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PubMed1986

Classifying function for health outcome and quality-of-life evaluation. Self- versus interviewer modes.

Validity assessment and the underreporting of dysfunction have been major problems in health-related quality-of-life measurement, including collecting data for analysis by the General Health Policy Model, using the Quality of Well-being scale (QWB). This analysis compares the results of self- versus interviewer modes of measurement and short, direct-answer questions versus probing algorithms in the QWB. The comparisons are made in terms of 1) correlations; 2) aggregate frequencies; 3) individual subject classifications; and 4) the actual state, established using evidence from multiple sources. Despite extremely high correlations between QWB scores from the two modes (greater than 0.98), the lowest interviewer mode sensitivity (0.86) and predictive value dysfunctional (0.91) were substantially superior to the highest self-classification characteristics (0.66 and 0.73). In the populations studied, specificities and predictive values functional were equivalent (greater than 0.94) for the two modes. The probe pattern of the interviewer mode was also less susceptible to false reports of dysfunction. These results are consistent with the underreporting of dysfunction noted by several major investigations of health status measurement. The authors conclude that interviewer-administered instruments using question algorithms are necessary if health-related quality of life is to be measured with sufficient reliability and validity to evaluate major clinical trials and follow-up studies.

Adult↗

PubMedDate not supplied

Serum protein expression profiling for cancer detection: validation of a SELDI-based approach for prostate cancer.

Multiple studies have reported that analysis of serum and other bodily fluids using surface enhanced laser desorption/ionization time of flight mass spectroscopy (SELDI-TOF-MS) can identify a "fingerprint" or "signature" of spectral peaks that can separate patients with a specific disease from normal control patients. Ultimately, classification by SELDI-TOF-MS relies on spectral differences in position and amplitude of resolved peaks. Since the reproducibility of quantitation, resolution and mass accuracy of the SELDI-TOF-MS, or any high throughput mass spectrometric technique, has never been determined this method has come under some skepticism as to its clinical usefulness. This manuscript describes a detailed design of a three-phase study to validate the clinical usefulness of SELDI-TOF-MS in the identification of patients with prostatic adenocarcinoma (PCA). At the end of this validation study, the usefulness of the general SELDI-TOF-MS approach to identifying patients with PCA will be demonstrated and how it compares with PCA diagnosis by measuring prostate specific antigen.

Adenocarcinoma↗

PubMed1999

[Mortality due to multiple sclerosis in Spain, 1951-1992].

UNLABELLED: FOUNDATIONS: In this work, multiple sclerosis mortality trend in Spain from 1951 to 1992 is displayed. The purpose is to identify the pattern of age-adjusted mortality evolution and to measure the effect of environmental factors. METHODS: Multiple sclerosis mortality is standardized by age using the world standard population. In each year from 1951 to 1992, age-specific mortality rates are transversely fitted to the Gompertz law. The Longitudinal Gompertzian analysis is applied to the obtained coefficients to quantify the effects of competing risks and environmental factors. RESULTS: Multiple sclerosis age-adjusted mortality increased from 1951 to 1968; a step-down is produced in 1969 (coinciding with change from 7th to 8th revision of the International Classification of Diseases) and a stability from 1970 on. Multiple sclerosis in Spain is a Gompertzian disease. Adjusting mortality for R0 (which in the Gompertz function represents the addition of the environmental factors acting in a point near the beginning of the life and the competing risks of death) the result was almost constant throughout the whole analyzed period. CONCLUSIONS: It is suggested that multiple sclerosis mortality trend in Spain is due to changes in some environmental factor acting early and in a point; on the other hand, diet or other environmental factors acting for long time or genetic factors have and little or no influence in this trend.

Adult↗

PubMed1996

Distinct patterns of multiple sclerosis pathology indicates heterogeneity on pathogenesis.

Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. The hallmark of its pathology is the demyelinated plaque with reactive glial scar formation. However, a detailed analysis of the patterns of demyelination, oligodendroglia cell pathology and the reaction of other tissue components suggests that the pathogenesis of myelin destruction in this disease may be heterogeneous. In this review we present a new classification scheme of lesional activity on the basis of the molecular composition of myelin degradation products in macrophages. When these criteria are used, different patterns of demyelination can be distinguished, including demyelination with relative preservation of oligodendrocytes, myelin destruction with concomitant and complete destruction of oligodendrocytes or primary destruction or disturbance of myelinating cells with secondary demyelination. Furthermore, in some cases a primary selective demyelination may be followed by a secondary oligodendrocyte loss in the established lesions. Finally, some extraordinarily severe conditions may result in destructive lesions with loss of myelin, oligodendrocytes, axons and astrocytes. This heterogeneity of plaque pathology is discussed in the context of recent experimental models of inflammatory demyelination, which show that different immunological pathways may lead to the formation of demyelinated plaques that reveal the diverse structural aspects described above. Our data indicate, that the demyelinated plaques of multiple sclerosis may reflect a common pathological end point of a variety of different immunological mechanisms of myelin destruction in this disease.

Animals↗

PubMed2002

Differential profiles of verbal learning in traumatic brain injury.

Several recent investigations have utilized cluster analytic procedures to elucidate profiles of verbal learning on the California Verbal Learning Test following traumatic brain injury (TBI). Although the results of these studies have contributed to our understanding of verbal learning following TBI, limitations in sample composition and methodology render the results difficult to evaluate. The current study provides an analysis of verbal learning clusters in the most comprehensive sample (n = 160) of TBI patients reported thus far. Results obtained from multiple hierarchical agglomerative clustering procedures suggested the presence of two distinct clusters, the first consisting of performance patterns falling within normal limits and the second consisting of moderate-to-severe impairment. Two iterative partitioning analyses further suggested a reliable solution with better-than-chance agreement (kappa coefficients >.85, p <.001). Thus, it is concluded that a two-cluster classification solution provides a parsimonious understanding of verbal learning profiles after TBI.

Adult↗

PubMed1999

Estrogen receptor methylation is associated with improved survival in adult acute myeloid leukemia.

Estrogen receptor methylation (ERM) is a frequent molecular alteration in adult acute myeloid leukemia (AML). In this study, we sought to determine the clinical characteristics and prognostic significance of ERM in AML. ERM was determined for 268 patients who had leukemic blasts available for molecular analysis. ERM was measured by Southern blot analysis, and results were obtained for 261 patients (ages 17-69). ERM ranged from 0-99.1%, with a median of 25%. One hundred sixty patients (61%) had ERM values over 15% and were considered ERM+. In a subset of patients analyzed, ERM+ samples had markedly lower ER gene expression compared with ERM- samples. In multiple regression analyses of patient and disease characteristics at diagnosis, two factors had significant independent association with ERM: ERM decreased with increasing age (P = 0.0001) and was significantly lower in patients with French-American-British classification M4 or M5 (P = 0.0019). In regression analyses of outcome measures, ERM had no significant impact on complete remission rate after initial induction therapy. However, ERM+ patients had significantly better overall survival [OS; 18% at 6 years; 95% confidence interval (CI), 12-24% versus 9%; CI, 3-14% for ERM- patients; P = 0.022]. In multiple regression analyses, OS increased with increasing ERM (P = 0.0044). Similar results were seen for relapse-free survival (23% at 6 years; CI, 15-32% for ERM+ versus 10%; CI, 2-19% for ERM-), although the effect of ERM was not statistically significant (P = 0.15 in multiple regression analysis). Our results indicate that ERM at diagnosis may be a favorable prognostic factor for OS in adult AML.

Acute Disease↗

PubMed2001

Molecular epidemiology of human astroviruses.

Human astroviruses (HAstVs) are associated with 5-9 percent of cases of gastroenteritis in young children. Seven serotypes (HAstV-1 to -7), which correlate with genotypes, have been defined by using immune typing methods. We have used partial nucleotide sequence information from the capsid protein gene for molecular typing of 29 unique human astrovirus strains obtained from prospective studies of children with gastroenteritis in Egypt and Malawi. HAstV-1 was the most commonly detected strain, consistent with previous studies, but a surprising variety of strains were identified in both collections. An eighth astrovirus type, HAstV-8, has been defined on the basis of the complete capsid protein gene sequence and was detected in both collections analysed in this study. Although HAstV-8 and HAstV-4 strains segregate into well resolved clades by analysis of sequences from the region encoding protein P2 (VP32), the pair-wise distances between these types are less than those between strains of the other serotypes. In contrast, analysis of sequences from the region encoding protein P3 unambiguously resolve HAstV-4 and HAstV-8 strains, consistent with their classification as distinct serotypes. Overall, strains representing six of the eight serotypes were detected in two collections of samples from prospective studies of gastroenteritis in young children indicating that multiple astrovirus types are frequently co-circulating within communities.

Gastroenteritis↗

PubMed2005

Stochastic-based descriptors studying biopolymers biological properties: extended MARCH-INSIDE methodology describing antibacterial activity of lactoferricin derivatives.

Lactoferricin are a number of related peptides derived from the enzymatic cleavage of lactoferrin, an iron-binding protein. These peptides, and other peptides derived from them by simple amino acid substitutions, have shown interesting antibacterial activity. In this paper we applied the MARCH-INSIDE methodology extended to peptide and proteins, to a QSAR study related to antibacterial activity of 31 derivatives of lactoffericin against E. Coli and S. Aureus by means of Linear Discriminant (LDA) and Multiple Linear Regression Analysis (MLR). In the case of LDA we obtained models that classify correctly more than 80% of all cases (85.7% for E. Coli antibacterial activity and 83.9 for S. Aureus). With the application of a Leave-One-Out Cross Validation Procedure, the percentage of good classification of both classification models remained near the above reported values (87.1% for E. Coli antibacterial activity and 83.9 for S. Aureus). We obtained several linear regression models taking into account total and local descriptors. The inclusion of those local descriptors improved the correlation parameters, the statistical quality, and the predictive power of the former model obtained only with total descriptors. The best models explained more than 80% of the experimental variance in the antimicrobial activity of those compounds. These results are comparable with those reported previously by Strom (Strom, M. B.; Rekdal, O.; Svendesen, J. S. J Peptide Res 2001, 57, 127-139.) and Tore-Lejon (Lejon, T.; Strom, M.; Svendsen, S. J Protein Sci 2001, 7, 74-78.; Lejon, T.; Svendsen J. S.; Haug, B. E. J Peptide Sci 2002, 8, 302-306.) in a smaller dataset applying Z-scales and volume-based descriptors and PLS as statistical techniques.

Amino Acid Sequence↗

PubMed2004

Potential of multivariate quantitative methods for delineation and visualization of ecoregions.

Multivariate clustering based on fine spatial resolution maps of elevation, temperature, precipitation, soil characteristics, and solar inputs has been used at several specified levels of division to produce a spectrum of quantitative ecoregion maps for the conterminous United States. The coarse ecoregion divisions accurately capture intuitively-understood regional environmental differences, whereas the finer divisions highlight local condition gradients, ecotones, and clines. Such statistically generated ecoregions can be produced based on user-selected continuous variables, allowing customized regions to be delineated for any specific problem. By creating an objective ecoregion classification, the ecoregion concept is removed from the limitations of human subjectivity, making possible a new array of ecologically useful derivative products. A red-green-blue visualization based on principal components analysis of ecoregion centroids indicates with color the relative combination of environmental conditions found within each ecoregion. Multiple geographic areas can be classified into a single common set of quantitative ecoregions to provide a basis for comparison, or maps of a single area through time can be classified to portray climatic or environmental changes geographically in terms of current conditions. Quantified representativeness can characterize borders between ecoregions as gradual, sharp, or of changing character along their length. Similarity of any ecoregion to all other ecoregions can be quantified and displayed as a "representativeness" map. The representativeness of an existing spatial array of sample locations or study sites can be mapped relative to a set of quantitative ecoregions, suggesting locations for additional samples or sites. In addition, the shape of Hutchinsonian niches in environment space can be defined if a multivariate range map of species occurrence is available.

Color↗

PubMed2006

Evaluation of magnetic resonance imaging criteria for cavernous sinus invasion in patients with pituitary adenomas: logistic regression analysis and correlation with surgical findings.

BACKGROUND: This study used high-resolution magnetic resonance (MR) imaging (1.5 T) to define and evaluate preoperative imaging criteria for cavernous sinus invasion (CSI) by pituitary adenoma (PA). METHODS: Magnetic resonance images obtained from 103 patients with PA submitted to surgery (48 with CSI) were retrospectively reviewed. The following MR signs were studied and compared with intraoperative findings: (1) presence of normal pituitary gland between the adenoma and cavernous sinus (CS), (2) status of the CS venous compartments, (3) CS size, (4) CS lateral wall bulging, (5) displacement of the intracavernous internal carotid artery (ICA) by adenoma, (6) grade of parasellar extension (Knosp-Steiner classification), and (7) percentage of intracavernous ICA encased by the tumor. Statistical analysis was performed using chi2 testing, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained for each MR finding. The odds ratio of the most significant criteria was also obtained, and the multiple logistic regression test was used to compare the criteria altogether. RESULTS: The following signs have been found to represent accurate criteria for noninvasion of the CS: (1) normal pituitary gland interposed between the adenoma and the CS (PPV, 100.0%), (2) intact medial venous compartment (PPV, 100.0%), and (3) percentage of encasement of the intracavernous ICA lower than 25% (NPV, 100.0%). Cavernous sinus invasion was certain if the percentage of encasement of the intracavernous ICA was higher than 45% and 3 or more CS venous compartments were not depicted. The most valuable criterion of CSI by logistic regression analysis was the percentage of encasement of intracavernous ICA of 30% or more, with an odds ratio of 49.25. CONCLUSION: The preoperative diagnosis of CSI by PA is extremely important because endocrinologic remission is rarely obtained after microsurgery alone in patients with invasive tumors. The aforementioned MR imaging criteria may be useful in patient's management and in advising most of the patients preoperatively on the potential need for complimentary therapy after surgery.

Adenoma↗

PubMed1998

Location of the transverse colon in relationship to the umbilicus: implications for laparoscopic techniques.

STUDY OBJECTIVE: To establish the location of the transverse colon in relationship to the umbilicus, and determine if it varies as a function of patient height or weight. DESIGN: Retrospective review of computed tomograms (CT) of the abdomen (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: Sixty-seven women with normal abdominal anatomy. INTERVENTION: Review of abdominal CT scans. MEASUREMENTS AND MAIN RESULTS: The relative relationships of the transverse colon and umbilicus were compared with age, height, weight, and body mass index (BMI = kg/m2) using multiple regression analysis. Average location of the superior margin of the transverse colon was 4.6 cm (95% CI 3.5-5.7 cm) above the umbilicus. In nine (13%) women it was below the umbilicus. The colon was below the umbilicus in 25% of nonobese women (BMI <25 kg/m2). CONCLUSION: Because the transverse colon lies below the umbilicus in more than 10% of women, injury to it may be an uncommon yet unavoidable complication of laparoscopy.

Colon↗

PubMed1999

Sequential neuromotor examination in children with intrauterine cocaine/polydrug exposure.

Data are presented on 157 newborn infants followed sequentially in a randomized home-based nursing-intervention trial for drug-exposed infants with follow up at 3 (N=118), 6 (N=124), and 12 months (N=77). The objectives of this study were to describe the longitudinal neurodevelopmental status of a cohort of children with intrauterine exposure to illicit drugs during their gestation, characterize the evolution of early tone abnormalities in a polydrug-exposed cohort, and determine whether neuromotor outcome is associated with drug-exposure patterns. For analysis, infants were grouped based on maternal drug-use pattern and the presence of drug metabolites in the neonatal drug screen. The sequential neuromotor examination was used at each age to define the neuromotor status of six domains and define categorical classifications as either normal, suspect, or abnormal. Multiple patterns of neuromotor abnormalities were observed during the neonatal period; most resolved over time. Axial hypotonia was a prominent finding in the neonatal period; however, it was infrequent in abnormal examinations at 12 months. Increased lower-extremity tone was a less frequent finding during the neonatal period. Infants whose neonatal urine drug screen was positive for both cocaine and opiates, were more likely than infants with negative urine drug screens, cocaine only, or opiate only drug screen results to have abnormal neuromotor examinations; while positive maternal drug screens for concurrent cocaine and opiate use were associated with peripheral hypertonia. Persistence of increased leg-extensor tone was found in 67% of the abnormal examinations at 12 months. Acquisition of rolling and walking was delayed in the drug-exposed cohort.

Age Factors↗

PubMed1999

Ill-defined and multiple causes on death certificates--a study of misclassification in mortality statistics.

Biases can distort, limit or inhibit the value of mortality data as an epidemiological re source. From 9500 deaths occurring in Naples (Italy during 1994, a random sample of 372 death certificates reporting ill-defined causes and multiple causes of death was extracted. The code for the underlying cause on the death certificate (assigned code) was compared with the cause reattributed with the aid of interview of the certifying physician or clinical records (modified code). The aim was to investigate the extent of misclassification of 'underlying cause' in deaths attributed to ill-defined and/or multiple causes and the shortcomings in the ICD-IX. Ill-defined underlying causes of death (7.0% of death certificates) were cardiovascular diseases, tumours with no specified site or nature, symptoms, signs, ill-defined conditions and senility. There was disagreement between the initially assigned code and the modified code in 53.8% of ill-defined underlying causes; discordance was high for the certificates filled in by the family physician. Multiple causes of death were observed in 23.6% of certificates; of these 59.2% concerned subjects aged 75 years and over at death. Diabetes was always listed in association with other pathologies but neoplasms and traumas were generally listed alone. Disagreement between codes occurred in 48 (54.5%) certificates indicating multiple causes. In 10 of them, death was established as due to a concurrence of causes. As regards ill-defined causes of death, the authors concluded that specific training on certifying procedures would be insufficient on their own; the physician should be made aware that certification is a fundamental requirement for building up epidemiological data. Evidence-based educational interventions are needed. As regards multiple causes of death, multicausal analysis may be indicated for deaths due to a concurrence of causes.

Age Factors↗

PubMed2000

Factors associated with repeat suicide attempts among adolescents.

OBJECTIVE: To determine potential risk factors associated with repeat suicide attempts among adolescents. METHOD: Retrospective medical record review of all patients aged 13-20 years who presented to the emergency department at an inner city tertiary hospital after attempted suicide between 1994 and 1996. Subjects were identified using the International Classification of Diseases (ICD-9) codes E950.0 to E959.9 for attempted suicide. Study variables included demographic parameters, chronic medical conditions/illnesses, psychiatric and substance abuse disorders, history of sexual abuse and previous and subsequent suicide attempts. Variables univariately associated with repetition at p < 0.25 were entered into a multiple regression analysis. RESULTS: Eighty seven per cent of patients presented with a drug overdose. Seventy-six per cent of all subjects attempted suicide in the context of a dispute or relationship break-up. At least one psychiatric disorder was present in 76% of subjects at the index attempt. The most frequently diagnosed disorders were depression (45.5%) and drug (34%) and alcohol abuse (27%). Variables predicting repetition within 12 months were drug (OR = 3.891, p = 0.02) and alcohol abuse (OR = 3.56, p = 0.05), non-affective psychotic disorders (OR = 3.81, p = 0.04), and chronic medical conditions/illness (OR = 3.29, p = 0.03). A history of sexual abuse was almost significant (OR = 3.03, p = 0.06). CONCLUSIONS: Adolescents most likely to re-attempt suicide with 12 months present with either substance abuse, non-affective psychotic disorders, chronic medical conditions, or a history of sexual abuse. All adolescents with a possible suicide attempt should receive a comprehensive mental health and psychosocial assessment. Closer scrutiny of the role of chronic illnesses and sexual abuse in both future research and clinical management is urged. A broad based, multidisciplinary intervention approach is recommended.

Adolescent↗

PubMed1987

Alveolar bone levels in a geriatric Swedish population.

A random sample of non-institutionalized elderly people in Orebro County, Sweden, has been examined. The present report studies marginal bone levels in this population. Measurements were made on intra-oral radiographs. The marginal bone levels of the teeth were measured in fifths between the apex and a point 1 mm apical to the cemento-enamel junction. More than 87% of the teeth received a bone score 1 or 2, which indicates that more than 60% of the original bone level was remaining. About half of the teeth were given the bone score of 1, i.e., having more than 80% of the original bone level intact. For those subjects receiving regular dental treatment, the average bone level index (mean bone score for the subject) was lower than for the others. The general bone level of a subject is described by a classification which takes into consideration only the best 70% of the teeth. Using these bone level classes, people aged 65-74 years positively differ from older groups. The % of subjects belonging to the better bone level classes increases with increasing number of remaining teeth. In a multiple stepwise regression analysis, the number of teeth is the only predictor having significant correlation to bone level index. A variable such as regular treatment in itself seems to have little influence.

Aged↗

PubMed2003

Risk factors for nuclear, cortical and posterior subcapsular cataracts in the Chinese population of Singapore: the Tanjong Pagar Survey.

AIM: To describe risk factors for nuclear, cortical, and posterior subcapsular (PSC) cataracts in Chinese Singaporeans. METHODS: A population based cross sectional study was carried out on ethnic Chinese men and women aged 40-81 years. A stratified, clustered, disproportionate (more weights to older people), random sampling procedure was used to initially select 2000 Chinese names of those aged 40-79 years from the 1996 electoral register in the Tanjong Pagar district in Singapore. Eligible subjects (n = 1717) were invited for a standardised ocular examination and interview at a centralised clinic, following which an abbreviated examination was conducted for non-respondents in their homes. Cataract was graded clinically using to the Lens Opacity Classification System (LOCS) III system. The main outcome measures were adjusted odds ratio for risk factors for specific cataract types (nuclear, cortical and PSC), any cataract and cataract surgery, examined in multiple logistic regression models. RESULTS: Out of the 1232 (71.8%) examined, 1206 (70.2%) provided lens data for this analysis. Increasing age was associated with all cataract types, any cataract, and cataract surgery. There was no significant sex difference in presence of any cataract, specific cataract types or cataract surgery. After controlling for age, sex, and other factors, diabetes was associated with cortical cataract (3.1; 95% CI: 1.6 to 6.1), PSC cataract (2.2; 95% CI 1.2 to 4.1), any cataract (2.0; 95% CI: 0.9 to 4.5), and cataract surgery (2.3; 95% CI: 1.3 to 4.1). Lower body mass index was associated with cortical cataract (1.8; 95% CI: 1.1 to 2.9; lowest versus highest quintile) and any cataract (2.3; 95% CI: 1.3 to 4.0). Current cigarette smoking was associated with nuclear cataract (1.7, 95% CI: 1.0 to 2.9; more than 10 cigarettes per day versus none). A non-professional occupation was associated with nuclear cataract (2.9; 95% CI: 1.5 to 5.8; for production or machine operators and 2.6; 95% CI: 1.2 to 5.5; for labourers or agricultural workers, both versus professionals). Lower education was associated with nuclear cataract (2.3; 95% CI: 1.0 to 5.2, none versus tertiary), while lower household income was associated with PSC cataract (4.7, 95% CI: 1.1 to 20.0; income S$4000). CONCLUSIONS: Age related cataracts are associated with a variety of risk factors among Chinese people in Singapore, similar to those reported in European, Indian, and African derived populations. These data support common aetiological mechanisms for age related cataracts, irrespective of ethnic origin.

Adult↗

PubMed2006

Demographic and clinicopathological characteristics of nonalcoholic fatty liver disease in the East-Southeastern Anatolia regions in Turkey.

OBJECTIVE: To identify the demographic and clinicopathological characteristics of patients diagnosed with nonalcoholic fatty liver disease (NAFLD) and the risk factors for fibrosis based on histopathological findings in East-Southeastern Anatolia regions in Turkey. SUBJECTS AND METHODS: The study included a total of 93 patients diagnosed with NAFLD from 5 different centers. Histopathological findings were evaluated by dividing them into four categories using Matteoni classifications. Cases with fibrosis were further evaluated using Brunt classifications. RESULTS: The patients with a nonalcoholic fatty liver were in the 3rd and 4th decade age groups. The mean age was 38 years, 76% of the patients were male, 85% were overweight, 37% were obese, 18% had type 2 diabetes mellitus, and 80.6% had hyperlipidemia. A multiple regression analysis showed that age, type 2 diabetes mellitus, and aspartate aminotransferase (AST) levels were linked with the severity of the disease. Of the 93 patients, 55 (59.1%) had fibrosis, of which 10.8% were classified as severe. The severity of fibrosis was significantly higher in obese patients. CONCLUSIONS: The risk factors for severity of NAFLD included advanced age, type 2 diabetes mellitus and serum AST level, while the risk factor for the severity of fibrosis was obesity.

Adult↗

PubMed1992

Electronystagmographic features in some peripheral and central vestibular disorders: application of multiple discriminant analysis of electronystagmographic parameters.

In routine clinical electronystagmographic (ENG) tests (postrotatory, optokinetic, caloric and tracking tests), eye movement signals were analyzed and a multiple discriminant analysis was carried out with the aid of a microcomputer. Six parameters were selected and, based on these, two functions for discriminating between peripheral and central disorders were established. Discrimination between 35 patients with peripheral lesions and 15 patients with central lesions was made with a correct classification rate of 97.1 and 86.7%, respectively. These rates are significantly higher than that of any single ENG test analysis. Our results indicate that the clinical application of ENG can be improved by searching for more sensitive ENG parameters and adopting the comprehensive analysis approach.

Adult↗