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At least 19 recordsLinked to original sources
PubMed1988

[Discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception].

The purpose of this study was to assess and compare discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception. For this study, 124 hospitalized patients and the same numbered nurses assigned for direct care of each 124 patients were selected from general ward of C. University Hospital in Seoul during the time period from September to November 1987. Degree of uncertainty was measured by 27 items modified from Mishel Uncertainty in Illness Scale (M-UIS), and was utilized by a Likert type scale The data were analysed by Mcnemar-test, Unpaired t-test, ANOVA, Scheffé-test and Stepwise multiple regression. The results are summarized as follows: 1. The discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception showed significant differences in 23 of 27 items: 11 of 23 items showed that the scores of patients' perception of uncertainty were higher than that of nurses' interperson perception of uncertainty. but 12 of 23 items were revealed reversely. 2. With regard to nurse's demographic variables, the discrepancy scores were the highest in the group under 22 years of age (F = 3.20, p = .026) and in the group less than 1 year of nursing experience among 4 groups (F = 4.41, p = .006). 3. The discrepancy scores had a tendency to be lowered in the higher age group (r = .27, p = .0026) and in the longer experienced group (r = .25, p = .0052).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Radiologist uncertainty and the interpretation of screening.

OBJECTIVE: To determine radiologists' reactions to uncertainty when interpreting mammography and the extent to which radiologist uncertainty explains variability in interpretive performance. METHODS: The authors used a mailed survey to assess demographic and clinical characteristics of radiologists and reactions to uncertainty associated with practice. Responses were linked to radiologists' actual interpretive performance data obtained from 3 regionally located mammography registries. RESULTS: More than 180 radiologists were eligible to participate, and 139 consented for a response rate of 76.8%. Radiologist gender, more years interpreting, and higher volume were associated with lower uncertainty scores. Positive predictive value, recall rates, and specificity were more affected by reactions to uncertainty than sensitivity or negative predictive value; however, none of these relationships was statistically significant. CONCLUSION: Certain practice factors, such as gender and years of interpretive experience, affect uncertainty scores. Radiologists' reactions to uncertainty do not appear to affect interpretive performance.

Colorado↗
PubMed2001

Correlates of quality of life in symptomatic HIV patients living in Hong Kong.

This cross-sectional study assessed quality of life (QOL), coping styles, mood and uncertainty in illness in a non-random sample of 46 (out of 91 eligible) symptomatic HIV patients living in Hong Kong. QOL was moderate and the main concerns were related to the environmental aspects of QOL, spirituality and social relationships. Considerable mood disturbance was demonstrated in the sample, especially with regards to depression, fatigue and tension/anxiety. High levels of uncertainty in illness were also reported. A median split of the uncertainty score demonstrated that high uncertainty was related to lower levels of overall QOL (p = 0.04), higher psychological dysfunction (p = 0.05), worse adjustment with the environment (p < 0.001) and higher mood disturbance (p = 0.008). The sample predominantly used internal coping, which also correlated well with higher QOL scores. Through regression analysis it was shown that QOL could be predicted with the combined effects of uncertainty in illness and fatigue (adjusted R2 = 0.51, p < 0.001). Findings indicate that efforts should be directed towards improving QOL issues in the Chinese HIV patients and interventions could be introduced to alleviate those factors that were found to affect QOL. It is suggested that such interventions may include group or individual psychological therapies, management of fatigue and teaching patients more effective coping techniques.

Adaptation, Psychological↗
PubMed2002

Uncertainty and scoring systems.

Estimating risks for individual patients facilitates communication with patients, relatives and colleagues, and determines whether further treatment is futile. The process of estimating risks involves mathematics (i.e. scoring systems) and human experience and expertise. Understanding how risks are estimated is important because prognostication is an integral part of any medical specialty. In the USA, such treatment limitation or withdrawal decisions were made on only 7% of all intensive care unit patients but this represented 47% of all deaths on such units. In the UK, data reported by the Intensive Care National Audit and Research Centre suggest that although treatment limitation decisions are made on only 11.8% of patients, this accounts for over 50% of deaths on intensive care. Scoring systems offer a useful adjunct in identifying futility but there are important inherent weaknesses that limit their performance. This review aims to discuss some of these limitations.

Critical Illness↗
PubMed2003

Groundwater abstraction pollution risk assessment.

A generic groundwater pollution risk assessment methodology has been developed to enable the evaluation and ranking of the potential risk of pollution to groundwater abstractions. The ranking can then be used to prioritise risk management or mitigation procedures in a robust and quantifiable framework and thus inform business investment decisions. The risk assessment consider the three components of the pollution transport model: source-pathway-receptor. For groundwater abstractions these correspond to land use (with associated pollutants and shallow subsurface characteristics), aquifer and the abstraction borehole. An hierarchical approach was chosen to allow the risk assessment to be successfully carried out with different quality data for different parts of the model. The 400-day groundwater protection zone defines the catchment boundary that form the spatial limit of the land use audit for each receptor. A risk score is obtained for each land use (potential pollution source) within the catchment. These scores are derived by considering the characteristics (such as load, persistence and toxicity) of all pollutants pertaining to each land use, their on-site management and the potential for the unsaturated subsurface to attenuate their effects in the event of a release. Risk scores are also applied to the aquifer characteristics (as pollutant pathway) and to the abstraction borehole (as pollutant receptor). Each risk score is accompanied by an uncertainty score which provides a guide to the confidence in the data used to compile the risk assessment. The application of the methodology has highlighted a number of problems in this type of work and results of initial case studies are being used to trial alternative scoring methods and a more simplified approach to accelerate the process of pollution risk assessment.

Models, Theoretical↗
PubMed1984

The significance of the doctor-patient relationship in coping with cancer.

The uncertainty and anxiety experienced by cancer patients and their ways of coping with uncertainty and anxiety were studied on the basis of a questionnaire completed by 418 patients. The study shows that 28.2% of the patients had a low and 33.5% had a high uncertainty score, while 50% had a low and 9% had a high anxiety score. Four ways of coping with uncertainty and anxiety can be distinguished, of which the use of self-instruction means was most common. Expert help proved to be important for reduction of uncertainty. For reduction of anxiety the support of the home environment and of fellow-patients was also of importance. The implications of these findings for the doctor's performance and for the care of cancer patients are discussed.

Adaptation, Psychological↗
PubMed2026

scATAnno: Automated Cell Type Annotation for Single-cell ATAC-seq Data.

Recent advances in single-cell epigenomic techniques have increased the demand for single-cell assay for transposase-accessible chromatin using sequencing (scATAC-seq) analysis. One key analytical task is to determine cell type identity based on epigenetic data. Here, we introduce scATAnno, a Python package designed to automatically annotate scATAC-seq data using large-scale scATAC-seq reference atlases. This workflow generates reference atlases from publicly available datasets, enabling accurate cell type annotation by integrating query data with reference atlases without the use of single-cell RNA sequencing (scRNA-seq) data. To enhance annotation accuracy, we incorporated k-nearest neighbors (KNN)-based and weighted distance-based uncertainty scores to effectively detect cell populations within the query data that are distinct from all cell types in the reference data. We compared and benchmarked scATAnno against five other published cell annotation approaches, demonstrating its superior performance across multiple datasets and metrics. We further showcased the utility of scATAnno across multiple datasets, including peripheral blood mononuclear cells (PBMCs), triple-negative breast cancer (TNBC), and basal cell carcinoma (BCC), and demonstrated that scATAnno accurately annotates cell types across diverse biological conditions. Overall, scATAnno is a useful tool for scATAC-seq reference atlas construction and cell type annotation and can facilitate the interpretation of new scATAC-seq datasets in complex biological systems. scATAnno is publicly available at https://scatanno-main.readthedocs.io/.

Single-Cell Analysis↗
PubMed2005

Physician risk attitudes and hospitalization of infants with bronchiolitis.

OBJECTIVES: To determine whether the risk attitudes of pediatric emergency physicians are related to the likelihood that otherwise healthy infants with bronchiolitis will be admitted for inpatient care. METHODS: Risk aversion and discomfort with diagnostic uncertainty were assessed among 46 pediatric emergency physicians from three hospitals participating in the Child Health Accountability Initiative. Study physicians managed 397 otherwise healthy infants ages 0 to 12 months presenting to their hospital emergency departments with bronchiolitis. Mean risk aversion and discomfort with diagnostic uncertainty scores were compared across physician gender, years of experience, and formal training in emergency medicine. Additional analyses based on infants as the analytic unit determined admission rates of physicians scoring high and low on risk attitude measures. This model was controlled for severity of illness. RESULTS: Scores on measures of risk aversion and discomfort with uncertainty were similar for male and female physicians and for physicians who had completed pediatric emergency medicine fellowship training and those without such training. Risk aversion scores were significantly higher for physicians with 15 or more years of experience. Admission rates for infants with bronchiolitis were no higher among physicians scoring above the median on risk attitude measures. When adjusted for severity of illness, physicians' risk attitudes were not associated with admission rates. CONCLUSIONS: Recent growth in per-capita admissions for bronchiolitis is not accounted for by physician intolerance for diagnostic uncertainty. Physician risk attitudes should be considered in the context of hospital admissions for other pediatric conditions with unclear prognoses.

Analysis of Variance↗
PubMed2006

Quantifying how tests reduce diagnostic uncertainty.

BACKGROUND: Diagnostic tests are commonly evaluated from sensitivity and specificity, which are robust and independent of prevalence, but clinically not intuitive. Many clinicians prefer to use positive and negative predictive values (PPV and NPV), but they are frequently applied as if they are independent of prevalence, whereas this may make an important difference. METHODS AND RESULTS: We present graphs that allow easy reference to appropriate values and demonstrate that PPV and NPV are not independent of prevalence. PPV and NPV figures reflect the prior probability of the case having a positive diagnosis, estimated clinically from the history, examination and other results, as well as the impact of the test result. To avoid the common error of allowing for prior probability twice, and to interpret the impact of the test result alone, we present graphs of the proportionate reduction in uncertainty score (PRU), calculated from sensitivity, specificity and prevalence. These plots show the extent to which either a positive or negative test result affects the remaining degree of uncertainty about a diagnosis in either direction, according to likely clinical prevalence. CONCLUSIONS: PRU plots demonstrate the discriminatory value of tests more clearly than sensitivity and specificity from which they are derived, and should be published alongside them.

Child↗
PubMed2004

Reducing family members' anxiety and uncertainty in illness around transfer from intensive care: an intervention study.

INTRODUCTION: This intervention study examines anxiety and uncertainty in illness in families transferring from intensive care to a general ward. METHODS: The pre-test, post-test design purposively allocated family members to a control (n = 80) and intervention group (n = 82). The intervention group experienced a structured individualised transfer method whereas the control group received existing ad hoc transfer methods. Families were surveyed before and after transfer. RESULTS: Families' uncertainty was significantly related to their state anxiety (P < 0.000), the relationship to the patient (P = 0.022), and the unexpected nature of patients' admission (P < 0.000). Anxiety increased significantly with reduced social support (P = 0.002). Following transfer, anxiety reduced significantly for both groups whereas uncertainty reduced significantly for the intervention group (P = 0.03). CONCLUSION: Families at the time of transfer experience uncertainty and anxiety, which are significantly related in this study. The intervention significantly reduced uncertainty scores. When the family member was a parent, when admissions were unexpected, and those with fewer social supports represent potential 'at risk' groups whose adaptation to transfer may limit their coping ability. The structured individualised method of transfer is recommended with further research of ICU families to further examine the dimension of uncertainty and how it affects patient outcomes.

Adolescent↗
PubMed2005

Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity.

The goal of this study was to investigate the diagnostic and symptom specificity of a model of GAD that has four main features: intolerance of uncertainty, positive beliefs about worry, poor problem orientation, and cognitive avoidance. The authors compared 17 patients with non-comorbid generalized anxiety disorder (GAD) to 28 patients with non-comorbid panic disorder with agoraphobia (PDA) and found that only intolerance of uncertainty showed evidence of diagnostic specificity, i.e., intolerance of uncertainty scores were higher in the GAD group relative to the PDA group. In terms of symptom specificity, when both groups were combined, all model variables were significantly related to worry but unrelated to fear of bodily sensations, agoraphobic cognitions, and behavioral avoidance. Taken together, these findings provide further support for the link between intolerance of uncertainty and GAD and underscore the importance of pursuing the issue of specificity from both a diagnostic and symptom perspective.

Adult↗
PubMed1991

Stools containing altered blood-plasma urea: creatinine ratio as a simple test for the source of bleeding.

The plasma urea:creatinine ratio (U:C ratio) is known to be elevated in cases of upper gastrointestinal bleeding. Almost all patients with haematemesis have upper gastrointestinal (or generalized) bleeding so that in this study we characterized the diagnostic power of the U:C ratio in patients with stools containing altered blood without haematemesis in the hope that this simple laboratory test (used in conjunction, perhaps, with clinical data) might reduce the number of patients subjected to an unrewarding gastroscopy or colonoscopy. Of 76 cases seen in a provincial and a metropolitan hospital, 42 and 34 patients had upper and lower gastrointestinal bleeding, respectively. Fifty-four per cent of those with upper gastrointestinal bleeding and none of those with lower gastrointestinal bleeding had U:C ratios above 110 on admission. However, a discriminating level of 90 is considered to be more suitable, judged by the quadratic uncertainty score. At this level the odds for upper gastrointestinal bleeding were 15:1.

Aged↗
PubMed2004

Algorithms for inferring haplotypes.

Haplotype phase information in diploid organisms provides valuable information on human evolutionary history and may lead to the development of more efficient strategies to identify genetic variants that increase susceptibility to human diseases. Molecular haplotyping methods are labor-intensive, low-throughput, and very costly. Therefore, algorithms based on formal statistical theories were shown to be very effective and cost-efficient for haplotype reconstruction. This review covers 1) population-based haplotype inference methods: Clark's algorithm, expectation-maximization (EM) algorithm, coalescence-based algorithms (pseudo-Gibbs sampler and perfect/imperfect phylogeny), and partition-ligation algorithm implemented by a fully Bayesian model (Haplotyper) or by EM (PLEM); 2) family-based haplotype inference methods; 3) the handling of genotype scoring uncertainties (i.e., genotyping errors and raw two-dimensional genotype scatterplots) in inferring haplotypes; and 4) haplotype inference methods for pooled DNA samples. The advantages and limitations of each algorithm are discussed. By using simulations based on empirical data on the G6PD gene and TNFRSF5 gene, I demonstrate that different algorithms have different degrees of sensitivity to various extents of population diversities and genotyping error rates. Future development of statistical algorithms for addressing haplotype reconstruction will resort more and more to ideas based on combinatorial mathematics, graphical models, and machine learning, and they will have profound impacts on population genetics and genetic epidemiology with the advent of the human HapMap.

Algorithms↗
PubMed2025

raxtax: a k-mer-based non-Bayesian taxonomic classifier.

MOTIVATION: Taxonomic classification in biodiversity studies is the process of assigning the anonymous sequences of a marker gene (barcode) or whole genomes (metagenomics) to a specific lineage using a reference database that contains named sequences in a known taxonomy. This classification is important for assessing the diversity of biological systems. Taxonomic classification faces two main challenges: first, accuracy is critical as errors can propagate to downstream analysis results; and second, the classification time requirements can limit study size and study design, in particular when considering the constantly growing reference databases. To address these two challenges, we introduce raxtax, an efficient, novel taxonomic classification tool for barcodes that uses common k-mers between all pairs of query and reference sequences. We also introduce two novel uncertainty scores which take into account the fundamental biases of reference databases. RESULTS: We validate raxtax on three widely-used empirical reference databases and show that it is 2.7-100 times faster than competing state-of-the-art tools on the largest database while being equally accurate. In particular, raxtax exhibits increasing speedups with growing query and reference sequence numbers compared to existing tools (for 100&#x2009;000 and 1&#x2009;000&#x2009;000 query and reference sequences overall, it is 1.3 and 2.9 times faster, respectively), and therefore alleviates the taxonomic classification scalability challenge. AVAILABILITY AND IMPLEMENTATION: raxtax is available at https://github.com/noahares/raxtax under a CC-NC-BY-SA license. The scripts and summary metrics used in our analyses are available at https://github.com/noahares/raxtax_paper_scripts. The source code, sequence data, and summarized results of the analyses are available at https://doi.org/10.5281/zenodo.15057027.

Software↗
PubMed1998

Uncertainties in bone mineral density T scores.

In the diagnosis and management of osteopenia and osteoporosis, dual photon absorptiometric measurements of lumbar spine and proximal femur bone mineral density are interpreted by calculating a T score, which is the number of standard deviations by which a result deviates from the mean bone density in young adults of the same sex. Threshold values are then used to categorize patients as having osteopenia or osteoporosis. The uncertainty associated with a single bone mineral density measurement, as well as the uncertainties in the assumed values for the bone mineral density in young adults and the population standard deviation, combine to create an uncertainty in the calculated T score. It is estimated that 95% of bone density measurements have a T score uncertainty of less than 0.4. This means that a single measurement of bone mineral density should not be used in isolation to assign a given patient to a specific diagnostic category. Rather, a bone mineral density measurement should be regarded as only one of the variables that determine the risk of fracture in a given patient.

Absorptiometry, Photon↗
PubMed2001

Lod scores for gene mapping in the presence of marker map uncertainty.

Multipoint lod scores are typically calculated for a grid of locus positions, moving the putative disease locus across a fixed map of genetic markers. Changing the order of a set of markers and/or the distances between the markers can make a substantial difference in the resulting lod score curve and the location and height of its maximum. The typical approach of using the best maximum likelihood marker map is not easily justified if other marker orders are nearly as likely and give substantially different lod score curves. To deal with this problem, we propose three weighted multipoint lod score statistics that make use of information from all plausible marker orders. In each of these statistics, the information conditional on a particular marker order is included in a weighted sum, with weight equal to the posterior probability of that order. We evaluate the type 1 error rate and power of these three statistics on the basis of results from simulated data, and compare these results to those obtained using the best maximum likelihood map and the map with the true marker order. We find that the lod score based on a weighted sum of maximum likelihoods improves on using only the best maximum likelihood map, having a type 1 error rate and power closest to that of using the true marker order in the simulation scenarios we considered.

Bias↗
PubMed2004

An electronic application for rapidly calculating Charlson comorbidity score.

BACKGROUND: Uncertainty regarding comorbid illness, and ability to tolerate aggressive therapy has led to minimal enrollment of elderly cancer patients into clinical trials and often substandard treatment. Increasingly, comorbid illness scales have proven useful in identifying subgroups of elderly patients who are more likely to tolerate and benefit from aggressive therapy. Unfortunately, the use of such scales has yet to be widely integrated into either clinical practice or clinical trials research. METHODS: This article reviews evidence for the validity of the Charlson Comorbidity Index (CCI) in oncology and provides a Microsoft Excel (MS Excel) Macro for the rapid and accurate calculation of CCI score. The interaction of comorbidity and malignant disease and the validation of the Charlson Index in oncology are discussed. RESULTS: The CCI score is based on one year mortality data from internal medicine patients admitted to an inpatient setting and is the most widely used comorbidity index in oncology. An MS Excel Macro file was constructed for calculating the CCI score using Microsoft Visual Basic. The Macro is provided for download and dissemination. The CCI has been widely used and validated throughout the oncology literature and has demonstrated utility for most major cancers. The MS Excel CCI Macro provides a rapid method for calculating CCI score with or without age adjustments. The calculator removes difficulty in score calculation as a limitation for integration of the CCI into clinical research. The simple nature of the MS Excel CCI Macro and the CCI itself makes it ideal for integration into emerging electronic medical records systems. CONCLUSIONS: The increasing elderly population and concurrent increase in oncologic disease has made understanding the interaction between age and comorbid illness on life expectancy increasingly important. The MS Excel CCI Macro provides a means of increasing the use of the CCI scale in clinical research with the ultimate goal of improving determination of optimal treatments for elderly cancer patients.

Aged↗