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Sample records for accurate diagnostic tests

  1. Accurate, Fast and Cost-Effective Diagnostic Test for Monosomy 1p36 Using Real-Time Quantitative PCR

    PubMed Central

    Cunha, Pricila da Silva; Pena, Heloisa B.; D'Angelo, Carla Sustek; Koiffmann, Celia P.; Rosenfeld, Jill A.; Shaffer, Lisa G.; Stofanko, Martin; Gonçalves-Dornelas, Higgor; Pena, Sérgio Danilo Junho

    2014-01-01

    Monosomy 1p36 is considered the most common subtelomeric deletion syndrome in humans and it accounts for 0.5–0.7% of all the cases of idiopathic intellectual disability. The molecular diagnosis is often made by microarray-based comparative genomic hybridization (aCGH), which has the drawback of being a high-cost technique. However, patients with classic monosomy 1p36 share some typical clinical characteristics that, together with its common prevalence, justify the development of a less expensive, targeted diagnostic method. In this study, we developed a simple, rapid, and inexpensive real-time quantitative PCR (qPCR) assay for targeted diagnosis of monosomy 1p36, easily accessible for low-budget laboratories in developing countries. For this, we have chosen two target genes which are deleted in the majority of patients with monosomy 1p36: PRKCZ and SKI. In total, 39 patients previously diagnosed with monosomy 1p36 by aCGH, fluorescent in situ hybridization (FISH), and/or multiplex ligation-dependent probe amplification (MLPA) all tested positive on our qPCR assay. By simultaneously using these two genes we have been able to detect 1p36 deletions with 100% sensitivity and 100% specificity. We conclude that qPCR of PRKCZ and SKI is a fast and accurate diagnostic test for monosomy 1p36, costing less than 10 US dollars in reagent costs. PMID:24839341

  2. Evaluating diagnostic tests.

    PubMed

    Kennedy, Ashley Graham

    2016-08-01

    Although much has been written on the role of randomized controlled trials and mechanistic reasoning in the evaluation of therapeutic treatments, philosophers of medicine have not yet turned their attention to the question of how diagnostic tests and procedures should be evaluated. I aim to begin to fill this gap by examining each of the following questions: What is the best way to determine the accuracy of a diagnostic test? What is the best way to determine the clinical effectiveness of a diagnostic test? Can an accurate diagnostic test be considered medically valuable even if it is not clinically effective? I argue that while diagnostic accuracy is a minimum requirement for both clinical effectiveness and medical value, accuracy and effectiveness are not sufficient for determining the value of a diagnostic test, because diagnostic value extends beyond patient outcomes. PMID:27091221

  3. What Is Diagnostic Testing?

    MedlinePlus

    ... Primary care providers Specialists Getting covered Research Basic science research Research in people ... screening Diagnostic testing Direct-to-consumer genetic testing Newborn screening Pharmacogenomic testing ...

  4. Rapid diagnostic tests for malaria

    PubMed Central

    Daily, Jennifer; Hotte, Nora; Dolkart, Caitlin; Cunningham, Jane; Yadav, Prashant

    2015-01-01

    Abstract Maintaining quality, competitiveness and innovation in global health technology is a constant challenge for manufacturers, while affordability, access and equity are challenges for governments and international agencies. In this paper we discuss these issues with reference to rapid diagnostic tests for malaria. Strategies to control and eliminate malaria depend on early and accurate diagnosis. Rapid diagnostic tests for malaria require little training and equipment and can be performed by non-specialists in remote settings. Use of these tests has expanded significantly over the last few years, following recommendations to test all suspected malaria cases before treatment and the implementation of an evaluation programme to assess the performance of the malaria rapid diagnostic tests. Despite these gains, challenges exist that, if not addressed, could jeopardize the progress made to date. We discuss recent developments in rapid diagnostic tests for malaria, highlight some of the challenges and provide suggestions to address them. PMID:26668438

  5. SOPROLIFE System: An Accurate Diagnostic Enhancer

    PubMed Central

    Zeitouny, Mona; Feghali, Mireille; Nasr, Assaad; Abou-Samra, Philippe; Saleh, Nadine; Bourgeois, Denis; Farge, Pierre

    2014-01-01

    Objectives. The aim of this study was to evaluate a light-emitting diode fluorescence tool, the SOPROLIFE light-induced fluorescence evaluator, and compare it to the international caries detection and assessment system-II (ICDAS-II) in the detection of occlusal caries. Methods. A total of 219 permanent posterior teeth in 21 subjects, with age ranging from 15 to 65 years, were examined. An intraclass correlation coefficient (ICC) was computed to assess the reliability between the two diagnostic methods. Results. The results showed a high reliability between the two methods (ICC = 0.92; IC = 0.901–0.940; P < 0.001). The SOPROLIFE blue fluorescence mode had a high sensitivity (87%) and a high specificity (99%) when compared to ICDAS-II. Conclusion. Compared to the most used visual method in the diagnosis of occlusal caries lesions, the finding from this study suggests that SOPROLIFE can be used as a reproducible and reliable assessment tool. At a cut-off point, categorizing noncarious lesions and visual change in enamel, SOPROLIFE shows a high sensitivity and specificity. We can conclude that financially ICDAS is better than SOPROLIFE. However SOPROLIFE is easier for clinicians since it is a simple evaluation of images. Finally in terms of efficiency SOPROLIFE is not superior to ICDAS but tends to be equivalent with the same advantages. PMID:25401161

  6. Diagnostic Tests and Examination Results.

    ERIC Educational Resources Information Center

    Barker, Dennis

    1988-01-01

    A study of the usefulness of several diagnostic tests for selecting students to enter a civil engineering program found that the tests were not appropriate and that tests should be developed specifically for civil engineering. (MSE)

  7. Classroom Diagnostic Testing With Microcomputers.

    ERIC Educational Resources Information Center

    Okey, James R.; McGarity, John

    1982-01-01

    Discusses value of computer diagnostic testing (CDT) including time factors in preparing programs, cost analysis, and possibilities for activities other than CDT. Includes a computer program, written in BASIC for a PET, and instructions for using the program. (SK)

  8. Diagnosing the Diagnostic Test

    ERIC Educational Resources Information Center

    Popham, W. James

    2009-01-01

    Scads of pseudodiagnostic tests are peddled by commercial vendors who recognize that desperate educators will do almost anything to dodge an impending accountability cataclysm. And this "almost anything" includes buying tests that promise to help a teacher raise test scores--even if they don't. Accordingly, today's educators need to be aware of…

  9. Diagnostic Testing in Cystic Fibrosis.

    PubMed

    Brewington, John; Clancy, J P

    2016-03-01

    Cystic Fibrosis (CF) is a rare, multisystem disease leading to significant morbidity and mortality. CF is caused by defects in the cystic fibrosis transmembrane conductance regulator protein (CFTR), a chloride and bicarbonate transporter. Early diagnosis and access to therapies provides benefits in nutrition, pulmonary health, and cognitive ability. Several screening and diagnostic tests are available to support a diagnosis. We discuss the characteristics of screening and diagnostic tests for CF and guideline-based algorithms using these tools to establish a diagnosis. We discuss classification and management of common "diagnostic dilemmas," including the CFTR-related metabolic syndrome and other CFTR-associated diseases. PMID:26857766

  10. Metropolitan Achievement Tests (MAT6) Reading Diagnostic Tests (Test Review).

    ERIC Educational Resources Information Center

    Canney, George

    1989-01-01

    Reviews the Reading Diagnostic Tests which form part of the battery of survey and diagnostic Metropolitan Achievement Tests. Finds the tests to be an impressive tool for diagnosing the reading strengths and weaknesses of elementary and junior high students. (RS)

  11. Diagnostic tests for syphilis

    PubMed Central

    Johnson, Steven C.

    2014-01-01

    Summary Syphilis is a sexually transmitted infection caused by Treponema pallidum. A total of 13,106 cases of primary and secondary syphilis were reported in the United States in 2011 and the rate of infection has increased in subgroups, particularly men who have sex with men. The disease is mainly diagnosed through clinical findings and serologic testing. However, no single serologic test of syphilis is sufficient. Hence, the serologic diagnosis of syphilis requires the detection of 2 types of antibodies (nontreponemal antibodies and treponemal antibodies). The paradigm in syphilis testing has recently shifted in many centers to screen with a treponemal antibody test, reflexing to a nontreponemal test if the treponemal antibody test is positive. This reverse of the traditional algorithm may not be widely recognized among clinicians.

  12. Appropriateness of diagnostics tests.

    PubMed

    Cappelletti, P

    2016-05-01

    The evolution of the concept of 'appropriateness', in the three past decades, from 'no harm' and 'no waste' to 'medical decision-making' and 'determining outcomes' highlights two main points: its foundation is evidence-based medicine, and it is a quality of every phase of the total testing process, not only for the selection of tests. Nevertheless, appropriateness in Laboratory Hematology, as well as in Laboratory Medicine, is an elusive concept: 'Appropriateness' interplays with 'patient's safety', 'healthcare costs', 'clinical decision-making', and 'effectiveness', and the criteria for appropriateness, mainly adherence to clinical guidelines, are often not evidence-based and not always consensus-based. Moreover, practising appropriateness is a complex issue because of the ambiguity of the criteria and targets, the never-ending work of implementing guidelines and their audit, and the uniqueness of the clinical situation of the individual patient. Authors agree on some practical rules: establishing a multidisciplinary and multiprofessional team, choosing carefully clinical targets, finding or building evidences, sharing guidelines with clinicians, choosing adequate tools for changing, working hard on implementation, identifying the 'right' laboratory methods and processes, checking progress indefinitely, providing information, interpretations, and consultations, and promoting feedback and audits. The success depends on the 'right' combination of educational, operative, and reinforcing interventions. Competences in organization, in implementation science, and in interpersonal relationship management are essential as well as knowledge and experience in Hematology, not only in Laboratory Hematology. PMID:27161094

  13. [Diagnostic protocol and special tests].

    PubMed

    Bellia, M; Pennarola, R

    2008-01-01

    Diagnostic protocol and special tests to ionizing radiations have a preventive function in the medical surveillance of the exposed worker. This protocol must be provided with laboratory and special test assessing fitness for working at the risk of ionizing radiations. The health of workers must be compatible with working conditions and radiation risk. This healthiness of workers is evalued in the time to give an assessment fitness for working at ionizing radiations. For this purpose the basic diagnostic protocol must guarantee minimum information about state of organs and apparatus in addition to the normality of the metabolisms. The diagnostic protocol of the exposed worker to ionizing radiations must be adapted to the specific clinical situation so as to finally make a costs-benefits balance sheet. PMID:19288808

  14. Basic principles on selection and use of diagnostic tests: properties of diagnostic tests.

    PubMed

    Carneiro, A V

    2001-12-01

    In clinical practice, in order to design and implement a specific therapeutic plan, as well as communicating an appropriate prognosis, the doctor needs to establish a precise diagnosis of the condition. Sometimes all one needs is a clinical impression. More often, however, the definition of an accurate diagnosis will mandate the interpretation of specific diagnostic tests as well. The rational use of diagnostic tests in cardiology--whether laboratorial or imaging--should be based on three factors: 1) validity of results of studies on the test; 2) diagnostic properties of the test; and 3) applicability of the test in the clinical setting. The rational use and the correct interpretation of diagnostic tests are based on these three factors. In a previous article we presented the basic principles concerning the validity of the results from the study that defined the specific test, and what level of evidence that constitutes. In this article we present the diagnostic properties of tests (sensitivity, specificity, positive and negative predictive values, likelihood ratios, odds). Finally, in a forthcoming paper we will discuss the applicability of the test in clinical cardiological practice. PMID:11865687

  15. Molecular diagnostic tests for microsporidia.

    PubMed

    Ghosh, Kaya; Weiss, Louis M

    2009-01-01

    The Microsporidia are a ubiquitous group of eukaryotic obligate intracellular parasites which were recognized over 100 years ago with the description of Nosema bombycis, a parasite of silkworms. It is now appreciated that these organisms are related to the Fungi. Microsporidia infect all major animal groups most often as gastrointestinal pathogens; however they have been reported from every tissue and organ, and their spores are common in environmental sources such as ditch water. Several different genera of these organisms infect humans, but the majority of infections are due to either Enterocytozoon bieneusi or Encephalitozoon species. These pathogens can be difficult to diagnose, but significant progress has been made in the last decade in the development of molecular diagnostic reagents for these organisms. This report reviews the molecular diagnostic tests that have been described for the identification of the microsporidia that infect humans. PMID:19657457

  16. Molecular Diagnostic Tests for Microsporidia

    PubMed Central

    Ghosh, Kaya; Weiss, Louis M.

    2009-01-01

    The Microsporidia are a ubiquitous group of eukaryotic obligate intracellular parasites which were recognized over 100 years ago with the description of Nosema bombycis, a parasite of silkworms. It is now appreciated that these organisms are related to the Fungi. Microsporidia infect all major animal groups most often as gastrointestinal pathogens; however they have been reported from every tissue and organ, and their spores are common in environmental sources such as ditch water. Several different genera of these organisms infect humans, but the majority of infections are due to either Enterocytozoon bieneusi or Encephalitozoon species. These pathogens can be difficult to diagnose, but significant progress has been made in the last decade in the development of molecular diagnostic reagents for these organisms. This report reviews the molecular diagnostic tests that have been described for the identification of the microsporidia that infect humans. PMID:19657457

  17. Informatics-based, highly accurate, noninvasive prenatal paternity testing

    PubMed Central

    Ryan, Allison; Baner, Johan; Demko, Zachary; Hill, Matthew; Sigurjonsson, Styrmir; Baird, Michael L.; Rabinowitz, Matthew

    2013-01-01

    Purpose: The aim of the study was to evaluate the diagnostic accuracy of an informatics-based, noninvasive, prenatal paternity test using array-based single-nucleotide polymorphism measurements of cell-free DNA isolated from maternal plasma. Methods: Blood samples were taken from 21 adult pregnant women (with gestational ages between 6 and 21 weeks), and a genetic sample was taken from the corresponding biological fathers. Paternity was confirmed by genetic testing of the infant, products of conception, control of fertilization, and/or preimplantation genetic diagnosis during in vitro fertilization. Parental DNA samples and maternal plasma cell-free DNA were amplified and analyzed using a HumanCytoSNP-12 array. An informatics-based method measured single-nucleotide polymorphism data, confirming or rejecting paternity. Each plasma sample with a sufficient fetal cell-free DNA fraction was independently tested against the confirmed father and 1,820 random, unrelated males. Results: One of the 21 samples had insufficient fetal cell-free DNA. The test correctly confirmed paternity for the remaining 20 samples (100%) when tested against the biological father, with P values of <10−4. For the 36,400 tests using an unrelated male as the alleged father, 99.95% (36,382) correctly excluded paternity and 0.05% (18) were indeterminate. There were no miscalls. Conclusion: A noninvasive paternity test using informatics-based analysis of single-nucleotide polymorphism array measurements accurately determined paternity early in pregnancy. PMID:23258349

  18. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. 410.32 Section 410.32 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other...

  19. Myasthenia Gravis: Tests and Diagnostic Methods

    MedlinePlus

    ... Affiliations Foundation Focus Newsletter E-Update Test & Diagnostic methods In addition to a complete medical and neurological ... How can I help? About MGFA Test & Diagnostic methods Treatment for MG FAQ's Upcoming Events Spring 2016 ...

  20. Progeria Research Foundation Diagnostic Testing Program

    MedlinePlus

    ... PRF By The Numbers Medical Database Cell & Tissue Bank Diagnostic Testing Research Funding Opportunities Scientific Meetings Scientific ... New in Progeria Research Medical Database Cell & Tissue Bank Diagnostic Testing Research Funding Opportunities Scientific Meetings Scientific ...

  1. How Accurate Are Oral Reading Tests?

    ERIC Educational Resources Information Center

    Schell, Leo M.

    Errors in oral reading tests result from inaccuracies that tend to creep in because children are not totally consistent while taking a test and from inaccuracies caused when the examiner does not catch a word recognition error, giving credit for an answer that is more wrong than right or vice versa. Every test contains a standard error of…

  2. What Do Diagnostic Reading Tests Really Diagnose?

    ERIC Educational Resources Information Center

    Winkley, Carol K.

    A study was made of nine reading tests, including both group and individually-administered measures, which are claimed to be chiefly diagnostic. Instruments analyzed were the following: Silent Reading Diagnostic Tests (Bond, Balow, and Hoyt), Botel Reading Inventory, Durrell Analysis of Reading Difficulty, Gates-McKillop Reading Diagnostic Tests,…

  3. Accurate interpretation of the Lachman test.

    PubMed

    Frank, C

    1986-12-01

    In a consecutive series of patients with knee complaints, tibial rotation consistently affected the interpretation of the Lachman test (passive anterior tibial translation in slight knee flexion). To perform the Lachman test correctly, the anterior tibial force must be applied posteromedially on the proximal tibia. This is best achieved by having the leg under examination on the same side of the bed as the examiner, and with slight external tibial rotation. Reaching across the bed to examine either leg can create either false positive or false negative Lachman results due to inadvertent tibial rotation (internal tibial rotation decreases translation) and inaccurate comparisons of the injured and normal legs. The importance of tibial rotation must be recognized if the Lachman test is to be used reliably and with maximum sensitivity. PMID:3780086

  4. Gage tests tube flares quickly and accurately

    NASA Technical Reports Server (NTRS)

    Griffin, F. D.

    1966-01-01

    Flared tube gage with a test cone that is precisely made with a tapering surface to complement the tube flare is capable of determining the accuracy of a tube flare efficiently and economically. This device should improve the speed, efficiency, and accuracy of tube flare inspections.

  5. Extremely Early Diagnostic Test for Prostate Cancer

    SciTech Connect

    James, Veronica Jean

    2011-11-17

    This article reports the results of a blinded fiber diffraction study of skin samples taken from TRAMP mice and age-matched controls to determine whether changes noted in fiber diffraction studies of human skin were present in these TRAMP mice studies. These mice are bred to progress to Gleeson Type 3 to Type 5 prostate cancer. Small strips, 1 mm x 5 mm, cut from the mouse skin samples were loaded into cells in the same way as human samples and slightly stretched to remove the crimp. They remained fully hydrated throughout exposure to the synchrotron beam. The added change that was reported for prostate cancer in 2009 was obtained for all TRAMP mice samples, indicating that this change can be read as High Grade Cancer in human diagnostic tests. These changes were evident for all 3 and 7 week old TRAMP mice samples but not for any of the control samples. This indicates that the changes in the fibre diffraction patterns appear much earlier than in any other available prostate cancer diagnostic test, as none of these can verify the presence of prostate cancer in the TRAMP mice before 10 weeks of age. The fiber diffraction test is therefore the most accurate and earliest test for high grade prostate cancer.

  6. 9 CFR 93.406 - Diagnostic tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Diagnostic tests. 93.406 Section 93... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis tests of cattle. Except as provided in paragraph (d) of this section and in §§ 93.418, 93.427(d), and...

  7. 9 CFR 93.406 - Diagnostic tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Diagnostic tests. 93.406 Section 93... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis tests of cattle. Except as provided in paragraph (d) of this section and in §§ 93.418, 93.427(d), and...

  8. Accurate Point-of-Care Detection of Ruptured Fetal Membranes: Improved Diagnostic Performance Characteristics with a Monoclonal/Polyclonal Immunoassay

    PubMed Central

    Rogers, Linda C.; Scott, Laurie; Block, Jon E.

    2016-01-01

    OBJECTIVE Accurate and timely diagnosis of rupture of membranes (ROM) is imperative to allow for gestational age-specific interventions. This study compared the diagnostic performance characteristics between two methods used for the detection of ROM as measured in the same patient. METHODS Vaginal secretions were evaluated using the conventional fern test as well as a point-of-care monoclonal/polyclonal immunoassay test (ROM Plus®) in 75 pregnant patients who presented to labor and delivery with complaints of leaking amniotic fluid. Both tests were compared to analytical confirmation of ROM using three external laboratory tests. Diagnostic performance characteristics were calculated including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. RESULTS Diagnostic performance characteristics uniformly favored ROM detection using the immunoassay test compared to the fern test: sensitivity (100% vs. 77.8%), specificity (94.8% vs. 79.3%), PPV (75% vs. 36.8%), NPV (100% vs. 95.8%), and accuracy (95.5% vs. 79.1%). CONCLUSIONS The point-of-care immunoassay test provides improved diagnostic accuracy for the detection of ROM compared to fern testing. It has the potential of improving patient management decisions, thereby minimizing serious complications and perinatal morbidity. PMID:27199579

  9. 9 CFR 93.406 - Diagnostic tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis..., ages, markings, and tattoo and eartag numbers. (c) Further tests during quarantine. Ruminants that...

  10. 9 CFR 93.406 - Diagnostic tests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis..., ages, markings, and tattoo and eartag numbers. (c) Further tests during quarantine. Ruminants that...

  11. 9 CFR 93.406 - Diagnostic tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.406 Diagnostic tests. (a) Tuberculosis and brucellosis..., ages, markings, and tattoo and eartag numbers. (c) Further tests during quarantine. Ruminants that...

  12. Diagnostic values of Helicobacter pylori diagnostic tests: stool antigen test, urea breath test, rapid urease test, serology and histology*

    PubMed Central

    Kazemi, Shadi; Tavakkoli, Hamid; Habizadeh, Mohamad Reza; Emami, Mohammad Hasan

    2011-01-01

    BACKGROUND: The purpose of this study is to compare validity of 5 diagnostic tests of helicobacter pylori with each other: stool antigen test, urea breath test (UBT), rapid urease test (RUT), serology and histology. METHODS: A total of 94 patients who had indication of endoscopy entered the study. All of the 5 tests were performed for each patient. When the results of at least 2 tests were positive (except serology), Helicobacter pylori infection was considered to be positive. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under receiver operating characteristic (ROC) curve of these 5 tests were determined. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under ROC curve of these 5 tests are as below, respectively. Histology: 89%, 78%, 93%, 91%, 85% and 0.881; RUT: 93%, 75%, 95%, 94%, 86% and 0.831; serology: 50%, 54%, 46%, 61%, 52% and 0.563; stool antigen test: 96%, 83%, 98%, 96%, 91% and 0.897; UBT: 89%, 73%, 92%, 90%, 82% and 0.892. CONCLUSIONS: Stool antigen test is the most accurate test for Helicobacter pylori diagnosis before eradication of these bacteria. PMID:22973378

  13. TB diagnostic tests: how do we figure out their costs?

    PubMed

    Sohn, Hojoon; Minion, Jessica; Albert, Heidi; Dheda, Keertan; Pai, Madhukar

    2009-08-01

    Tuberculosis continues to be a major global health problem. Lack of accurate, rapid and cost-effective diagnostic tests poses a huge obstacle to global TB control. While several new diagnostic tools are being developed and evaluated for TB, it is important that new tools are introduced for widespread use only after careful validation of accuracy, impact as well as cost-effectiveness in real-world settings. While there are large numbers of studies on the accuracy of TB diagnostic tests, there are few studies that are focused on cost and cost-effectiveness. There are currently no widely accepted standards on how to evaluate costs of a TB test. In this review, we describe the basic approach for computing the costs of TB diagnostic tests, and provide templates for various data elements and parameters that go into the costing analysis. We hope this will pave the way for a standardized methodology for costing of TB diagnostic tests. Such a tool would enable improved and more generalizable costing analyses that can provide a strong foundation for more sophisticated economic analyses that evaluate the full economic and epidemiological impact resulting from the implementation and routine use of performance-verified new and innovative diagnostic tools. This, in turn, will facilitate evidence-based adoption and use of new diagnostics, especially in resource-limited settings. PMID:19681700

  14. [Basic principles of selection and use of diagnostic tests: analysis of the results of diagnostic studies].

    PubMed

    Carneiro, A V

    2001-11-01

    In clinical practice, in order to design and implement a specific therapeutic plan, as well as communicating an appropriate prognosis, the doctor needs to establish a precise diagnosis of the condition. Sometimes all one needs is a clinical impression. More often, however, the definition of an accurate diagnosis will need the interpretation of specific diagnostic tests as well. The rational use of diagnostic tests in cardiology--whether laboratorial or imagiologic--should be based on three factors: 1) validity of the study results about the test; 2) diagnostic properties of the test and 3) applicability of the test in the clinical setting. The rational use and correct interpretation of diagnostic tests are based on these three factors. In this article we present the basic principles concerning the validity of the results from the study that defined the specific test, and what level of evidence that constitutes. Other articles will address diagnostic properties of tests (sensitivity, specificity, positive and negative predictive values, likelihood ratios) as well as the applicability of the test in clinical practice. PMID:11826705

  15. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Service Act, as implemented by 21 CFR part 900, subpart B. (d) Diagnostic laboratory tests—(1) Who may... required throughout the performance of the test. (i) General supervision means the procedure is furnished... material relevant to the medical necessity of the specific test(s), taking into consideration current...

  16. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... implemented by 21 CFR part 900, subpart B. (d) Diagnostic laboratory tests—(1) Who may furnish services... performance of the test. (i) General supervision means the procedure is furnished under the physician's... necessity of the specific test(s), taking into consideration current rules and regulations on...

  17. Diagnostic Testing for Male Factor Infertility

    MedlinePlus

    ... PATIENT FACT SHEET Diagnostic Testing for Male Factor Infertility When a couple has trouble having a baby, ... to find out what may be causing your infertility. Semen analysis Semen analysis is probably the first ...

  18. Patent pools and diagnostic testing.

    PubMed

    Verbeure, Birgit; van Zimmeren, Esther; Matthijs, Gert; Van Overwalle, Geertrui

    2006-03-01

    There is increasing concern that overlapping patents in the field of genetics will create a costly and legally complex situation known as a patent thicket, which, along with the associated issues of accumulating royalty payments, can act as a disincentive for innovation. One potential means of preventing this is for the patent holders to enter into a so-called patent pool, such as those established in the electronics and telecommunications industries. Precedents for these also exist in the field of genetics, notably with the patents pertaining to the SARS genome. In this review, we initially address the patent pool concept in general and its application in genetics. Following this, we will explore patent pools in the diagnostic field in more detail, and examine some existing and novel examples of patent pools in genetics. PMID:16443296

  19. Laboratory and diagnostic testing: a perioperative update.

    PubMed

    Pagana, Kathleen D

    2007-04-01

    Perioperative nurses are challenged to stay informed about the rapidly changing field of diagnostic and laboratory testing. The brain natriuretic peptide test primarily is used to differentiate dyspnea caused by heart failure from dyspnea that results from other causes. Virtual colonoscopy is a promising new alternative for detecting colorectal polyps and cancers. The microalbumin urine test provides an early indication of the development of diabetic complications. This update of relatively new laboratory tests and diagnostic studies also provides implications for perioperative nurses. PMID:17418132

  20. Diagnostic Testing for Female Infertility

    MedlinePlus

    ... the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. Ovarian Reserve Testing: When attempting ... of intrauterine problems such as endometrial polyps and fibroids compared with using transvaginal ultrasonography alone. If an ...

  1. Instrument accurately measures small temperature changes on test surface

    NASA Technical Reports Server (NTRS)

    Harvey, W. D.; Miller, H. B.

    1966-01-01

    Calorimeter apparatus accurately measures very small temperature rises on a test surface subjected to aerodynamic heating. A continuous thin sheet of a sensing material is attached to a base support plate through which a series of holes of known diameter have been drilled for attaching thermocouples to the material.

  2. Diagnostic Performance of Visual Screening Tests in the Elderly

    NASA Astrophysics Data System (ADS)

    Lança, Carla Costa; Carolino, Elisabete

    2011-09-01

    This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. This study is defined as study of diagnostic performance. The diagnostic accuracy of 5 visual tests -near convergence point, near accommodation point, stereopsis, contrast sensibility and amsler grid—was evaluated by means of the ROC method (receiver operating characteristics curves), sensitivity, specificity, positive and negative likelihood ratios (LR+/LR-). Visual acuity was used as the reference standard. A sample of 44 elderly aged 76.7 years (±9.32), who were institutionalized, was collected. The curves of contrast sensitivity and stereopsis are the most accurate (area under the curves were 0.814-p = 0.001, C.I.95%[0.653;0.975]— and 0.713-p = 0.027, C.I.95%[0,540;0,887], respectively). The scores with the best diagnostic validity for the stereopsis test were 0.605 (sensitivity 0.87, specificity 0.54; LR+ 1.89, LR-0.24) and 0.610 (sensitivity 0.81, specificity 0.54; LR+ 1.75, LR-0.36). The scores with higher diagnostic validity for the contrast sensibility test were 0.530 (sensitivity 0.94, specificity 0.69; LR+ 3.04, LR-0.09). The contrast sensitivity and stereopsis test's proved to be clinically useful in detecting vision loss in the elderly.

  3. Hyperaldosteronism: Screening and Diagnostic Tests.

    PubMed

    Sabbadin, Chiara; Fallo, Francesco

    2016-06-01

    Primary aldosteronism (PA) is the most common secondary cause of hypertension, accounting for 10 % of hypertensives and 20 % of those with drug-resistant hypertension. Aldosterone excess is associated with the development of adverse cardiovascular, renal and metabolic effects that are partly independent of its effect on blood pressure. Guidelines recommended wider screening for PA in an effort to maximize detection of patients who may benefit from optimal, specific management. All patient groups with increased prevalence of PA, including hypertensive patients with type 2 diabetes mellitus and those with obstructive sleep apnea, should be carefully screened for PA. Screening with aldosterone-to-renin ratio (ARR) is the most practical and informative initial test. Subsequent confirmatory tests are: (1) oral salt loading; (2) saline infusion; (3) captopril challenge and (4) fludrocortisone suppression test. Confirmation of PA can avoid that patients with a false positive ARR would inappropriately undergo costly and harmful lateralization procedures. If confirmatory testing is positive, further investigations are directed toward determining the subtype of PA, as the treatment differs for each subtype. PMID:26971505

  4. Future of DNA diagnostic testing

    NASA Astrophysics Data System (ADS)

    Petersen, Kurt E.

    2001-09-01

    Progress in sequencing the human genome and the DNA of other organisms is providing many opportunities for creating powerful systems for numerous and diverse applications in DNA testing. These systems and the chemical processes, such as PCR, which they are designed to carry out, have recently made great strides in miniaturization through advances in micro-fluidics and micro-optics. In addition, new techniques in biological processing, such as controlled ultrasonic lysis, are being applied to small, automated, integrated instruments designed to provide important DNA results in a timely and routine manner. These systems are bringing DNA identification out of the laboratory and into our daily lives. Instead of waiting for days or weeks for a result, we will have them in minutes. Instead of relying on the skills of molecular biologists, the average person will be able to run a DNA test. These new advances will widely impact many aspects of our medical practices, food processing, and public safety.

  5. Does Diagnostic Math Testing Improve Student Learning?

    ERIC Educational Resources Information Center

    Betts, Julian R.; Hahn, Youjin; Zau, Andrew C.

    2011-01-01

    The Mathematics Diagnostic Testing Project (MDTP) offers course-specific assessments that provide teachers with timely feedback on their students' strengths and weaknesses in mathematics, often returning feedback to teachers on individual students and the entire class within a week of testing. In this way, teachers can quickly act on what they…

  6. Diagnostic Testing for Fecal Incontinence

    PubMed Central

    Olson, Craig H.

    2014-01-01

    Many tests are available to assist in the diagnosis and management of fecal incontinence. Imaging studies such as endoanal ultrasonography and defecography provide an anatomic and functional picture of the anal canal which can be useful, especially in the setting of planned sphincter repair. Physiologic tests including anal manometry and anal acoustic reflexometry provide objective data regarding functional values of the anal canal. The value of this information is of some debate; however, as we learn more about these methods, they may prove useful in the future. Finally, nerve studies, such as pudendal motor nerve terminal latency, evaluate the function of the innervation of the anal canal. This has been shown to have significant prognostic value and can help guide clinical decision making. Significant advances have also happened in the field, with the relatively recent advent of magnetic resonance defecography and high-resolution anal manometry, which provide even greater objective anatomic and physiologic information about the anal canal and its function. PMID:25320566

  7. Diagnostic methodology is critical for accurately determining the prevalence of ichthyophonus infections in wild fish populations

    USGS Publications Warehouse

    Kocan, R.; Dolan, H.; Hershberger, P.

    2011-01-01

    Several different techniques have been employed to detect and identify Ichthyophonus spp. in infected fish hosts; these include macroscopic observation, microscopic examination of tissue squashes, histological evaluation, in vitro culture, and molecular techniques. Examination of the peer-reviewed literature revealed that when more than 1 diagnostic method is used, they often result in significantly different results; for example, when in vitro culture was used to identify infected trout in an experimentally exposed population, 98.7% of infected trout were detected, but when standard histology was used to confirm known infected tissues from wild salmon, it detected ~50% of low-intensity infections and ~85% of high-intensity infections. Other studies on different species reported similar differences. When we examined a possible mechanism to explain the disparity between different diagnostic techniques, we observed non-random distribution of the parasite in 3-dimensionally visualized tissue sections from infected hosts, thus providing a possible explanation for the different sensitivities of commonly used diagnostic techniques. Based on experimental evidence and a review of the peer-reviewed literature, we have concluded that in vitro culture is currently the most accurate diagnostic technique for determining infection prevalence of Ichthyophonus, particularly when the exposure history of the population is not known.

  8. Diagnostic methodology is critical for accurately determining the prevalence of Ichthyophonus infections in wild fish populations.

    PubMed

    Kocan, Richard; Dolan, Heather; Hershberger, Paul

    2011-04-01

    Several different techniques have been employed to detect and identify Ichthyophonus spp. in infected fish hosts; these include macroscopic observation, microscopic examination of tissue squashes, histological evaluation, in vitro culture, and molecular techniques. Examination of the peer-reviewed literature revealed that when more than 1 diagnostic method is used, they often result in significantly different results; for example, when in vitro culture was used to identify infected trout in an experimentally exposed population, 98.7% of infected trout were detected, but when standard histology was used to confirm known infected tissues from wild salmon, it detected ~50% of low-intensity infections and ~85% of high-intensity infections. Other studies on different species reported similar differences. When we examined a possible mechanism to explain the disparity between different diagnostic techniques, we observed non-random distribution of the parasite in 3-dimensionally visualized tissue sections from infected hosts, thus providing a possible explanation for the different sensitivities of commonly used diagnostic techniques. Based on experimental evidence and a review of the peer-reviewed literature, we have concluded that in vitro culture is currently the most accurate diagnostic technique for determining infection prevalence of Ichthyophonus , particularly when the exposure history of the population is not known. PMID:21506773

  9. Cost of carrying out clinical diagnostic tests.

    PubMed

    Barnard, D J; Bingle, J P; Garratt, C J

    1978-06-01

    The total cost of performing diagnostic tests in a hospital laboratory during one year was assessed. The largest single item of expenditure was the cost of the salaries of the technical staff, while the cost of reagents (including radiopharmaceuticals) was relatively small. The total costs of carrying out diagnostic tests are much higher than is often recognised by those who request them. The use of relatively expensive, commercially available assay kits saves time and gives good value for money. It may be worth taking this into account when planning hospital budgets. PMID:647338

  10. Cost of carrying out clinical diagnostic tests.

    PubMed Central

    Barnard, D J; Bingle, J P; Garratt, C J

    1978-01-01

    The total cost of performing diagnostic tests in a hospital laboratory during one year was assessed. The largest single item of expenditure was the cost of the salaries of the technical staff, while the cost of reagents (including radiopharmaceuticals) was relatively small. The total costs of carrying out diagnostic tests are much higher than is often recognised by those who request them. The use of relatively expensive, commercially available assay kits saves time and gives good value for money. It may be worth taking this into account when planning hospital budgets. PMID:647338

  11. New Claus catalyst tests accurately reflect process conditions

    SciTech Connect

    Maglio, A.; Schubert, P.F.

    1988-09-12

    Methods for testing Claus catalysts are developed that more accurately represent the actual operating conditions in commercial sulfur recovery units. For measuring catalyst activity, an aging method has been developed that results in more meaningful activity data after the catalyst has been aged, because all catalysts undergo rapid initial deactivation in commercial units. An activity test method has been developed where catalysts can be compared at less than equilibrium conversion. A test has also been developed to characterize abrasion loss of Claus catalysts, in contrast to the traditional method of determining physical properties by measuring crush strengths. Test results from a wide range of materials correlated well with actual pneumatic conveyance attrition. Substantial differences in Claus catalyst properties were observed as a result of using these tests.

  12. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... performs a test he or she is authorized by the State to perform, or an independent diagnostic testing... administers an entire diagnostic test at the beneficiary's location, the beneficiary's location is the place... individual or organization; or (iii) Sharing diagnostic testing equipment used in the initial diagnostic...

  13. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... performs a test he or she is authorized by the State to perform, or an independent diagnostic testing... administers an entire diagnostic test at the beneficiary's location, the beneficiary's location is the place... individual or organization; or (iii) Sharing diagnostic testing equipment used in the initial diagnostic...

  14. Item Structures for Diagnostic Testing. Methodology Project.

    ERIC Educational Resources Information Center

    Herman, Joan; Webb, Noreen

    This paper describes a four-step approach to constructing a diagnostic test that provides precise but practical information on students' problems and needs for additional instruction or remediation. The approach is based on analyzing the structure of the domain to determine which skills within the domain need to be assessed to diagnose students'…

  15. Diagnostic methods for CW laser damage testing

    NASA Astrophysics Data System (ADS)

    Stewart, Alan F.; Shah, Rashmi S.

    2004-06-01

    High performance optical coatings are an enabling technology for many applications - navigation systems, telecom, fusion, advanced measurement systems of many types as well as directed energy weapons. The results of recent testing of superior optical coatings conducted at high flux levels will be presented. The diagnostics used in this type of nondestructive testing and the analysis of the data demonstrates the evolution of test methodology. Comparison of performance data under load to the predictions of thermal and optical models shows excellent agreement. These tests serve to anchor the models and validate the performance of the materials and coatings.

  16. Using Copula Distributions to Support More Accurate Imaging-Based Diagnostic Classifiers for Neuropsychiatric Disorders

    PubMed Central

    Bansal, Ravi; Hao, Xuejun; Liu, Jun; Peterson, Bradley S.

    2014-01-01

    Many investigators have tried to apply machine learning techniques to magnetic resonance images (MRIs) of the brain in order to diagnose neuropsychiatric disorders. Usually the number of brain imaging measures (such as measures of cortical thickness and measures of local surface morphology) derived from the MRIs (i.e., their dimensionality) has been large (e.g. >10) relative to the number of participants who provide the MRI data (<100). Sparse data in a high dimensional space increases the variability of the classification rules that machine learning algorithms generate, thereby limiting the validity, reproducibility, and generalizability of those classifiers. The accuracy and stability of the classifiers can improve significantly if the multivariate distributions of the imaging measures can be estimated accurately. To accurately estimate the multivariate distributions using sparse data, we propose to estimate first the univariate distributions of imaging data and then combine them using a Copula to generate more accurate estimates of their multivariate distributions. We then sample the estimated Copula distributions to generate dense sets of imaging measures and use those measures to train classifiers. We hypothesize that the dense sets of brain imaging measures will generate classifiers that are stable to variations in brain imaging measures, thereby improving the reproducibility, validity, and generalizability of diagnostic classification algorithms in imaging datasets from clinical populations. In our experiments, we used both computer-generated and real-world brain imaging datasets to assess the accuracy of multivariate Copula distributions in estimating the corresponding multivariate distributions of real-world imaging data. Our experiments showed that diagnostic classifiers generated using imaging measures sampled from the Copula were significantly more accurate and more reproducible than were the classifiers generated using either the real-world imaging

  17. 20 CFR 404.1519m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as...

  18. 20 CFR 404.1519m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as...

  19. 20 CFR 404.1519m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as...

  20. 20 CFR 404.1519m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as...

  1. 20 CFR 404.1519m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as...

  2. Immunochromatographic diagnostic test analysis using Google Glass.

    PubMed

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2014-03-25

    We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health. PMID:24571349

  3. Immunochromatographic Diagnostic Test Analysis Using Google Glass

    PubMed Central

    2014-01-01

    We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health. PMID:24571349

  4. Ascitic Fluid Calprotectin and Serum Procalcitonin as Accurate Diagnostic Markers for Spontaneous Bacterial Peritonitis

    PubMed Central

    Abdel-Razik, Ahmed; Mousa, Nasser; Elhammady, Dina; Elhelaly, Rania; Elzehery, Rasha; Elbaz, Sherif; Eissa, Mohamed; El-Wakeel, Niveen; Eldars, Waleed

    2016-01-01

    Background/Aims The diagnosis of spontaneous bacterial peritonitis (SBP) is based on a polymorphonuclear leukocytes (PMNs) exceeding 250/μL in ascitic fluid. The aim of the study was to evaluate serum procalcitonin and ascitic fluid calprotectin as accurate diagnostic markers for detecting SBP. Methods Seventy-nine patients with cirrhotic ascites were included. They were divided into a SBP group, including 52 patients, and a non-SBP group of 27 patients. Serum procalcitonin, ascitic calprotectin, and serum and ascitic levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were measured using an enzyme-linked immunosorbent assay. Results Serum procalcitonin and ascitic calprotectin were significantly higher in SBP patients than in non-SBP patients. Significant increases in both serum and ascitic levels of TNF-α and IL-6 were observed in SBP patients versus non-SBP patients. At a cutoff value of 0.94 ng/mL, serum procalcitonin had 94.3% sensitivity and 91.8% specificity for detecting SBP. In addition, at a cutoff value of 445 ng/mL, ascitic calprotectin had 95.4% sensitivity and 85.2% specificity for detecting SBP. Both were positively correlated with ascitic fluid proteins, PMN count, TNF-α, and IL-6. Conclusions According to our findings, determination of serum procalcitonin levels and ascitic calprotectin appears to provide satisfactory diagnostic markers for the diagnosis of SBP. PMID:26601826

  5. Use of Diagnostic Testing to Detect Infertility

    PubMed Central

    Hwang, Kathleen; Lipshultz, Larry I.; Lamb, Dolores J.

    2011-01-01

    The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated; however, the etiology of suboptimal semen quality is poorly understood. This review focuses on the diagnostic testing currently available, as well as future directions that will be helpful for the practicing urologist and other clinicians to fully evaluate the infertile male. PMID:21088937

  6. Google glass based immunochromatographic diagnostic test analysis

    NASA Astrophysics Data System (ADS)

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2015-03-01

    Integration of optical imagers and sensors into recently emerging wearable computational devices allows for simpler and more intuitive methods of integrating biomedical imaging and medical diagnostics tasks into existing infrastructures. Here we demonstrate the ability of one such device, the Google Glass, to perform qualitative and quantitative analysis of immunochromatographic rapid diagnostic tests (RDTs) using a voice-commandable hands-free software-only interface, as an alternative to larger and more bulky desktop or handheld units. Using the built-in camera of Glass to image one or more RDTs (labeled with Quick Response (QR) codes), our Glass software application uploads the captured image and related information (e.g., user name, GPS, etc.) to our servers for remote analysis and storage. After digital analysis of the RDT images, the results are transmitted back to the originating Glass device, and made available through a website in geospatial and tabular representations. We tested this system on qualitative human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) RDTs. For qualitative HIV tests, we demonstrate successful detection and labeling (i.e., yes/no decisions) for up to 6-fold dilution of HIV samples. For quantitative measurements, we activated and imaged PSA concentrations ranging from 0 to 200 ng/mL and generated calibration curves relating the RDT line intensity values to PSA concentration. By providing automated digitization of both qualitative and quantitative test results, this wearable colorimetric diagnostic test reader platform on Google Glass can reduce operator errors caused by poor training, provide real-time spatiotemporal mapping of test results, and assist with remote monitoring of various biomedical conditions.

  7. Bioaccessibility tests accurately estimate bioavailability of lead to quail

    USGS Publications Warehouse

    Beyer, W. Nelson; Basta, Nicholas T; Chaney, Rufus L.; Henry, Paula F.; Mosby, David; Rattner, Barnett A.; Scheckel, Kirk G.; Sprague, Dan; Weber, John

    2016-01-01

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, we measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contaminated soils. Relative bioavailabilities were expressed by comparison with blood Pb concentrations in quail fed a Pb acetate reference diet. Diets containing soil from five Pb-contaminated Superfund sites had relative bioavailabilities from 33%-63%, with a mean of about 50%. Treatment of two of the soils with phosphorus significantly reduced the bioavailability of Pb. Bioaccessibility of Pb in the test soils was then measured in six in vitro tests and regressed on bioavailability. They were: the “Relative Bioavailability Leaching Procedure” (RBALP) at pH 1.5, the same test conducted at pH 2.5, the “Ohio State University In vitro Gastrointestinal” method (OSU IVG), the “Urban Soil Bioaccessible Lead Test”, the modified “Physiologically Based Extraction Test” and the “Waterfowl Physiologically Based Extraction Test.” All regressions had positive slopes. Based on criteria of slope and coefficient of determination, the RBALP pH 2.5 and OSU IVG tests performed very well. Speciation by X-ray absorption spectroscopy demonstrated that, on average, most of the Pb in the sampled soils was sorbed to minerals (30%), bound to organic matter (24%), or present as Pb sulfate (18%). Additional Pb was associated with P (chloropyromorphite, hydroxypyromorphite and tertiary Pb phosphate), and with Pb carbonates, leadhillite (a lead sulfate carbonate hydroxide), and Pb sulfide. The formation of chloropyromorphite reduced the bioavailability of Pb and the amendment of Pb-contaminated soils with P may be a thermodynamically favored means to sequester Pb.

  8. Bioaccessibility tests accurately estimate bioavailability of lead to quail.

    PubMed

    Beyer, W Nelson; Basta, Nicholas T; Chaney, Rufus L; Henry, Paula F P; Mosby, David E; Rattner, Barnett A; Scheckel, Kirk G; Sprague, Daniel T; Weber, John S

    2016-09-01

    Hazards of soil-borne lead (Pb) to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, the authors measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contaminated soils. Relative bioavailabilities were expressed by comparison with blood Pb concentrations in quail fed a Pb acetate reference diet. Diets containing soil from 5 Pb-contaminated Superfund sites had relative bioavailabilities from 33% to 63%, with a mean of approximately 50%. Treatment of 2 of the soils with phosphorus (P) significantly reduced the bioavailability of Pb. Bioaccessibility of Pb in the test soils was then measured in 6 in vitro tests and regressed on bioavailability: the relative bioavailability leaching procedure at pH 1.5, the same test conducted at pH 2.5, the Ohio State University in vitro gastrointestinal method, the urban soil bioaccessible lead test, the modified physiologically based extraction test, and the waterfowl physiologically based extraction test. All regressions had positive slopes. Based on criteria of slope and coefficient of determination, the relative bioavailability leaching procedure at pH 2.5 and Ohio State University in vitro gastrointestinal tests performed very well. Speciation by X-ray absorption spectroscopy demonstrated that, on average, most of the Pb in the sampled soils was sorbed to minerals (30%), bound to organic matter (24%), or present as Pb sulfate (18%). Additional Pb was associated with P (chloropyromorphite, hydroxypyromorphite, and tertiary Pb phosphate) and with Pb carbonates, leadhillite (a lead sulfate carbonate hydroxide), and Pb sulfide. The formation of chloropyromorphite reduced the bioavailability of Pb, and the amendment of Pb-contaminated soils with P may be a thermodynamically favored means to sequester Pb. Environ Toxicol Chem 2016;35:2311-2319. Published 2016 Wiley Periodicals Inc. on behalf of

  9. Diagnostic rhyme test statistical analysis programs

    NASA Astrophysics Data System (ADS)

    Sim, A.; Bain, R.; Belyavin, A. J.; Pratt, R. L.

    1991-08-01

    The statistical techniques and associated computer programs used to analyze data from Diagnostic Rhyme Test (DRT) are described. The DRT is used extensively for assessing the intelligibility of military communications systems and became an accepted NATO standard for testing linear predictive coders. The DRT vocabulary comprises ninety six minimally contrasting rhyming word pairs, the initial consonants of which differ only by a single acoustic feature, or attribute. There are six such attributes: voicing, nasality, sustention, silibation, graveness, and compactness. The attribute voicing is present when the vocal cords are excited: in the word pair 'veal-feel', the consonant 'v' is voiced, but the constant 'f' is unvoiced. The procedure for the implementation of the DRT is presented. To ensure the stability of the results, tests using not less than eight talkers and eight listeners are conducted.

  10. Practical diagnostic testing for human immunodeficiency virus.

    PubMed Central

    Jackson, J B; Balfour, H H

    1988-01-01

    Since the discovery of human immunodeficiency virus (HIV) as the causative agent of acquired immunodeficiency syndrome in 1983, there has been a proliferation of diagnostic tests. These assays can be used to detect the presence of HIV antibody, HIV antigen, HIV ribonucleic and deoxyribonucleic acids, and HIV reverse transcriptase. Enzyme-linked immunosorbent assays, Western blot, radioimmunoprecipitation assays, indirect immunofluorescence assays, reverse transcriptase assays, and several molecular hybridization techniques are currently available. Enzyme-linked immunosorbent, Western blot, and indirect immunofluorescence assays for HIV antibody are very sensitive, specific, and adaptable to most laboratories. An enzyme-linked immunosorbent assay for HIV antigen is also readily adaptable to most laboratories and will be commercially available soon. While the other assays are more tedious, they are valuable confirmatory tests and are suitable for reference laboratories. The biohazards of performing HIV testing can be minimized with proper biosafety measures. Images PMID:3060241

  11. 20 CFR 416.919m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or...

  12. 20 CFR 416.919m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or...

  13. 20 CFR 416.919m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or...

  14. 20 CFR 416.919m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or...

  15. 20 CFR 416.919m - Diagnostic tests or procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or...

  16. Clonality Testing in Veterinary Medicine: A Review With Diagnostic Guidelines.

    PubMed

    Keller, S M; Vernau, W; Moore, P F

    2016-07-01

    The accurate distinction of reactive and neoplastic lymphoid proliferations can present challenges. Given the different prognoses and treatment strategies, a correct diagnosis is crucial. Molecular clonality assays assess rearranged lymphocyte antigen receptor gene diversity and can help differentiate reactive from neoplastic lymphoid proliferations. Molecular clonality assays are commonly used to assess atypical, mixed, or mature lymphoid proliferations; small tissue fragments that lack architecture; and fluid samples. In addition, clonality testing can be utilized to track neoplastic clones over time or across anatomic sites. Molecular clonality assays are not stand-alone tests but useful adjuncts that follow clinical, morphologic, and immunophenotypic assessment. Even though clonality testing provides valuable information in a variety of situations, the complexities and pitfalls of this method, as well as its dependency on the experience of the interpreter, are often understated. In addition, a lack of standardized terminology, laboratory practices, and interpretational guidelines hinders the reproducibility of clonality testing across laboratories in veterinary medicine. The objectives of this review are twofold. First, the review is intended to familiarize the diagnostic pathologist or interested clinician with the concepts, potential pitfalls, and limitations of clonality testing. Second, the review strives to provide a basis for future harmonization of clonality testing in veterinary medicine by providing diagnostic guidelines. PMID:26933096

  17. New challenges for BRCA testing: a view from the diagnostic laboratory.

    PubMed

    Wallace, Andrew J

    2016-09-01

    Increased demand for BRCA testing is placing pressures on diagnostic laboratories to raise their mutation screening capacity and handle the challenges associated with classifying BRCA sequence variants for clinical significance, for example interpretation of pathogenic mutations or variants of unknown significance, accurate determination of large genomic rearrangements and detection of somatic mutations in DNA extracted from formalin-fixed, paraffin-embedded tumour samples. Many diagnostic laboratories are adopting next-generation sequencing (NGS) technology to increase their screening capacity and reduce processing time and unit costs. However, migration to NGS introduces complexities arising from choice of components of the BRCA testing workflow, such as NGS platform, enrichment method and bioinformatics analysis process. An efficient, cost-effective accurate mutation detection strategy and a standardised, systematic approach to the reporting of BRCA test results is imperative for diagnostic laboratories. This review covers the challenges of BRCA testing from the perspective of a diagnostics laboratory. PMID:27514839

  18. Elementary School-Age Children's Capacity To Choose Positive Diagnostic and Negative Diagnostic Tests.

    ERIC Educational Resources Information Center

    Samuels, Mark C.; McDonald, John

    2002-01-01

    Two experiments compared 10-year-olds' and adults' ability to choose positive and negative diagnostic tests over positive and negative nondiagnostic tests. Findings indicated that both age groups were more likely to prefer positive diagnostic tests over positive nondiagnostic tests, although only adults showed a significant preference for negative…

  19. RHIC electron lens test bench diagnostics

    SciTech Connect

    Gassner, D.; Beebe, E.; Fischer, W.; Gu, X.; Hamdi, K.; Hock, J.; Liu, C.; Miller, T.; Pikin, A.; Thieberger, P.

    2011-05-16

    An Electron Lens (E-Lens) system will be installed in RHIC to increase luminosity by counteracting the head-on beam-beam interaction. The proton beam collisions at the RHIC experimental locations will introduce a tune spread due to a difference of tune shifts between small and large amplitude particles. A low energy electron beam will be used to improve luminosity and lifetime of the colliding beams by reducing the betatron tune shift and spread. In preparation for the Electron Lens installation next year, a test bench facility will be used to gain experience with many sub-systems. This paper will discuss the diagnostics related to measuring the electron beam parameters.

  20. Blood-Mimicking Fluid for Testing Ultrasonic Diagnostic Instrument

    NASA Astrophysics Data System (ADS)

    Tanaka, Kouhei; Yoshida, Tomoji; Sato, Kazuishi; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko

    2012-07-01

    We present a blood-mimicking fluid (BMF) for the Doppler test object of medical diagnostic instruments. Accurate measurement in a flow Doppler test requires a BMF that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore, they must be stable over time. To formulate a fluid with the desired density and acoustic velocity, we have developed a new fluid made of glycerine and water-soluble silicone oil. The new BMF includes dispersed polystyrene particles as scatterers. The density of the liquid can be adjusted to maintain it at the same value as that of the polystyrene particles, thus ensuring neutral buoyancy of the particles. The MBF was stable over a period of 2 weeks, during which the density and acoustic velocity did not change.

  1. SSME Post Test Diagnostic System: Systems Section

    NASA Technical Reports Server (NTRS)

    Bickmore, Timothy

    1995-01-01

    An assessment of engine and component health is routinely made after each test firing or flight firing of a Space Shuttle Main Engine (SSME). Currently, this health assessment is done by teams of engineers who manually review sensor data, performance data, and engine and component operating histories. Based on review of information from these various sources, an evaluation is made as to the health of each component of the SSME and the preparedness of the engine for another test or flight. The objective of this project - the SSME Post Test Diagnostic System (PTDS) - is to develop a computer program which automates the analysis of test data from the SSME in order to detect and diagnose anomalies. This report primarily covers work on the Systems Section of the PTDS, which automates the analyses performed by the systems/performance group at the Propulsion Branch of NASA Marshall Space Flight Center (MSFC). This group is responsible for assessing the overall health and performance of the engine, and detecting and diagnosing anomalies which involve multiple components (other groups are responsible for analyzing the behavior of specific components). The PTDS utilizes several advanced software technologies to perform its analyses. Raw test data is analyzed using signal processing routines which detect features in the data, such as spikes, shifts, peaks, and drifts. Component analyses are performed by expert systems, which use 'rules-of-thumb' obtained from interviews with the MSFC data analysts to detect and diagnose anomalies. The systems analysis is performed using case-based reasoning. Results of all analyses are stored in a relational database and displayed via an X-window-based graphical user interface which provides ranked lists of anomalies and observations by engine component, along with supporting data plots for each.

  2. Uncomplicated malaria in children: The place of rapid diagnostic test

    PubMed Central

    Elechi, Hassan Abdullahi; Rabasa, Adamu Ibrahim; Bashir, Muhammad Faruk; Gofama, Mustapha Modu; Ibrahim, Halima Abubakar; Askira, Umoru Muhammed

    2015-01-01

    Background: Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate. Materials and Methods: In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate. Result: Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001). Conclusion: Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria. PMID:25838621

  3. 40 CFR 85.2207 - Onboard diagnostic test standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... described in 40 CFR 86.1806. ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Onboard diagnostic test standards. 85... Tests § 85.2207 Onboard diagnostic test standards. (a) A vehicle shall fail the OBD test if it is a...

  4. 40 CFR 85.2223 - Onboard diagnostic test report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Onboard diagnostic test report. 85.2223 Section 85.2223 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Tests § 85.2223 Onboard diagnostic test report. (a) Motorists whose vehicles fail the OBD test...

  5. Bioaccessibility tests accurately estimate bioavailability of lead to quail

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb, we incorporated Pb-contaminated soils or Pb acetate into diets for Japanese quail (Coturnix japonica), fed the quail for 15 days, and ...

  6. BIOACCESSIBILITY TESTS ACCURATELY ESTIMATE BIOAVAILABILITY OF LEAD TO QUAIL

    EPA Science Inventory

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, we measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contami...

  7. RT-PCR is a more accurate diagnostic tool for detection of BCR-ABL rearrangement

    SciTech Connect

    Zehnbauer, B.A.; Allen, A.P.; McGrath, S.D.

    1994-09-01

    Detection of the Philadelphia chromosome (Ph1) or genomic Southern hybridization for clonal gene rearrangement (GSH-R) has provided very specific identification of BCR-ABL gene rearrangement. Reverse transcriptase-polymerase chain reaction (RT-PCR) is diagnostic for patterns of BCR-ABL expression which are undetected by GSH-R and/or Ph1 and provides increased sensitivity both at diagnosis and in detection of minimal residual leukemia. Fifty-three specimens (of 150 tested from 119 consecutive leukemia patients) were RT-PCR positive for BCR-ABL gene expression confirmed by hybridization of PCR products with b{sub 3}a{sub 2}, b{sub 2}a{sub 2}, or e{sub 1}a{sub 2} junction-specific oligonucleotides. In 6 cases of CML with GSH-R{sup {minus}}at diagnosis, RT-PCR provided specific BCR-ABL identification. Deletion of BCR regions, low mitotic index, or e{sub 1}a{sub 2} expression caused failure to detect GSH-R or Ph1 translocation.

  8. Hospital discharge diagnostic and procedure codes for upper gastro-intestinal cancer: how accurate are they?

    PubMed Central

    2012-01-01

    Background Population-level health administrative datasets such as hospital discharge data are used increasingly to evaluate health services and outcomes of care. However information about the accuracy of Australian discharge data in identifying cancer, associated procedures and comorbidity is limited. The Admitted Patients Data Collection (APDC) is a census of inpatient hospital discharges in the state of New South Wales (NSW). Our aim was to assess the accuracy of the APDC in identifying upper gastro-intestinal (upper GI) cancer cases, procedures for associated curative resection and comorbidities at the time of admission compared to data abstracted from medical records (the ‘gold standard’). Methods We reviewed the medical records of 240 patients with an incident upper GI cancer diagnosis derived from a clinical database in one NSW area health service from July 2006 to June 2007. Extracted case record data was matched to APDC discharge data to determine sensitivity, positive predictive value (PPV) and agreement between the two data sources (κ-coefficient). Results The accuracy of the APDC diagnostic codes in identifying site-specific incident cancer ranged from 80-95% sensitivity. This was comparable to the accuracy of APDC procedure codes in identifying curative resection for upper GI cancer. PPV ranged from 42-80% for cancer diagnosis and 56-93% for curative surgery. Agreement between the data sources was >0.72 for most cancer diagnoses and curative resections. However, APDC discharge data was less accurate in reporting common comorbidities - for each condition, sensitivity ranged from 9-70%, whilst agreement ranged from κ = 0.64 for diabetes down to κ < 0.01 for gastro-oesophageal reflux disorder. Conclusions Identifying incident cases of upper GI cancer and curative resection from hospital administrative data is satisfactory but under-ascertained. Linkage of multiple population-health datasets is advisable to maximise case ascertainment and

  9. Neural net diagnostics for VLSI test

    NASA Technical Reports Server (NTRS)

    Lin, T.; Tseng, H.; Wu, A.; Dogan, N.; Meador, J.

    1990-01-01

    This paper discusses the application of neural network pattern analysis algorithms to the IC fault diagnosis problem. A fault diagnostic is a decision rule combining what is known about an ideal circuit test response with information about how it is distorted by fabrication variations and measurement noise. The rule is used to detect fault existence in fabricated circuits using real test equipment. Traditional statistical techniques may be used to achieve this goal, but they can employ unrealistic a priori assumptions about measurement data. Our approach to this problem employs an adaptive pattern analysis technique based on feedforward neural networks. During training, a feedforward network automatically captures unknown sample distributions. This is important because distributions arising from the nonlinear effects of process variation can be more complex than is typically assumed. A feedforward network is also able to extract measurement features which contribute significantly to making a correct decision. Traditional feature extraction techniques employ matrix manipulations which can be particularly costly for large measurement vectors. In this paper we discuss a software system which we are developing that uses this approach. We also provide a simple example illustrating the use of the technique for fault detection in an operational amplifier.

  10. Comparing diagnostic tests: trials in people with discordant test results.

    PubMed

    Hooper, R; Díaz-Ordaz, K; Takeda, A; Khan, K

    2013-06-30

    Diagnostic tests are traditionally compared for accuracy against a gold standard but can also be compared prospectively in a trial. A conventional trial comparing two tests would randomize each participant to a testing strategy, but a more efficient alternative is to give both tests to all participants and follow up those with discordant results. Participants could be randomized before or after testing. The statistical analysis of such a trial has not previously been described. We investigated two estimates of the risk difference for a binary outcome: one based on analysing outcomes as if from a conventional trial and one combining estimates of different parameters in the manner of a decision analysis. We show that the trial estimate and decision analysis estimate are both unbiased and derive approximate formulae for their standard errors. By using the decision analysis estimate (but not the trial estimate), the same precision can be achieved by randomizing before testing as by randomizing after. To avoid destroying equipoise, and to allow consenting and randomizing to be carried out at the same visit, we recommend randomizing before testing. Giving both tests to all participants means fewer need to be recruited: in one example from the literature, the proposed design was nearly four times more efficient in this sense than a conventional trial design. PMID:23172716

  11. An accurate test for acute appendicitis: In-111 WBC imaging

    SciTech Connect

    Navarro, D.A.; Weber, P.M.; Kang, I.Y.; dosRemedios, L.V.; Jasko, I.A.

    1985-05-01

    The decision to operate when acute appendicitis (APPY) is suspected is often difficult. Surgeons accept up to a 20% false positive rate to avoid any delay that may result in appendiceal rupture and peritonitis. The authors have successfully improved early diagnostic accuracy by using abdominal imaging beginning 2 hours after injecting In-111 labeled WBC. Patients with clear-cut (APPY) had laparotomy and were not studied. Those who were to be observed in the ER for possible (APPY) had their leukocytes harvested, labeled with In-111 oxine, and reinjected. Abnormal localized activity in the right lower quadrant (RLQ) imaged at 2 hours was graded relative to bone marrow activity (8M): 0, 1+BM. When available the surgical specimen was imaged for In-111 activity. Of 31 patients studied there were 13 with positive scans for (APPY) all surgically confirmed. There were 4 additional abnormal studies all demonstrating known diagnostic patterns, 2 of pertonitis and 2 of colitis. There were 14 negative studies in 8 of whom the clinical course was benign; the remaining 6 had laparotomy with 3 having (APPY) and 3 not. Thus there were no false positives and 3 false negatives. One case negative at 2 hours had appendiceal activity later. The 3 cases with 3+ activity all had apendiceal abscesses. This new application of In-111 oxine WBC imaging is safe, simple, sensitive and specific. It shortens the time to surgical intervention and should reduce the surgical false positive rate.

  12. Diagnostic reliability of MMPI-2 computer-based test interpretations.

    PubMed

    Pant, Hina; McCabe, Brian J; Deskovitz, Mark A; Weed, Nathan C; Williams, John E

    2014-09-01

    Reflecting the common use of the MMPI-2 to provide diagnostic considerations, computer-based test interpretations (CBTIs) also typically offer diagnostic suggestions. However, these diagnostic suggestions can sometimes be shown to vary widely across different CBTI programs even for identical MMPI-2 profiles. The present study evaluated the diagnostic reliability of 6 commercially available CBTIs using a 20-item Q-sort task developed for this study. Four raters each sorted diagnostic classifications based on these 6 CBTI reports for 20 MMPI-2 profiles. Two questions were addressed. First, do users of CBTIs understand the diagnostic information contained within the reports similarly? Overall, diagnostic sorts of the CBTIs showed moderate inter-interpreter diagnostic reliability (mean r = .56), with sorts for the 1/2/3 profile showing the highest inter-interpreter diagnostic reliability (mean r = .67). Second, do different CBTIs programs vary with respect to diagnostic suggestions? It was found that diagnostic sorts of the CBTIs had a mean inter-CBTI diagnostic reliability of r = .56, indicating moderate but not strong agreement across CBTIs in terms of diagnostic suggestions. The strongest inter-CBTI diagnostic agreement was found for sorts of the 1/2/3 profile CBTIs (mean r = .71). Limitations and future directions are discussed. PMID:24749753

  13. Diagnostic odyssey in severe neurodevelopmental disorders: toward clinical whole-exome sequencing as a first-line diagnostic test.

    PubMed

    Thevenon, J; Duffourd, Y; Masurel-Paulet, A; Lefebvre, M; Feillet, F; El Chehadeh-Djebbar, S; St-Onge, J; Steinmetz, A; Huet, F; Chouchane, M; Darmency-Stamboul, V; Callier, P; Thauvin-Robinet, C; Faivre, L; Rivière, J B

    2016-06-01

    The current standard of care for diagnosis of severe intellectual disability (ID) and epileptic encephalopathy (EE) results in a diagnostic yield of ∼50%. Affected individuals nonetheless undergo multiple clinical evaluations and low-yield laboratory tests often referred to as a 'diagnostic odyssey'. This study was aimed at assessing the utility of clinical whole-exome sequencing (WES) in individuals with undiagnosed and severe forms of ID and EE, and the feasibility of its implementation in routine practice by a small regional genetic center. We performed WES in a cohort of 43 unrelated individuals with undiagnosed ID and/or EE. All individuals had undergone multiple clinical evaluations and diagnostic tests over the years, with no definitive diagnosis. Sequencing data analysis and interpretation were carried out at the local molecular genetics laboratory. The diagnostic rate of WES reached 32.5% (14 out of 43 individuals). Genetic diagnosis had a direct impact on clinical management in four families, including a prenatal diagnostic test in one family. Our data emphasize the clinical utility and feasibility of WES in individuals with undiagnosed forms of ID and EE and highlight the necessity of close collaborations between ordering physicians, molecular geneticists, bioinformaticians and researchers for accurate data interpretation. PMID:26757139

  14. Use of Diagnostic Testing in a Classification Information Program.

    ERIC Educational Resources Information Center

    Veterans Administration Hospital, Bedford, MA.

    The three parts of this study concern the application of diagnostic testing to measure the effectiveness of classification training, the development of a systematic approach to applying the results, and a long-term study of employee retention of classification information. The measurement instrument selected for diagnostic testing of employees of…

  15. Diagnostic Testing at UK Universities: An E-Mail Survey

    ERIC Educational Resources Information Center

    Gillard, Jonathan; Levi, Margaret; Wilson, Robert

    2010-01-01

    In July 2009, an e-mail survey was sent to various UK universities to gain information regarding current practices concerning mathematics diagnostic testing, and to provide an update from the review "Diagnostic Testing for Mathematics" published by the LTSN MathsTEAM Project in 2003. A total of 38 university departments were contacted and the…

  16. A rapid diagnostic test for schistosomiasis mansoni

    PubMed Central

    Mello-Silva, Clélia Christina; João, Roberto Carlos; Augusto, Ronaldo de Carvalho; Santos, Claudia Portes

    2013-01-01

    This article presents an improvement to the Kato-Katz (KK) method, making it faster and more efficient for the visualisation of fertile eggs in stool samples. This modified KK method uses sodium acetate formalin as a fixative and reveals the intensity of infection in less than 1 h, reducing the diagnostic time without increasing the cost. This modified method may contribute to future epidemiological studies in both hospitals and the field due to its rapid and precise diagnostic, which allow for immediate treatment. PMID:24402146

  17. A novel technique for detecting antibiotic-resistant typhoid from rapid diagnostic tests.

    PubMed

    Nic Fhogartaigh, Caoimhe; Dance, David A B; Davong, Viengmon; Tann, Pisey; Phetsouvanh, Rattanaphone; Turner, Paul; Dittrich, Sabine; Newton, Paul N

    2015-05-01

    Fluoroquinolone-resistant typhoid is increasing. An antigen-detecting rapid diagnostic test (RDT) can rapidly diagnose typhoid from blood cultures. A simple, inexpensive molecular technique performed with DNA from positive RDTs accurately identified gyrA mutations consistent with phenotypic susceptibility testing results. Field diagnosis combined with centralized molecular resistance testing could improve typhoid management and surveillance in low-resource settings. PMID:25762768

  18. Diagnostic tools for hypertension and salt sensitivity testing

    PubMed Central

    Felder, Robin A.; White, Marquitta J.; Williams, Scott M.; Jose, Pedro A.

    2013-01-01

    Purpose of review One-third of the world’s population has hypertension and it is responsible for almost 50% of deaths from stroke or coronary heart disease. These statistics do not distinguish salt-sensitive from salt-resistant hypertension or include normotensives who are salt-sensitive even though salt sensitivity, independent of blood pressure, is a risk factor for cardiovascular and other diseases, including cancer. This review describes new personalized diagnostic tools for salt sensitivity. Recent findings The relationship between salt intake and cardiovascular risk is not linear, but rather fits a J-shaped curve relationship. Thus, a low-salt diet may not be beneficial to everyone and may paradoxically increase blood pressure in some individuals. Current surrogate markers of salt sensitivity are not adequately sensitive or specific. Tests in the urine that could be surrogate markers of salt sensitivity with a quick turn-around time include renal proximal tubule cells, exosomes, and microRNA shed in the urine. Summary Accurate testing of salt sensitivity is not only laborious but also expensive, and with low patient compliance. Patients who have normal blood pressure but are salt-sensitive cannot be diagnosed in an office setting and there are no laboratory tests for salt sensitivity. Urinary surrogate markers for salt sensitivity are being developed. PMID:23197156

  19. Better Tests, Better Care: Improved Diagnostics for Infectious Diseases

    PubMed Central

    Caliendo, Angela M.; Gilbert, David N.; Ginocchio, Christine C.; Hanson, Kimberly E.; May, Larissa; Quinn, Thomas C.; Tenover, Fred C.; Alland, David; Blaschke, Anne J.; Bonomo, Robert A.; Carroll, Karen C.; Ferraro, Mary Jane; Hirschhorn, Lisa R.; Joseph, W. Patrick; Karchmer, Tobi; MacIntyre, Ann T.; Reller, L. Barth; Jackson, Audrey F.

    2013-01-01

    In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians. PMID:24200831

  20. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Independent diagnostic testing facility. 410.33 Section 410.33 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.33 Independent diagnostic...

  1. Personalized Medicine’s Bottleneck: Diagnostic Test Evidence and Reimbursement

    PubMed Central

    Cohen, Joshua P.; Felix, Abigail E.

    2014-01-01

    Background: Personalized medicine is gradually emerging as a transformative field. Thus far, seven co-developed drug-diagnostic combinations have been approved and several dozen post-hoc drug-diagnostic combinations (diagnostic approved after the drug). However, barriers remain, particularly with respect to reimbursement. Purpose, methods: This study analyzes barriers facing uptake of drug-diagnostic combinations. We examine Medicare reimbursement in the U.S. of 10 drug-diagnostic combinations on the basis of a formulary review and a survey. Findings: We found that payers reimburse all 10 drugs, but with variable and relatively high patient co-insurance, as well as imposition of formulary restrictions. Payer reimbursement of companion diagnostics is limited and highly variable. In addition, we found that the body of evidence on the clinical- and cost-effectiveness of therapeutics is thin and even less robust for diagnostics. Conclusions, discussion: The high cost of personalized therapeutics and dearth of evidence concerning the comparative clinical effectiveness of drug-diagnostic combinations appear to contribute to high patient cost sharing, imposition of formulary restrictions, and limited and variable reimbursement of companion diagnostics. Our findings point to the need to increase the evidence base supportive of establishing linkage between diagnostic testing and positive health outcomes. PMID:25563222

  2. A vibration monitoring acquisition and diagnostic system for helicopter drive train bench tests

    NASA Astrophysics Data System (ADS)

    Dousis, Dimitri A.

    An automated drive train test stand vibration monitoring system called VMADS has been developed by Bell Helicopter Textron, Inc., and has been installed at Bell's transmission bench test facility. VMADS provides the operator with warning and alarm indications for preselected degraded conditions, and acquires vibration data to be used by engineers to improve the diagnostics for better fault detection and fault isolation. VMADS is used as a test bed for new monitoring and diagnostic algorithm evaluation and validation, a necessary step to ensure development of accurate, reliable integrated health usage monitoring systems for the Bell rotorcraft fleet. This paper highlights the VMADS features for helicopter and tiltrotor aircraft drive train bench test monitoring and diagnostics and discusses supportive ongoing health and usage monitoring activities at BHTI, both military and commercial for enhanced safety and reduced maintenance costs. Bell is translating VMADS developed capability to airborne applications, while simultaneously enhancing the original VMADS capabilities.

  3. Concordance in diagnostic testing for respiratory pathogens of Bighorn Sheep

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Reliable diagnostic tests are essential for disease investigation and management. This is particularly true for diseases of free-ranging wildlife where sampling is logistically difficult precluding retesting. Clinical assays for wildlife diseases frequently vary among laboratories because of lack ...

  4. 40 CFR 85.2231 - Onboard diagnostic test equipment requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... interface to the vehicle shall include a plug that conforms to the requirements and specifications of 40 CFR... CFR 86.1806. ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Onboard diagnostic test...

  5. Raman Spectroscopy Provides a Powerful Diagnostic Tool for Accurate Determination of Albumin Glycation

    PubMed Central

    Dingari, Narahara Chari; Horowitz, Gary L.; Kang, Jeon Woong; Dasari, Ramachandra R.; Barman, Ishan

    2012-01-01

    We present the first demonstration of glycated albumin detection and quantification using Raman spectroscopy without the addition of reagents. Glycated albumin is an important marker for monitoring the long-term glycemic history of diabetics, especially as its concentrations, in contrast to glycated hemoglobin levels, are unaffected by changes in erythrocyte life times. Clinically, glycated albumin concentrations show a strong correlation with the development of serious diabetes complications including nephropathy and retinopathy. In this article, we propose and evaluate the efficacy of Raman spectroscopy for determination of this important analyte. By utilizing the pre-concentration obtained through drop-coating deposition, we show that glycation of albumin leads to subtle, but consistent, changes in vibrational features, which with the help of multivariate classification techniques can be used to discriminate glycated albumin from the unglycated variant with 100% accuracy. Moreover, we demonstrate that the calibration model developed on the glycated albumin spectral dataset shows high predictive power, even at substantially lower concentrations than those typically encountered in clinical practice. In fact, the limit of detection for glycated albumin measurements is calculated to be approximately four times lower than its minimum physiological concentration. Importantly, in relation to the existing detection methods for glycated albumin, the proposed method is also completely reagent-free, requires barely any sample preparation and has the potential for simultaneous determination of glycated hemoglobin levels as well. Given these key advantages, we believe that the proposed approach can provide a uniquely powerful tool for quantification of glycation status of proteins in biopharmaceutical development as well as for glycemic marker determination in routine clinical diagnostics in the future. PMID:22393405

  6. Diagnostic testing of dogs for food hypersensitivity.

    PubMed

    Jeffers, J G; Shanley, K J; Meyer, E K

    1991-01-15

    Thirteen food-allergic dogs were studied to evaluate the efficacy of feeding a commercially available egg and rice diet, intradermal skin testing, and serologic testing by ELISA for diagnosing and/or characterizing food hypersensitivity. Feeding of a home-cooked whole lamb meat and rice diet for 3 weeks, followed by challenge with each dog's regular diet, served as the standard for diagnosing food hypersensitivity. Each dog underwent provocative testing with 6 individual ingredients to determine as many of its dietary allergens as possible. Prior to skin testing and serologic testing by ELISA, most dogs had been recently exposed to the offending diet and subsequently manifested clinical signs of allergy. All dogs that tolerated the aforementioned commercial diet were exposed to it for at least 7 weeks; 84.6% of food-hypersensitive dogs ate the commercial diet with impunity. Of the 2 reactors to the commercial diet, only 1 became pruritic in response to provocation testing with chicken eggs. Low sensitivity and high specificity were found for skin testing and the ELISA, indicating a lack of true- and false-positive reactions. Neither the positive nor negative predictive values adequately predicted positive and negative reactions, respectively, for either test. On the basis of these results, the commercial diet, skin testing, and anti-IgE ELISA cannot replace an owner-prepared food elimination diet for food hypersensitivity testing in dogs. PMID:2004984

  7. The Feasibility of a Diagnostic Media Test System Model.

    ERIC Educational Resources Information Center

    Rapp, Alfred V.

    Research investigated the feasibility of a diagnostic media test system. Two distinct tests were developed for sixth grade and university populations, each having: 1) a main phase with three specific teaching sequences, one for each media form; 2) test items for each teaching sequence; and 3) a validation phase with one teaching sequence…

  8. Rapid diagnostics for avian influenza -- Advances in testing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A variety of tools are available for the diagnosis of avian influenza virus. They can be generally divided into the serologic diagnostic tests and direct virus detection tests. The serologic tests are important primarily for active surveillance to assure our poultry flocks are free of avian influe...

  9. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... requirements of section 354 of the Public Health Service Act, as implemented by 21 CFR part 900, subpart B. (d... required, physician supervision at the specified level is required throughout the performance of the test... additional documentation, it must request material relevant to the medical necessity of the specific...

  10. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... requirements of section 354 of the Public Health Service Act, as implemented by 21 CFR part 900, subpart B. (d... required, physician supervision at the specified level is required throughout the performance of the test... additional documentation, it must request material relevant to the medical necessity of the specific...

  11. Regulating whole exome sequencing as a diagnostic test.

    PubMed

    Lapin, Valentina; Mighion, Lindsey C; da Silva, Cristina P; Cuperus, Ymkje; Bean, Lora J H; Hegde, Madhuri R

    2016-06-01

    In the last decade, there has been a flood of new technology in the sequencing arena. The onset of next-generation sequencing (NGS) technology has resulted in the vast increase in genetic diagnostic testing available to the ordering physician. Whole exome sequencing (WES) has become available as a diagnostic test performed in certified clinical laboratories. This has led to increased presence in the diagnostic marketplace, increased consumer awareness, and the question has been raised by various stakeholders to whether there is sufficient stringent regulation of WES and other NGS-based tests. We discuss the various WES services currently available in the marketplace, current regulation of WES as a laboratory developed test, the proposed FDA involvement in its oversight as well as the response of various laboratory groups that provide these diagnostic services. Overall, a rigorous process oversight and assessment of inter-lab reproducibility is strongly warranted for WES as it is used as a diagnostic test, but regulation should be mindful of the excessive administrative burden on academic and smaller diagnostic laboratories. PMID:27167135

  12. Whole Genome Sequencing Increases Molecular Diagnostic Yield Compared with Current Diagnostic Testing for Inherited Retinal Disease

    PubMed Central

    Ellingford, Jamie M.; Barton, Stephanie; Bhaskar, Sanjeev; Williams, Simon G.; Sergouniotis, Panagiotis I.; O'Sullivan, James; Lamb, Janine A.; Perveen, Rahat; Hall, Georgina; Newman, William G.; Bishop, Paul N.; Roberts, Stephen A.; Leach, Rick; Tearle, Rick; Bayliss, Stuart; Ramsden, Simon C.; Nemeth, Andrea H.; Black, Graeme C.M.

    2016-01-01

    Purpose To compare the efficacy of whole genome sequencing (WGS) with targeted next-generation sequencing (NGS) in the diagnosis of inherited retinal disease (IRD). Design Case series. Participants A total of 562 patients diagnosed with IRD. Methods We performed a direct comparative analysis of current molecular diagnostics with WGS. We retrospectively reviewed the findings from a diagnostic NGS DNA test for 562 patients with IRD. A subset of 46 of 562 patients (encompassing potential clinical outcomes of diagnostic analysis) also underwent WGS, and we compared mutation detection rates and molecular diagnostic yields. In addition, we compared the sensitivity and specificity of the 2 techniques to identify known single nucleotide variants (SNVs) using 6 control samples with publically available genotype data. Main Outcome Measures Diagnostic yield of genomic testing. Results Across known disease-causing genes, targeted NGS and WGS achieved similar levels of sensitivity and specificity for SNV detection. However, WGS also identified 14 clinically relevant genetic variants through WGS that had not been identified by NGS diagnostic testing for the 46 individuals with IRD. These variants included large deletions and variants in noncoding regions of the genome. Identification of these variants confirmed a molecular diagnosis of IRD for 11 of the 33 individuals referred for WGS who had not obtained a molecular diagnosis through targeted NGS testing. Weighted estimates, accounting for population structure, suggest that WGS methods could result in an overall 29% (95% confidence interval, 15–45) uplift in diagnostic yield. Conclusions We show that WGS methods can detect disease-causing genetic variants missed by current NGS diagnostic methodologies for IRD and thereby demonstrate the clinical utility and additional value of WGS. PMID:26872967

  13. Understanding the incremental value of novel diagnostic tests for tuberculosis.

    PubMed

    Arinaminpathy, Nimalan; Dowdy, David

    2015-12-01

    Tuberculosis is a major source of global mortality caused by infection, partly because of a tremendous ongoing burden of undiagnosed disease. Improved diagnostic technology may play an increasingly crucial part in global efforts to end tuberculosis, but the ability of diagnostic tests to curb tuberculosis transmission is dependent on multiple factors, including the time taken by a patient to seek health care, the patient's symptoms, and the patterns of transmission before diagnosis. Novel diagnostic assays for tuberculosis have conventionally been evaluated on the basis of characteristics such as sensitivity and specificity, using assumptions that probably overestimate the impact of diagnostic tests on transmission. We argue for a shift in focus to the evaluation of such tests' incremental value, defining outcomes that reflect each test's purpose (for example, transmissions averted) and comparing systems with the test against those without, in terms of those outcomes. Incremental value can also be measured in units of outcome per incremental unit of resource (for example, money or human capacity). Using a novel, simplified model of tuberculosis transmission that addresses some of the limitations of earlier tuberculosis diagnostic models, we demonstrate that the incremental value of any novel test depends not just on its accuracy, but also on elements such as patient behaviour, tuberculosis natural history and health systems. By integrating these factors into a single unified framework, we advance an approach to the evaluation of new diagnostic tests for tuberculosis that considers the incremental value at the population level and demonstrates how additional data could inform more-effective implementation of tuberculosis diagnostic tests under various conditions. PMID:26633767

  14. Evaluation of diagnostic tests for human leptospirosis.

    PubMed

    Ribeiro, M A; Brandão, A P; Romero, E C

    1996-06-01

    The IgM-PK-ELISA, an enzyme-linked immunosorbent assay for immunoglobulin M employing a proteinase K-treated antigen, and the "Leptoteste-S" macroagglutination test were evaluated for use in a rapid serodiagnosis of human leptospirosis. The microscopic agglutination test (MAT) was used as reference. The three serological tests were applied to serum samples from patients with leptospirosis (N = 89), typhoid fever (N = 8), malaria (N = 19), syphilis (N = 20), hepatitis (N = 16) and from clinically healthy donors (N = 92). The overall results of the IgM-PK-ELISA and the "Leptoteste-S" are comparable to those of the MAT. However, both tests differed statistically from MAT in terms of the positivity of the acute-phase sera, with approximately 38% of the patients with leptospirosis being identified earlier than when MAT was used. The IgM-PK-ELISA, with 89.9% sensitivity and 97.4% specificity, could be the test of choice for those laboratories which are equipped to perform ELISA. The "Leptoteste-S", with 89.9% sensitivity and 94.8% specificity, seems to be easier to perform and the most accessible to peripheral laboratories for rapid screening of human sera. Both techniques present the important characteristic of detecting early antibodies against leptospires, thus providing a diagnosis during the early stages of the disease. PMID:9070390

  15. The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

    PubMed Central

    Liu, Yu-Lei; Ao, Ying-Fang; Yan, Hui; Cui, Guo-Qing

    2016-01-01

    Background: The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests. Methods: Between November 2012 and January 2014, 200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively. The hug-up test, empty can (EC) test, full can (FC) test, Neer impingement sign, and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears, with arthroscopic findings as the gold standard. Muscle strength was precisely quantified using an electronic digital tensiometer. Results: The prevalence of supraspinatus tears was 76.5%. The hug-up test demonstrated the highest sensitivity (94.1%), with a low negative likelihood ratio (NLR, 0.08) and comparable specificity (76.6%) compared with the other four tests. The area under the receiver operating characteristic curve for the hug-up test was 0.854, with no statistical difference compared with the EC test (z = 1.438, P = 0.075) or the FC test (z = 1.498, P = 0.067). The hug-up test showed no statistical difference in terms of detecting different tear patterns according to the position (χ2 = 0.578, P = 0.898) and size (Fisher's exact test, P > 0.999) compared with the arthroscopic examination. The interobserver reproducibility of the hug-up test was high, with a kappa coefficient of 0.823. Conclusions: The hug-up test can accurately detect supraspinatus tears with a high sensitivity, comparable specificity, and low NLR compared with the conventional clinical tests and

  16. Safety of falciparum malaria diagnostic strategy based on rapid diagnostic tests in returning travellers and migrants: a retrospective study

    PubMed Central

    2012-01-01

    Background Rapid diagnostic tests for malaria (RDTs) allow accurate diagnosis and prompt treatment. Validation of their usefulness in travellers with fever was needed. The safety of a strategy to diagnose falciparum malaria based on RDT followed by immediate or delayed microscopy reading at first attendance was evaluated in one referral hospital in Switzerland. Methods A retrospective study was conducted in the outpatient clinic and emergency ward of University Hospital, covering a period of eight years (1999–2007). The study was conducted in the outpatient clinic and emergency ward of University Hospital. All adults suspected of malaria with a diagnostic test performed were included. RDT and microscopy as immediate tests were performed during working hours, and RDT as immediate test and delayed microscopy reading out of laboratory working hours. The main outcome measure was occurrence of specific complications in RDT negative and RDT positive adults. Results 2,139 patients were recruited. 1987 had both initial RDT and blood smear (BS) result negative. Among those, 2/1987 (0.1%) developed uncomplicated malaria with both RDT and BS positive on day 1 and day 6 respectively. Among the 152 patients initially malaria positive, 137 had both RDT and BS positive, four only BS positive and five only RDT positive (PCR confirmed) (six had only one test performed). None of the four initially RDT negative/BS positive and none of the five initially BS negative/RDT positive developed severe malaria while 6/137 of both RDT and BS positive did so. The use of RDT allowed a reduction of a median of 2.1 hours to get a first malaria test result. Conclusions A malaria diagnostic strategy based on RDTs and a delayed BS is safe in non-immune populations, and shortens the time to first malaria test result. PMID:23158019

  17. When is diagnostic testing inappropriate or irrational? Acceptable regret approach.

    PubMed

    Hozo, Iztok; Djulbegovic, Benjamin

    2008-01-01

    The authors provide a new model within the framework of theories of bounded rationality for the observed physicians' behavior that their ordering of diagnostic tests may not be rational. Contrary to the prevailing thinking, the authors find that physicians do not act irrationally or inappropriately when they order diagnostic tests in usual clinical practice. When acceptable regret (i.e., regret that a decision maker finds tolerable upon making a wrong decision) is taken into account, the authors show that physicians tend to order diagnostic tests at a higher level of pretest probability of disease than predicted by expected utility theory. They also show why physicians tend to overtest when regret about erroneous decisions is extremely small. Finally, they explain variations in the practice of medicine. They demonstrate that in the same clinical situation, different decision makers might have different acceptable regret thresholds for withholding treatment, for ordering a diagnostic test, or for administering treatment. This in turn means that for some decision makers, the most rational strategy is to do nothing, whereas for others, it may be to order a diagnostic test, and still for others, choosing treatment may be the most rational course of action. PMID:18480041

  18. [Systematic review of diagnostic tests accuracy: a narrative review].

    PubMed

    de Oliveira, Glória Maria; Camargo, Fábio Trinca; Gonçalves, Eduardo Costa; Duarte, Carlos Vinicius Nascimento; Guimarães, Carlos Alberto

    2010-04-01

    The aim of this study is to perform a narrative review of systematic reviews of diagnostic tests accuracy. We undertook a search using The Cochrane Methodology Reviews (Cochrane Reviews of Diagnostic Test Accuracy), Medline and LILACS up to October 2009. Reference lists of included studies were also hand searched. The following search strategy was constructed by using a combination of subject headings and text words: 1. Cochrane Methodology Reviews: accuracy study "Methodology" 2. In Pubmed "Meta-Analysis" [Publication Type] AND "Evidence-Based Medicine" [Mesh]) AND "Sensitivity and Specificity" [Mesh] 3. LILACS (revisao sistematica) or "literatura de REVISAO como assunto" [Descritor de assunto] and (sistematica) or "SISTEMATICA" [Descritor de assunto] and (acuracia) or "SENSIBILIDADE e especificidade" [Descritor de assunto]. In summary, the methodological planning and preparation of systematic reviews of therapeutic interventions are prior to that used in systematic reviews of diagnostic tests accuracy. There are more sources of heterogeneity in design of diagnostic test studies, which impair the synthesis - meta-analysis - of the results. To work around this problem, there are currently uniform requirements for diagnostic test manuscripts submitted to leading biomedical journals. PMID:20549106

  19. University Students' Perspectives on Diagnostic Testing in Mathematics

    ERIC Educational Resources Information Center

    Ní Fhloinn, Eabhnat; Bhaird, Ciarán Macan; Nolan, Brien

    2014-01-01

    Many universities issue mathematical diagnostic tests to incoming first-year students, covering a range of the basic concepts with which they should be comfortable from secondary school. As far as many lecturers are concerned, the purpose of this test is to determine the students' mathematical knowledge on entry. It should also provide an…

  20. Psychoacoustic Assessment of Speech Communication Systems. The Diagnostic Discrimination Test.

    ERIC Educational Resources Information Center

    Grether, Craig Blaine

    The present report traces the rationale, development and experimental evaluation of the Diagnostic Discrimination Test (DDT). The DDT is a three-choice test of consonant discriminability of the perceptual/acoustic dimensions of consonant phonemes within specific vowel contexts. The DDT was created and developed in an attempt to provide a…

  1. Commercial dengue rapid diagnostic tests for point-of-care application: recent evaluations and future needs?

    PubMed

    Blacksell, Stuart D

    2012-01-01

    Dengue fever, dengue haemorrhagic fever, and dengue shock syndrome (DF/DHF/DSS) are tropical diseases that cause significant humanitarian and economic hardship. It is estimated that more than 2.5 billion people are at risk of infection and more than 100 countries have endemic dengue virus transmission. Laboratory tests are essential to provide an accurate diagnosis of dengue virus infection so that appropriate treatment and patient management may be administered. In many dengue endemic settings, laboratory diagnostic resources are limited and simple rapid diagnostic tests (RDTs) provide opportunities for point-of-care diagnosis. This paper addresses current issues relating to the application of commercial dengue RDTs for the diagnosis of acute dengue virus infection, recent diagnostic evaluations, and identifies future needs. PMID:22654479

  2. ACER Physics Unit Tests: Unit Tests, Diagnostic Aids, [and] Teachers Handbook.

    ERIC Educational Resources Information Center

    Australian Council for Educational Research, Hawthorn.

    The Physics Unit Tests are designed to assist in the diagnostic evaluation of students' progress in the study of physics during the last two years of secondary schooling. They consist of a collection of 21 separate tests, each related to a different topic, and 21 diagnostic aids corresponding to the tests. The topics covered are: physical…

  3. DIAGNOSTIC ACCURACY OF PHYSICAL EXAMINATION TESTS OF THE ANKLE/FOOT COMPLEX: A SYSTEMATIC REVIEW

    PubMed Central

    Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren

    2013-01-01

    Background: Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. Purpose: The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. Methods: A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Conclusion: Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. Level of Evidence: 3a PMID:24175128

  4. Diagnostic Accuracy of Xpert Test in Tuberculosis Detection: A Systematic Review and Meta-analysis

    PubMed Central

    Kaur, Ravdeep; Kachroo, Kavita; Sharma, Jitendar Kumar; Vatturi, Satyanarayana Murthy; Dang, Amit

    2016-01-01

    Background: World Health Organization (WHO) recommends the use of Xpert MTB/RIF assay for rapid diagnosis of tuberculosis (TB) and detection of rifampicin resistance. This systematic review was done to know about the diagnostic accuracy and cost-effectiveness of the Xpert MTB/RIF assay. Methods: A systematic literature search was conducted in following databases: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, MEDLINE, PUBMED, Scopus, Science Direct and Google Scholar for relevant studies for studies published between 2010 and December 2014. Studies given in the systematic reviews were accessed separately and used for analysis. Selection of studies, data extraction and assessment of quality of included studies was performed independently by two reviewers. Studies evaluating the diagnostic accuracy of Xpert MTB/RIF assay among adult or predominantly adult patients (≥14 years), presumed to have pulmonary TB with or without HIV infection were included in the review. Also, studies that had assessed the diagnostic accuracy of Xpert MTB/RIF assay using sputum and other respiratory specimens were included. Results: The included studies had a low risk of any form of bias, showing that findings are of high scientific validity and credibility. Quantitative analysis of 37 included studies shows that Xpert MTB/RIF is an accurate diagnostic test for TB and detection of rifampicin resistance. Conclusion: Xpert MTB/RIF assay is a robust, sensitive and specific test for accurate diagnosis of tuberculosis as compared to conventional tests like culture and microscopic examination. PMID:27013842

  5. Diagnostic development and support of MHD test facilities

    SciTech Connect

    Not Available

    1990-01-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for Magnetohydrodynamics (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. 9 figs., 1 tab.

  6. Diagnostic development and support of MHD test facilities

    SciTech Connect

    Not Available

    1990-01-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. 25 figs., 6 tabs.

  7. Advanced material testing in support of accurate sheet metal forming simulations

    NASA Astrophysics Data System (ADS)

    Kuwabara, Toshihiko

    2013-05-01

    This presentation is a review of experimental methods for accurately measuring and modeling the anisotropic plastic deformation behavior of metal sheets under a variety of loading paths: biaxial compression test, hydraulic bulge test, biaxial tension test using a cruciform specimen, multiaxial tube expansion test using a closed-loop electrohydraulic testing machine for the measurement of forming limit strains and stresses, combined tension-shear test, and in-plane stress reversal test. Observed material responses are compared with predictions using phenomenological plasticity models to highlight the importance of accurate material testing. Special attention is paid to the plastic deformation behavior of sheet metals commonly used in industry, and to verifying the validity of constitutive models based on anisotropic yield functions at a large plastic strain range. The effects of using appropriate material models on the improvement of predictive accuracy for forming defects, such as springback and fracture, are also presented.

  8. [STARD 2015 for the evaluation of diagnostic tests].

    PubMed

    Korevaar, D A; Bossuyt, P M M

    2016-01-01

    Each year, many new diagnostic tests appear on the market that claim to be better, faster, cheaper, less invasive and more reliable than those already available. Diagnostic accuracy studies can assist in the objective assessment of such claims but, unfortunately, important information is often missing from the corresponding study reports. Authors are responsible for the completeness of their study reports, but they may not always be aware of the type of information that needs to be provided for an adequate appraisal of the study. To assist authors in writing informative reports, the STAndards for Reporting Diagnostic accuracy studies (STARD) were recently updated. The aim of STARD 2015 is to improve the ease of use of STARD, while also including several new crucial elements. Future initiatives to improve the uptake of STARD 2015 include the development of extensions for specific fields of testing and tools for specific user groups. PMID:27165460

  9. Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital

    PubMed Central

    Hwang, Hamish; Marsh, Ian; Doyle, Jason

    2014-01-01

    Background Acute cholecystitis is one of the most common diseases requiring emergency surgery. Ultrasonography is an accurate test for cholelithiasis but has a high false-negative rate for acute cholecystitis. The Murphy sign and laboratory tests performed independently are also not particularly accurate. This study was designed to review the accuracy of ultrasonography for diagnosing acute cholecystitis in a regional hospital. Methods We studied all emergency cholecystectomies performed over a 1-year period. All imaging studies were reviewed by a single radiologist, and all pathology was reviewed by a single pathologist. The reviewers were blinded to each other’s results. Results A total of 107 patients required an emergency cholecystectomy in the study period; 83 of them underwent ultrasonography. Interradiologist agreement was 92% for ultrasonography. For cholelithiasis, ultrasonography had 100% sensitivity, 18% specificity, 81% positive predictive value (PPV) and 100% negative predictive value (NPV). For acute cholecystitis, it had 54% sensitivity, 81% specificity, 85% PPV and 47% NPV. All patients had chronic cholecystitis and 67% had acute cholecystitis on histology. When combined with positive Murphy sign and elevated neutrophil count, an ultrasound showing cholelithiasis or acute cholecystitis yielded a sensitivity of 74%, specificity of 62%, PPV of 80% and NPV of 53% for the diagnosis of acute cholecystitis. Conclusion Ultrasonography alone has a high rate of false-negative studies for acute cholecystitis. However, a higher rate of accurate diagnosis can be achieved using a triad of positive Murphy sign, elevated neutrophil count and an ultrasound showing cholelithiasis or cholecystitis. PMID:24869607

  10. Accurate bs and w testing important for crude-oil custody transfer

    SciTech Connect

    Williams, J. )

    1990-11-12

    This paper discusses how monitoring crude-oil sediment and water content at the field production site is essential in accurate crude-oil custody transfer operations. This is accomplished by manual methods, or on-line devices like capacitance, density, or energy-absorption analyzers. For custody-transfer purposes, sediment and water is determined by a test which follows one of the API manuals of petroleum measurement standards (MPMS). Typically, this test is conducted in the field by the field centrifuge method which, if performed properly, yields very accurate results. Laboratory tests can be performed, but sample handling becomes even more critical.

  11. 30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What do I submit if my casing diagnostic test... diagnostic test requires action? Within 14 days after you perform a casing diagnostic test requiring action... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request,...

  12. 30 CFR 250.526 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What do I submit if my casing diagnostic test... diagnostic test requires action? Within 14 days after you perform a casing diagnostic test requiring action... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request,...

  13. 30 CFR 250.526 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What do I submit if my casing diagnostic test... diagnostic test requires action? Within 14 days after you perform a casing diagnostic test requiring action... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request,...

  14. Diagnostic testing in extraesophageal GERD: another case of "furor medicus"?

    PubMed

    Spiegel, Brennan

    2013-06-01

    Proton pump inhibitors (PPIs) work for most patients with gastroesophageal reflux disease (GERD). But when PPIs fail to work, or when there are atypical extra-esophageal symptoms, diagnostic and management decisions become much more difficult. Although atypical GERD is common, there are limited data about how best to approach these patients. The temptation is often to perform extensive diagnostic testing, sometimes to little avail. In this issue of The Journal, Francis et al. present a new study to help close the research gap in understanding the costs and benefits of testing in atypical GERD. The authors conclude that diagnostic testing is very expensive and real-life benefits are modest. This editorial reviews the findings, places them into clinical perspective, and concludes that diagnostic testing in atypical GERD may be another example of "furor medicus" - an old but descriptive term referring to the instinct of doctors to implore "don't just stand there, do something!" The data from Francis et al. suggest we might do the opposite in atypical GERD: "Don't just do something, stand there." PMID:23735914

  15. Comparison of Self-Instruction Methods for Teaching Diagnostic Testing.

    ERIC Educational Resources Information Center

    Puskas, Jane C.

    1991-01-01

    Self-teaching booklets and computer media were evaluated for teaching diagnostic testing with first (n=49), second (n=41) and third year (n=71) dental students as a foundation for further development of clinical decision-making skills. Results found the media more effective than no instruction and equally effective to the traditional lecture…

  16. Diagnostics of the ITER neutral beam test facility

    SciTech Connect

    Pasqualotto, R.; Serianni, G.; Agostini, M.; Brombin, M.; Dalla Palma, M.; Gazza, E.; Pomaro, N.; Rizzolo, A.; Spolaore, M.; Zaniol, B.; Sonato, P.; De Muri, M.; Croci, G.; Gorini, G.

    2012-02-15

    The ITER heating neutral beam (HNB) injector, based on negative ions accelerated at 1 MV, will be tested and optimized in the SPIDER source and MITICA full injector prototypes, using a set of diagnostics not available on the ITER HNB. The RF source, where the H{sup -}/D{sup -} production is enhanced by cesium evaporation, will be monitored with thermocouples, electrostatic probes, optical emission spectroscopy, cavity ring down, and laser absorption spectroscopy. The beam is analyzed by cooling water calorimetry, a short pulse instrumented calorimeter, beam emission spectroscopy, visible tomography, and neutron imaging. Design of the diagnostic systems is presented.

  17. Genetic testing can resolve diagnostic confusion in Alport syndrome

    PubMed Central

    Adam, Jennifer; Connor, Thomas M. F.; Wood, Katrina; Lewis, David; Naik, Ramesh; Gale, Daniel P.; Sayer, John A.

    2014-01-01

    Alport syndrome (AS) is a familial glomerular disorder resulting from mutations in the genes encoding several members of the type IV collagen protein family. Despite advances in molecular genetics, renal biopsy remains an important initial diagnostic tool. Histological diagnosis is challenging as features may be non-specific, particularly early in the disease course and in females with X-linked disease. We present three families for whom there was difficulty in correctly diagnosing AS or thin basement membrane nephropathy as a result of misinterpretation of non-specific and incomplete histology. We highlight the importance of electron microscopy and immunofluorescence in improving diagnostic yield and also the hazard of interpreting a descriptive histological term as a diagnostic label. Molecular genetic testing allows a definitive diagnosis to be made in index patients and at-risk family members. PMID:24944784

  18. Diagnostic development and support of MHD (magnetohydrodynamics) test facilities

    SciTech Connect

    Not Available

    1989-07-01

    Mississippi State University (MSU) is developing diagnostic instruments for Magnetohydrodynamics (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for HRSR support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with MHD Energy Center computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. MSU personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs.

  19. Applications of Molecular Diagnostic Testing in Food Allergy.

    PubMed

    Hoffmann-Sommergruber, Karin; Pfeifer, Sabine; Bublin, Merima

    2015-09-01

    IgE-mediated food allergy is a relevant health problem inducing symptoms ranging from mild local reactions up to severe life-threatening situations. Currently, no immunotherapy is available and avoidance of the incriminating food is the method of choice. Therefore, reliable diagnostic tools to formulate dietary recommendations and to avoid unnecessary exclusion diets for the individual patient are urgently needed. This review provides an update on the current knowledge on food allergens and their application in various diagnostic approaches such as skin prick test, basophil activation test, and serum IgE testing. Furthermore, these new approaches are discussed and compared to conventional extract-based assays and correlated to the gold standard of food allergy diagnosis, the double-blind placebo-controlled food challenge. Finally, the application of food allergens for preventive measurements such as allergen detection assays and the determination of threshold levels for allergen levels are discussed. PMID:26233429

  20. Advanced tests for early and accurate diagnosis of Creutzfeldt-Jakob disease.

    PubMed

    Zanusso, Gianluigi; Monaco, Salvatore; Pocchiari, Maurizio; Caughey, Byron

    2016-06-01

    Early and accurate diagnosis of Creutzfeldt-Jakob disease (CJD) is a necessary to distinguish this untreatable disease from treatable rapidly progressive dementias, and to prevent iatrogenic transmission. Currently, definitive diagnosis of CJD requires detection of the abnormally folded, CJD-specific form of protease-resistant prion protein (PrP(CJD)) in brain tissue obtained postmortem or via biopsy; therefore, diagnosis of sporadic CJD in clinical practice is often challenging. Supporting investigations, including MRI, EEG and conventional analyses of cerebrospinal fluid (CSF) biomarkers, are helpful in the diagnostic work-up, but do not allow definitive diagnosis. Recently, novel ultrasensitive seeding assays, based on the amplified detection of PrP(CJD), have improved the diagnostic process; for example, real-time quaking-induced conversion (RT-QuIC) is a sensitive method to detect prion-seeding activity in brain homogenate from humans with any subtype of sporadic CJD. RT-QuIC can also be used for in vivo diagnosis of CJD: its diagnostic sensitivity in detecting PrP(CJD) in CSF samples is 96%, and its specificity is 100%. Recently, we provided evidence that RT-QuIC of olfactory mucosa brushings is a 97% sensitive and 100% specific for sporadic CJD. These assays provide a basis for definitive antemortem diagnosis of prion diseases and, in doing so, improve prospects for reducing the risk of prion transmission. Moreover, they can be used to evaluate outcome measures in therapeutic trials for these as yet untreatable infections. PMID:27174240

  1. 30 CFR 250.522 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false When do I have to repeat casing diagnostic... repeat casing diagnostic testing? Casing diagnostic testing must be repeated according to the following table: When * * * you must repeat diagnostic testing * * * (a) your casing pressure request...

  2. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for a new clinical diagnostic laboratory... HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  3. 30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What do I submit if my casing diagnostic test... if my casing diagnostic test requires action? Within 14 days after you perform a casing diagnostic... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request,...

  4. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  5. 30 CFR 250.523 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false When do I have to repeat casing diagnostic... diagnostic testing? Casing diagnostic testing must be repeated according to the following table: When . . . you must repeat diagnostic testing . . . (a) your casing pressure request approved term has...

  6. 30 CFR 250.520 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false When do I have to perform a casing diagnostic... diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first observing or... diagnostic test if . . . (1) fixed platform well, the casing pressure is greater than 100 psig. (2)...

  7. 30 CFR 250.521 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false When do I have to perform a casing diagnostic... diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first observing or... diagnostic test if . . . (1) fixed platform well, the casing pressure is greater than 100 psig. (2)...

  8. 30 CFR 250.520 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false When do I have to perform a casing diagnostic... perform a casing diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first... a casing diagnostic test if * * * (1) fixed platform well, the casing pressure is greater than...

  9. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Payment for a new clinical diagnostic laboratory... HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  10. 30 CFR 250.521 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false When do I have to perform a casing diagnostic... diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first observing or... diagnostic test if . . . (1) fixed platform well, the casing pressure is greater than 100 psig. (2)...

  11. 30 CFR 250.523 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false When do I have to repeat casing diagnostic... diagnostic testing? Casing diagnostic testing must be repeated according to the following table: When . . . you must repeat diagnostic testing . . . (a) your casing pressure request approved term has...

  12. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for a new clinical diagnostic laboratory... HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  13. 30 CFR 250.522 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false When do I have to repeat casing diagnostic... diagnostic testing? Casing diagnostic testing must be repeated according to the following table: When . . . you must repeat diagnostic testing . . . (a) your casing pressure request approved term has...

  14. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  15. The impact of new trends in POCTs for companion diagnostics, non-invasive testing and molecular diagnostics.

    PubMed

    Huckle, David

    2015-06-01

    Point-of-care diagnostics have been slowly developing over several decades and have taken on a new importance in current healthcare delivery for both diagnostics and development of new drugs. Molecular diagnostics have become a key driver of technology change and opened up new areas in companion diagnostics for use alongside pharmaceuticals and in new clinical approaches such as non-invasive testing. Future areas involving smartphone and other information technology advances, together with new developments in molecular biology, microfluidics and surface chemistry are adding to advances in the market. The focus for point-of-care tests with molecular diagnostic technologies is focused on advancing effective applications. PMID:25990929

  16. Chromosome microarrays in diagnostic testing: interpreting the genomic data.

    PubMed

    Peters, Greg B; Pertile, Mark D

    2014-01-01

    DNA-based Chromosome MicroArrays (CMAs) are now well established as diagnostic tools in clinical genetics laboratories. Over the last decade, the primary application of CMAs has been the genome-wide detection of a particular class of mutation known as copy number variants (CNVs). Since 2010, CMA testing has been recommended as a first-tier test for detection of CNVs associated with intellectual disability, autism spectrum disorders, and/or multiple congenital anomalies…in the post-natal setting. CNVs are now regarded as pathogenic in 14-18 % of patients referred for these (and related) disorders.Through consideration of clinical examples, and several microarray platforms, we attempt to provide an appreciation of microarray diagnostics, from the initial inspection of the microarray data, to the composing of the patient report. In CMA data interpretation, a major challenge comes from the high frequency of clinically irrelevant CNVs observed within "patient" and "normal" populations. As might be predicted, the more common and clinically insignificant CNVs tend to be the smaller ones <100 kb in length, involving few or no known genes. However, this relationship is not at all straightforward: CNV length and gene content are only very imperfect indicators of CNV pathogenicity. Presently, there are no reliable means of separating, a priori, the benign from the pathological CNV classes.This chapter also considers sources of technical "noise" within CMA data sets. Some level of noise is inevitable in diagnostic genomics, given the very large number of data points generated in any one test. Noise further limits CMA resolution, and some miscalling of CNVs is unavoidable. In this, there is no ideal solution, but various strategies for handling noise are available. Even without solutions, consideration of these diagnostic problems per se is informative, as they afford critical insights into the biological and technical underpinnings of CNV discovery. These are indispensable

  17. Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

    PubMed Central

    Sá, Luísa; Costa-Santos, Cristina; Teixeira, Andreia; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto; Santos, Paulo; Martins, Carlos

    2015-01-01

    Background Physicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests. Methods A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated. Results One-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain. Conclusions Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care. PMID:26356625

  18. Background review for diagnostic test development for Zika virus infection

    PubMed Central

    Charrel, Rémi N; Leparc-Goffart, Isabelle; Pas, Suzan; de Lamballerie, Xavier; Koopmans, Marion; Reusken, Chantal

    2016-01-01

    Abstract Objective To review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge. Methods We made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain. Findings We identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated. Conclusion An international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs. PMID:27516635

  19. [Comparative diagnostic value of Helicobacter pylori infection testing methods].

    PubMed

    Girdalidze, A M; Elisabedashvili, G V; Sharvadze, L G; Dzhorbenadze, T A

    2013-12-01

    In 213 patients with gastric and duodenal pathology, including received surgery, comparative estimation of results of Helicobacter pylori (Hp) infection testing with invasive and noninvasive methods, were performed. Material for invasive endoscopic biopsy test (EBT), including rapid urease test (RUT) for rapid Hp identification by determination of urease activity, smear cytology and histology was extracted on endoscopy or intraoperationally. RUT was carried out with the help of URE-HP test kit. Serological test for Hp antibodies IgG and IgA class was performed by IFA using kit ELISA. 13С urea breath test (UBT) was made by determination of 13/12CO2 in breath samples on infrared spectroscope. Based on 5 different methods of Hp infection testing Hp positivity in 172 (80,8%) and Hp negativity in 41 (19,2%) from 213 examined patients was revealed. 13С-UBT revealed the highest diagnostic value (accuracy-97,5%, sensibility-97,0%, specificity-100%) in Hp infection diagnostics. In treatment efficiency control this parameters of 13С-UBT are also much high (96,7%, 90,0% and 100% respectively). In spite of high sensitivity of serological test (100%), it had comparative low specificity (71,0%) with high probability of false positive results in treated patients (antibodies titer to Hp after eradication retains for a long time). Thought, this test may be successfully used only in primary patients and in epidemiological studies. Among three methods of EBT, Hp infection detection with RUT revealed the best results (accuracy-94,8%, sensibility-95,0%, specificity-100%). Correlation of RUT and UBT results and much higher diagnostic value of UBT, necessitate RUT with histological study of stomach body mucosa to perform in patients over 45 year, with prolonged anamnesis and dangerous symptoms of disease. In Hp positive patients correlation of index DOB‰ of breath test with results of RUT was revealed. This can serve the index DOB‰ of 13С-UBT as a marker of Hp infection rate. The

  20. Inventing a new diagnostic test for vaginal infection.

    PubMed

    O'Dowd, T C; Bourne, N

    1994-07-01

    Bacterial vaginosis, which is underdiagnosed in clinical practice, has a characteristic fishy smell because of production of diamines. This smell is the basis of a visual rapid diagnostic test that is technically simple to perform. The test has been patented in Europe and America, and a licence agreement has been negotiated. This paper describes the process from idea to invention to patenting and licensing. The combined costs of research and patenting were met by a multinational company in return for rights to exploit the patent invention. The process has taken nine years and has needed clinical, scientific, legal, and commercial input to get the test to the marketplace. PMID:8044068

  1. Diagnostic validation of selected serological tests for detecting scrub typhus.

    PubMed

    Koraluru, Munegowda; Bairy, Indira; Varma, Muralidhar; Vidyasagar, Sudha

    2015-07-01

    Clinical diagnosis of scrub typhus is often difficult because the symptoms are very similar to those of other febrile illness such as dengue, leptospirosis, malaria and other viral hemorrhagic fevers. Though better diagnostic tests are available for rickettsial diseases and scrub typhus elsewhere, the Weil-Felix test is still commonly used in India, mainly because microimmunofluorescence assays (M-IFA) were not available in India till recently and relevant staff had insufficient training. The present study was performed to investigate the performance of M-IFA, IgM ELISA, and Weil-Felix test on 546 non-repeated serum samples from subjects suspected of having scrub typhus. One hundred and forty-three of these 546 samples were positive by M-IFA; these cases were also confirmed clinically to have scrub typhus based on their dramatic responses to doxycycline therapy. IgM ELISA was positive in 122 of the 143 M-IFA positive cases and the Weil-Felix test in 96. Though the Weil-Felix test is a heterophile agglutination test, it was found in this study to have good specificity but far too little sensitivity to use as a routine diagnostic test. IgM ELISA can be a good substitute for M-IFA. Incorporation of multiple prototype antigens on M-IFA slides is likely one of the reasons for its superior performance. As newer and better diagnostic assays become available for scrub typhus diagnosis in developed countries, it will be imperative to also use such tests in other endemic countries to prevent over- or under-diagnosis of scrub typhus. PMID:26011315

  2. Practice Bulletin No. 162: Prenatal Diagnostic Testing for Genetic Disorders.

    PubMed

    2016-05-01

    Prenatal genetic diagnostic testing is intended to determine, with as much certainty as possible, whether a specific genetic disorder or condition is present in the fetus. In contrast, prenatal genetic screening is designed to assess whether a patient is at increased risk of having a fetus affected by a genetic disorder. Originally, prenatal genetic testing focused primarily on Down syndrome (trisomy 21), but now it is able to detect a broad range of genetic disorders. Although it is necessary to perform amniocentesis or chorionic villus sampling (CVS) to definitively diagnose most genetic disorders, in some circumstances, fetal imaging with ultrasonography, echocardiography, or magnetic resonance imaging may be diagnostic of a particular structural fetal abnormality that is suggestive of an underlying genetic condition.The objective of prenatal genetic testing is to detect health problems that could affect the woman, fetus, or newborn and provide the patient and her obstetrician-gynecologist or other obstetric care provider with enough information to allow a fully informed decision about pregnancy management. Prenatal genetic testing cannot identify all abnormalities or problems in a fetus, and any testing should be focused on the individual patient's risks, reproductive goals, and preferences. It is important that patients understand the benefits and limitations of all prenatal screening and diagnostic testing, including the conditions for which tests are available and the conditions that will not be detected by testing. It also is important that patients realize that there is a broad range of clinical presentations, or phenotypes, for many genetic disorders and that results of genetic testing cannot predict all outcomes. Prenatal genetic testing has many benefits, including reassuring patients when results are normal, identifying disorders for which prenatal treatment may provide benefit, optimizing neonatal outcomes by ensuring the appropriate location for

  3. Diagnostic testing: a key component of high-value care.

    PubMed

    Cardinal, Lucien J

    2016-01-01

    This is the fourth article of a series on fundamental concepts in biostatistics and research. In this article, the author reviews the fundamental concepts in diagnostic testing, sensitivity, and specificity and how they relate to the concept of high-value care. The topics are discussed in common language, with a minimum of jargon and mathematics, and with clinical examples. Emphasis is given to conceptual understanding. A companion article will follow focusing on predictive value and prior probability. PMID:27406456

  4. Diagnostic testing: a key component of high-value care

    PubMed Central

    Cardinal, Lucien J.

    2016-01-01

    This is the fourth article of a series on fundamental concepts in biostatistics and research. In this article, the author reviews the fundamental concepts in diagnostic testing, sensitivity, and specificity and how they relate to the concept of high-value care. The topics are discussed in common language, with a minimum of jargon and mathematics, and with clinical examples. Emphasis is given to conceptual understanding. A companion article will follow focusing on predictive value and prior probability. PMID:27406456

  5. A general diagnostic model applied to language testing data.

    PubMed

    von Davier, Matthias

    2008-11-01

    Probabilistic models with one or more latent variables are designed to report on a corresponding number of skills or cognitive attributes. Multidimensional skill profiles offer additional information beyond what a single test score can provide, if the reported skills can be identified and distinguished reliably. Many recent approaches to skill profile models are limited to dichotomous data and have made use of computationally intensive estimation methods such as Markov chain Monte Carlo, since standard maximum likelihood (ML) estimation techniques were deemed infeasible. This paper presents a general diagnostic model (GDM) that can be estimated with standard ML techniques and applies to polytomous response variables as well as to skills with two or more proficiency levels. The paper uses one member of a larger class of diagnostic models, a compensatory diagnostic model for dichotomous and partial credit data. Many well-known models, such as univariate and multivariate versions of the Rasch model and the two-parameter logistic item response theory model, the generalized partial credit model, as well as a variety of skill profile models, are special cases of this GDM. In addition to an introduction to this model, the paper presents a parameter recovery study using simulated data and an application to real data from the field test for TOEFL Internet-based testing. PMID:17535481

  6. Diagnostic application of KRAS mutation testing in uterine microglandular proliferations.

    PubMed

    Hong, Wei; Abi-Raad, Rita; Alomari, Ahmed K; Hui, Pei; Buza, Natalia

    2015-07-01

    Microglandular proliferations often pose a diagnostic challenge in small endocervical and endometrial biopsies. Microglandular hyperplasia (MGH) is one of the most common pseudoneoplastic glandular proliferations of uterine cervix, which can closely mimic endometrial adenocarcinomas (EAC) with a microglandular pattern (microglandular EAC). Although MGH is typically characterized by relatively uniform nuclei and rare to absent mitoses, atypical forms with architectural and/or cytologic deviation from the usual morphology have been previously described. Recently, a series of MGH with high mitotic activity has also been documented. Although careful morphological assessment and immunohistochemical workup can resolve the diagnostic dilemma in some cases, additional differential diagnostic tools are needed to separate both the common and atypical variants of MGH from EAC with microglandular pattern. Frequent KRAS mutation has been previously reported in endometrial complex mucinous lesions and endometrial mucinous carcinomas. However, the diagnostic utility of KRAS mutation analysis has not yet been explored in the context of cervical and endometrial microglandular lesions. Twelve mitotically active MGH cases and 15 cases of EAC with microglandular growth pattern were selected for the study. KRAS mutation analysis was performed in all cases by highly sensitive single-strand conformation polymorphism analysis. Clinical history and follow-up data were retrieved from electronic medical records. KRAS mutation was absent in all MGH cases, whereas 9 (60%) of 15 microglandular EAC cases tested positive for KRAS mutation. Our data indicate that KRAS mutation analysis may offer additional discriminatory power in separating benign MGH from EAC with microglandular pattern. PMID:25997988

  7. The dexamethasone suppression test: promises and problems of diagnostic laboratory tests in psychiatry.

    PubMed

    Insel, T R; Goodwin, F K

    1983-12-01

    Diagnostic tests in medicine must satisfy certain validity and accuracy criteria to be clinically useful. In psychiatry, the validity of a diagnostic procedure might be tested independently against clinical diagnosis, treatment response, and family history criteria; a strong relationship to any of the three would suggest clinical usefulness. Predictive value theory provides a model for such a test. The dexamethasone suppression test (DST) has a lower predictive value for major depressive disorder than most conventional laboratory tests used for diagnosis in medicine. In spite of promising early reports, the DST is not predictive of treatment response nor does it appear to identify genetic subtypes of depression. Although no diagnostic laboratory test is currently powerful enough for routine clinical use in psychiatry, laboratory tests may prove useful in predicting relapse and in continuing research on the psychobiology of mental disorders. PMID:6642460

  8. Diagnostic testing during pregnancy: a descriptive analysis of utilisation data.

    PubMed

    Rushworth, R L; Bell, S M; Rob, M I; Taylor, P T

    1994-12-01

    To describe patterns of diagnostic testing during the antenatal period and to assess the potential benefit of using Medicare claims data in monitoring testing practice, we examined the matched claims data (with identifying details removed) on approximately 10,000 women having a confinement for which a Medicare benefit was claimed between 1 July and 30 September 1990. The results showed that almost all the women included in the study sample had an ultrasound and blood group and antibody examination. A smaller proportion had serological tests for syphilis (77 per cent), rubella (51 per cent) and hepatitis B carriage (73 per cent). Two-thirds had urine microscopy and culture, and under half (40 per cent) had serum alpha-fetoprotein estimation. Few (18 per cent) had a claim processed for microscopy and culture of a genital swab and fewer than 8 per cent claimed for any other pathology tests. There were differences in the proportions having tests, depending on whether the clinician managing the confinement was a specialist obstetrician or a general practitioner, and depending on geographic area and age group. While the data do not represent all women having a confinement in New South Wales, the selective use of antenatal diagnostic tests found in this study is of considerable public health importance and analysis of claims data can provide useful information for health professionals. PMID:7536479

  9. Results from the Astronomy Diagnostic Test National Project

    NASA Astrophysics Data System (ADS)

    Deming, G. L.

    2001-12-01

    During 2000 and 2001, the validity and reliability of the Astronomy Diagnostic Test Version 2.0 (ADT 2.0) were formally investigated through the Astronomy Diagnostic Test National Project. The ADT 2.0 was administered as a pre-test to 5346 students and as a post-test to 3842 students. Student test results were collected from 97 classes that ranged in size from 4 to 320 students with 30 states represented. The 68 professors participating in the ADT National Project taught classes at universities (54%), 4-year colleges (27%), and 2-year colleges (19%). The database was analyzed for reliability at the Ontario Institute for Studies in Education. A pre-test value for Cronbach's alpha of 0.65 and post-test value of 0.76 demonstrate an acceptable degree of internal consistency. The average score for the 44 participating professors who completed the ADT as experts was 98%. Face and content validity were established by combining results from the experts with feedback from 60 student interviews. Student results from the National Project yielded an average score of 32.4% for the pre-test and 47.3% for the post-test. There is a gender discrepancy in favor of males that persists in both the pre-test (11% points) and the post-test (12% points) scores. The variations across geographic distribution and institution types were not significant. In addition to the 21 content items, the ADT 2.0 has 12 student background questions enabling instructors to have a better understanding of who takes introductory astronomy. This research was supported by the National Science Foundation through grants REC-0089239 (GD) and DGE-9714489 (BH).

  10. Temperature and the Field Stability of a Dengue Rapid Diagnostic Test in the Tropics

    PubMed Central

    Phommasone, Koukeo; Sengvilaipaseuth, Onanong; de Lamballerie, Xavier; Vongsouvath, Manivanh; Phonemixay, Ooyanong; Blacksell, Stuart D.; Newton, Paul N.; Dubot-Pérès, Audrey

    2015-01-01

    The global incidence of dengue has increased significantly in recent decades, resulting in a large public health burden in tropical and subtropical countries. Dengue rapid diagnostic tests (RDTs) can provide accurate, rapid accessible diagnosis for patient management and may be easily used by health workers in rural areas. However, in dengue-endemic areas, ambient temperatures are often higher than manufacturer's recommendation. We therefore evaluated the effect of high temperature over time on the performance of one commonly used dengue RDT, the Standard Diagnostics Bioline Dengue Duo. RDTs were kept in five different conditions (at 4°C, 35°C, 45°C, 60°C, and at fluctuant ambient temperatures in a free-standing hut) for between 2 days and 2 years in the Lao People's Democratic Republic (PDR). RDTs were tested with four control sera (negative, dengue nonstructural protein 1 [NS1], anti-dengue immunoglobulin [Ig] M, and anti-dengue IgG positive). The RDTs had 100% consistency over the 2-year study, despite high temperatures, including in the hut in which temperatures exceeded the manufacturer's recommendations for 29% of time points. These data suggest that the diagnostic accuracy of the SD Bioline Dengue Duo RDT remains stable even after long-term storage at high temperatures. Therefore, use at such ambient temperatures in tropical areas should not jeopardize the dengue diagnostic outcome. PMID:25962773

  11. Flight Test of Propulsion Monitoring and Diagnostic System

    NASA Technical Reports Server (NTRS)

    Gabel, Steve; Elgersma, Mike

    2002-01-01

    The objective of this program was to perform flight tests of the propulsion monitoring and diagnostic system (PMDS) technology concept developed by Honeywell under the NASA Advanced General Aviation Transport Experiment (AGATE) program. The PMDS concept is intended to independently monitor the performance of the engine, providing continuous status to the pilot along with warnings if necessary as well as making the data available to ground maintenance personnel via a special interface. These flight tests were intended to demonstrate the ability of the PMDS concept to detect a class of selected sensor hardware failures, and the ability to successfully model the engine for the purpose of engine diagnosis.

  12. Ultrasonic diagnostic load testing of steel highway bridges

    NASA Astrophysics Data System (ADS)

    Mandracchia, Efrain A.

    1996-11-01

    This paper presents a new product, the SonicForce Acoustic Strain Gauge (ASG), that utilizes a non-contact ultrasonic technology to measure applied strain requiring no paint removal and minimal surface preparation. After an overview of the ultrasonic technology is presented the results of a diagnostic test utilizing a prototype of the ASG will be discussed. The purpose of this test was to validate the ASG as being functionally equivalent to the resistance strain gauge, and to demonstrate a cost effective enabling technology to the civil and structural engineering communities. The diagnostic tests program was supervised by Dr. Abba Lichtenstein in accordance with accepted guidelines contained in the manual for 'Rating Bridges Through Testing'. FOr the purpose of this study the bridge superstructure was modeled and structural loading profiles were determined using both resistive and acoustic strain measurement techniques. Measured strains as determined by the ASG were compared to theoretical loads in order to determine if the rodeo gulch superstructure was operating in a safe and reliable manner. Additionally, under the direction of Phil Fish, two pre-production ASGs were used to monitor accumulated cyclic loading. These test data presented as a time series strip chart and rainflow histogram.

  13. Metagenomic abundance estimation and diagnostic testing on species level

    PubMed Central

    Lindner, Martin S.; Renard, Bernhard Y.

    2013-01-01

    One goal of sequencing-based metagenomic community analysis is the quantitative taxonomic assessment of microbial community compositions. In particular, relative quantification of taxons is of high relevance for metagenomic diagnostics or microbial community comparison. However, the majority of existing approaches quantify at low resolution (e.g. at phylum level), rely on the existence of special genes (e.g. 16S), or have severe problems discerning species with highly similar genome sequences. Yet, problems as metagenomic diagnostics require accurate quantification on species level. We developed Genome Abundance Similarity Correction (GASiC), a method to estimate true genome abundances via read alignment by considering reference genome similarities in a non-negative LASSO approach. We demonstrate GASiC’s superior performance over existing methods on simulated benchmark data as well as on real data. In addition, we present applications to datasets of both bacterial DNA and viral RNA source. We further discuss our approach as an alternative to PCR-based DNA quantification. PMID:22941661

  14. NREL Develops Diagnostic Test Cases to Improve Building Energy Simulation Programs (Fact Sheet)

    SciTech Connect

    Not Available

    2011-12-01

    This technical highlight describes NREL research to develop a set of diagnostic test cases for building energy simulations in order to achieve more accurate energy use and savings predictions. The National Renewable Energy Laboratory (NREL) Residential and Commercial Buildings research groups developed a set of diagnostic test cases for building energy simulations. Eight test cases were developed to test surface conduction heat transfer algorithms of building envelopes in building energy simulation programs. These algorithms are used to predict energy flow through external opaque surfaces such as walls, ceilings, and floors. The test cases consist of analytical and vetted numerical heat transfer solutions that have been available for decades, which increases confidence in test results. NREL researchers adapted these solutions for comparisons with building energy simulation results. Testing the new cases with EnergyPlus identified issues with the conduction finite difference (CondFD) heat transfer algorithm in versions 5 and 6. NREL researchers resolved these issues for EnergyPlus version 7. The new test cases will help users and developers of EnergyPlus and other building energy tools to identify and fix problems associated with solid conduction heat transfer algorithms of building envelopes and their boundary conditions. In the long term, improvements to software algorithms will result in more accurate energy use and savings predictions. NREL researchers plan to document the set of test cases and make them available for future consideration by validation standards such as ASHRAE Standard 140: Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs. EnergyPlus users will also have access to the improved CondFD model in version 7 after its next scheduled release.

  15. Integrated Rapid-Diagnostic-Test Reader Platform on a Cellphone

    PubMed Central

    Mudanyali, Onur; Dimitrov, Stoyan; Sikora, Uzair; Padmanabhan, Swati; Navruz, Isa; Ozcan, Aydogan

    2012-01-01

    We demonstrate a cellphone based Rapid-Diagnostic-Test (RDT) reader platform that can work with various lateral flow immuno-chromatographic assays and similar tests to sense the presence of a target analyte in a sample. This compact and cost-effective digital RDT reader, weighing only ~65 grams, mechanically attaches to the existing camera unit of a cellphone, where various types of RDTs can be inserted to be imaged in reflection or transmission modes under light-emitting-diode (LED) based illumination. Captured raw images of these tests are then digitally processed (within less than 0.2 sec/image) through a smart application running on the cellphone for validation of the RDT as well as for automated reading of its diagnostic result. The same smart application running on the cellphone then transmits the resulting data, together with the RDT images and other related information (e.g., demographic data) to a central server, which presents the diagnostic results on a world-map through geo-tagging. This dynamic spatio-temporal map of various RDT results can then be viewed and shared using internet browsers or through the same cellphone application. We tested this platform using malaria, tuberculosis (TB) as well as HIV RDTs by installing it on both Android based smart-phones as well as an iPhone. Providing real-time spatio-temporal statistics for the prevalence of various infectious diseases, this smart RDT reader platform running on cellphones might assist health-care professionals and policy makers to track emerging epidemics worldwide and help epidemic preparedness. PMID:22596243

  16. Integrated rapid-diagnostic-test reader platform on a cellphone.

    PubMed

    Mudanyali, Onur; Dimitrov, Stoyan; Sikora, Uzair; Padmanabhan, Swati; Navruz, Isa; Ozcan, Aydogan

    2012-08-01

    We demonstrate a cellphone-based rapid-diagnostic-test (RDT) reader platform that can work with various lateral flow immuno-chromatographic assays and similar tests to sense the presence of a target analyte in a sample. This compact and cost-effective digital RDT reader, weighing only ~65 g, mechanically attaches to the existing camera unit of a cellphone, where various types of RDTs can be inserted to be imaged in reflection or transmission modes under light-emitting diode (LED)-based illumination. Captured raw images of these tests are then digitally processed (within less than 0.2 s per image) through a smart application running on the cellphone for validation of the RDT, as well as for automated reading of its diagnostic result. The same smart application then transmits the resulting data, together with the RDT images and other related information (e.g., demographic data), to a central server, which presents the diagnostic results on a world map through geo-tagging. This dynamic spatio-temporal map of various RDT results can then be viewed and shared using internet browsers or through the same cellphone application. We tested this platform using malaria, tuberculosis (TB) and HIV RDTs by installing it on both Android-based smartphones and an iPhone. Providing real-time spatio-temporal statistics for the prevalence of various infectious diseases, this smart RDT reader platform running on cellphones might assist healthcare professionals and policymakers to track emerging epidemics worldwide and help epidemic preparedness. PMID:22596243

  17. Using Combined Diagnostic Test Results to Hindcast Trends of Infection from Cross-Sectional Data.

    PubMed

    Rydevik, Gustaf; Innocent, Giles T; Marion, Glenn; Davidson, Ross S; White, Piran C L; Billinis, Charalambos; Barrow, Paul; Mertens, Peter P C; Gavier-Widén, Dolores; Hutchings, Michael R

    2016-07-01

    Infectious disease surveillance is key to limiting the consequences from infectious pathogens and maintaining animal and public health. Following the detection of a disease outbreak, a response in proportion to the severity of the outbreak is required. It is thus critical to obtain accurate information concerning the origin of the outbreak and its forward trajectory. However, there is often a lack of situational awareness that may lead to over- or under-reaction. There is a widening range of tests available for detecting pathogens, with typically different temporal characteristics, e.g. in terms of when peak test response occurs relative to time of exposure. We have developed a statistical framework that combines response level data from multiple diagnostic tests and is able to 'hindcast' (infer the historical trend of) an infectious disease epidemic. Assuming diagnostic test data from a cross-sectional sample of individuals infected with a pathogen during an outbreak, we use a Bayesian Markov Chain Monte Carlo (MCMC) approach to estimate time of exposure, and the overall epidemic trend in the population prior to the time of sampling. We evaluate the performance of this statistical framework on simulated data from epidemic trend curves and show that we can recover the parameter values of those trends. We also apply the framework to epidemic trend curves taken from two historical outbreaks: a bluetongue outbreak in cattle, and a whooping cough outbreak in humans. Together, these results show that hindcasting can estimate the time since infection for individuals and provide accurate estimates of epidemic trends, and can be used to distinguish whether an outbreak is increasing or past its peak. We conclude that if temporal characteristics of diagnostics are known, it is possible to recover epidemic trends of both human and animal pathogens from cross-sectional data collected at a single point in time. PMID:27384712

  18. Using Combined Diagnostic Test Results to Hindcast Trends of Infection from Cross-Sectional Data

    PubMed Central

    Rydevik, Gustaf; Innocent, Giles T.; Marion, Glenn; White, Piran C. L.; Billinis, Charalambos; Barrow, Paul; Mertens, Peter P. C.; Gavier-Widén, Dolores; Hutchings, Michael R.

    2016-01-01

    Infectious disease surveillance is key to limiting the consequences from infectious pathogens and maintaining animal and public health. Following the detection of a disease outbreak, a response in proportion to the severity of the outbreak is required. It is thus critical to obtain accurate information concerning the origin of the outbreak and its forward trajectory. However, there is often a lack of situational awareness that may lead to over- or under-reaction. There is a widening range of tests available for detecting pathogens, with typically different temporal characteristics, e.g. in terms of when peak test response occurs relative to time of exposure. We have developed a statistical framework that combines response level data from multiple diagnostic tests and is able to ‘hindcast’ (infer the historical trend of) an infectious disease epidemic. Assuming diagnostic test data from a cross-sectional sample of individuals infected with a pathogen during an outbreak, we use a Bayesian Markov Chain Monte Carlo (MCMC) approach to estimate time of exposure, and the overall epidemic trend in the population prior to the time of sampling. We evaluate the performance of this statistical framework on simulated data from epidemic trend curves and show that we can recover the parameter values of those trends. We also apply the framework to epidemic trend curves taken from two historical outbreaks: a bluetongue outbreak in cattle, and a whooping cough outbreak in humans. Together, these results show that hindcasting can estimate the time since infection for individuals and provide accurate estimates of epidemic trends, and can be used to distinguish whether an outbreak is increasing or past its peak. We conclude that if temporal characteristics of diagnostics are known, it is possible to recover epidemic trends of both human and animal pathogens from cross-sectional data collected at a single point in time. PMID:27384712

  19. Epidemiology and diagnostic testing for hemochromatosis and iron overload.

    PubMed

    Adams, P C

    2015-05-01

    Hemochromatosis is the most common genetic disease in northern European populations. Body iron stores progressively increase in most patients, which can lead to cirrhosis of the liver, hepatocellular carcinoma, heart failure, arthritis, and pigmentation. Simple blood tests such as the serum ferritin and transferrin saturation are useful to suggest the diagnosis which can be confirmed in most cases with a simple genetic test for the C282Y mutation of the HFE gene. However, these blood tests are often misinterpreted and there are rare patients with iron overload without HFE mutations. A diagnostic approach is presented based on a large referral practice and a population-based study (HEIRS) which screened for iron overload in 101,168 participants. PMID:25976957

  20. Validation of Three Early Ejaculation Diagnostic Tools: A Composite Measure Is Accurate and More Adequate for Diagnosis by Updated Diagnostic Criteria

    PubMed Central

    Jern, Patrick; Piha, Juhana; Santtila, Pekka

    2013-01-01

    Purpose To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes. Materials and Methods Data from 148 diagnosed early ejaculation patients (Mage = 42.8) and 892 controls (Mage = 33.1 years) from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation). Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1) responses regarding the situation before starting pharmacological treatment and 2) responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls. Results All instruments had very good precision (Areas under the Curve ranging from .93-.98). A new five-item instrument (named CHecklist for Early Ejaculation Symptoms – CHEES) consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R2 range .51-.79 for backwards/forwards logistic regression) equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance). Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria. Conclusions All three screening tools had good validity. A new 5-item diagnostic tool (CHEES) based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three tools, but is

  1. Rapid Diagnostic Tests for Dengue Virus Infection in Febrile Cambodian Children: Diagnostic Accuracy and Incorporation into Diagnostic Algorithms

    PubMed Central

    Carter, Michael J.; Emary, Kate R.; Moore, Catherine E.; Parry, Christopher M.; Sona, Soeng; Putchhat, Hor; Reaksmey, Sin; Chanpheaktra, Ngoun; Stoesser, Nicole; Dobson, Andrew D. M.; Day, Nicholas P. J.; Kumar, Varun; Blacksell, Stuart D.

    2015-01-01

    Background Dengue virus (DENV) infection is prevalent across tropical regions and may cause severe disease. Early diagnosis may improve supportive care. We prospectively assessed the Standard Diagnostics (Korea) BIOLINE Dengue Duo DENV rapid diagnostic test (RDT) to NS1 antigen and anti-DENV IgM (NS1 and IgM) in children in Cambodia, with the aim of improving the diagnosis of DENV infection. Methodology and principal findings We enrolled children admitted to hospital with non-localised febrile illnesses during the 5-month DENV transmission season. Clinical and laboratory variables, and DENV RDT results were recorded at admission. Children had blood culture and serological and molecular tests for common local pathogens, including reference laboratory DENV NS1 antigen and IgM assays. 337 children were admitted with non-localised febrile illness over 5 months. 71 (21%) had DENV infection (reference assay positive). Sensitivity was 58%, and specificity 85% for RDT NS1 and IgM combined. Conditional inference framework analysis showed the additional value of platelet and white cell counts for diagnosis of DENV infection. Variables associated with diagnosis of DENV infection were not associated with critical care admission (70 children, 21%) or mortality (19 children, 6%). Known causes of mortality were melioidosis (4), other sepsis (5), and malignancy (1). 22 (27%) children with a positive DENV RDT had a treatable other infection. Conclusions The DENV RDT had low sensitivity for the diagnosis of DENV infection. The high co-prevalence of infections in our cohort indicates the need for a broad microbiological assessment of non-localised febrile illness in these children. PMID:25710684

  2. Using Three-Tier Diagnostic Test to Assess Students' Misconceptions of States of Matter

    ERIC Educational Resources Information Center

    Kirbulut, Zubeyde Demet; Geban, Omer

    2014-01-01

    This study involves the development of a three-tier diagnostic test to measure high school students' understanding of states of matter concepts. The States of Matter Diagnostic Test (SMDT) is a 19-item three-tier diagnostic test consisting of three-tier items for assessing students' understanding of states of matter concepts. The SMDT…

  3. 30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What do I submit if my casing diagnostic test...-Completion Operations Casing Pressure Management § 250.525 What do I submit if my casing diagnostic test requires action? Within 14 days after you perform a casing diagnostic test requiring action under §...

  4. Digital test signal generation: An accurate SNR calibration approach for the DSN

    NASA Technical Reports Server (NTRS)

    Gutierrez-Luaces, B. O.

    1991-01-01

    A new method of generating analog test signals with accurate signal to noise ratios (SNRs) is described. High accuracy will be obtained by simultaneous generation of digital noise and signal spectra at a given baseband or bandpass limited bandwidth. The digital synthesis will provide a test signal embedded in noise with the statistical properties of a stationary random process. Accuracy will only be dependent on test integration time with a limit imposed by the system quantization noise (expected to be 0.02 dB). Setability will be approximately 0.1 dB. The first digital SNR generator to provide baseband test signals is being built and will be available in early 1991.

  5. TF-Test Modified: New Diagnostic Tool for Human Enteroparasitosis.

    PubMed

    Carvalho, Juliana Barboza de; Santos, Bianca Martins Dos; Gomes, Jancarlo Ferreira; Suzuki, Celso Tetsuo Nagase; Hoshino Shimizu, Sumie; Falcão, Alexandre Xavier; Pierucci, Julia Cestari; Matos, Lucas Vinicius Shigaki de; Bresciani, Katia Denise Saraiva

    2016-07-01

    Intestinal parasitosis is highly prevalent worldwide, being among the main causes of illness and death in humans. Currently, laboratory diagnosis of the intestinal parasites is accomplished through manual technical procedures, mostly developed decades ago, which justifies the development of more sensitive and practical techniques. Therefore, the main objective of this study was to develop, evaluate, and validate a new parasitological technique referred to as TF-Test Modified, in comparison to three conventional parasitological techniques: TF-Test Conventional; Rugai, Mattos & Brisola; and Helm Test/Kato-Katz. For this realization, we collected stool samples from 457 volunteers located in endemic areas of Campinas, São Paulo, Brazil, and statistically compared the techniques. Intestinal protozoa and helminths were detected qualitatively in 42.23% (193/457) of the volunteers by TF-Test Modified technique, against 36.76% (168/457) by TF-Test Conventional, 5.03% (23/457) by Helm Test/Kato-Katz, and 4.16% (19/457) by Rugai, Mattos & Brisola. Furthermore, the new technique presented "almost perfect kappa" agreement in all evaluated parameters with 95% (P < 0.05) of estimation. The current study showed that the TF-Test Modified technique can be comprehensively used in the diagnosis of intestinal protozoa and helminths, and its greater diagnostic sensitivity should help improving the quality of laboratory diagnosis, population surveys, and control of intestinal parasites. PMID:25968065

  6. New Rapid Diagnostic Tests for Neisseria meningitidis Serogroups A, W135, C, and Y

    PubMed Central

    Chanteau, Suzanne; Dartevelle, Sylvie; Mahamane, Ali Elhadj; Djibo, Saacou; Boisier, Pascal; Nato, Farida

    2006-01-01

    Background Outbreaks of meningococcal meningitis (meningitis caused by Neisseria meningitidis) are a major public health concern in the African “meningitis belt,” which includes 21 countries from Senegal to Ethiopia. Of the several species that can cause meningitis, N. meningitidis is the most important cause of epidemics in this region. In choosing the appropriate vaccine, accurate N. meningitidis serogroup determination is key. To this end, we developed and evaluated two duplex rapid diagnostic tests (RDTs) for detecting N. meningitidis polysaccharide (PS) antigens of several important serogroups. Methods and Findings Mouse monoclonal IgG antibodies against N. meningitidis PS A, W135/Y, Y, and C were used to develop two immunochromatography duplex RDTs, RDT1 (to detect serogroups A and W135/Y) and RDT2 (to detect serogroups C and Y). Standards for Reporting of Diagnostic Accuracy criteria were used to determine diagnostic accuracy of RDTs on reference strains and cerebrospinal fluid (CSF) samples using culture and PCR, respectively, as reference tests. The cutoffs were 105 cfu/ml for reference strains and 1 ng/ml for PS. Sensitivities and specificities were 100% for reference strains, and 93.8%–100% for CSF serogroups A, W135, and Y in CSF. For CSF serogroup A, the positive and negative likelihood ratios (± 95% confidence intervals [CIs]) were 31.867 (16.1–63.1) and 0.065 (0.04–0.104), respectively, and the diagnostic odds ratio (± 95% CI) was 492.9 (207.2–1,172.5). For CSF serogroups W135 and Y, the positive likelihood ratio was 159.6 (51.7–493.3) Both RDTs were equally reliable at 25 °C and 45 °C. Conclusions These RDTs are important new bedside diagnostic tools for surveillance of meningococcus serogroups A and W135, the two serogroups that are responsible for major epidemics in Africa. PMID:16953658

  7. Noninvasive prenatal screening or advanced diagnostic testing: caveat emptor.

    PubMed

    Evans, Mark I; Wapner, Ronald J; Berkowitz, Richard L

    2016-09-01

    The past few years have seen extraordinary advances in prenatal genetic practice led by 2 major technological advances; next-generation sequencing of cell-free DNA in the maternal plasma to noninvasively identify fetal chromosome abnormalities, and microarray analysis of chorionic villus sampling and amniotic fluid samples, resulting in increased cytogenetic resolution. Noninvasive prenatal screening of cell-free DNA has demonstrated sensitivity and specificity for trisomy 21 superior to all previous screening approaches with slightly lower performance for other common aneuploidies. These tests have rapidly captured an increasing market share, with substantial reductions in the number of chorionic villus sampling and amniocentesis performed suggesting that physicians and patients regard such screening approaches as an equivalent replacement for diagnostic testing. Simultaneously, many clinical programs have noted significant decreases in patient counseling. In 2012 the Eunice Kennedy Shriver National Institute of Child Health and Human Development funded a blinded comparison of karyotype with the emerging technology of array comparative genomic hybridization showing that in patients with a normal karyotype, 2.5% had a clinically relevant microdeletion or duplication identified. In pregnancies with an ultrasound-detected structural anomaly, 6% had an incremental finding, and of those with a normal scan, 1.6% had a copy number variant. For patients of any age with a normal ultrasound and karyotype, the chance of a pathogenic copy number variant is greater than 1%, similar to the age-related risk of aneuploidy in the fetus of a 38 year old. This risk is 4-fold higher than the risk of trisomy 21 in a woman younger than 30 years and 5- to 10-fold higher than the present accepted risk of a diagnostic procedure. Based on this, we contend that every patient, regardless of her age, be educated about these risks and offered the opportunity to have a diagnostic procedure with

  8. Fan Noise Source Diagnostic Test: Rotor Alone Aerodynamic Performance Results

    NASA Technical Reports Server (NTRS)

    Hughes, Christopher E.; Jeracki, Robert J.; Woodward, Richard P.; Miller, Christopher J.

    2005-01-01

    The aerodynamic performance of an isolated fan or rotor alone model was measured in the NASA Glenn Research Center 9- by 15- Foot Low Speed Wind Tunnel as part of the Fan Broadband Source Diagnostic Test conducted at NASA Glenn. The Source Diagnostic Test was conducted to identify the noise sources within a wind tunnel scale model of a turbofan engine and quantify their contribution to the overall system noise level. The fan was part of a 1/5th scale model representation of the bypass stage of a current technology turbofan engine. For the rotor alone testing, the fan and nacelle, including the inlet, external cowl, and fixed area fan exit nozzle, were modeled in the test hardware; the internal outlet guide vanes located behind the fan were removed. Without the outlet guide vanes, the velocity at the nozzle exit changes significantly, thereby affecting the fan performance. As part of the investigation, variations in the fan nozzle area were tested in order to match as closely as possible the rotor alone performance with the fan performance obtained with the outlet guide vanes installed. The fan operating performance was determined using fixed pressure/temperature combination rakes and the corrected weight flow. The performance results indicate that a suitable nozzle exit was achieved to be able to closely match the rotor alone and fan/outlet guide vane configuration performance on the sea level operating line. A small shift in the slope of the sea level operating line was measured, which resulted in a slightly higher rotor alone fan pressure ratio at take-off conditions, matched fan performance at cutback conditions, and a slightly lower rotor alone fan pressure ratio at approach conditions. However, the small differences in fan performance at all fan conditions were considered too small to affect the fan acoustic performance.

  9. Diagnostic Tests for Entering and Departing Undergraduate Students

    NASA Astrophysics Data System (ADS)

    Waltham, Chris; Kotlicki, A.

    2006-12-01

    A diagnostic test administered at the start of a class should test basic concepts which are recognized as course prerequisites. The questions should not be over-packaged: e.g. students should be required to create models, rather than this being done for them each time. Students should be allowed great latitude in their answers, so we can discover what they are thinking. When administered at the end of a class the goals should be similar: testing concepts taught in the class itself and the retention of necessary concepts from previous classes. Great care has to be taken to avoid teaching to the test. In assessing an entire program, for example an undergraduate majors degree in physics, then one looks for very general skills and knowledge not specific to any one course. The purpose of an undergraduate degree in physics (or indeed any science) is to equip the students with a set of problem-solving skills and basic knowledge which can be applied in a large variety of workplace settings and to allow that student to contribute to civic society as a science-literate person. The creator of any diagnostic test should always have these big goals in mind. We have developed a set of questions which we think fulfill these criteria, yet are not specific to any particular level of science education. They have been administered to students in secondary schools across Canada, incoming first-year science students and final-year physics students at the University of British Columbia. The results will be presented.

  10. Diagnostic testing of the emergency department patient with chest pain.

    PubMed

    Zalenski, R J; Shamsa, F H

    1998-07-01

    In evaluating patients with nondiagnostic initial clinical or electrocardiogram (ECG) findings for acute cardiac ischemia, continuous 12-lead ECG monitoring increases the detection of diagnostic ECG findings, including ST-segment elevation, in patients awaiting hospital admission. Rest scanning with technitium-99m sestamibi is able to risk stratify low-moderate risk patients into lower and higher risk groups for cardiac events. Caveats include the reduced sensitivity of scanning of patients who are pain free and the need for follow-up exercise scans for patients free of perfusion defects at rest. Cardiac markers, particularly the troponins, show great promise for the detection of a larger part of the spectrum of acute coronary syndromes in the emergency department, including patients with minimal myocardial damage and higher risk for short-term death and nonfatal acute myocardial infarction. Accelerated diagnostic protocols using serial testing with cardiac markers, ECGs and then provocative testing over a 14-hour period, are feasible, safe, and cost-effective. PMID:10091020

  11. The Astronomy Diagnostic Test: Past, Present and Future

    NASA Astrophysics Data System (ADS)

    Deming, G. L.; Hufnagel, B. R.

    2000-12-01

    During 1998, the Collaboration for Astronomy Education Research (Adams, Adrian, Brick, Deming, Hufnagel, Slater, and Zeilik) developed a content-based diagnostic test for undergraduate non-science majors taking their first introductory level astronomy course. Student interviews and written feedback were used to construct a series of questions reflecting the students' natural language and with distractors (wrong answers) that mirror commonly held misconceptions. Version 1.9 of the Astronomy Diagnostic Test (ADT) was administered during Spring 1999 by volunteers teaching astronomy at 22 institutions across the United States. Minor modifications were made and Version 2.0 was released on June 21, 1999. The ADT 2.0 currently is available to the astronomical community through two websites and we continue to collect pretest/posttest results. Award of an NSF Small Grant for Exploratory Research has enabled us to work with a team of education researchers at the Ontario Institute for Studies in Education. Our database will be subjected to a statistical analysis in order to establish reliability of ADT 2.0. In addition, content, face, and construct validity are being examined. If you are teaching an introductory astronomy course aimed at non-science majors for Spring 2001, your class can be part of this project. We are looking for volunteers! We are also interested in hearing your ideas for a "next-generation" version of the ADT. Funding provided by NSF grant REC-0089239

  12. Reactor protection system with automatic self-testing and diagnostic

    DOEpatents

    Gaubatz, D.C.

    1996-12-17

    A reactor protection system is disclosed having four divisions, with quad redundant sensors for each scram parameter providing input to four independent microprocessor-based electronic chassis. Each electronic chassis acquires the scram parameter data from its own sensor, digitizes the information, and then transmits the sensor reading to the other three electronic chassis via optical fibers. To increase system availability and reduce false scrams, the reactor protection system employs two levels of voting on a need for reactor scram. The electronic chassis perform software divisional data processing, vote 2/3 with spare based upon information from all four sensors, and send the divisional scram signals to the hardware logic panel, which performs a 2/4 division vote on whether or not to initiate a reactor scram. Each chassis makes a divisional scram decision based on data from all sensors. Automatic detection and discrimination against failed sensors allows the reactor protection system to automatically enter a known state when sensor failures occur. Cross communication of sensor readings allows comparison of four theoretically ``identical`` values. This permits identification of sensor errors such as drift or malfunction. A diagnostic request for service is issued for errant sensor data. Automated self test and diagnostic monitoring, sensor input through output relay logic, virtually eliminate the need for manual surveillance testing. This provides an ability for each division to cross-check all divisions and to sense failures of the hardware logic. 16 figs.

  13. Reactor protection system with automatic self-testing and diagnostic

    DOEpatents

    Gaubatz, Donald C.

    1996-01-01

    A reactor protection system having four divisions, with quad redundant sensors for each scram parameter providing input to four independent microprocessor-based electronic chassis. Each electronic chassis acquires the scram parameter data from its own sensor, digitizes the information, and then transmits the sensor reading to the other three electronic chassis via optical fibers. To increase system availability and reduce false scrams, the reactor protection system employs two levels of voting on a need for reactor scram. The electronic chassis perform software divisional data processing, vote 2/3 with spare based upon information from all four sensors, and send the divisional scram signals to the hardware logic panel, which performs a 2/4 division vote on whether or not to initiate a reactor scram. Each chassis makes a divisional scram decision based on data from all sensors. Automatic detection and discrimination against failed sensors allows the reactor protection system to automatically enter a known state when sensor failures occur. Cross communication of sensor readings allows comparison of four theoretically "identical" values. This permits identification of sensor errors such as drift or malfunction. A diagnostic request for service is issued for errant sensor data. Automated self test and diagnostic monitoring, sensor input through output relay logic, virtually eliminate the need for manual surveillance testing. This provides an ability for each division to cross-check all divisions and to sense failures of the hardware logic.

  14. Diagnostic potential of ancillary molecular testing in differentiation of benign and malignant thyroid nodules.

    PubMed

    Bhatia, Parisha; Deniwar, Ahmed; Friedlander, Paul; Aslam, Rizwan; Kandil, Emad

    2015-03-01

    Fine needle aspiration (FNA) cytology, being the mainstay to diagnose thyroid nodules, does not provide definitive results in a subset of patients. The use of molecular markers testing has been described as a useful aid in differentiation of thyroid nodules that present with an indeterminate cytodiagnosis. Molecular tests, such as the Afirma gene classifier, mutational assay and immunohistochemical markers have been increasingly used to further increase the accuracy and defer unnecessary surgeries for benign thyroid nodules. However, in light of the current literature, their emerging roles in clinical practice are limited due to financial and technical limitations. Nevertheless, their synergistic implementation can predict the risk of malignancy and yield an accurate diagnosis. This review discusses the clinical utility of various molecular tests done on FNA indeterminate nodules to avoid diagnostic thyroidectomies and warrant the need of future multi-Institutional studies. PMID:25750270

  15. Culture-independent diagnostic testing: have we opened Pandora's box for good?

    PubMed

    Janda, J Michael; Abbott, Sharon A

    2014-11-01

    The ability to accurately and quickly identify microbial agents associated with infectious diseases has been a longstanding and continuous goal of diagnostic microbiology laboratories. Over the course of several decades, technology and testing methodologies in this field have gradually evolved from traditional- or classic-based culture and identification approaches to antigen capture systems and more molecular-oriented applications. Recently, these molecular-based applications have signaled a new era in clinical diagnostic microbiology with the commercial introduction of culture-independent diagnostic testing (CIDT) systems. The first major commercial venture into the CIDT arena involves the detection of acute bacterial gastroenteritis. Several commercial products are now on the market globally with at least 4 Food and Drug Administration approved since January of 2013. These new systems offer the direct detection of a variety of enteropathogens quickly without the need for traditional culture. In Greek mythology, Pandora opened a "jar" or "box" out of curiosity thereby releasing all of humanity's evils most notably diseases and plagues according to Hesiod's Theogony. While not ill-intentioned the only thing left in the box was Hope. PMID:25200256

  16. Testing for cattle allergy: modified diagnostic cutoff levels improve sensitivity in symptomatic claw trimmers

    PubMed Central

    Dik, Natalja; Hallier, Ernst; Zuberbier, Torsten; Bergmann, Karl-Christian

    2010-01-01

    Background The diagnosis of cattle-related sensitization is complicated by the variability and complexity of cattle allergen extracts. Objective To evaluate a modified diagnostic procedure leading to more accurate results especially in the early phase of sensitization. Methods We tested 27 claw trimmers with and 65 without cattle-related symptoms using two commercially available cattle allergen extracts. We also used a self-prepared cattle allergen mix designed to represent the full spectrum of cattle allergens from a typical agricultural workplace. Results More than 50% of symptomatic claw trimmers showed negative test results with commercial extracts and a sensitization cutoff point of 0.35 kU/l. In contrast, with the self-prepared cattle allergen mix, positive results were observed for almost all of them. Evaluating the results of the commercial test kits at different cutoff levels, we found an ideal cutoff point to improve the sensitivity at 0.2 kU/l. Conclusion Additional tests with self-made cattle hair extracts can help to bridge the diagnostic gap seen in patients showing cattle-related symptoms, but negative results in commercially available tests. For early-stage sensitization screening, we propose to lower the cutoff level indicating sensitization to 0.2 kU/l. PMID:20658147

  17. Accurate Cold-Test Model of Helical TWT Slow-Wave Circuits

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.; Dayton, J. A., Jr.

    1998-01-01

    Recently, a method has been established to accurately calculate cold-test data for helical slow-wave structures using the three-dimensional (3-D) electromagnetic computer code, MAFIA. Cold-test parameters have been calculated for several helical traveling-wave tube (TWT) slow-wave circuits possessing various support rod configurations, and results are presented here showing excellent agreement with experiment. The helical models include tape thickness, dielectric support shapes and material properties consistent with the actual circuits. The cold-test data from this helical model can be used as input into large-signal helical TWT interaction codes making it possible, for the first time, to design a complete TWT via computer simulation.

  18. Accurate Cold-Test Model of Helical TWT Slow-Wave Circuits

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.; Dayton, James A., Jr.

    1998-01-01

    Recently, a method has been established to accurately calculate cold-test data for helical slow-wave structures using the three-dimensional (3-D) electromagnetic computer code, MAxwell's equations by the Finite Integration Algorithm (MAFIA). Cold-test parameters have been calculated for several helical traveLing-wave tube (TWT) slow-wave circuits possessing various support rod configurations, and results are presented here showing excellent agreement with experiment. The helical models include tape thickness, dielectric support shapes and material properties consistent with the actual circuits. The cold-test data from this helical model can be used as input into large-signal helical TWT interaction codes making It possible, for the first time, to design complete TWT via computer simulation.

  19. Accurate Cold-Test Model of Helical TWT Slow-Wave Circuits

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.; Dayton, James A., Jr.

    1997-01-01

    Recently, a method has been established to accurately calculate cold-test data for helical slow-wave structures using the three-dimensional electromagnetic computer code, MAFIA. Cold-test parameters have been calculated for several helical traveling-wave tube (TWT) slow-wave circuits possessing various support rod configurations, and results are presented here showing excellent agreement with experiment. The helical models include tape thickness, dielectric support shapes and material properties consistent with the actual circuits. The cold-test data from this helical model can be used as input into large-signal helical TWT interaction codes making it possible, for the first time, to design a complete TWT via computer simulation.

  20. A powerful test of independent assortment that determines genome-wide significance quickly and accurately

    PubMed Central

    Stewart, W C L; Hager, V R

    2016-01-01

    In the analysis of DNA sequences on related individuals, most methods strive to incorporate as much information as possible, with little or no attention paid to the issue of statistical significance. For example, a modern workstation can easily handle the computations needed to perform a large-scale genome-wide inheritance-by-descent (IBD) scan, but accurate assessment of the significance of that scan is often hindered by inaccurate approximations and computationally intensive simulation. To address these issues, we developed gLOD—a test of co-segregation that, for large samples, models chromosome-specific IBD statistics as a collection of stationary Gaussian processes. With this simple model, the parametric bootstrap yields an accurate and rapid assessment of significance—the genome-wide corrected P-value. Furthermore, we show that (i) under the null hypothesis, the limiting distribution of the gLOD is the standard Gumbel distribution; (ii) our parametric bootstrap simulator is approximately 40 000 times faster than gene-dropping methods, and it is more powerful than methods that approximate the adjusted P-value; and, (iii) the gLOD has the same statistical power as the widely used maximum Kong and Cox LOD. Thus, our approach gives researchers the ability to determine quickly and accurately the significance of most large-scale IBD scans, which may contain multiple traits, thousands of families and tens of thousands of DNA sequences. PMID:27245422

  1. A powerful test of independent assortment that determines genome-wide significance quickly and accurately.

    PubMed

    Stewart, W C L; Hager, V R

    2016-08-01

    In the analysis of DNA sequences on related individuals, most methods strive to incorporate as much information as possible, with little or no attention paid to the issue of statistical significance. For example, a modern workstation can easily handle the computations needed to perform a large-scale genome-wide inheritance-by-descent (IBD) scan, but accurate assessment of the significance of that scan is often hindered by inaccurate approximations and computationally intensive simulation. To address these issues, we developed gLOD-a test of co-segregation that, for large samples, models chromosome-specific IBD statistics as a collection of stationary Gaussian processes. With this simple model, the parametric bootstrap yields an accurate and rapid assessment of significance-the genome-wide corrected P-value. Furthermore, we show that (i) under the null hypothesis, the limiting distribution of the gLOD is the standard Gumbel distribution; (ii) our parametric bootstrap simulator is approximately 40 000 times faster than gene-dropping methods, and it is more powerful than methods that approximate the adjusted P-value; and, (iii) the gLOD has the same statistical power as the widely used maximum Kong and Cox LOD. Thus, our approach gives researchers the ability to determine quickly and accurately the significance of most large-scale IBD scans, which may contain multiple traits, thousands of families and tens of thousands of DNA sequences. PMID:27245422

  2. Performance of rapid influenza diagnostic testing in outbreak settings.

    PubMed

    Peci, Adriana; Winter, Anne-Luise; King, Eddie-Chong; Blair, Joanne; Gubbay, Jonathan B

    2014-12-01

    Rapid influenza diagnostic tests (RIDTs) may be useful during institutional respiratory disease outbreaks to identify influenza and enable antivirals to be rapidly administered to patients and for the prophylactic treatment of those exposed to the virus but not yet symptomatic. The performance of RIDTs at the outbreak level is not well documented in the literature. This study aimed to evaluate the performance of RIDTs in comparison with that of real-time reverse transcription (rRT)-PCR in the context of institutional respiratory disease outbreaks. This study included outbreak-related respiratory specimens tested for influenza virus at Public Health Ontario Laboratories by both RIDT and rRT-PCR, from 1 September 2010 to 30 April 2013. At the outbreak level, performance testing of RIDTs compared to rRT-PCR for the detection of any influenza virus type demonstrated an overall sensitivity of 76.5%, a specificity of 99.7%, a positive predictive value (PPV) of 99.5%, and a negative predictive value of 85.3%. Because of their high specificity and PPV, even outside of the influenza season, RIDTs can play a role in screening for influenza virus in outbreaks and instituting antiviral therapy in a timely manner when positive. RIDTs can also be useful in remote settings where molecular virology testing is not easily accessible. Suboptimal sensitivity of RIDTs can be addressed by the use of molecular testing. PMID:25320225

  3. Performance of Rapid Influenza Diagnostic Testing in Outbreak Settings

    PubMed Central

    Winter, Anne-Luise; King, Eddie-Chong; Blair, Joanne; Gubbay, Jonathan B.

    2014-01-01

    Rapid influenza diagnostic tests (RIDTs) may be useful during institutional respiratory disease outbreaks to identify influenza and enable antivirals to be rapidly administered to patients and for the prophylactic treatment of those exposed to the virus but not yet symptomatic. The performance of RIDTs at the outbreak level is not well documented in the literature. This study aimed to evaluate the performance of RIDTs in comparison with that of real-time reverse transcription (rRT)-PCR in the context of institutional respiratory disease outbreaks. This study included outbreak-related respiratory specimens tested for influenza virus at Public Health Ontario Laboratories by both RIDT and rRT-PCR, from 1 September 2010 to 30 April 2013. At the outbreak level, performance testing of RIDTs compared to rRT-PCR for the detection of any influenza virus type demonstrated an overall sensitivity of 76.5%, a specificity of 99.7%, a positive predictive value (PPV) of 99.5%, and a negative predictive value of 85.3%. Because of their high specificity and PPV, even outside of the influenza season, RIDTs can play a role in screening for influenza virus in outbreaks and instituting antiviral therapy in a timely manner when positive. RIDTs can also be useful in remote settings where molecular virology testing is not easily accessible. Suboptimal sensitivity of RIDTs can be addressed by the use of molecular testing. PMID:25320225

  4. Self Diagnostic Accelerometer Testing on the C-17 Aircraft

    NASA Technical Reports Server (NTRS)

    Tokars, Roger P.; Lekki, John D.

    2013-01-01

    The self diagnostic accelerometer (SDA) developed by the NASA Glenn Research Center was tested for the first time in an aircraft engine environment as part of the Vehicle Integrated Propulsion Research (VIPR) program. The VIPR program includes testing multiple critical flight sensor technologies. One such sensor, the accelerometer, measures vibrations to detect faults in the engine. In order to rely upon the accelerometer, the health of the accelerometer must be ensured. The SDA is a sensor system designed to actively determine the accelerometer structural health and attachment condition, in addition to vibration measurements. The SDA uses a signal conditioning unit that sends an electrical chirp to the accelerometer and recognizes changes in the response due to changes in the accelerometer health and attachment condition. To demonstrate the SDAs flight worthiness and robustness, multiple SDAs were mounted and tested on a C-17 aircraft engine. The engine test conditions varied from engine off, to idle, to maximum power. The SDA attachment conditions were varied from fully tight to loose. The newly developed SDA health algorithm described herein uses cross correlation pattern recognition to discriminate a healthy from a faulty SDA. The VIPR test results demonstrate for the first.

  5. Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: limitations of diagnostic testing in the reality of diagnosis.

    PubMed

    Chandler, Clare I R; Hall-Clifford, Rachel; Asaph, Turinde; Pascal, Magnussen; Clarke, Siân; Mbonye, Anthony K

    2011-03-01

    In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis. PMID:21349623

  6. Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: Limitations of diagnostic testing in the reality of diagnosis.

    PubMed Central

    Hall-Clifford, Rachel; Asaph, Turinde; Magnussen, Pascal; Clarke, Siân; Mbonye, Anthony K

    2014-01-01

    In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis. PMID:21349623

  7. [List of diagnostic tests and procedures in leg ulcer].

    PubMed

    Spoljar, Sanja

    2013-10-01

    Many factors contribute to the pathogenesis of leg ulcer. Most patients have venous leg ulcer due to chronic venous insufficiency. Less often, patients have arterial leg ulcer resulting from peripheral arterial occlusive disease, the most common cause of which is arteriosclerosis. Leg ulcer may be of a mixed arteriovenous origin. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of diabetic leg ulcer. Other causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infectious diseases, primary skin diseases, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is based on medical history, inspection, palpation of skin temperature, palpation of arteries, fascia holes, presence and degree of edema, firm painful cords, and functional testing to assess peripheral occlusive arterial disease or identify superficial and deep venous reflux of the legs. Knowledge of differential diagnosis is essential for ensuring treatment success in patients with leg ulcer. There are many possible etiologic factors of leg ulcers and sometimes, clinical findings are similar. Additional testing should be performed, e.g., serologic testing such as blood count, C-reactive protein, HBA1c, erythrocyte sedimentation rate, differential blood count, total proteins, electrolytes, coagulation parameters, circulating immune complex, cryoglobulins, homocysteins, AT, PAI-1, APC resistance, proteins C and S, paraproteins, ANA, ENA, ANCA, dsDNA, antiphospholipid antibodies, urea, creatinine, blood lipids, vitamins and trace elements. Also, biopsy of the lesion for histopathology, direct immunofluorescence, bacteriology and mycology should be included. Other tests are Raynaud (cold stimulation) test and pathergy test. Device-based diagnostic testing should be performed for future

  8. Evolution of apnoea test in brain death diagnostics.

    PubMed

    Sołek-Pastuszka, Joanna; Saucha, Wojciech; Iwańczuk, Waldemar; Bohatyrewicz, Romuald

    2015-01-01

    The concept of brain death (BD) was initially described in 1959 and subsequently became widely accepted in the majority of countries. Nevertheless, the diagnostic guidelines for BD markedly differ, especially regarding the apnoea test (AT), a crucial element of clinical BD confirmation. The current basic guidelines recommend preoxygenation rather than disconnection from the ventilator and insertion of an oxygen insufflation catheter into the endotracheal tube. Although a properly prepared and conducted AT is relatively safe, it has to be aborted in cases of serious disturbances, such as severe cardiac arrhythmia, cardiac arrest, hypotension, hypercarbia, desaturation and tension pneumothorax. These complications may be more frequent in patients with previously existing risk factors, such as poor oxygenation, severe acidosis, hypotension and cardiac rhythm disturbances. Airway injuries can occur if the insufflation catheter is placed too deep or catheter-related obstruction of the intubation tube occurs. It is widely accepted that AT should be performed as the very last BD diagnostic procedure due to its possible lethal consequences. Reports concerning the possible pitfalls of AT and confounding situations have inspired attempts to determine the most effective and safe method of AT. The use of CPAP with oxygen supplementation is becoming highly popular. CPAP can be generated in three manners: directly by the ventilator; through the use of a CPAP valve with a reservoir; and through the use of a highly traditional T-piece system with a reservoir bag connected to distal tubing immersed in water. PMID:26401744

  9. ORNL/IAT ARMATURE DIAGNOSTICS DEMONSTRATION TEST REPORT

    SciTech Connect

    Allison, Stephen W; Cates, Michael R; Goedeke, Shawn; Crawford, M. T.; Ferraro, S. B.; Akerman, A.

    2005-03-01

    This test established feasibility for 'on the fly' temperature measurements of rail gun projectiles. In addition, an approach for projectile velocity measurement was also demonstrated. Insight was gained into other useful optical and fiberoptic diagnostic approaches. Instantaneous diagnostics could be critical for achieving further improvements in rail gun operation. They have the potential to enable design enhancements by providing information on the state of the armature and its relationship to the rail as it proceeds down the bore. To that end, the following was accomplished: (1) Optical fibers successfully delivered optical excitation and returned reflective and fluorescence signals as desired. (2) Luminescent coatings survived multiple firings--approximately 40 shots. (3) Optical triggering effectively synchronized an ultraviolet laser pulse to strike the moving armature. (4) Velocity measurements were successfully accomplished by either triggering on the armature front edge using two red diode lasers or by using a single laser and grooved marks a known distance apart on the armature surface. (5) Velocities ranged from 19 to 88 m/s. (6) Temperatures of 30 to 92 C were measured with a precision of about 2 C-: (a) This precision was achieved with a single laser shot and (b) Motion effect was observed but a methodology adequately corrected the result. The correction was only about 2 C. (7) Adequate signal-to-noise and measurement precision was achieved with a single laser shot.

  10. Reporting Diagnostic Scores in Educational Testing: Temptations, Pitfalls, and Some Solutions

    ERIC Educational Resources Information Center

    Sinharay, Sandip; Puhan, Gautam; Haberman, Shelby J.

    2010-01-01

    Diagnostic scores are of increasing interest in educational testing due to their potential remedial and instructional benefit. Naturally, the number of educational tests that report diagnostic scores is on the rise, as are the number of research publications on such scores. This article provides a critical evaluation of diagnostic score reporting…

  11. 30 CFR 250.520 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When do I have to perform a casing diagnostic... Operations Casing Pressure Management § 250.520 When do I have to perform a casing diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first observing or imposing casing...

  12. Fan Noise Source Diagnostic Test: Tone Modal Structure Results

    NASA Technical Reports Server (NTRS)

    Heidelberg, Laurence J.

    2002-01-01

    This investigation is part of a test series that was extremely comprehensive and included aerodynamic and acoustic testing of a fan stage using two different fan rotors and three different stator designs. The test series is known as the Source Diagnostic Test (SDT) and was conducted by NASA Glenn as part of the Advanced Subsonic Technology (AST) Noise Reduction Program. Tone mode measurements of one of the rotors with three different stators were made. The stator designs involve changes in vane count and sweep at constant solidity. The results of both inlet and exhaust tone mode measurements are presented in terms of mode power for both circumferential and radial mode orders. The results show benefits of vane sweep to be large, up to 13 dB in total tone power. At many conditions, the increase in power due to cutting on the rotor/stator interaction is more than offset by vane sweep. The rotor locked mode is shown as an important contributor to tone power when the blade tip speed is near and above Mach one. This is most evident in the inlet when the direct rotor field starts to cut on.

  13. A Novel Automatic Rapid Diagnostic Test Reader Platform

    PubMed Central

    Ozkan, Haydar; Kayhan, Osman Semih

    2016-01-01

    A novel automatic Rapid Diagnostic Test (RDT) reader platform is designed to analyze and diagnose target disease by using existing consumer cameras of a laptop-computer or a tablet. The RDT reader is useable with numerous lateral immunochromatographic assays and similar biomedical tests. The system has two different components, which are 3D-printed, low-cost, tiny, and compact stand and a decision program named RDT-AutoReader 2.0. The program takes the image of RDT, crops the region of interest (ROI), and extracts the features from the control end test lines to classify the results as invalid, positive, or negative. All related patient's personal information, image of ROI, and the e-report are digitally saved and transferred to the related clinician. Condition of the patient and the progress of the disease can be monitored by using the saved data. The reader platform has been tested by taking image from used cassette RDTs of rotavirus (RtV)/adenovirus (AdV) and lateral flow strip RDTs of Helicobacter pylori (H. pylori) before discarding them. The created RDT reader can also supply real-time statistics of various illnesses by using databases and Internet. This can help to inhibit propagation of contagious diseases and to increase readiness against epidemic diseases worldwide. PMID:27190549

  14. Efficient Noninferiority Testing Procedures for Simultaneously Assessing Sensitivity and Specificity of Two Diagnostic Tests.

    PubMed

    Shan, Guogen; Amei, Amei; Young, Daniel

    2015-01-01

    Sensitivity and specificity are often used to assess the performance of a diagnostic test with binary outcomes. Wald-type test statistics have been proposed for testing sensitivity and specificity individually. In the presence of a gold standard, simultaneous comparison between two diagnostic tests for noninferiority of sensitivity and specificity based on an asymptotic approach has been studied by Chen et al. (2003). However, the asymptotic approach may suffer from unsatisfactory type I error control as observed from many studies, especially in small to medium sample settings. In this paper, we compare three unconditional approaches for simultaneously testing sensitivity and specificity. They are approaches based on estimation, maximization, and a combination of estimation and maximization. Although the estimation approach does not guarantee type I error, it has satisfactory performance with regard to type I error control. The other two unconditional approaches are exact. The approach based on estimation and maximization is generally more powerful than the approach based on maximization. PMID:26366190

  15. The Astronomy Diagnostic Test National Project: Watch Out FCI!

    NASA Astrophysics Data System (ADS)

    Zeilik, Michael; Deming, Grace L.; Hufnagel, Beth

    2002-04-01

    With funding from the NSF, a multidisciplinary team at the University of New Mexico transformed “Astro 101” from a mostly descriptive to a highly-focused conceptual course based on cognitive models of adult learning. By 1996, we had developed a mature implementation, which required alternative assessment tools. One of these, an Astronomy Diagnostic Test version 1 (ADT), was based on misconceptions research in astronomy, and demonstrated large and robust gains with hundreds of participants at UNM. To improve the ADT and expand its use, we formed the Consortium for Astronomy Education Research (CAER) to develop ADT version 2, which was released in June 1999. With additional NSF funding, we kicked off the ADT National Project, which has so far included over 5000 students in the pretest and almost 4000 in the posttest. I will present selected results from ADT 1 and 2, which now has a database almost as extensive as that of the Force Concept Inventory (FCI).

  16. Detection of lipoarabinomannan as a diagnostic test for tuberculosis.

    PubMed Central

    Sada, E; Aguilar, D; Torres, M; Herrera, T

    1992-01-01

    A coagglutination technique was established for the detection of lipoarabinomannan of Mycobacterium tuberculosis in human serum samples and evaluated for its utility in the diagnosis of tuberculosis at the Instituto Nacional de Enfermedades Respiratorias in Mexico City. The test had a sensitivity of 88% in patients with sputum-smear-positive active pulmonary tuberculosis. The sensitivity in patients with active pulmonary tuberculosis negative for acid-fast bacilli in sputum was 67%. Less favorable results were obtained for patients with AIDS and tuberculosis, with a sensitivity of 57%. The specificity in control patients with lung diseases different from tuberculosis and in healthy subjects was 100%. The positive predictive value was 100%, and the negative predictive value for patients with sputum-positive active pulmonary tuberculosis was 97%. The results of this study suggest that the detection of lipoarabinomannan is an accurate test for the diagnosis of pulmonary tuberculosis. PMID:1401008

  17. Produced water toxicity tests accurately measure the produced water toxicity in marine environments?

    SciTech Connect

    Douglas, W.S.; Veil, J.A.

    1996-10-01

    U.S. Environmental Protection Agency (EPA) Region VI has issued a general permit for offshore oil and gas discharges to the Gulf of Mexico that places numerical limits on whole effluent toxicity (WEI) for produced water. Recently proposed EPA general permits for other produced water discharges in Regions VI and X also include enforceable numerical limits on WET. Clearly, the industry will be conducting extensive produced water WET testing. Unfortunately, the WET test may not accurately measure the toxicity of the chemical constituents of produced water. Rather the mortality of test organisms may be attributable to (1) the high salinity of produced water, which causes salinity shock to the organisms, or (2) an ionic imbalance caused by excesses or deficiencies of one or more of seawater`s essential ions in the test chambers. Both of these effects are likely to be mitigated in actual offshore discharge settings, where the receiving water will be seawater and substantial dilution will be probable. Thus, the additional salinity of produced water will be rapidly assimilated, and the proper marine ionic balance will be quickly restored. Regulatory authorities should be aware of these factors when interpreting WET test results.

  18. A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency.

    PubMed

    Dušková, Michaela; Šimůnková, Kateřina; Vítků, Jana; Sosvorová, Lucie; Jandíková, Hana; Pospíšilová, Hana; Šrámková, Monika; Kosák, Mikuláš; Kršek, Michal; Hána, Václav; Žánová, Magdaléna; Springer, Drahomíra; Stárka, Luboslav

    2016-01-01

    Numerous diagnostic tests are used to evaluate the hypothalamic-pituitary-adrenal axis (HPA axis). The gold standard is still considered the insulin tolerance test (ITT), but this test has many limitations. Current guidelines therefore recommend the Synacthen test first when an HPA axis insufficiency is suspected. However, the dose of Synacthen that is diagnostically most accurate and sensitive is still a matter of debate. We investigated 15 healthy men with mean/median age 27.4/26 (SD±4.8) years, and mean/median BMI (body mass index) 25.38/24.82 (SD±3.2) kg/m2. All subjects underwent 4 dynamic tests of the HPA axis, specifically 1 μg, 10 μg, and 250 μg Synacthen (ACTH) tests and an ITT. Salivary cortisol, cortisone, pregnenolone, and DHEA (dehydroepiandrosterone) were analysed using liquid chromatography-tandem mass spectrometry. During the ITT maximum salivary cortisol levels over 12.5 nmol/l were found at 60 minutes. Maximum cortisol levels in all of the Synacthen tests were higher than this; however, demonstrating that sufficient stimulation of the adrenal glands was achieved. Cortisone reacted similarly as cortisol, i.e. we did not find any change in the ratio of cortisol to cortisone. Pregnenolone and DHEA were higher during the ITT, and their peaks preceded the cortisol peak. There was no increase of pregnenolone or DHEA in any of the Synacthen tests. We demonstrate that the 10 μg Synacthen dose is sufficient stimulus for testing the HPA axis and is also a safe and cost-effective alternative. This dose also largely eliminates both false negative and false positive results. PMID:26995200

  19. Molecular and Biological Diagnostic Tests for Monitoring Benzimidazole Resistance in Human Soil-Transmitted Helminths

    PubMed Central

    Diawara, Aïssatou; Schwenkenbecher, Jan M.; Kaplan, Ray M.; Prichard, Roger K.

    2013-01-01

    In endemic countries with soil-transmitted helminths mass drug administration with albendazole or mebendazole are being implemented as a control strategy. However, it is well known in veterinary helminths that the use of the same benzimidazole drugs can place selection on the β-tubulin gene, leading to resistance. Given the concern that resistance could arise in human soil-transmitted helminths, there is an urgent need to develop accurate diagnostic tools for monitoring resistance. In this study, we developed molecular assays to detect putative resistance genetic changes in Ascaris lumbricoides, Trichuris trichiura, and hookworms, and we optimized an egg hatch assay for the canine hookworm Ancylostoma caninum and applied it to Necator americanus. Both assays were tested on field samples. The molecular assays demonstrated their reproducibility and capacity to detect the presence of worms carrying putative resistance-associated genetic changes. However, further investigations are needed to validate our molecular and biological tests on additional field isolates. PMID:23458960

  20. Molecular and biological diagnostic tests for monitoring benzimidazole resistance in human soil-transmitted helminths.

    PubMed

    Diawara, Aïssatou; Schwenkenbecher, Jan M; Kaplan, Ray M; Prichard, Roger K

    2013-06-01

    In endemic countries with soil-transmitted helminths mass drug administration with albendazole or mebendazole are being implemented as a control strategy. However, it is well known in veterinary helminths that the use of the same benzimidazole drugs can place selection on the β-tubulin gene, leading to resistance. Given the concern that resistance could arise in human soil-transmitted helminths, there is an urgent need to develop accurate diagnostic tools for monitoring resistance. In this study, we developed molecular assays to detect putative resistance genetic changes in Ascaris lumbricoides, Trichuris trichiura, and hookworms, and we optimized an egg hatch assay for the canine hookworm Ancylostoma caninum and applied it to Necator americanus. Both assays were tested on field samples. The molecular assays demonstrated their reproducibility and capacity to detect the presence of worms carrying putative resistance-associated genetic changes. However, further investigations are needed to validate our molecular and biological tests on additional field isolates. PMID:23458960

  1. SSME HPOTP post-test diagnostic system enhancement project

    NASA Technical Reports Server (NTRS)

    Bickmore, Timothy W.

    1995-01-01

    An assessment of engine and component health is routinely made after each test or flight firing of a space shuttle main engine (SSME). Currently, this health assessment is done by teams of engineers who manually review sensor data, performance data, and engine and component operating histories. Based on review of information from these various sources, an evaluation is made as to the health of each component of the SSME and the preparedness of the engine for another test or flight. The objective of this project is to further develop a computer program which automates the analysis of test data from the SSME high-pressure oxidizer turbopump (HPOTP) in order to detect and diagnose anomalies. This program fits into a larger system, the SSME Post-Test Diagnostic System (PTDS), which will eventually be extended to assess the health and status of most SSME components on the basis of test data analysis. The HPOTP module is an expert system, which uses 'rules-of-thumb' obtained from interviews with experts from NASA Marshall Space Flight Center (MSFC) to detect and diagnose anomalies. Analyses of the raw test data are first performed using pattern recognition techniques which result in features such as spikes, shifts, peaks, and drifts being detected and written to a database. The HPOTP module then looks for combination of these features which are indicative of known anomalies, using the rules gathered from the turbomachinery experts. Results of this analysis are then displayed via a graphical user interface which provides ranked lists of anomalies and observations by engine component, along with supporting data plots for each.

  2. Mutual Information Item Selection Method in Cognitive Diagnostic Computerized Adaptive Testing with Short Test Length

    ERIC Educational Resources Information Center

    Wang, Chun

    2013-01-01

    Cognitive diagnostic computerized adaptive testing (CD-CAT) purports to combine the strengths of both CAT and cognitive diagnosis. Cognitive diagnosis models aim at classifying examinees into the correct mastery profile group so as to pinpoint the strengths and weakness of each examinee whereas CAT algorithms choose items to determine those…

  3. Birth of the Astronomy Diagnostic Test: Prototest Evolution

    NASA Astrophysics Data System (ADS)

    Zeilik, M.

    2001-12-01

    In 1992, with funding by the National Science Foundation, a multidisciplinary research team at the University of New Mexico accreted to transform a "traditional Astro 101" course into a conceptually-oriented one. The team consisted of people from astronomy, cognitive psychology, and education. Our aim was to improve the learning environment in a large "lecture" course based on current cognitive models of adult learning. We demanded that our effort be research-based, but found little in the literature to assist us; for example, no field-tested assessment tools that would measure appropiate outcomes had been developed in higher education. From prior research at lower grades, we saw the need of a valid and reliable "misconceptions" test. We also desired to tap into higher level conceptual learning, and so developed concept map assessments to measure acquisition of the "Big Picture" in astronomy. These "misconceptions measures" were protoversions of the Astronomy Diagnostic Test (ADT) that gained in structure and usefulness over four semesters involving hundreds of students. I will outline our methodology to develop the ADT in a bootstrap way, its basis as a learning tool, and its correlation with other assessments (especially the concept maps) and achievement in the UNM "Astro 101" course. This work was supported in part by NSF DUE grants 9253983 and 9981155.

  4. Systematic review of diagnostic tests for vaginal trichomoniasis.

    PubMed Central

    Patel, S R; Wiese, W; Patel, S C; Ohl, C; Byrd, J C; Estrada, C A

    2000-01-01

    OBJECTIVE: To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis. METHODS: We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture. RESULTS: The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM. CONCLUSIONS: The sensitivity and specificity of tests to diagnose trichomoniasis vary widely. PMID:11220487

  5. Diagnostic performance of the "MESACUP anti-Skin profile TEST".

    PubMed

    Horváth, Orsolya N; Varga, Rita; Kaneda, Makoto; Schmidt, Enno; Ruzicka, Thomas; Sárdy, Miklós

    2016-02-01

    The "MESACUP anti-Skin profile TEST" is a new, commercially available ELISA kit to detect circulating IgG autoantibodies against desmoglein 1, desmoglein 3, BP180, BP230, and type VII collagen, both simultaneously and more rapidly than previous assays. The aim of this study was to evaluate the diagnostic accuracy of this kit for the diagnosis of pemphigus foliaceus, pemphigus vulgaris, bullous pemphigoid and epidermolysis bullosa acquisita. Dual-centre retrospective study in which 138 patients with autoimmune blistering diseases were compared to 40 controls Using the MESACUP anti-Skin profile TEST, both sensitivities and specificities for desmoglein 1, desmoglein 3, BP180, BP230, and type VII collagen autoantibodies were similar to those obtained using previous, specific ELISA systems and 88% of the results were concordant without any significant difference. The MESACUP anti-Skin profile TEST had a similar performance to previously produced ELISA systems. The novel kit can be used for rapid diagnosis of most common autoimmune blistering diseases and is especially suitable for identifying overlapping disorders. PMID:26771500

  6. A new algorithm for generating highly accurate benchmark solutions to transport test problems

    SciTech Connect

    Azmy, Y.Y.

    1997-06-01

    We present a new algorithm for solving the neutron transport equation in its discrete-variable form. The new algorithm is based on computing the full matrix relating the scalar flux spatial moments in all cells to the fixed neutron source spatial moments, foregoing the need to compute the angular flux spatial moments, and thereby eliminating the need for sweeping the spatial mesh in each discrete-angular direction. The matrix equation is solved exactly in test cases, producing a solution vector that is free from iteration convergence error, and subject only to truncation and roundoff errors. Our algorithm is designed to provide method developers with a quick and simple solution scheme to test their new methods on difficult test problems without the need to develop sophisticated solution techniques, e.g. acceleration, before establishing the worthiness of their innovation. We demonstrate the utility of the new algorithm by applying it to the Arbitrarily High Order Transport Nodal (AHOT-N) method, and using it to solve two of Burre`s Suite of Test Problems (BSTP). Our results provide highly accurate benchmark solutions, that can be distributed electronically and used to verify the pointwise accuracy of other solution methods and algorithms.

  7. Digital test signal generation: An accurate SNR calibration approach for the DSN

    NASA Technical Reports Server (NTRS)

    Gutierrez-Luaces, Benito O.

    1993-01-01

    In support of the on-going automation of the Deep Space Network (DSN) a new method of generating analog test signals with accurate signal-to-noise ratio (SNR) is described. High accuracy is obtained by simultaneous generation of digital noise and signal spectra at the desired bandwidth (base-band or bandpass). The digital synthesis provides a test signal embedded in noise with the statistical properties of a stationary random process. Accuracy is dependent on test integration time and limited only by the system quantization noise (0.02 dB). The monitor and control as well as signal-processing programs reside in a personal computer (PC). Commands are transmitted to properly configure the specially designed high-speed digital hardware. The prototype can generate either two data channels modulated or not on a subcarrier, or one QPSK channel, or a residual carrier with one biphase data channel. The analog spectrum generated is on the DC to 10 MHz frequency range. These spectra may be up-converted to any desired frequency without loss on the characteristics of the SNR provided. Test results are presented.

  8. Persistent digestive disorders in the tropics: causative infectious pathogens and reference diagnostic tests

    PubMed Central

    2013-01-01

    Background Persistent digestive disorders account for considerable disease burden in the tropics. Despite advances in understanding acute gastrointestinal infections, important issues concerning epidemiology, diagnosis, treatment and control of most persistent digestive symptomatologies remain to be elucidated. Helminths and intestinal protozoa are considered to play major roles, but the full extent of the aetiologic spectrum is still unclear. We provide an overview of pathogens causing digestive disorders in the tropics and evaluate available reference tests. Methods We searched the literature to identify pathogens that might give rise to persistent diarrhoea, chronic abdominal pain and/or blood in the stool. We reviewed existing laboratory diagnostic methods for each pathogen and stratified them by (i) microscopy; (ii) culture techniques; (iii) immunological tests; and (iv) molecular methods. Pathogen-specific reference tests providing highest diagnostic accuracy are described in greater detail. Results Over 30 pathogens may cause persistent digestive disorders. Bacteria, viruses and parasites are important aetiologic agents of acute and long-lasting symptomatologies. An integrated approach, consisting of stool culture, microscopy and/or specific immunological techniques for toxin, antigen and antibody detection, is required for accurate diagnosis of bacteria and parasites. Molecular techniques are essential for sensitive diagnosis of many viruses, bacteria and intestinal protozoa, and are increasingly utilised as adjuncts for helminth identification. Conclusions Diagnosis of the broad spectrum of intestinal pathogens is often cumbersome. There is a need for rapid diagnostic tests that are simple and affordable for resource-constrained settings, so that the management of patients suffering from persistent digestive disorders can be improved. PMID:23347408

  9. Evaluation of coproexamination as a diagnostic test for avian botulism

    USGS Publications Warehouse

    Jensen, W.I.

    1981-01-01

    Fecal extracts and blood sera from 113 ducks showing clinical signs of botulism were examined for Clostridium botulinum type C toxin by means of the mouse toxicity test to evaluate coproexamination as a diagnostic procedure, as compared with demonstration of toxin in serum. When death of test mice unprotected with type specific antitoxin (while protected controls survived) was the criterion, 78.8% of the sera and 5.3% of the fecal extracts were positive. When characteristic signs of intoxication in the unprotected mice was included as evidence of toxin in the specimens, these percentages increased to 86.7 and 6.2, respectively. Fecal specimens were collected hourly for the first 6 h after peroral dosing of eight mallards (Anas platyrhynchos) with 1.0 LD50 of type C toxin and at 24, 48, and 72 h from birds surviving that long. From 2 to 4 toxin-positive specimens were passed by all eight ducks during the first 6 h, five specimens were positive at 24 h, and three were positive at 48 h. Only three specimens were collected at 72 h, all of which were negative. These findings suggest that attempts to detect toxin in the feces of wild ducks might have been more successful had the birds been captured earlier in the course of the disease.

  10. Toward a Diagnostic Test for Hidden Hearing Loss.

    PubMed

    Plack, Christopher J; Léger, Agnès; Prendergast, Garreth; Kluk, Karolina; Guest, Hannah; Munro, Kevin J

    2016-01-01

    Cochlear synaptopathy (or hidden hearing loss), due to noise exposure or aging, has been demonstrated in animal models using histological techniques. However, diagnosis of the condition in individual humans is problematic because of (a) test reliability and (b) lack of a gold standard validation measure. Wave I of the transient-evoked auditory brainstem response is a noninvasive electrophysiological measure of auditory nerve function and has been validated in the animal models. However, in humans, Wave I amplitude shows high variability both between and within individuals. The frequency-following response, a sustained evoked potential reflecting synchronous neural activity in the rostral brainstem, is potentially more robust than auditory brainstem response Wave I. However, the frequency-following response is a measure of central activity and may be dependent on individual differences in central processing. Psychophysical measures are also affected by intersubject variability in central processing. Differential measures may help to reduce intersubject variability due to unrelated factors. A measure can be compared, within an individual, between conditions that are affected differently by cochlear synaptopathy. Validation of the metrics is also an issue. Comparisons with animal models, computational modeling, auditory nerve imaging, and human temporal bone histology are all potential options for validation, but there are technical and practical hurdles and difficulties in interpretation. Despite the obstacles, a diagnostic test for hidden hearing loss is a worthwhile goal, with important implications for clinical practice and health surveillance. PMID:27604783

  11. A valid, accurate, office based non-radioactive test for gastric emptying of solids

    PubMed Central

    Lee, J; Camilleri, M; Zinsmeister, A; Burton, D; Kost, L; Klein, P

    2000-01-01

    BACKGROUND—Current breath tests for measurement of gastric emptying of solids are expensive, possibly inaccurate, and require cumbersome calculations.
AIMS—We wished to validate a simplified solid gastric emptying test using a [13C]Spirulina platensis breath test for accurate results relative to scintigraphy.
SUBJECTS—Thirty healthy volunteers.
METHODS—We measured gastric emptying of egg containing [13C]S platensis and 99mTc sulphur colloid by breath 13CO2 and scintigraphy over six hours. A generalised linear regression model was used to predict t1/2 and tLAG by scintigraphy from breath 13CO2 data. The model was cross validated and normative data calculated for a prepacked [13C]meal.
RESULTS—Regression models using all breath data over six hours, for the first three hours, and for samples at 75, 90, and 180 minutes ("reduced model") predicted t1/2 and tLAG values similar to scintigraphy (tLAG 43 (SD 12) min; t1/2 100 (20) min). Standard deviations of differences in t1/2 and tLAG between scintigraphy and the "reduced model" were both 10 minutes. Gastric t1/2 for the prepacked [13C]meal was 91 (15) min (10-90% range: 74-118).
CONCLUSION—The [13C]S platensis breath test and a simple formula using breath 13CO2 at baseline, 90, and 180 minutes measured gastric emptying t1/2 for solids with results that were comparable with scintigraphy.


Keywords: stable isotope; breath test; gastric emptying PMID:10807886

  12. Clinical Evaluation of Rapid Diagnostic Test Kit for Scrub Typhus with Improved Performance

    PubMed Central

    2016-01-01

    Diagnosis of scrub typhus is challenging due to its more than twenty serotypes and the similar clinical symptoms with other acute febrile illnesses including leptospirosis, murine typhus and hemorrhagic fever with renal syndrome. Accuracy and rapidity of a diagnostic test to Orientia tsutsugamushi is an important step to diagnose this disease. To discriminate scrub typhus from other diseases, the improved ImmuneMed Scrub Typhus Rapid Diagnostic Test (RDT) was evaluated in Korea and Sri Lanka. The sensitivity at the base of each IgM and IgG indirect immunofluorescent assay (IFA) in Korean patients was 98.6% and 97.1%, and the specificity was 98.2% and 97.7% respectively. The sensitivity and specificity for retrospective diagnosis at the base of IFA in Sri Lanka was 92.1% and 96.1%. ImmuneMed RDT was not reactive to any serum from seventeen diseases including hemorrhagic fever with renal syndrome (n = 48), leptospirosis (n = 23), and murine typhus (n = 48). ImmuneMed RDT shows superior sensitivity (98.6% and 97.1%) compared with SD Bioline RDT (84.4% at IgM and 83.3% at IgG) in Korea. The retrospective diagnosis of ImmuneMed RDT exhibits 94.0% identity with enzyme-linked Immunosorbent assay (ELISA) using South India patient serum samples. These results suggest that this RDT can replace other diagnostic tests and is applicable for global diagnosis of scrub typhus. This rapid and accurate diagnosis will be beneficial for diagnosing and managing scrub typhus. PMID:27478327

  13. Clinical Evaluation of Rapid Diagnostic Test Kit for Scrub Typhus with Improved Performance.

    PubMed

    Kim, Young-Jin; Park, Sungman; Premaratna, Ranjan; Selvaraj, Stephen; Park, Sang-Jin; Kim, Sora; Kim, Donghwan; Kim, Min Soo; Shin, Dong Hoon; Choi, Kyung-Chan; Kwon, Soon-Hwan; Seo, Wonjun; Lee, Nam Taek; Kim, Seung-Han; Kang, Heui Keun; Kim, Yoon-Won

    2016-08-01

    Diagnosis of scrub typhus is challenging due to its more than twenty serotypes and the similar clinical symptoms with other acute febrile illnesses including leptospirosis, murine typhus and hemorrhagic fever with renal syndrome. Accuracy and rapidity of a diagnostic test to Orientia tsutsugamushi is an important step to diagnose this disease. To discriminate scrub typhus from other diseases, the improved ImmuneMed Scrub Typhus Rapid Diagnostic Test (RDT) was evaluated in Korea and Sri Lanka. The sensitivity at the base of each IgM and IgG indirect immunofluorescent assay (IFA) in Korean patients was 98.6% and 97.1%, and the specificity was 98.2% and 97.7% respectively. The sensitivity and specificity for retrospective diagnosis at the base of IFA in Sri Lanka was 92.1% and 96.1%. ImmuneMed RDT was not reactive to any serum from seventeen diseases including hemorrhagic fever with renal syndrome (n = 48), leptospirosis (n = 23), and murine typhus (n = 48). ImmuneMed RDT shows superior sensitivity (98.6% and 97.1%) compared with SD Bioline RDT (84.4% at IgM and 83.3% at IgG) in Korea. The retrospective diagnosis of ImmuneMed RDT exhibits 94.0% identity with enzyme-linked Immunosorbent assay (ELISA) using South India patient serum samples. These results suggest that this RDT can replace other diagnostic tests and is applicable for global diagnosis of scrub typhus. This rapid and accurate diagnosis will be beneficial for diagnosing and managing scrub typhus. PMID:27478327

  14. Incidental findings in imaging diagnostic tests: a systematic review

    PubMed Central

    Lumbreras, B; Donat, L; Hernández-Aguado, I

    2010-01-01

    The objective of this review is to summarise the available evidence on the frequency and management of incidental findings in imaging diagnostic tests. Original articles were identified by a systematic search of the MEDLINE, EMBASE and Cochrane Library Plus databases using appropriate medical headings. Extracted variables were study design; sample size; type of imaging test; initial diagnosis; frequency and location of incidental findings; whether clinical follow-up was performed; and whether a definitive diagnosis was made. Study characteristics were assessed by one reviewer and checked by a second reviewer. Any disagreement was solved by consensus. The relationship between the frequency of incidental findings and the study characteristics was assessed using a one-way ANOVA test, as was the frequency of follow-up of incidental findings and the frequency of confirmation. 251 potentially relevant abstracts were identified and 44 articles were finally included in the review. Overall, the mean frequency of incidental findings was 23.6% (95% confidence interval (CI) 15.8–31.3%). The frequency of incidental findings was higher in studies involving CT technology (mean 31.1%, 95% CI 20.1–41.9%), in patients with an unspecific initial diagnosis (mean 30.5, 95% CI 0–81.6) and when the location of the incidental findings was unspecified (mean 33.9%, 95% CI 18.1–49.7). The mean frequency of clinical follow-up was 64.5% (95% CI 52.9–76.1%) and mean frequency of clinical confirmation was 45.6% (95% CI 32.1–59.2%). Although the optimal strategy for the management of these abnormalities is still unclear, it is essential to be aware of the low clinical confirmation in findings of moderate and major importance. PMID:20335439

  15. New frontiers for diagnostic testing: taking advantage of forces changing health care.

    PubMed

    Allawi, S J; Hill, B T; Shah, N R

    1998-01-01

    The transformation of the health-care industry holds great economic potential for laboratory diagnostic testing providers who understand the five market forces driving change and who are shaping their own roles in the emerging market. Because of these trends, provider-based laboratories (PBLs) are competing with independent laboratories (ILs) for the latter's traditional client base--outpatients and nonpatients. PBLs will continue to service acute care patients while becoming more IL-like in logistics, sales, customer service, and marketing. Forced to compete on price, ILs have engaged in mega-mergers and will try to break into acute care via joint ventures. The ILs will need to choose their markets carefully, solidly integrate with parent organizations, and find ways to be profit centers. Consumers' demands also are forcing change. Consumers want accurate, legible bills and simplified eligibility determination and registration. They want an emphasis on prevention and wellness, which means that diagnostic testing must address early identification and monitoring of high-risk groups. To realize cost-efficiencies under whole-life capitation, laboratory networks must be part of a completely integrated health-care system. The laboratory of the future will be multicentered, without walls, and with quick access to information through technology. PMID:10178702

  16. Teaching Posttraining : Influencing Diagnostic Strategy with Instructions at Test

    ERIC Educational Resources Information Center

    Kulatunga-Moruzi, Chan; Brooks, Lee R.; Norman, Geoffrey R.

    2011-01-01

    It is believed that medical diagnosis involves two complementary processes, analytic and similarity-based. There is considerable debate as to which of these processes defines diagnostic expertise and how best to teach clinical diagnosis and reduce diagnostic errors. The purpose of these studies is to document the use of these strategies in medical…

  17. Evaluation of poultry diagnostic tests for avial influenza virus in duck origin samples

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Diagnostic test for the detection and identification of avian influenza virus (AIV) infection in chickens and turkeys have been well established and commercial test kits are available for some applications. However few, if any diagnostic tests have been validated or evaluated for use with specimens...

  18. 30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and diagnostic tests? 250.523 Section 250.523 Mineral Resources MINERALS MANAGEMENT SERVICE... casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing diagnostic test for each...

  19. 30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and diagnostic tests? 250.523 Section 250.523 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... records of casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing diagnostic test...

  20. 30 CFR 250.524 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and diagnostic tests? 250.524 Section 250.524 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... records of casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing diagnostic test...

  1. 30 CFR 250.524 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and diagnostic tests? 250.524 Section 250.524 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... records of casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing diagnostic test...

  2. Broadband Liner Optimization for the Source Diagnostic Test Fan

    NASA Technical Reports Server (NTRS)

    Nark, Douglas M.; Jones, Michael G.

    2012-01-01

    The broadband component of fan noise has grown in relevance with the utilization of increased bypass ratio and advanced fan designs. Thus, while the attenuation of fan tones remains paramount, the ability to simultaneously reduce broadband fan noise levels has become more appealing. This paper describes a broadband acoustic liner optimization study for the scale model Source Diagnostic Test fan. Specifically, in-duct attenuation predictions with a statistical fan source model are used to obtain optimum impedance spectra over a number of flow conditions for three liner locations in the bypass duct. The predicted optimum impedance information is then used with acoustic liner modeling tools to design liners aimed at producing impedance spectra that most closely match the predicted optimum values. Design selection is based on an acceptance criterion that provides the ability to apply increased weighting to specific frequencies and/or operating conditions. Typical tonal liner designs targeting single frequencies at one operating condition are first produced to provide baseline performance information. These are followed by multiple broadband design approaches culminating in a broadband liner targeting the full range of frequencies and operating conditions. The broadband liner is found to satisfy the optimum impedance objectives much better than the tonal liner designs. In addition, the broadband liner is found to provide better attenuation than the tonal designs over the full range of frequencies and operating conditions considered. Thus, the current study successfully establishes a process for the initial design and evaluation of novel broadband liner concepts for complex engine configurations.

  3. Rapid non-invasive tests for diagnostics of infectious diseases

    NASA Astrophysics Data System (ADS)

    Malamud, Daniel

    2014-06-01

    A rapid test for an infectious disease that can be used at point-of-care at a physician's office, a pharmacy, or in the field is critical for the prompt and appropriate therapeutic intervention. Ultimately by treating infections early on will decrease transmission of the pathogen. In contrast to metabolic diseases or cancer where multiple biomarkers are required, infectious disease targets (e.g. antigen, antibody, nucleic acid) are simple and specific for the pathogen causing the disease. Our laboratory has focused on three major infectious disease; HIV, Tuberculosis, and Malaria. These diseases are pandemic in much of the world thus putting natives, tourists and military personnel at risk for becoming infected, and upon returning to the U.S., transmitting these diseases to their contacts. Our devices are designed to detect antigens, antibodies or nucleic acids in blood or saliva samples in less than 30 minutes. An overview describing the current status of each of the three diagnostic platforms is presented. These microfluidic point-of-care devices will be relatively inexpensive, disposable, and user friendly.

  4. Fan Noise Source Diagnostic Test: Vane Unsteady Pressure Results

    NASA Technical Reports Server (NTRS)

    Envia, Edmane

    2002-01-01

    To investigate the nature of fan outlet guide vane pressure fluctuations and their link to rotor-stator interaction noise, time histories of vane fluctuating pressures were digitally acquired as part of the Fan Noise Source Diagnostic Test. Vane unsteady pressures were measured at seven fan tip speeds for both a radial and a swept vane configuration. Using time-domain averaging and spectral analysis, the blade passing frequency (BPF) harmonic and broadband contents of the vane pressures were individually analyzed. Significant Sound Pressure Level (SPL) reductions were observed for the swept vane relative to the radial vane for the BPF harmonics of vane pressure, but vane broadband reductions due to sweep turned out to be much smaller especially on an average basis. Cross-correlation analysis was used to establish the level of spatial coherence of broadband pressures between different locations on the vane and integral length scales of pressure fluctuations were estimated from these correlations. Two main results of this work are: (1) the average broadband level on the vane (in dB) increases linearly with the fan tip speed for both the radial and swept vanes, and (2) the broadband pressure distribution on the vane is nearly homogeneous and its integral length scale is a monotonically decreasing function of fan tip speed.

  5. Multi-Level High School Classes: Astronomy Diagnostic Test Results

    NASA Astrophysics Data System (ADS)

    Hubbard, R.; Hufnagel, B.

    2001-12-01

    A content survey, the Astronomy Diagnostic Test (ADT) designed for undergraduate non-science astronomy courses, was administered as a post-course survey to five senior high classes in a Maryland high school. In 2001, the five classes chosen included all three levels of physics and an astronomy class. Each class had an even distribution of male and female students, with a total of 115 girls and 104 boys as subjects. Results of the survey include: (1) The Advanced Placement (AP) physics class scored highest and general physics lowest. (2) The AP class, most of whom will major in engineering or computer sciences, had a mean ADT score similar to post-course undergraduate non-science astronomy classes. (3) For all five classes, the girls had lower mean scores than the boys. (4) In two classes the girls' self-reported mean confidence was 40% lower than the boys' confidence; in the other three classes the confidence levels were the same. Additional detailed research was done on the three cosmology and ten physics questions in the ADT; girls outperformed the boys in only two of these thirteen questions.

  6. Diagnostic tests for conceptualizing transport in bedrock aquifers

    NASA Astrophysics Data System (ADS)

    Worthington, Stephen R. H.

    2015-10-01

    Transport in bedrock aquifers is complex because there is often substantial flow through fractures, and the apertures and interconnectivity of these fractures are usually uncertain. Single-porosity numerical models often give satisfactory results for simulating flow. However, simulating transport is more challenging and results based on single-porosity assumptions can yield inaccurate results. Seven cases are reviewed where travel times were found to be unexpectedly short. Results show that dual-porosity flow is common, with advective flow through fracture networks and immobile storage in the matrix. However, in some cases a dual- or multiple-permeability (or porosity) approach provides better simulations of aquifer behavior. Fracture porosity of bedrock aquifers is usually <1%, resulting in rapid groundwater velocities in many aquifers. Overestimation of the effective porosity is the most common reason for the overestimation of travel times. Residence times of artificial tracers in bedrock aquifers are typically two to three orders of magnitude less than residence times of environmental tracers because the latter are retarded by matrix diffusion. Fourteen diagnostic tests for determining the appropriate conceptual model for bedrock aquifers are described.

  7. A new automatic blood pressure kit auscultates for accurate reading with a smartphone: A diagnostic accuracy study.

    PubMed

    Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi

    2016-08-01

    The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and -0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989-0.995) and diastolic (ICC = 0.987, 95% CI: 0.979-0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland-Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service. PMID:27512876

  8. Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina

    PubMed Central

    2016-01-01

    Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis. PMID:26839470

  9. Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina.

    PubMed

    Lee, Jin-Woo; Park, Sungman; Kim, Seung Han; Christova, Iva; Jacob, Paulina; Vanasco, Norma B; Kang, Yeon-Mi; Woo, Ye-Ju; Kim, Min Soo; Kim, Young-Jin; Cho, Min-Kee; Kim, Yoon-Won

    2016-02-01

    Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis. PMID:26839470

  10. Diagnostic analysis of pumping tests using derivative of dlgs/dlgt with case study.

    PubMed

    Xiao, Liang; Xu, Yongxin

    2014-09-01

    Diagnostic derivative interpretation of drawdown data from pumping tests is discussed in this paper. An emphasis is placed on the conceptualization of derivative term of dlgs/dlgt. Use of a combined plot of dlgs/dlgt and ds/dlgt is made to identify various flow patterns from variable discharge tests with infinite conditions, constant rate tests in bounded aquifers, and tests involving double porosity, which can be used to further characterize the aquifer. Compared with the standard derivative method (ds/dlgt), the combined derivative analysis of dlgs/dlgt and ds/dlgt of drawdown behaviours possesses certain advantages identified as follows: (1) the plot of dlgs/dlgt is strikingly sensitive for use in unveiling differences between pumping and recovery periods in a variable discharge test; (2) storativity (S) of pumped aquifers can be accurately evaluated by the combined plot; and (3) a quantitative assessment of double porosity behaviour can also be achieved. Based on applied case studies, Lagrange Interpolation Regression (LIR) is recommended for numerical derivative calculation. Advantages and disadvantages of LIR and traditional methods are demonstrated via a selected case study. The result of the case study confirms that LIR is a preferred method for numerical derivative calculation as it can be used to effectively minimise noisy effect during derivative processes. The proposed derivative approach provides the hydrologists with an additional tool for characterizing pumped aquifers. PMID:24597544

  11. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    PubMed

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course. PMID:27001769

  12. Screening for Wilson Disease in Acute Liver Failure: A Comparison of Currently Available Diagnostic Tests

    PubMed Central

    Korman, Jessica D.; Volenberg, Irene; Balko, Jody; Webster, Joe; Schiodt, Frank V.; Squires, Robert H.; Lee, William M.; Schilsky, Michael L.

    2013-01-01

    Acute liver failure (ALF) due to Wilson disease (WD) is invariably fatal without emergency liver transplantation. Therefore, rapid diagnosis of WD should aid prompt transplant listing. To identify the best method for diagnosis of ALF due to WD (ALF-WD), data and serum were collected from 140 ALF patients (16 with WD), 29 with other chronic liver diseases and 17 with treated chronic WD. Ceruloplasmin (Cp) was measured by both oxidase activity and nephelometry and serum copper levels by atomic absorption spectroscopy. In patients with ALF, a serum Cp <20 mg/dL by the oxidase method provided a diagnostic sensitivity of 21% and specificity of 84% while, by nephelometry, a sensitivity of 56% and specificity of 63%. Serum copper levels exceeded 200 g/dL in all ALF-WD patients measured (13/16), but were also elevated in non-WD ALF. An alkaline phosphatase (AP) to total bilirubin (TB) ratio <4 yielded a sensitivity of 94%, specificity of 96%, and a likelihood ratio of 23 for diagnosing fulminant WD. In addition, an AST:ALT ratio > 2.2 yielded a sensitivity of 94%, a specificity of 86%, and a likelihood ratio of 7 for diagnosing fulminant WD. Combining the tests provided a diagnostic sensitivity and specificity of 100%. In conclusion, conventional WD testing utilizing serum ceruloplasmin and/or serum copper levels are less sensitive and specific in identifying patients with ALF-WD than other available tests. More readily available laboratory tests including alkaline phosphatase, bilirubin and serum aminotransferases by contrast provides the most rapid and accurate method for diagnosis of ALF due to WD. PMID:18798336

  13. Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy

    PubMed Central

    Reid, Hamish; Thomas, Emma; Foster, Charlie; Darton, Thomas C.

    2016-01-01

    Background Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). Purpose To assess the quality of the evidence supporting the use of the TT and perform a diagnostic accuracy meta-analysis comparing the TT to antibody response measured by ELISA. Data Sources A comprehensive literature search was conducted in the following databases to April, 2016: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, BIOSIS, Web of Science, SCOPUS. Study Selection Studies comparing the diagnostic accuracy of the tourniquet test with ELISA for the diagnosis of dengue were included. Data Extraction Two independent authors extracted data using a standardized form. Data Synthesis A total of 16 studies with 28,739 participants were included in the meta-analysis. Pooled sensitivity for dengue diagnosis by TT was 58% (95% Confidence Interval (CI), 43%-71%) and the specificity was 71% (95% CI, 60%-80%). In the subgroup analysis sensitivity for non-severe dengue diagnosis was 55% (95% CI, 52%-59%) and the specificity was 63% (95% CI, 60%-66%), whilst sensitivity for dengue hemorrhagic fever diagnosis was 62% (95% CI, 53%-71%) and the specificity was 60% (95% CI, 48%-70%). Receiver-operator characteristics demonstrated a test accuracy (AUC) of 0.70 (95% CI, 0.66–0.74). Conclusion The tourniquet test is widely used in resource poor settings despite currently available evidence demonstrating only a marginal benefit in making a diagnosis of dengue infection alone. Registration The protocol for this systematic review was registered at PROSPERO: CRD42015020323. PMID:27486661

  14. Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda

    PubMed Central

    Schroeder, Lee F.; Elbireer, Ali; Jackson, J. Brooks; Amukele, Timothy K.

    2015-01-01

    Background Diagnostic laboratory tests are routinely defined in terms of their sensitivity, specificity, and ease of use. But the actual clinical impact of a diagnostic test also depends on its availability and price. This is especially true in resource-limited settings such as sub-Saharan Africa. We present a first-of-its-kind report of diagnostic test types, availability, and prices in Kampala, Uganda. Methods Test types (identity) and availability were based on menus and volumes obtained from clinical laboratories in late 2011 in Kampala using a standard questionnaire. As a measure of test availability, we used the Availability Index (AI). AI is the combined daily testing volumes of laboratories offering a given test, divided by the combined daily testing volumes of all laboratories in Kampala. Test prices were based on a sampling of prices collected in person and via telephone surveys in 2015. Findings Test volumes and menus were obtained for 95% (907/954) of laboratories in Kampala city. These 907 laboratories offered 100 different test types. The ten most commonly offered tests in decreasing order were Malaria, HCG, HIV serology, Syphilis, Typhoid, Urinalysis, Brucellosis, Stool Analysis, Glucose, and ABO/Rh. In terms of AI, the 100 tests clustered into three groups: high (12 tests), moderate (33 tests), and minimal (55 tests) availability. 50% and 36% of overall availability was provided through private and public laboratories, respectively. Point-of-care laboratories contributed 35% to the AI of high availability tests, but only 6% to the AI of the other tests. The mean price of the most commonly offered test types was $2.62 (range $1.83–$3.46). Interpretation One hundred different laboratory test types were in use in Kampala in late 2011. Both public and private laboratories were critical to test availability. The tests offered in point-of-care laboratories tended to be the most available tests. Prices of the most common tests ranged from $1

  15. Effects of Training on the Test of Diagnostic Skills. Publication No. 30.

    ERIC Educational Resources Information Center

    Haley, John V.

    This report summarizes research performed on the Test of Diagnostic Skills, used to evaluate the clinical diagnostic skills of medical students. Forms of the test were administered to groups at different levels of medical experience to ascertain the effect of training on performance. A cross-sectional study was conducted with approximately 90…

  16. Use of Individual-level Covariates to Improve Latent Class Analysis of Trypanosoma Cruzi Diagnostic Tests

    PubMed Central

    Tustin, Aaron W.; Small, Dylan S.; Delgado, Stephen; Neyra, Ricardo Castillo; Verastegui, Manuela R.; Ancca Juárez, Jenny M.; Quispe Machaca, Víctor R.; Gilman, Robert H.; Bern, Caryn; Levy, Michael Z.

    2013-01-01

    Statistical methods such as latent class analysis can estimate the sensitivity and specificity of diagnostic tests when no perfect reference test exists. Traditional latent class methods assume a constant disease prevalence in one or more tested populations. When the risk of disease varies in a known way, these models fail to take advantage of additional information that can be obtained by measuring risk factors at the level of the individual. We show that by incorporating complex field-based epidemiologic data, in which the disease prevalence varies as a continuous function of individual-level covariates, our model produces more accurate sensitivity and specificity estimates than previous methods. We apply this technique to a simulated population and to actual Chagas disease test data from a community near Arequipa, Peru. Results from our model estimate that the first-line enzyme-linked immunosorbent assay has a sensitivity of 78% (95% CI: 62–100%) and a specificity of 100% (95% CI: 99–100%). The confirmatory immunofluorescence assay is estimated to be 73% sensitive (95% CI: 65–81%) and 99% specific (95% CI: 96–100%). PMID:24083130

  17. Development of a diagnostic test based on multiple continuous biomarkers with an imperfect reference test.

    PubMed

    García Barrado, Leandro; Coart, Els; Burzykowski, Tomasz

    2016-02-20

    Ignoring the fact that the reference test used to establish the discriminative properties of a combination of diagnostic biomarkers is imperfect can lead to a biased estimate of the diagnostic accuracy of the combination. In this paper, we propose a Bayesian latent-class mixture model to select a combination of biomarkers that maximizes the area under the ROC curve (AUC), while taking into account the imperfect nature of the reference test. In particular, a method for specification of the prior for the mixture component parameters is developed that allows controlling the amount of prior information provided for the AUC. The properties of the model are evaluated by using a simulation study and an application to real data from Alzheimer's disease research. In the simulation study, 100 data sets are simulated for sample sizes ranging from 100 to 600 observations, with a varying correlation between biomarkers. The inclusion of an informative as well as a flat prior for the diagnostic accuracy of the reference test is investigated. In the real-data application, the proposed model was compared with the generally used logistic-regression model that ignores the imperfectness of the reference test. Conditional on the selected sample size and prior distributions, the simulation study results indicate satisfactory performance of the model-based estimates. In particular, the obtained average estimates for all parameters are close to the true values. For the real-data application, AUC estimates for the proposed model are substantially higher than those from the 'traditional' logistic-regression model. PMID:26388206

  18. Accuracy of three diagnostic tests for determining Mycobacterium bovis infection status in live-sampled wild meerkats (Suricata suricatta).

    PubMed

    Drewe, Julian A; Dean, Gillian S; Michel, Anita L; Lyashchenko, Konstantin P; Greenwald, Rena; Pearce, Gareth P

    2009-01-01

    Accurate diagnosis of Mycobacterium bovis infection (bovine tuberculosis [bTB]) in live animals is notoriously problematic. The aim of the present study was to evaluate the diagnostic potential of 2 new serologic tests (multiantigen print immunoassay [MAPIA] and lateral flow immunoassay rapid test [RT]) in comparison with mycobacterial culture of tracheal washes for determining M. bovis infection status in a free-ranging population of wild meerkats (Suricata suricatta). During a longitudinal study lasting 2.5 years, 240 individually identifiable meerkats were each sampled up to 8 times under anesthesia every 3 months. Diagnostic accuracy was determined through Bayesian and maximum likelihood estimations of sensitivity, specificity, and likelihood ratios for each diagnostic test when used independently and in parallel to classify the disease status of individual meerkats in the absence of a gold standard. Culture of tracheal washes was highly specific (0.99; 95% confidence interval [CI] = 0.77, 1.00) but of low sensitivity (0.36; 95% CI = 0.24, 0.50) for diagnosing M. bovis-infected individuals. The longitudinal nature of the study with repeated sampling of the same individual animals served simultaneously to improve chances of detecting infection and increase confidence in a negative result in individual animals repeatedly testing negative. Although MAPIA and RT were individually of limited diagnostic use, interpreting the results of these 2 tests in parallel produced estimates of sensitivity (0.83; 95% CI = 0.67, 0.93) and specificity (0.73; 95% CI = 0.62, 0.82) high enough to usefully inform decision making when determining exposure to bTB in wild meerkats and potentially other species in which bTB poses a diagnostic challenge. PMID:19139498

  19. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

    PubMed Central

    2013-01-01

    Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P<0.05) and combinations of traditional tests were not able to discriminate between a PAR and a negative anaesthetic response (AUC 0.507; 95% CI: 0.366, 0.647; P>0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR

  20. Test and Product Review: Pediatric Attention Disorders Diagnostic Screener

    ERIC Educational Resources Information Center

    Huang, Leesa V.

    2009-01-01

    This article presents a comprehensive evaluation of the Pediatric Attention Disorders Diagnostic Screener (PADDS). PADDS was developed as a computer-based assessment system to screen for attention and executive function disorders in children aged 6 through 12 years. The evaluation of the PADDS indicated that it can be a useful and efficient…

  1. Effects of microcomputer-administered diagnostic testing on immediate and continuing science achievement and attitudes

    NASA Astrophysics Data System (ADS)

    Waugh, Michael Leonard

    This investigation had three purposes: (1) to document any immediate and continuing benefits associated with the use of microcomputer-administered testing; (2) to determine what type of student might benefit most from microcomputer-administered diagnostic testing; and (3) to document the feasibility of microcomputer-administered diagnostic testing. The subjects of the study were enrolled in a biology course based on the BSCS Blue text. A random half of the students received behaviorally-stated performance objectives, while the remaining half received behaviorally-stated performance objectives in conjunction with microcomputer-administered diagnostic testing. The results of this study indicate that microcomputer-administered diagnostic testing can positively influence the immediate, but not the continuing, achievement of students in science. In addition, neither student aptitude nor achievement motivation level were found to interact with treatment or influence achievement. Affective data indicate that students react favorably to the use of objectives, computers, and diagnostic testing. Cost summary data reveal that when the expense of administering diagnostic testing by microcomputer is prorated over a five-year period, the cost of a diagnostic test is reduced to approximately three cents.

  2. Assessment of Clinical Diagnosis, Microscopy, Rapid Diagnostic Tests, and Polymerase Chain Reaction in the Diagnosis of Plasmodium falciparum in Nigeria

    PubMed Central

    Ojurongbe, Olusola; Adegbosin, Olunike Olayeni; Taiwo, Sunday Samuel; Alli, Oyebode Armstrong Terry; Olowe, Olugbenga Adekunle; Ojurongbe, Taiwo Adetola; Bolaji, Oloyede Samuel; Adeyeba, Oluwaseyi Adegboyega

    2013-01-01

    This study compares the performance of clinical diagnosis and three laboratory diagnostic methods (thick film microscopy (TFM), rapid diagnostic test (RDT), and polymerase chain reaction (PCR)) for the diagnosis of Plasmodium falciparum in Nigeria. Using clinical criteria, 217 children were recruited into the study out of which 106 (48.8%) were positive by TFM, 84 (38.7%) by RDT, and 125 (57.6%) by PCR. Using a composite reference method generated from the three diagnostic methods, 71 (32.7%) patients were found to be truly infected and 90 (41.5%) truly uninfected, while 56 (25.8%) were misidentified as infected or noninfected. When each of the 3 diagnostic methods was compared with the composite reference, PCR had sensitivity of 97.3%, specificity of 62.5%, positive predictive value (PPV) of 56.8%, and negative predictive value (NPV) of 97.8%; microscopy had sensitivity of 77.2%, specificity of 72%, PPV of 66.9%, and NPV of 81.1%, while RDT had sensitivity of 62.3%, specificity of 87.4%, PPV of 67.7%, and NPV of 84.5%. PCR test performed best among the three methods followed by TFM and RDT in that order. The result of this study shows that clinical diagnosis cannot be relied upon for accurate diagnosis of P. falciparum in endemic areas. PMID:24371538

  3. BRAF mutation testing with a rapid, fully integrated molecular diagnostics system

    PubMed Central

    Huang, Helen J.; Falchook, Gerald S.; Devogelaere, Benoit; Kockx, Mark; Bempt, Isabelle Vanden; Reijans, Martin; Naing, Aung; Fu, Siqing; Piha-Paul, Sarina A.; Hong, David S.; Holley, Veronica R.; Tsimberidou, Apostolia M.; Stepanek, Vanda M.; Patel, Sapna P.; Kopetz, E. Scott; Subbiah, Vivek; Wheler, Jennifer J.; Zinner, Ralph G.; Karp, Daniel D.; Luthra, Rajyalakshmi; Roy-Chowdhuri, Sinchita; Sablon, Erwin; Meric-Bernstam, Funda; Maertens, Geert; Kurzrock, Razelle

    2015-01-01

    Fast and accurate diagnostic systems are needed for further implementation of precision therapy of BRAF-mutant and other cancers. The novel IdyllaTM BRAF Mutation Test has high sensitivity and shorter turnaround times compared to other methods. We used Idylla to detect BRAF V600 mutations in archived formalin-fixed paraffin-embedded (FFPE) tumor samples and compared these results with those obtained using the cobas 4800 BRAF V600 Mutation Test or MiSeq deep sequencing system and with those obtained by a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory employing polymerase chain reaction–based sequencing, mass spectrometric detection, or next-generation sequencing. In one set of 60 FFPE tumor samples (15 with BRAF mutations per Idylla), the Idylla and cobas results had an agreement of 97%. Idylla detected BRAF V600 mutations in two additional samples. The Idylla and MiSeq results had 100% concordance. In a separate set of 100 FFPE tumor samples (64 with BRAF mutation per Idylla), the Idylla and CLIA-certified laboratory results demonstrated an agreement of 96% even though the tests were not performed simultaneously and different FFPE blocks had to be used for 9 cases. The IdyllaTM BRAF Mutation Test produced results quickly (sample to results time was about 90 minutes with about 2 minutes of hands on time) and the closed nature of the cartridge eliminates the risk of PCR contamination. In conclusion, our observations demonstrate that the Idylla test is rapid and has high concordance with other routinely used but more complex BRAF mutation–detecting tests. PMID:26330075

  4. BRAF mutation testing with a rapid, fully integrated molecular diagnostics system.

    PubMed

    Janku, Filip; Claes, Bart; Huang, Helen J; Falchook, Gerald S; Devogelaere, Benoit; Kockx, Mark; Bempt, Isabelle Vanden; Reijans, Martin; Naing, Aung; Fu, Siqing; Piha-Paul, Sarina A; Hong, David S; Holley, Veronica R; Tsimberidou, Apostolia M; Stepanek, Vanda M; Patel, Sapna P; Kopetz, E Scott; Subbiah, Vivek; Wheler, Jennifer J; Zinner, Ralph G; Karp, Daniel D; Luthra, Rajyalakshmi; Roy-Chowdhuri, Sinchita; Sablon, Erwin; Meric-Bernstam, Funda; Maertens, Geert; Kurzrock, Razelle

    2015-09-29

    Fast and accurate diagnostic systems are needed for further implementation of precision therapy of BRAF-mutant and other cancers. The novel IdyllaTMBRAF Mutation Test has high sensitivity and shorter turnaround times compared to other methods. We used Idylla to detect BRAF V600 mutations in archived formalin-fixed paraffin-embedded (FFPE) tumor samples and compared these results with those obtained using the cobas 4800 BRAF V600 Mutation Test or MiSeq deep sequencing system and with those obtained by a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory employing polymerase chain reaction-based sequencing, mass spectrometric detection, or next-generation sequencing. In one set of 60 FFPE tumor samples (15 with BRAF mutations per Idylla), the Idylla and cobas results had an agreement of 97%. Idylla detected BRAF V600 mutations in two additional samples. The Idylla and MiSeq results had 100% concordance. In a separate set of 100 FFPE tumor samples (64 with BRAF mutation per Idylla), the Idylla and CLIA-certified laboratory results demonstrated an agreement of 96% even though the tests were not performed simultaneously and different FFPE blocks had to be used for 9 cases. The IdyllaTMBRAF Mutation Test produced results quickly (sample to results time was about 90 minutes with about 2 minutes of hands on time) and the closed nature of the cartridge eliminates the risk of PCR contamination. In conclusion, our observations demonstrate that the Idylla test is rapid and has high concordance with other routinely used but more complex BRAF mutation-detecting tests. PMID:26330075

  5. LeRC rail accelerators - Test designs and diagnostic techniques

    NASA Technical Reports Server (NTRS)

    Zana, L. M.; Kerslake, W. R.; Sturman, J. C.; Wang, S. Y.; Terdan, F. F.

    1984-01-01

    The feasibility of using rail accelerators for various in-space and to-space propulsion applications was investigated. A 1 meter, 24 sq mm bore accelerator was designed with the goal of demonstrating projectile velocities of 15 km/sec using a peak current of 200 kA. A second rail accelerator, 1 meter long with a 156.25 sq mm bore, was designed with clear polycarbonate sidewalls to permit visual observation of the plasma arc. A study of available diagnostic techniques and their application to the rail accelerator is presented. Specific topics of discussion include the use of interferometry and spectroscopy to examine the plasma armature as well as the use of optical sensors to measure rail displacement during acceleration. Standard diagnostics such as current and voltage measurements are also discussed. Previously announced in STAR as N83-35053

  6. [Activity of ISO/TC212, clinical laboratory testing and in vitro diagnostic test systems].

    PubMed

    Kawai, T

    1998-10-01

    ISO is the International Organization for Standardization, which is a worldwide federation of national standards bodies from 130 countries, one from each country. ISO is a non-governmental organization established in 1947. ISO/TC212, Clinical laboratory testing and in vitro diagnostic test systems was newly established in 1995, consisting of 86 P-members and 12 O-members. ISO/TC212 secretariat is the American National Standards Institute, and NCCLS carries out its secretarial activity. On behalf of the Japanese Industrial Standards Committee (JISC), the Japanese Committee for Clinical Laboratory Standards (JCCLS) serves as the secretariat for the ISO/TC212 National Technical Advisory Group. Three working groups are in the process of preparing the Draft International Standards (DIS) among 9 work items. The next plenary session of ISO/TC212 will be held on May 19-21, 1999 in Tokyo, Japan. PMID:9816905

  7. Results of metallographical diagnostic examination of Navy half-watt thermoelectric converters degraded by accelerated tests

    NASA Technical Reports Server (NTRS)

    Rosell, F. E., Jr.; Rouklove, P. G.

    1977-01-01

    To verify the 15-year reliability of the Navy half-watt radioisotope thermoelectric generator (RTG), bismuth-telluride thermoelectric converters were submitted to testing at high temperatures which accelerated the degradation and caused failure of the converters. Metallographic diagnostic examination of failed units verified failure mechanisms. Results of diagnostic examinations are presented.

  8. Diagnostic test accuracy: methods for systematic review and meta-analysis.

    PubMed

    Campbell, Jared M; Klugar, Miloslav; Ding, Sandrine; Carmody, Dennis P; Hakonsen, Sasja J; Jadotte, Yuri T; White, Sarahlouise; Munn, Zachary

    2015-09-01

    Systematic reviews are carried out to provide an answer to a clinical question based on all available evidence (published and unpublished), to critically appraise the quality of studies, and account for and explain variations between the results of studies. The Joanna Briggs Institute specializes in providing methodological guidance for the conduct of systematic reviews and has developed methods and guidance for reviewers conducting systematic reviews of studies of diagnostic test accuracy. Diagnostic tests are used to identify the presence or absence of a condition for the purpose of developing an appropriate treatment plan. Owing to demands for improvements in speed, cost, ease of performance, patient safety, and accuracy, new diagnostic tests are continuously developed, and there are often several tests available for the diagnosis of a particular condition. In order to provide the evidence necessary for clinicians and other healthcare professionals to make informed decisions regarding the optimum test to use, primary studies need to be carried out on the accuracy of diagnostic tests and the results of these studies synthesized through systematic review. The Joanna Briggs Institute and its international collaboration have updated, revised, and developed new guidance for systematic reviews, including systematic reviews of diagnostic test accuracy. This methodological article summarizes that guidance and provides detailed advice on the effective conduct of systematic reviews of diagnostic test accuracy. PMID:26355602

  9. Performance of commercial latex agglutination tests for the differentiation of Candida dubliniensis and Candida albicans in routine diagnostics.

    PubMed

    Chryssanthou, E; Fernandez, V; Petrini, B

    2007-11-01

    Candida dubliniensis is phenotypically similar to Candida albicans and may therefore be underdiagnosed in the clinical microbiology laboratory. The performance of Bichro-Dubli latex agglutination test for rapid species identification of C. dubliniensis was prospectively evaluated on 111 vaginal and 118 respiratory isolates. These had presumptively been identified as C. albicans/C. dubliniensis by their green colonies on CHROMagar Candida plates. Bichro-Dubli test identifed 2 (1.8%) vaginal and 6 (5.1%) respiratory isolates as C. dubliniensis. The test was also positive for 37 C. dubliniensis control strains characterised by 18S-28S DNA-sequencing. Bichro-Dubli test is thus a sensitive and accurate tool for rapid diagnostics in routine laboratories. PMID:18092961

  10. Chronic Vomiting in Cats: Etiology and Diagnostic Testing.

    PubMed

    Hauck, Shannon Ryan; Gisselman, Kelly; Cordner, Amy; Nicholson, Angela Gasser

    2016-01-01

    Chronic vomiting in cats is a common presenting problem seen in veterinary practice today. The initial step when presented with a vomiting patient is to differentiate between vomiting and regurgitation or dysphagia. There are numerous causes for chronic vomiting in cats, and therefore a detailed and comprehensive patient history and a systematic diagnostic approach are key steps in determining the cause for vomiting and the most appropriate treatment plan. Common causes for chronic vomiting in cats may include inflammatory bowel disease, food allergy, gastrointestinal motility disorders, neoplasia, and extra-gastrointestinal diseases, such as renal disease, hepatobiliary disease, and hyperthyroidism. PMID:27487349

  11. 34 CFR 462.41 - How must tests be administered in order to accurately measure educational gain?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... measure educational gain? 462.41 Section 462.41 Education Regulations of the Offices of the Department of... to accurately measure educational gain? (a) General. A local eligible provider must measure the... provider must— (1) Administer a pre-test to measure a student's educational functioning level at intake,...

  12. 34 CFR 462.41 - How must tests be administered in order to accurately measure educational gain?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... measure educational gain? 462.41 Section 462.41 Education Regulations of the Offices of the Department of... to accurately measure educational gain? (a) General. A local eligible provider must measure the... provider must— (1) Administer a pre-test to measure a student's educational functioning level at intake,...

  13. 34 CFR 462.41 - How must tests be administered in order to accurately measure educational gain?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... measure educational gain? 462.41 Section 462.41 Education Regulations of the Offices of the Department of... to accurately measure educational gain? (a) General. A local eligible provider must measure the... provider must— (1) Administer a pre-test to measure a student's educational functioning level at intake,...

  14. 34 CFR 462.41 - How must tests be administered in order to accurately measure educational gain?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... measure educational gain? 462.41 Section 462.41 Education Regulations of the Offices of the Department of... to accurately measure educational gain? (a) General. A local eligible provider must measure the... provider must— (1) Administer a pre-test to measure a student's educational functioning level at intake,...

  15. Borehole flowmeter logging for the accurate design and analysis of tracer tests.

    PubMed

    Basiricò, Stefano; Crosta, Giovanni B; Frattini, Paolo; Villa, Alberto; Godio, Alberto

    2015-04-01

    Tracer tests often give ambiguous interpretations that may be due to the erroneous location of sampling points and/or the lack of flow rate measurements through the sampler. To obtain more reliable tracer test results, we propose a methodology that optimizes the design and analysis of tracer tests in a cross borehole mode by using vertical borehole flow rate measurements. Experiments using this approach, herein defined as the Bh-flow tracer test, have been performed by implementing three sequential steps: (1) single-hole flowmeter test, (2) cross-hole flowmeter test, and (3) tracer test. At the experimental site, core logging, pumping tests, and static water-level measurements were previously carried out to determine stratigraphy, fracture characteristics, and bulk hydraulic conductivity. Single-hole flowmeter testing makes it possible to detect the presence of vertical flows as well as inflow and outflow zones, whereas cross-hole flowmeter testing detects the presence of connections along sets of flow conduits or discontinuities intercepted by boreholes. Finally, the specific pathways and rates of groundwater flow through selected flowpaths are determined by tracer testing. We conclude that the combined use of single and cross-borehole flowmeter tests is fundamental to the formulation of the tracer test strategy and interpretation of the tracer test results. PMID:25417730

  16. 77 FR 71170 - Notice of Public Roundtable on Genetic Diagnostic Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-29

    ... after the roundtable. Written commentary should not exceed 25 pages using at least 12-point and double... Hearings on Genetic Diagnostic Testing, 77 FR 3748 (Jan. 25, 2012). The Office also provided the...

  17. 30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and diagnostic tests? 250.523 Section 250.523 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT... long do I keep records of casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last...

  18. 30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... casing diagnostic test? 250.524 Section 250.524 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT... am I required to take action from my casing diagnostic test? You must take action if you have any of... is not bled to 0 psig during a casing diagnostic test; (c) Any well that has demonstrated...

  19. 30 CFR 250.525 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... casing diagnostic test? 250.525 Section 250.525 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... take action from my casing diagnostic test? You must take action if you have any of the following... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing,...

  20. 30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... casing diagnostic test? 250.524 Section 250.524 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT... from my casing diagnostic test? You must take action if you have any of the following conditions: (a... casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser,...

  1. 30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... casing diagnostic test? 250.524 Section 250.524 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... take action from my casing diagnostic test? You must take action if you have any of the following... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing,...

  2. 30 CFR 250.525 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... casing diagnostic test? 250.525 Section 250.525 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL... take action from my casing diagnostic test? You must take action if you have any of the following... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing,...

  3. Testing of optical diagnostics for ion-beam-driven WDM experiments at NDCX-1

    NASA Astrophysics Data System (ADS)

    Ni, P. A.; Bieniosek, F. M.; Leitner, M.; Weber, C.; Waldron, W. L.

    2009-07-01

    We report on the testing of optical diagnostics developed for warm-dense-matter (WDM) experiments on the neutralized drift compression experiments (NDCX-1) at Lawrence Berkeley National Laboratory (LBNL). The diagnostics consists of a fast optical pyrometer, a streak camera spectrometer, and a Doppler-shift laser interferometer (VISAR). While the NDCX is in the last stage of commissioning for the target experiments, the diagnostics were tested elsewhere in an experiment where an intense laser pulse was used to generate the WDM state in metallic and carbon samples.

  4. The robustness of diagnostic tests for GH deficiency in adults.

    PubMed

    Andersen, Marianne

    2015-06-01

    Since the 1970s, GH treatment has been an important tool in paediatric endocrinology for the management of growth retardation. It is now accepted that adults with severe GH deficiency (GHD) demonstrate impaired physical and psychological well-being and may benefit from replacement therapy with recombinant human GH. There is, however, an ongoing debate on how to diagnose GHD, especially in adults. A GH response below the cut-off limit of a GH-stimulation test is required in most cases for establishing GHD in adults. No 'gold standard' GH-stimulation test exists, but some GH stimulation tests may be more robust to variations in patient characteristics such as age and gender, as well as to pre-test conditions like heat exposure due to a hot bath or bicycling. However, body mass index (BMI) is negatively associated with GH-responses to all available GH-stimulation tests and glucocorticoid treatment, including conventional substitution therapy, influences the GH-responses. Recently, the role of IGF-I measurements in the clinical decision making has been discussed. The aim of this review is to discuss the available GH-stimulation tests. In this author's opinion, tests which include growth-hormone-releasing hormone (GHRH) tend to be more potent and robust, especially the GHRH+arginine test which has been proven to be of clinical use. In contrast, the insulin tolerance test (ITT) and the glucagon test appear to have too many drawbacks. PMID:25900364

  5. A Genetically Optimized Predictive System for Success in General Chemistry Using a Diagnostic Algebra Test

    NASA Astrophysics Data System (ADS)

    Cooper, Cameron I.; Pearson, Paul T.

    2012-02-01

    In higher education, many high-enrollment introductory courses have evolved into "gatekeeper" courses due to their high failure rates. These courses prevent many students from attaining their educational goals and often become graduation roadblocks. At the authors' home institution, general chemistry has become a gatekeeper course in which approximately 25% of students do not pass. This failure rate in chemistry is common, and often higher, at many other institutions of higher education, and mathematical deficiencies are perceived to be a large contributing factor. This paper details the development of a highly accurate predictive system that identifies students at the beginning of the semester who are "at-risk" for earning a grade of C- or below in chemistry. The predictive accuracy of this system is maximized by using a genetically optimized neural network to analyze the results of a diagnostic algebra test designed for a specific population. Once at-risk students have been identified, they can be helped to improve their chances of success using techniques such as concurrent support courses, online tutorials, "just-in-time" instructional aides, study skills, motivational interviewing, and/or peer mentoring.

  6. [Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections].

    PubMed

    Toledano-Sierra, Pilar; Arriola-Hernández, Maite; Orueta-Sánchez, Ramón

    2015-01-01

    Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease) where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics. PMID:25646631

  7. THE ANALYSIS OF DIAGNOSTIC EFFECTIVENESS OF A FACET DESIGN BATTERY OF ACHIEVEMENT AND ANALYTICAL ABILITY TEST.

    ERIC Educational Resources Information Center

    GUTTMAN, LOUIS; SCHLESINGER, I.M.

    THE INTERNAL STRUCTURE OF A BATTERY OF ACHIEVEMENT AND INTELLIGENCE TESTS WAS ANALYZED TO ENHANCE THE DIAGNOSTIC VALUE OF THE BATTERY. CONSTRUCTION OF THE ACHIEVEMENT AND INTELLIGENCE TESTS WAS GUIDED BY A FACET DESIGN. THE RESEARCH HYPOTHESES WERE THAT--(1) STAGES OF DEVELOPMENT AND ACHIEVEMENT IN THE VARIOUS AREAS TESTED IN THE BATTERY EXIST,…

  8. A Procedure for Accurately Measuring the Shaker Overturning Moment During Random Vibration Tests

    NASA Technical Reports Server (NTRS)

    Nayeri, Reza D.

    2011-01-01

    Motivation: For large system level random vibration tests, there may be some concerns about the shaker's capability for the overturning moment. It is the test conductor's responsibility to predict and monitor the overturning moment during random vibration tests. If the predicted moment is close to the shaker's capability, test conductor must measure the instantaneous moment at low levels and extrapolate to higher levels. That data will be used to decide whether it is safe to proceed to the next test level. Challenge: Kistler analog formulation for computing the real-time moment is only applicable to very limited cases in which we have 3 or 4 load cells installed at shaker interface with hardware. Approach: To overcome that limitation, a simple procedure was developed for computing the overturning moment time histories using the measured time histories of the individual load cells.

  9. Biosensors and rapid diagnostic tests on the frontier between analytical and clinical chemistry for biomolecular diagnosis of dengue disease: a review.

    PubMed

    Teles, Fernando Sérgio Rodrigues Ribeiro

    2011-02-14

    The past decades have witnessed enormous technological improvements towards the development of simple, cost-effective and accurate rapid diagnostic tests for detection and identification of infectious pathogens. Among them is dengue virus, the etiologic agent of the mosquito-borne dengue disease, one of the most important emerging infectious pathologies of nowadays. Dengue fever may cause potentially deadly hemorrhagic symptoms and is endemic in the tropical and sub-tropical world, being also a serious threat to temperate countries in the developed world. Effective diagnostics for dengue should be able to discriminate among the four antigenically related dengue serotypes and fulfill the requirements for successful decentralized (point-of-care) testing in the harsh environmental conditions found in most tropical regions. The accurate identification of circulating serotypes is crucial for the successful implementation of vector control programs based on reliable epidemiological predictions. This paper briefly summarizes the limitations of the main conventional techniques for biomolecular diagnosis of dengue disease and critically reviews some of the most relevant biosensors and rapid diagnostic tests developed, implemented and reported so far for point-of-care testing of dengue infections. The invaluable contributions of microfluidics and nanotechnology encompass the whole paper, while evaluation concerns of rapid diagnostic tests and foreseen technological improvements in this field are also overviewed for the diagnosis of dengue and other infectious and tropical diseases as well. PMID:21241843

  10. Cost Implications of Value-Based Pricing for Companion Diagnostic Tests in Precision Medicine.

    PubMed

    Zaric, Gregory S

    2016-07-01

    Many interpretations of personalized medicine, also referred to as precision medicine, include discussions of companion diagnostic tests that allow drugs to be targeted to those individuals who are most likely to benefit or that allow treatment to be designed in a way such that individuals who are unlikely to benefit do not receive treatment. Many authors have commented on the clinical and competitive implications of companion diagnostics, but there has been relatively little formal analysis of the cost implications of companion diagnostics, although cost reduction is often cited as a significant benefit of precision medicine. We investigate the potential impact on costs of precision medicine implemented through the use of companion diagnostics. We develop a framework in which the costs of companion diagnostic tests are determined by considerations of profit maximization and cost effectiveness. We analyze four scenarios that are defined by the incremental cost-effectiveness ratio of the new drug in the absence of a companion diagnostic test. We find that, in most scenarios, precision medicine strategies based on companion diagnostics should be expected to lead to increases in costs in the short term and that costs would fall only in a limited number of situations. PMID:26899833

  11. Human Immunodeficiency Virus Diagnostic Testing: 30 Years of Evolution.

    PubMed

    Alexander, Thomas S

    2016-04-01

    A concern during the early AIDS epidemic was the lack of a test to identify individuals who carried the virus. The first HIV antibody test, developed in 1985, was designed to screen blood products, not to diagnose AIDS. The first-generation assays detected IgG antibody and became positive 6 to 12 weeks postinfection. False-positive results occurred; thus, a two-test algorithm was developed using a Western blot or immunofluorescence test as a confirmatory procedure. The second-generation HIV test added recombinant antigens, and the third-generation HIV tests included IgM detection, reducing the test-negative window to approximately 3 weeks postinfection. Fourth- and fifth-generation HIV assays added p24 antigen detection to the screening assay, reducing the test-negative window to 11 to 14 days. A new algorithm addressed the fourth-generation assay's ability to detect both antibody and antigen and yet not differentiate between them. The fifth-generation HIV assay provides separate antigen and antibody results and will require yet another algorithm. HIV infection may now be detected approximately 2 weeks postexposure, with a reduced number of false-positive results. PMID:26936099

  12. Colorado Diagnostic Test of English as a Second Language.

    ERIC Educational Resources Information Center

    Stansfield, Charles

    The testing of non-English dominant children cannot be achieved through written examinations that demand reading proficiency and that fail to ascertain the strengths or weaknesses of individual performance. Nor can an oral proficiency test, involving a lengthy tension-inducing interview and relatively inconclusive scoring, provide the information…

  13. EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS).

    PubMed

    Dench, Rosalie; Sulistyo, Fransiska; Fahroni, Agus; Philippa, Joost

    2015-12-01

    The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the

  14. Estimation of diagnostic test accuracy without full verification: a review of latent class methods

    PubMed Central

    Collins, John; Huynh, Minh

    2014-01-01

    The performance of a diagnostic test is best evaluated against a reference test that is without error. For many diseases, this is not possible, and an imperfect reference test must be used. However, diagnostic accuracy estimates may be biased if inaccurately verified status is used as the truth. Statistical models have been developed to handle this situation by treating disease as a latent variable. In this paper, we conduct a systematized review of statistical methods using latent class models for estimating test accuracy and disease prevalence in the absence of complete verification. PMID:24910172

  15. Test system accurately determines tensile properties of irradiated metals at cryogenic temperatures

    NASA Technical Reports Server (NTRS)

    Levine, P. J.; Skalka, R. J.; Vandergrift, E. F.

    1967-01-01

    Modified testing system determines tensile properties of irradiated brittle-type metals at cryogenic temperatures. The system includes a lightweight cryostat, split-screw grips, a universal joint, and a special temperature control system.

  16. Paradoxical effects of testing: retrieval enhances both accurate recall and suggestibility in eyewitnesses.

    PubMed

    Chan, Jason C K; Langley, Moses M

    2011-01-01

    Although retrieval practice typically enhances memory retention, it can also impair subsequent eyewitness memory accuracy (Chan, Thomas, & Bulevich, 2009). Specifically, participants who had taken an initial test about a witnessed event were more likely than nontested participants to recall subsequently encountered misinformation—an effect we called retrieval-enhanced suggestibility (RES). Here, we sought to test the generality of RES and to further elucidate its underlying mechanisms. To that end, we tested a dual mechanism account, which suggests that RES occurs because initial testing (a) enhances learning of the later misinformation by reducing proactive interference and (b) causes the reactivated memory trace to be more susceptible to later interference (i.e., a reconsolidation account). Three major findings emerged. First, RES was found after a 1-week delay, where a robust testing benefit occurred for event details that were not contradicted by later misinformation. Second, blockage of reconsolidation was unnecessary for RES to occur. Third, initial testing enhanced learning of the misinformation even when proactive interference played a minimal role. PMID:20919785

  17. Comprehensive Carrier Screening and Molecular Diagnostic Testing for Recessive Childhood Diseases

    PubMed Central

    Kingsmore, Stephen

    2012-01-01

    Of 7,028 disorders with suspected Mendelian inheritance, 1,139 are recessive and have an established molecular basis. Although individually uncommon, Mendelian diseases collectively account for ~20% of infant mortality and ~18% of pediatric hospitalizations. Molecular diagnostic testing is currently available for only ~300 recessive disorders. Preconception screening, together with genetic counseling of carriers, has resulted in remarkable declines in the incidence of several severe recessive diseases including Tay-Sachs disease and cystic fibrosis. However, extension of preconception screening and molecular diagnostic testing to most recessive disease genes has hitherto been impractical. Recently, we reported a preconception carrier screen / molecular diagnostic test for 448 recessive childhood diseases. The current status of this test is reviewed here. Currently, this reports analytical validity of the comprehensive carrier test. As the clinical validity and clinical utility in the contexts described is ascertained, this article will be updated. PMID:22872815

  18. Comprehensive carrier screening and molecular diagnostic testing for recessive childhood diseases.

    PubMed

    Kingsmore, Stephen

    2012-01-01

    Of 7,028 disorders with suspected Mendelian inheritance, 1,139 are recessive and have an established molecular basis. Although individually uncommon, Mendelian diseases collectively account for ~20% of infant mortality and ~18% of pediatric hospitalizations. Molecular diagnostic testing is currently available for only ~300 recessive disorders. Preconception screening, together with genetic counseling of carriers, has resulted in remarkable declines in the incidence of several severe recessive diseases including Tay-Sachs disease and cystic fibrosis. However, extension of preconception screening and molecular diagnostic testing to most recessive disease genes has hitherto been impractical. Recently, we reported a preconception carrier screen / molecular diagnostic test for 448 recessive childhood diseases. The current status of this test is reviewed here. Currently, this reports analytical validity of the comprehensive carrier test. As the clinical validity and clinical utility in the contexts described is ascertained, this article will be updated. PMID:22872815

  19. A Novel Malaria Pf/Pv Ab Rapid Diagnostic Test Using a Differential Diagnostic Marker Identified by Network Biology.

    PubMed

    Cho, Sung Jin; Lee, Jihoo; Lee, Hyun Jae; Jo, Hyun-Young; Sinniah, Mangalam; Kim, Hak-Yong; Chong, Chom-Kyu; Song, Hyun-Ok

    2016-01-01

    Rapid diagnostic tests (RDTs) can detect anti-malaria antibodies in human blood. As they can detect parasite infection at the low parasite density, they are useful in endemic areas where light infection and/or re-infection of parasites are common. Thus, malaria antibody tests can be used for screening bloods in blood banks to prevent transfusion-transmitted malaria (TTM), an emerging problem in malaria endemic areas. However, only a few malaria antibody tests are available in the microwell-based assay format and these are not suitable for field application. A novel malaria antibody (Ab)-based RDT using a differential diagnostic marker for falciparum and vivax malaria was developed as a suitable high-throughput assay that is sensitive and practical for blood screening. The marker, merozoite surface protein 1 (MSP1) was discovered by generation of a Plasmodium-specific network and the hierarchical organization of modularity in the network. Clinical evaluation revealed that the novel Malaria Pf/Pv Ab RDT shows improved sensitivity (98%) and specificity (99.7%) compared with the performance of a commercial kit, SD BioLine Malaria P.f/P.v (95.1% sensitivity and 99.1% specificity). The novel Malaria Pf/Pv Ab RDT has potential for use as a cost-effective blood-screening tool for malaria and in turn, reduces TTM risk in endemic areas. PMID:27313496

  20. A Novel Malaria Pf/Pv Ab Rapid Diagnostic Test Using a Differential Diagnostic Marker Identified by Network Biology

    PubMed Central

    Cho, Sung Jin; Lee, Jihoo; Lee, Hyun Jae; Jo, Hyun-Young; Sinniah, Mangalam; Kim, Hak-Yong; Chong, Chom-Kyu; Song, Hyun-Ok

    2016-01-01

    Rapid diagnostic tests (RDTs) can detect anti-malaria antibodies in human blood. As they can detect parasite infection at the low parasite density, they are useful in endemic areas where light infection and/or re-infection of parasites are common. Thus, malaria antibody tests can be used for screening bloods in blood banks to prevent transfusion-transmitted malaria (TTM), an emerging problem in malaria endemic areas. However, only a few malaria antibody tests are available in the microwell-based assay format and these are not suitable for field application. A novel malaria antibody (Ab)-based RDT using a differential diagnostic marker for falciparum and vivax malaria was developed as a suitable high-throughput assay that is sensitive and practical for blood screening. The marker, merozoite surface protein 1 (MSP1) was discovered by generation of a Plasmodium-specific network and the hierarchical organization of modularity in the network. Clinical evaluation revealed that the novel Malaria Pf/Pv Ab RDT shows improved sensitivity (98%) and specificity (99.7%) compared with the performance of a commercial kit, SD BioLine Malaria P.f/P.v (95.1% sensitivity and 99.1% specificity). The novel Malaria Pf/Pv Ab RDT has potential for use as a cost-effective blood-screening tool for malaria and in turn, reduces TTM risk in endemic areas. PMID:27313496

  1. Diagnostic development and support of MHD test facilities. Final progress report, March 1980--March 1994

    SciTech Connect

    Not Available

    1995-02-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU), under U.S. Department of Energy (DOE) Contract No. DE-AC02-80ET-15601, Diagnostic Development and Support of MHD Test Facilities, developed diagnostic instruments for magnetohydrodynamic (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery (HRSR) support, were refined, and new systems to measure temperatures and gas-seed-slag stream characteristics were developed. To further data acquisition and analysis capabilities, the diagnostic systems were interfaced with DIAL`s computers. Technical support was provided for the diagnostic needs of the national MHD research effort. DIAL personnel also cooperated with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. The initial contract, Testing and Evaluation of Heat Recovery/Seed Recovery, established a data base on heat transfer, slagging effects on heat transfer surfaces, metal durability, secondary combustor performance, secondary combustor design requirements, and other information pertinent to the design of HR/SR components at the Coal-Fired Flow Facility (CFFF). To accomplish these objectives, a combustion test stand was constructed that simulated MHD environments, and mathematical models were developed and evaluated for the heat transfer in hot-wall test sections. Two transitions occurred during the span of this contract. In May 1983, the objectives and title of the contract changed from Testing and Evaluation of Heat Recovery/Seed Recovery to Diagnostic Development and Support of MHD Test Facilities. In July 1988, the research laboratory`s name changed from the MHD Energy Center to the Diagnostic Instrumentation and Analysis Laboratory.

  2. Improving Building Energy Simulation Programs Through Diagnostic Testing (Fact Sheet)

    SciTech Connect

    Not Available

    2012-02-01

    New test procedure evaluates quality and accuracy of energy analysis tools for the residential building retrofit market. Reducing the energy use of existing homes in the United States offers significant energy-saving opportunities, which can be identified through building simulation software tools that calculate optimal packages of efficiency measures. To improve the accuracy of energy analysis for residential buildings, the National Renewable Energy Laboratory's (NREL) Buildings Research team developed the Building Energy Simulation Test for Existing Homes (BESTEST-EX), a method for diagnosing and correcting errors in building energy audit software and calibration procedures. BESTEST-EX consists of building physics and utility bill calibration test cases, which software developers can use to compare their tools simulation findings to reference results generated with state-of-the-art simulation tools. Overall, the BESTEST-EX methodology: (1) Tests software predictions of retrofit energy savings in existing homes; (2) Ensures building physics calculations and utility bill calibration procedures perform to a minimum standard; and (3) Quantifies impacts of uncertainties in input audit data and occupant behavior. BESTEST-EX is helping software developers identify and correct bugs in their software, as well as develop and test utility bill calibration procedures.

  3. Rapid diagnostic tests for diagnosing uncomplicated non-falciparum or Plasmodium vivax malaria in endemic countries

    PubMed Central

    Abba, Katharine; Kirkham, Amanda J; Olliaro, Piero L; Deeks, Jonathan J; Donegan, Sarah; Garner, Paul; Takwoingi, Yemisi

    2014-01-01

    specificities are presented alongside 95% confidence intervals (95% CI). Main results We included 47 studies enrolling 22,862 participants. Patient characteristics, sampling methods and reference standard methods were poorly reported in most studies. RDTs detecting 'non-falciparum' parasitaemia Eleven studies evaluated Type 2 tests compared with microscopy, 25 evaluated Type 3 tests, and 11 evaluated Type 4 tests. In meta-analyses, average sensitivities and specificities were 78% (95% CI 73% to 82%) and 99% (95% CI 97% to 99%) for Type 2 tests, 78% (95% CI 69% to 84%) and 99% (95% CI 98% to 99%) for Type 3 tests, and 89% (95% CI 79% to 95%) and 98% (95% CI 97% to 99%) for Type 4 tests, respectively. Type 4 tests were more sensitive than both Type 2 (P = 0.01) and Type 3 tests (P = 0.03). Five studies compared Type 3 tests with PCR; in meta-analysis, the average sensitivity and specificity were 81% (95% CI 72% to 88%) and 99% (95% CI 97% to 99%) respectively. RDTs detecting P.vivax parasitaemia Eight studies compared pLDH tests to microscopy; the average sensitivity and specificity were 95% (95% CI 86% to 99%) and 99% (95% CI 99% to 100%), respectively. Authors' conclusions RDTs designed to detect P. vivax specifically, whether alone or as part of a mixed infection, appear to be more accurate than older tests designed to distinguish P. falciparum malaria from non-falciparum malaria. Compared to microscopy, these tests fail to detect around 5% ofP. vivax cases. This Cochrane Review, in combination with other published information about in vitro test performance and stability in the field, can assist policy-makers to choose between the available RDTs. PLAIN LANGUAGE SUMMARY Rapid tests for diagnosing malaria caused by Plasmodium vivax or other less common parasites This review summarises trials evaluating the accuracy of rapid diagnostic tests (RDTs) for diagnosing malaria due to Plasmodium vivax or other non-falciparum species. After searching for relevant studies up to December

  4. A new tool improves diagnostic test performance for transmission em evaluation of axonemal dynein arms.

    PubMed

    Funkhouser, W Keith; Niethammer, Marc; Carson, Johnny L; Burns, Kimberlie A; Knowles, Michael R; Leigh, Margaret W; Zariwala, Maimoona A; Funkhouser, William K

    2014-08-01

    Abstract Diagnosis of primary ciliary dyskinesia (PCD) by identification of dynein arm loss in transmission electron microscopy (TEM) images can be confounded by high background noise due to random electron-dense material within the ciliary matrix, leading to diagnostic uncertainty even for experienced morphologists. The authors developed a novel image analysis tool to average the axonemal peripheral microtubular doublets, thereby increasing microtubular signal and reducing random background noise. In a randomized, double-blinded study that compared two experienced morphologists and three different diagnostic approaches, they found that use of this tool led to improvement in diagnostic TEM test performance. PMID:23957500

  5. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory...

  6. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

  7. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory...

  8. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

  9. A Viscoelastic Constitutive Model Can Accurately Represent Entire Creep Indentation Tests of Human Patella Cartilage

    PubMed Central

    Pal, Saikat; Lindsey, Derek P.; Besier, Thor F.; Beaupre, Gary S.

    2013-01-01

    Cartilage material properties provide important insights into joint health, and cartilage material models are used in whole-joint finite element models. Although the biphasic model representing experimental creep indentation tests is commonly used to characterize cartilage, cartilage short-term response to loading is generally not characterized using the biphasic model. The purpose of this study was to determine the short-term and equilibrium material properties of human patella cartilage using a viscoelastic model representation of creep indentation tests. We performed 24 experimental creep indentation tests from 14 human patellar specimens ranging in age from 20 to 90 years (median age 61 years). We used a finite element model to reproduce the experimental tests and determined cartilage material properties from viscoelastic and biphasic representations of cartilage. The viscoelastic model consistently provided excellent representation of the short-term and equilibrium creep displacements. We determined initial elastic modulus, equilibrium elastic modulus, and equilibrium Poisson’s ratio using the viscoelastic model. The viscoelastic model can represent the short-term and equilibrium response of cartilage and may easily be implemented in whole-joint finite element models. PMID:23027200

  10. Paradoxical Effects of Testing: Retrieval Enhances Both Accurate Recall and Suggestibility in Eyewitnesses

    ERIC Educational Resources Information Center

    Chan, Jason C. K.; Langley, Moses M.

    2011-01-01

    Although retrieval practice typically enhances memory retention, it can also impair subsequent eyewitness memory accuracy (Chan, Thomas, & Bulevich, 2009). Specifically, participants who had taken an initial test about a witnessed event were more likely than nontested participants to recall subsequently encountered misinformation--an effect we…

  11. Revisiting the blind tests in crystal structure prediction: accurate energy ranking of molecular crystals.

    PubMed

    Asmadi, Aldi; Neumann, Marcus A; Kendrick, John; Girard, Pascale; Perrin, Marc-Antoine; Leusen, Frank J J

    2009-12-24

    In the 2007 blind test of crystal structure prediction hosted by the Cambridge Crystallographic Data Centre (CCDC), a hybrid DFT/MM method correctly ranked each of the four experimental structures as having the lowest lattice energy of all the crystal structures predicted for each molecule. The work presented here further validates this hybrid method by optimizing the crystal structures (experimental and submitted) of the first three CCDC blind tests held in 1999, 2001, and 2004. Except for the crystal structures of compound IX, all structures were reminimized and ranked according to their lattice energies. The hybrid method computes the lattice energy of a crystal structure as the sum of the DFT total energy and a van der Waals (dispersion) energy correction. Considering all four blind tests, the crystal structure with the lowest lattice energy corresponds to the experimentally observed structure for 12 out of 14 molecules. Moreover, good geometrical agreement is observed between the structures determined by the hybrid method and those measured experimentally. In comparison with the correct submissions made by the blind test participants, all hybrid optimized crystal structures (apart from compound II) have the smallest calculated root mean squared deviations from the experimentally observed structures. It is predicted that a new polymorph of compound V exists under pressure. PMID:19950907

  12. The use of experimental bending tests to more accurate numerical description of TBC damage process

    NASA Astrophysics Data System (ADS)

    Sadowski, T.; Golewski, P.

    2016-04-01

    Thermal barrier coatings (TBCs) have been extensively used in aircraft engines to protect critical engine parts such as blades and combustion chambers, which are exposed to high temperatures and corrosive environment. The blades of turbine engines are additionally exposed to high mechanical loads. These loads are created by the high rotational speed of the rotor (30 000 rot/min), causing the tensile and bending stresses. Therefore, experimental testing of coated samples is necessary in order to determine strength properties of TBCs. Beam samples with dimensions 50×10×2 mm were used in those studies. The TBC system consisted of 150 μm thick bond coat (NiCoCrAlY) and 300 μm thick top coat (YSZ) made by APS (air plasma spray) process. Samples were tested by three-point bending test with various loads. After bending tests, the samples were subjected to microscopic observation to determine the quantity of cracks and their depth. The above mentioned results were used to build numerical model and calibrate material data in Abaqus program. Brittle cracking damage model was applied for the TBC layer, which allows to remove elements after reaching criterion. Surface based cohesive behavior was used to model the delamination which may occur at the boundary between bond coat and top coat.

  13. Comparative evaluation of two rapid field tests for malaria diagnosis: Partec Rapid Malaria Test® and Binax Now® Malaria Rapid Diagnostic Test

    PubMed Central

    2011-01-01

    Background About 90% of all malaria deaths in sub-Saharan Africa occur in children under five years. Fast and reliable diagnosis of malaria requires confirmation of the presence of malaria parasites in the blood of patients with fever or history suggestive of malaria; hence a prompt and accurate diagnosis of malaria is the key to effective disease management. Confirmation of malaria infection requires the availability of a rapid, sensitive, and specific testing at an affordable cost. We compared two recent methods (the novel Partec Rapid Malaria Test® (PT) and the Binax Now® Malaria Rapid Diagnostic Test (BN RDT) with the conventional Giemsa stain microscopy (GM) for the diagnosis of malaria among children in a clinical laboratory of a hospital in a rural endemic area of Ghana. Methods Blood samples were collected from 263 children admitted with fever or a history of fever to the pediatric clinic of the Agogo Presbyterian Hospital. The three different test methods PT, BN RDT and GM were performed independently by well trained and competent laboratory staff to assess the presence of malaria parasites. Results were analyzed and compared using GM as the reference standard. Results In 107 (40.7%) of 263 study participants, Plasmodium sp. was detected by GM. PT and BN RDT showed positive results in 111 (42.2%) and 114 (43.4%), respectively. Compared to GM reference standard, the sensitivities of the PT and BN RDT were 100% (95% CI: 96.6-100) and 97.2% (95% CI: 92.0-99.4), respectively, specificities were 97.4% (95% CI: 93.6-99.3) and 93.6% (95% CI: 88.5-96.9), respectively. There was a strong agreement (kappa) between the applied test methods (GM vs PT: 0.97; p < 0.001 and GM vs BN RDT: 0.90; p < 0.001). The average turnaround time per tests was 17 minutes. Conclusion In this study two rapid malaria tests, PT and BN RDT, demonstrated a good quality of their performance compared to conventional GM. Both methods require little training, have short turnaround times, are

  14. Selection of diagnostic tests for clinical decision making and translation to a problem oriented medical record.

    PubMed

    Realdi, Giuseppe; Previato, Lorenzo; Vitturi, Nicola

    2008-07-01

    The leading function of the physician is the clinical reasoning, which involves appropriate investigation of the problems of the patient, formulation of a diagnostic suspect based on the patient's symptoms and signs, gathering of additional relevant information, to select necessary tests and administration of the most suitable therapy. The problems of the patient are expressed by symptoms or signs or abnormal test results, requested for a variety of reasons. The entire scientific, as well as diagnostic approach, is based on three steps: to stumble in a problem; to try a solution through a hypothesis; to disprove or to prove the hypothesis by a process of criticism. Clinicians use the information obtained from the history and physical examination to estimate initial (or pre-test) probability and then use the results from tests and other diagnostic procedures to modify this probability until the post-test probability is such that the suspected diagnosis is either confirmed or ruled out. When the pre-test probability of disease is high, tests characterized by high specificity will be preferred, in order to confirm the diagnostic suspect. When the pre-test probability of disease is low, a test with high sensitivity is advisable to exclude the hypothetical disease. The above mentioned process of decision making has been transferred to a problem oriented medical record that is currently employed in our Clinic. PMID:18420030

  15. Diagnostic efficacy of in vitro methods vs. skin testing in patients with inhalant allergies

    SciTech Connect

    Corey, J.P.; Liudahl, J.J.; Young, S.A.; Rodman, S.M. )

    1991-03-01

    The purpose of our study was to investigate the diagnostic efficacy of two selected methods of in vitro allergy testing. Specifically, the PRIST/modified RAST I125 isotope systems and the Quantizyme/modified EAST alkaline phosphatase method were compared. The time, expense, convenience, and diagnostic efficacy of the two procedures are discussed. Special attention is given to the practicality of each method for the practicing physician.

  16. Observations on diagnostic tests for paratuberculosis in a deer herd.

    PubMed

    Temple, R M; Muscoplat, C C; Thoen, C O; Himes, E M; Johnson, D W

    1979-11-01

    Paratuberculosis was diagnosed in a herd of 62 fallow deer (Dama dama) and 38 sika deer (Cervus nipon) maintained in an animal park in Ohio. A comparison was made of delayed-type hypersensitivity responses, results of in vitro lymphocyte immunostimulation tests, and isolation of Mycobacterium paratuberculosis on fecal culture in 19 deer. PMID:521371

  17. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests

    PubMed Central

    Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests. PMID:27574576

  18. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    PubMed

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests. PMID:27574576

  19. [The diagnostic value of tests for mental control].

    PubMed

    Lindeboom, J; Koene, T; Matto, D

    1993-06-01

    Designated as Mental Control, the recitation of word lists and arithmetic progressions is often used for a cursory examination of attention and concentration in elderly patients. We studied the psychometric properties of the EMCT (Expanded Mental Control Test), which consists of 12 mental control tasks. The test was given to 174 residents of rest homes and semi-independent housing projects (aged 68 to 94) and 74 neurologic patients (aged 65 to 87) who had been referred for neuropsychological assessment. The reliability of the EMCT was satisfactory. Performance was related to education level but not to sex or age. In healthy subjects the EMCT score was associated with the backward digit span score. The correlations between the EMCT and subtests of the Amsterdam Dementia Screening (Ads6) in patients appeared to depend on the complexity of the target behavior. Performance on the EMCT may reflect the functioning of the Supervisory Attentional System postulated by Shallice. PMID:8328004

  20. A diagnostic skin test for Onchocerca volvulus infection.

    PubMed

    Ngu, J L; Ndumbe, P M; Titanji, V; Leke, R

    1981-09-01

    Onchocerca supernatant (OS) was prepared by a technique permitting live microfilariae to migrate from nodule tissue through agar gel into sterile Hanks balanced salt/Penicillin-Streptomycin solution where they metabolized. The OS, after dialysis, was passed through Seitz viral filter and either concentrated or lyophilized. Using rabbit antiserum in immunodiffusion and immunoelectrophoresis tests, microfilariae proteins and also human protein were detected in out OS. No common antigens were found between this and somatic extracts of Loa loa, O. gutturosa, O. volvulus, L. carinii, D. immittis and A. lumbricoides. 125I labelled OS was purified by passage through protein A column and then through immunosorbent column of horse anti-human serum linked to CNB-activated sepharose 4B. Autoradiography, after sodium dodecyl sulphate polyacylamide slab gel eletrophoresis of purified OS, showed 10 protein bands in the molecular range 10,000 to 125,000. Skin prick tests with OS, shown not to be contaminated with Hepatitis B antigens, elicited immediate hypersensitivity reaction. Using our criteria, positive reactions were seen in 81% of proven onchocerca cases and only occasionally in Loasis 4.5%, ascaridiasis 13.5% or healthy controls 2.4%. The poor skin reactivity to OS in loasis was not due to immunosuppression as these patients, when also infested with ascaris, reacted just as well as onchocerca patients with ascaris to skin prick test using somatic extracts of ascaris. PMID:6808726

  1. Blood lactate diagnostics in exercise testing and training.

    PubMed

    Beneke, Ralph; Leithäuser, Renate M; Ochentel, Oliver

    2011-03-01

    A link between lactate and muscular exercise was seen already more than 200 years ago. The blood lactate concentration (BLC) is sensitive to changes in exercise intensity and duration. Multiple BLC threshold concepts define different points on the BLC power curve during various tests with increasing power (INCP). The INCP test results are affected by the increase in power over time. The maximal lactate steady state (MLSS) is measured during a series of prolonged constant power (CP) tests. It detects the highest aerobic power without metabolic energy from continuing net lactate production, which is usually sustainable for 30 to 60 min. BLC threshold and MLSS power are highly correlated with the maximum aerobic power and athletic endurance performance. The idea that training at threshold intensity is particularly effective has no evidence. Three BLC-orientated intensity domains have been established: (1) training up to an intensity at which the BLC clearly exceeds resting BLC, light- and moderate-intensity training focusing on active regeneration or high-volume endurance training (Intensity < Threshold); (2) heavy endurance training at work rates up to MLSS intensity (Threshold ≤ Intensity ≤ MLSS); and (3) severe exercise intensity training between MLSS and maximum oxygen uptake intensity mostly organized as interval and tempo work (Intensity > MLSS). High-performance endurance athletes combining very high training volume with high aerobic power dedicate 70 to 90% of their training to intensity domain 1 (Intensity < Threshold) in order to keep glycogen homeostasis within sustainable limits. PMID:21487146

  2. Simple Diagnostic Tests to Detect Toxic Alcohol Intoxications

    PubMed Central

    Shin, Jai Moo; Sachs, George; Kraut, Jeffrey A.

    2008-01-01

    Methanol, ethylene glycol, and diethylene glycol intoxications can produce visual disturbances, neurological disturbances, acute renal failure, pulmonary dysfunction, cardiac dysfunction, metabolic acidosis, and death. Metabolic acidosis and an increased serum osmolality are important clues to their diagnosis. The former reflects the organic acids produced by metabolism of the parent alcohol, while the latter is due to accumulation of the offending alcohol. However, neither the clinical nor the laboratory findings are specific for toxic alcohol ingestions. The definitive diagnosis of the alcohol intoxications is commonly based on detection of the alcohol or its metabolites in blood. Early diagnosis is important, because initiation of appropriate treatment can markedly lessen their morbidity and mortality. At present detection of the parent alcohol in body fluids is inferred from its measurement in blood. This measurement is often performed by specialty laboratories using expensive equipment, and a long delay between obtaining the specimen and getting the results is not unusual. In this report, we describe liquid- based tests that detect methanol, ethylene glycol, diethylene glycol, and ethanol in saliva. The tests are sensitive and they have different specificity for each of the alcohols facilitating distinction among them. The relatively high sensitivity and specificity of the tests as a whole will facilitate the rapid diagnosis of each of these alcohol intoxications. PMID:18940722

  3. Cognitive Diagnostic Models for Tests with Multiple-Choice and Constructed-Response Items

    ERIC Educational Resources Information Center

    Kuo, Bor-Chen; Chen, Chun-Hua; Yang, Chih-Wei; Mok, Magdalena Mo Ching

    2016-01-01

    Traditionally, teachers evaluate students' abilities via their total test scores. Recently, cognitive diagnostic models (CDMs) have begun to provide information about the presence or absence of students' skills or misconceptions. Nevertheless, CDMs are typically applied to tests with multiple-choice (MC) items, which provide less diagnostic…

  4. [Appropriateness of diagnostic tests in cardiovascular prevention: what can we skip?].

    PubMed

    Cherubini, Antonella; Mureddu, Gian Francesco; Temporelli, Pier Luigi; Frisinghelli, Anna; Clavario, Piero; Cesana, Francesca; Fattirolli, Francesco

    2014-04-01

    In recent years, a huge increase in the use of cardiac procedures, both invasive and non-invasive, was observed. Diagnostic tests, mainly non-invasive tests, are often prescribed inappropriately, in most cases replacing the clinical evaluation. The rate of inappropriate tests in cardiology is largely variable, depending on regional issues and different medical approach. When the test entails radiation exposure, the biological risk for both the patient and the environment must be taken into account. For this reason, the test that results in less biological risk should always be preferred as a first step.Moreover, it has not been clearly demonstrated that some diagnostic tests help to improve the outcome, that is to prevent cardiovascular events. As many as one sixth of the patients who undergo stress imaging are not taking proper medication, and very frequently no change in therapy is made after the test, regardless of the outcome. Since the appropriateness of diagnostic evaluation requests is mandatory, we focused on the diagnostic tests usually performed in primary and secondary prevention that carry no contribution to the clinical management of patients. This review addresses the need to optimize available resources, reduce costs and avoid unnecessary cardiovascular assessments, thereby enhancing the more efficient care delivery models. PMID:24873815

  5. Diagnostic Tests and Criterion-Referenced Assessments: Their Contribution to the Resolution of Pupil Learning Difficulties.

    ERIC Educational Resources Information Center

    Simpson, Mary; Arnold, Brian

    1983-01-01

    Suggests that failure to learn is often the result of inappropriateness of level of instruction and deficiencies in instructional procedures and educational strategies, and differentiates between the functions of criterion referenced tests and diagnostic tests. Results are reported from two studies of the teaching of osmosis and photosynthesis.…

  6. Constructing and Validating a Q-Matrix for Cognitive Diagnostic Analyses of a Reading Test

    ERIC Educational Resources Information Center

    Li, Hongli; Suen, Hoi K.

    2013-01-01

    Cognitive diagnostic analyses have been advocated as methods that allow an assessment to function as a formative assessment to inform instruction. To use this approach, it is necessary to first identify the skills required for each item in the test, known as a Q-matrix. However, because the construct being tested and the underlying cognitive…

  7. An Investigation into the Consequential Validity of a Diagnostic College English Speaking Test

    ERIC Educational Resources Information Center

    Zhao, Zhongbao

    2013-01-01

    This paper reports the verification of the consequential validity of a Diagnostic College English Speaking Test. A case study was conducted with 28 sophomore students from a national key university in China engaged in seven sets of DCEST tests. The analysis of the DCEST scores of the students in the experiment group indicates that progress has…

  8. Development and Validation of a Diagnostic Grammar Test for Japanese Learners of English

    ERIC Educational Resources Information Center

    Koizumi, Rie; Sakai, Hideki; Ido, Takahiro; Ota, Hiroshi; Hayama, Megumi; Sato, Masatoshi; Nemoto, Akiko

    2011-01-01

    This article reports on the development and validation of the English Diagnostic Test of Grammar (EDiT Grammar) for Japanese learners of English. From among the many aspects of grammar, this test focuses on the knowledge of basic English noun phrases (NPs), especially their internal structures, because previous research has indicated the…

  9. Development and Use of Diagnostic Tests to Evaluate Students' Misconceptions in Science.

    ERIC Educational Resources Information Center

    Treagust, David F.

    1988-01-01

    Describes 10 steps for developing a diagnostic test of students' misconceptions and the use of two tests in chemistry (covalent bonding and structure) and in biology (photosynthesis and respiration in plants). Discusses the results and some implications for teaching science. (YP)

  10. Rotating Arc Jet Test Model: Time-Accurate Trajectory Heat Flux Replication in a Ground Test Environment

    NASA Technical Reports Server (NTRS)

    Laub, Bernard; Grinstead, Jay; Dyakonov, Artem; Venkatapathy, Ethiraj

    2011-01-01

    Though arc jet testing has been the proven method employed for development testing and certification of TPS and TPS instrumentation, the operational aspects of arc jets limit testing to selected, but constant, conditions. Flight, on the other hand, produces timevarying entry conditions in which the heat flux increases, peaks, and recedes as a vehicle descends through an atmosphere. As a result, we are unable to "test as we fly." Attempts to replicate the time-dependent aerothermal environment of atmospheric entry by varying the arc jet facility operating conditions during a test have proven to be difficult, expensive, and only partially successful. A promising alternative is to rotate the test model exposed to a constant-condition arc jet flow to yield a time-varying test condition at a point on a test article (Fig. 1). The model shape and rotation rate can be engineered so that the heat flux at a point on the model replicates the predicted profile for a particular point on a flight vehicle. This simple concept will enable, for example, calibration of the TPS sensors on the Mars Science Laboratory (MSL) aeroshell for anticipated flight environments.

  11. Accurate time delay technology in simulated test for high precision laser range finder

    NASA Astrophysics Data System (ADS)

    Chen, Zhibin; Xiao, Wenjian; Wang, Weiming; Xue, Mingxi

    2015-10-01

    With the continuous development of technology, the ranging accuracy of pulsed laser range finder (LRF) is higher and higher, so the maintenance demand of LRF is also rising. According to the dominant ideology of "time analog spatial distance" in simulated test for pulsed range finder, the key of distance simulation precision lies in the adjustable time delay. By analyzing and comparing the advantages and disadvantages of fiber and circuit delay, a method was proposed to improve the accuracy of the circuit delay without increasing the count frequency of the circuit. A high precision controllable delay circuit was designed by combining the internal delay circuit and external delay circuit which could compensate the delay error in real time. And then the circuit delay accuracy could be increased. The accuracy of the novel circuit delay methods proposed in this paper was actually measured by a high sampling rate oscilloscope actual measurement. The measurement result shows that the accuracy of the distance simulated by the circuit delay is increased from +/- 0.75m up to +/- 0.15m. The accuracy of the simulated distance is greatly improved in simulated test for high precision pulsed range finder.

  12. Bacterial Cytological Profiling (BCP) as a Rapid and Accurate Antimicrobial Susceptibility Testing Method for Staphylococcus aureus

    PubMed Central

    Quach, D.T.; Sakoulas, G.; Nizet, V.; Pogliano, J.; Pogliano, K.

    2016-01-01

    Successful treatment of bacterial infections requires the timely administration of appropriate antimicrobial therapy. The failure to initiate the correct therapy in a timely fashion results in poor clinical outcomes, longer hospital stays, and higher medical costs. Current approaches to antibiotic susceptibility testing of cultured pathogens have key limitations ranging from long run times to dependence on prior knowledge of genetic mechanisms of resistance. We have developed a rapid antimicrobial susceptibility assay for Staphylococcus aureus based on bacterial cytological profiling (BCP), which uses quantitative fluorescence microscopy to measure antibiotic induced changes in cellular architecture. BCP discriminated between methicillin-susceptible (MSSA) and -resistant (MRSA) clinical isolates of S. aureus (n = 71) within 1–2 h with 100% accuracy. Similarly, BCP correctly distinguished daptomycin susceptible (DS) from daptomycin non-susceptible (DNS) S. aureus strains (n = 20) within 30 min. Among MRSA isolates, BCP further identified two classes of strains that differ in their susceptibility to specific combinations of beta-lactam antibiotics. BCP provides a rapid and flexible alternative to gene-based susceptibility testing methods for S. aureus, and should be readily adaptable to different antibiotics and bacterial species as new mechanisms of resistance or multidrug-resistant pathogens evolve and appear in mainstream clinical practice. PMID:26981574

  13. Bacterial Cytological Profiling (BCP) as a Rapid and Accurate Antimicrobial Susceptibility Testing Method for Staphylococcus aureus.

    PubMed

    Quach, D T; Sakoulas, G; Nizet, V; Pogliano, J; Pogliano, K

    2016-02-01

    Successful treatment of bacterial infections requires the timely administration of appropriate antimicrobial therapy. The failure to initiate the correct therapy in a timely fashion results in poor clinical outcomes, longer hospital stays, and higher medical costs. Current approaches to antibiotic susceptibility testing of cultured pathogens have key limitations ranging from long run times to dependence on prior knowledge of genetic mechanisms of resistance. We have developed a rapid antimicrobial susceptibility assay for Staphylococcus aureus based on bacterial cytological profiling (BCP), which uses quantitative fluorescence microscopy to measure antibiotic induced changes in cellular architecture. BCP discriminated between methicillin-susceptible (MSSA) and -resistant (MRSA) clinical isolates of S. aureus (n = 71) within 1-2 h with 100% accuracy. Similarly, BCP correctly distinguished daptomycin susceptible (DS) from daptomycin non-susceptible (DNS) S. aureus strains (n = 20) within 30 min. Among MRSA isolates, BCP further identified two classes of strains that differ in their susceptibility to specific combinations of beta-lactam antibiotics. BCP provides a rapid and flexible alternative to gene-based susceptibility testing methods for S. aureus, and should be readily adaptable to different antibiotics and bacterial species as new mechanisms of resistance or multidrug-resistant pathogens evolve and appear in mainstream clinical practice. PMID:26981574

  14. Rolling Element Bearing Diagnostics in Run-To Lifetime Testing

    NASA Astrophysics Data System (ADS)

    Williams, T.; Ribadeneira, X.; Billington, S.; Kurfess, T.

    2001-09-01

    Bearing failure is one of the foremost causes of breakdown in rotating machinery. Such failures can be catastrophic and can result in costly downtime. To date, most research has studied crack propagation resulting from artificial or 'seeded' damage. This damage has been induced in bearings by: scratching the surface, introducing debris into the lubricant or machined with an electrical discharge. The work presented here involves running new undamaged ball and roller bearings through to failure. Traditional vibration metrics such as: root mean square, peak value, kurtosis and crest factor are recorded through the test duration from accelerometers and acoustic emission sensors.

  15. Fan Noise Source Diagnostic Test: LDV Measured Flow Field Results

    NASA Technical Reports Server (NTRS)

    Podboy, Gary C.; Krupar, Martin J.; Hughes, Christopher E.; Woodward, Richard P.

    2003-01-01

    Results are presented of an experiment conducted to investigate potential sources of noise in the flow developed by two 22-in. diameter turbofan models. The R4 and M5 rotors that were tested were designed to operate at nominal take-off speeds of 12,657 and 14,064 RPMC, respectively. Both fans were tested with a common set of swept stators installed downstream of the rotors. Detailed measurements of the flows generated by the two were made using a laser Doppler velocimeter system. The wake flows generated by the two rotors are illustrated through a series of contour plots. These show that the two wake flows are quite different, especially in the tip region. These data are used to explain some of the differences in the rotor/stator interaction noise generated by the two fan stages. In addition to these wake data, measurements were also made in the R4 rotor blade passages. These results illustrate the tip flow development within the blade passages, its migration downstream, and (at high rotor speeds) its merging with the blade wake of the adjacent (following) blade. Data also depict the variation of this tip flow with tip clearance. Data obtained within the rotor blade passages at high rotational speeds illustrate the variation of the mean shock position across the different blade passages.

  16. Diagnostic performance characteristics of a rapid field test for anthrax in cattle.

    PubMed

    Muller, Janine; Gwozdz, Jacek; Hodgeman, Rachel; Ainsworth, Catherine; Kluver, Patrick; Czarnecki, Jill; Warner, Simone; Fegan, Mark

    2015-07-01

    Although diagnosis of anthrax can be made in the field with a peripheral blood smear, and in the laboratory with bacterial culture or molecular based tests, these tests require either considerable experience or specialised equipment. Here we report on the evaluation of the diagnostic sensitivity and specificity of a simple and rapid in-field diagnostic test for anthrax, the anthrax immunochromatographic test (AICT). The AICT detects the protective antigen (PA) component of the anthrax toxin present within the blood of an animal that has died from anthrax. The test provides a result in 15min and offers the advantage of avoiding the necessity for on-site necropsy and subsequent occupational risks and environmental contamination. The specificity of the test was determined by testing samples taken from 622 animals, not infected with Bacillus anthracis. Diagnostic sensitivity was estimated on samples taken from 58 animals, naturally infected with B. anthracis collected over a 10-year period. All samples used to estimate the diagnostic sensitivity and specificity of the AICT were also tested using the gold standard of bacterial culture. The diagnostic specificity of the test was estimated to be 100% (99.4-100%; 95% CI) and the diagnostic sensitivity was estimated to be 93.1% (83.3-98.1%; 95% CI) (Clopper-Pearson method). Four samples produced false negative AICT results. These were among 9 samples, all of which tested positive for B. anthracis by culture, where there was a time delay between collection and testing of >48h and/or the samples were collected from animals that were >48h post-mortem. A statistically significant difference (P<0.001; Fishers exact test) was found between the ability of the AICT to detect PA in samples from culture positive animals <48h post-mortem, 49 of 49, Se=100% (92.8-100%; 95% CI) compared with samples tested >48h post-mortem 5 of 9 Se=56% (21-86.3%; 95% CI) (Clopper-Pearson method). Based upon these results a post hoc cut-off for use of

  17. Diffusion of Molecular Diagnostic Lung Cancer Tests: A Survey of German Oncologists

    PubMed Central

    Steffen, Julius Alexander

    2014-01-01

    This study was aimed at examining the diffusion of diagnostic lung cancer tests in Germany. It was motivated by the high potential of detecting and targeting oncogenic drivers. Recognizing that the diffusion of diagnostic tests is a conditio sine qua non for the success of personalized lung cancer therapies, this study analyzed the diffusion of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tests in Germany. Qualitative and quantitative research strategies were combined in a mixed-method design. A literature review and subsequent Key Opinion Leader interviews identified a set of qualitative factors driving the diffusion process, which were then translated into an online survey. The survey was conducted among a sample of 961 oncologists (11.34% response rate). The responses were analyzed in a multiple linear regression which identified six statistically significant factors driving the diffusion of molecular diagnostic lung cancer tests: reimbursement, attitude towards R&D, information self-assessment, perceived attitudes of colleagues, age and test-pathway strategies. Besides the important role of adequate reimbursement and relevant guidelines, the results of this study suggest that an increasing usage of test-pathway strategies, especially in an office-based setting, can increase the diffusion of molecular diagnostic lung cancer tests in the future. PMID:25562146

  18. Evaluation of delayed puberty: what diagnostic tests should be performed in the seemingly otherwise well adolescent?

    PubMed

    Abitbol, Leah; Zborovski, Stephen; Palmert, Mark R

    2016-08-01

    Delayed puberty (DP) is defined as the lack of pubertal development by an age that is 2-2.5 SDs beyond the population mean. Although it generally represents a normal variant in pubertal timing, concern that DP could be the initial presentation of a serious underlying disorder has led to a diagnostic approach that is variable and may include tests that are unnecessary and costly. In this review, we examine available literature regarding the recommended diagnostic tests and aetiologies identified during the evaluation of youth with DP. We view this literature through the prism of the seemingly otherwise well adolescent. To provide further clinical context, we also evaluate the clinical and laboratory data from patients seen with DP in our centre over a 2-year period. The literature and our data reveal wide variability in the number of tests performed and raise the question of whether tests, other than gonadotropins, obtained in the absence of signs or symptoms of an underlying disorder are routinely warranted. Together this information provides a pragmatic rationale for revisiting recommendations calling for broad testing during the initial diagnostic evaluation of an otherwise healthy adolescent with DP. We highlight the need for further research comparing the utility of broader screening with a more streamlined approach, such as limiting initial testing to gonadotropins and a bone age, which, while not diagnostic, is often useful for height prediction, followed by close clinical monitoring. If future research supports a more streamlined approach to DP, then much unnecessary testing could be eliminated. PMID:27190100

  19. Optimal Sequential Diagnostic Strategy Generation Considering Test Placement Cost for Multimode Systems.

    PubMed

    Zhang, Shigang; Song, Lijun; Zhang, Wei; Hu, Zheng; Yang, Yongmin

    2015-01-01

    Sequential fault diagnosis is an approach that realizes fault isolation by executing the optimal test step by step. The strategy used, i.e., the sequential diagnostic strategy, has great influence on diagnostic accuracy and cost. Optimal sequential diagnostic strategy generation is an important step in the process of diagnosis system construction, which has been studied extensively in the literature. However, previous algorithms either are designed for single mode systems or do not consider test placement cost. They are not suitable to solve the sequential diagnostic strategy generation problem considering test placement cost for multimode systems. Therefore, this problem is studied in this paper. A formulation is presented. Two algorithms are proposed, one of which is realized by system transformation and the other is newly designed. Extensive simulations are carried out to test the effectiveness of the algorithms. A real-world system is also presented. All the results show that both of them have the ability to solve the diagnostic strategy generation problem, and they have different characteristics. PMID:26457709

  20. Optimal Sequential Diagnostic Strategy Generation Considering Test Placement Cost for Multimode Systems

    PubMed Central

    Zhang, Shigang; Song, Lijun; Zhang, Wei; Hu, Zheng; Yang, Yongmin

    2015-01-01

    Sequential fault diagnosis is an approach that realizes fault isolation by executing the optimal test step by step. The strategy used, i.e., the sequential diagnostic strategy, has great influence on diagnostic accuracy and cost. Optimal sequential diagnostic strategy generation is an important step in the process of diagnosis system construction, which has been studied extensively in the literature. However, previous algorithms either are designed for single mode systems or do not consider test placement cost. They are not suitable to solve the sequential diagnostic strategy generation problem considering test placement cost for multimode systems. Therefore, this problem is studied in this paper. A formulation is presented. Two algorithms are proposed, one of which is realized by system transformation and the other is newly designed. Extensive simulations are carried out to test the effectiveness of the algorithms. A real-world system is also presented. All the results show that both of them have the ability to solve the diagnostic strategy generation problem, and they have different characteristics. PMID:26457709

  1. Mathematics diagnostic testing in engineering: an international comparison between Ireland and Portugal

    NASA Astrophysics Data System (ADS)

    Carr, M.; Fidalgo, C.; Bigotte de Almeida, M. E.; Branco, J. R.; Santos, V.; Murphy, E.; Fhloinn, E. Ní

    2015-09-01

    Concern has been expressed throughout Europe about the significant deficiencies in the basic mathematical skills of many engineering undergraduates. Mathematics diagnostic tests in the UK, Ireland and Portugal have shown these shortcomings, which provide a challenge to those striving to introduce more innovative educational practices into engineering education, such as projects or real-world problems. Every year, in the Dublin Institute of Technology (Ireland) and the Instituto Superior de Engenharia de Coimbra (Portugal), a diagnostic test is given to incoming first-year students. A comparison showed some potentially interesting differences between these students. In September 2013, a project was undertaken to compare mathematical competencies of incoming engineering students in both countries. A modified diagnostic test was devised and the results were then compared to ascertain if there are common areas of difficulty between students in Ireland and Portugal, or evidence of one group significantly outperforming the other in a particular area.

  2. Convergent and diagnostic validity of STAVUX, a word and pseudoword spelling test for adults.

    PubMed

    Östberg, Per; Backlund, Charlotte; Lindström, Emma

    2016-10-01

    Few comprehensive spelling tests are available in Swedish, and none have been validated in adults with reading and writing disorders. The recently developed STAVUX test includes word and pseudoword spelling subtests with high internal consistency and adult norms stratified by education. This study evaluated the convergent and diagnostic validity of STAVUX in adults with dyslexia. Forty-six adults, 23 with dyslexia and 23 controls, took STAVUX together with a standard word-decoding test and a self-rated measure of spelling skills. STAVUX subtest scores showed moderate to strong correlations with word-decoding scores and predicted self-rated spelling skills. Word and pseudoword subtest scores both predicted dyslexia status. Receiver-operating characteristic (ROC) analysis showed excellent diagnostic discriminability. Sensitivity was 91% and specificity 96%. In conclusion, the results of this study support the convergent and diagnostic validity of STAVUX. PMID:26059176

  3. Diagnostic development and support of MHD Test Facilities. Technical progress report, October 1991--December 1991

    SciTech Connect

    Not Available

    1994-07-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for magnetohydrodynamic (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery (HRSR) support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL`s computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs.

  4. Development and testing of a diagnostic system for intelligen distributed control at EBR-2

    SciTech Connect

    Edwards, R.M.; Ruhl, D.W.; Klevans, E.H.; Robinson, G.E.

    1990-01-01

    A diagnostic system is under development for demonstration of Intelligent Distributed Control at the Experimental Breeder Reactor (EBR--II). In the first phase of the project a diagnostic system is being developed for the EBR-II steam plant based on the DISYS expert systems approach. Current testing uses recorded plant data and data from simulated plant faults. The dynamical simulation of the EBR-II steam plant uses the Babcock and Wilcox (B W) Modular Modeling System (MMS). At EBR-II the diagnostic system operates in the UNIX workstation and receives live plant data from the plant Data Acquisition System (DAS). Future work will seek implementation of the steam plant diagnostic in a distributed manner using UNIX based computers and Bailey microprocessor-based control system. 10 refs., 6 figs.

  5. Diagnostic development and support of MHD test facilities. Technical progress report, January--March 1991

    SciTech Connect

    Shepard, W.S.; Cook, R.L.

    1991-12-31

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for magnetohydrodynamic (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery (HRSR) support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL`S computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs.

  6. Veterinary practitioners’ selection of diagnostic tests for the primary evaluation of colic in the horse

    PubMed Central

    Curtis, L.; Trewin, I.; England, G. C. W.; Burford, J. H.; Freeman, S. L.

    2015-01-01

    The aim of this study was to survey veterinary practitioners’ selection of diagnostic tests for horses with clinical signs of abdominal pain. A questionnaire was distributed to veterinary surgeons involved in the primary evaluation of horses with abdominal pain, including the respondent's demographics, selection of diagnostic tests and factors affecting decision-making. Data analysis included descriptive analysis, categorisation of free text and simple univariable correlations to explore the relationships between independent variables and the relative self-estimated frequency that diagnostic tests were performed. A total of 228 responses were analysed. Participants worked in mixed practice (55.7 per cent), first opinion equine (22.8 per cent), first and second opinion equine (17.9 per cent) and referral practice (3.1 per cent). The majority (48.2 per cent, 105/218) were very confident managing a colic case (confidence level 4/5). The most frequently used diagnostic tests were ‘response to analgesia’ (87.2±24.0 per cent cases), rectal examination (75.9±21.2 per cent) and nasogastric intubation (43.8±27.6 per cent). Approach varied between practitioners, and for all diagnostic tests with frequency of use ranging from 0 to 100 per cent of cases. ‘Risk to personal safety’ was the most common reason for not using rectal examination. Practitioner's opinion of their confidence level in managing a colic case was associated with how frequently they used different diagnostic tests. There was marked variation in practitioners’ approaches, highlighting the need for further evidence to support decision-making. PMID:26457192

  7. Perspectives on Introduction and Implementation of New Point-of-Care Diagnostic Tests

    PubMed Central

    Palamountain, Kara M.; Baker, Jeff; Cowan, Elliot P.; Essajee, Shaffiq; Mazzola, Laura T.; Metzler, Mutsumi; Schito, Marco; Stevens, Wendy S.; Young, Gloria J.

    2012-01-01

    In recent years, there has been significant investment from both the private and public sectors in the development of diagnostic technologies to meet the need for human immunodeficiency virus (HIV) and tuberculosis testing in low-resource settings. Future investments should ensure that the most appropriate technologies are adopted in settings where they will have a sustainable impact. Achieving these aims requires the involvement of many stakeholders, as their needs, operational constraints, and priorities are often distinct. Here, we discuss these considerations from different perspectives representing those of various stakeholders involved in the development, introduction, and implementation of diagnostic tests. We also discuss some opportunities to address these considerations. PMID:22402038

  8. Stretch calculated from grip distance accurately approximates mid-specimen stretch in large elastic arteries in uniaxial tensile tests.

    PubMed

    Tian, Lian; Henningsen, Joseph; Salick, Max R; Crone, Wendy C; Gunderson, McLean; Dailey, Seth H; Chesler, Naomi C

    2015-07-01

    The mechanical properties of vascular tissues affect hemodynamics and can alter disease progression. The uniaxial tensile test is a simple and effective method for determining the stress-strain relationship in arterial tissue ex vivo. To enable calculation of strain, stretch can be measured directly with image tracking of markers on the tissue or indirectly from the distance between the grips used to hold the specimen. While the imaging technique is generally considered more accurate, it also requires more analysis, and the grip distance method is more widely used. The purpose of this study is to compare the stretch of the testing specimen calculated from the grip distance method to that obtained from the imaging method for canine descending aortas and large proximal pulmonary arteries. Our results showed a significant difference in stretch between the two methods; however, this difference was consistently less than 2%. Therefore, the grip distance method is an accurate approximation of the stretch in large elastic arteries in the uniaxial tensile test. PMID:25881308

  9. Stretch calculated from grip distance accurately approximates mid-specimen stretch in large elastic arteries in uniaxial tensile tests

    PubMed Central

    Tian, Lian; Henningsen, Joseph; Salick, Max R.; Crone, Wendy C.; Gunderson, McLean; Dailey, Seth H.; Chesler, Naomi C.

    2015-01-01

    The mechanical properties of vascular tissues affect hemodynamics and can alter disease progression. The uniaxial tensile test is a simple and effective method for determining the stress-strain relationship in arterial tissue ex vivo. To enable calculation of strain, stretch can be measured directly with image tracking of markers on the tissue or indirectly from the distance between the grips used to hold the specimen. While the imaging technique is generally considered more accurate, it also requires more analysis, and the grip distance method is more widely used. The purpose of this study is to compare the stretch of the testing specimen calculated from the grip distance method to that obtained from the imaging method for canine descending aortas and large proximal pulmonary arteries. Our results showed a significant difference in stretch between the two methods; however, this difference was consistently less than 2%. Therefore, the grip distance method is an accurate approximation of the stretch in large elastic arteries in the uniaxial tensile test. PMID:25881308

  10. Special Educator's Complete Guide to 109 Diagnostic Tests: How To Select & Interpret Tests, Use Results in IEPs, and Remediate Specific Difficulties.

    ERIC Educational Resources Information Center

    Pierangelo, Roger; Giuliani, George

    This manual is a guide to the special education diagnostic process and covers the various stages of evaluation, interpretation, diagnosis, prescription, and remediation. Test information includes: explanations of the most commonly used diagnostic tests, coverage of the areas measured by each test, interpretation of test patterns for commonly used…

  11. A multivariate method for meta-analysis and comparison of diagnostic tests.

    PubMed

    Dimou, Niki L; Adam, Maria; Bagos, Pantelis G

    2016-09-10

    We present here an extension of the classic bivariate random effects meta-analysis for the log-transformed sensitivity and specificity that can be applied for two or more diagnostic tests. The advantage of this method is that a closed-form expression is derived for the calculation of the within-studies covariances. The method allows the direct calculation of sensitivity and specificity, as well as, the diagnostic odds ratio, the area under curve and the parameters of the summary receiver operator's characteristic curve, along with the means for a formal comparison of these quantities for different tests. There is no need for individual patient data or the simultaneous evaluation of both diagnostic tests in all studies. The method is simple and fast; it can be extended for several diagnostic tests and can be fitted in nearly all statistical packages. The method was evaluated in simulations and applied in a meta-analysis for the comparison of anti-cyclic citrullinated peptide antibody and rheumatoid factor for discriminating patients with rheumatoid arthritis, with encouraging results. Simulations suggest that the method is robust and more powerful compared with the standard bivariate approach that ignores the correlation between tests. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26940666

  12. Assessing value of innovative molecular diagnostic tests in the concept of predictive, preventive, and personalized medicine.

    PubMed

    Akhmetov, Ildar; Bubnov, Rostyslav V

    2015-01-01

    Molecular diagnostic tests drive the scientific and technological uplift in the field of predictive, preventive, and personalized medicine offering invaluable clinical and socioeconomic benefits to the key stakeholders. Although the results of diagnostic tests are immensely influential, molecular diagnostic tests (MDx) are still grudgingly reimbursed by payers and amount for less than 5 % of the overall healthcare costs. This paper aims at defining the value of molecular diagnostic test and outlining the most important components of "value" from miscellaneous assessment frameworks, which go beyond accuracy and feasibility and impact the clinical adoption, informing healthcare resource allocation decisions. The authors suggest that the industry should facilitate discussions with various stakeholders throughout the entire assessment process in order to arrive at a consensus about the depth of evidence required for positive marketing authorization or reimbursement decisions. In light of the evolving "value-based healthcare" delivery practices, it is also recommended to account for social and ethical parameters of value, since these are anticipated to become as critical for reimbursement decisions and test acceptance as economic and clinical criteria. PMID:26425215

  13. [Laboratory practices: diagnostics and antibiotics resistance testing of Neisseria gonorrhoeae in Germany].

    PubMed

    Loenenbach, Anna; Dudareva-Vizule, S; Buder, S; Sailer, A; Kohl, P K; Bremer, V

    2015-08-01

    Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring. PMID:26112875

  14. Challenges in Evaluating the Cost-effectiveness of New Diagnostic Tests for HIV-Associated Tuberculosis

    PubMed Central

    Andrews, Jason R.; Lawn, Stephen D.; Dowdy, David W.; Walensky, Rochelle P.

    2013-01-01

    With an emerging array of rapid diagnostic tests for tuberculosis, cost-effectiveness analyses are needed to inform scale-up in various populations and settings. Human immunodeficiency virus (HIV)–associated tuberculosis poses unique challenges in estimating and interpreting the cost-effectiveness of novel diagnostic tools. First, gains in sensitivity and specificity do not directly correlate with impact on clinical outcomes. Second, the cost-effectiveness of implementing tuberculosis diagnostics in HIV-infected populations is heavily influenced by downstream costs of HIV care. As a result, tuberculosis diagnostics may appear less cost-effective in this population than among HIV-uninfected individuals, raising important ethical and policy questions about the design and interpretation of cost-effectiveness analyses in this setting. Third, conventional cost-effectiveness benchmarks may be inadequate for making decisions about whether to adopt new diagnostics. If we are to appropriately deploy novel diagnostics for tuberculosis to people living with HIV in resource-constrained settings, these challenges in measuring cost-effectiveness must be more widely recognized and addressed. PMID:23788239

  15. Combination of culture, antigen and toxin detection, and cytotoxin neutralization assay for optimal Clostridium difficile diagnostic testing

    PubMed Central

    Alfa, Michelle J; Sepehri, Shadi

    2013-01-01

    BACKGROUND: There has been a growing interest in developing an appropriate laboratory diagnostic algorithm for Clostridium difficile, mainly as a result of increases in both the number and severity of cases of C difficile infection in the past decade. A C difficile diagnostic algorithm is necessary because diagnostic kits, mostly for the detection of toxins A and B or glutamate dehydrogenase (GDH) antigen, are not sufficient as stand-alone assays for optimal diagnosis of C difficile infection. In addition, conventional reference methods for C difficile detection (eg, toxigenic culture and cytotoxin neutralization [CTN] assays) are not routinely practiced in diagnostic laboratory settings. OBJECTIVE: To review the four-step algorithm used at Diagnostic Services of Manitoba sites for the laboratory diagnosis of toxigenic C difficile. RESULT: One year of retrospective C difficile data using the proposed algorithm was reported. Of 5695 stool samples tested, 9.1% (n=517) had toxigenic C difficile. Sixty per cent (310 of 517) of toxigenic C difficile stools were detected following the first two steps of the algorithm. CTN confirmation of GDH-positive, toxin A- and B-negative assays resulted in detection of an additional 37.7% (198 of 517) of toxigenic C difficile. Culture of the third specimen, from patients who had two previous negative specimens, detected an additional 2.32% (12 of 517) of toxigenic C difficile samples. DISCUSSION: Using GDH antigen as the screening and toxin A and B as confirmatory test for C difficile, 85% of specimens were reported negative or positive within 4 h. Without CTN confirmation for GDH antigen and toxin A and B discordant results, 37% (195 of 517) of toxigenic C difficile stools would have been missed. Following the algorithm, culture was needed for only 2.72% of all specimens submitted for C difficile testing. CONCLUSION: The overview of the data illustrated the significance of each stage of this four-step C difficile algorithm and

  16. Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi

    PubMed Central

    2014-01-01

    Background Plasmodium knowlesi, a malaria parasite of Southeast Asian macaques, infects humans and can cause fatal malaria. It is difficult to diagnose by microscopy because of morphological similarity to Plasmodium malariae. Nested PCR assay is the most accurate method to distinguish P. knowlesi from other Plasmodium species but is not cost effective in resource-poor settings. Rapid diagnostic tests (RDTs) are recommended for settings where malaria is prevalent. In this study, the effectiveness of three RDTs in detecting P. knowlesi from fresh and frozen patient blood samples was evaluated. Methods Forty malaria patients (28 P. knowlesi, ten P. vivax and two P. falciparum) diagnosed by microscopy were recruited in Sarawak, Malaysian Borneo during a 16-month period. Patient blood samples were used to determine parasitaemia by microscopy, confirm the Plasmodium species present by PCR and evaluate three RDTs: OptiMAL-IT, BinaxNOW® Malaria and Paramax-3. The RDTs were also evaluated using frozen blood samples from 41 knowlesi malaria patients. Results OptiMAL-IT was the most sensitive RDT, with a sensitivity of 71% (20/28; 95% CI = 54-88%) for fresh and 73% (30/41; 95% CI = 59-87%) for frozen knowlesi samples. However, it yielded predominantly falciparum-positive results due to cross-reactivity of the P. falciparum test reagent with P. knowlesi. BinaxNOW® Malaria correctly detected non-P. falciparum malaria in P. knowlesi samples but was the least sensitive, detecting only 29% (8/28; 95% CI = 12-46%) of fresh and 24% (10/41; 95% CI = 11-37%) of frozen samples. The Paramax-3 RDT tested positive for P. vivax with PCR-confirmed P. knowlesi samples with sensitivities of 40% (10/25; 95% CI = 21-59%) with fresh and 32% (13/41; 95% CI = 17-46%) with frozen samples. All RDTs correctly identified P. falciparum- and P. vivax-positive controls with parasitaemias above 2,000 parasites/μl blood. Conclusions The RDTs detected Plasmodium in P. knowlesi-infected blood samples with

  17. Development and preparation of lead-containing paint films and diagnostic test materials.

    PubMed

    Binstock, David; Gutknecht, William; Sorrell, Kristen; Haas, Curtis; Winstead, Wayne; McCombs, Michelle; Brown, Gordon; Salmons, Cynthia; Harper, Sharon L

    2012-05-01

    Lead in paint continues to be a threat to children's health in cities across the United States, which means there is an ongoing need for testing and analysis of paint. This ongoing analytical effort and especially development of new methods continue to drive the need for diagnostic testing materials that provide the analytical challenges of real-world paints. To this end, 31 different types of paint test materials were developed and prepared. Preparation of the materials included development of lead-containing paint films yielding an overall relative standard error for one individual test sample being less than 10%. The 31 diagnostic test materials prepared with these paint films included two lead pigments; lead concentrations from nominally 0 to 2.0 mg lead/cm(2) (0 to 5% lead by weight); overlayers of both "lead-free," oil-based and water-based paints; Al, Ba, and Mg as potential chemical interferents; red and black potential color interferents; and substrates of wood, metal, masonry, and plaster. These materials challenge each step in method development and evaluation, including paint sample collection and preparation, lead extraction, and measurement of solubilized lead. When the materials were used to test performance of a new lead-in-paint testing method based on extraction using a rotor/stator method and measurement using turbidimetry, the results agreed to within ±20% of the expected lead values for 30 out of 31 of the diagnostic test materials, thereby demonstrating their levels of quality and utility. PMID:22460838

  18. On Efficient and Accurate Calculation of Significance P-Values for Sequence Kernel Association Testing of Variant Set.

    PubMed

    Wu, Baolin; Guan, Weihua; Pankow, James S

    2016-03-01

    The objective of this paper is to discuss and develop alternative computational methods to accurately and efficiently calculate significance P-values for the commonly used sequence kernel association test (SKAT) and adaptive sum of SKAT and burden test (SKAT-O) for variant set association. We show that the existing software can lead to either conservative or inflated type I errors. We develop alternative and efficient computational algorithms that quickly compute the SKAT P-value and have well-controlled type I errors. In addition, we derive an alternative and simplified formula for calculating the significance P-value of SKAT-O, which sheds light on the development of efficient and accurate numerical algorithms. We implement the proposed methods in the publicly available R package that can be readily used or adapted to large-scale sequencing studies. Given that more and more large-scale exome and whole genome sequencing or re-sequencing studies are being conducted, the proposed methods are practically very important. We conduct extensive numerical studies to investigate the performance of the proposed methods. We further illustrate their usefulness with application to associations between rare exonic variants and fasting glucose levels in the Atherosclerosis Risk in Communities (ARIC) study. PMID:26757198

  19. Assessing the impact of next-generation rapid diagnostic tests on Plasmodium falciparum malaria elimination strategies.

    PubMed

    Slater, Hannah C; Ross, Amanda; Ouédraogo, André Lin; White, Lisa J; Nguon, Chea; Walker, Patrick G T; Ngor, Pengby; Aguas, Ricardo; Silal, Sheetal P; Dondorp, Arjen M; La Barre, Paul; Burton, Robert; Sauerwein, Robert W; Drakeley, Chris; Smith, Thomas A; Bousema, Teun; Ghani, Azra C

    2015-12-01

    Mass-screen-and-treat and targeted mass-drug-administration strategies are being considered as a means to interrupt transmission of Plasmodium falciparum malaria. However, the effectiveness of such strategies will depend on the extent to which current and future diagnostics are able to detect those individuals who are infectious to mosquitoes. We estimate the relationship between parasite density and onward infectivity using sensitive quantitative parasite diagnostics and mosquito feeding assays from Burkina Faso. We find that a diagnostic with a lower detection limit of 200 parasites per microlitre would detect 55% of the infectious reservoir (the combined infectivity to mosquitoes of the whole population weighted by how often each individual is bitten) whereas a test with a limit of 20 parasites per microlitre would detect 83% and 2 parasites per microlitre would detect 95% of the infectious reservoir. Using mathematical models, we show that increasing the diagnostic sensitivity from 200 parasites per microlitre (equivalent to microscopy or current rapid diagnostic tests) to 2 parasites per microlitre would increase the number of regions where transmission could be interrupted with a mass-screen-and-treat programme from an entomological inoculation rate below 1 to one of up to 4. The higher sensitivity diagnostic could reduce the number of treatment rounds required to interrupt transmission in areas of lower prevalence. We predict that mass-screen-and-treat with a highly sensitive diagnostic is less effective than mass drug administration owing to the prophylactic protection provided to uninfected individuals by the latter approach. In low-transmission settings such as those in Southeast Asia, we find that a diagnostic tool with a sensitivity of 20 parasites per microlitre may be sufficient for targeted mass drug administration because this diagnostic is predicted to identify a similar village population prevalence compared with that currently detected using

  20. An International Comparison Using a Diagnostic Testing Model: Turkish Students' Profile of Mathematical Skills on TIMSS-R

    ERIC Educational Resources Information Center

    Dogan, Enis; Tatsuoka, Kikumi

    2008-01-01

    This study illustrates how a diagnostic testing model can be used to make detailed comparisons between student populations participating in international assessments. The performance of Turkish students on the TIMSS-R mathematics test was reanalyzed with a diagnostic testing model called the Rule Space Model. First, mathematical and cognitive…

  1. Scratching Where They Itch: Evaluation of Feedback on a Diagnostic English Grammar Test for Taiwanese University Students

    ERIC Educational Resources Information Center

    Yin, Muchun; Sims, James; Cothran, Daniel

    2012-01-01

    Feedback to the test taker is a defining characteristic of diagnostic language testing (Alderson, 2005). This article reports on a study that investigated how much and in what ways students at a Taiwan university perceived the feedback to be useful on an online multiple-choice diagnostic English grammar test, both in general and by students of…

  2. The Effects of Diagnostic Testing and Remediation on Science Achievement and Retention.

    ERIC Educational Resources Information Center

    Long, Joe C.; And Others

    The purpose of this study was to provide students with differing types of learning needs instruction following diagnostic testing; also examined were the effects of the instruction on science achievement and retention. A total of 154 seventh-grade students from six classes completed a five-week block of instruction in earth science composed of…

  3. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: Relationship with Achievement Criteria.

    ERIC Educational Resources Information Center

    Fuller, Gerald B.; Wallbrown, Fred H.

    1983-01-01

    Compared the Bender Gestalt (BD) and Minnesota Percepto-Diagnostic Test (MPD) in predicting academic achievement for younger children (N=69). Results suggested that the MPD is more sensitive than the Bender in identifying visual-motor perception areas of achievement performance problems. (LLL)

  4. Mathematics Diagnostic Testing in Engineering: An International Comparison between Ireland and Portugal

    ERIC Educational Resources Information Center

    Carr, M.; Fidalgo, C.; Bigotte de Almeida, M. E.; Branco, J. R.; Santos, V.; Murphy, E.; Ní Fhloinn, E.

    2015-01-01

    Concern has been expressed throughout Europe about the significant deficiencies in the basic mathematical skills of many engineering undergraduates. Mathematics diagnostic tests in the UK, Ireland and Portugal have shown these shortcomings, which provide a challenge to those striving to introduce more innovative educational practices into…

  5. Restrictive Stochastic Item Selection Methods in Cognitive Diagnostic Computerized Adaptive Testing

    ERIC Educational Resources Information Center

    Wang, Chun; Chang, Hua-Hua; Huebner, Alan

    2011-01-01

    This paper proposes two new item selection methods for cognitive diagnostic computerized adaptive testing: the restrictive progressive method and the restrictive threshold method. They are built upon the posterior weighted Kullback-Leibler (KL) information index but include additional stochastic components either in the item selection index or in…

  6. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Procedures for preparing egg yolk... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for diagnostic... chapter. (a) Under the supervision of an Authorized Agent or State Inspector, the eggs which are used...

  7. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Procedures for preparing egg yolk... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for diagnostic... chapter. (a) Under the supervision of an Authorized Agent or State Inspector, the eggs which are used...

  8. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Procedures for preparing egg yolk... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for diagnostic... chapter. (a) Under the supervision of an Authorized Agent or State Inspector, the eggs which are used...

  9. 81 FR 10878 - Determination and Declaration Regarding Emergency Use of in Vitro Diagnostic Tests for Detection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2016-03-02

    ... Detection of Zika Virus and/or Diagnosis of Zika Virus Infection AGENCY: Office of the Secretary, Department... health and security of United States citizens living abroad and that involves Zika virus. On the basis of... emergency use of in vitro diagnostic tests for detection of Zika virus and/or diagnosis of Zika...

  10. The Literacy Skills of Secondary Teaching Undergraduates: Results of Diagnostic Testing and a Discussion of Findings

    ERIC Educational Resources Information Center

    Moon, Brian

    2014-01-01

    The capacity of secondary school teachers to support general literacy and to teach discipline-specific literacy skills depends upon their personal literacy competence. Diagnostic testing of 203 secondary teaching undergraduates at one Australian university revealed deficiencies in personal literacy competence that could affect their future…

  11. A Needs-Based Approach to the Development of a Diagnostic College English Speaking Test

    ERIC Educational Resources Information Center

    Zhao, Zhongbao

    2014-01-01

    This paper investigated the current situation of oral English teaching, learning, and assessment at the tertiary level in China through needs analysis and explored the implications for the development of a diagnostic speaking test. Through random sampling, the researcher administered both a student questionnaire and a teacher questionnaire to over…

  12. Development and Preparation of Lead-Containing Paint Films and Diagnostic Test Materials

    EPA Science Inventory

    Lead in paint continues to be a threat to children’s health in cities across the United States, which means there is an ongoing need for testing and analysis of paint. This ongoing analytical effort and especially development of new methods continue to drive the need for diagnost...

  13. Diagnostic Classification Models and Multidimensional Adaptive Testing: A Commentary on Rupp and Templin

    ERIC Educational Resources Information Center

    Frey, Andreas; Carstensen, Claus H.

    2009-01-01

    On a general level, the objective of diagnostic classifications models (DCMs) lies in a classification of individuals regarding multiple latent skills. In this article, the authors show that this objective can be achieved by multidimensional adaptive testing (MAT) as well. The authors discuss whether or not the restricted applicability of DCMs can…

  14. Web-Based Two-Tier Diagnostic Test and Remedial Learning Experiment

    ERIC Educational Resources Information Center

    Lai, Ah-Fur; Chen, Deng-Jyi

    2010-01-01

    Offering a series of diagnosis and individual remedial learning activities for a general class by means of web and multimedia technology can overcome the dilemma of conventional diagnosis and remedial instruction. The study proposes a three-layer conceptual framework and adopts a two-tier diagnostic test theory to develop a web-based two-tier…

  15. Laboratory Evaluation of Three Rapid Diagnostic Tests for Dual Detection of HIV and Treponema pallidum Antibodies

    PubMed Central

    Woo, Jennifer S.; Chung, Jun Ho; Sokovic, Anita; Bristow, Claire C.; Klausner, Jeffrey D.

    2014-01-01

    The performance of three research-use-only, dual HIV and syphilis rapid diagnostic tests (RDTs) was evaluated for 150 patient serum samples and compared to reference HIV and Treponema pallidum antibody detection methods. The RDTs performed comparably, with sensitivities of 93 to 99% and specificities of 97 to 100%. The kappa statistic between the RDTs was 0.95. PMID:25297332

  16. Laboratory evaluation of three rapid diagnostic tests for dual detection of HIV and Treponema pallidum antibodies.

    PubMed

    Humphries, Romney M; Woo, Jennifer S; Chung, Jun Ho; Sokovic, Anita; Bristow, Claire C; Klausner, Jeffrey D

    2014-12-01

    The performance of three research-use-only, dual HIV and syphilis rapid diagnostic tests (RDTs) was evaluated for 150 patient serum samples and compared to reference HIV and Treponema pallidum antibody detection methods. The RDTs performed comparably, with sensitivities of 93 to 99% and specificities of 97 to 100%. The kappa statistic between the RDTs was 0.95. PMID:25297332

  17. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Procedures for preparing egg yolk samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE LIVESTOCK IMPROVEMENT AUXILIARY PROVISIONS ON NATIONAL...

  18. 9 CFR 147.8 - Procedures for preparing egg yolk samples for diagnostic tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Procedures for preparing egg yolk samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE LIVESTOCK IMPROVEMENT AUXILIARY PROVISIONS ON NATIONAL...

  19. Comparing Eighth-Grade Diagnostic Test Results for Korean, Czech, and American Students.

    ERIC Educational Resources Information Center

    Um, Eunkyoung; Dogan, Enis; Im, Seongah; Tatsuoka, Kimumi; Corter, James E.

    Diagnostic analyses were conducted on data from the Third International Mathematics and Science Study second population (TIMSS-R; 1999) from the United States, Korea, and the Czech Republic in terms of test item attributes (i.e., content, processing skills, and item format) and inferred students' knowledge. The Rule Space model (K. Tatsuoka, 1998)…

  20. Diagnostic test for prenatal identification of Down's syndrome and mental retardation and gene therapy therefor

    SciTech Connect

    Smith, Desmond J.; Rubin, Edward M.

    2000-01-01

    A a diagnostic test useful for prenatal identification of Down syndrome and mental retardation. A method for gene therapy for correction and treatment of Down syndrome. DYRK gene involved in the ability to learn. A method for diagnosing Down's syndrome and mental retardation and an assay therefor. A pharmaceutical composition for treatment of Down's syndrome mental retardation.

  1. The Changing Landscape of Molecular Diagnostic Testing: Implications for Academic Medical Centers

    PubMed Central

    Rehm, Heidi L.; Hynes, Elizabeth; Funke, Birgit H.

    2016-01-01

    Over the last decade, the field of molecular diagnostics has undergone tremendous transformation, catalyzed by the clinical implementation of next generation sequencing (NGS). As technical capabilities are enhanced and current limitations are addressed, NGS is increasingly capable of detecting most variant types and will therefore continue to consolidate and simplify diagnostic testing. It is likely that genome sequencing will eventually serve as a universal first line test for disorders with a suspected genetic origin. Academic Medical Centers (AMCs), which have been at the forefront of this paradigm shift are now presented with challenges to keep up with increasing technical, bioinformatic and interpretive complexity of NGS-based tests in a highly competitive market. Additional complexity may arise from altered regulatory oversight, also triggered by the unprecedented scope of NGS-based testing, which requires new approaches. However, these challenges are balanced by unique opportunities, particularly at the interface between clinical and research operations, where AMCs can capitalize on access to cutting edge research environments and establish collaborations to facilitate rapid diagnostic innovation. This article reviews present and future challenges and opportunities for AMC associated molecular diagnostic laboratories from the perspective of the Partners HealthCare Laboratory for Molecular Medicine (LMM). PMID:26828522

  2. A Mixed Model Approach to Meta-Analysis of Diagnostic Studies with Binary Test Outcome

    ERIC Educational Resources Information Center

    Doebler, Philipp; Holling, Heinz; Bohning, Dankmar

    2012-01-01

    We propose 2 related models for the meta-analysis of diagnostic tests. Both models are based on the bivariate normal distribution for transformed sensitivities and false-positive rates. Instead of using the logit as a transformation for these proportions, we employ the "t"[subscript alpha] family of transformations that contains the log, logit,…

  3. 75 FR 15443 - Advancing the Development of Diagnostic Tests and Biomarkers for Tuberculosis; Public Workshop...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Advancing the Development of Diagnostic Tests and Biomarkers for Tuberculosis; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop; request...

  4. Medicare Program; Medicare Clinical Diagnostic Laboratory Tests Payment System. Final rule.

    PubMed

    2016-06-23

    This final rule implements requirements of section 216 of the Protecting Access to Medicare Act of 2014 (PAMA), which significantly revises the Medicare payment system for clinical diagnostic laboratory tests. This final rule also announces an implementation date of January 1, 2018 for the private payor rate-based fee schedule required by PAMA. PMID:27373013

  5. Evaluating Operational Specifications of Point-of-Care Diagnostic Tests: A Standardized Scorecard

    PubMed Central

    Lehe, Jonathan D.; Sitoe, Nádia E.; Tobaiwa, Ocean; Loquiha, Osvaldo; Quevedo, Jorge I.; Peter, Trevor F.; Jani, Ilesh V.

    2012-01-01

    The expansion of HIV antiretroviral therapy into decentralized rural settings will increasingly require simple point-of-care (POC) diagnostic tests that can be used without laboratory infrastructure and technical skills. New POC test devices are becoming available but decisions around which technologies to deploy may be biased without systematic assessment of their suitability for decentralized healthcare settings. To address this, we developed a standardized, quantitative scorecard tool to objectively evaluate the operational characteristics of POC diagnostic devices. The tool scores devices on a scale of 1–5 across 30 weighted characteristics such as ease of use, quality control, electrical requirements, shelf life, portability, cost and service, and provides a cumulative score that ranks products against a set of ideal POC characteristics. The scorecard was tested on 19 devices for POC CD4 T-lymphocyte cell counting, clinical chemistry or hematology testing. Single and multi-parameter devices were assessed in each of test categories. The scores across all devices ranged from 2.78 to 4.40 out of 5. The tool effectively ranked devices within each category (p<0.01) except the CD4 and multi-parameter hematology products. The tool also enabled comparison of different characteristics between products. Agreement across the four scorers for each product was high (intra-class correlation >0.80; p<0.001). Use of this tool enables the systematic evaluation of diagnostic tests to facilitate product selection and investment in appropriate technology. It is particularly relevant for countries and testing programs considering the adoption of new POC diagnostic tests. PMID:23118871

  6. Use of quality rapid diagnostic testing for safe blood transfusion in resource-limited settings.

    PubMed

    Mbanya, D

    2013-05-01

    Blood safety in sub-Saharan Africa is jeopardized by multiple and diverse factors, including the predominance of high-risk family/replacement donors and the high prevalence of transfusion-transmissible infections (TTIs). Thus, stringent diagnostic strategies are vital. Western blotting is costly and technically demanding, and nucleic acid testing technologies, which have been reported to reliably reduce the rate of TTI, are not available in resource-limited settings. Therefore, there is a need for reliable and affordable testing alternatives in these settings. Rapid diagnostic testing has been widely adopted in developing countries, but, for effectiveness in blood safety, highly sensitive tests and the strict selection of low-risk blood donors are indispensable. Although the pre-serological window period remains a source of residual risk for transmission of TTIs during blood transfusion, the combination antigen-antibody rapid tests could contribute significantly to shortening the window period. Thus, despite its limitations, rapid diagnostic testing continues to contribute significantly to blood safety, as a cost-effective means of enhancing screening for TTIs and reducing their transmission in resource-limited rural settings. PMID:23464853

  7. Assessment of a multi-assay biological diagnostic test for mood disorders in a Japanese population.

    PubMed

    Yamamori, Hidenaga; Ishima, Tamaki; Yasuda, Yuka; Fujimoto, Michiko; Kudo, Noriko; Ohi, Kazutaka; Hashimoto, Kenji; Takeda, Masatoshi; Hashimoto, Ryota

    2016-01-26

    The current diagnostic tests for mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), have limitations. Inflammatory markers, growth factors, and oxidative stress markers are involved in the pathophysiology of mood disorders. A multi-assay biological diagnostic test combining these biomarkers might improve diagnostic efficiency. The plasma levels of soluble tumor necrosis factor receptor 2 (sTNFR2), epidermal growth factor (EGF), and myeloperoxidase were measured in 40 MDD patients, 40 BD patients and 40 controls in a Japanese population. We also investigated the plasma levels of these markers in 40 patients with schizophrenia to determine the utility of these markers in differential diagnosis. The plasma levels of sTNFR2 were significantly higher in BD and schizophrenia patients than in controls. The plasma levels of EGF and myeloperoxidase were significantly higher in patients with BD than in controls. The correct classification rate obtained from discriminant analysis with sTNFR2 and EGF between controls and mood disorders was 69.2%, with a sensitivity and specificity of 62.5% and 82.5%, respectively. The correct classification rate obtained from discriminant analysis with sTNFR2 and EGF between controls and BD was 85.0%, with a sensitivity and specificity of 77.6% and 92.5%, respectively. Our results suggest that sTNFR2 and EGF could be biological markers of BD. Further studies are needed to determine the utility of these markers in diagnostic tests for mood disorders. PMID:26687272

  8. The Status of Spectral EEG Abnormality as a Diagnostic Test for Schizophrenia

    PubMed Central

    Boutros, Nash N.; Arfken, Cynthia; Galderisi, Silvana; Warrick, Joshua; Pratt, Garrett; Iacono, William

    2008-01-01

    Objective A literature review was conducted to ascertain whether or not EEG spectral abnormalities are consistent enough to warrant additional effort towards developing them into a clinical diagnostic test for schizophrenia. Methods Fifty three papers met criteria for inclusion into the review and 15 were included in a meta-analysis of the degree of significance of EEG deviations as compared to healthy controls. Studies were classified based on a 4-step approach based on guidelines for evaluating the clinical usefulness of a diagnostic test. Results Our review and meta-analysis revealed that most of the abnormalities are replicated in the expected directions with the most consistent results related to the increased preponderance of slow rhythms in schizophrenia patients. This effect remained consistent in un-medicated patients. Only a small number of studies provided data on the sensitivity and specificity of the findings in differentiating among the psychiatric disorders that frequently appear on the same differential diagnostic list as schizophrenia (step 3 studies). No multicenter studies using standardized assessment criteria were found (step 4 studies). Conclusions Additional Step 3 and Step 4 studies are needed to draw conclusions on the usefulness of EEG spectral abnormalities as a diagnostic test for schizophrenia PMID:18160260

  9. Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea

    PubMed Central

    Gasparini, Giulio; Vicini, Claudio; De Benedetto, Michele; Salamanca, Fabrizio; Sorrenti, Giovanni; Romandini, Mario; Bosi, Marcello; Saponaro, Gianmarco; Foresta, Enrico; Laforì, Andreina; Meccariello, Giuseppe; Bianchi, Alessandro; Toraldo, Domenico Maurizio; Campanini, Aldo; Montevecchi, Filippo; Rizzotto, Grazia; Cervelli, Daniele; Moro, Alessandro; Arigliani, Michele; Gobbi, Riccardo; Pelo, Sandro

    2015-01-01

    Rationale. The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. Objectives. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients. Methods. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. Measurements and Main Results. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 (p < 0.01). The area under the ROC curve (95% CI) was the parameter to evaluate the accuracy of the OAAT: it was 0.91 (0.81–1.00) for the diagnosis of OSA (AHI ≥ 5), 0.90 (0.82–0.98) for moderate OSA (AHI ≥ 15), and 0.84 (0.76–0.92) for severe OSA (AHI ≥ 30). Conclusions. The OAAT has shown a high correlation with polysomnography and also a high diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed. PMID:26636102

  10. The development of a post-test diagnostic system for rocket engines

    NASA Technical Reports Server (NTRS)

    Zakrajsek, June F.

    1991-01-01

    An effort was undertaken by NASA to develop an automated post-test, post-flight diagnostic system for rocket engines. The automated system is designed to be generic and to automate the rocket engine data review process. A modular, distributed architecture with a generic software core was chosen to meet the design requirements. The diagnostic system is initially being applied to the Space Shuttle Main Engine data review process. The system modules currently under development are the session/message manager, and portions of the applications section, the component analysis section, and the intelligent knowledge server. An overview is presented of a rocket engine data review process, the design requirements and guidelines, the architecture and modules, and the projected benefits of the automated diagnostic system.

  11. Diagnostic Role of Captopril Challenge Test in Korean Subjects with High Aldosterone-to-Renin Ratios

    PubMed Central

    Kim, Jung Hee; Park, Kyeong Seon; Hong, A Ram; Shin, Chan Soo; Kim, Seong Yeon

    2016-01-01

    Background Diagnosis of primary aldosteronism (PA) begins with aldosterone-to-renin ratio (ARR) measurement followed by confirmative tests. However, the ARR has high false positive rates which led to unnecessary confirmatory tests. Captopril challenge test (CCT) has been used as one of confirmatory tests, but the accuracy of it in the diagnosis of PA is still controversial. We aimed to examine the clinical efficacy of CCT as a post-screening test in PA. Methods In a prospective study, we enrolled subjects with suspected PA who had hypertension and ARR >20 (ng/dL)/(ng/mL/hr). Sixty-four patients who underwent both the saline infusion test and the CCT were included. Results The diagnostic performance of plasma aldosterone concentration (PAC) post-CCT was greater than that of ARR post-CCT and ARR pre-CCT in PA (area under the curve=0.956, 0.797, and 0.748, respectively; P=0.001). A cut-off value of 13 ng/dL showed the highest diagnostic odds ratio considering PAC post-CCT at 60 and 90 minutes. A PAC post-CCT of 19 ng/dL had a specificity of 100%, which can be used as a cut-off value for the confirmative test. Determining the diagnostic performance of PAC post-CCT at 90 minutes was sufficient for PA diagnosis. Subjects with PAC post-CCT at 90 minutes <13 ng/dL are less likely to have PA, and those with PAC post-CCT at 90 minutes ≥13 but <19 ng/dL should undergo secondary confirmatory tests. Conclusion The CCT test may be a reliable post-screening test to avoid the hospitalization in the setting of falsely elevated ARR screening tests. PMID:27184013

  12. Fibre Diffraction Analysis of Skin Offers a Very Early and Extremely Accurate Diagnostic Test for Prostate Cancer

    DOE PAGESBeta

    James, Veronica J.; O’Malley Ford, Judith M.

    2014-01-01

    Double blind analysis of a batch of thirty skin tissue samples from potential prostate cancer sufferers correctly identified all “control” patients, patients with high and low grade prostate cancers, the presence of benign prostate hyperplasia (BPH), perineural invasions, and the one lymphatic invasion. Identification was by analysis of fibre diffraction patterns interpreted using a schema developed from observations in nine previous studies. The method, schema, and specific experiment results are reported in this paper, with some implications then drawn.

  13. Clinical Assessment of Dizzy Patients: The Necessity and Role of Diagnostic Tests

    PubMed Central

    Bakhit, Mahsa; Heidarian, Alireza; Ehsani, Sara; Delphi, Maryam; Latifi, Seyed M.

    2014-01-01

    Over administration of diagnostic tests in health care settings is a critical issue, imposing a great deal of expenditure on health sector. Vertigo and dizziness are common complaints of many patients who seek medical advice, and the vast majority of them undergo several evaluations, including Brain Magnetic Resonance Imaging (MRI), Laboratory tests, Pure Tone Audiometry (PTA), and Electrocardiography (ECG). The aim of this study was to investigate the performing rate of these diagnostic tests, and to evaluate their necessity and medical indications. This study was conducted on 270 dizzy patients referred to Apadana Dizziness and Vertigo Clinic, Ahvaz, Iran, from July 2008 to February 2013. Of these, 71.9% were diagnosed with peripheral lesions while laboratory assessment (58.1%) and brain MRI (38.1%) were the most requested tests. Age was an important factor, affecting the frequency of performing the ECG and Brain MRI. Medications were still administered widely even to those who seemed to respond well enough to vestibular rehabilitation. These findings revealed that many unnecessary and time-consuming diagnostic tests were performed, which had minor contribution to the final diagnosis and treatment of the patients. Therefore, a modification in the assessment methods of the dizzy patients with emphasis on history and clinical presentation seems essential. PMID:24762362

  14. Prospective Evaluation of Three Rapid Diagnostic Tests for Diagnosis of Human Leptospirosis

    PubMed Central

    Goris, Marga G. A.; Leeflang, Mariska M. G.; Loden, Martin; Wagenaar, Jiri F. P.; Klatser, Paul R.; Hartskeerl, Rudy A.; Boer, Kimberly R.

    2013-01-01

    Background Diagnosis of leptospirosis by the microscopic agglutination test (MAT) or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs) can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. Methodology During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture) on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. Results The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB), but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB). Conclusions All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended. PMID:23875034

  15. High Diagnostic Accuracy of Nitrite Test Paired with Urine Sediment can Reduce Unnecessary Antibiotic Therapy

    PubMed Central

    Ferry, Sven A.; E. Holm, Stig; Ferry, B. Magnus; Monsen, Tor J.

    2015-01-01

    Background: Urinary tract infections (UTIs) are common bacterial infections dominated by lower UTI in women (LUTIW). Symptoms only are insufficient for diagnosis and accordingly, near patient diagnostic tests confidently confirming significant bacteriuria are desirable. The nitrite test (NIT) has low sensitivity, while bacterial and leukocyte counts disjunctively paired in urine sediment microscopy (SED) have high sensitivity. Similar symptomatic cure rates are found post antibiotic vs. placebo therapy in patients with negative cultures. Consequently, prescription on symptoms only implies unnecessary antibiotic therapy. Aims: to evaluate the diagnostic outcomes of NIT, SED and NIT disjunctively paired with SED (NIT+SED) vs. urine culture, with special focus on bladder incubation time (BIT), and to assess if NIT+SED can reduce unnecessary antibiotic therapy. Methods: A diagnostic, primary care, multicentre study including 1070 women with symptoms suggestive of lower UTI. Results: Significant bacteriuria was found in 77%. The BIT highly influenced the diagnostic outcomes and the optimal duration was ≥4h with sensitivity of 66, 90 and 95% for NIT, SED and NIT+SED, respectively. SED performed only in NIT negative specimens could reduce unnecessary antibiotics by 10% vs. prescription on symptoms only. The number needed to test with SED to reduce one unnecessary antibiotic course was five patients at BIT ≥4h and six patients at ≤3h or overall. Conclusion: The BIT highly influences the diagnostic outcomes with the highest accuracy of NIT+SED. Diagnosis of LUTIW with NIT+SED can reduce unnecessary antibiotic therapy and subsequently decrease antimicrobial resistance. Trial registration: The Swedish Medical Product Agency 1995 03 01:151:01783/94. PMID:26668667

  16. An Overview of Models of Speaking Performance and Its Implications for the Development of Procedural Framework for Diagnostic Speaking Tests

    ERIC Educational Resources Information Center

    Zhao, Zhongbao

    2013-01-01

    This paper aims at developing a procedural framework for the development and validation of diagnostic speaking tests. The researcher reviews the current available models of speaking performance, analyzes the distinctive features and then points out the implications for the development of a procedural framework for diagnostic speaking tests. On…

  17. 42 CFR 414.50 - Physician or other supplier billing for diagnostic tests performed or interpreted by a physician...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) or professional component (PC) of a diagnostic test that was ordered by the physician or other... behalf of the beneficiary) for the TC or PC of the diagnostic test may not exceed the lowest of the... who supervised the TC, and with respect to the PC, the performing supplier is the physician...

  18. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical...

  19. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical...

  20. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical...

  1. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical...

  2. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical...

  3. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical...

  4. Novel laboratory diagnostic tests for tuberculosis and their potential role in an integrated and tiered laboratory network.

    PubMed

    Somoskovi, Akos

    2015-06-01

    Lack of laboratory capacity in high-burden countries presents a significant barrier in providing diagnosis and treatment to patients infected with HIV/AIDS, tuberculosis (TB), and malaria. Strengthening laboratory services in these settings via implementation of novel diagnostic tests is especially indispensable to battle against TB and MDR/XDR-TB. Novel TB diagnostic assays have to be applicable to field conditions, affordable and accessible to all patients at different levels of the tiered laboratory network. A functional laboratory network should be based on well-developed diagnostic platforms that can provide not only timely and adequate diagnosis but are simple to use, and easy to implement and sustain. The article is overviewing the latest developments of TB laboratory diagnostics such as smear microscopy, rapid growth detection and susceptibility testing and rapid molecular testing with focus on performance and applicability to diagnostic needs at different levels of the diagnostic network. PMID:25736539

  5. Effect on diagnostic yield of repeated stool testing during outbreaks of Clostridium difficile-associated disease.

    PubMed

    Debast, S B; van Kregten, E; Oskam, K M G; van den Berg, T; Van den Berg, R J; Kuijper, E J

    2008-06-01

    The effect on diagnostic yield of testing sequential stools was assessed during two hospital epidemics of Clostridium difficile. Using a rapid immunoassay, C. difficile-associated disease was diagnosed in 237 diarrhoeal patients, of whom 204 (86%) were diagnosed from the first faeces sample and 12 (5%) were diagnosed from follow-up samples obtained within 1 week. The remaining 21 (9%) patients yielded a positive test from stools obtained >1 week after the initial negative sample. It was concluded that repeated testing of stools for C. difficile toxin is of value in controlling outbreaks of C. difficile infection. PMID:18393996

  6. Analysis of diagnostic testing of Gladys McCall Well No. 1

    SciTech Connect

    Riney, T.D.; Garg, S.K.

    1991-12-01

    Gladys McCall Well No. 1 was flow tested from 1983 to 1987, underwent long-term pressure buildup testing from October 1987 to October 1991, and has recently been re-entered for final diagnostic testing. The combination of a very large, poorly defined reservoir with data from only a single well has required that the testing be carried out over an unusually long time period for an understanding of the pressure maintenance mechanisms to be developed. Ongoing diagnostic testing of the well has been undertaken by DOE to help resolve questions that arose during the analysis of the test data from the eight year depletion and recovery testing. A rather complete summary of the synthesis, correlation and analysis of the earlier test data has recently been published (Riney, 1991.) and is included in this report as an Appendix. Figure 1 (an update of Figure 9 in the Appendix) includes the final pressure buildup data in the comparison with the earlier reservoir simulation model. During October 1991 the Gladys McCall well was flowed twice as part of the diagnostic testing. On October 1 flow was started to clean out the well and to perform a spinner survey to determine the fluid entry distribution across the perforated interval of Sand 8. The spinner log was run on October 2 with the well producing at a constant rate of {approx} 4800 stb/d. Total production during the October 1-2 test period was 5954 stb. The second flow was from October 10 to 14 to obtain downhole pressure transient data to determine if the transmissivity (kh product) of Sand 8 had changed during the four-year shutin period (October 1987 to October 1991). The total production during the four day constant-rate (5958 stb/d) drawdown test of October 10-14 was 23,850 stb. Eaton Operating Co. and Institute of Gas Technology are continuing with the diagnostic testing; entry and pressure measurements in two overlaying sands (2 and 4) are planned. Since neither time nor funds are sufficient to complete the Gladys Mc

  7. Sequential Test Selection by Quantifying of the Reduction in Diagnostic Uncertainty for the Diagnosis of Proximal Caries

    PubMed Central

    Arslan, Umut; Karaağaoğlu, Ahmet Ergun; Akkaya, Nursel; Çağırankaya, Leyla Berna; Kansu, Ayşe Özden; Kansu, Hilmi

    2013-01-01

    Background: In order to determine the presence or absence of a certain disease, multiple diagnostic tests may be necessary. Performance of these tests can be sequentially evaluated. Aims: The aim of the study is to determine the contribution of the test in each step, in reducing diagnostic uncertainty when multiple tests are sequentially used for the diagnosis. Study Design: Diagnostic accuracy study Methods: Radiographs of seventy-three patients of the Department of Dento-Maxillofacial Radiology of Hacettepe University Faculty of Dentistry were assessed. Panoramic (PAN), full mouth intraoral (FM), and bitewing (BW) radiographs were used for the diagnosis of proximal caries in the maxillary and mandibular molar regions. Diagnostic performance of radiography was sequentially evaluated by using the reduction in diagnostic uncertainty. Results: FM provided maximum diagnostic information for ruling in potential in the maxillary and mandibular molar regions in the first step. FM provided more diagnostic information than BW radiographs for ruling in the mandibular region in the second step. In the mandibular region, BW radiographs provided more diagnostic information than FM for ruling out in the first step. Conclusion: The presented method in this study provides the clinicians with a solution for the decision of the sequential selection of diagnostic tests for the correct diagnosis of the presence or absence of a certain disease. PMID:25207090

  8. Practice Bulletin No. 162 Summary: Prenatal Diagnostic Testing for Genetic Disorders.

    PubMed

    2016-05-01

    Prenatal genetic diagnostic testing is intended to determine, with as much certainty as possible, whether a specific genetic disorder or condition is present in the fetus. In contrast, prenatal genetic screening is designed to assess whether a patient is at increased risk of having a fetus affected by a genetic disorder. Originally, prenatal genetic testing focused primarily on Down syndrome (trisomy 21), but now it is able to detect a broad range of genetic disorders. Although it is necessary to perform amniocentesis or chorionic villus sampling (CVS) to definitively diagnose most genetic disorders, in some circumstances, fetal imaging with ultrasonography, echocardiography, or magnetic resonance imaging may be diagnostic of a particular structural fetal abnormality that is suggestive of an underlying genetic condition.The objective of prenatal genetic testing is to detect health problems that could affect the woman, fetus, or newborn and provide the patient and her obstetrician-gynecologist or other obstetric care provider with enough information to allow a fully informed decision about pregnancy management. Prenatal genetic testing cannot identify all abnormalities or problems in a fetus, and any testing should be focused on the individual patient's risks, reproductive goals, and preferences. It is important that patients understand the benefits and limitations of all prenatal screening and diagnostic testing, including the conditions for which tests are available and the conditions that will not be detected by testing. It also is important that patients realize that there is a broad range of clinical presentations, or phenotypes, for many genetic disorders and that results of genetic testing cannot predict all outcomes. Prenatal genetic testing has many benefits, including reassuring patients when results are normal, identifying disorders for which prenatal treatment may provide benefit, optimizing neonatal outcomes by ensuring the appropriate location for

  9. Bayesian evaluation of clinical diagnostic test characteristics of visual observations and remote monitoring to diagnose bovine respiratory disease in beef calves.

    PubMed

    White, Brad J; Goehl, Dan R; Amrine, David E; Booker, Calvin; Wildman, Brian; Perrett, Tye

    2016-04-01

    Accurate diagnosis of bovine respiratory disease (BRD) in beef cattle is a critical facet of therapeutic programs through promotion of prompt treatment of diseased calves in concert with judicious use of antimicrobials. Despite the known inaccuracies, visual observation (VO) of clinical signs is the conventional diagnostic modality for BRD diagnosis. Objective methods of remotely monitoring cattle wellness could improve diagnostic accuracy; however, little information exists describing the accuracy of this method compared to traditional techniques. The objective of this research is to employ Bayesian methodology to elicit diagnostic characteristics of conventional VO compared to remote early disease identification (REDI) to diagnose BRD. Data from previous literature on the accuracy of VO were combined with trial data consisting of direct comparison between VO and REDI for BRD in two populations. No true gold standard diagnostic test exists for BRD; therefore, estimates of diagnostic characteristics of each test were generated using Bayesian latent class analysis. Results indicate a 90.0% probability that the sensitivity of REDI (median 81.3%; 95% probability interval [PI]: 55.5, 95.8) was higher than VO sensitivity (64.5%; PI: 57.9, 70.8). The specificity of REDI (median 92.9%; PI: 88.2, 96.9) was also higher compared to VO (median 69.1%; PI: 66.3, 71.8). The differences in sensitivity and specificity resulted in REDI exhibiting higher positive and negative predictive values in both high (41.3%) and low (2.6%) prevalence situations. This research illustrates the potential of remote cattle monitoring to augment conventional methods of BRD diagnosis resulting in more accurate identification of diseased cattle. PMID:26879058

  10. Repeated significance tests of linear combinations of sensitivity and specificity of a diagnostic biomarker.

    PubMed

    Wu, Mixia; Shu, Yu; Li, Zhaohai; Liu, Aiyi

    2016-08-30

    A sequential design is proposed to test whether the accuracy of a binary diagnostic biomarker meets the minimal level of acceptance. The accuracy of a binary diagnostic biomarker is a linear combination of the marker's sensitivity and specificity. The objective of the sequential method is to minimize the maximum expected sample size under the null hypothesis that the marker's accuracy is below the minimal level of acceptance. The exact results of two-stage designs based on Youden's index and efficiency indicate that the maximum expected sample sizes are smaller than the sample sizes of the fixed designs. Exact methods are also developed for estimation, confidence interval and p-value concerning the proposed accuracy index upon termination of the sequential testing. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. PMID:26947768

  11. [Clinical Application of Non-invasive Diagnostic Tests for Liver Fibrosis].

    PubMed

    Shin, Jung Woo; Park, Neung Hwa

    2016-07-25

    The diagnostic assessment of liver fibrosis is an important step in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard to assess necroinflammation and fibrosis. However, recent technical advances have introduced numerous serum biomarkers and imaging tools using elastography as noninvasive alternatives to biopsy. Serum markers can be direct or indirect markers of the fibrosis process. The elastography-based studies include transient elastography, acoustic radiation force imaging, supersonic shear wave imaging and magnetic resonance elastography. As accumulation of clinical data shows that noninvasive tests provide prognostic information of clinical relevance, non-invasive diagnostic tools have been incorporated into clinical guidelines and practice. Here, the authors review noninvasive tests for the diagnosis of liver fibrosis. PMID:27443617

  12. Accurate diagnosis of myalgic encephalomyelitis and chronic fatigue syndrome based upon objective test methods for characteristic symptoms

    PubMed Central

    Twisk, Frank NM

    2015-01-01

    Although myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are considered to be synonymous, the definitional criteria for ME and CFS define two distinct, partially overlapping, clinical entities. ME, whether defined by the original criteria or by the recently proposed criteria, is not equivalent to CFS, let alone a severe variant of incapacitating chronic fatigue. Distinctive features of ME are: muscle weakness and easy muscle fatigability, cognitive impairment, circulatory deficits, a marked variability of the symptoms in presence and severity, but above all, post-exertional “malaise”: a (delayed) prolonged aggravation of symptoms after a minor exertion. In contrast, CFS is primarily defined by (unexplained) chronic fatigue, which should be accompanied by four out of a list of 8 symptoms, e.g., headaches. Due to the subjective nature of several symptoms of ME and CFS, researchers and clinicians have questioned the physiological origin of these symptoms and qualified ME and CFS as functional somatic syndromes. However, various characteristic symptoms, e.g., post-exertional “malaise” and muscle weakness, can be assessed objectively using well-accepted methods, e.g., cardiopulmonary exercise tests and cognitive tests. The objective measures acquired by these methods should be used to accurately diagnose patients, to evaluate the severity and impact of the illness objectively and to assess the positive and negative effects of proposed therapies impartially. PMID:26140274

  13. Accurate diagnosis of myalgic encephalomyelitis and chronic fatigue syndrome based upon objective test methods for characteristic symptoms.

    PubMed

    Twisk, Frank Nm

    2015-06-26

    Although myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are considered to be synonymous, the definitional criteria for ME and CFS define two distinct, partially overlapping, clinical entities. ME, whether defined by the original criteria or by the recently proposed criteria, is not equivalent to CFS, let alone a severe variant of incapacitating chronic fatigue. Distinctive features of ME are: muscle weakness and easy muscle fatigability, cognitive impairment, circulatory deficits, a marked variability of the symptoms in presence and severity, but above all, post-exertional "malaise": a (delayed) prolonged aggravation of symptoms after a minor exertion. In contrast, CFS is primarily defined by (unexplained) chronic fatigue, which should be accompanied by four out of a list of 8 symptoms, e.g., headaches. Due to the subjective nature of several symptoms of ME and CFS, researchers and clinicians have questioned the physiological origin of these symptoms and qualified ME and CFS as functional somatic syndromes. However, various characteristic symptoms, e.g., post-exertional "malaise" and muscle weakness, can be assessed objectively using well-accepted methods, e.g., cardiopulmonary exercise tests and cognitive tests. The objective measures acquired by these methods should be used to accurately diagnose patients, to evaluate the severity and impact of the illness objectively and to assess the positive and negative effects of proposed therapies impartially. PMID:26140274

  14. Diagnostic efficiency of ImPACT and CogSport in concussed rugby union players who have not undergone baseline neurocognitive testing.

    PubMed

    Gardner, Andrew; Shores, E Arthur; Batchelor, Jennifer; Honan, Cynthia A

    2012-01-01

    The current study endeavored to replicate the approach to sports-related concussion management adopted by some community-based sporting organizations by examining the diagnostic efficiency of CogSport and ImPACT in athletes without baseline test data and assessed only once postinjury. Recently concussed nonelite-level rugby union players (N = 51) were tested within 72 hours of sustaining a concussion and were compared to nonconcussed matched controls (N = 41). Demographic information and history of recent concussion were also collected. Logistic regression analysis and receiver-operating characteristic curve analysis were conducted to evaluate the most accurate scores at identifying group membership. Overall, the classification accuracy of CogSport and ImPACT represented only very minimal improvements over a demographic-only (age, estimated premorbid Full-Scale IQ, and number of previous concussions) model. Positive predictive power and negative predictive power of composite scores were modest. The ImPACT postconcussion symptoms total (severity) score was most accurate at classifying concussed athletes. Where neuropsychological tests are utilized on a single occasion postconcussion and in the absence of baseline testing, postinjury testing does not improve diagnostic utility beyond the demographic model. These results do not validate this approach as a useful method of managing sports-related concussion. PMID:23373575

  15. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice. PMID:26244571

  16. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing

    PubMed Central

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called “threshold probability” at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today’s clinical practice. PMID:26244571

  17. Experimental comparison of three nondestructive testing diagnostics on pigments and ligands

    NASA Astrophysics Data System (ADS)

    Giardini-Guidoni, Anna; Vendittelli, M.; Flamini, Chiari; Fantoni, Roberta; Sciuti, S.; Mele, Aldo

    2000-02-01

    Three non destructive testing techniques x-ray fluorescence spectroscopy, laser induced fluorescence and fast luminescence imaging by an intensified charge coupled device have been applied to analyze a few most common painting materials, namely natural and synthetic pigments and resins. A comparison of the experimental results obtained shows the applicability of these three methods and to observe and study an entire oil painting by a mobile station for 'in situ' diagnostics for restoration and conservation.

  18. Spectrum of false positivity for the fourth generation human immunodeficiency virus diagnostic tests.

    PubMed

    Liu, Peter; Jackson, Patrick; Shaw, Nathan; Heysell, Scott

    2016-01-01

    Novel fourth generation screening and confirmatory human immunodeficiency virus (HIV) assays are now commercially available and incorporated into new diagnostic algorithms. We report two cases involving a total of three patients which highlight the spectrum of false positivity for both the Abbott Architect p24 antigen/antibody assay and the confirmatory Multispot antibody differentiation test. We then discuss the mechanisms for false positivity and the associated clinical conditions or laboratory scenarios that may predispose to inaccurate interpretation. PMID:26734067

  19. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    PubMed

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin. PMID:25904126

  20. Data mining approach to the evaluation of diagnostic tests in Wilson disease

    NASA Astrophysics Data System (ADS)

    Plutecki, Michal M.; Dądalski, Maciej; Socha, Piotr; Mulawka, Jan J.

    2009-06-01

    The purpose of this paper is to figure out a new, better than so-far-known, evaluation method of diagnostic tests in Wilson disease. In order to find the most interesting classification models various data mining techniques were applied to real, suffering from Wilson disease, set of patients. It occurred that a combination of two classification algorithms with its implementations in Weka environment may significantly increase classification ability.

  1. Variability in the diagnostic performance of a bedside rapid diagnostic influenza test over four epidemic seasons in a pediatric emergency department.

    PubMed

    Avril, E; Lacroix, S; Vrignaud, B; Moreau-Klein, A; Coste-Burel, M; Launay, E; Gras-Le Guen, C

    2016-07-01

    We wanted to determine the diagnostic performance of a rapid influenza diagnostic test (RIDT) used bedside in a pediatric emergency department (PED). This was a prospective study over four consecutive winters (2009-2013), comparing the results of a RIDT (QuickVue®) with RT-PCR in children admitted to a PED. Among the 764 children included, we did not observe any significant differences in the diagnostic performance of RIDT except during the H1N1 pandemic. The overall sensitivity of the test was 0.82; the specificity 0.98; the positive and negative likelihood ratios 37.8 and 0.19. The positive and negative post-test probabilities of infection were 98% and 17%. The diagnostic performance was increased for influenza B cases (P = 0.03). RIDTs are suitable for use every winter with few differences in its diagnostic value, except during specific pandemic periods. This test could limit unnecessary complementary exams and guide the prescription of antivirals during influenza epidemic periods in PEDs. PMID:27139081

  2. Planning for Plume Diagnostics for Ground Testing of J-2X Engines at the SSC

    NASA Technical Reports Server (NTRS)

    SaintCyr, William W.; Tejwani, Gopal D.; McVay, Gregory P.; Langford, Lester A.; SaintCyr, William W.

    2010-01-01

    John C. Stennis Space Center (SSC) is the premier test facility for liquid rocket engine development and certification for the National Aeronautics and Space Administration (NASA). Therefore, it is no surprise that the SSC will play the most prominent role in the engine development testing and certification for the J-2X engine. The Pratt & Whitney Rocketdyne J-2X engine has been selected by the Constellation Program to power the Ares I Upper Stage Element and the Ares V Earth Departure Stage in NASA s strategy of risk mitigation for hardware development by building on the Apollo program and other lessons learned to deliver a human-rated engine that is on an aggressive development schedule, with first demonstration flight in 2010 and human test flights in 2012. Accordingly, J-2X engine design, development, test, and evaluation is to build upon heritage hardware and apply valuable experience gained from past development and testing efforts. In order to leverage SSC s successful and innovative expertise in the plume diagnostics for the space shuttle main engine (SSME) health monitoring,1-10 this paper will present a blueprint for plume diagnostics for various proposed ground testing activities for J-2X at SSC. Complete description of the SSC s test facilities, supporting infrastructure, and test facilities is available in Ref. 11. The A-1 Test Stand is currently being prepared for testing the J-2X engine at sea level conditions. The A-2 Test Stand is currently being used for testing the SSME and may also be used for testing the J-2X engine at sea level conditions in the future. Very recently, ground-breaking ceremony for the new A-3 rocket engine test stand took place at SSC on August 23, 2007. A-3 is the first large - scale test stand to be built at the SSC since the A and B stands were constructed in the 1960s. The A-3 Test Stand will be used for testing J-2X engines under vacuum conditions simulating high altitude operation at approximately 30,480 m (100,000 ft

  3. Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.

    PubMed

    Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N

    2016-02-01

    Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. PMID:26423384

  4. SMS messages increase adherence to rapid diagnostic test results among malaria patients: results from a pilot study in Nigeria

    PubMed Central

    2014-01-01

    Background The World Health Organization now recommends parasitological confirmation for malaria case management. Rapid diagnostic tests (RDTs) for malaria are an accurate and simple diagnostic to confirm parasite presence in blood. However, where they have been deployed, adherence to RDT results has been poor, especially when the test result is negative. Few studies have examined adherence to RDTs distributed or purchased through the private sector. Methods The Rapid Examination of Malaria and Evaluation of Diagnostic Information (REMEDI) study assessed the acceptability of and adherence to RDT results for patients seeking care from private sector drug retailers in two cities in Oyo State in south-west Nigeria. In total, 465 adult participants were enrolled upon exit from a participating drug shop having purchased anti-malaria drugs for themselves. Participants were given a free RDT and the appropriate treatment advice based on their RDT result. Short Message Service (SMS) text messages reiterating the treatment advice were sent to a randomly selected half of the participants one day after being tested. Participants were contacted via phone four days after the RDT was conducted to assess adherence to the RDT information and treatment advice. Results Adherence to RDT results was 14.3 percentage points (P-val <0.001) higher in the treatment group who were sent the SMS. The higher adherence in the treatment group was robust to several specification tests and the estimated difference in adherence ranged from 9.7 to 16.1 percentage points. Further, the higher adherence to the treatment advice was specific to the treatment advice for anti-malarial drugs and not other drugs purchased to treat malaria symptoms in the RDT-negative participants who bought both anti-malarial and symptom drugs. There was no difference in adherence for the RDT-positive participants who were sent the SMS. Conclusions SMS text messages substantially increased adherence to RDT results for

  5. Impact of gene patents on diagnostic testing: a new patent landscaping method applied to spinocerebellar ataxia

    PubMed Central

    Berthels, Nele; Matthijs, Gert; Van Overwalle, Geertrui

    2011-01-01

    Recent reports in Europe and the United States raise concern about the potential negative impact of gene patents on the freedom to operate of diagnosticians and on the access of patients to genetic diagnostic services. Patents, historically seen as legal instruments to trigger innovation, could cause undesired side effects in the public health domain. Clear empirical evidence on the alleged hindering effect of gene patents is still scarce. We therefore developed a patent categorization method to determine which gene patents could indeed be problematic. The method is applied to patents relevant for genetic testing of spinocerebellar ataxia (SCA). The SCA test is probably the most widely used DNA test in (adult) neurology, as well as one of the most challenging due to the heterogeneity of the disease. Typically tested as a gene panel covering the five common SCA subtypes, we show that the patenting of SCA genes and testing methods and the associated licensing conditions could have far-reaching consequences on legitimate access to this gene panel. Moreover, with genetic testing being increasingly standardized, simply ignoring patents is unlikely to hold out indefinitely. This paper aims to differentiate among so-called ‘gene patents' by lifting out the truly problematic ones. In doing so, awareness is raised among all stakeholders in the genetic diagnostics field who are not necessarily familiar with the ins and outs of patenting and licensing. PMID:21811306

  6. Diagnostic Methods of Helicobacter pylori Infection for Epidemiological Studies: Critical Importance of Indirect Test Validation.

    PubMed

    Miftahussurur, Muhammad; Yamaoka, Yoshio

    2016-01-01

    Among the methods developed to detect H. pylori infection, determining the gold standard remains debatable, especially for epidemiological studies. Due to the decreasing sensitivity of direct diagnostic tests (histopathology and/or immunohistochemistry [IHC], rapid urease test [RUT], and culture), several indirect tests, including antibody-based tests (serology and urine test), urea breath test (UBT), and stool antigen test (SAT) have been developed to diagnose H. pylori infection. Among the indirect tests, UBT and SAT became the best methods to determine active infection. While antibody-based tests, especially serology, are widely available and relatively sensitive, their specificity is low. Guidelines indicated that no single test can be considered as the gold standard for the diagnosis of H. pylori infection and that one should consider the method's advantages and disadvantages. Based on four epidemiological studies, culture and RUT present a sensitivity of 74.2-90.8% and 83.3-86.9% and a specificity of 97.7-98.8% and 95.1-97.2%, respectively, when using IHC as a gold standard. The sensitivity of serology is quite high, but that of the urine test was lower compared with that of the other methods. Thus, indirect test validation is important although some commercial kits propose universal cut-off values. PMID:26904678

  7. Log-linear and logistic modeling of dependence among diagnostic tests.

    PubMed

    Hanson, T E; Johnson, W O; Gardner, I A

    2000-05-30

    We developed log-linear and logistic-modeling approaches to investigate dependence among diagnostic tests. To illustrate the approaches, we used published data for swine toxoplasmosis, bovine paratuberculosis, and swine brucellosis. These diseases were selected because each animal's true disease status was known, at least five tests were used, and the serologic tests had been previously shown to have moderate-to-high pairwise dependence in test sensitivities (and sometimes in test specificities). Log-linear and logistic modeling yielded similar results for swine toxoplasmosis and swine brucellosis. However, logistic modeling could not be used to investigate test dependence for bovine paratuberculosis because of quasi-separation in the data attributable to two fecal-based tests having specificities of 100%. Findings from our modeling indicated that 3 (modified agglutination, enzyme-linked immunosorbent assay (ELISA), latex agglutination) of 5 serologic tests for toxoplasmosis and 2 (rivanol and particle concentration fluorescence immunoassay) of 6 serologic tests for brucellosis were adequate for diagnosis. For bovine paratuberculosis, both fecal-based tests (Herrold's egg-yolk culture and radiometric culture) and 1 (ELISA) of 3 serologic tests were necessary in serial and parallel testing schemes. PMID:10802337

  8. Diagnostic Methods of Helicobacter pylori Infection for Epidemiological Studies: Critical Importance of Indirect Test Validation

    PubMed Central

    Miftahussurur, Muhammad; Yamaoka, Yoshio

    2016-01-01

    Among the methods developed to detect H. pylori infection, determining the gold standard remains debatable, especially for epidemiological studies. Due to the decreasing sensitivity of direct diagnostic tests (histopathology and/or immunohistochemistry [IHC], rapid urease test [RUT], and culture), several indirect tests, including antibody-based tests (serology and urine test), urea breath test (UBT), and stool antigen test (SAT) have been developed to diagnose H. pylori infection. Among the indirect tests, UBT and SAT became the best methods to determine active infection. While antibody-based tests, especially serology, are widely available and relatively sensitive, their specificity is low. Guidelines indicated that no single test can be considered as the gold standard for the diagnosis of H. pylori infection and that one should consider the method's advantages and disadvantages. Based on four epidemiological studies, culture and RUT present a sensitivity of 74.2–90.8% and 83.3–86.9% and a specificity of 97.7–98.8% and 95.1–97.2%, respectively, when using IHC as a gold standard. The sensitivity of serology is quite high, but that of the urine test was lower compared with that of the other methods. Thus, indirect test validation is important although some commercial kits propose universal cut-off values. PMID:26904678

  9. Prevalence and density-related concordance of three diagnostic tests for malaria in a region of Tanzania with hypoendemic malaria.

    PubMed

    Schachterle, Stephen E; Mtove, George; Levens, Joshua P; Clemens, Emily G; Shi, Lirong; Raj, Amirita; Munoz, Beatrice; Reller, Megan E; West, Sheila; Dumler, J Stephen; Sullivan, David

    2011-11-01

    Accurate malaria diagnosis has dual roles in identification of symptomatic persons for effective malaria treatment and also enumeration of asymptomatic persons who contribute to the epidemiologic determinants of transmission. Three currently used diagnostic tests, microscopy, rapid diagnostic tests (RDTs), and real-time PCR, all have different sensitivities and specificities, which are parasite density dependent. Here, we compare their concordance among 451 febrile episodes in a cohort of 2,058 children and adults followed over 6 months in a region in central Tanzania with hypoendemic malaria. Microscopy, a histidine-rich protein-based RDT, and two different real-time PCR gene probes detected Plasmodium falciparum in 20, 54, 41, and 78 episodes of fever, respectively. They had complete concordance in only 9 episodes. Real-time PCR with an 18S probe was more sensitive than with a mitochondrial probe for cytochrome b despite higher copy numbers of mitochondrial DNA. Both PCR yields were increased 4-fold by glycogen/acetate precipitation with low-speed centrifugation. Duplicate PCR increases low-density malaria detection. RDT had the highest number of unique positives, presumably from persistent antigen despite the absence of parasites, although RDT did not detect 3 parasitemias with over 1,000 parasites/μl. In a latent class analysis, real-time PCR had significantly higher sensitivity than did microscopy or RDT. Agreement between real-time PCR, RDT, and microscopy was highest in March and April, when both the P. falciparum parasite rate and parasite densities are highest. Real-time PCR is more sensitive and specific than RDT and microscopy in low-prevalence, low-parasite-density settings. PMID:21880972

  10. Fool's Gold: Why Imperfect Reference Tests Are Undermining the Evaluation of Novel Diagnostics: A Reevaluation of 5 Diagnostic Tests for Leptospirosis

    PubMed Central

    Limmathurotsakul, Direk; Turner, Elizabeth L.; Wuthiekanun, Vanaporn; Thaipadungpanit, Janjira; Suputtamongkol, Yupin; Chierakul, Wirongrong; Smythe, Lee D.; Day, Nicholas P. J.; Cooper, Ben; Peacock, Sharon J.

    2012-01-01

    Background. We observed that some patients with clinical leptospirosis supported by positive results of rapid tests were negative for leptospirosis on the basis of our diagnostic gold standard, which involves isolation of Leptospira species from blood culture and/or a positive result of a microscopic agglutination test (MAT). We hypothesized that our reference standard was imperfect and used statistical modeling to investigate this hypothesis. Methods. Data for 1652 patients with suspected leptospirosis recruited during three observational studies and one randomized control trial that described the application of culture, MAT, immunofluorescence assay (IFA), lateral flow (LF) and/or PCR targeting the 16S rRNA gene were reevaluated using Bayesian latent class models and random-effects meta-analysis. Results. The estimated sensitivities of culture alone, MAT alone, and culture plus MAT (for which the result was considered positive if one or both tests had a positive result) were 10.5% (95% credible interval [CrI], 2.7%–27.5%), 49.8% (95% CrI, 37.6%–60.8%), and 55.5% (95% CrI, 42.9%–67.7%), respectively. These low sensitivities were present across all 4 studies. The estimated specificity of MAT alone (and of culture plus MAT) was 98.8% (95% CrI, 92.8%–100.0%). The estimated sensitivities and specificities of PCR (52.7% [95% CrI, 45.2%–60.6%] and 97.2% [95% CrI, 92.0%–99.8%], respectively), lateral flow test (85.6% [95% CrI, 77.5%–93.2%] and 96.2% [95% CrI, 87.7%–99.8%], respectively), and immunofluorescence assay (45.5% [95% CrI, 33.3%–60.9%] and 96.8% [95% CrI, 92.8%–99.8%], respectively) were considerably different from estimates in which culture plus MAT was considered a perfect gold standard test. Conclusions. Our findings show that culture plus MAT is an imperfect gold standard against which to compare alterative tests for the diagnosis of leptospirosis. Rapid point-of-care tests for this infection would bring an important improvement

  11. Toward accurate molecular identification of species in complex environmental samples: testing the performance of sequence filtering and clustering methods

    PubMed Central

    Flynn, Jullien M; Brown, Emily A; Chain, Frédéric J J; MacIsaac, Hugh J; Cristescu, Melania E

    2015-01-01

    Metabarcoding has the potential to become a rapid, sensitive, and effective approach for identifying species in complex environmental samples. Accurate molecular identification of species depends on the ability to generate operational taxonomic units (OTUs) that correspond to biological species. Due to the sometimes enormous estimates of biodiversity using this method, there is a great need to test the efficacy of data analysis methods used to derive OTUs. Here, we evaluate the performance of various methods for clustering length variable 18S amplicons from complex samples into OTUs using a mock community and a natural community of zooplankton species. We compare analytic procedures consisting of a combination of (1) stringent and relaxed data filtering, (2) singleton sequences included and removed, (3) three commonly used clustering algorithms (mothur, UCLUST, and UPARSE), and (4) three methods of treating alignment gaps when calculating sequence divergence. Depending on the combination of methods used, the number of OTUs varied by nearly two orders of magnitude for the mock community (60–5068 OTUs) and three orders of magnitude for the natural community (22–22191 OTUs). The use of relaxed filtering and the inclusion of singletons greatly inflated OTU numbers without increasing the ability to recover species. Our results also suggest that the method used to treat gaps when calculating sequence divergence can have a great impact on the number of OTUs. Our findings are particularly relevant to studies that cover taxonomically diverse species and employ markers such as rRNA genes in which length variation is extensive. PMID:26078860

  12. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

    PubMed Central

    Miller, Eric; Sikes, Hadley D.

    2015-01-01

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs. PMID:26594252

  13. Comparison of the sensitivity of different diagnostic tests for pancreatitis in cats.

    PubMed

    Gerhardt, A; Steiner, J M; Williams, D A; Kramer, S; Fuchs, C; Janthur, M; Hewicker-Trautwein, M; Nolte, I

    2001-01-01

    The objective of this study was to compare the sensitivity of different diagnostic tests for pancreatitis in cats. Twenty-one cats with confirmed pancreatitis were evaluated at the Small Animal Clinic of the School of Veterinary Medicine in Hannover, Germany, between September 1997 and January 1999. Clinical signs of affected cats were nonspecific, with 95% of the cats showing anorexia and 86% lethargy. Also, hematologic and biochemical abnormalities of affected cats were nonspecific. Serum feline trypsin-like immunoreactivity (fTLI) in these 21 cats with pancreatitis was 127.5 +/- 109.5 microg/L (mean +/- SD; range, 24-500 microg/L). Fourteen of the 21 cats with pancreatitis had complicating conditions. Their serum fTLI was 153.9 +/- 124.3 microg/L (mean +/- SD; range, 29 500 microg/L). In this study, abdominal ultrasound showed a sensitivity for pancreatitis of 24%, and abdominal computed tomography had a sensitivity of 20%. Serum fTLI had a sensitivity between 86% when a cut-off value of 49 microg/L was used (upper limit of the control range) and 33% when a cut-off value of 100 microg/L was used. We conclude that in this group of cats with pancreatitis, measurement of serum fTLI was the most sensitive diagnostic test of those evaluated. Abdominal ultrasound, however, may be a valuable diagnostic tool in some cats with pancreatitis. PMID:11467589

  14. Informational analysis: a Shannon theoretic approach to measure the performance of a diagnostic test.

    PubMed

    Girometti, Rossano; Fabris, Francesco

    2015-09-01

    Diagnostic test accuracy, based on sensitivity, specificity, positive/negative predictive values (dichotomous case), and on ROC analysis (continuous case), should be expressed with a single, coherent index. We propose to modelize the diagnostic test as a flow of information between the disease, that is, a hidden state of the patient, and the physicians. We assume that (1) sensitivity, specificity, and false-positive/false-negative rates are the probabilities of a binary asymmetric channel; (2) the diagnostic channel information is measured by mutual information. We introduce two summary measures of accuracy, namely the information ratio (IR) for the dichotomous case, and the global information ratio (GIR) for the continuous case. We apply our model to a study by Pisano et al. (N Engl J Med 353(17):1773-1783, 2005), who compared digital versus film mammography, in diagnosing breast cancer in a screening population of 42,760 women. In film mammography, the maximum IR (0.178) corresponds to the standard cutoff of sensitivity and specificity provided by the ROC analysis (GIR 0.200). Maximum IR and GIR for digital mammography are higher (0.201 and 0.229, respectively), but IR corresponds to a cutoff with higher sensitivity but lower specificity, thus suggesting that larger information provided by digital mammography carries the risk of more false-positive cases. PMID:25894466

  15. Performance of commercially available serological diagnostic tests to detect Leishmania infantum infection on experimentally infected dogs.

    PubMed

    Rodríguez-Cortés, Alhelí; Ojeda, Ana; Todolí, Felicitat; Alberola, Jordi

    2013-01-31

    Leishmania infantum (syn. Leishmania chagasi) is the etiological agent of a widespread serious zoonotic disease that affects both humans and dogs. Prevalence and incidence of the canine infection are important parameters to determine the risk and the ways to control this reemergent zoonosis. Unfortunately, there is not a gold standard test for Leishmania infection. Our aim was to assess the operative validity of commercial tests used to detect antibodies to Leishmania in serum samples from experimental infections. Three ELISA tests (LEISCAN(®) Leishmania ELISA Test, INGEZIM(®) LEISHMANIA, and INGEZIM(®) LEISHMANIA VET), three immunochromatographic tests (INGEZIM(®) LEISHMACROM, SNAP(®) Leishmania, and WITNESS(®) Leishmania), and one IFAT were evaluated. LEISCAN(®) Leishmania ELISA test achieved the highest sensitivity and accuracy (both 0.98). Specificity was 1 for all tests except for IFAT. All tests but IFAT obtained a positive predictive value of 1, while the maximum negative predictive value was achieved by LEISCAN(®) Leishmania ELISA Test (0.93). The best positive likelihood ratio was obtained by INGEZIM(®) LEISHMANIA VET (30.26), while the best negative likelihood ratio was obtained by LEISCAN(®) Leishmania ELISA Test (0.02). The highest diagnostic odds ratio was achieved by LEISCAN(®) Leishmania ELISA Test (729.00). The largest area under the ROC curve was obtained by LEISCAN(®) Leishmania ELISA Test (0.981). Quantitative ELISA based tests performmed better than qualitative tests ("Rapid Tests"), and the test best suited to detect Leishmania in infected dogs and to provide clinically useful information was LEISCAN(®) Leishmania ELISA Test. This and other results point also to the need of revising the status of IFAT as a gold standard for the diagnosis of leishmaniasis. PMID:23021261

  16. Supervisory control and diagnostics system for the mirror fusion test facility: overview and status 1980

    SciTech Connect

    McGoldrick, P.R.

    1981-01-01

    The Mirror Fusion Test Facility (MFTF) is a complex facility requiring a highly-computerized Supervisory Control and Diagnostics System (SCDS) to monitor and provide control over ten subsystems; three of which require true process control. SCDS will provide physicists with a method of studying machine and plasma behavior by acquiring and processing up to four megabytes of plasma diagnostic information every five minutes. A high degree of availability and throughput is provided by a distributed computer system (nine 32-bit minicomputers on shared memory). Data, distributed across SCDS, is managed by a high-bandwidth Distributed Database Management System. The MFTF operators' control room consoles use color television monitors with touch sensitive screens; this is a totally new approach. The method of handling deviations to normal machine operation and how the operator should be notified and assisted in the resolution of problems has been studied and a system designed.

  17. Are natural products and medical diagnostic tests still eligible for patents in the USA?

    PubMed

    Cockbain, Julian; Sterckx, Sigrid

    2012-09-01

    In 2010, the biotechnology and molecular diagnostics industries were shocked by the decision from a US District Court to the effect that isolated endogenous DNA and diagnostic tests based on newly discovered DNA sequences were not eligible for US patents. The case related to the BRCA1/2 genes for breast and ovarian cancer. On appeal, the decision was almost entirely overturned. However, in March 2012, the US Supreme Court vacated the appeal court decision and instructed the appeals court to rehear the case in the light of its very recent decision, which suggested that products of nature and their obvious uses should not be patentable. This commentary explores the points at issue. PMID:24236874

  18. An Integrated Architecture for Aircraft Engine Performance Monitoring and Fault Diagnostics: Engine Test Results

    NASA Technical Reports Server (NTRS)

    Rinehart, Aidan W.; Simon, Donald L.

    2014-01-01

    This paper presents a model-based architecture for performance trend monitoring and gas path fault diagnostics designed for analyzing streaming transient aircraft engine measurement data. The technique analyzes residuals between sensed engine outputs and model predicted outputs for fault detection and isolation purposes. Diagnostic results from the application of the approach to test data acquired from an aircraft turbofan engine are presented. The approach is found to avoid false alarms when presented nominal fault-free data. Additionally, the approach is found to successfully detect and isolate gas path seeded-faults under steady-state operating scenarios although some fault misclassifications are noted during engine transients. Recommendations for follow-on maturation and evaluation of the technique are also presented.

  19. Meta-analysis of diagnostic tests accounting for disease prevalence: a new model using trivariate copulas.

    PubMed

    Hoyer, A; Kuss, O

    2015-05-20

    In real life and somewhat contrary to biostatistical textbook knowledge, sensitivity and specificity (and not only predictive values) of diagnostic tests can vary with the underlying prevalence of disease. In meta-analysis of diagnostic studies, accounting for this fact naturally leads to a trivariate expansion of the traditional bivariate logistic regression model with random study effects. In this paper, a new model is proposed using trivariate copulas and beta-binomial marginal distributions for sensitivity, specificity, and prevalence as an expansion of the bivariate model. Two different copulas are used, the trivariate Gaussian copula and a trivariate vine copula based on the bivariate Plackett copula. This model has a closed-form likelihood, so standard software (e.g., SAS PROC NLMIXED) can be used. The results of a simulation study have shown that the copula models perform at least as good but frequently better than the standard model. The methods are illustrated by two examples. PMID:25712874

  20. An Integrated Architecture for Aircraft Engine Performance Monitoring and Fault Diagnostics: Engine Test Results

    NASA Technical Reports Server (NTRS)

    Rinehart, Aidan W.; Simon, Donald L.

    2015-01-01

    This paper presents a model-based architecture for performance trend monitoring and gas path fault diagnostics designed for analyzing streaming transient aircraft engine measurement data. The technique analyzes residuals between sensed engine outputs and model predicted outputs for fault detection and isolation purposes. Diagnostic results from the application of the approach to test data acquired from an aircraft turbofan engine are presented. The approach is found to avoid false alarms when presented nominal fault-free data. Additionally, the approach is found to successfully detect and isolate gas path seeded-faults under steady-state operating scenarios although some fault misclassifications are noted during engine transients. Recommendations for follow-on maturation and evaluation of the technique are also presented.

  1. Assessing Diagnostic Tests: How to Correct for the Combined Effects of Interpretation and Reference Standard

    PubMed Central

    Omurtag, Ahmet; Fenton, Andre A.

    2012-01-01

    We describe a general solution to the problem of determining diagnostic accuracy without the use of a perfect reference standard and in the presence of interpreter variability. The accuracy of a diagnostic test is typically determined by comparing its outcomes with those of an established reference standard. But the accuracy of the standard itself and those of the interpreters strongly influence such assessments. We use our solution to examine the effects of the properties of the standard, the reliability of the interpreters, and the prevalence of abnormality on the measured sensitivity and specificity. Our results provide a method of systematically adjusting the measured sensitivity and specificity in order to estimate their true values. The results are validated by simulations and their detailed application to specific cases are described. PMID:23300619

  2. Accurate Time-Dependent Traveling-Wave Tube Model Developed for Computational Bit-Error-Rate Testing

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.

    2001-01-01

    The phenomenal growth of the satellite communications industry has created a large demand for traveling-wave tubes (TWT's) operating with unprecedented specifications requiring the design and production of many novel devices in record time. To achieve this, the TWT industry heavily relies on computational modeling. However, the TWT industry's computational modeling capabilities need to be improved because there are often discrepancies between measured TWT data and that predicted by conventional two-dimensional helical TWT interaction codes. This limits the analysis and design of novel devices or TWT's with parameters differing from what is conventionally manufactured. In addition, the inaccuracy of current computational tools limits achievable TWT performance because optimized designs require highly accurate models. To address these concerns, a fully three-dimensional, time-dependent, helical TWT interaction model was developed using the electromagnetic particle-in-cell code MAFIA (Solution of MAxwell's equations by the Finite-Integration-Algorithm). The model includes a short section of helical slow-wave circuit with excitation fed by radiofrequency input/output couplers, and an electron beam contained by periodic permanent magnet focusing. A cutaway view of several turns of the three-dimensional helical slow-wave circuit with input/output couplers is shown. This has been shown to be more accurate than conventionally used two-dimensional models. The growth of the communications industry has also imposed a demand for increased data rates for the transmission of large volumes of data. To achieve increased data rates, complex modulation and multiple access techniques are employed requiring minimum distortion of the signal as it is passed through the TWT. Thus, intersymbol interference (ISI) becomes a major consideration, as well as suspected causes such as reflections within the TWT. To experimentally investigate effects of the physical TWT on ISI would be

  3. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

    PubMed Central

    Choi, Young Jun; Chung, Mi Sun; Koo, Hyun Jung; Park, Ji Eun; Yoon, Hee Mang

    2016-01-01

    Objective To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors. Materials and Methods All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011–2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted. Results Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5–25) and 11.4 (7–15), respectively. The mean citation number was 4 (0–21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266). Conclusion The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate. PMID:27587959

  4. Malaria surveillance in the Democratic Republic of the Congo: comparison of microscopy, PCR, and rapid diagnostic test.

    PubMed

    Doctor, Stephanie M; Liu, Yunhao; Whitesell, Amy; Thwai, Kyaw L; Taylor, Steve M; Janko, Mark; Emch, Michael; Kashamuka, Melchior; Muwonga, Jérémie; Tshefu, Antoinette; Meshnick, Steven R

    2016-05-01

    Malaria surveillance is critical for control efforts, but diagnostic methods frequently disagree. Here, we compare microscopy, PCR, and a rapid diagnostic test in 7137 samples from children in the Democratic Republic of the Congo using latent class analysis. PCR had the highest sensitivity (94.6%) and microscopy had the lowest (76.7%). PMID:26915637

  5. Differential Item Functioning Assessment in Cognitive Diagnostic Modeling: Application of the Wald Test to Investigate DIF in the DINA Model

    ERIC Educational Resources Information Center

    Hou, Likun; de la Torre, Jimmy; Nandakumar, Ratna

    2014-01-01

    Analyzing examinees' responses using cognitive diagnostic models (CDMs) has the advantage of providing diagnostic information. To ensure the validity of the results from these models, differential item functioning (DIF) in CDMs needs to be investigated. In this article, the Wald test is proposed to examine DIF in the context of CDMs. This…

  6. Clinical evaluation of the ZstatFlu-II test: a chemiluminescent rapid diagnostic test for influenza virus.

    PubMed

    Hamilton, Marilyn S; Abel, David M; Ballam, Yolanda J; Otto, Mary K; Nickell, Angela F; Pence, Lisa M; Appleman, James R; Shimasaki, Craig D; Achyuthan, Komandoor E

    2002-07-01

    Exploiting the high sensitivity of the chemiluminescence phenomenon, an accurate and sensitive point-of-care test, called the ZstatFlu-II test (ZymeTx, Inc., Oklahoma City, Okla.), was developed to detect influenza virus infections. The ZstatFlu-II test takes 20 min and requires approximately 2 min of "hands-on" time for operational steps. The ZstatFlu-II test does not distinguish between infections with influenza virus types A and B. ZstatFlu-II test results are printed on Polaroid High-Speed Detector Film, allowing test results to be archived. A prototype version of the ZstatFlu-II test was evaluated during the 2000-to-2001 flu season with 300 nasal aspirate specimens from children at a pediatric hospital. Compared to culture, the ZstatFlu-II test had 88% sensitivity and 92% specificity. The Directigen test had a sensitivity of 75% and a specificity of 93%. The sensitivity of the ZstatFlu-II test was significantly higher than that of the Directigen test (P < 0.0574). PMID:12089243

  7. Clinical Implications of Referral Bias in the Diagnostic Performance of Exercise Testing for Coronary Artery Disease

    PubMed Central

    Ladapo, Joseph A.; Blecker, Saul; Elashoff, Michael R.; Federspiel, Jerome J.; Vieira, Dorice L.; Sharma, Gaurav; Monane, Mark; Rosenberg, Steven; Phelps, Charles E.; Douglas, Pamela S.

    2013-01-01

    Background Exercise testing with echocardiography or myocardial perfusion imaging is widely used to risk‐stratify patients with suspected coronary artery disease. However, reports of diagnostic performance rarely adjust for referral bias, and this practice may adversely influence patient care. Therefore, we evaluated the potential impact of referral bias on diagnostic effectiveness and clinical decision‐making. Methods and Results Searching PubMed and EMBASE (1990–2012), 2 investigators independently evaluated eligibility and abstracted data on study characteristics and referral patterns. Diagnostic performance reported in 4 previously published meta‐analyses of exercise echocardiography and myocardial perfusion imaging was adjusted using pooled referral rates and Bayesian methods. Twenty‐one studies reported referral patterns in 49 006 patients (mean age 60.7 years, 39.6% women, and 0.8% prior history of myocardial infarction). Catheterization referral rates after normal and abnormal exercise tests were 4.0% (95% CI, 2.9% to 5.0%) and 42.5% (36.2% to 48.9%), respectively, with odds ratio for referral after an abnormal test of 14.6 (10.7 to 19.9). After adjustment for referral, exercise echocardiography sensitivity fell from 84% (80% to 89%) to 34% (27% to 41%), and specificity rose from 77% (69% to 86%) to 99% (99% to 100%). Similarly, exercise myocardial perfusion imaging sensitivity fell from 85% (81% to 88%) to 38% (31% to 44%), and specificity rose from 69% (61% to 78%) to 99% (99% to 100%). Summary receiver operating curve analysis demonstrated only modest changes in overall discriminatory power but adjusting for referral increased positive‐predictive value and reduced negative‐predictive value. Conclusions Exercise echocardiography and myocardial perfusion imaging are considerably less sensitive and more specific for coronary artery disease after adjustment for referral. Given these findings, future work should assess the comparative ability of

  8. Diagnostic performance of serological tests for swine brucellosis in the presence of false positive serological reactions.

    PubMed

    Dieste-Pérez, L; Blasco, J M; de Miguel, M J; Moriyón, I; Muñoz, P M

    2015-04-01

    Swine brucellosis caused by Brucella suis biovar 2 is an emerging disease in Europe. Currently used diagnostic tests for swine brucellosis detect antibodies to the O-polysaccharide (O-PS) of Brucella smooth lipopolysaccharide (S-LPS) but their specificity is compromised by false-positive serological reactions (FPSRs) when bacteria carrying cross-reacting O-PS infect pigs. FPSRs occur throughout Europe, and the only tool available for a specific B. suis diagnosis is the intradermal test with Brucella protein extracts free of O-PS or S-LPS. Using sera of 162 sows naturally infected by B. suis biovar 2, 406 brucellosis-free sows, and 218 pigs of brucellosis-free farms affected by FPSR, we assessed the diagnostic performance of an indirect ELISA with rough LPS (thus devoid of O-PS) and of gel immunodiffusion, counterimmunoelectrophoresis, latex agglutination and indirect ELISA with O-PS free proteins in comparison with several S-LPS tests (Rose Bengal, complement fixation, gel immunodiffusion and indirect ELISA). When adjusted to 100% specificity, the sensitivity of the rough LPS ELISA was very low (30%), and adoption of other cut-offs resulted in poor specificity/sensitivity ratios. Although their specificity was 100%, the sensitivity of protein tests (ELISA, latex agglutination, counterimmunoelectrophoresis, and gel immunodiffusion) was only moderate (45, 58, 61 and 63%, respectively). Among S-LPS tests, gel immunodiffusion was the only test showing acceptable sensitivity/specificity (68 and 100%, respectively). Despite these shortcomings, and when the purpose is to screen out FPSR at herd level, gel immunodiffusion tests may offer a technically simple and practical alternative to intradermal testing. PMID:25661496

  9. Comparison of Diagnostic Tests in Distinct Well-Defined Conditions Related to Dry Eye Disease

    PubMed Central

    Alves, Monica; Reinach, Peter Sol; Paula, Jayter Silva; Vellasco e Cruz, Antonio Augusto; Bachette, Leticia; Faustino, Jacqueline; Aranha, Francisco Penteado; Vigorito, Afonso; de Souza, Carmino Antonio; Rocha, Eduardo Melani

    2014-01-01

    Purpose This study compares signs, symptoms and predictive tools used to diagnose dry eye disease (DED) and ocular surface disorders in six systemic well-defined and non-overlapping diseases. It is well known that these tests are problematic because of a lack of agreement between them in identifying these conditions. Accordingly, we provide here a comparative clinical profile analysis of these different diseases. Methods A spontaneous and continuous sample of patients with Sjögren's syndrome (SS) (n = 27), graft-versus-host-disease (GVHD) (n = 28), Graves orbitopathy (n = 28), facial palsy (n = 8), diabetes mellitus without proliferative retinopathy (n = 14) and glaucoma who chronically received topical drugs preserved with benzalkonium chloride (n = 20) were enrolled. Evaluation consisted of a comprehensive protocol encompassing: (1) structured questionnaire - Ocular Surface Disease Index (OSDI); (2) tear osmolarity (TearLab Osmolarity System - Ocusense); (3) tear film break-up time (TBUT); (4) fluorescein and lissamine green staining; (5) Schirmer test and (6) severity grading. Results One hundred and twenty five patients (aged 48.8 years-old±14.1, male:female ratio = 0.4) were enrolled in the study, along with 24 age and gender matched controls. Higher scores on DED tests were obtained in Sjögren Syndrome (P<0.05), except for tear film osmolarity that was higher in diabetics (P<0.001) and fluorescein staining, that was higher in facial palsy (P<0.001). TFBUT and OSDI correlated better with other tests. The best combination of diagnostic tests for DED was OSDI, TBUT and Schirmer test (sensitivity 100%, specificity 95% and accuracy 99.3%). Conclusions DED diagnostic test results present a broad range of variability among different conditions. Vital stainings and TBUT correlated best with one another whereas the best test combination to detect DED was: OSDI/TBUT/Schirmer. PMID:24848115

  10. Use of Rapid, Point-of-Care Assays by Private Practitioners in Chennai, India: Priorities for Tuberculosis Diagnostic Testing

    PubMed Central

    Ananthakrishnan, Ramya; Sukumar, Sumanya; Augustine, Sheela; Krishnan, Nalini; Pai, Madhukar; Dowdy, David W.

    2016-01-01

    Setting Private practitioners are frequently the first point of healthcare contact for patients with tuberculosis (TB) in India. As new molecular tests are developed for point-of-care (POC) diagnosis of TB, it is imperative to understand these individuals’ practices and preferences for POC testing. Objective To evaluate rapid testing practices and identify priorities for novel POC TB tests among private practitioners in Chennai. Design We conducted a cross-sectional survey of 228 practitioners practicing in the private sector from January 2014 to February 2015 who saw at least one TB patient in the previous year. Practitioners were randomly selected from both the general community and a list of practitioners who referred patients to a public-private mix program for TB treatment. We used standardized questionnaires to collect data on current practices related to point-of-care diagnosis and interest in hypothetical POC tests. We used multivariable Poisson regression with robust estimates of standard error to calculate measures of association. Results Among 228 private practitioners, about half (48%) utilized any rapid testing in their current practice, most commonly for glucose (43%), pregnancy (21%), and malaria (5%). Providers using POC tests were more likely to work in hospitals (56% vs. 43%, P = 0.05) and less likely to be chest specialists (21% vs. 54%, P<0.001). Only half (51%) of providers would use a hypothetical POC test for TB that was accurate, equipment-free, and took 20 minutes to complete. Chest specialists were half as likely to express interest in performing the hypothetical POC TB test in-house as other practitioners (aPR 0.5, 95%CI: 0.2–0.9). Key challenges to performing POC testing for TB in this study included time constraints, easy access to local private labs and lack of an attached lab facility. Conclusion As novel POC tests for TB are developed and scaled up, attention must be paid to integrating these diagnostics into healthcare

  11. Update on diagnostic value of breath test in gastrointestinal and liver diseases

    PubMed Central

    Siddiqui, Imran; Ahmed, Sibtain; Abid, Shahab

    2016-01-01

    In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed. PMID:27574563

  12. Evaluating Frequency, Diagnostic Quality, and Cost of Lyme Borreliosis Testing in Germany: A Retrospective Model Analysis

    PubMed Central

    Müller, I.; Freitag, M. H.; Poggensee, G.; Scharnetzky, E.; Straube, E.; Schoerner, Ch.; Hlobil, H.; Hagedorn, H.-J.; Stanek, G.; Schubert-Unkmeir, A.; Norris, D. E.; Gensichen, J.; Hunfeld, K.-P.

    2012-01-01

    Background. Data on the economic impact of Lyme borreliosis (LB) on European health care systems is scarce. This project focused on the epidemiology and costs for laboratory testing in LB patients in Germany. Materials and Methods. We performed a sentinel analysis of epidemiological and medicoeconomic data for 2007 and 2008. Data was provided by a German statutory health insurance (DAK) company covering approx. 6.04 million members. In addition, the quality of diagnostic testing for LB in Germany was studied. Results. In 2007 and 2008, the incident diagnosis LB was coded on average for 15,742 out of 6.04 million insured members (0.26%). 20,986 EIAs and 12,558 immunoblots were ordered annually for these patients. For all insured members in the outpatient sector, a total of 174,820 EIAs and 52,280 immunoblots were reimbursed annually to health care providers (cost: 2,600,850€). For Germany, the overall expected cost is estimated at 51,215,105€. However, proficiency testing data questioned test quality and standardization of diagnostic assays used. Conclusion. Findings from this study suggest ongoing issues related to care for LB and may help to improve future LB disease management. PMID:22242037

  13. Update on diagnostic value of breath test in gastrointestinal and liver diseases.

    PubMed

    Siddiqui, Imran; Ahmed, Sibtain; Abid, Shahab

    2016-08-15

    In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed. PMID:27574563

  14. [Testing the electric resistance as an objective diagnostic test in dental pulp diseases].

    PubMed

    Constantin, I; Severineanu, V; Tudose, N

    1976-01-01

    The authors test by means of a measuring device of high precision the resistence of health or sick human pulpa, comparing it to them of gums, excluding in the same time the sensibility of the patient in question. The authors corroborate the obtained dates with clinical symptomatology and the histopathological photos, discussing the possibility of objective electrical test as an expedient in the diagnosis of pulpa-affections. PMID:137616

  15. Effects of Concept Map Extraction and a Test-Based Diagnostic Environment on Learning Achievement and Learners' Perceptions

    ERIC Educational Resources Information Center

    Lin, Yu-Shih; Chang, Yi-Chun; Liew, Keng-Hou; Chu, Chih-Ping

    2016-01-01

    Computerised testing and diagnostics are critical challenges within an e-learning environment, where the learners can assess their learning performance through tests. However, a test result based on only a single score is insufficient information to provide a full picture of learning performance. In addition, because test results implicitly…

  16. Effect of Two-Tier Diagnostic Tests on Promoting Learners' Conceptual Understanding of Variables in Conducting Scientific Experiments

    ERIC Educational Resources Information Center

    Çil, Emine

    2015-01-01

    Taking a test generally improves the retention of the material tested. This is a phenomenon commonly referred to as testing effect. The present research investigated whether two-tier diagnostic tests promoted student teachers' conceptual understanding of variables in conducting scientific experiments, which is a scientific process skill. In this…

  17. Antimicrobial susceptibility testing for bovine respiratory disease: getting more from diagnostic results.

    PubMed

    Lubbers, Brian V; Turnidge, John

    2015-02-01

    Bovine respiratory disease (BRD) is one of the most common diseases of cattle worldwide. Given the significant bacterial component of this disease, antimicrobial agents remain one of the mainstays of therapy. However, the potential welfare and economic impact resulting from the selection of inappropriate antimicrobial therapy for BRD poses significant risks to both animal and animal owner. To determine the 'best' antimicrobial agent for a specific case, the decision-making process needs to incorporate all available evidence, often including the results of bacterial culture and antimicrobial susceptibility testing. While antimicrobial susceptibility testing can be a valuable diagnostic tool, integrating the test results into the clinical decision making process can be a challenging experience. This review details the process by which interpretive criteria for susceptibility tests are developed. Principles for how to best integrate antimicrobial susceptibility testing, both at the individual animal test and aggregate test levels, into the clinical decision making process are discussed. Non-traditional testing methodologies and how they may improve susceptibility testing in the future are also reviewed. PMID:25582794

  18. Exploring Ways to Provide Diagnostic Feedback with an ESL Placement Test: Cognitive Diagnostic Assessment of L2 Reading Ability

    ERIC Educational Resources Information Center

    Kim, Ah-Young

    2015-01-01

    Previous research in cognitive diagnostic assessment (CDA) of L2 reading ability has been frequently conducted using large-scale English proficiency exams (e.g., TOEFL, MELAB). Using CDA, it is possible to analyze individual learners' strengths and weaknesses in multiple attributes (i.e., knowledge, skill, strategy) measured at the item level.…

  19. Comparison of the Diagnostic Accuracy of Three Rapid Tests for the Serodiagnosis of Hepatic Cystic Echinococcosis in Humans

    PubMed Central

    Tamarozzi, Francesca; Covini, Ilaria; Mariconti, Mara; Narra, Roberta; Tinelli, Carmine; De Silvestri, Annalisa; Manzoni, Federica; Casulli, Adriano; Ito, Akira; Neumayr, Andreas; Brunetti, Enrico

    2016-01-01

    Background The diagnosis of cystic echinococcosis (CE) is based primarily on imaging, in particular with ultrasound for abdominal CE, complemented by serology when imaging results are unclear. In rural endemic areas, where expertise in ultrasound may be scant and conventional serology techniques are unavailable due to lack of laboratory equipment, Rapid Diagnostic Tests (RDTs) are appealing. Methodology/Principal Findings We evaluated the diagnostic accuracy of 3 commercial RDTs for the diagnosis of hepatic CE. Sera from 59 patients with single hepatic CE cysts in well-defined ultrasound stages (gold standard) and 25 patients with non-parasitic cysts were analyzed by RDTs VIRapid HYDATIDOSIS (Vircell, Spain), Echinococcus DIGFA (Unibiotest, China), ADAMU-CE (ICST, Japan), and by RIDASCREEN Echinococcus IgG ELISA (R-Biopharm, Germany). Sensitivity, specificity and ROC curves were compared with McNemar and t-test. For VIRapid and DIGFA, correlation between semiquantitative results and ELISA OD values were evaluated by Spearman’s coefficient. Reproducibility was assessed on 16 randomly selected sera with Cohen’s Kappa coefficient. Sensitivity and Specificity of VIRapid (74%, 96%) and ADAMU-CE (57%, 100%) did not differ from ELISA (69%, 96%) while DIGFA (72%, 72%) did (p = 0.045). ADAMU-CE was significantly less sensitive in the diagnosis of active cysts (p = 0.019) while DIGFA was significantly less specific (p = 0.014) compared to ELISA. All tests were poorly sensitive in diagnosing inactive cysts (33.3% ELISA and ADAMU-CE, 42.8% DIGFA, 47.6% VIRapid). The reproducibility of all RDTs was good-very good. Band intensity of VIRapid and DIGFA correlated with ELISA OD values (r = 0.76 and r = 0.79 respectively, p<0.001). Conclusions/Significance RDTs may be useful in resource-poor settings to complement ultrasound diagnosis of CE in uncertain cases. VIRapid test appears to perform best among the examined kits, but all tests are poorly sensitive in the presence of

  20. Personality Assessment in the Diagnostic Manuals: On Mindfulness, Multiple Methods, and Test Score Discontinuities

    PubMed Central

    Bornstein, Robert F.

    2015-01-01

    Recent controversies have illuminated the strengths and limitations of different frameworks for conceptualizing personality pathology (e.g., trait perspectives, categorical models), and stimulated debate regarding how best to diagnose personality disorders (PDs) in DSM-5, and in other diagnostic systems (i.e., the International Classification of Diseases, the Psychodynamic Diagnostic Manual). In this article I argue that regardless of how PDs are conceptualized and which diagnostic system is employed, multi-method assessment must play a central role in PD diagnosis. By complementing self-reports with evidence from other domains (e.g., performance-based tests), a broader range of psychological processes are engaged in the patient, and the impact of self-perception and self-presentation biases may be better understood. By providing the assessor with evidence drawn from multiple modalities, some of which provide converging patterns and some of which yield divergent results, the assessor is compelled to engage this evidence more deeply. The mindful processing that ensues can help minimize the deleterious impact of naturally occurring information processing bias and distortion on the part of the clinician (e.g., heuristics, attribution errors), bringing greater clarity to the synthesis and integration of assessment data. PMID:25856565

  1. Application of diagnostic tests for mycoplasmal infections of desert and gopher tortoises with management recommendations

    USGS Publications Warehouse

    Brown, D.R.; Schumacher, I.M.; Mclaughlin, Grace S.; Wendland, L.D.; Brown, Mary E.; Klein, P.A.; Jacobson, E.R.

    2002-01-01

    Mycoplasmosis is a transmissible upper respiratory tract disease that has affected plans for management and conservation of wild desert and gopher tortoises in the United States. Although impact of mycoplasmosis on populations of desert and gopher tortoises is unknown, increased prevalence of seropositive animals as well as field observations of clinically ill tortoises have occurred in association with declining populations. In order to help in the identification of potentially infected animals, three tests have been developed to diagnose mycoplasmal infections of tortoises: 1) direct mycoplasmal culture; 2) detection of mycolplasmal chromosomal DNA by polymerase chain reaction (PCR); and 3) detection of anti-Mycoplasma antibodies in tortoise plasma by enzyme-linked immunosorbent assay (ELISA). Each test provides different, complementary information that collectively can be used to define tortoise mycoplasmal infection status. The types of samples required, the predictive value, interpretation, and cost vary among tests. These assays have been used for epidemiological surveys and in decision making for relocation, repatriation, or captive management of tortoises to minimize the risk of outbreaks of mycoplasmal respiratory disease and spread of the causative agent of this disease. Certain features of mycoplasmal infections of tortoises and other animals create a diagnostic dilemma. Multiple Mycoplasma species can cause respiratory disease with identical clinical presentations. Further, individual strains of a given species may vary with respect to their virulence potential, and some species may be commensals rather than pathogens. Current diagnostic tests may not differentiate among mycoplasmal species or strains or permit determination of pathogenicity of individual isolates. Thus, the information provided by testing is not a simple 'positive' vs. 'negative' issue. While these tests provide much needed information on the exposure of tortoise populations to

  2. TESTING DIAGNOSTICS OF NUCLEAR ACTIVITY AND STAR FORMATION IN GALAXIES AT z > 1

    SciTech Connect

    Trump, Jonathan R.; Barro, Guillermo; Koo, David C.; Faber, S. M.; Kocevski, Dale D.; Yan, Renbin; Juneau, Stephanie; McLean, Ian S.; Perez-Gonzalez, Pablo G.; Villar, Victor

    2013-01-20

    We present some of the first science data with the new Keck/MOSFIRE instrument to test the effectiveness of different AGN/SF diagnostics at z {approx} 1.5. MOSFIRE spectra were obtained in three H-band multi-slit masks in the GOODS-S field, resulting in 2 hr exposures of 36 emission-line galaxies. We compare X-ray data with the traditional emission-line ratio diagnostics and the alternative mass-excitation and color-excitation diagrams, combining new MOSFIRE infrared data with previous HST/WFC3 infrared spectra (from the 3D-HST survey) and multiwavelength photometry. We demonstrate that a high [O III]/H{beta} ratio is insufficient as an active galactic nucleus (AGN) indicator at z > 1. For the four X-ray-detected galaxies, the classic diagnostics ([O III]/H{beta} versus [N II]/H{alpha} and [S II]/H{alpha}) remain consistent with X-ray AGN/SF classification. The X-ray data also suggest that 'composite' galaxies (with intermediate AGN/SF classification) host bona fide AGNs. Nearly {approx}2/3 of the z {approx} 1.5 emission-line galaxies have nuclear activity detected by either X-rays or the classic diagnostics. Compared to the X-ray and line ratio classifications, the mass-excitation method remains effective at z > 1, but we show that the color-excitation method requires a new calibration to successfully identify AGNs at these redshifts.

  3. Is there a pathological alpha angle for hip impingement? A diagnostic test study.

    PubMed

    Barrientos, Cristián; Barahona, Maximiliano; Diaz, Jorge; Brañes, Julian; Chaparro, Felipe; Hinzpeter, Jaime

    2016-08-01

    The normal value of alpha angle is controversial. The aim of this study was to compare the alpha angle in asymptomatic volunteers versus patients who had undergone surgery for symptomatic cam-type femoroacetabular impingement (FAI) and determine a diagnostic cut-off value for symptomatic cam impingement. This is a diagnostic test study. Cases were defined as those patients who had undergone surgery for symptomatic cam or mixed type FAI. Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason. In both groups, the alpha angle was measured in an oblique axial CT reconstruction of the femoral neck. A logistic regression model was first estimated and a receiver operating characteristics (ROC) curve was then calculated. The diagnostic cut-off value selected was the one that maximizes sensitivity and specificity. Data were analysed from 38 consecutive cases of cam or mixed FAI and 101 controls. The average alpha angle was 67°(±12°) among cases and 48°°(±5°) among controls. An odds ratio of 1.28 [1.18-1.39] was obtained. A ROC curve of 0.96 [0.93-0.99] was calculated, and using an alpha angle of 57° as the diagnostic cut-off value, provided a sensitivity of 92% and a specificity of 95%. If a patient complains of hip pain and an alpha angle of 57° is found in CT, strongly suggest that cam impingement is causing the pain. PMID:27583162

  4. Is there a pathological alpha angle for hip impingement? A diagnostic test study

    PubMed Central

    Barrientos, Cristián; Barahona, Maximiliano; Diaz, Jorge; Brañes, Julian; Chaparro, Felipe; Hinzpeter, Jaime

    2016-01-01

    The normal value of alpha angle is controversial. The aim of this study was to compare the alpha angle in asymptomatic volunteers versus patients who had undergone surgery for symptomatic cam-type femoroacetabular impingement (FAI) and determine a diagnostic cut-off value for symptomatic cam impingement. This is a diagnostic test study. Cases were defined as those patients who had undergone surgery for symptomatic cam or mixed type FAI. Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason. In both groups, the alpha angle was measured in an oblique axial CT reconstruction of the femoral neck. A logistic regression model was first estimated and a receiver operating characteristics (ROC) curve was then calculated. The diagnostic cut-off value selected was the one that maximizes sensitivity and specificity. Data were analysed from 38 consecutive cases of cam or mixed FAI and 101 controls. The average alpha angle was 67°(±12°) among cases and 48°°(±5°) among controls. An odds ratio of 1.28 [1.18–1.39] was obtained. A ROC curve of 0.96 [0.93–0.99] was calculated, and using an alpha angle of 57° as the diagnostic cut-off value, provided a sensitivity of 92% and a specificity of 95%. If a patient complains of hip pain and an alpha angle of 57° is found in CT, strongly suggest that cam impingement is causing the pain. PMID:27583162

  5. ViDI: Virtual Diagnostics Interface. Volume 1; The Future of Wind Tunnel Testing

    NASA Technical Reports Server (NTRS)

    Fleming, Gary A. (Technical Monitor); Schwartz, Richard J.

    2004-01-01

    The quality of data acquired in a given test facility ultimately resides within the fidelity and implementation of the instrumentation systems. Over the last decade, the emergence of robust optical techniques has vastly expanded the envelope of measurement possibilities. At the same time the capabilities for data processing, data archiving and data visualization required to extract the highest level of knowledge from these global, on and off body measurement techniques have equally expanded. Yet today, while the instrumentation has matured to the production stage, an optimized solution for gaining knowledge from the gigabytes of data acquired per test (or even per test point) is lacking. A technological void has to be filled in order to possess a mechanism for near-real time knowledge extraction during wind tunnel experiments. Under these auspices, the Virtual Diagnostics Interface, or ViDI, was developed.

  6. [Diagnostic value of the procalcitonine test in purulent-septic complications of chest traumas].

    PubMed

    Vadachkoriia, V K; Gogishvili, Sh G; Shapatava, K K

    2007-04-01

    The aim of the present work was to assess the value of the semi-quantitative procalcitonine test (PCT) in diagnosis of purulent-septic complications of chest traumas, efficacy of the therapy carried out, and outcome prognosis. For this, 71 patients with chest traumas were enrolled in the study. Concentrations of PCT were assessed in dynamics using an immunochromatographic, semi-quantitative quick test. Semi-quantitative quick PCT test is highly sensitive diagnostic marker that can be used for the assessment of a chest trauma, infectious-septic complication severity, and efficiency of the therapy indicated. Thus, it can be successfully used for monitoring trauma therapy. PCT sensitivity during first 12 hrs of infectious-septic complication development is 2-3-times higher than that of routine methods for laboratory diagnostics, and even more sensitive that IL-6 and CRT, when we are dealing with combined chest traumas. PCT concentration increase is 4-times more frequent in gram-positive bacterial processes than in gram-negative ones. This has to be taken into account, when appropriate antibacterial treatment is selected for restricted infectious-septic complications. PMID:17525495

  7. Gamma radiation grafted polymers for immobilization of Brucella antigen in diagnostic test studies

    NASA Astrophysics Data System (ADS)

    Docters, E. H.; Smolko, E. E.; Suarez, C. E.

    The radiation grafting process has a wide field of industrial applications, and in the recent years the immobilization of biocomponents in grafted polymeric materials obtained by means of ionizing radiations is a new and important contribution to biotechnology. In the present work, gamma preirradiation grafting method was employed to produce acrylics hydrogels onto polyethylene (PE), polyvinyl chloride (PVC) and polystyrene (PS). Two monomers were used to graft the previously mentioned polymers: methacrylic acid (MAAc) and acrylamide (AAm), and several working conditions were considered as influencing the degree of grafting. All this grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA).

  8. Cognitive Reserve in Alzheimer's Dementia: Diagnostic Accuracy of a Testing-the-Limits Paradigm.

    PubMed

    Küster, Olivia C; Kösel, Jonas; Spohn, Stephanie; Schurig, Niklas; Tumani, Hayrettin; von Arnim, Christine A F; Uttner, Ingo

    2016-03-29

    Individuals with higher cognitive reserve are more able to cope with pathological brain alterations, potentially due to the application of more efficient cognitive strategies. The extent to which an individual's cognitive performance can be increased by advantageous conditions differs substantially between patients with Alzheimer's dementia (AD) and healthy older adults and can be assessed with the Testing-the-Limits (TtL) approach. Thus, TtL has been proposed as a tool for the early diagnosis of AD. Here, we report the diagnostic accuracy of a memory TtL paradigm to discriminate between AD patients and controls. The TtL paradigm was administered to 57 patients with clinically diagnosed AD and 94 controls. It consisted of a pre-test condition, representing baseline cognitive performance, the presentation of an encoding strategy, and two subsequent post-test conditions, representing learning potential. Receiver operating characteristic (ROC) curves were analyzed for each condition in order to receive optimal cutoff points along with their sensitivity and specificity and to compare the diagnostic accuracy of the conditions. Differentiation between AD patients and controls, indicated by the area under the ROC curve, increased significantly for the TtL post-test and total error scores compared to the pre-test score. The combined error score in the two post-tests could differentiate between AD patients and controls with a sensitivity of 0.93 and a specificity of 0.80. The presented approach can be carried out in 25 minutes and thus constitutes a time- and cost-effective way to diagnose AD with high accuracy. PMID:27031485

  9. Validating the Astronomy Diagnostics Test for Undergraduate Non-Science Majors

    NASA Astrophysics Data System (ADS)

    Slater, T. F.; Hufnagel, B.; Adams, J. P.

    1999-05-01

    The Astronomy Diagnostics Test (ADT) is a standard diagnostic test for undergraduate non-science majors taking introductory astronomy. Serving to compare the effectiveness of various instructional interventions, the ADT has been developed and field-tested over the last year by a multi-institutional team, known as the Collaboration for Astronomy Education Research (CAER). The team includes Jeff Adams, Rebecca Lindell Adrian, Christine Brick, Gina Brissenden, Grace Deming, Beth Hufnagel, Tim Slater, and Michael Zeilik, among others. The need for a nationally normed, valid, and reliable assessment instrument in astronomy has been articulated in a wide variety of forums. This need results from the simultaneous occurrence of several important phenomena over the last decade including: the inclusion of astronomy concepts in national science education standards; documentation of widespread astronomical misconceptions; the influence of the Force Concept Inventory guiding reform in physics; and the call for university faculty to document improvements in instruction. In a triangulated effort to validate the ADT for widespread use, the researchers used on a three-phase strategy. In this context, "validity" means that the ADT measures what it purports to measure. In other words, do students give the correct answer for the scientifically correct reasons or, alternatively, do students give the correct answer even though they have misunderstandings about the phenomena being tested? These three phases were: (1) conduct statistical item-analysis on each test question for a large and diverse student population (n=2000 from 21 institutions); (2) conduct 60 clinical student interviews using the test questions as the script; and (3) conduct an inductive analysis of 30 student supplied written responses to ADT questions posed without the multiple-choices provided. The ADT and its supporting comparative database is available at URL: http://solar.physics.montana.edu/aae/adt/. This research

  10. Comparative Yield of Different Diagnostic Tests for Tuberculosis among People Living with HIV in Western Kenya

    PubMed Central

    Cavanaugh, Joseph S.; Modi, Surbhi; Musau, Susan; McCarthy, Kimberly; Alexander, Heather; Burmen, Barbara; Heilig, Charles M.; Shiraishi, Ray W.; Cain, Kevin

    2016-01-01

    Background Diagnosis followed by effective treatment of tuberculosis (TB) reduces transmission and saves lives in persons living with HIV (PLHIV). Sputum smear microscopy is widely used for diagnosis, despite limited sensitivity in PLHIV. Evidence is needed to determine the optimal diagnostic approach for these patients. Methods From May 2011 through June 2012, we recruited PLHIV from 15 HIV treatment centers in western Kenya. We collected up to three sputum specimens for Ziehl-Neelsen (ZN) and fluorescence microscopy (FM), GeneXpert MTB/RIF (Xpert), and culture, regardless of symptoms. We calculated the incremental yield of each test, stratifying results by CD4 cell count and specimen type; data were analyzed to account for complex sampling. Results From 778 enrolled patients, we identified 88 (11.3%) laboratory-confirmed TB cases. Of the 74 cases who submitted 2 specimens for microscopy and Xpert testing, ZN microscopy identified 25 (33.6%); Xpert identified those plus an additional 18 (incremental yield = 24.4%). Xpert testing of spot specimens identified 48 (57.0%) of 84 cases; whereas Xpert testing of morning specimens identified 50 (66.0%) of 76 cases. Two Xpert tests detected 22/24 (92.0%) TB cases with CD4 counts <100 cells/μL and 30/45 (67.0%) of cases with CD4 counts ≥100 cells/μl. Conclusions In PLHIV, Xpert substantially increased diagnostic yield compared to smear microscopy and had the highest yield when used to test morning specimens and specimens from PLHIV with CD4 count <100 cells/μL. TB programs unable to replace smear microscopy with Xpert for all symptomatic PLHIV should consider targeted replacement and using morning specimens. PMID:27023213

  11. Using patient management as a surrogate for patient health outcomes in diagnostic test evaluation

    PubMed Central

    2012-01-01

    Background Before a new test is introduced in clinical practice, evidence is needed to demonstrate that its use will lead to improvements in patient health outcomes. Studies reporting test accuracy may not be sufficient, and clinical trials of tests that measure patient health outcomes are rarely feasible. Therefore, the consequences of testing on patient management are often investigated as an intermediate step in the pathway. There is a lack of guidance on the interpretation of this evidence, and patient management studies often neglect a discussion of the limitations of measuring patient management as a surrogate for health outcomes. Methods We discuss the rationale for measuring patient management, describe the common study designs and provide guidance about how this evidence should be reported. Results Interpretation of patient management studies relies on the condition that patient management is a valid surrogate for downstream patient benefits. This condition presupposes two critical assumptions: the test improves diagnostic accuracy; and the measured changes in patient management improve patient health outcomes. The validity of this evidence depends on the certainty around these critical assumptions and the ability of the study design to minimise bias. Three common designs are test RCTs that measure patient management as a primary endpoint, diagnostic before-after studies that compare planned patient management before and after testing, and accuracy studies that are extended to report on the actual treatment or further tests received following a positive and negative test result. Conclusions Patient management can be measured as a surrogate outcome for test evaluation if its limitations are recognised. The potential consequences of a positive and negative test result on patient management should be pre-specified and the potential patient benefits of these management changes clearly stated. Randomised comparisons will provide higher quality evidence about

  12. Small-scale deflagration cylinder test with velocimetry wall-motion diagnostics

    SciTech Connect

    Hooks, Daniel E; Hill, Larry G; Pierce, Timothy H

    2010-01-01

    Predicting the likelihood and effects of outcomes resultant from thermal initiation of explosives remains a significant challenge. For certain explosive formulations, the general outcome can be broadly predicted given knowledge of certain conditions. However, there remain unexplained violent events, and increased statistical understanding of outcomes as a function of many variables, or 'violence categorization,' is needed. Additionally, the development of an equation of state equivalent for deflagration would be very useful in predicting possible detailed event consequences using traditional hydrodynamic detonation moders. For violence categorization, it is desirable that testing be efficient, such that it is possible to statistically define outcomes reliant on the processes of initiation of deflagration, steady state deflagration, and deflagration to detonation transitions. If the test simultaneously acquires information to inform models of violent deflagration events, overall predictive capabilities for event likelihood and consequence might improve remarkably. In this paper we describe an economical scaled deflagration cylinder test. The cyclotetramethylene tetranitramine (HMX) based explosive formu1lation PBX 9501 was tested using different temperature profiles in a thick-walled copper cylindrical confiner. This test is a scaled version of a recently demonstrated deflagration cylinder test, and is similar to several other thermal explosion tests. The primary difference is the passive velocimetry diagnostic, which enables measurement of confinement vessel wall velocities at failure, regardless of the timing and location of ignition.

  13. Survey of Physicians’ Perspectives and Knowledge about Diagnostic Tests for Bloodstream Infections

    PubMed Central

    She, Rosemary C.; Alrabaa, Sally; Lee, Seung Heon; Norvell, Meghan; Wilson, Andrew; Petti, Cathy A.

    2015-01-01

    Background Physicians rely on blood culture to diagnose bloodstream infections (BSI) despite its limitations. As new technologies emerge for rapid BSI diagnosis, optimization of their application to patient care requires an understanding of clinicians’ perspectives on BSI diagnosis and how a rapid test would influence medical decisions. Methods We administered a 26-question survey to practitioners in infectious diseases/microbiology, critical care, internal medicine, and hematology/oncology services in USA and Germany about current standards in diagnosing and treating BSI and a hypothetical rapid BSI test. Results Responses from 242 providers had roughly equal representation across specialties. For suspected BSI patients, 78% of practitioners would administer empiric broad spectrum antibiotics although they estimated, on average, that 31% of patients received incorrect antibiotics while awaiting blood culture results. The ability of blood culture to rule in or rule out infection was very/extremely acceptable in 67% and 36%, respectively. Given rapid test results, 60–87% of practitioners would narrow the spectrum of antimicrobial therapy depending on the microorganism detected, with significantly higher percentages when resistance determinants were also tested. Over half of respondents felt a rapid test would be very/extremely influential on clinical practice. Conclusions Limitations of blood culture were perceived as a barrier to patient care. A rapid test to diagnose BSI would impact clinical practice, but the extent of impact may be limited by prevailing attitudes and practices. Opportunities exist for interventions to influence practitioners’ behaviors in BSI management particularly with emergence of newer diagnostic tests. PMID:25811910

  14. Evaluation of triple stage mass spectrometry as a robust and accurate diagnostic tool for determination of free cordycepin in designer egg.

    PubMed

    Chen, Yi Hsin; Lim, Chee Wei; Chan, Sheot Harn

    2014-05-01

    Direct determination of free cordycepin in designer egg using a highly selective mass spectrometric (MS) technique aided by a rapid and efficient dilute-and-shoot workflow would enhance their application as diagnostic tools in food fraud control. Here, triple stage mass spectrometry (MS(3)) demonstrated excellent analyte selectivity capability even when incomplete chromatographic separation was performed. Method validation was performed at six concentration levels of 100, 200, 400, 800, 1200 and 1600ngg(-1). Spiking experiments were examined at three concentration levels of 200, 400, and 1200ngg(-1) in individual egg white and egg yolk, measured over 2days. MS(3) enabled ion chromatograms with zero-background interference to be made in egg extracts. MS(3) eliminated severe over recovery (p<0.05) observed in all fortified samples, a challenge that MRM-transition could not address in a single step. Matrix-matched calibrants were needed to compensate for over recovery observed under MRM-transition mode. PMID:24360442

  15. Development of three-tier heat, temperature and internal energy diagnostic test

    NASA Astrophysics Data System (ADS)

    Gurcay, Deniz; Gulbas, Etna

    2015-05-01

    Background:Misconceptions are major obstacles to learning physics, and the concepts of heat and temperature are some of the common misconceptions that are encountered in daily life. Therefore, it is important to develop valid and reliable tools to determine students' misconceptions about basic thermodynamics concepts. Three-tier tests are effective assessment tools to determine misconceptions in physics. Although a limited number of three-tier tests about heat and temperature are discussed in the literature, no reports discuss three-tier tests that simultaneously consider heat, temperature and internal energy. Purpose:The aim of this study is to develop a valid and reliable three-tier test to determine students' misconceptions about heat, temperature and internal energy. Sample:The sample consists of 462 11th-grade Anatolian high school students. Of the participants, 46.8% were female and 53.2% were male. Design and methods:This research takes the form of a survey study. Initially, a multiple-choice test was developed. To each multiple-choice question was added one open-ended question asking the students to explain their answers. This test was then administered to 259 high school students and the data were analyzed both quantitatively and qualitatively. The students' answers for each open-ended question were analyzed and used to create the choices for the second-tier questions of the test. Depending on those results, a three-tier Heat, Temperature and Internal Energy Diagnostic Test (HTIEDT) was developed by adding a second-tier and certainty response index to each item. This three-tier test was administered to the sample of 462 high school students. Results:The Cronbach alpha reliability for the test was estimated for correct and misconception scores as .75 and .68, respectively. The results of the study suggested that HTIEDT could be used as a valid and reliable test in determining misconceptions about heat, temperature and internal energy concepts.

  16. Diagnostic accuracy of tests based on radiologic measurements of dogs and cats: a systematic review.

    PubMed

    Lamb, Christopher R; Nelson, Justin R

    2015-01-01

    A systematic review of diagnostic tests based on radiologic measurements of structures in dogs and cats was done in order to reach generalizable conclusions about the value of making such measurements. Literature search was done using the ISI Web of Knowledge(SM) for studies in the subject category Veterinary sciences. Studies were eligible for inclusion that employed length, angle, area or volume measurements from radiographic, ultrasonographic, CT or MR images of dogs or cats as a diagnostic test for a naturally occurring condition, compared the results of imaging with a reference standard, included at least 10 subjects, and sufficient data that a 2 × 2 table of results could be constructed. Quality of studies was assessed using the QUADAS-2 tool. Twenty-six studies were found describing 40 tests that satisfied the inclusion criteria. Tests were radiographic in 22 (55%) instances and ultrasonographic in 18 (45%). Quality of studies was generally low, with a risk of bias in patient selection in 92% studies, performance of the index test in 73% studies, and patient flow in 42% studies. Median (range) number of subjects was 64 (20-305), sensitivity was 77% (38-99%), specificity was 82% (50-99%), positive likelihood ratio was 4.1 (1-103), and negative likelihood ratio was 0.29 (0.01-1). Two studies that compared accuracy of radiographic measurements to subjective image interpretation alone found no difference. Evidence is weak that radiologic measurements of structures in dogs and cats are useful for diagnosis, hence measurements should not be emphasized as a basis for diagnosis in either teaching or clinical imaging reports. PMID:25339347

  17. Diagnostic accuracy of bedside tests for predicting difficult intubation in Indian population: An observational study

    PubMed Central

    Dhanger, Sangeeta; Gupta, Suman Lata; Vinayagam, Stalin; Bidkar, Prasanna Udupi; Elakkumanan, Lenin Babu; Badhe, Ashok Shankar

    2016-01-01

    Background: Unanticipated difficult intubation can be challenging to anesthesiologists, and various bedside tests have been tried to predict difficult intubation. Aims: The aim of this study was to determine the incidence of difficult intubation in the Indian population and also to determine the diagnostic accuracy of bedside tests in predicting difficult intubation. Settings and Design: In this study, 200 patients belonging to age group 18–60 years of American Society of Anesthesiologists I and II, scheduled for surgery under general anesthesia requiring endotracheal intubation were enrolled. Patients with upper airway pathology, neck mass, and cervical spine injury were excluded from the study. Materials and Methods: An attending anesthesiologist conducted preoperative assessment and recorded parameters such as body mass index, modified Mallampati grading, inter-incisor distance, neck circumference, and thyromental distance (NC/TMD). After standard anesthetic induction, laryngoscopy was performed, and intubation difficulty assessed using intubation difficulty scale on the basis of seven variables. Statistical Analysis: The Chi-square test or student t-test was performed when appropriate. The binary multivariate logistic regression (forward-Wald) model was used to determine the independent risk factors. Results: Among the 200 patients, 26 patients had difficult intubation with an incidence of 13%. Among different variables, the Mallampati score and NC/TMD were independently associated with difficult intubation. Receiver operating characteristic curve showed a cut-off point of 3 or 4 for Mallampati score and 5.62 for NC/TMD to predict difficult intubation. Conclusion: The diagnostic accuracy of NC/TM ratio and Mallampatti score were better compared to other bedside tests to predict difficult intubation in Indian population. PMID:26957691

  18. Self Diagnostic Accelerometer Ground Testing on a C-17 Aircraft Engine

    NASA Technical Reports Server (NTRS)

    Tokars, Roger P.; Lekki, John D.

    2013-01-01

    The self diagnostic accelerometer (SDA) developed by the NASA Glenn Research Center was tested for the first time in an aircraft engine environment as part of the Vehicle Integrated Propulsion Research (VIPR) program. The VIPR program includes testing multiple critical flight sensor technologies. One such sensor, the accelerometer, measures vibrations to detect faults in the engine. In order to rely upon the accelerometer, the health of the accelerometer must be ensured. Sensor system malfunction is a significant contributor to propulsion in flight shutdowns (IFSD) which can lead to aircraft accidents when the issue is compounded with an inappropriate crew response. The development of the SDA is important for both reducing the IFSD rate, and hence reducing the rate at which this component failure type can put an aircraft in jeopardy, and also as a critical enabling technology for future automated malfunction diagnostic systems. The SDA is a sensor system designed to actively determine the accelerometer structural health and attachment condition, in addition to making vibration measurements. The SDA uses a signal conditioning unit that sends an electrical chirp to the accelerometer and recognizes changes in the response due to changes in the accelerometer health and attachment condition. In an effort toward demonstrating the SDAs flight worthiness and robustness, multiple SDAs were mounted and tested on a C-17 aircraft engine. The engine test conditions varied from engine off, to idle, to maximum power. The two SDA attachment conditions used were fully tight and loose. The newly developed SDA health algorithm described herein uses cross correlation pattern recognition to discriminate a healthy from a faulty SDA. The VIPR test results demonstrate for the first time the robustness of the SDA in an engine environment characterized by high vibration levels.

  19. Self diagnostic accelerometer ground testing on a C-17 aircraft engine

    NASA Astrophysics Data System (ADS)

    Tokars, Roger P.; Lekki, John D.

    The self diagnostic accelerometer (SDA) developed by the NASA Glenn Research Center was tested for the first time in an aircraft engine environment as part of the Vehicle Integrated Propulsion Research (VIPR) program. The VIPR program includes testing multiple critical flight sensor technologies. One such sensor, the accelerometer, measures vibrations to detect faults in the engine. In order to rely upon the accelerometer, the health of the accelerometer must be ensured. Sensor system malfunction is a significant contributor to propulsion in flight shutdowns (IFSD) which can lead to aircraft accidents when the issue is compounded with an inappropriate crew response. The development of the SDA is important for both reducing the IFSD rate, and hence reducing the rate at which this component failure type can put an aircraft in jeopardy, and also as a critical enabling technology for future automated malfunction diagnostic systems. The SDA is a sensor system designed to actively determine the accelerometer structural health and attachment condition, in addition to making vibration measurements. The SDA uses a signal conditioning unit that sends an electrical chirp to the accelerometer and recognizes changes in the response due to changes in the accelerometer health and attachment condition. In an effort toward demonstrating the SDA's flight worthiness and robustness, multiple SDAs were mounted and tested on a C-17 aircraft engine. The engine test conditions varied from engine off, to idle, to maximum power. The two SDA attachment conditions used were fully tight and loose. The newly developed SDA health algorithm described herein uses cross correlation pattern recognition to discriminate a healthy from a faulty SDA. The VIPR test results demonstrate for the first time the robustness of the SDA in an engine environment characterized by high vibration levels.

  20. Diagnostic test accuracy of glutamate dehydrogenase for Clostridium difficile: Systematic review and meta-analysis.

    PubMed

    Arimoto, Jun; Horita, Nobuyuki; Kato, Shingo; Fuyuki, Akiko; Higurashi, Takuma; Ohkubo, Hidenori; Endo, Hiroki; Takashi, Nonaka; Kaneko, Takeshi; Nakajima, Atsushi

    2016-01-01

    We performed this systematic review and meta-analysis to assess the diagnostic accuracy of detecting glutamate dehydrogenase (GDH) for Clostridium difficile infection (CDI) based on the hierarchical model. Two investigators electrically searched four databases. Reference tests were stool cell cytotoxicity neutralization assay (CCNA) and stool toxigenic culture (TC). To assess the overall accuracy, we calculated the diagnostic odds ratio (DOR) using a DerSimonian-Laird random-model and area the under hierarchical summary receiver operating characteristics (AUC) using Holling's proportional hazard models. The summary estimate of the sensitivity and the specificity were obtained using the bivariate model. According to 42 reports consisting of 3055 reference positive comparisons, and 26188 reference negative comparisons, the DOR was 115 (95%CI: 77-172, I(2) = 12.0%) and the AUC was 0.970 (95%CI: 0.958-0.982). The summary estimate of sensitivity and specificity were 0.911 (95%CI: 0.871-0.940) and 0.912 (95%CI: 0.892-0.928). The positive and negative likelihood ratios were 10.4 (95%CI 8.4-12.7) and 0.098 (95%CI 0.066-0.142), respectively. Detecting GDH for the diagnosis of CDI had both high sensitivity and specificity. Considering its low cost and prevalence, it is appropriate for a screening test for CDI. PMID:27418431

  1. Diagnostic test accuracy of glutamate dehydrogenase for Clostridium difficile: Systematic review and meta-analysis

    PubMed Central

    Arimoto, Jun; Horita, Nobuyuki; Kato, Shingo; Fuyuki, Akiko; Higurashi, Takuma; Ohkubo, Hidenori; Endo, Hiroki; Takashi, Nonaka; Kaneko, Takeshi; Nakajima, Atsushi

    2016-01-01

    We performed this systematic review and meta-analysis to assess the diagnostic accuracy of detecting glutamate dehydrogenase (GDH) for Clostridium difficile infection (CDI) based on the hierarchical model. Two investigators electrically searched four databases. Reference tests were stool cell cytotoxicity neutralization assay (CCNA) and stool toxigenic culture (TC). To assess the overall accuracy, we calculated the diagnostic odds ratio (DOR) using a DerSimonian-Laird random-model and area the under hierarchical summary receiver operating characteristics (AUC) using Holling’s proportional hazard models. The summary estimate of the sensitivity and the specificity were obtained using the bivariate model. According to 42 reports consisting of 3055 reference positive comparisons, and 26188 reference negative comparisons, the DOR was 115 (95%CI: 77–172, I2 = 12.0%) and the AUC was 0.970 (95%CI: 0.958–0.982). The summary estimate of sensitivity and specificity were 0.911 (95%CI: 0.871–0.940) and 0.912 (95%CI: 0.892–0.928). The positive and negative likelihood ratios were 10.4 (95%CI 8.4–12.7) and 0.098 (95%CI 0.066–0.142), respectively. Detecting GDH for the diagnosis of CDI had both high sensitivity and specificity. Considering its low cost and prevalence, it is appropriate for a screening test for CDI. PMID:27418431

  2. The Diagnostic Accuracy of a New Test of Early Nonword Repetition for Differentiating Late Talking and Typically Developing Children

    ERIC Educational Resources Information Center

    Stokes, Stephanie F.; Klee, Thomas

    2009-01-01

    Purpose: To assess the diagnostic accuracy of a new Test of Early Nonword Repetition (TENR) for 2-year-old children. Method: 232 British-English-speaking children aged 27 ([plus or minus] 3) months were assessed on 3 standardized tests (receptive and expressive vocabulary and visual processing) and a novel nonword repetition (NWR) test. Parents…

  3. Development and Application of a Three-Tier Diagnostic Test to Assess Secondary Students' Understanding of Waves

    ERIC Educational Resources Information Center

    Caleon, Imelda; Subramaniam, R.

    2010-01-01

    This study focused on the development and application of a three-tier multiple-choice diagnostic test (or three-tier test) on the nature and propagation of waves. A question in a three-tier test comprises the "content tier", which measures content knowledge; the "reason tier", which measures explanatory knowledge; and the "confidence tier", which…

  4. Monocyte Activation in Immunopathology: Cellular Test for Development of Diagnostics and Therapy

    PubMed Central

    Ivanova, Ekaterina A.; Orekhov, Alexander N.

    2016-01-01

    Several highly prevalent human diseases are associated with immunopathology. Alterations in the immune system are found in such life-threatening disorders as cancer and atherosclerosis. Monocyte activation followed by macrophage polarization is an important step in normal immune response to pathogens and other relevant stimuli. Depending on the nature of the activation signal, macrophages can acquire pro- or anti-inflammatory phenotypes that are characterized by the expression of distinct patterns of secreted cytokines and surface antigens. This process is disturbed in immunopathologies resulting in abnormal monocyte activation and/or bias of macrophage polarization towards one or the other phenotype. Such alterations could be used as important diagnostic markers and also as possible targets for the development of immunomodulating therapy. Recently developed cellular tests are designed to analyze the phenotype and activity of living cells circulating in patient's bloodstream. Monocyte/macrophage activation test is a successful example of cellular test relevant for atherosclerosis and oncopathology. This test demonstrated changes in macrophage activation in subclinical atherosclerosis and breast cancer and could also be used for screening a panel of natural agents with immunomodulatory activity. Further development of cellular tests will allow broadening the scope of their clinical implication. Such tests may become useful tools for drug research and therapy optimization. PMID:26885534

  5. Diagnostic Accuracy of Clinical Tests for Morton's Neuroma Compared With Ultrasonography.

    PubMed

    Mahadevan, Devendra; Venkatesan, Muralidharan; Bhatt, Raj; Bhatia, Maneesh

    2015-01-01

    The aim of the present study was to assess the diagnostic accuracy of 7 clinical tests for Morton's neuroma (MN) compared with ultrasonography (US). Forty patients (54 feet) were diagnosed with MN using predetermined clinical criteria. These patients were subsequently referred for US, which was performed by a single, experienced musculoskeletal radiologist. The clinical test results were compared against the US findings. MN was confirmed on US at the site of clinical diagnosis in 53 feet (98%). The operational characteristics of the clinical tests performed were as follows: thumb index finger squeeze (96% sensitivity, 96% accuracy), Mulder's click (61% sensitivity, 62% accuracy), foot squeeze (41% sensitivity, 41% accuracy), plantar percussion (37% sensitivity, 36% accuracy), dorsal percussion (33% sensitivity, 26% accuracy), and light touch and pin prick (26% sensitivity, 25% accuracy). No correlation was found between the size of MN on US and the positive clinical tests, except for Mulder's click. The size of MN was significantly larger in patients with a positive Mulder's click (10.9 versus 8.5 mm, p = .016). The clinical assessment was comparable to US in diagnosing MN. The thumb index finger squeeze test was the most sensitive screening test for the clinical diagnosis of MN. PMID:25432459

  6. DVA as a Diagnostic Test for Vestibulo-Ocular Reflex Function

    NASA Technical Reports Server (NTRS)

    Wood, Scott J.; Appelbaum, Meghan

    2010-01-01

    The vestibulo-ocular reflex (VOR) stabilizes vision on earth-fixed targets by eliciting eyes movements in response to changes in head position. How well the eyes perform this task can be functionally measured by the dynamic visual acuity (DVA) test. We designed a passive, horizontal DVA test to specifically study the acuity and reaction time when looking in different target locations. Visual acuity was compared among 12 subjects using a standard Landolt C wall chart, a computerized static (no rotation) acuity test and dynamic acuity test while oscillating at 0.8 Hz (+/-60 deg/s). In addition, five trials with yaw oscillation randomly presented a visual target in one of nine different locations with the size and presentation duration of the visual target varying across trials. The results showed a significant difference between the static and dynamic threshold acuities as well as a significant difference between the visual targets presented in the horizontal plane versus those in the vertical plane when comparing accuracy of vision and reaction time of the response. Visual acuity increased proportional to the size of the visual target and increased between 150 and 300 msec duration. We conclude that dynamic visual acuity varies with target location, with acuity optimized for targets in the plane of rotation. This DVA test could be used as a functional diagnostic test for visual-vestibular and neuro-cognitive impairments by assessing both accuracy and reaction time to acquire visual targets.

  7. Stable erythrocyte diagnostic preparation for passive haemagglutination test with herpes simplex virus antigen.

    PubMed

    Krichevskaya, G I; Basova, N N

    1976-10-01

    A method for the preparation of stable suspensions of erythrocytes sensitized with herpes simplex virus (HSV) antigen and for their use in the passive haemagglutination test (PHAT) was developed. Formolized sheep erythrocytes were treated with tannin and sensitized with HSV antigen prepared from infected chick embryo cell culture by ultrasonication and virus extraction with alkaline glycine buffer. Antibody titres determined in the PHAT were higher than titres of neutralizing antibody. The specificity of the results was checked by the passive haemagglutination-inhibition test (PHAIT). The sensitized erythrocytes retained their activity for 5 months (the observation period) and gave reproducible results. The availability of stable erythrocyte diagnostic preparations simplifies the detection of herpesvirus antibody and makes the method widely applicable. PMID:11670

  8. Development and Evaluation of a Dipstick Diagnostic Test for Neisseria meningitidis Serogroup X

    PubMed Central

    Agnememel, Alain; Traincard, François; Dartevelle, Sylvie; Mulard, Laurence; Mahamane, Ali Elhaji; Oukem-Boyer, Odile Ouwe Missi; Denizon, Mélanie; Kacou-N′douba, Adèle; Dosso, Mireille; Gake, Bouba; Lombart, Jean-Pierre

    2014-01-01

    The emergence of Neisseria meningitidis serogroup X (NmX) in the African meningitis belt has urged the development of diagnostic tools and vaccines for this serogroup, especially following the introduction of a conjugate vaccine against N. meningitidis serogroup A (NmA). We have developed and evaluated a new rapid diagnostic test (RDT) for detecting the capsular polysaccharide (cps) antigen of this emerging serogroup. Whole inactivated NmX bacteria were used to immunize rabbits. Following purification by affinity chromatography, the cpsX-specific IgG antibodies were utilized to develop an NmX-specific immunochromatography dipstick RDT. The test was validated against purified cpsX and meningococcal strains of different serogroups. Its performance was evaluated against that of PCR on a collection of 369 cerebrospinal fluid (CSF) samples obtained from patients living in countries within the meningitis belt (Cameroon, Côte d'Ivoire, and Niger) or in France. The RDT was highly specific for NmX strains. Cutoffs of 105 CFU/ml and 1 ng/ml were observed for the reference NmX strain and purified cpsX, respectively. Sensitivity and specificity were 100% and 94%, respectively. A high agreement between PCR and RDT (Kappa coefficient, 0.98) was observed. The RDT gave a high positive likelihood ratio and a low negative likelihood (0.07), indicating almost 100% probability of declaring disease or not when the test is positive or negative, respectively. This unique NmX-specific test could be added to the available set of RDT for the detection of meningococcal meningitis in Africa as a major tool to reinforce epidemiological surveillance after the introduction of the NmA conjugate vaccine. PMID:25411183

  9. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia

    PubMed Central

    Osorio, Lyda; Uribe, Marcela; Ardila, Gloria Ines; Orejuela, Yaneth; Velasco, Margarita; Bonelo, Anilza; Parra, Beatriz

    2015-01-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were identified using contingency tables, nonparametric tests and logistic regression. A total of 778 subjects were diagnosed with dengue by the treating physician, of whom 386 (49.5%) were tested for dengue. Another 491 dengue tests were ordered in subjects whose primary diagnosis was not dengue. Severe dengue classification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergency consultation (OR 1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5) were independently associated with ordering of dengue tests. Dengue tests were used both to rule in and rule out diagnosis. The latter use is not justified by the sensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appear to depend on a combination of factors, including physician and institutional preferences, as well as other patient and epidemiological factors. PMID:25993399

  10. Some issues in resolution of diagnostic tests using an imperfect gold standard.

    PubMed

    Hawkins, D M; Garrett, J A; Stephenson, B

    2001-07-15

    As a subject's true disease status is seldom known with certainty, it is necessary to compare the performance of new diagnostic tests with those of a currently accepted but imperfect 'gold standard'. Errors made by the gold standard mean that the sensitivity and specificity calculated for the new test are biased, and do not correctly estimate the new method's sensitivity and specificity. The traditional approach to this problem was 'discrepant resolution', in which the subjects for whom the two methods disagreed were subjected to a third 'resolver' test. Recent work has pointed out that this does not automatically solve the problem. A sounder approach goes beyond the discordant test results and tests at least some of the subjects with concordant results with the resolver also. This leaves some issues unresolved. One is the basic question of the direction of biases in various estimators. We point out that this question does not have a simple universal answer. Another issue, if one is to test a sample of the subjects with concordant results rather than all cases, is how to compute estimates and standard errors of the measures of test performance, notably sensitivity and specificity of the test method relative to the resolver. Expressions for these standard errors are given and illustrated with a numeric example. It is shown that using just a sample of subjects with concordant results may lead to great savings in assays. The design issue of how many concordant cells to test depends on the numbers of concordants and discordants. The formulae given show how to evaluate impact of different choices for these numbers and hence settle on a design that gives the required precision of estimates. PMID:11427955

  11. Leukotriene D4 nasal provocation test: Rationale, methodology and diagnostic value

    PubMed Central

    ZHU, ZHENG; XIE, YANQING; GUAN, WEIJIE; GAO, YI; XIA, SHU; LIANG, JIANXIN; ZHENG, JINPING

    2016-01-01

    Cysteinyl leukotrienes (LT) play a vital role in the pathogenesis of allergic rhinitis (AR), but few studies have investigated the nasal mucosal physiological response to LTs in AR patients. The aim of the present study was to establish the methodology and investigate the diagnostic value and safety of a leukotriene D4 (LTD4) nasal provocation test. LTD4 nasal provocation tests were performed in 26 AR patients and 16 normal control subjects. Nasal airway responsiveness was assessed by calculating the concentration of LTD4 required to cause a 60% increase in nasal airway resistance (PC60NAR-LTD4), which was measured using rhinomanometry and a composite symptom score. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of LTD4 nasal provocation test, and adverse events were recorded. The study protocol was registered with the U.S. National Institutes of Health (https://clinicaltrials.gov/ct2/show/NCT01963741). PC60NAR-LTD4 in AR was significantly lower compared with that of normal controls [8.36 (IQR, 10.00) vs. 17.00 (IQR, 0.00) µg/ml, P=0.005]. Composite symptom score was higher in AR as compared with normal controls (1.19±0.94 vs. 0.12±0.50, P<0.001). The symptom scores included sneezing (0.12±0.34 vs. 0.00±0.00, P=0.149), rhinorrhea (0.79±0.66 vs. 0.06±0.25, P<0.001) and chemosis or itching of the eyes (0.06±0.25 vs. 0.21±0.42, P=0.216). High diagnostic value was indicated by the ROC [AUC: 0.822, 95%CI (0.665, 0.961)]. No serious adverse events were observed. Thus, the present results indicate that AR patients exhibited nasal hyperactivity to LTD4, and the established procedure of LTD4 nasal provocation testing is effective and safe for use in the diagnosis of AR. PMID:27347089

  12. The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report

    PubMed Central

    Dieterle, Thomas; Giusti, Francesco; Messina, Carlo Guiseppe Mario; Toerien, Eduard; Moch, Holger; Schäfer, Hans Hendrik

    2016-01-01

    Background In vitro diagnostic (IVD) investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE). Aim To investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers. Methods Past and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or post-treatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician’s perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed. Results IVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81%) believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0–4%, p<0.001). When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001); 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform) alone (p<0.0001). Conclusions Our results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes. PMID

  13. Thiopurine S-methyltransferase testing for averting drug toxicity: a meta-analysis of diagnostic test accuracy.

    PubMed

    Zur, R M; Roy, L M; Ito, S; Beyene, J; Carew, C; Ungar, W J

    2016-08-01

    Thiopurine S-methyltransferase (TPMT) deficiency increases the risk of serious adverse events in persons receiving thiopurines. The objective was to synthesize reported sensitivity and specificity of TPMT phenotyping and genotyping using a latent class hierarchical summary receiver operating characteristic meta-analysis. In 27 studies, pooled sensitivity and specificity of phenotyping for deficient individuals was 75.9% (95% credible interval (CrI), 58.3-87.0%) and 98.9% (96.3-100%), respectively. For genotype tests evaluating TPMT*2 and TPMT*3, sensitivity and specificity was 90.4% (79.1-99.4%) and 100.0% (99.9-100%), respectively. For individuals with deficient or intermediate activity, phenotype sensitivity and specificity was 91.3% (86.4-95.5%) and 92.6% (86.5-96.6%), respectively. For genotype tests evaluating TPMT*2 and TPMT*3, sensitivity and specificity was 88.9% (81.6-97.5%) and 99.2% (98.4-99.9%), respectively. Genotyping has higher sensitivity as long as TPMT*2 and TPMT*3 are tested. Both approaches display high specificity. Latent class meta-analysis is a useful method for synthesizing diagnostic test performance data for clinical practice guidelines.The Pharmacogenomics Journal advance online publication, 24 May 2016; doi:10.1038/tpj.2016.37. PMID:27217052

  14. EM field and instrumentation diagnostics in support of the LFT&E HPM methodology testing

    SciTech Connect

    Anderson, R A; Nelson, S D

    1997-09-04

    The Naval Air Warfare Center, China Lake, under the direction of the DoD LFT&E Office performed a series of HPM tests for the purpose of exercising the HPM methodology for LFT&E applications. An AH-1S Cobra helicopter was used as the canonical test bed. The Air Force Research Lab (formally Phillips Lab) provided the wide-band source and the Army Research Lab provided the narrow-band used in the tests. LLNL provided the EM diagnostics used at the site for both test series. Our mission was to measure the radiated field from the sources, measure the fields inside the helicopter and the coupling onto various signal lines inside the helicopter, and to monitor the various system signal levels for "bird health" purposes. These experiments were performed during June of 1997 and consisted of exposing the test bed to a series of narrow-band and wide-band pulses from HPM sources. This report covers the measured radiated fields, the fields inside the helicopter, and the coupled signal levels. The radiated fields were measured over a region which spans the physical body of the helicopter. The fields inside the helicopter and the coupled fields were measured using a series of probes inside the helicopter and connected to the outside measurement system using fiber-optic cables. The helicopter effects data are presented in the main China Lake report.

  15. EM field and instrumentation diagnostics in support of the LFT E HPM methodology testing

    SciTech Connect

    Anderson, R. A.; Nelson, S. D.

    1997-09-04

    The Naval Air Warfare Center, China Lake, under the direction of the DOD LFT E Office performed a series of HPM tests for the purpose of exercising the HPM methodology for LFT E applications. An AH-1S Cobra helicopter was used as the canonical test bed. The Air Force Research Lab (formally Phillips Lab) provided the wide-band source and the Army Research Lab provided the narrow-band used in the tests. LLNL provided the EM diagnostics used at the site for both test series. Our mission was to measure the radiated field from the sources, measure the fields inside the helicopter and the coupling onto various signal lines inside the helicopter, and to monitor the various system signal levels for bird health purposes. These experiments were performed during June of 1997 and consisted of exposing the test bed to a series of narrow-band and wide-band pulses from HPM sources. This report covers the measured radiated fields, the fields inside the helicopter, and the coupled signal levels. The radiated fields were measured over a region which spans the physical body of the helicopter. The fields inside the helicopter and the coupled fields were measured using a series of probes inside the helicopter and connected to the outside measurement system using fiber-optic cables. The helicopter effects data are presented in the main China Lake report.

  16. Evaluation of a rapid diagnostic test for yaws infection in a community surveillance setting.

    PubMed

    Marks, Michael; Goncalves, Adriana; Vahi, Ventis; Sokana, Oliver; Puiahi, Elliot; Zhang, Zaixing; Dalipanda, Tenneth; Bottomley, Christian; Mabey, David; Solomon, Anthony W

    2014-09-01

    Yaws is a non-venereal treponemal infection caused by Treponema pallidum ssp. pertenue. The WHO has launched a worldwide control programme, which aims to eradicate yaws by 2020. The development of a rapid diagnostic test (RDT) for serological diagnosis in the isolated communities affected by yaws is a key requirement for the successful implementation of the WHO strategy. We conducted a study to evaluate the utility of the DPP test in screening for yaws, utilizing samples collected as part of a community prevalence survey conducted in the Solomon Islands. 415 serum samples were tested using both traditional syphilis serology (TPPA and quantitative RPR) and the Chembio DPP Syphilis Screen and Confirm RDT. We calculated the sensitivity and specificity of the RDT as compared to gold standard serology. The sensitivity of the RDT against TPPA was 58.5% and the specificity was 97.6%. The sensitivity of the RDT against RPR was 41.7% and the specificity was 95.2%. The sensitivity of the DPP was strongly related to the RPR titre with a sensitivity of 92.0% for an RPR titre of >1/16. Wider access to DPP testing would improve our understanding of worldwide yaws case reporting and the test may play a key role in assessing patients presenting with yaws like lesions in a post-mass drug administration (MDA) setting. PMID:25211018

  17. Summary of Glaucoma Diagnostic Testing Accuracy: An Evidence-Based Meta-Analysis

    PubMed Central

    Ahmed, Saad; Khan, Zainab; Si, Francie; Mao, Alex; Pan, Irene; Yazdi, Fatemeh; Tsertsvadze, Alexander; Hutnik, Cindy; Moher, David; Tingey, David; Trope, Graham E.; Damji, Karim F.; Tarride, Jean-Eric; Goeree, Ron; Hodge, William

    2016-01-01

    Background New glaucoma diagnostic technologies are penetrating clinical care and are changing rapidly. Having a systematic review of these technologies will help clinicians and decision makers and help identify gaps that need to be addressed. This systematic review studied five glaucoma technologies compared to the gold standard of white on white perimetry for glaucoma detection. Methods OVID® interface: MEDLINE® (In-Process & Other Non-Indexed Citations), EMBASE®, BIOSIS Previews®, CINAHL®, PubMed, and the Cochrane Library were searched. A gray literature search was also performed. A technical expert panel, information specialists, systematic review method experts and biostatisticians were used. A PRISMA flow diagram was created and a random effect meta-analysis was performed. Results A total of 2,474 articles were screened. The greatest accuracy was found with frequency doubling technology (FDT) (diagnostic odds ratio (DOR): 57.7) followed by blue on yellow perimetry (DOR: 46.7), optical coherence tomography (OCT) (DOR: 41.8), GDx (DOR: 32.4) and Heidelberg retina tomography (HRT) (DOR: 17.8). Of greatest concern is that tests for heterogeneity were all above 50%, indicating that cutoffs used in these newer technologies were all very varied and not uniform across studies. Conclusions Glaucoma content experts need to establish uniform cutoffs for these newer technologies, so that studies that compare these technologies can be interpreted more uniformly. Nevertheless, synthesized data at this time demonstrate that amongst the newest technologies, OCT has the highest glaucoma diagnostic accuracy followed by GDx and then HRT. PMID:27540437

  18. Routine compliance testing for diagnostic x-ray systems or components of diagnostic x-ray systems to which 21 CFR subchapter J is applicable

    SciTech Connect

    Not Available

    1988-12-01

    This manual was developed by the National Center for Devices and Radiological Health, FDA, to establish procedures for routine testing of diagnostic x-ray systems for compliance with Federal Performance Standard 21 CFR 1021.30. It has been prepared to instruct FDA personnel and State officials who assist FDA in the use of the various devices that FDA may procure. The procedures and routine test equipment will be used for screening diagnostic x-ray systems for evidence of non-compliance with the Performance Standard. More rigorous followup testing will be performed as required. The manual has two major subject areas: testing procedures and test equipment. The first section presently contains procedures that provide efficient means of testing against many performance requirements and are applicable to many different types of x-ray systems. It includes detailed drawings of the routine compliance test stand, operating manuals for the x-ray exposure monitor and the photometer, and descriptions of how to use the direct-print paper.

  19. Parallel Recovery in a Trilingual Speaker: The Use of the Bilingual Aphasia Test as a Diagnostic Complement to the Comprehensive Aphasia Test

    ERIC Educational Resources Information Center

    Green, David W.; Ruffle, Louise; Grogan, Alice; Ali, Nilufa; Ramsden, Sue; Schofield, Tom; Leff, Alex P.; Crinion, Jenny; Price, Cathy J.

    2011-01-01

    We illustrate the value of the Bilingual Aphasia Test in the diagnostic assessment of a trilingual speaker post-stroke living in England for whom English was a non-native language. The Comprehensive Aphasia Test is routinely used to assess patients in English, but only in combination with the Bilingual Aphasia Test is it possible and practical to…

  20. Toward an Earlier Diagnosis of Primary Ciliary Dyskinesia. Which Patients Should Undergo Detailed Diagnostic Testing?

    PubMed

    Kuehni, Claudia E; Lucas, Jane S

    2016-08-01

    Primary ciliary dyskinesia (PCD) is a rare, heterogeneous, recessive, genetic disorder of motile cilia, leading to chronic upper and lower respiratory symptoms. Prevalence is estimated at around 1:10,000, but many patients remain undiagnosed, whereas others receive the label incorrectly. Proper diagnosis is complicated by the fact that the key symptoms, such as wet cough, chronic rhinitis, and recurrent upper and lower respiratory infection, are common and nonspecific. There is no single gold standard test to diagnose PCD. Currently, the diagnosis is made in patients with a compatible medical history after a demanding combination of tests including nasal nitric oxide, high-speed video microscopy, and transmission electron microscopy and genetic and ciliary culture testing. These tests are costly and need sophisticated equipment and experienced staff, restricting use to highly specialized centers. Therefore, it would be desirable to have a screening test for identifying those patients who should undergo detailed diagnostic testing. Three recent studies focused on potential screening tools: one study assessed the validity of nasal nitric oxide for screening, and two studies developed new symptom-based screening tools. These simple tools are welcome, and it is hoped that they will assist physicians in determining whom to refer for definitive testing. However, they have been developed in tertiary care settings, where 10 to 50% of tested patients have PCD. The sensitivity and specificity of the tools are reasonable, but positive and negative predictive values may be poor in primary or secondary care settings. Although these studies are an important step toward an earlier diagnosis of PCD, more remains to be done before we have tools tailored to different health care settings. PMID:27258773