing of all the antigens are at the same concentration, there are many antigens that are not given in adequate amounts to cause a good IgG response whereas, by calibrating the concentrations of antigens in the intradermal titration and the modified RAST testing, all the antigens are being injected in sufficient quantities to get a good blocking antibody response.

Desensitization, Immunologic↗

PubMed1983

Antimicrobial susceptibility testing (AST): a review of changing trends, quality control guidelines, test accuracy, and recommendation for the testing of beta-lactam drugs.

The review that follows presents the changing trends in antimicrobial susceptibility testing observed from the author's clinical laboratory experience and the proficiency testing surveys of the College of American Pathologists (CAP). The CAP Microbiology Surveys show a clear trend toward standardized test methods of the National Committee for Clinical Laboratory Standard (NCCLS) and greater compliance with specified methods' technical steps. This has favorably influenced the laboratory performance on proficiency challenges where a 3-5% improvement has been noted over the last 5 years for the disk tests (overall acceptable rate of 95.2% in 1981). A concurrent increase in dilution test use, mainly broth microdilution methods, has resulted in greater than 25% of larger hospital laboratories reporting results as MICs (overall acceptable or good performance = 98%). Automated systems use also continues to increase, with user performance being monitored at an acceptable level. Quality control frequency may be reduced to once weekly without compromising test accuracy or patient care, but only after adequate daily or concurrent QC performance has been documented. Most methods continue to have problems in testing enterococci, methicillin-resistant staphylococci, and the class-disk concept appears to be less applicable. Recommendations are made for the testing of the newer semisynthetic penicillins and cephalosporins based on their spectrum comparability and cross-resistance studies with bacteria possessing known susceptibility or resistance mechanisms. The concept of "spectrum-class" is introduced with peer drugs within classes. The general trends and quality of antimicrobial susceptibility tests seem outstanding and point toward continued excellent intra- and interlaboratory reproducibility at the national level, primarily due to the efforts of the inspection and accreditation agencies, CAP, CDC, and other concerned professional groups.

Anti-Bacterial Agents↗

PubMed2001

Absence of risk factors for false-positive test results in blood donors with a reactive test result in an automated treponemal test (PK-TP) for syphilis.

BACKGROUND: Screening and confirmatory serologic tests for syphilis are known to generate false-positive results in low-risk populations, which include blood donors. This study assessed whether conditions previously reported to cause biological false-positive (BFP) test results for syphilis are relevant to contemporary syphilis testing of blood donors and the extent to which seropositive donors report a history of syphilis. STUDY DESIGN AND METHODS: A history of conditions reported to be associated with BFP syphilis tests or a history of syphilis infection was assessed by a case-control study of donors with reactive and nonreactive automated treponemal test results, using an anonymous mail survey. Analysis of cases was stratified by fluorescent treponemal antibody absorption (FTA-ABS) result. RESULTS: Adjusted ORs (95% CIs) for reported BFP-associated conditions were 1.3 (0.8-2.1) for FTA-ABS-positive cases and 0.8 (0.3-1.9) for FTA-ABS-negative cases. Among responding blood donors, syphilis history was reported in 78 (51%) of 153 FTA-ABS-positive cases, 0 of 142 FTA-ABS-negative cases, and 3 (0.4%) of 716 automated treponemal test (PK-TP)-negative controls. CONCLUSION: Approximately half of donors with FTA-ABS-positive test results reported a syphilis history. There was no difference between reported BFP conditions for FTA-ABS-positive or FTA-ABS-negative cases and controls. This information may be useful when providing donors with better predonation or post-test counseling information about syphilis testing.

Adolescent↗

PubMed2002

Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds.

BACKGROUND AND PURPOSE: The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities. The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults. SUBJECTS: Ninety-six community-dwelling elderly people (61-89 years of age) with independent functioning performed 4 clinical tests. METHODS: Data were collected on the Six-Minute Walk Test (6MW), Berg Balance Scale (BBS), and Timed Up & Go Test (TUG) and during comfortable- and fast-speed walking (CGS and FGS). Intraclass correlation coefficients (ICCs) were used to determine the test-retest reliability for the 6MW, TUG, CGS, and FGS measurements. Data were analyzed by gender and age (60-69, 70-79, and 80-89 years) cohorts, similar to previous studies. Means, standard deviations, and 95% confidence intervals for each measurement were calculated for each cohort. RESULTS: The 6MW, TUG, CGS, and FGS measurements showed high test-retest reliability (ICC [2,1]=.95-.97). Mean test scores showed a trend of age-related declines for the 6MW, BBS, TUG, CGS, and FGS for both male and female subjects. DISCUSSION AND CONCLUSION: Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW, BBS, TUG, CGS and FGS. Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons.

Activities of Daily Living↗

PubMed1977

Comparison between the automated reagin test and reagin screen test methods of VDRL screening tests for syphilis in use in a routine laboratory.

A comparison is made between the automated reagin test (ART) using Technicon AutoAnalyzer equipment and the reagin screen test (RST) introduced by Lederle using a new antigen formulation. Treponemal haemagglutination tests (TPHA) were done simultaneously as second screen tests. The absorbed fluorescent treponemal antibody test (FTA-ABS) was used in all seropositive cases. Altogether 1154 sera were tested; 1028 were negative with all tests, 66 were positive with all tests, 42 were positive with TPHA and negative with ART and RST, and 16 were positive with TPHA and RST and negative with ART. It was concluded that the use of the RST and TPHA together would be the more sensitive screen test.

Antibodies, Bacterial↗

PubMed1992

The use of the D-dimer test in combination with non-invasive testing versus serial non-invasive testing alone for the diagnosis of deep-vein thrombosis.

We studied the usefulness of the determination of plasma D-dimer levels (using an ELISA) in combination with non-invasive testing with impedance plethysmography (IPG) or real-time ultrasonography (US) for the diagnosis of deep-vein thrombosis (DVT), in outpatients with clinically suspected DVT. This combined approach was compared to serial non-invasive testing alone in these patients. The sensitivity of a positive D-dimer test (greater than 300 micrograms/l) for the presence of DVT was 100% (70/70 patients; 95% C.I.: 95-100%), whereas the specificity was 29% (69/239 patients; 95% C.I.: 23-34%). The proportion of patients in which a definitive decision about the presence or absence of DVT could be made on the day of referral, was calculated for both approaches. When applying the combined approach, in 42% of all referred patients the diagnosis of DVT could either be established or refuted on entry, as opposed to only 19% of patients using serial non-invasive testing alone. Also, the costs per DVT diagnosed were calculated for the two diagnostic approaches. For the diagnosis of DVT the costs using serial IPG were comparable to the costs using the combination of IPG and the D-dimer test. The same conclusion holds for the comparison of serial US with the combination of US and D-dimer testing. We conclude that for the diagnosis of DVT in symptomatic outpatients the combination of non-invasive testing with the D-dimer test might be preferred over serial non-invasive testing alone, although the safety of such an approach remains to be established in future management studies.

Cost-Benefit Analysis↗

PubMedDate not supplied

[Comparison of rheumatoid test procedures--value and critical interpretation of sensitivity and specificity and their effect on pre-test and post-test probability].

In this prospective study, sera of 440 patients with rheumatic and degenerative joint diseases were tested for the presence of rheumatoid factor (RF). The Latex agglutination test (LFT), Waaler-Rose hemagglutination, laser nephelometry and IgM-Enzyme immunoassay (IgM-EIA) were used for detecting IgM-rheumatoid factors. In addition, rheumatoid factor of IgA isotype was measured by an IgA-Enzyme immunoassay. Sensitivity, specificity, pre-test- and post-test-probability were evaluated based on the data obtained to compare the test systems used. Under prospective patient selection, none of the test systems used reached a sensitivity of 100% concerning its cut off level. Despite this limitation, latex agglutination and IgM-EIA reached the highest sensitivity. Waaler-Rose test (90,8%) showed the best result for specificity. The IgA-EIA held the third position in sensitivity, specificity and efficiency. By comparing sensitivity with specificity, no test system can be recognized as the absolutely best one, since the receiver operating characteristic curves (ROC) overlapped. Practically rheumatoid factor measurement should initially use a highly sensitive assay, such as LFT and IgM-EIA to screen for RF. In the case of a positive result a more specific assay should be used, for example laser nephelometry, to confirm the result.

Adolescent↗