Science.gov

Sample records for additional diagnostic test

  1. 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 ...

  2. Diagnostic Testing Project.

    ERIC Educational Resources Information Center

    McArthur, David L.

    This paper presents an explanation of the program design of the three separate Pascal-language programs which comprise UCLA's Diagnostic Testing Package "DX." The three parts of the DX test package are three closely interrelated programs--Editest, Runtest, and Summary. Editest serves the following functions: (1) the creation of a suitable…

  3. [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

  4. Rapid diagnostic tests for malaria.

    PubMed

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

    2015-12-01

    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.

  5. 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

  6. 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…

  7. Using and interpreting diagnostic tests.

    PubMed

    McKenna, Shawn L B; Dohoo, Ian R

    2006-03-01

    Diagnostic tests are invaluable to the practice of veterinary medicine. Using them correctly and interpreting the results appropriately depend on having a good understanding of the basic principles outlined in this article. Topics covered include sensitivity and specificity, agreement among tests, using multiple tests, and other issues related to the use and interpretation of diagnostic tests. The most important principle is recognition that the interpretation of test results varies across populations and requires an estimate of the prevalence of the infection (or disease) in the population being studied.

  8. 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.

  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

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. 410.32 Section 410.32 Public Health CENTERS FOR MEDICARE... (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic...

  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

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. 410.32 Section 410.32 Public Health CENTERS FOR MEDICARE... (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic...

  11. 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

  12. 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

    ... Service Act, as implemented by 21 CFR part 900, subpart B. (d) Diagnostic laboratory tests—(1) Who may... 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...

  13. 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... 42 Public Health 2 2012-10-01 2012-10-01 false Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. 410.32 Section 410.32 Public Health CENTERS FOR...

  14. 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... 42 Public Health 2 2010-10-01 2010-10-01 false Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. 410.32 Section 410.32 Public Health CENTERS FOR...

  15. Cochrane diagnostic test accuracy reviews.

    PubMed

    Leeflang, Mariska M G; Deeks, Jonathan J; Takwoingi, Yemisi; Macaskill, Petra

    2013-10-07

    In 1996, shortly after the founding of The Cochrane Collaboration, leading figures in test evaluation research established a Methods Group to focus on the relatively new and rapidly evolving methods for the systematic review of studies of diagnostic tests. Seven years later, the Collaboration decided it was time to develop a publication format and methodology for Diagnostic Test Accuracy (DTA) reviews, as well as the software needed to implement these reviews in The Cochrane Library. A meeting hosted by the German Cochrane Centre in 2004 brought together key methodologists in the area, many of whom became closely involved in the subsequent development of the methodological framework for DTA reviews. DTA reviews first appeared in The Cochrane Library in 2008 and are now an integral part of the work of the Collaboration.

  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. 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 ...

  18. An Additive Manufacturing Test Artifact.

    PubMed

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system. PMID:26601039

  19. An Additive Manufacturing Test Artifact

    PubMed Central

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system. PMID:26601039

  20. An Additive Manufacturing Test Artifact.

    PubMed

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system.

  1. 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...

  2. 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...

  3. How to appraise a diagnostic test.

    PubMed

    Manikandan, Ramanitharan; Dorairajan, Lalgudi N

    2011-10-01

    Urologists frequently encounter problems in making a clinical diagnosis whose resolution requires the use of diagnostic tests. With an ever increasing choice of investigations being available, the urologist often has to decide which diagnostic test(s) will best resolve the patient's diagnostic problem. In this article, we aim to help the urologist understand how to critically appraise studies on diagnostic tests and make a rational choice. This article presents the guiding principles in scientifically assessing studies on diagnostic tests by proposing a clinical scenario. The authors describe a standardized protocol to assess the validity of the test and its relevance to the clinical problem that can help the urologist in decision making. The three important issues to be considered when evaluating the validity of the study are to identify how the study population was chosen, how the test was performed and whether there is a comparison to the gold standard test so as to confirm or refute the diagnosis. Then, the urologist would need to know the probability of the test in providing the correct diagnosis in an individual patient in order to decide about its utility in solving the diagnostic dilemma. By performing the steps described in this article, the urologist would be able to critically appraise diagnostic studies and draw meaningful conclusions about the investigations in terms of validity, results and its applicability to the patient's problem. This would provide a scientific basis for using diagnostic tests for improving patient care.

  4. 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...

  5. 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...

  6. 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...

  7. Diagnostic testing for erectile dysfunction.

    PubMed

    Sprouse, D O

    1992-09-01

    What can we expect in the next decade? In addition to the obviously anticipated clarification of normal values relating to erectile function and anatomy and refinement of examinations, tests, and procedures, there is still much to be discovered, refined, and defined. We can anticipate new medications being found to enhance penile erections. Maybe a pacemaker will be possible that will stimulate an erection. New methods will be developed to insert coils and scarring agents for veno-occlusive disorders. Drugs will be produced in the form of pills, creams, or injectables that will dilate, clean out, or prevent blockage in the arteries. Preventing erectile dysfunction should become the issue in the 1990s and the next century. Changes in life-style such as reducing stress, eating healthier, stopping smoking, exercising more, and reducing alcohol consumption will lead to better bodily functioning. Essentially, taking responsibility for our own well being will become important. Health promotion, instead of curing, will receive greater focus. Education will play an important part in realizing a goal of mature sexuality and improved general well-being. PMID:1529366

  8. 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 ...

  9. 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 ...

  10. Diagnostic Testing System: A Complete Diagnostic Multiple-Choice Test Package for the Apple II.

    ERIC Educational Resources Information Center

    McArthur, David; And Others

    The Diagnostic Testing System (DX) is an integral system for developing and administering tests. The system can be utilized for testing in any subject matter, or any number of subject matters, at any level on scholastic or cognitive continuums. The major purpose of DX is to provide diagnostic data about the level at which a given student (or group…

  11. [Patch-testing methods: additional specialised or additional series].

    PubMed

    Cleenewerck, M-B

    2009-01-01

    The tests in the European standard battery must occasionally be supplemented by specialised or additional batteries, particularly where the contact allergy is thought to be of occupational origin. These additional batteries cover all allergens associated with various professional activities (hairdressing, baking, dentistry, printing, etc.) and with different classes of materials and chemical products (glue, plastic, rubber...). These additional tests may also include personal items used by patients on a daily basis such as cosmetics, shoes, plants, textiles and so on.

  12. Instructional Implications of Diagnostic Reading Tests.

    ERIC Educational Resources Information Center

    Reynolds, Marianne C.

    This paper examines remedial programs in colleges and discusses the relationship of those programs to diagnostic testing. The Basic Skills Placement Test (BSPT) is required of all College freshman in New Jersey public colleges. Mercer County Community College, used as an example throughout this paper, uses the BSPT as a basis for placing students…

  13. Testing and Diagnostic Testing in Mathematics

    ERIC Educational Resources Information Center

    Cresswell, M.

    1977-01-01

    The author outlines some of the ways in which published mathematics tests, particularly the general standardized type, can be used in a constructive way by teachers to learn more about their pupils. (MN)

  14. 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

  15. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  16. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  17. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  18. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  19. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  20. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  1. 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

  2. Analysis of the Astronomy Diagnostic Test

    ERIC Educational Resources Information Center

    Brogt, Erik; Sabers, Darrell; Prather, Edward E.; Deming, Grace L.; Hufnagel, Beth; Slater, Timothy F.

    2007-01-01

    Seventy undergraduate class sections were examined from the database of Astronomy Diagnostic Test (ADT) results of Deming and Hufnagel to determine if course format correlated with ADT normalized gain scores. Normalized gains were calculated for four different classroom scenarios: lecture, lecture with discussion, lecture with lab, and lecture…

  3. Computerized Diagnostic Testing: Problems and Possibilities.

    ERIC Educational Resources Information Center

    McArthur, David L.

    The use of computers to build diagnostic inferences is explored in two contexts. In computerized monitoring of liquid oxygen systems for the space shuttle, diagnoses are exact because they can be derived within a world which is closed. In computerized classroom testing of reading comprehension, programs deliver a constrained form of adaptive…

  4. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... performs a test he or she is authorized by the State to perform, or an independent diagnostic testing... furnishes diagnostic procedures in a physician's office. (2) Exceptions. The following diagnostic tests that... Drug Administration. (ii) Diagnostic tests personally furnished by a qualified audiologist as...

  5. 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... furnishes diagnostic procedures in a physician's office. (2) Exceptions. The following diagnostic tests that... Drug Administration. (ii) Diagnostic tests personally furnished by a qualified audiologist as...

  6. 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... furnishes diagnostic procedures in a physician's office. (2) Exceptions. The following diagnostic tests that... Drug Administration. (ii) Diagnostic tests personally furnished by a qualified audiologist as...

  7. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... performs a test he or she is authorized by the State to perform, or an independent diagnostic testing... furnishes diagnostic procedures in a physician's office. (2) Exceptions. The following diagnostic tests that... Drug Administration. (ii) Diagnostic tests personally furnished by a qualified audiologist as...

  8. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... performs a test he or she is authorized by the State to perform, or an independent diagnostic testing... furnishes diagnostic procedures in a physician's office. (2) Exceptions. The following diagnostic tests that... Drug Administration. (ii) Diagnostic tests personally furnished by a qualified audiologist as...

  9. 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.

  10. 78 FR 22209 - Additional Synthetic Drug Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... COMMISSION 10 CFR Part 26 Additional Synthetic Drug Testing AGENCY: Nuclear Regulatory Commission. ACTION... NRC amend its Fitness for Duty program regulations to amend drug testing requirements to test for additional synthetic drugs currently not included in the regulations. The NRC determined that the...

  11. 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.

  12. 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

  13. Caustic addition system operability test procedure

    SciTech Connect

    Parazin, R.E.

    1994-11-01

    This test procedure provides instructions for performing operational testing of the major components of the 241-AN-107 Caustic Addition System by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E).

  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. 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

  16. [Genetic diagnostic testing in inherited retinal dystrophies].

    PubMed

    Kohl, S; Biskup, S

    2013-03-01

    Inherited retinal dystrophies are clinically and genetically highly heterogeneous. They can be divided according to the clinical phenotype and course of the disease, as well as the underlying mode of inheritance. Isolated retinal dystrophies (i.e., retinitis pigmentosa, Leber's congenital amaurosis, cone and cone-rod dystrophy, macular dystrophy, achromatopsia, congenital stationary nightblindness) and syndromal forms (i.e., Usher syndrome, Bardet-Biedl syndrome) can be differentiated. To date almost 180 genes and thousands of distinct mutations have been identified that are responsible for the different forms of these blinding illnesses. Until recently, there was no adequate diagnostic genetic testing available. With the development of the next generation sequencing technologies, a comprehensive genetic screening analysis for all known genes for inherited retinal dystrophies has been established at reasonable costs and in appropriate turn-around times. Depending on the primary clinical diagnosis and the presumed mode of inheritance, different diagnostic panels can be chosen for genetic testing. Statistics show that in 55-80 % of the cases the genetic defect of the inherited retinal dystrophy can be identified with this approach, depending on the initial clinical diagnosis. The aim of any genetic diagnostics is to define the genetic cause of a given illness within the affected patient and family and thereby i) confirm the clinical diagnosis, ii) provide targeted genetic testing in family members, iii) enable therapeutic intervention, iv) give a prognosis on disease course and progression and v) in the long run provide the basis for novel therapeutic approaches and personalised medicine.

  17. 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.

  18. 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.

  19. Beam Diagnostics for the BNL Energy Recovery Linac Test Facility

    SciTech Connect

    Cameron, Peter; Ben-Zvi, Ilan; Blaskiewicz, Michael; Brennan, Michael; Connolly, Roger; Dawson, William; Degen, Chris; DellaPenna, Al; Gassner, David; Kesselman, Martin; Kewish, Jorg; Litvinenko, Vladimir; Mead, Joseph; Oerter, Brian; Russo, Tom; Vetter, Kurt; Yakimenko, Vitaly

    2004-11-10

    An Energy Recovery Linac (ERL) test facility is presently under construction at BNL. The goals of this test facility are first to demonstrate stable intense CW electron beam with parameters typical for the RHIC e-cooling project (and potentially for eRHIC), second to test novel elements of the ERL (high current CW photo-cathode, superconducting RF cavity with HOM dampers, and feedback systems), and finally to test lattice dependence of stability criteria. Planned diagnostics include position monitors, loss monitors, transverse profile monitors (both optical and wires), scrapers/halo monitors, a high resolution differential current monitor, phase monitors, an energy spread monitor, and a fast transverse monitor (for beam break-up studies and the energy feedback system). We discuss diagnostics challenges that are unique to this project, and present preliminary system specifications. In addition, we include a brief discussion of the timing system.

  20. University students' perspectives on diagnostic testing in mathematics

    NASA Astrophysics Data System (ADS)

    fhloinn, Eabhnat Ní; Macan Bhaird, Ciarán; 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 early indication of which students are likely to need additional help, and hopefully encourage such students to avail of extra support mechanisms at an early stage. However, it is not clear that students recognize these intentions and there is a fear that students who score poorly in the test will have their confidence further damaged in relation to mathematics and will be reluctant to seek help. To this end, a questionnaire was developed to explore students' perspectives on diagnostic testing. Analysis of responses received to the questionnaire provided an interesting insight into students' perspectives including the optimum time to conduct such a test, their views on the aims of diagnostic testing, whether they feel that testing is a good idea, and their attitudes to the support systems put in place to help those who scored poorly in the test.

  1. Eating Disorder Diagnostic Scale: Additional Evidence of Reliability and Validity

    ERIC Educational Resources Information Center

    Stice, Eric; Fisher, Melissa; Martinez, Erin

    2004-01-01

    The authors conducted 4 studies investigating the reliability and validity of the Eating Disorder Diagnostic Scale (HDDS; E. Stice, C. F. Telch, & S. L. Rizvi, 2000), a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa, and binge eating disorder. Study 1 found that the HDDS showed criterion validity with interview-based…

  2. Development of the Astronomy Diagnostic Test

    NASA Astrophysics Data System (ADS)

    Hufnagel, B.

    2001-12-01

    The starting point for questions in the Astronomy Diagnostic Test (ADT) Version 2.0 was two precursor surveys, the STAR Evaluation by Philip M. Sadler and Michael Zeilik's Astronomy Diagnostic Test Version 1.0. Questions were selected or developed for the new ADT which (1) addressed concepts included in most introductory astronomy courses for non-science majors, (2) included only concepts recognizable to most high-school graduates, (3) focused on one concept only, and (4) stressed concepts and not jargon. This version was administered to about 1000 students at four colleges and universities. The statistical results, e.g., item discrimination, guided re-writing and elimination of questions. Sixty student interviews at Montana State and the University of Maryland, as well as thirty written responses to the questions in open-ended format, were the basis for determining if the questions were interpreted by the students as intended. This student input was also the basis for distractors (wrong answers) reflecting the ideas and the words of the students themselves. After revision, the ADT was administered the next semester to 1557 students enrolled in 22 introductory classes, twenty students were interviewed, and comments solicited from the instructors of those classes. The result was the final ADT Version 2.0, which consists of 21 content and 12 student background multiple-choice questions. This work has been partly supported by NSF grant # DGE-9714489.

  3. Rapid diagnostic tests for malaria ---Haiti, 2010.

    PubMed

    2010-10-29

    Plasmodium falciparum malaria is endemic to Haiti and remains a major concern for residents, including displaced persons, and emergency responders in the aftermath of the January 12, 2010 earthquake. Microscopy has been the only test approved in the national policy for the diagnosis and management of malaria in Haiti; however, the use of microscopy often has been limited by lack of equipment or trained personnel. In contrast, malaria rapid diagnostic tests (RDTs) require less equipment or training to use. To assist in the timely diagnosis and treatment of malaria in Haiti, the Ministry of Public Health and Population (MSPP), in collaboration with CDC, conducted a field assessment that guided the decision to approve the use of RDTs. This data-driven policy change greatly expands the opportunities for accurate malaria diagnosis across the country, allows for improved clinical management of febrile patients, and will improve the quality of malaria surveillance in Haiti.

  4. 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.

  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.

  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.

  7. Laboratory tests of sludge-control additives

    SciTech Connect

    Tatnall, R.E.

    1996-07-01

    Laboratory {open_quotes}jar{close_quotes} tests compared eleven different fuel oil and diesel fuel sludge-control additives. Factors studied included (1) ability to disperse and prevent buildup of sludge deposits on surfaces, (2) ability to protect steel from corrosion, (3) ability to inhibit growth and proliferation of bacteria, and (4) ability to disperse water. Results varied greatly, and it was found that many commercial products do not do what they claim. It is concluded that fuel retailers should not believe manufacturers` claims for their additive products, but rather should test such products themselves to be sure that the benefits of treatment are real. A simplified form of the procedure used here is proposed as one way for dealers to do such testing.

  8. The teratology testing of food additives.

    PubMed

    Barrow, Paul C; Spézia, François

    2013-01-01

    The developmental and reproductive toxicity testing (including teratogenicity) of new foods and food additives is performed worldwide according to the guidelines given in the FDA Redbook. These studies are not required for substances that are generally recognized as safe, according to the FDA inventory. The anticipated cumulated human exposure level above which developmental or reproduction studies are required depends on the structure-alert category. For food additives of concern, both developmental (prenatal) and reproduction (multigeneration) studies are required. The developmental studies are performed in two species, usually the rat and the rabbit. The reproduction study is generally performed in the rat. The two rat studies are preferably combined into a single experimental design, if possible. The test methods described in the FDA Redbook are similar to those specified by the OECD for the reproductive toxicity testing of chemicals.

  9. 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.

  10. 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.

  11. 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...

  12. 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.

  13. Diagnostic tests in allergy to green coffee.

    PubMed

    Osterman, K; Johansson, S G; Zetterström, O

    1985-07-01

    Twenty-two coffee roastery workers with work-related symptoms of various degree from the eyes, nose or bronchi were tested with partly purified water-soluble extract from dust of green coffee beans (GCB). Eighteen persons had a positive prick test, eight a positive bronchial provocation test and seven a positive nasal provocation test. Fourteen had a positive methacholine test, indicating unspecific bronchial hyperreactivity. Specific IgE antibodies to GCB extract were found in sera of 11 workers and to castor bean (CB) extract in 16. The workers measured their lung function with an air flow meter, three times a day for 1 week, and the values were lower in the second half of the week for the workers with IgE antibodies to GCB, but not for the others. It is concluded that the case history, prick test, RAST, and simple lung function tests for one or a few weeks are the best tools when investigating occupational allergy. When the allergen is unknown, but the occurrence of an IgE-mediated allergy is suspected, serial lung function measurements and determinations of total serum IgE, in addition to taking a careful case history, are valuable methods with which to start the investigation.

  14. 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

  15. Effects on Diagnostic Parameters After Removing Additional Synchronous Gear Meshes

    NASA Technical Reports Server (NTRS)

    Decker, Harry J.

    2003-01-01

    Gear cracks are typically difficult to diagnose with sufficient time before catastrophic damage occurs. Significant damage must be present before algorithms appear to be able to detect the damage. Frequently there are multiple gear meshes on a single shaft. Since they are all synchronous with the shaft frequency, the commonly used synchronous averaging technique is ineffective in removing other gear mesh effects. Carefully applying a filter to these extraneous gear mesh frequencies can reduce the overall vibration signal and increase the accuracy of commonly used vibration metrics. The vibration signals from three seeded fault tests were analyzed using this filtering procedure. Both the filtered and unfiltered vibration signals were then analyzed using commonly used fault detection metrics and compared. The tests were conducted on aerospace quality spur gears in a test rig. The tests were conducted at speeds ranging from 2500 to 5000 revolutions per minute and torques from 184 to 228 percent of design load. The inability to detect these cracks with high confidence results from the high loading which is causing fast fracture as opposed to stable crack growth. The results indicate that these techniques do not currently produce an indication of damage that significantly exceeds experimental scatter.

  16. Test verification and validation for molecular diagnostic assays.

    PubMed

    Halling, Kevin C; Schrijver, Iris; Persons, Diane L

    2012-01-01

    With our ever-increasing understanding of the molecular basis of disease, clinical laboratories are implementing a variety of molecular diagnostic tests to aid in the diagnosis of hereditary disorders, detection and monitoring of cancer, determination of prognosis and guidance for cancer therapy, and detection and monitoring of infectious diseases. Before introducing any new test into the clinical laboratory, the performance characteristics of the assay must be "verified," if it is a US Food and Drug Administration (FDA)-approved or FDA-cleared test, or "validated," if it is a laboratory-developed test. Although guidelines exist for how validation and verification studies may be addressed for molecular assays, the specific details of the approach used by individual laboratories is rarely published. Many laboratories, especially those introducing new types of molecular assays, would welcome additional guidance, especially in the form of specific examples, on the process of preparing a new molecular assay for clinical use. PMID:22208481

  17. 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).

  18. Diagnostic value of exercise testing in asbestosis

    SciTech Connect

    Zejda, J. )

    1989-01-01

    The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease.

  19. Diagnostic criteria and laboratory tests for disseminated intravascular coagulation.

    PubMed

    Wada, Hideo; Matsumoto, Takeshi; Hatada, Tuyoshi

    2012-12-01

    Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been established by the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH) and the Japanese Association for Acute Medicine. The diagnostic criteria involving global coagulation tests, such as the Japanese Ministry of Health, Labor and Welfare criteria and the ISTH overt diagnostic criteria, are first-generation DIC diagnostic criteria, those involving global coagulation tests and changes in these tests such as the Japanese Association for Acute Medicine criteria, are second-generation DIC diagnostic criteria, and those including non-overt DIC diagnostic criteria involving global coagulation tests, changes in these tests and hemostatic molecular markers will be the future (third-generation) DIC diagnostic criteria. There are no significant differences in the three diagnostic criteria with respect to predicting poor outcomes. Therefore, the third generation of diagnostic criteria including hemostatic molecular markers is expected to be established. Standardization and the determination of adequate cutoff values should be required for each laboratory test.

  20. Assessing Diagnostic Tests II: Grading on a Curve.

    PubMed

    Jupiter, Daniel C

    2015-01-01

    In this Investigators' Corner, I continue discussing how to introduce and assess new diagnostic tests to replace older tests that are considered gold standards. Specifically, I talk about how to assess a "family" of diagnostics, and how to choose an optimal "family member."

  1. 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…

  2. PIC Reading and Spelling Diagnostic Test Form.

    ERIC Educational Resources Information Center

    Short, N. J.

    This diagnostic skills checklist enables the methods and materials specialists to note the reading and spelling skills the child has mastered, those skills which are weak or not developed, and those skills which are clearly beyond the child's capability of mastering because of insufficiently developed abilities at lower, prerequisite levels. Also…

  3. Assessment of diagnostics and antimicrobial susceptibility testing of Brachyspira species using a ring test.

    PubMed

    Råsbäck, T; Fellström, C; Bergsjø, B; Cizek, A; Collin, K; Gunnarsson, A; Jensen, S M; Mars, A; Thomson, J; Vyt, P; Pringle, M

    2005-08-30

    There is no ring test for quality assessment available in Europe for diagnostics and antimicrobial susceptibility testing of the fastidious, anaerobic bacteria of the genus Brachyspira. Therefore, an international ring test for Brachyspira spp. was performed once a year during 2002-2004. Two sets of coded samples were prepared and distributed on each occasion. One set comprised six swabs dipped in pig faeces spiked with Brachyspira spp. intended for diagnostics. The other set comprised two pure strains intended only for susceptibility testing. All methods used were in-house methods. The species used were Brachyspira hyodysenteriae, Brachyspira pilosicoli, Brachyspira innocens, Brachyspira murdochii and Brachyspira intermedia. In most cases, the correct Brachyspira spp. were detected. However, the results showed that Brachyspira spp. could be difficult to identify, especially if two Brachyspira spp. were mixed or if the concentration of Brachyspira in faeces was low. Additionally, some laboratories reported Brachyspira growth in control samples that were not seeded with any spirochaetes. The lowest detection level was 10(2) bacteria/ml faeces for both B. hyodysenteriae and B. pilosicoli. The susceptibility tests performed showed that disc diffusion was not recommendable for Brachyspira spp. Extended antimicrobial dilution series gave most congruent results. The diversity of the results highlights the importance of ring tests for a high quality of diagnostics and antimicrobial susceptibility tests for Brachyspira spp. This is the first ring test described for Brachyspira spp.

  4. 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

  5. [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

  6. Evaluating Diagnostic Point-of-Care Tests in Resource-Limited Settings

    PubMed Central

    Drain, Paul K; Hyle, Emily P; Noubary, Farzad; Freedberg, Kenneth A; Wilson, Douglas; Bishai, William; Rodriguez, William; Bassett, Ingrid V

    2014-01-01

    Diagnostic point-of-care (POC) testing is intended to minimize the time to obtain a test result, thereby allowing clinicians and patients to make an expeditious clinical decision. As POC tests expand into resource-limited settings (RLS), the benefits must outweigh the costs. To optimize POC testing in RLS, diagnostic POC tests need rigorous evaluations focused on relevant clinical outcomes and operational costs, which differ from evaluations of conventional diagnostic tests. Here, we reviewed published studies on POC testing in RLS, and found no clearly defined metric for the clinical utility of POC testing. Therefore, we propose a framework for evaluating POC tests, and suggest and define the term “test efficacy” to describe a diagnostic test’s capacity to support a clinical decision within its operational context. We also proposed revised criteria for an ideal diagnostic POC test in resource-limited settings. Through systematic evaluations, comparisons between centralized diagnostic testing and novel POC technologies can be more formalized, and health officials can better determine which POC technologies represent valuable additions to their clinical programs. PMID:24332389

  7. 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...

  8. 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 ...

  9. 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

  10. 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.

  11. 42 CFR 84.308 - Additional testing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....S.C. 552(a) and 1 CFR Part 51. All approved material is available for inspection at NIOSH, National... will test the eye protection's resistance to fogging in accordance with the method specified in BS EN 168:2002, Clause 16, Test for resistance to fogging of oculars. The lens shall remain free...

  12. 42 CFR 84.308 - Additional testing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....S.C. 552(a) and 1 CFR Part 51. All approved material is available for inspection at NIOSH, National... will test the eye protection's resistance to fogging in accordance with the method specified in BS EN 168:2002, Clause 16, Test for resistance to fogging of oculars. The lens shall remain free...

  13. 42 CFR 84.308 - Additional testing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....S.C. 552(a) and 1 CFR Part 51. All approved material is available for inspection at NIOSH, National... will test the eye protection's resistance to fogging in accordance with the method specified in BS EN 168:2002, Clause 16, Test for resistance to fogging of oculars. The lens shall remain free...

  14. Impact of contacting study authors to obtain additional data for systematic reviews: diagnostic accuracy studies for hepatic fibrosis

    PubMed Central

    2014-01-01

    Background Seventeen of 172 included studies in a recent systematic review of blood tests for hepatic fibrosis or cirrhosis reported diagnostic accuracy results discordant from 2 × 2 tables, and 60 studies reported inadequate data to construct 2 × 2 tables. This study explores the yield of contacting authors of diagnostic accuracy studies and impact on the systematic review findings. Methods Sixty-six corresponding authors were sent letters requesting additional information or clarification of data from 77 studies. Data received from the authors were synthesized with data included in the previous review, and diagnostic accuracy sensitivities, specificities, and positive and likelihood ratios were recalculated. Results Of the 66 authors, 68% were successfully contacted and 42% provided additional data for 29 out of 77 studies (38%). All authors who provided data at all did so by the third emailed request (ten authors provided data after one request). Authors of more recent studies were more likely to be located and provide data compared to authors of older studies. The effects of requests for additional data on the conclusions regarding the utility of blood tests to identify patients with clinically significant fibrosis or cirrhosis were generally small for ten out of 12 tests. Additional data resulted in reclassification (using median likelihood ratio estimates) from less useful to moderately useful or vice versa for the remaining two blood tests and enabled the calculation of an estimate for a third blood test for which previously the data had been insufficient to do so. We did not identify a clear pattern for the directional impact of additional data on estimates of diagnostic accuracy. Conclusions We successfully contacted and received results from 42% of authors who provided data for 38% of included studies. Contacting authors of studies evaluating the diagnostic accuracy of serum biomarkers for hepatic fibrosis and cirrhosis in hepatitis C patients

  15. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... controlled by the pilot under normal operating conditions (such as where the primary engine power control is...: (1) Category A. Unless such failures are extremely remote, it must be shown by test that any...

  16. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... controlled by the pilot under normal operating conditions (such as where the primary engine power control is...: (1) Category A. Unless such failures are extremely remote, it must be shown by test that any...

  17. 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.

  18. 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…

  19. Modules and supporting hardware for FASTBUS test and diagnostic purposes

    SciTech Connect

    Bertolucci, B.

    1981-10-01

    This paper contains detailed descriptions and circuitry of some modules and supporting hardware for the FASTBUS System developed at SLAC. A fast slave-only Memory Module (PRIMO), a Dummy Module (U2), a FASTBUS Test Box (LAIKA), and a Bus Display Bar (BBD) have been built, tested and used for test and diagnostic purposes for FASTBUS.

  20. 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.

  1. Improved diagnostic testing and malaria treatment practices in Zambia

    PubMed Central

    Hamer, Davidson H; Ndhlovu, Micky; Zurovac, Dejan; Fox, Matthew; Yeboah-Antwi, Kojo; Chanda, Pascalina; Sipilinyambe, Naawa; Simon, Jonathon L; Snow, Robert W

    2009-01-01

    Context Improving the accuracy of malaria diagnosis using rapid diagnostic tests (RDT) has been proposed as an approach for reducing over-treatment of malaria in the current era of widespread implementation of artemisinin-based combination therapy in sub-Saharan Africa. Objective To assess the impact of microscopy and RDT use on prescription of antimalarials. Design, Setting, and Participants Cross-sectional, cluster sample survey of all sick outpatients seen at a health facility during one working day that included all public and mission health facilities in four sentinel districts in Zambia. Main Outcome Measures Proportions of patients undergoing malaria diagnostic procedures and receiving anti-malarial treatment. Results 17% of the 104 health facilities surveyed had functional microscopy, 63% had RDTs available, and 73% had at least one type of malaria diagnostics. 27.8% of subjects with fever (suspected malaria) seen in health facilities with malaria diagnostics were tested and 44.6% were positive. 58.4% of patients with negative blood smears were prescribed an antimalarial as were 35.5% of those with a negative RDT result. 65.9% of the subjects with fever who did not have diagnostic tests done were also prescribed antimalarials. In facilities with artemether-lumefantrine in stock, this antimalarial was prescribed to a larger proportion of febrile patients with a positive diagnostic test (blood smear 75.0%; RDT 70.4%) than those with a negative diagnostic test (blood smear 30.4%; RDT 26.7%). Conclusion Despite efforts to scale up the provision of malaria diagnostics in Zambia they continue to be under-utilized and patients with negative test results frequently receive antimalarials. The provision of new tools to reduce the inappropriate use of new expensive antimalarial treatments must be accompanied by a paradigm shift in clinical management of patients without evidence of malaria infection. PMID:17519412

  2. [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

  3. The DEX/CRH test for major depression: a potentially useful diagnostic test.

    PubMed

    Mokhtari, Mohammadreza; Arfken, Cynthia; Boutros, Nash

    2013-07-30

    The dexamethasone/corticotropin-releasing hormone (DEX/CRH) test has been proposed as a potential diagnostic test for major depressive disorder (MDD). A previously proposed four-step approach assesses the stage of development for a biological finding into a clinically useful diagnostic test. Using this approach, we evaluated the progress of the DEX/CRH test using meta-analysis as a part of step 1. A literature review identified 15 studies of the DEX/CRH test in patients with MDD and healthy controls. Meta-analysis estimated the effect size, heterogeneity, and confidence intervals using random effects models. Studies consistent with any step of the four-step approach were identified, and their characteristics were presented. Eleven studies reported significantly higher cortisol levels with the DEX/CRH test in patients with MDD, compared with the healthy controls (step 1). Eight eligible studies were included in meta-analysis, and had an effect size of 1.34 (95% confidence interval: 0.70-1.97). Most studies were step-1 studies (comparison of patients and healthy controls), and no step-4 studies (multicenter trials) were found. This review emphasizes that despite appearing as a promising test, the DEX/CRH has not been adequately studied for the required stages of development into a clinically useful laboratory test. Particularly, additional step-3 and step-4 studies are necessary.

  4. 76 FR 39110 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Certain Complex Diagnostic Laboratory Tests Demonstration AGENCY: Centers for Medicare & Medicaid Services... participate in the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The Demonstration... complex diagnostic laboratory test under the Demonstration. The statute requires a Report to Congress...

  5. Diagnostic Accuracy of BRAF Immunohistochemistry in Colorectal Cancer: a Meta-Analysis and Diagnostic Test Accuracy Review.

    PubMed

    Pyo, Jung-Soo; Sohn, Jin Hee; Kang, Guhyun

    2016-10-01

    The aim of this study was to evaluate the concordance between the BRAF (V600E) mutation test and immunohistochemistry (IHC) and to evaluate the diagnostic accuracy of BRAF IHC for colorectal cancer (CRC) through a systematic review, meta-analysis, and diagnostic test accuracy review. The current study included 1021 CRCs from eight eligible studies. The concordance rates were investigated between BRAF IHC and the mutation test. In addition, diagnostic test accuracy review was conducted and calculated using the value of area under curve (AUC) on the summary receiver operating characteristic (SROC) curve. The positive rate of BRAF IHC was 30.5 % (range; 13.2-66.2 %), and the BRAF mutation was found in 30.2 % (range; 11.7-66.2 %). The overall concordance rate between BRAF IHC and the mutation test was 0.944 (95 % confidence interval (CI) 0.873-0.977). In the BRAF IHC-positive and -negative groups, the concordance rates between BRAF IHC and the mutation test were 0.895 (95 % CI 0.800-0.945) and 0.956 (95 % CI 0.878-0.985), respectively. The pooled sensitivity and specificity were 0.94 (95 % CI 0.91-0.96) and 0.96 (95 % CI 0.95-0.98), respectively. The diagnostic odds ratio was 272.86 (95 % CI 46.11-1614.88), and the value of AUC on SROC curve was 0.9846. Taken together, our results suggest that BRAF IHC is strongly concordant with the BRAF mutation test and has high diagnostic accuracy in BRAF mutation analysis of CRCs. Further cumulative studies on detailed evaluation criteria are needed before application in daily practice.

  6. Alzheimer's disease dementia guidelines for diagnostic testing: a systematic review.

    PubMed

    Arevalo-Rodriguez, Ingrid; Pedraza, Olga L; Rodríguez, Andrea; Sánchez, Erick; Gich, Ignasi; Solà, Ivan; Bonfill, Xavier; Alonso-Coello, Pablo

    2013-03-01

    Alzheimer's disease dementia (AD dementia) is one of the most common neurodegenerative diseases worldwide, with a growing incidence during the last decades. Clinical diagnosis of cognitive impairment and presence of AD biomarkers have become important issues for early and adequate treatment. We performed a systematic literature search and quality appraisal of AD dementia guidelines, published between 2005 and 2011, which contained diagnostic recommendations on AD dementia. We also analyzed diagnostic recommendations related to the use of brief cognitive tests, neuropsychological evaluation, and AD biomarkers. Of the 537 retrieved references, 15 met the selection criteria. We found that Appraisal of Guidelines Research and Evaluation (AGREE)-II domains such as applicability and editorial independence had the lowest scores. The wide variability on assessment of quality of evidence and strength of recommendations were the main concerns identified regarding diagnostic testing. Although the appropriate methodology for clinical practice guideline development is well known, the quality of diagnostic AD dementia guidelines can be significantly improved. PMID:23288575

  7. Translating biological parameters into clinically useful diagnostic tests.

    PubMed

    Arfken, Cynthia L; Carney, Stuart; Boutros, Nash N

    2009-08-01

    Psychiatry has lagged behind other specialties in developing diagnostic laboratory tests for the purpose of confirming or ruling out a diagnosis. Biological research into the pathophysiology of psychiatric disorders has, however, yielded some highly replicable abnormalities that have the potential for development into clinically useful diagnostic tests. To achieve this goal, a process for systematic translation must be developed and implemented. Building on our previous work, we review a proposed process using four clearly defined steps. We conclude that biological parameters currently face challenges in their pathways to becoming diagnostic tests because of both the premature release and premature abandonment of tests. Attention to a systematic translation process aided by these principles may help to avoid these problems.

  8. 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

  9. 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.

  10. 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…

  11. 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…

  12. Additive manufacture (3d printing) of plasma diagnostic components and assemblies for fusion experiments

    NASA Astrophysics Data System (ADS)

    Sieck, Paul; Woodruff, Simon; Stuber, James; Romero-Talamas, Carlos; Rivera, William; You, Setthivoine; Card, Alexander

    2015-11-01

    Additive manufacturing (or 3D printing) is now becoming sufficiently accurate with a large range of materials for use in printing sensors needed universally in fusion energy research. Decreasing production cost and significantly lowering design time of energy subsystems would realize significant cost reduction for standard diagnostics commonly obtained through research grants. There is now a well-established set of plasma diagnostics, but these expensive since they are often highly complex and require customization, sometimes pace the project. Additive manufacturing (3D printing) is developing rapidly, including open source designs. Basic components can be printed for (in some cases) less than 1/100th costs of conventional manufacturing. We have examined the impact that AM can have on plasma diagnostic cost by taking 15 separate diagnostics through an engineering design using Conventional Manufacturing (CM) techniques to determine costs of components and labor costs associated with getting the diagnostic to work as intended. With that information in hand, we set about optimizing the design to exploit the benefits of AM. Work performed under DOE Contract DE-SC0011858.

  13. 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.

  14. 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.

  15. Advances in diagnostic testing for gastroesophageal reflux disease.

    PubMed

    Gawron, Andrew J; Hirano, Ikuo

    2010-08-14

    Gastroesophageal reflux disease (GERD) contributes substantially to morbidity and to costs in the United States health care system. The burden of this disease has resulted in attempts at improving diagnosis and characterizing patients. Numerous research and technical advances have enhanced our understanding of both the utility and limitations of a variety of diagnostic modalities. The purpose of this review is to highlight recent advances in GERD diagnostic testing and to discuss their implications for use in clinical practice. Topics addressed include esophageal pH monitoring, impedance testing, symptom association analyses, narrow-band imaging, and histopathology. PMID:20698036

  16. 21 CFR 660.54 - Potency tests, specificity tests, tests for heterospecific antibodies, and additional tests for...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... heterospecific antibodies, and additional tests for nonspecific properties. 660.54 Section 660.54 Food and Drugs..., specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties. The...) Specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties....

  17. 21 CFR 660.54 - Potency tests, specificity tests, tests for heterospecific antibodies, and additional tests for...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... heterospecific antibodies, and additional tests for nonspecific properties. 660.54 Section 660.54 Food and Drugs..., specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties. The...) Specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties....

  18. 21 CFR 660.54 - Potency tests, specificity tests, tests for heterospecific antibodies, and additional tests for...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... heterospecific antibodies, and additional tests for nonspecific properties. 660.54 Section 660.54 Food and Drugs..., specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties. The...) Specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties....

  19. 21 CFR 660.54 - Potency tests, specificity tests, tests for heterospecific antibodies, and additional tests for...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... heterospecific antibodies, and additional tests for nonspecific properties. 660.54 Section 660.54 Food and Drugs..., specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties. The...) Specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties....

  20. 21 CFR 660.54 - Potency tests, specificity tests, tests for heterospecific antibodies, and additional tests for...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... heterospecific antibodies, and additional tests for nonspecific properties. 660.54 Section 660.54 Food and Drugs..., specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties. The...) Specificity tests, tests for heterospecific antibodies, and additional tests for nonspecific properties....

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

    PubMed

    Korevaar, Daniël A; Bossuyt, Patrick 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

  2. Unexplained syncope: diagnostic value of tilt-table testing.

    PubMed

    Futterman, L G; Lemberg, L

    1994-07-01

    Vasovagal syncope is a common syncope in patients who have no structural heart disease and occurs more often in young adults. It typically occurs in the erect posture, either standing or sitting. Upon recognition of the prodrome associated with NCS, subjects may avert syncope by lying down or putting the head between the knees. Use of head-up tilting is a recognized diagnostic tool and widely used for the evaluation of vasovagal syncope. However, cardiac diagnostic tests are not 100% accurate. This fact was recently underscored by what occurred in the recent tragic loss, due to ventricular fibrillation, of basketball star Reggie Lewis of the Boston Celtics. It is alleged that the tilt-table test was positive but that he also had structural heart disease. The most important diagnostic tool is the physician's clinical judgment.

  3. 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

  4. 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…

  5. 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.

  6. 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.

  7. Diagnostics of the ITER neutral beam test facility.

    PubMed

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

    2012-02-01

    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(-)∕D(-) 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.

  8. Verification and validation of diagnostic laboratory tests in clinical virology.

    PubMed

    Rabenau, Holger F; Kessler, Harald H; Kortenbusch, Marhild; Steinhorst, Andreas; Raggam, Reinhard B; Berger, Annemarie

    2007-10-01

    This review summarizes major issues of verification and validation procedures and describes minimum requirements for verification and validation of diagnostic assays in clinical virology including instructions for CE/IVD-labeled as well as for self-developed ("home-brewed") tests or test systems. It covers techniques useful for detection of virus specific antibodies, for detection of viral antigens, for detection of viral nucleic acids, and for isolation of viruses on cell cultures in the routine virology laboratory.

  9. 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.

  10. 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…

  11. Saliva and dental caries: diagnostic tests for normal dental practice.

    PubMed

    Larmas, M

    1992-08-01

    Salivary diagnostics is now entering the surgery of the modern dentist, although no test yet available is so specific and sensitive that caries can be diagnosed from saliva samples only. The present tests are useful for estimating the caries activity due to bad dietary habits (salivary lactobacilli), establishing the presence of infection (salivary mutans streptococci), and identification of salivary yeasts for the determination of the medical condition of the patient. Buffer capacity reveals the most important host response factor acting against caries, while measures of flow rate form the diagnostic basis for treatment planning. These tests, alone or in combination, are now so easy to perform that they should be used in every dental practice.

  12. 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

  13. Diagnostic Testing and Interpretation of Tests for Autoimmunity

    PubMed Central

    Castro, Christine; Gourley, Mark

    2010-01-01

    Laboratory testing is of great value when evaluating a patient with a suspected autoimmune disease. The results can confirm a diagnosis, estimate disease severity, aid in assessing prognosis and are useful to follow disease activity. Components of the laboratory exam include complete blood count with differential, comprehensive metabolic panel, inflammatory markers, autoantibodies, and flow cytometry. This chapter discusses these components and includes a discussion about organ-specific immunologic diseases where immunological laboratory testing is employed. Comprehensive laboratory evaluation of a suspected autoimmune illness in conjunction with a thorough clinical evaluation provides a better understanding of a patient's immunologic disease. PMID:20061009

  14. 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

  15. 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.

  16. The ethics of testing a test: randomized trials of the health impact of diagnostic tests for infectious diseases.

    PubMed

    Dowdy, David W; Gounder, Celine R; Corbett, Elizabeth L; Ngwira, Lucky G; Chaisson, Richard E; Merritt, Maria W

    2012-12-01

    In the last decade, many new rapid diagnostic tests for infectious diseases have been developed. In general, these new tests are developed with the intent to optimize feasibility and population health, not accuracy alone. However, unlike drugs or vaccines, diagnostic tests are evaluated and licensed on the basis of accuracy, not health impact (eg, reduced morbidity or mortality). Thus, these tests are sometimes recommended or scaled up for purposes of improving population health without randomized evidence that they do so. We highlight the importance of randomized trials to evaluate the health impact of novel diagnostics and note that such trials raise distinctive ethical challenges of equipoise, equity, and informed consent. We discuss the distinction between equipoise for patient-important outcomes versus diagnostic accuracy, the equity implications of evaluating health impact of diagnostics under routine conditions, and the importance of offering reasonable choices for informed consent in diagnostic trials.

  17. 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

  18. Advancing the development of diagnostic tests and biomarkers for tuberculosis.

    PubMed

    Yasinskaya, Y; Plikaytis, B; Sizemore, C; Sacks, L

    2011-07-01

    High costs and limited returns on investment have hampered progress in developing new diagnostic tests and treatments for tuberculosis (TB). We need new biomarkers to develop assays that can rapidly, efficiently and reliably detect Mycobacterium tuberculosis infection and disease, identify drug resistance and expedite drug and vaccine development. This can only be accomplished through cross-disciplinary collaborations to facilitate access to human specimens. The Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, the industry and academia experts came together in a June 2010 workshop to examine the field of TB diagnostic test development and biomarker discovery, identify areas of most urgent need and formulate strategies to address those needs.

  19. 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.

  20. 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

  1. 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

  2. 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…

  3. Grading Evidence for Laboratory Test Studies Beyond Diagnostic Accuracy: Application to Prognostic Testing

    PubMed Central

    Santaguida, Pasqualina L.

    2015-01-01

    Background Evidence-based guideline development requires transparent methodology for gathering, synthesizing and grading the quality and strength of evidence behind recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) project has addressed diagnostic test use in many of their publications. Most of the work has been directed at diagnostic tests and no consensus has been reached for prognostic biomarkers. Aim of this paper The GRADE system for rating the quality of evidence and the strength of a recommendation is described. The application of GRADE to diagnostic testing is discussed and a description of application to prognostic testing is detailed. Some strengths and limitations of the GRADE process in relation to clinical laboratory testing are presented. Conclusions The GRADE system is applicable to clinical laboratory testing and if correctly applied should improve the reporting of recommendations for clinical laboratory tests by standardising the style of recommendation and by encouraging transparent reporting of the actual guideline process.

  4. 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.

  5. Aptitude and Reading Tests for Consideration in Designing a Screening and Diagnostic Test Battery.

    ERIC Educational Resources Information Center

    Pierson, Dorothy A.

    Aptitude and reading tests to be administered to technical college students are discussed in considering the design of a screening and diagnostic test battery. Diagnosis is condidered as a series of sequential steps: screening; testing; individualized program planning; program implementation; and investigation of the causes of reading difficulty.…

  6. Test Procedure - pumping system for caustic addition project

    SciTech Connect

    Leshikar, G.A.

    1994-10-01

    This test procedure provides the requirements for sub-system testing and integrated operational testing of the submersible mixer pump and caustic addition equipment by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E).

  7. How to Use the DX SYSTEM of Diagnostic Testing. Methodology Project.

    ERIC Educational Resources Information Center

    McArthur, David; Cabello, Beverly

    The DX SYSTEM of Diagnostic Testing is an easy-to-use computerized system for developing and administering diagnostic tests. A diagnostic test measures a student's mastery of a specific domain (skill or content area). It examines the necessary subskills hierarchically from the most to the least complex. The DX SYSTEM features tailored testing with…

  8. 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

  9. DiagTest3Grp: An R Package for Analyzing Diagnostic Tests with Three Ordinal Groups

    PubMed Central

    Luo, Jingqin; Xiong, Chengjie

    2012-01-01

    Medical researchers endeavor to identify potentially useful biomarkers to develop marker-based screening assays for disease diagnosis and prevention. Useful summary measures which properly evaluate the discriminative ability of diagnostic markers are critical for this purpose. Literature and existing software, for example, R packages nicely cover summary measures for diagnostic markers used for the binary case (e.g., healthy vs. diseased). An intermediate population at an early disease stage usually exists between the healthy and the fully diseased population in many disease processes. Supporting utilities for three-group diagnostic tests are highly desired and important for identifying patients at the early disease stage for timely treatments. However, application packages which provide summary measures for three ordinal groups are currently lacking. This paper focuses on two summary measures of diagnostic accuracy—volume under the receiver operating characteristic surface and the extended Youden index, with three diagnostic groups. We provide the R package DiagTest3Grp to estimate, under both parametric and nonparametric assumptions, the two summary measures and the associated variances, as well as the optimal cut-points for disease diagnosis. An omnibus test for multiple markers and a Wald test for two markers, on independent or paired samples, are incorporated to compare diagnostic accuracy across biomarkers. Sample size calculation under the normality assumption can be performed in the R package to design future diagnostic studies. A real world application evaluating the diagnostic accuracy of neuropsychological markers for Alzheimer’s disease is used to guide readers through step-by-step implementation of DiagTest3Grp to demonstrate its utility. PMID:23504300

  10. 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

  11. 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

  12. Reporting standards for studies of diagnostic test accuracy in dementia

    PubMed Central

    Noel-Storr, Anna H.; McCleery, Jenny M.; Richard, Edo; Ritchie, Craig W.; Flicker, Leon; Cullum, Sarah J.; Davis, Daniel; Quinn, Terence J.; Hyde, Chris; Rutjes, Anne W.S.; Smailagic, Nadja; Marcus, Sue; Black, Sandra; Blennow, Kaj; Brayne, Carol; Fiorivanti, Mario; Johnson, Julene K.; Köpke, Sascha; Schneider, Lon S.; Simmons, Andrew; Mattsson, Niklas; Zetterberg, Henrik; Bossuyt, Patrick M.M.; Wilcock, Gordon

    2014-01-01

    Objective: To provide guidance on standards for reporting studies of diagnostic test accuracy for dementia disorders. Methods: An international consensus process on reporting standards in dementia and cognitive impairment (STARDdem) was established, focusing on studies presenting data from which sensitivity and specificity were reported or could be derived. A working group led the initiative through 4 rounds of consensus work, using a modified Delphi process and culminating in a face-to-face consensus meeting in October 2012. The aim of this process was to agree on how best to supplement the generic standards of the STARD statement to enhance their utility and encourage their use in dementia research. Results: More than 200 comments were received during the wider consultation rounds. The areas at most risk of inadequate reporting were identified and a set of dementia-specific recommendations to supplement the STARD guidance were developed, including better reporting of patient selection, the reference standard used, avoidance of circularity, and reporting of test-retest reliability. Conclusion: STARDdem is an implementation of the STARD statement in which the original checklist is elaborated and supplemented with guidance pertinent to studies of cognitive disorders. Its adoption is expected to increase transparency, enable more effective evaluation of diagnostic tests in Alzheimer disease and dementia, contribute to greater adherence to methodologic standards, and advance the development of Alzheimer biomarkers. PMID:24944261

  13. Ethical issues in the diagnostic genetic testing process.

    PubMed

    Nyrhinen, Tarja; Leino-Kilpi, Helena; Hietala, Marja

    2004-04-01

    The diagnostic genetic testing process has certain unique ethical features and deserves special consideration. The purpose of this study was to determine through empirical research, using focussed interview, what ethical issues are involved in the diagnostic genetic testing process. This article describes views and perceptions of adult patients, parents of child patients and various personnel groups (n=30). The ethical issues were analysed classified into three main categories: a) personnel characteristics, including personality, professional skills, morals and values; b) realization of ethical principles in the examination process, with subcategories of knowledge, autonomy, data protection and equity; and c) consequences of genetic testing, including patients' control over their own lives, manifestation of heterogeneity and outlook on the world. Problematic ethical issues in all three main categories were described in a more many-sided way by parents and personnel than by adult patients. In the future, attention should be paid to the content areas highlighted by the study, in both clinical practice and further studies.

  14. 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

  15. Multidrug-resistant tuberculosis drug susceptibility and molecular diagnostic testing.

    PubMed

    Kalokhe, Ameeta S; Shafiq, Majid; Lee, James C; Ray, Susan M; Wang, Yun F; Metchock, Beverly; Anderson, Albert M; Nguyen, Minh Ly T

    2013-02-01

    Multidrug-resistant tuberculosis (MDR TB), defined by resistance to the 2 most effective first-line drugs, isoniazid and rifampin, is on the rise globally and is associated with significant morbidity and mortality. Despite the increasing availability of novel rapid diagnostic tools for Mycobacterium tuberculosis (Mtb) drug susceptibility testing, the clinical applicability of these methods is unsettled. In this study, the mechanisms of action and resistance of Mtb to isoniazid and rifampin, and the utility, advantages and limitations of the available Mtb drug susceptibility testing tools are reviewed, with particular emphasis on molecular methods with rapid turnaround including line probe assays, molecular beacon-based real-time polymerase chain reaction and pyrosequencing. The authors conclude that neither rapid molecular drug testing nor phenotypic methods are perfect in predicting Mtb drug susceptibility and therefore must be interpreted within the clinical context of each patient.

  16. 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.

  17. ECG in stress testing: child of a lesser diagnostic god?

    PubMed

    Longo, S; Del Negro, B; Picano, E

    1997-01-01

    When new technologies are added to the previously existing ones, the latter can be prematurely discarded and judged obsolete not only on the basis of rational scientific facts, but also on irrational trends. Old techniques, like electrocardiography, suffer from diagnostic ambiguities that can be solved by combination with a cardiac imaging technique, like stress echocardiography. ECG monitoring during all forms of stress testing can still offer surprising dividends for a better understanding of the complex physiology of coronary artery disease, a better clinical characterization of patients with microvascular angina, and may serve as an important adjunct marker to cardiac imaging techniques. PMID:9350596

  18. 30. GENERAL TEST ROOM IN 1946 ADDITION, FOURTH FLOOR, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. GENERAL TEST ROOM IN 1946 ADDITION, FOURTH FLOOR, LOOKING WEST. ORIGINALLY HAD SUSPENDED ACOUSTICAL CEILINGS WITH FLOURESCENT LIGHTING AND ASPHALT MASTIC TILE FLOORS - Underwriters' Laboratories, 207-231 East Ohio Street, Chicago, Cook County, IL

  19. 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…

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. The bone diagnostic instrument III: testing mouse femora.

    PubMed

    Randall, Connor; Mathews, Phillip; Yurtsev, Eugene; Sahar, Nadder; Kohn, David; Hansma, Paul

    2009-06-01

    Here we describe modifications that allow the bone diagnostic instrument (BDI) [P. Hansma et al., Rev. Sci. Instrum. 79, 064303 (2008); Rev. Sci. Instrum. 77, 075105 (2006)], developed to test human bone, to test the femora of mice. These modifications include reducing the effective weight of the instrument on the bone, designing and fabricating new probe assemblies to minimize damage to the small bone, developing new testing protocols that involve smaller testing forces, and fabricating a jig for securing the smaller bones for testing. With these modifications, the BDI was used to test the hypothesis that short-term running has greater benefit on the mechanical properties of the femur for young growing mice compared to older, skeletally mature mice. We measured elastic modulus, hardness, and indentation distance increase (IDI), which had previously been shown to be the best discriminators in model systems known to exhibit differences in mechanical properties at the whole bone level. In the young exercised murine femora, the IDI was significantly lower than in young control femora. Since IDI has a relation to postyield properties, these results suggest that exercise during bone development increases post yield mechanical competence. We were also able to measure effects of aging on bone properties with the BDI. There was a significant increase in the IDI, and a significant decrease in the elastic modulus and hardness between the young and old groups. Thus, with the modifications described here, the BDI can take measurements on mouse bones and obtain statistically significant results.

  8. Test of a new tip material for Langmuir probe diagnostic

    NASA Astrophysics Data System (ADS)

    Naz, M. Y.; Shukrullah, S.; Ghaffar, A.; Rehman, N. U.; Khan, Y.

    2016-03-01

    The objective of the work is to test a nickel-chrome alloy as a probe tip material for characterization of discharge plasmas. In order to meet the objective, a symmetric triple Langmuir probe diagnostic system and an associated driving circuit are designed and tested in an inductively coupled plasma generated by a 13.56-MHz radio frequency source coupled with an automated impedance match network. This probe is used to measure the electron temperature, electron number density, and ion saturation current as functions of the input power of the radio frequency source and the filling gas pressure. An increasing trend is noticed in the electron temperature and electron number density with an increase in the input power, whilst a decreasing trend is evident in these parameters with an increase in the nitrogen gas pressure. The overall inaccuracies in electron temperature and electron number density measurements are 5-12% and 3-13%, respectively.

  9. 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.

  10. 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

  11. 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.

  12. Clinical Utility of Prostate Carcinoma Molecular Diagnostic Tests

    PubMed Central

    Shappell, Scott B

    2008-01-01

    Instead of relying on serum prostate-specific antigen (PSA) to identify patients for prostate biopsy, new laboratory tests are needed that have improved specificity for prostate carcinoma (CaP), allow accurate classification of clinically insignificant CaPs, allow for detection of clinically significant CaP in patients without elevated serum PSA, and allow for identification of aggressive forms of CaP, which may warrant adjunctive or even molecularly targeted therapy in the future. Over the last several years, high-throughput gene expression profiling and proteinomics have led to the identification of genes and proteins that are specifically overexpressed in CaP. Molecular diagnostic techniques readily translated to the clinical laboratory have been incorporated into the development of new tests based on these novel molecular alterations in CaP. Some of these tests already have well-documented clinical utility, such as in facilitating prostate biopsy decisions, and are routinely available. The current review focuses on the biological, clinical, and laboratory aspects of the most promising of these current and near-future molecular CaP tests. PMID:18470278

  13. A Novel Automatic Rapid Diagnostic Test Reader Platform.

    PubMed

    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. 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

  15. 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.

  16. [An additional test in the identification of Enterobacteriaceae and some representatives of the genus Vibrio].

    PubMed

    Bril'man, Ia E

    1995-01-01

    An additional test: aerobic redox fermentation in semiliquid Hiss' medium with mannitol is recommended for the indication of Enterobacteriaceae, Vibrio, etc. The majority of mannite-fermenting enterobacteria change the color of the indicator in a thin upper layer of a column of semiliquid Hiss' medium in comparison with the bulk of medium after 20-24 h growth in it. Such changes of the indicator are never observed with Shigella, Salmonella, Vibrio bacteria of the studied strains, Yersinia, some cocci, etc., which may be considered as an additional differential diagnostic test at early stages of investigation with due consideration for other known signs. The aerobic redox test does not require additional quantities of nutrient media, reagents, or glassware.

  17. 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.

  18. Anti-phosphatidylserine/prothrombin antibodies: an additional diagnostic marker for APS?

    PubMed

    Pregnolato, Francesca; Chighizola, Cecilia B; Encabo, Susan; Shums, Zakera; Norman, Gary L; Tripodi, Armando; Chantarangkul, Veena; Bertero, Tiziana; De Micheli, Valeria; Borghi, Maria Orietta; Meroni, Pier Luigi

    2013-07-01

    Among the diagnostic assays for anti-phospholipid syndrome (APS), lupus anticoagulant (LA) is the strongest predictor of thrombosis; however, it presents several limitations as interference with anticoagulant therapy and poor inter-laboratory agreement. Two-thirds of LA activity is apparently due to antibodies against prothrombin (PT), usually detectable by ELISA. Binding of PT to phosphatidylserine (PS) has been shown to enhance solid-phase anti-PT assay sensitivity. To determine the prevalence of antibodies against PS/PT (aPS/PT) in APS, we tested the semiquantitative QUANTA Lite(®) aPS/PT ELISA in a cohort of 80 APS patients. The prevalence of aPS/PT was 81.3%, rising to 87.6% when considering LA-positive subjects only. We observed a strong correlation between aPS/PT and LA (p = 0.006). To note, APS patients with thrombotic manifestations displayed significantly higher IgG aPS/PT titers compared to 20 aPL asymptomatic carriers (p = 0.012). To rule out a possible cross-reactivity of anti-β2 glycoprotein I antibodies (aβ2GPI) with PS/PT complex, we tested two monoclonal aβ2GPI antibodies and an affinity-purified (AP) polyclonal aβ2GPI IgG obtained from the serum of a patient reacting against both β2GPI and PS/PT. The two monoclonal antibodies did not show any reactivity against PS/PT complex, similarly the AP IgGs did not react toward PS/PT antigen while preserved their aβ2GPI activity. Our findings suggest that aPS/PT are a definite antibody population in APS. Moreover, the good correlation between aPS/PT ELISA and LA may support its use as a surrogate test for LA, particularly useful to overcome the technical limitations of the functional assay.

  19. 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…

  20. 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.

  1. Simple Additivity of Stochastic Psychological Processes: Tests and Measures.

    ERIC Educational Resources Information Center

    Balakrishnan, J. D.

    1994-01-01

    Methods of testing relatively complete (distributional) models of internal psychological processes are described. It is shown that there is a sufficient condition for additive models to imply this property of the likelihood ratio. Also discussed are the examination of hazard rate functions of component processes and change in cumulative…

  2. Basophil activation test with food additives in chronic urticaria patients.

    PubMed

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the tested food additives. One patient responded to monosodium glutamate, showing 18.7% of CD203c-positive basophils. Another patient showed a positive BAT result to sodium benzoate. Both patients had clinical correlations with the agents, which were partly determined by elimination diets. The present study suggested that at least a small proportion of patients with CU had symptoms associated with food additives. The results may suggest the potential utility of the BAT to identity the role of food additives in CU.

  3. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    PubMed Central

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the tested food additives. One patient responded to monosodium glutamate, showing 18.7% of CD203c-positive basophils. Another patient showed a positive BAT result to sodium benzoate. Both patients had clinical correlations with the agents, which were partly determined by elimination diets. The present study suggested that at least a small proportion of patients with CU had symptoms associated with food additives. The results may suggest the potential utility of the BAT to identity the role of food additives in CU. PMID:24527415

  4. Center for Disease Control Diagnostic Immunology Proficiency Testing Program results for 1978.

    PubMed Central

    Taylor, R N; Fulford, K M; Przybyszewski, V A; Pope, V

    1979-01-01

    Data from about 1,000 laboratories participating in the Diagnostic Immunology portion of the 1978 Center for Disease Control Proficiency Testing Program provided information dealing with laboratory performance and trends in testing protocols. Ninety specimens were distributed in scheduled quarterly and semiannual shipments, and five additional specimens were provided in a special survey. The specimens offered both qualitative and quantitative challenges for a wide variety of analytes which included syphilis serology, rheumatoid factor, bacterial agglutinins, hepatitis B surface antigen, immunoglobulins and other serum proteins, infectious mononucleosis, rubella, toxoplasma, antinuclear antibodies, and streptococcal exoenzymes. This paper summarizes the results of the 1978 program. PMID:230201

  5. Diagnostic errors and abnormal diagnostic tests lost to follow-up: a source of needless waste and delay to treatment.

    PubMed

    Wahls, Terry

    2007-01-01

    Diagnostic errors are an important and often underappreciated source of medical error, needless delays to treatment, and needlessly wasted resources. Almost 65% of diagnostic errors have an important contribution of system errors, of which many are an abnormal test result that was lost to follow-up, that is, missed results. These system problems that contribute to missed results may represent low-hanging fruit for those who wish to reduce diagnostic errors in their institution. The rate of missed results and associated treatment delay are discussed. The system factors and human factors that contribute to these errors are discussed along with strategies that can be adopted to reduce these errors. PMID:17873665

  6. 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.

  7. 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

  8. Filtering Medline for a clinical discipline: diagnostic test assessment framework

    PubMed Central

    Iansavichus, Arthur V; Wilczynski, Nancy L; Kastner, Monika; Baier, Leslie A; Shariff, Salimah Z; Rehman, Faisal; Weir, Matthew; McKibbon, K Ann; Haynes, R Brian

    2009-01-01

    Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database. Design Diagnostic test assessment framework with development and validation phases. Setting Sample of 4657 articles published in 2006 from 40 journals. Reviews Each article was manually reviewed, and 19.8% contained information relevant to the discipline of nephrology. The performance of 1 155 087 unique renal filters was compared with the manual review. Main outcome measures Sensitivity, specificity, precision, and accuracy of each filter. Results The best renal filters combined two to 14 terms or phrases and included the terms “kidney” with multiple endings (that is, truncation), “renal replacement therapy”, “renal dialysis”, “kidney function tests”, “renal”, “nephr” truncated, “glomerul” truncated, and “proteinuria”. These filters achieved peak sensitivities of 97.8% and specificities of 98.5%. Performance of filters remained excellent in the validation phase. Conclusions Medline can be filtered for the discipline of nephrology in a reliable manner. Storing these high performance renal filters in PubMed could help clinicians with their everyday searching. Filters can also be developed for other clinical disciplines by using similar methods. PMID:19767336

  9. Toward a Diagnostic Test for Hidden Hearing Loss

    PubMed Central

    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

  10. 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…

  11. 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.

  12. Pre-course Results from the Astronomy Diagnostic Test

    NASA Astrophysics Data System (ADS)

    Hufnagel, Beth; Slater, Timothy; Deming, Grace; Adams, Jeff; Adrian, Rebecca L.; Brick, Christine; Zeilik, Michael

    2000-08-01

    We present selected results from the January 1999 semester pre-course administration of the Astronomy Diagnostic Test (ADT), a research-based, multiple-choice instrument that assesses student knowledge and understanding about selected concepts in astronomy. The ADT is valid for undergraduate non-science majors taking an introductory astronomy course. This paper briefly summarises the development and validation processes, which included pre-course administration to 1557 students in 22 classes attending 17 various post-secondary institutions across the USA in the January 1999 semester. Two interesting results of the ADT's pre-course administration are (1) the average class score of the ADT is about the same (32%) regardless of type of post-secondary institution or class size and (2) there is a significant gender difference, with women scoring an average of 28% and men 38%, with the standard errors both less than 1%. The current version of the ADT (Version 2 dated 21 June 1999) and a comparative by-class database is available to astronomy instructors at the (USA) Association of Astronomy Educators' and the National Institute for Science Education's (NISE) WebPages.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. A Comparison Between Two Methods for Display of Programmed Diagnostic Tests.

    ERIC Educational Resources Information Center

    Graham, Peter

    Two methods for presentation of programed diagnostic tests were compared. One method used a five-screen, tape and slide format and the other used television in the form of videotape recording. The electronics course used for the study employed 10 diagnostic tests, five for each method. Evaluation was made on the basis of test scores and attitude…

  18. Assessing Diagnostic Tests I: You Can't Be Too Sensitive.

    PubMed

    Jupiter, Daniel C

    2015-01-01

    Clinicians and patients are always interested in less invasive, cheaper, and faster diagnostic tests. When introducing such a test, physicians must ensure that it is reliable in its diagnoses and does not commit errors. In this article, I discuss several ways that new tests are compared against gold standard diagnostics.

  19. Feasibility of an early Alzheimer's disease immunosignature diagnostic test.

    PubMed

    Restrepo, Lucas; Stafford, Phillip; Johnston, Stephen Albert

    2013-01-15

    A practical diagnostic test is needed for early Alzheimer's disease (AD) detection. Immunosignaturing, a technology that employs antibody binding to a random-sequence peptide microarray, generates profiles that distinguish transgenic mice engineered with familial AD mutations (APPswe/PSEN1-dE9) from non-transgenic littermates. It can also detect an AD-like signature in humans. Here, we assess the changes in the immunosignature at different time points of the disease in mice and humans. We also evaluate the accuracy of the late-stage signature as a test to discriminate between young mice with familial AD mutations from non-transgenic littermates. Plasma samples from AD patients were assayed 3-12 months apart, while APPswe/PSEN1-dE9 and non-transgenic controls supplied plasma at monthly intervals until they reached 15 months of age. Microarrays with 10,000 random-sequence peptides were used to compare antibody binding patterns. These patterns gradually changed over the life-span of mice. Strong, characteristic signatures were observed in transgenic mice at early, mid and late stages, but these profiles had minimal overlap. The signature of young transgenic mice had an error rate of 18% at classifying plasma samples from late-stage transgenic mice. Conversely, the late-stage transgenic mice signature discriminated between young transgenic mice and littermates with an error rate of 21%. Less distinctive profiles were recognizable throughout the transgenic mice lifespan, being detectable as early as 2 months. The human signature had minimal change on short-term follow-up. Our results call for a reappraisal of the way incipient AD is studied, as biomarkers seen in late-stages of the disease may not be relevant in earlier stages.

  20. 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

  1. Indiana Reading Diagnostic Assessment: Resource & Intervention Guide, Kindergarten. Additional Activities and Assessments

    ERIC Educational Resources Information Center

    Indiana Department of Education, 2006

    2006-01-01

    The materials included in this manual are organized according to the Indiana's Kindergarten Academic Standards for English/Language Arts. In each section teachers will find: (1) Indiana's Kindergarten Academic Standards for English/Language Arts Assessments: Black Line Masters of diagnostic/practice pages for skill areas, checklists, and rubrics;…

  2. Diagnostic testing for Clostridium difficile in Italian microbiological laboratories.

    PubMed

    Spigaglia, Patrizia; Barbanti, Fabrizio; Morandi, Matteo; Moro, Maria Luisa; Mastrantonio, Paola

    2016-02-01

    A laboratory diagnosis survey of Clostridium difficile infection (CDI) was performed in Italy in 2012-2013. Questionnaires from 278 healthcare settings from 15 regions of Italy were collected and analysed. Eighty seven percent of the laboratories declared to routinely perform CDI diagnosis, 99% of them only after the clinician's request. Among the 216 laboratories providing information on the size of the hospitals in which they were located, 65 had more than 500 beds (large hospitals), while 151 had less than 500 beds (small hospitals). The average percentage of positive tests for C. difficile toxins was 12.2%. Almost half of the laboratories (42%) used immunoenzymatic assay (EIA) for Tox A/B as a stand-alone method, while only 34% used an algorithm for CDI as indicated by the European guidelines. A low percentage of laboratories performed molecular assays or C. difficile culture, 25% and 29%, respectively. Most laboratories (161/278) declared to type C. difficile strains, the majority in collaboration with a reference laboratory. Among the 103 C. difficile clinical isolates collected during the study, 31 different PCR-ribotypes were identified. PCR-ribotype 356/607 (27%) was predominant, followed by 018 (12%). These two PCR-ribotypes show 87.5% of similarity in ribotyping profile. PCR-ribotypes 027 and 078 represented 8% and 4% of the strains, respectively. Four PCR-ribotypes (027, 033, 078 and 126) were positive for the binary toxin CDT. In particular, PCR-ribotype 033 produces only CDT, and it has recently been associated with symptomatic cases. The majority of strains were multidrug resistant. In particular, all strains PCR-ribotypes 356/607 and 018 were resistant to moxifloxacin, rifampicin, erythromycin and clindamycin. The results obtained highlight the need to raise awareness to the microbiological diagnosis of CDI among clinicians and to implement and harmonize diagnostic methods for CDI in Italian laboratories in the perspective of a future national

  3. Development of additional tasks for the executive function performance test.

    PubMed

    Hahn, Bridget; Baum, Carolyn; Moore, Jennifer; Ehrlich-Jones, Linda; Spoeri, Susan; Doherty, Meghan; Wolf, Timothy J

    2014-01-01

    OBJECTIVE. The Executive Function Performance Test (EFPT) is a reliable and valid performance-based assessment of executive function for people with stroke. The objective of this study was to enhance the clinical utility of the EFPT by developing and testing additional tasks for the EFPT in the Alternate EFPT (aEFPT). METHOD. We performed a cross-sectional study with poststroke participants (n = 25) and healthy control participants (n = 25). All participants completed a neuropsychological assessment battery and both the EFPT and the aEFPT. RESULTS. No statistically significant differences were found between the EFPT and the aEFPT when examining total scores, construct scores, and two overall task scores. Correlations between the aEFPT and the neuropsychological measures were adequate to strong (r2s = .59-.83). CONCLUSION. The aEFPT tasks are comparable to the original EFPT tasks, providing occupational therapy practitioners with additional tasks that can be used clinically to identify performance-based executive function deficits in people with stroke. PMID:25397771

  4. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Pilot-Scale Test Results

    SciTech Connect

    Gary M. Blythe

    2006-03-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, ''Field Testing of a Wet FGD Additive.'' The objective of the project is to demonstrate the use of a flue gas desulfurization (FGD) additive, Degussa Corporation's TMT-15, to prevent the reemissions of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate that the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine TMT salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project will conduct pilot and full-scale tests of the TMT-15 additive in wet FGD absorbers. The tests are intended to determine required additive dosage requirements to prevent Hg{sup 0} reemissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Power River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, TXU Generation Company LP, Southern Company, and Degussa Corporation. TXU Generation has provided the Texas lignite/PRB co-fired test site for pilot FGD tests, Monticello Steam Electric Station Unit 3. Southern Company is providing the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot and full-scale jet bubbling reactor (JBR) FGD systems to be tested. A third utility, to be named later, will provide the high-sulfur Eastern bituminous coal full-scale FGD test site. Degussa Corporation is providing the TMT-15 additive and technical support to the test program. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves management and reporting. The other four tasks involve field testing on FGD systems, either at pilot or full scale. The four tasks include: Task 2 - Pilot Additive Testing in

  5. 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

  6. Diagnostic Testing Package DX v 2.0 Technical Specification. Methodology Project.

    ERIC Educational Resources Information Center

    McArthur, David

    This paper contains the technical specifications, schematic diagrams, and program printout for a computer software package for the development and administration of diagnostic tests. The second version of the Diagnostic Testing Package DX consists of a PASCAL-based set of modules located in two main programs: (1) EDITTEST creates, modifies, and…

  7. 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

  8. 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

  9. 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

  10. [Critical reading of articles about diagnostic tests (part II): Analyzing results].

    PubMed

    Moratalla Rodríguez, G

    2015-01-01

    A new diagnostic test needs to be validated through comparison with a reference standard in an appropriate spectrum of patients. Diagnostic tests are not perfectly accurate; on the contrary, there can be false-positive and false-negative findings. A good diagnostic test is that which provides an acceptable proportion of positive results when a determinate condition is present in patients and an acceptable proportion of negative results when it is absent. The best measure of the usefulness of a diagnostic test is the likelihood ratio, which informs us to what degree a particular result is more likely in a person in whom a condition is present than in a person in whom the condition is absent. The present article discusses the fundamental statistical concepts necessary to interpret the results section of an article about a diagnostic test; however, the approach is clearly oriented toward clinical practice, with emphasis on concepts rather than mathematics.

  11. 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…

  12. Additives

    NASA Technical Reports Server (NTRS)

    Smalheer, C. V.

    1973-01-01

    The chemistry of lubricant additives is discussed to show what the additives are chemically and what functions they perform in the lubrication of various kinds of equipment. Current theories regarding the mode of action of lubricant additives are presented. The additive groups discussed include the following: (1) detergents and dispersants, (2) corrosion inhibitors, (3) antioxidants, (4) viscosity index improvers, (5) pour point depressants, and (6) antifouling agents.

  13. The use of the rapid osmotic fragility test as an additional test to diagnose canine immune-mediated haemolytic anaemia

    PubMed Central

    2013-01-01

    practice. Although, the ROFT cannot replace other diagnostic tests, it may be a valuable additional tool to diagnose canine IMHA. PMID:24160183

  14. Testing for Additivity at Select Mixture Groups of Interest Based on Statistical Equivalence Testing Methods

    SciTech Connect

    Stork, LeAnna M.; Gennings, Chris; Carchman, Richard; Carter, Jr., Walter H.; Pounds, Joel G.; Mumtaz, Moiz

    2006-12-01

    Several assumptions, defined and undefined, are used in the toxicity assessment of chemical mixtures. In scientific practice mixture components in the low-dose region, particularly subthreshold doses, are often assumed to behave additively (i.e., zero interaction) based on heuristic arguments. This assumption has important implications in the practice of risk assessment, but has not been experimentally tested. We have developed methodology to test for additivity in the sense of Berenbaum (Advances in Cancer Research, 1981), based on the statistical equivalence testing literature where the null hypothesis of interaction is rejected for the alternative hypothesis of additivity when data support the claim. The implication of this approach is that conclusions of additivity are made with a false positive rate controlled by the experimenter. The claim of additivity is based on prespecified additivity margins, which are chosen using expert biological judgment such that small deviations from additivity, which are not considered to be biologically important, are not statistically significant. This approach is in contrast to the usual hypothesis-testing framework that assumes additivity in the null hypothesis and rejects when there is significant evidence of interaction. In this scenario, failure to reject may be due to lack of statistical power making the claim of additivity problematic. The proposed method is illustrated in a mixture of five organophosphorus pesticides that were experimentally evaluated alone and at relevant mixing ratios. Motor activity was assessed in adult male rats following acute exposure. Four low-dose mixture groups were evaluated. Evidence of additivity is found in three of the four low-dose mixture groups.The proposed method tests for additivity of the whole mixture and does not take into account subset interactions (e.g., synergistic, antagonistic) that may have occurred and cancelled each other out.

  15. Summary of TFTR (Tokamak Fusion Test Reactor) diagnostics, including JET (Joint European Torus) and JT-60

    SciTech Connect

    Hill, K.W.; Young, K.M.; Johnson, L.C.

    1990-05-01

    The diagnostic instrumentation on TFTR (Tokamak Fusion Test Reactor) and the specific properties of each diagnostic, i.e., number of channels, time resolution, wavelength range, etc., are summarized in tables, grouped according to the plasma parameter measured. For comparison, the equivalent diagnostic capabilities of JET (Joint European Torus) and the Japanese large tokamak, JT-60, as of late 1987 are also listed in the tables. Extensive references are given to publications on each instrument.

  16. 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

  17. 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.

  18. Antibodies to phosphatidylserine/prothrombin complex as an additional diagnostic marker of APS?

    PubMed

    Žigon, P; Čučnik, S; Ambrožič, A; Sodin Šemrl, S; Kveder, T; Božič, B

    2012-06-01

    Antiprothrombin antibodies can be measured by ELISA using either a prothrombin/phosphatidylserine complex (aPS/PT) or prothrombin alone (aPT) as antigen. We aimed to compare the clinical features of autoimmune patients with avidity of aPS/PT and determine the diagnostic efficiency of aPS/PT and aPT for assessing antiphospholipid syndrome (APS). aPS/PT were of low (n = 9), heterogeneous (n = 31) and high (n = 8) avidity out of 48 cases. None of the samples with low avidity were positive in aPT ELISA. Among patients with heterogeneous or high avidity aPS/PT, there was a significantly greater number of patients with APS as compared to patients with low avidity (38/39 vs. 7/9; p < 0.05). No SLE patients had high avidity antiprothrombin antibodies.

  19. 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.

  20. 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

  1. Additional Revised Push-Up Test Norms for College Students

    ERIC Educational Resources Information Center

    Mozumdar, Arupendra; Liguori, Gary; Baumgartner, Ted A.

    2010-01-01

    The push-up test is commonly used to assess arm and shoulder girdle strength and endurance. Baumgartner, Oh, Chung, and Hales (2002) developed a revised push-up test for college students with a standardized test protocol. The purpose of the present study was to develop percentile norms for the revised push-up test based on the push-up scores of…

  2. Using Meta-Analysis to Inform the Design of Subsequent Studies of Diagnostic Test Accuracy

    ERIC Educational Resources Information Center

    Hinchliffe, Sally R.; Crowther, Michael J.; Phillips, Robert S.; Sutton, Alex J.

    2013-01-01

    An individual diagnostic accuracy study rarely provides enough information to make conclusive recommendations about the accuracy of a diagnostic test; particularly when the study is small. Meta-analysis methods provide a way of combining information from multiple studies, reducing uncertainty in the result and hopefully providing substantial…

  3. 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.

  4. 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

  5. A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

    PubMed Central

    Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

    2014-01-01

    Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 77 FR 3748 - Request for Comments and Notice of Public Hearings on Genetic Diagnostic Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... in gathering information on the genetic diagnostic testing for purposes of preparing a report on the... testing. Public Hearings: The USPTO will hold two public hearings in support of the genetic testing study... ``Genetic Testing Study.'' Because written comments and testimony will be made available for...

  12. Detection of OXA-48-type carbapenemase-producing Enterobacteriaceae in diagnostic laboratories can be enhanced by addition of bicarbonates to cultivation media or reaction buffers.

    PubMed

    Studentova, Vendula; Papagiannitsis, Costas C; Izdebski, Radoslaw; Pfeifer, Yvonne; Chudackova, Eva; Bergerova, Tamara; Gniadkowski, Marek; Hrabak, Jaroslav

    2015-03-01

    Carbapenemase-mediated resistance to carbapenems in Enterobacteriaceae has become the main challenge in the treatment and prevention of infections recently. The partially unnoticed spread of OXA-48-type carbapenemase producers is usually assigned to low minimum inhibitory concentrations (MICs) of carbapenems that OXA-48-producing isolates often display. Therefore, there is an urgent need of specific and sensitive methods for isolation and detection of OXA-48 producers in clinical microbiology diagnostics. The influence of bicarbonates on carbapenem MICs against carbapenemase-producing Enterobacteriaceae was tested. We also checked whether the addition of bicarbonates to liquid media supplemented with meropenem may facilitate the selective enrichment of various carbapenemase producers in cultures. Furthermore, the sensitivity of carbapenemase confirmation by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) and spectrophotometric hydrolysis assays upon the addition of NH4HCO3 was examined. The addition of NaHCO3 significantly increased MICs of ertapenem and meropenem for OXA-48 producers. Furthermore, liquid media supplemented with NaHCO3 and meropenem were reliable for the selective enrichment of carbapenemase producers. The presence of NH4HCO3 in buffers used in the spectrophotometric and MALDI-TOF MS carbapenemase detection increased the sensitivity of that assay. Our results demonstrate that bicarbonates in media or reaction buffers can enhance the sensitivity of screening methods and diagnostic tests for carbapenemase producers.

  13. 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.

  14. 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

  15. Fecal microbiome analysis as a diagnostic test for diverticulitis.

    PubMed

    Daniels, L; Budding, A E; de Korte, N; Eck, A; Bogaards, J A; Stockmann, H B; Consten, E C; Savelkoul, P H; Boermeester, M A

    2014-11-01

    Disease-specific variations in intestinal microbiome composition have been found for a number of intestinal disorders, but little is known about diverticulitis. The purpose of this study was to compare the fecal microbiota of diverticulitis patients with control subjects from a general gastroenterological practice and to investigate the feasibility of predictive diagnostics based on complex microbiota data. Thirty-one patients with computed tomography (CT)-proven left-sided uncomplicated acute diverticulitis were included and compared with 25 control subjects evaluated for a range of gastrointestinal indications. A high-throughput polymerase chain reaction (PCR)-based profiling technique (IS-pro) was performed on DNA isolates from baseline fecal samples. Differences in bacterial phylum abundance and diversity (Shannon index) of the resulting profiles were assessed by conventional statistics. Dissimilarity in microbiome composition was analyzed with principal coordinate analysis (PCoA) based on cosine distance measures. To develop a prediction model for the diagnosis of diverticulitis, we used cross-validated partial least squares discriminant analysis (PLS-DA). Firmicutes/Bacteroidetes ratios and Proteobacteria load were comparable among patients and controls (p = 0.20). The Shannon index indicated a higher diversity in diverticulitis for Proteobacteria (p < 0.00002) and all phyla combined (p = 0.002). PCoA based on Proteobacteria profiles resulted in visually separate clusters of patients and controls. The diagnostic accuracy of the cross-validated PLS-DA regression model was 84 %. The most discriminative species derived largely from the family Enterobacteriaceae. Diverticulitis patients have a higher diversity of fecal microbiota than controls from a mixed population, with the phylum Proteobacteria defining the difference. The analysis of intestinal microbiota offers a novel way to diagnose diverticulitis.

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

    SciTech Connect

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

    2008-06-01

    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 consist of a fast optical pyrometer, a streak camera spectrometer, and a 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.

  17. The use of rapid diagnostic tests for transfusion infectious screening in Africa: a literature review.

    PubMed

    Pruett, Cristina R; Vermeulen, Marion; Zacharias, Pete; Ingram, Charlotte; Tayou Tagny, Claude; Bloch, Evan M

    2015-01-01

    Infectious risk associated with blood transfusion remains a major public health challenge in Africa, where prevalence rates of the major transfusion-transmissible infections (ie, hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis) are among the highest in the world. Resource-limited blood services often operate with minimal predonation screening safeguards, prompting exclusive reliance on laboratory testing to mitigate infectious risk. Transfusion screening with rapid diagnostic tests (RDTs) has been adopted in areas that lack the capacity to support the routine use of more sophisticated technologies. However, uncertainty surrounding the performance of some RDTs in the field has spurred debate regarding their application to blood donation screening. Our review of the literature identified 17 studies that evaluated RDTs for the infectious screening of blood donors in Africa. The review highlights the variable performance of available RDTs and the importance of their use in a quality-assured manner. Deficiencies in performance observed with some RDTs underscore the need to validate test kits prior to use under field conditions with locally acquired samples. Suboptimal sensitivities of some available tests, specifically hepatitis B virus rapid assays, question their suitability in single-test algorithms, particularly in high-prevalence regions. Although RDTs have limitations, many of which can be addressed through improved training and quality systems, they are frequently the only viable option for infectious screening in resource-poor African countries. Therefore, additional studies and specific guidelines regarding the use of RDTs in the context of blood safety are needed.

  18. 40 CFR 63.504 - Additional requirements for performance testing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... emission test using the techniques specified in § 63.11(b)(4); (2) Determine the net heating value of the... the Administrator the opportunity to have an observer present during the test. If after 30 days notice... in Method 301, 40 CFR part 63, appendix A. (c) Notwithstanding any other provision of this...

  19. Diagnostic value of the head-up tilt test and the R-test in patients with syncope

    PubMed Central

    RADDINO, RICCARDO; ZANINI, GREGORIANA; ROBBA, DEBORA; BONADEI, IVANO; CHIEPPA, FEDERICA; PEDRINAZZI, CLAUDIO; CARETTA, GIORGIO; MADURERI, ALBERTO; VIZZARDI, ENRICO; DEI CAS, LIVIO

    2006-01-01

    The diagnostic value of the head-up tilt test (HUTT) in discovering vasovagal syndrome depends on the pre-test probability. An accurate anamnesis and clinical examination screens the patients indicated for the HUTT. In patients with unexplained syncope, the R-test is an alternative procedure to discover its cause. In our study, we evaluated the diagnostic significance of the HUTT in a group of 211 patients and of the R-test in a subgroup of 45 patients with negative HUTT results and with negative traditional Holter ECG monitoring (24 hr). PMID:21977267

  20. 40 CFR 63.1352 - Additional test methods.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... determine the rates of emission of hydrogen chloride (HCl) from kilns, in-line kiln/raw mills and associated... operators conducting tests to determine the rates of emission of hydrogen chloride (HCl) from kilns,...

  1. Diagnostic Testing for Hemorrhagic Fevers in Pakistan: 2007–2013

    PubMed Central

    Hasan, Zahra; Atkinson, Barry; Jamil, Bushra; Samreen, Azra; Altaf, Lamia; Hewson, Roger

    2014-01-01

    Crimean–Congo hemorrhagic fever virus (CCHFV) and dengue virus (DENV) are endemic to Pakistan. Patients presenting with symptoms of fever, bleeding, and rash cannot be distinguished without appropriate testing. We report data on 354 samples tested for CCHFV at The Aga Khan University Hospital in Pakistan between 2007 and 2013. All samples were tested for the presence of CCHFV RNA. Some samples were also tested for DENV RNA, NS-1 antigen, and/or reactive immunoglobulin M antibodies. Of 354 clinical specimens screened for CCHFV, 52 specimens were positive, with 24 cases in 2013 alone. Most cases were from Sindh and Baluchistan, which border other CCHFV-endemic regions: Iran and Afghanistan. Among CCHFV-negative samples, 168 samples were tested for DENV, and 36% of these samples were found to be DENV-positive. Rapid differentiation of CCHFV and DENV can prevent nosocomial transmission and result in time and cost savings for patients and healthcare workers. PMID:25311694

  2. Diagnostic Metabolomic Blood Tests for Endoluminal Gastrointestinal Cancer--A Systematic Review and Assessment of Quality.

    PubMed

    Antonowicz, Stefan; Kumar, Sacheen; Wiggins, Tom; Markar, Sheraz R; Hanna, George B

    2016-01-01

    Advances in analytics have resulted in metabolomic blood tests being developed for the detection of cancer. This systematic review aims to assess the diagnostic accuracy of blood-based metabolomic biomarkers for endoluminal gastrointestinal (GI) cancer. Using endoscopic diagnosis as a reference standard, methodologic and reporting quality was assessed using validated tools, in addition to pathway-based informatics to biologically contextualize discriminant features. Twenty-nine studies (15 colorectal, 9 esophageal, 3 gastric, and 2 mixed) with data from 10,835 participants were included. All reported significant differences in hematologic metabolites. In pooled analysis, 246 metabolites were found to be significantly different after multiplicity correction. Incremental metabolic flux with disease progression was frequently reported. Two promising candidates have been validated in independent populations (both colorectal biomarkers), and one has been approved for clinical use. Networks analysis suggested modulation of elements of up to half of Edinburgh Human Metabolic Network subdivisions, and that the poor clinical applicability of commonly modulated metabolites could be due to extensive molecular interconnectivity. Methodologic and reporting quality was assessed as moderate-to-poor. Serum metabolomics holds promise for GI cancer diagnostics; however, future efforts must adhere to consensus standardization initiatives, utilize high-resolution discovery analytics, and compare candidate biomarkers with peer nonendoscopic alternatives.

  3. Auditory Automotive Mechanics Diagnostic Achievement Test. Center Technical Paper No. 2.

    ERIC Educational Resources Information Center

    Swanson, Richard Arthur

    The Auditory Automotive Mechanics Diagnostic Achievement Test assesses an automobile mechanic's ability to determine mechanical faults from auditory cues alone. The 44-item test and its instructions are recorded on magnetic tape; answer choices are presented on tape, and are also written in the printed test booklets. The norming and validity…

  4. Bayesian meta-analysis of diagnostic tests allowing for imperfect reference standards.

    PubMed

    Menten, J; Boelaert, M; Lesaffre, E

    2013-12-30

    There is an increasing interest in meta-analyses of rapid diagnostic tests (RDTs) for infectious diseases. To avoid spectrum bias, these meta-analyses should focus on phase IV studies performed in the target population. For many infectious diseases, these target populations attend primary health care centers in resource-constrained settings where it is difficult to perform gold standard diagnostic tests. As a consequence, phase IV diagnostic studies often use imperfect reference standards, which may result in biased meta-analyses of the diagnostic accuracy of novel RDTs. We extend the standard bivariate model for the meta-analysis of diagnostic studies to correct for differing and imperfect reference standards in the primary studies and to accommodate data from studies that try to overcome the absence of a true gold standard through the use of latent class analysis. Using Bayesian methods, improved estimates of sensitivity and specificity are possible, especially when prior information is available on the diagnostic accuracy of the reference test. In this analysis, the deviance information criterion can be used to detect conflicts between the prior information and observed data. When applying the model to a dataset of the diagnostic accuracy of an RDT for visceral leishmaniasis, the standard meta-analytic methods appeared to underestimate the specificity of the RDT. PMID:24003003

  5. Bayesian meta-analysis of diagnostic tests allowing for imperfect reference standards.

    PubMed

    Menten, J; Boelaert, M; Lesaffre, E

    2013-12-30

    There is an increasing interest in meta-analyses of rapid diagnostic tests (RDTs) for infectious diseases. To avoid spectrum bias, these meta-analyses should focus on phase IV studies performed in the target population. For many infectious diseases, these target populations attend primary health care centers in resource-constrained settings where it is difficult to perform gold standard diagnostic tests. As a consequence, phase IV diagnostic studies often use imperfect reference standards, which may result in biased meta-analyses of the diagnostic accuracy of novel RDTs. We extend the standard bivariate model for the meta-analysis of diagnostic studies to correct for differing and imperfect reference standards in the primary studies and to accommodate data from studies that try to overcome the absence of a true gold standard through the use of latent class analysis. Using Bayesian methods, improved estimates of sensitivity and specificity are possible, especially when prior information is available on the diagnostic accuracy of the reference test. In this analysis, the deviance information criterion can be used to detect conflicts between the prior information and observed data. When applying the model to a dataset of the diagnostic accuracy of an RDT for visceral leishmaniasis, the standard meta-analytic methods appeared to underestimate the specificity of the RDT.

  6. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    PubMed

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K

    2010-06-01

    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  7. 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

  8. Testing Nested Additive, Multiplicative, and General Multitrait-Multimethod Models.

    ERIC Educational Resources Information Center

    Coenders, Germa; Saris, Willem E.

    2000-01-01

    Provides alternatives to the definitions of additive and multiplicative method effects in multitrait-multimethod data given by D. Campbell and E. O'Connell (1967). The alternative definitions can be formulated by means of constraints in the parameters of the correlated uniqueness model (H. Marsh, 1989). (SLD)

  9. Malaria rapid diagnostic test evaluation at private retail pharmacies in Kumasi, Ghana

    PubMed Central

    Audu, Rauf; Anto, Berko Panyin; Koffuor, George Asumeng; Abruquah, Akua Afriyie; Buabeng, Kwame Ohene

    2016-01-01

    Objective: Malaria rapid diagnostic test (MRDT) provides a good alternative to malaria microscopy diagnosis, particularly in resource-constrained settings. This study therefore evaluated MRDT in private retail pharmacies (PRPs) as a critical step in community case malaria management. Methods: In a prospective, cross-over, validation survey at six PRPs in the Ashanti Region of Ghana, 1200 patients presenting with fever in the preceding 48 h were sampled. Fingerstick blood samples were collected for preparation of thick and thin blood films for malaria microscopy. Categorized patients (600 each) went through the processes of MRDT or presumptive diagnosis (PD) of malaria. The malaria disease prevalence of the study area was established. Selectivity (Se), specificity (Sp), positive predictive value (PPV) along with false discovery rate (FDR), and negative predictive value (NPV) along with the false omission rate (FOR), and diagnostic odds ratio (DOR) of MRDT were then calculated. Findings: While 43.0% tested positive using the MRDT, 57.0% tested negative. However, 62.0% MRDT-negative patients in addition to all the MRDT positives were given artemether-lumefantrine. Of those diagnosed by PD, 98.2% were prescribed with an antimalarial (microscopy however confirmed only 70.3% as positive). Se and Sp of the MRDT were 90.68 ± 11.18% and 98.68 ± 1.19%, respectively. Malaria prevalence was estimated to be 43.3%. PPV was 98.0%, FDR was 2.0%, NPV was 98.0%, FOR was 2.0%, and DOR was 2366.43. Conclusion: Results highlighted good performance of MRDTs at PRPs which could inform decision toward its implementation. PMID:27512708

  10. 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

  11. 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

  12. 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

  13. Toward an Objective Diagnostic Test for Bacterial Cellulitis

    PubMed Central

    Bry, Lynn; Dwyer, Richard C.; Lipworth, Adam D.; Leung, Donald Y.; Camargo, Carlos A.; Kupper, Thomas S.; Filbin, Michael R.; Murphy, George F.

    2016-01-01

    Background Prior studies repeatedly showed that cultures of skin lesions diagnosed as "cellulitis" are usually negative. However, lack of a gold standard for diagnosis (against which culture might be judged) and failure to assess the human immune response are important limitations of prior work. In this pilot study, we aimed to develop a criterion standard for research on bacterial cellulitis, to evaluate the sensitivity of procalcitonin for bacterial cellulitis, and to use gene expression analysis to find other candidate diagnostic markers. Methods We classified lesions via biopsies, 16s rRNA gene detection, culture, and histopathology. We quantified procalcitonin expression in blood. We also used Nanostring technology to quantify transcription of immunomodulators that may distinguish cases from inflamed controls. Results Of 28 participants, 15 had a clinical diagnosis of cellulitis, six had a diagnosis of non-infectious dermatitis, and seven were normal volunteers. Of the “cellulitis” patients, three (20%) had pathogens isolated, and were designated confirmed cases. Procalcitonin was undetectable in all three. HLA-DQA1 was expressed 34-fold more in confirmed cases vs. controls (fold change of geometric mean). Heat maps depicting multiplex gene expression analysis revealed a distinct profile of gene expression in confirmed cases relative to comparators. Conclusions Most “cellulitis” patients had microbiologically-negative biopsies. Procalcitonin was undetectable, and HLA-DQA1 elevated, in confirmed bacterial cases. Multivariable transcriptomic profiling results supported our algorithm’s ability to identify patients with true bacterial cellulitis. A larger sample may allow discovery of an immunological signature capable of distinguishing bacterial cellulitis from its mimics in clinical practice. PMID:27656884

  14. 40 CFR 63.504 - Additional requirements for performance testing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in Method 301, 40 CFR part 63, appendix A. (c) Notwithstanding any other provision of this subpart... customer; or necessitating that the owner or operator make product in excess of demand. (2) References in... emission test using the techniques specified in § 63.11(b)(4); (2) Determine the net heating value of...

  15. 40 CFR 63.1437 - Additional requirements for performance testing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... methods shall be validated according to the protocol in Method 301, 40 CFR part 63, appendix A. (c... necessitating that the owner or operator make a product in excess of demand. (iii) Causing plant or testing... General Provisions; (2) Determine the net heating value of the gas being combusted, using the...

  16. 40 CFR 63.1437 - Additional requirements for performance testing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... protocol in Method 301, 40 CFR part 63, appendix A. (c) Notwithstanding any other provision of this subpart... demand. (iii) Causing plant or testing personnel to be subject to unsafe conditions. Owners or operators... the techniques specified in § 63.11(b)(4) of the General Provisions; (2) Determine the net...

  17. 40 CFR 63.504 - Additional requirements for performance testing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in Method 301, 40 CFR part 63, appendix A. (c) Notwithstanding any other provision of this subpart... customer; or necessitating that the owner or operator make product in excess of demand. (2) References in... emission test using the techniques specified in § 63.11(b)(4); (2) Determine the net heating value of...

  18. Large-Scale Spray Releases: Additional Aerosol Test Results

    SciTech Connect

    Daniel, Richard C.; Gauglitz, Phillip A.; Burns, Carolyn A.; Fountain, Matthew S.; Shimskey, Rick W.; Billing, Justin M.; Bontha, Jagannadha R.; Kurath, Dean E.; Jenks, Jeromy WJ; MacFarlan, Paul J.; Mahoney, Lenna A.

    2013-08-01

    One of the events postulated in the hazard analysis for the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak event involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids that behave as a Newtonian fluid. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and in processing facilities across the DOE complex. To expand the data set upon which the WTP accident and safety analyses were based, an aerosol spray leak testing program was conducted by Pacific Northwest National Laboratory (PNNL). PNNL’s test program addressed two key technical areas to improve the WTP methodology (Larson and Allen 2010). The first technical area was to quantify the role of slurry particles in small breaches where slurry particles may plug the hole and prevent high-pressure sprays. The results from an effort to address this first technical area can be found in Mahoney et al. (2012a). The second technical area was to determine aerosol droplet size distribution and total droplet volume from prototypic breaches and fluids, including sprays from larger breaches and sprays of slurries for which literature data are mostly absent. To address the second technical area, the testing program collected aerosol generation data at two scales, commonly referred to as small-scale and large-scale testing. The small-scale testing and resultant data are described in Mahoney et al. (2012b), and the large-scale testing and resultant data are presented in Schonewill et al. (2012). In tests at both scales, simulants were used

  19. Design predictions and diagnostic test methods for hydronic heating systems in ASHRAE standard 152P

    SciTech Connect

    Andrews, J.W.

    1996-04-01

    A new method of test for residential thermal distribution efficiency is currently being developed under the auspices of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). The initial version of this test method is expected to have two main approaches, or ``pathways,`` designated Design and Diagnostic. The Design Pathway will use builder`s information to predict thermal distribution efficiency in new construction. The Diagnostic Pathway will use simple tests to evaluate thermal distribution efficiency in a completed house. Both forced-air and hydronic systems are included in the test method. This report describes an approach to predicting and measuring thermal distribution efficiency for residential hydronic heating systems for use in the Design and Diagnostic Pathways of the test method. As written, it is designed for single-loop systems with any type of passive radiation/convection (baseboard or radiators). Multiloop capability may be added later.

  20. Power calculation for comparing diagnostic accuracies in a multi-reader, multi-test design.

    PubMed

    Kim, Eunhee; Zhang, Zheng; Wang, Youdan; Zeng, Donglin

    2014-12-01

    Receiver operating characteristic (ROC) analysis is widely used to evaluate the performance of diagnostic tests with continuous or ordinal responses. A popular study design for assessing the accuracy of diagnostic tests involves multiple readers interpreting multiple diagnostic test results, called the multi-reader, multi-test design. Although several different approaches to analyzing data from this design exist, few methods have discussed the sample size and power issues. In this article, we develop a power formula to compare the correlated areas under the ROC curves (AUC) in a multi-reader, multi-test design. We present a nonparametric approach to estimate and compare the correlated AUCs by extending DeLong et al.'s (1988, Biometrics 44, 837-845) approach. A power formula is derived based on the asymptotic distribution of the nonparametric AUCs. Simulation studies are conducted to demonstrate the performance of the proposed power formula and an example is provided to illustrate the proposed procedure.

  1. 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

  2. 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

  3. 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.

  4. Small-Scale Spray Releases: Additional Aerosol Test Results

    SciTech Connect

    Schonewill, Philip P.; Gauglitz, Phillip A.; Kimura, Marcia L.; Brown, G. N.; Mahoney, Lenna A.; Tran, Diana N.; Burns, Carolyn A.; Kurath, Dean E.

    2013-08-01

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and across processing facilities in the DOE complex. To expand the data set upon which the WTP accident and safety analyses were based, an aerosol spray leak testing program was conducted by Pacific Northwest National Laboratory (PNNL). PNNL’s test program addressed two key technical areas to improve the WTP methodology (Larson and Allen 2010). The first technical area was to quantify the role of slurry particles in small breaches where slurry particles may plug the hole and prevent high-pressure sprays. The results from an effort to address this first technical area can be found in Mahoney et al. (2012a). The second technical area was to determine aerosol droplet size distribution and total droplet volume from prototypic breaches and fluids, including sprays from larger breaches and sprays of slurries for which literature data are largely absent. To address the second technical area, the testing program collected aerosol generation data at two scales, commonly referred to as small-scale and large-scale. The small-scale testing and resultant data are described in Mahoney et al. (2012b) and the large-scale testing and resultant data are presented in Schonewill et al. (2012). In tests at both scales, simulants were used to mimic the

  5. 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.

  6. Diagnostic testing, pre- and post-test probabilities, and their use in clinical practice.

    PubMed

    Paulo, Sérgio; Mendes, Susana; Vizinho, Ricardo; Carneiro, António Vaz

    2004-09-01

    In the process of establishing a diagnosis, the clinician calculates the disease probabilities, which keep changing as data is gathered from clinical history, physical examination and laboratory and imaging data. This paper sets out to explain, in a simple and practical way, how the characteristics of a test can be applied in order to determine post-test probability, that is, the probability of a specific disease being present. Before applying the test, we start with a pretest probability that corresponds to the prevalence of the disease. With each additional test this probability changes, until a threshold is reached that includes or excludes the clinical diagnosis. To calculate the post-test probabilities, the sensitivity and specificity of the test are used to calculate the positive and negative predictive values for a determined pretest probability, as well as likelihood ratios (through graphics or nomograms, approximations or equations). Among the test characteristics, the most useful for calculating post-test probabilities are likelihood ratios, which have several advantages over sensitivity and specificity.

  7. Selected diagnostic ophthalmic tests in the red kangaroo (Macropus rufus).

    PubMed

    Takle, Ginger L; Suedmeyer, W Kirk; Hunkeler, Amy

    2010-06-01

    The following tests were performed on a total of 20 eyes: Schirmer tear test, intraocular pressure (IOP), assessment of conjunctival flora, and pupillary diameter with application of topical tropicamide in 10 healthy captive red kangaroos (Macropus rufus) under manual restraint. The mean Schirmer tear test value was 22.6 +/- 6.07 mm/min. The mean intraocular pressure was 17.45 +/- 7.23 mm Hg. Values did not differ between eyes or gender for either test, but significant differences were identified for IOP values according to age. The most common bacteria isolated from the conjunctival fornix were Staphylococcus epidermidis (54.5%) and Corynebacterium sp. (18.2%). The mean onset of mydriasis after instillation of 1% tropicamide ophthalmic solution was 16.7 +/- 3.34 min and the mean duration of effect was 17.6 +/- 8.26 hr. The data obtained in this investigation will aid veterinary ophthalmologists and zoo veterinarians to diagnose ocular diseases in the red kangaroo accurately.

  8. 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...

  9. 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.

  10. 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

  11. A field diagnostic test for the improvised explosive urea nitrate.

    PubMed

    Almog, Joseph; Klein, Asne; Tamiri, Tsippy; Shloosh, Yael; Abramovich-Bar, Sara

    2005-05-01

    A sensitive, specific and simple color test for the improvised explosive urea nitrate is described. It is based on the formation of a red pigment upon the reaction between urea nitrate and p-dimethylaminocinnamaldehyde (p-DMAC) under neutral conditions. Urea itself, which is the starting material for urea nitrate, does not react with p-DMAC under the same conditions. Other potential sources of false positive response e.g., common fertilizers, medications containing the urea moiety and various amines, do not produce the red pigment with p-DMAC. Exhibits collected from 10 terrorist cases have been tested with p-DMAC. The results were in full agreement with those obtained by instrumental techniques including GC/MS, XRD and IR.

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

    PubMed

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

    1992-09-01

    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.

  13. 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

  14. Diagnostic Role of ECG Recording Simultaneously With EEG Testing.

    PubMed

    Kendirli, Mustafa Tansel; Aparci, Mustafa; Kendirli, Nurten; Tekeli, Hakan; Karaoglan, Mustafa; Senol, Mehmet Guney; Togrol, Erdem

    2015-07-01

    Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.

  15. Molecular diagnostics: harmonization through reference materials, documentary standards and proficiency testing.

    PubMed

    Holden, Marcia J; Madej, Roberta M; Minor, Philip; Kalman, Lisa V

    2011-09-01

    There is a great need for harmonization in nucleic acid testing for infectious disease and clinical genetics. The proliferation of assay methods, the number of targets for molecular diagnostics and the absence of standard reference materials contribute to variability in test results among laboratories. This article provides a comprehensive overview of reference materials, related documentary standards and proficiency testing programs. The article explores the relationships among these resources and provides necessary information for people practicing in this area that is not taught in formal courses and frequently is obtained on an ad hoc basis. The aim of this article is to provide helpful tools for molecular diagnostic laboratories.

  16. 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.

  17. 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

  18. Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

    PubMed Central

    Duarte, Luisa Fernanda; Flórez, Oscar; Rincón, Giovanna

    2014-01-01

    Objective: To compare the diagnostic performance of seven methods to determine Trypanosoma cruzi infection in patients with chronic Chagas disease. Methods: Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105). Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC), positive and negative likelihood ratio, as well as κ quality analysis. Results: The commercial Bioelisa Chagas test showed the highest sensitivity (98%), specificity (100%), and positive and negative predictive values; ​​additionally, it had the highest discriminatory power. Otherwise, the amplification of T. cruzi DNA in blood samples showed low values of sensitivity (kinetoplast DNA = 51%, nuclear DNA = 22%), but high values of specificity (100%), and moderate to low discriminatory ability. Conclusion: The comparative analysis among the different methods suggests that the diagnostic strategy of T. cruzi infection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis of T. cruzi infection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease. PMID:25100890

  19. 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 samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  20. 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... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  1. 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... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  2. 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 samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  3. 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 samples for diagnostic tests. 147.8 Section 147.8 Animals and Animal Products ANIMAL AND PLANT HEALTH... IMPROVEMENT PLAN Blood Testing Procedures § 147.8 Procedures for preparing egg yolk samples for...

  4. 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…

  5. The Application of the Monte Carlo Approach to Cognitive Diagnostic Computerized Adaptive Testing With Content Constraints

    ERIC Educational Resources Information Center

    Mao, Xiuzhen; Xin, Tao

    2013-01-01

    The Monte Carlo approach which has previously been implemented in traditional computerized adaptive testing (CAT) is applied here to cognitive diagnostic CAT to test the ability of this approach to address multiple content constraints. The performance of the Monte Carlo approach is compared with the performance of the modified maximum global…

  6. North Carolina Minimum Skills Diagnostic Testing Program. Administrative Information, 1992-93.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability Services/Research.

    Information is presented regarding the administration of the North Carolina Minimum Skills Diagnostic Testing Program. This testing program, mandated by the state's basic education program under the Secondary School Reform Act of 1984, checks the necessity for remediation by determining a student's mastery of specific objectives and diagnoses…

  7. 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.…

  8. 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…

  9. 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…

  10. Paths to Success, Volume III. Validating the California Chemistry Diagnostic Test for Local Use.

    ERIC Educational Resources Information Center

    Karpp, Edward R.

    The California Chemistry Diagnostic Test (CCDT) was developed by chemistry faculties at the University of California, California State University, and California Community College systems to address dissatisfaction with existing chemistry assessment instruments. The instrument was tested at 25 campuses of the 3 systems, after which Glendale…

  11. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... test. 414.508 Section 414.508 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... test. 414.508 Section 414.508 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new...

  13. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... test. 414.508 Section 414.508 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new...

  14. 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)

  15. 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

  16. 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

  17. 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.

  18. ADDITIVE TESTING FOR IMPROVED SULFUR RETENTION: PRELIMINARY REPORT

    SciTech Connect

    Amoroso, J.; Fox, K.

    2011-09-07

    The Savannah River National Laboratory is collaborating with Alfred University to evaluate the potential for additives in borosilicate glass to improve sulfur retention. This preliminary report provides further background on the incorporation of sulfur in glass and outlines the experiments that are being performed by the collaborators. A simulated waste glass composition has been selected for the experimental studies. The first phase of experimental work will evaluate the impacts of BaO, PbO, and V{sub 2}O{sub 5} at concentrations of 1.0, 2.0, and 5.0 wt % on sulfate retention in simulated high level waste borosilicate glass. The second phase of experimental work will evaluate the effects of time at the melt temperature on sulfur retention. The resulting samples will be characterized to determine the amount of sulfur remaining as well as to identify the formation of any crystalline phases. The results will be used to guide the future selection of frits and glass forming chemicals in vitrifying Department of Energy wastes containing high sulfur concentrations.

  19. Review of diagnostic plaque reduction neutralization tests for flavivirus infection.

    PubMed

    Maeda, Akihiko; Maeda, Junko

    2013-01-01

    Flavivirus infections (including Japanese encephalitis, West Nile encephalitis and dengue fever/severe dengue) present a worldwide public health problem. Recent climate change may affect the geographical distribution of the arthropod vectors for these viruses and so the risk of flavivirus epidemics may increase. Many methods have been developed for the serological diagnosis of flavivirus infections, such as haemagglutination inhibition assay, enzyme-linked immunosorbent assay, and immunofluorescence in staining. However, the specificity of these assays varies. The plaque reduction neutralizing test (PRNT) using live viruses is currently the 'gold standard' for the differential serodiagnosis of flaviviruses. The specificity of results obtained with PRNT is better than that for other protocols and many laboratories apply the PRNT protocol to the differential serodiagnosis of flaviviruses. Here, recent refinements to the PRNT protocols with genetically modified recombinant viruses or reporter-harbouring virus-like particles are reviewed. Further, the problems associated with the differential serodiagnosis of flaviviruses using PRNT are discussed.

  20. 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

  1. 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

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

    PubMed

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

    2015-10-08

    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.

  3. 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

  4. 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.

  5. 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.

  6. [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.

  7. [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

  8. 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.

  9. 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.

  10. 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

  11. Intelligent Condition Diagnosis Method Based on Adaptive Statistic Test Filter and Diagnostic Bayesian Network

    PubMed Central

    Li, Ke; Zhang, Qiuju; Wang, Kun; Chen, Peng; Wang, Huaqing

    2016-01-01

    A new fault diagnosis method for rotating machinery based on adaptive statistic test filter (ASTF) and Diagnostic Bayesian Network (DBN) is presented in this paper. ASTF is proposed to obtain weak fault features under background noise, ASTF is based on statistic hypothesis testing in the frequency domain to evaluate similarity between reference signal (noise signal) and original signal, and remove the component of high similarity. The optimal level of significance α is obtained using particle swarm optimization (PSO). To evaluate the performance of the ASTF, evaluation factor Ipq is also defined. In addition, a simulation experiment is designed to verify the effectiveness and robustness of ASTF. A sensitive evaluation method using principal component analysis (PCA) is proposed to evaluate the sensitiveness of symptom parameters (SPs) for condition diagnosis. By this way, the good SPs that have high sensitiveness for condition diagnosis can be selected. A three-layer DBN is developed to identify condition of rotation machinery based on the Bayesian Belief Network (BBN) theory. Condition diagnosis experiment for rolling element bearings demonstrates the effectiveness of the proposed method. PMID:26761006

  12. Intelligent Condition Diagnosis Method Based on Adaptive Statistic Test Filter and Diagnostic Bayesian Network.

    PubMed

    Li, Ke; Zhang, Qiuju; Wang, Kun; Chen, Peng; Wang, Huaqing

    2016-01-01

    A new fault diagnosis method for rotating machinery based on adaptive statistic test filter (ASTF) and Diagnostic Bayesian Network (DBN) is presented in this paper. ASTF is proposed to obtain weak fault features under background noise, ASTF is based on statistic hypothesis testing in the frequency domain to evaluate similarity between reference signal (noise signal) and original signal, and remove the component of high similarity. The optimal level of significance α is obtained using particle swarm optimization (PSO). To evaluate the performance of the ASTF, evaluation factor Ipq is also defined. In addition, a simulation experiment is designed to verify the effectiveness and robustness of ASTF. A sensitive evaluation method using principal component analysis (PCA) is proposed to evaluate the sensitiveness of symptom parameters (SPs) for condition diagnosis. By this way, the good SPs that have high sensitiveness for condition diagnosis can be selected. A three-layer DBN is developed to identify condition of rotation machinery based on the Bayesian Belief Network (BBN) theory. Condition diagnosis experiment for rolling element bearings demonstrates the effectiveness of the proposed method.

  13. Intelligent Condition Diagnosis Method Based on Adaptive Statistic Test Filter and Diagnostic Bayesian Network.

    PubMed

    Li, Ke; Zhang, Qiuju; Wang, Kun; Chen, Peng; Wang, Huaqing

    2016-01-01

    A new fault diagnosis method for rotating machinery based on adaptive statistic test filter (ASTF) and Diagnostic Bayesian Network (DBN) is presented in this paper. ASTF is proposed to obtain weak fault features under background noise, ASTF is based on statistic hypothesis testing in the frequency domain to evaluate similarity between reference signal (noise signal) and original signal, and remove the component of high similarity. The optimal level of significance α is obtained using particle swarm optimization (PSO). To evaluate the performance of the ASTF, evaluation factor Ipq is also defined. In addition, a simulation experiment is designed to verify the effectiveness and robustness of ASTF. A sensitive evaluation method using principal component analysis (PCA) is proposed to evaluate the sensitiveness of symptom parameters (SPs) for condition diagnosis. By this way, the good SPs that have high sensitiveness for condition diagnosis can be selected. A three-layer DBN is developed to identify condition of rotation machinery based on the Bayesian Belief Network (BBN) theory. Condition diagnosis experiment for rolling element bearings demonstrates the effectiveness of the proposed method. PMID:26761006

  14. Understanding laboratory testing in diagnostic uncertainty: a qualitative study in general practice.

    PubMed Central

    van der Weijden, Trudy; van Bokhoven, Marloes A; Dinant, Geert-Jan; van Hasselt, Cathelijne M; Grol, Richard P T M

    2002-01-01

    BACKGROUND: Better knowledge of the professional's motives for ordering laboratory tests in the case of diagnostic uncertainty may lead to interventions directed at reducing unnecessary testing. AIM: To gain insight into the general practitioner's (GP's) motives for ordering laboratory tests for patients presenting with unexplained complaints. DESIGN OF STUDY: Semi-structured interviews based on surgery observations. SETTING: Twenty-one general practices in rural and urban areas of The Netherlands. METHOD: Investigation of the GP's perception of determinants of test-ordering behaviour in the situation of diagnostic uncertainty. The interviews were structured by evaluating the consultations and test-ordering performance of that day. RESULTS: Dutch GPs vary considerably in their motives for ordering tests. Numerous motives emerged from the data. Some examples of important themes include: personal routines; tolerance of diagnostic uncertainty; time pressure; and tactical motives for test ordering. Complying with the perceived needs of the patient for reassurance through testing is seen as an easy, cost- and time-effective strategy. A clear hierarchy in the determinants was not found. CONCLUSION: The decision to request laboratory testing is the result of a complex interaction of considerations that are often conflicting. Designers of interventions meant to improve the ordering of tests should be aware of the numerous determinants, and take contextual variables into account. PMID:12528582

  15. Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test.

    PubMed

    Wang, C; Turnbull, B W; Nielsen, S S; Gröhn, Y T

    2011-05-01

    A Bayesian methodology was developed based on a latent change-point model to evaluate the performance of milk ELISA and fecal culture tests for longitudinal Johne's disease diagnostic data. The situation of no perfect reference test was considered; that is, no "gold standard." A change-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute the posterior estimates of the model parameters that provide the basis for inference concerning the accuracy of the diagnostic procedure. Based on the Bayesian approach, the posterior probability distribution of the change-point onset time can be obtained and used as a criterion for infection diagnosis. An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has an area under the receiver operating characteristic curve (AUC) of 0.984, and is superior to the raw ELISA (AUC=0.911) and fecal culture (sensitivity=0.358, specificity=0.980) tests for Johne's disease diagnosis. PMID:21524521

  16. Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis.

    PubMed Central

    Drobniewski, Francis; Cooke, Mary; Jordan, Jake; Casali, Nicola; Mugwagwa, Tendai; Broda, Agnieszka; Townsend, Catherine; Sivaramakrishnan, Anand; Green, Nathan; Jit, Mark; Lipman, Marc; Lord, Joanne; White, Peter J; Abubakar, Ibrahim

    2015-01-01

    BACKGROUND Drug-resistant tuberculosis (TB), especially multidrug-resistant (MDR, resistance to rifampicin and isoniazid) disease, is associated with a worse patient outcome. Drug resistance diagnosed using microbiological culture takes days to weeks, as TB bacteria grow slowly. Rapid molecular tests for drug resistance detection (1 day) are commercially available and may promote faster initiation of appropriate treatment. OBJECTIVES To (1) conduct a systematic review of evidence regarding diagnostic accuracy of molecular genetic tests for drug resistance, (2) conduct a health-economic evaluation of screening and diagnostic strategies, including comparison of alternative models of service provision and assessment of the value of targeting rapid testing at high-risk subgroups, and (3) construct a transmission-dynamic mathematical model that translates the estimates of diagnostic accuracy into estimates of clinical impact. REVIEW METHODS AND DATA SOURCES A standardised search strategy identified relevant studies from EMBASE, PubMed, MEDLINE, Bioscience Information Service (BIOSIS), System for Information on Grey Literature in Europe Social Policy & Practice (SIGLE) and Web of Science, published between 1 January 2000 and 15 August 2013. Additional 'grey' sources were included. Quality was assessed using quality assessment of diagnostic accuracy studies version 2 (QUADAS-2). For each diagnostic strategy and population subgroup, a care pathway was constructed to specify which medical treatments and health services that individuals would receive from presentation to the point where they either did or did not complete TB treatment successfully. A total cost was estimated from a health service perspective for each care pathway, and the health impact was estimated in terms of the mean discounted quality-adjusted life-years (QALYs) lost as a result of disease and treatment. Costs and QALYs were both discounted at 3.5% per year. An integrated transmission-dynamic and

  17. Evaluating the accuracy of molecular diagnostic testing for canine visceral leishmaniasis using latent class analysis.

    PubMed

    Solcà, Manuela da Silva; Bastos, Leila Andrade; Guedes, Carlos Eduardo Sampaio; Bordoni, Marcelo; Borja, Lairton Souza; Larangeira, Daniela Farias; da Silva Estrela Tuy, Pétala Gardênia; Amorim, Leila Denise Alves Ferreira; Nascimento, Eliane Gomes; de Sá Oliveira, Geraldo Gileno; dos-Santos, Washington Luis Conrado; Fraga, Deborah Bittencourt Mothé; Veras, Patrícia Sampaio Tavares

    2014-01-01

    Host tissues affected by Leishmania infantum have differing degrees of parasitism. Previously, the use of different biological tissues to detect L. infantum DNA in dogs has provided variable results. The present study was conducted to evaluate the accuracy of molecular diagnostic testing (qPCR) in dogs from an endemic area for canine visceral leishmaniasis (CVL) by determining which tissue type provided the highest rate of parasite DNA detection. Fifty-one symptomatic dogs were tested for CVL using serological, parasitological and molecular methods. Latent class analysis (LCA) was performed for accuracy evaluation of these methods. qPCR detected parasite DNA in 100% of these animals from at least one of the following tissues: splenic and bone marrow aspirates, lymph node and skin fragments, blood and conjunctival swabs. Using latent variable as gold standard, the qPCR achieved a sensitivity of 95.8% (CI 90.4-100) in splenic aspirate; 79.2% (CI 68-90.3) in lymph nodes; 77.3% (CI 64.5-90.1) in skin; 75% (CI 63.1-86.9) in blood; 50% (CI 30-70) in bone marrow; 37.5% (CI 24.2-50.8) in left-eye; and 29.2% (CI 16.7-41.6) in right-eye conjunctival swabs. The accuracy of qPCR using splenic aspirates was further evaluated in a random larger sample (n = 800), collected from dogs during a prevalence study. The specificity achieved by qPCR was 76.7% (CI 73.7-79.6) for splenic aspirates obtained from the greater sample. The sensitivity accomplished by this technique was 95% (CI 93.5-96.5) that was higher than those obtained for the other diagnostic tests and was similar to that observed in the smaller sampling study. This confirms that the splenic aspirate is the most effective type of tissue for detecting L. infantum infection. Additionally, we demonstrated that LCA could be used to generate a suitable gold standard for comparative CVL testing.

  18. Evaluating the Accuracy of Molecular Diagnostic Testing for Canine Visceral Leishmaniasis Using Latent Class Analysis

    PubMed Central

    Solcà, Manuela da Silva; Bastos, Leila Andrade; Guedes, Carlos Eduardo Sampaio; Bordoni, Marcelo; Borja, Lairton Souza; Larangeira, Daniela Farias; da Silva Estrela Tuy, Pétala Gardênia; Amorim, Leila Denise Alves Ferreira; Nascimento, Eliane Gomes; de Sá Oliveira, Geraldo Gileno; dos-Santos, Washington Luis Conrado; Fraga, Deborah Bittencourt Mothé; Veras, Patrícia Sampaio Tavares

    2014-01-01

    Host tissues affected by Leishmania infantum have differing degrees of parasitism. Previously, the use of different biological tissues to detect L. infantum DNA in dogs has provided variable results. The present study was conducted to evaluate the accuracy of molecular diagnostic testing (qPCR) in dogs from an endemic area for canine visceral leishmaniasis (CVL) by determining which tissue type provided the highest rate of parasite DNA detection. Fifty-one symptomatic dogs were tested for CVL using serological, parasitological and molecular methods. Latent class analysis (LCA) was performed for accuracy evaluation of these methods. qPCR detected parasite DNA in 100% of these animals from at least one of the following tissues: splenic and bone marrow aspirates, lymph node and skin fragments, blood and conjunctival swabs. Using latent variable as gold standard, the qPCR achieved a sensitivity of 95.8% (CI 90.4–100) in splenic aspirate; 79.2% (CI 68–90.3) in lymph nodes; 77.3% (CI 64.5–90.1) in skin; 75% (CI 63.1–86.9) in blood; 50% (CI 30–70) in bone marrow; 37.5% (CI 24.2–50.8) in left-eye; and 29.2% (CI 16.7–41.6) in right-eye conjunctival swabs. The accuracy of qPCR using splenic aspirates was further evaluated in a random larger sample (n = 800), collected from dogs during a prevalence study. The specificity achieved by qPCR was 76.7% (CI 73.7–79.6) for splenic aspirates obtained from the greater sample. The sensitivity accomplished by this technique was 95% (CI 93.5–96.5) that was higher than those obtained for the other diagnostic tests and was similar to that observed in the smaller sampling study. This confirms that the splenic aspirate is the most effective type of tissue for detecting L. infantum infection. Additionally, we demonstrated that LCA could be used to generate a suitable gold standard for comparative CVL testing. PMID:25076494

  19. Improving coeliac disease risk prediction by testing non-HLA variants additional to HLA variants

    PubMed Central

    Romanos, Jihane; Rosén, Anna; Kumar, Vinod; Trynka, Gosia; Franke, Lude; Szperl, Agata; Gutierrez-Achury, Javier; van Diemen, Cleo C; Kanninga, Roan; Jankipersadsing, Soesma A; Steck, Andrea; Eisenbarth, Georges; van Heel, David A; Cukrowska, Bozena; Bruno, Valentina; Mazzilli, Maria Cristina; Núñez, Concepcion; Bilbao, Jose Ramon; Mearin, M Luisa; Barisani, Donatella; Rewers, Marian; Norris, Jill M; Ivarsson, Anneli; Boezen, H Marieke; Liu, Edwin; Wijmenga, Cisca

    2014-01-01

    Background The majority of coeliac disease (CD) patients are not being properly diagnosed and therefore remain untreated, leading to a greater risk of developing CD-associated complications. The major genetic risk heterodimer, HLA-DQ2 and DQ8, is already used clinically to help exclude disease. However, approximately 40% of the population carry these alleles and the majority never develop CD. Objective We explored whether CD risk prediction can be improved by adding non-HLA-susceptible variants to common HLA testing. Design We developed an average weighted genetic risk score with 10, 26 and 57 single nucleotide polymorphisms (SNP) in 2675 cases and 2815 controls and assessed the improvement in risk prediction provided by the non-HLA SNP. Moreover, we assessed the transferability of the genetic risk model with 26 non-HLA variants to a nested case–control population (n=1709) and a prospective cohort (n=1245) and then tested how well this model predicted CD outcome for 985 independent individuals. Results Adding 57 non-HLA variants to HLA testing showed a statistically significant improvement compared to scores from models based on HLA only, HLA plus 10 SNP and HLA plus 26 SNP. With 57 non-HLA variants, the area under the receiver operator characteristic curve reached 0.854 compared to 0.823 for HLA only, and 11.1% of individuals were reclassified to a more accurate risk group. We show that the risk model with HLA plus 26 SNP is useful in independent populations. Conclusions Predicting risk with 57 additional non-HLA variants improved the identification of potential CD patients. This demonstrates a possible role for combined HLA and non-HLA genetic testing in diagnostic work for CD. PMID:23704318

  20. Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review.

    PubMed Central

    Aslam, Rabeea'h W; Bates, Vickie; Dundar, Yenal; Hounsome, Juliet; Richardson, Marty; Krishan, Ashma; Dickson, Rumona; Boland, Angela; Kotas, Eleanor; Fisher, Joanne; Sikdar, Sudip; Robinson, Louise

    2016-01-01

    were screened and 399 articles were shortlisted for full-text assessment. Sixteen studies were included in the diagnostic accuracy review. No studies were eligible for inclusion in the review of tools for monitoring progressive disease. Eleven automated computerised tests were assessed in the 16 included studies. The overall quality of the studies was good; however, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that meaningful synthesis or statistical analysis was not possible. LIMITATIONS The main limitation of this review is the substantial heterogeneity of the tests assessed in the included studies. As a result, no meta-analyses could be undertaken. CONCLUSION The quantity of information available is insufficient to be able to make recommendations on the clinical use of the computerised tests for diagnosing and monitoring MCI and early dementia progression. The value of these tests also depends on the costs of acquisition, training, administration and scoring. FUTURE WORK Research is required to establish stable cut-off points for automated computerised tests that are used to diagnose patients with MCI or early dementia. Additionally, the costs associated with acquiring and using these tests in clinical practice should be estimated. STUDY REGISTRATION The study is registered as PROSPERO CRD42015025410. FUNDING The National Institute for Health Research Health Technology Assessment programme. PMID:27767932

  1. Commercial Dengue Rapid Diagnostic Tests for Point-of-Care Application: Recent Evaluations and Future Needs?

    PubMed Central

    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. 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.

  3. 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…

  4. Fever of unknown origin (FUO) caused by multiple myeloma: the diagnostic value of the Naprosyn test.

    PubMed

    Cunha, Burke A; Bouyarden, Michael; Hamid, Naveed S

    2006-01-01

    Fever of unknown origin (FUO) remains a difficult diagnostic problem. The causes of FUO have changed over the years. Neoplastic disorders have now displaced infectious diseases as the most common cause of FUOs. Most neoplasms are associated with no or low-grade temperatures, with some important exceptions. Hypernephromas and lymphomas are neoplasms typically associated with high spiking fevers or may present as FUOs. Hematologic malignancies, that is, the acute and chronic leukemias, myeloproliferative disorders, and multiple myeloma, do not usually present with acute fevers or as FUOs. We present an elderly male patient who presented with an FUO, whose history is significant for multiple myeloma in remission. Differential diagnostic possibilities in this patient included plasma cell leukemia, relapse of multiple myeloma, secondary/superimposed malignancy, or opportunistic infection. The main differential diagnosis for his FUO was between neoplastic and infectious disorders. As part of the diagnostic workup, a Naprosyn test (naproxen 375 mg [by mouth] every 12 hours for 3 days) was used to differentiate neoplastic from infectious causes of FUO in this patient. The Naprosyn test was positive, which indicated a neoplastic explanation for the patient's FUO and eliminated, along with the infectious disease workup, an infectious explanation for his FUO. The patient's FUO was finally determined to be the result of a relapse of multiple myeloma and not of a secondary malignancy or malignant transformation of myeloma into plasma cell leukemia. We conclude the Naprosyn test remains a valuable diagnostic test to use to narrow differential diagnostic possibilities in patients with FUOs when a malignancy is a diagnostic consideration. PMID:16963369

  5. 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.

  6. Hydrogen Balmer beta: The separation between line peaks for plasma electron density diagnostics and self-absorption test

    NASA Astrophysics Data System (ADS)

    Ivković, Milivoje; Konjević, Nikola; Pavlović, Zoran

    2015-03-01

    We propose a diagnostic technique for the measurement of plasma electron number density, Ne, based on the wavelength separation between peaks, ΔλPS, of hydrogen Balmer beta line, Hβ. In favor of the proposed diagnostic technique we demonstrate high sensitivity of ΔλPS on Ne and low sensitivity on plasma elementary processes and plasma parameters that may distort the line profile. These properties of ΔλPS enable reliable Ne plasma diagnostics in the presence of considerable self-absorption. On the basis of available theoretical data tables for the Hβ line profiles, simple Ne=f(ΔλPS) formulas are proposed. Their validity is experimentally confirmed in a low initial pressure pulsed discharge for the Ne range of (0.2-7)*1023 m-3. The agreement of the proposed formulas with another diagnostic technique is well within 10%. In addition, the difference in Ne values obtained from peak separation and from the Hβ line width is successfully used as a self-absorption test for line profile.

  7. Rapid diagnostic tests versus clinical diagnosis for managing people with fever in malaria endemic settings

    PubMed Central

    Odaga, John; Sinclair, David; Lokong, Joseph A; Donegan, Sarah; Hopkins, Heidi; Garner, Paul

    2014-01-01

    Background In 2010, the World Health Organization recommended that all patients with suspected malaria are tested for malaria before treatment. In rural African settings light microscopy is often unavailable. Diagnosis has relied on detecting fever, and most people were given antimalarial drugs presumptively. Rapid diagnostic tests (RDTs) provide a point-of-care test that may improve management, particularly of people for whom the RDT excludes the diagnosis of malaria. Objectives To evaluate whether introducing RDTs into algorithms for diagnosing and treating people with fever improves health outcomes, reduces antimalarial prescribing, and is safe, compared to algorithms using clinical diagnosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; CENTRAL (The Cochrane Library); MEDLINE; EMBASE; CINAHL; LILACS; and the metaRegister of Controlled Trials for eligible trials up to 10 January 2014. We contacted researchers in the field and reviewed the reference lists of all included trials to identify any additional trials. Selection criteria Individual or cluster randomized trials (RCTs) comparing RDT-supported algorithms and algorithms using clinical diagnosis alone for diagnosing and treating people with fever living in malaria-endemic settings. Data collection and analysis Two authors independently applied the inclusion criteria and extracted data. We combined data from individually and cluster RCTs using the generic inverse variance method. We presented all outcomes as risk ratios (RR) with 95% confidence intervals (CIs), and assessed the quality of evidence using the GRADE approach. Main results We included seven trials, enrolling 17,505 people with fever or reported history of fever in this review; two individually randomized trials and five cluster randomized trials. All trials were conducted in rural African settings. In most trials the health workers diagnosing and treating malaria were nurses or clinical officers with less

  8. 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

  9. 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

    ... for Tuberculosis; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS... of Diagnostic Tests and Biomarkers for Tuberculosis (TB).'' The purpose of the workshop is to provide... Medicine, Ending Neglect: The Elimination of Tuberculosis in the United States, Committee on...

  10. 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,…

  11. 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)

  12. 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…

  13. 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…

  14. 30 CFR 250.523 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., immediately. (b) your well, previously on gas lift, has been shut-in or returned to flowing status without gas lift for more than 180 days, immediately on the production casing (A annulus). The production casing (A annulus) of wells on active gas lift are exempt from diagnostic testing. (c) your casing pressure...

  15. 30 CFR 250.522 - When do I have to repeat casing diagnostic testing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... term has expired, immediately. (b) your well, previously on gas lift, has been shut-in or returned to flowing status without gas lift for more than 180 days, immediately on the production casing (A annulus). The production casing (A annulus) of wells on active gas lift are exempt from diagnostic testing....

  16. 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…

  17. Diagnostic test for prenatal identification of Down's syndrome and mental retardation and gene therapy therefor

    DOEpatents

    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.

  18. 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

  19. Diagnostic testing and management of gastroesophageal reflux disease (GERD) in children.

    PubMed

    Cabrera, J; Subbarao, G; Croffie, J

    2012-12-01

    The diagnosis of gastroesophageal reflux disease (GERD) has evolved from reliance on history and fluoroscopy to continuous esophageal pH monitoring with catheter-based pH probes and wireless pH probes to continuous impedance/pH monitoring. This review describes the currently employed diagnostic tests and the actual management of GERD in children.

  20. 77 FR 71170 - Notice of Public Roundtable on Genetic Diagnostic Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-29

    ... Hearings on Genetic Diagnostic Testing, 77 FR 3748 (Jan. 25, 2012). The Office also provided the public... will be held on Thursday, January 10, 2013, beginning at 1:00 p.m. Eastern Standard Time (EST) and ending at 4:00 p.m. (EST) in Alexandria, Virginia. Those wishing to share commentary at the...

  1. 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)…

  2. 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…

  3. 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…

  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.

  5. Astronomy Diagnostic Test Results Reflect Course Goals and Show Room for Improvement

    ERIC Educational Resources Information Center

    LoPresto, Michael C.

    2007-01-01

    The results of administering the Astronomy Diagnostic Test (ADT) to introductory astronomy students at Henry Ford Community College over three years have shown gains comparable with national averages. Results have also accurately corresponded to course goals, showing greater gains in topics covered in more detail, and lower gains in topics covered…

  6. An Examination of the Diagnostic Claims of the Revised Illinois Test of Psycholinguistic Abilities.

    ERIC Educational Resources Information Center

    Tierney, Robert J.; Ames, Wilbur S.

    1978-01-01

    To analyze differential diagnostic efficiency of the Revised Illinois Test of Psycholinguistic Abilities (a measure designed to assess strengths and weaknesses of learning disabled children), the Kelley procedure for estimating the proportion of differences in excess of chance was applied to the standardization data. (SBH)

  7. 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...

  8. 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…

  9. Effects of a Web-Based Decision Aid Regarding Diagnostic Self-Testing. A Single-Blind Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Ickenroth, Martine H. P.; Grispen, J. E. J.; de Vries, N. K.; Dinant, G. J.; Ronda, G.; van der Weijden, T.

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized controlled trial was designed. A total of 1259…

  10. 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…

  11. 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…

  12. 49 CFR 199.111 - Retention of samples and additional testing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Retention of samples and additional testing. 199... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.111 Retention of samples and additional testing. (a... period, the employee or the employee's representative, the operator, the Administrator, or, if...

  13. Additional Value of CH₄ Measurement in a Combined (13)C/H₂ Lactose Malabsorption Breath Test: A Retrospective Analysis.

    PubMed

    Houben, Els; De Preter, Vicky; Billen, Jaak; Van Ranst, Marc; Verbeke, Kristin

    2015-09-07

    The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H₂) excretion after an oral dose of lactose. We use a combined (13)C/H₂ lactose breath test that measures breath (13)CO₂ as a measure of lactose digestion in addition to H₂ and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 (13)C/H₂ lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH₄ in addition to H₂ and (13)CO₂. Based on the (13)C/H₂ breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH₄ further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H₂-excretion were found to excrete CH₄. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH₄-concentrations has an added value to the (13)C/H₂ breath test to identify methanogenic subjects with lactose malabsorption or SIBO.

  14. Additional Value of CH₄ Measurement in a Combined (13)C/H₂ Lactose Malabsorption Breath Test: A Retrospective Analysis.

    PubMed

    Houben, Els; De Preter, Vicky; Billen, Jaak; Van Ranst, Marc; Verbeke, Kristin

    2015-09-01

    The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H₂) excretion after an oral dose of lactose. We use a combined (13)C/H₂ lactose breath test that measures breath (13)CO₂ as a measure of lactose digestion in addition to H₂ and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 (13)C/H₂ lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH₄ in addition to H₂ and (13)CO₂. Based on the (13)C/H₂ breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH₄ further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H₂-excretion were found to excrete CH₄. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH₄-concentrations has an added value to the (13)C/H₂ breath test to identify methanogenic subjects with lactose malabsorption or SIBO. PMID:26371034

  15. Introducing rapid diagnostic tests for malaria to drug shops in Uganda: a cluster-randomized controlled trial

    PubMed Central

    Fink, Günther; Maloney, Kathleen; Berg, Katrina; Jordan, Matthew; Svoronos, Theodore; Aber, Flavia; Dickens, William

    2015-01-01

    Abstract Objective To evaluate the impact – on diagnosis and treatment of malaria – of introducing rapid diagnostic tests to drug shops in eastern Uganda. Methods Overall, 2193 households in 79 study villages with at least one licensed drug shop were enrolled and monitored for 12 months. After 3 months of monitoring, drug shop vendors in 67 villages randomly selected for the intervention were offered training in the use of malaria rapid diagnostic tests and – if trained – offered access to such tests at a subsidized price. The remaining 12 study villages served as controls. A difference-in-differences regression model was used to estimate the impact of the intervention. Findings Vendors from 92 drug shops successfully completed training and 50 actively stocked and performed the rapid tests. Over 9 months, trained vendors did an average of 146 tests per shop. Households reported 22 697 episodes of febrile illness. The availability of rapid tests at local drug shops significantly increased the probability of any febrile illness being tested for malaria by 23.15% (P = 0.015) and being treated with an antimalarial drug by 8.84% (P = 0.056). The probability that artemisinin combination therapy was bought increased by a statistically insignificant 5.48% (P = 0.574). Conclusion In our study area, testing for malaria was increased by training drug shop vendors in the use of rapid tests and providing them access to such tests at a subsidized price. Additional interventions may be needed to achieve a higher coverage of testing and a higher rate of appropriate responses to test results.

  16. Field evaluation of a rapid diagnostic test to detect antibodies in human toxocariasis.

    PubMed

    Lim, P K C; Yamasaki, H; Mak, J W; Wong, S F; Chong, C W; Yap, I K S; Ambu, S; Kumarasamy, V

    2015-08-01

    Human toxocariasis which is caused mainly by the larvae of Toxocara canis and Toxocara cati, is a worldwide zoonotic disease that can be a potentially serious human infection. The enzyme-linked immunosorbent assay (ELISA) using T. canis excretory-secretory (TES) antigens harvested from T. canis larvae is currently the serological test for confirming toxocariasis. An alternative to producing large amounts of Toxocara TES and improved diagnosis for toxocariasis is through the development of highly specific recombinant antigens such as the T. canis second stage larva excretory-secretory 30 kDa protein (recTES-30). The aim of this study was to evaluate the sensitivity and specificity of a rapid diagnostic kit (RDT, named as iToxocara kit) in comparison to recTES-30 ELISA in Serendah Orang Asli village in Selangor, Malaysia. A total of 133 subjects were included in the study. The overall prevalence rates by ELISA and RDT were 29.3% and 33.1%, respectively, with more positive cases detected in males than females. However, no association was found between toxocariasis and gender or age. The percentage sensitivity, specificity, positive predictive value and negative predictive value of RDT were 85.7%, 90.1%, 80% and 93.2%, respectively. The prevalence for toxocariasis in this population using both ELISA and RDT was 27.1% (36/133) and the K-concordance test suggested good agreement of the two tests with a Cohen's kappa of 0.722, P<0.01. In addition, the followed-up Spearman rank correlation showed a moderately high correlation at R=0.704 and P<0.01. In conclusion, the RDT kit was faster and easier to use than an ELISA and is useful for the laboratory diagnosis of hospitalized cases of toxocariasis. PMID:25910623

  17. Methods and recommendations for evaluating and reporting a new diagnostic test.

    PubMed

    Hess, A S; Shardell, M; Johnson, J K; Thom, K A; Strassle, P; Netzer, G; Harris, A D

    2012-09-01

    No standardized guidelines exist for the biostatistical methods appropriate for studies evaluating diagnostic tests. Publication recommendations such as the STARD statement provide guidance for the analysis of data, but biostatistical advice is minimal and application is inconsistent. This article aims to provide a self-contained, accessible resource on the biostatistical aspects of study design and reporting for investigators. For all dichotomous diagnostic tests, estimates of sensitivity and specificity should be reported with confidence intervals. Power calculations are strongly recommended to ensure that investigators achieve desired levels of precision. In the absence of a gold standard reference test, the composite reference standard method is recommended for improving estimates of the sensitivity and specificity of the test under evaluation.

  18. Methods and recommendations for evaluating and reporting a new diagnostic test

    PubMed Central

    Shardell, M.; Johnson, J. K.; Thom, K. A.; Strassle, P.; Netzer, G.; Harris, A. D.

    2013-01-01

    No standardized guidelines exist for the biostatistical methods appropriate for studies evaluating diagnostic tests. Publication recommendations such as the STARD statement provide guidance for the analysis of data, but biostatistical advice is minimal and application is inconsistent. This article aims to provide a self-contained, accessible resource on the biostatistical aspects of study design and reporting for investigators. For all dichotomous diagnostic tests, estimates of sensitivity and specificity should be reported with confidence intervals. Power calculations are strongly recommended to ensure that investigators achieve desired levels of precision. In the absence of a gold standard reference test, the composite reference standard method is recommended for improving estimates of the sensitivity and specificity of the test under evaluation. PMID:22476385

  19. 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

  20. A weighted generalized score statistic for comparison of predictive values of diagnostic tests.

    PubMed

    Kosinski, Andrzej S

    2013-03-15

    Positive and negative predictive values are important measures of a medical diagnostic test performance. We consider testing equality of two positive or two negative predictive values within a paired design in which all patients receive two diagnostic tests. The existing statistical tests for testing equality of predictive values are either Wald tests based on the multinomial distribution or the empirical Wald and generalized score tests within the generalized estimating equations (GEE) framework. As presented in the literature, these test statistics have considerably complex formulas without clear intuitive insight. We propose their re-formulations that are mathematically equivalent but algebraically simple and intuitive. As is clearly seen with a new re-formulation we presented, the generalized score statistic does not always reduce to the commonly used score statistic in the independent samples case. To alleviate this, we introduce a weighted generalized score (WGS) test statistic that incorporates empirical covariance matrix with newly proposed weights. This statistic is simple to compute, always reduces to the score statistic in the independent samples situation, and preserves type I error better than the other statistics as demonstrated by simulations. Thus, we believe that the proposed WGS statistic is the preferred statistic for testing equality of two predictive values and for corresponding sample size computations. The new formulas of the Wald statistics may be useful for easy computation of confidence intervals for difference of predictive values. The introduced concepts have potential to lead to development of the WGS test statistic in a general GEE setting.

  1. Advanced Manufacturing Technologies (AMT): Additive Manufactured Hot Fire Planning and Testing in GRC Cell 32 Project

    NASA Technical Reports Server (NTRS)

    Fikes, John C.

    2014-01-01

    The objective of this project is to hot fire test an additively manufactured thrust chamber assembly TCA (injector and thrust chamber). GRC will install the additively manufactured Inconel 625 injector, two additively manufactured (SLM) water cooled Cu-Cr thrust chamber barrels and one additively manufactured (SLM) water cooled Cu-Cr thrust chamber nozzle on the test stand in Cell 32 and perform hot fire testing of the integrated TCA.

  2. 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

  3. 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

  4. Diagnostic Accuracy of PCR Alone and Compared to Urinary Antigen Testing for Detection of Legionella spp.: a Systematic Review

    PubMed Central

    Green, Hefziba; Steinmetz, Tali; Leibovici, Leonard; Paul, Mical

    2015-01-01

    The diagnosis of Legionnaires' disease (LD) is based on the isolation of Legionella spp., a 4-fold rise in antibodies, a positive urinary antigen (UA), or direct immunofluorescence tests. PCR is not accepted as a diagnostic tool for LD. This systematic review assesses the diagnostic accuracy of PCR in various clinical samples with a direct comparison versus UA. We included prospective or retrospective cohort and case-control studies. Studies were included if they used the Centers for Disease Control and Prevention consensus definition criteria of LD or a similar one, assessed only patients with clinical pneumonia, and reported data for all true-positive, false-positive, true-negative, and false-negative results. Two reviewers abstracted data independently. Risk of bias was assessed using Quadas-2. Summary sensitivity and specificity values were estimated using a bivariate model and reported with a 95% confidence interval (CI). Thirty-eight studies were included. A total of 653 patients had confirmed LD, and 3,593 patients had pneumonia due to other pathogens. The methodological quality of the studies as assessed by the Quadas-2 tool was poor to fair. The summary sensitivity and specificity values for diagnosis of LD in respiratory samples were 97.4% (95% CI, 91.1% to 99.2%) and 98.6% (95% CI, 97.4% to 99.3%), respectively. These results were mainly unchanged by any covariates tested and subgroup analysis. The diagnostic performance of PCR in respiratory samples was much better than that of UA. Compared to UA, PCR in respiratory samples (especially in sputum samples or swabs) revealed a significant advantage in sensitivity and an additional diagnosis of 18% to 30% of LD cases. The diagnostic performance of PCR in respiratory samples was excellent and preferable to that of the UA. Results were independent on the covariate tested. PCR in respiratory samples should be regarded as a valid tool for the diagnosis of LD. PMID:26659202

  5. 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.

  6. [Practical evaluation of rapid diagnostic tests for mycobacteriosis and virus infection].

    PubMed

    Nakamura, Hisako

    2002-01-01

    Because cultures of mycobacteria and viruses take a great number of days, the results are delayed in these clinical laboratory tests. For this reason, rapid diagnostic tests without these cultures are required. Among the laboratory tests of mycobacteria, acid-fast stain as a rapid diagnostic test is the first to give significant information to laboratory staffs and physicians. There are mainly two procedures, directly smearing clinical specimens and smearing concentrated specimens treated with NALC-NaOH on slide glass. The former is performed for specimens from emergency patients. When a patient is suspected of tuberculosis, a DNA-amplification test such as COBAS AMPLICOR TEST (PCR test) is performed for directly detecting Mycobacterium tuberculosis in clinical specimens, regardless of whether the specimens show positive or negative by acid-fast stain. Sixty-one of 1,023 specimens tested in Showa University Fujigaoka Hospital in February 2000-May 2002 were found positive by both PCR and culture tests. Fourteen were found negative by PCR test and positive by culture test. Five were found positive by PCR test and negative by culture test. Alternatively, MTB-64 (Capilia TB) is a kit for rapidly identifying M. tuberculosis using colonies. The time necessary for completion of the test was approximately 15 minutes per sample. In our study, the identification test showed weak-positive for 2 strains of M. marinum (ATCC927 and one clinical isolate), compared with positive for 28 clinical isolates and strain H37Ra of M. tuberculosis. Recently, rapid diagnostic kits for detecting various pathogenic viruses have been developed. The kits for detecting influenza virus are in especially great demand with the spread of newly-developed antiviral agents. There was an epidemic of the type A virus in the winters 2001-2002. 101 (32%) of 316 clinical specimens tested in the hospital were found positive with InfluA. B-Quick [SEIKEN] (Denka) or Directigen Flu A (Becton Dickinson). These

  7. Test and analytical results of a new bolt configuration for a diagnostic/device canister connection

    SciTech Connect

    Boyce, L.

    1981-09-01

    Underground nuclear explosive tests utilize a nuclear device canister suspended from a canister containing diagnostic equipment. A standard design for these canisters and their connection is being developed by the Nuclear Test Engineering Divisions, Test Systems Section of Lawrence Livermore National Laboratory. Test and analysis of a new bolt configuration for a portion of this bolted canister connection have been carried out and results are presented and compared for channel loads of 100,000 and 200,000 lb. When results for this connection design are compared with an earlier one, significant reductions are found in bolt loads, end plate separations, and certain stresses and moments.

  8. 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

  9. Decision Making for Borderline Cases in Pass/Fail Clinical Anatomy Courses: The Practical Value of the Standard Error of Measurement and Likelihood Ratio in a Diagnostic Test

    ERIC Educational Resources Information Center

    Severo, Milton; Silva-Pereira, Fernanda; Ferreira, Maria Amelia

    2013-01-01

    Several studies have shown that the standard error of measurement (SEM) can be used as an additional “safety net” to reduce the frequency of false-positive or false-negative student grading classifications. Practical examinations in clinical anatomy are often used as diagnostic tests to admit students to course final examinations. The aim of this…

  10. Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study.

    PubMed

    Halligan, E; Edgeworth, J; Bisnauthsing, K; Bible, J; Cliff, P; Aarons, E; Klein, J; Patel, A; Goldenberg, S

    2014-08-01

    Laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. Tests are often requested sequentially and undertaken in different laboratories. This causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. A molecular multiplex test (Luminex(®) Gastrointestinal Pathogen Panel (GPP)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use of isolation facilities and user acceptability. A total of 262 (12%) patients had a pathogen detected by conventional methods compared with 483 (22.1%) by GPP. Most additional cases were detected in patients developing symptoms in the first 4 days of admission. Additional cases were detected because of presumed improved diagnostic sensitivity but also because clinicians had not requested the correct pathogen. Turnaround time (41.8 h) was faster than bacterial culture (66.5 h) and parasite investigation (66.5 h) but slower than conventional testing for Clostridium difficile (17.3 h) and viruses (27 h). The test could allow simplified requesting by clinicians and a consolidated laboratory workflow, reducing the overall number of specimens received by the laboratory. A total of 154 isolation days were saved at an estimated cost of £30 800. Consumables and labour were estimated at £150 641 compared with £63 431 for conventional testing. Multiplex molecular testing using a panel of targets allowed enhanced detection and a consolidated laboratory workflow. This is likely to be of greater benefit to cases that present within the first 4 days of hospital admission. PMID:24274687

  11. The Evaluation of a Rapid In Situ HIV Confirmation Test in a Programme with a High Failure Rate of the WHO HIV Two-Test Diagnostic Algorithm

    PubMed Central

    Klarkowski, Derryck B.; Wazome, Joseph M.; Lokuge, Kamalini M.; Shanks, Leslie; Mills, Clair F.; O'Brien, Daniel P.

    2009-01-01

    Background Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF) HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT) (two positive RDTs alone for HIV diagnosis) used in voluntary counselling and testing (VCT) sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-positive rate of the WHO two-test algorithm compared with our adapted protocol including confirmation testing, and whether weakly reactive compared with strongly reactive rapid test results were more likely to be false positives. Methodology/Principal Findings 2864 clients presenting to MSF VCT centres in Bukavu during January to May 2006 were tested using Determine HIV-1/2® and UniGold HIV® rapid tests in parallel by nurse counsellors. Plasma samples on 229 clients confirmed as double RDT positive by laboratory retesting were further tested using both WB and the Orgenics Immunocomb Combfirm® HIV confirmation test (OIC-HIV). Of these, 24 samples were negative or indeterminate by WB representing a false-positive rate of the WHO two-test algorithm of 10.5% (95%CI 6.6-15.2). 17 of the 229 samples were weakly positive on rapid testing and all were negative or indeterminate by WB. The false-positive rate fell to 3.3% (95%CI 1.3–6.7) when only strong-positive rapid test results were considered. Agreement between OIC-HIV and WB was 99.1% (95%CI 96.9–99.9%) with no false OIC-HIV positives if stringent criteria for positive OIC-HIV diagnoses were used. Conclusions The WHO HIV two-test diagnostic algorithm produced an unacceptably high level of false-positive diagnoses in our setting, especially if results were weakly positive. The most probable causes of the false-positive results were serological cross-reactivity or non-specific immune reactivity. Our findings show that the OIC

  12. 46 CFR 160.035-12 - Additional preapproval tests required for F.R.P. lifeboats.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Additional preapproval tests required for F.R.P... Merchant Vessels § 160.035-12 Additional preapproval tests required for F.R.P. lifeboats. (a) General... p.s.i. of air pressure both before and after the tests described in paragraphs (b)(1) through (6)...

  13. 34 CFR 668.148 - Additional criteria for the approval of certain tests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Additional criteria for the approval of certain tests... of Independently Administered Tests; Specification of Passing Score; Approval of State Process § 668.148 Additional criteria for the approval of certain tests. Except as provided in § 668.143— (a)...

  14. Robust diagnostic genetic testing using solution capture enrichment and a novel variant-filtering interface.

    PubMed

    Watson, Christopher M; Crinnion, Laura A; Morgan, Joanne E; Harrison, Sally M; Diggle, Christine P; Adlard, Julian; Lindsay, Helen A; Camm, Nick; Charlton, Ruth; Sheridan, Eamonn; Bonthron, David T; Taylor, Graham R; Carr, Ian M

    2014-04-01

    Targeted hybridization enrichment prior to next-generation sequencing is a widespread method for characterizing sequence variation in a research setting, and is being adopted by diagnostic laboratories. However, the number of variants identified can overwhelm clinical laboratories with strict time constraints, the final interpretation of likely pathogenicity being a particular bottleneck. To address this, we have developed an approach in which, after automatic variant calling on a standard unix pipeline, subsequent variant filtering is performed interactively, using AgileExomeFilter and AgilePindelFilter (http://dna.leeds.ac.uk/agile), tools designed for clinical scientists with standard desktop computers. To demonstrate the method's diagnostic efficacy, we tested 128 patients using (1) a targeted capture of 36 cancer-predisposing genes or (2) whole-exome capture for diagnosis of the genetically heterogeneous disorder primary ciliary dyskinesia (PCD). In the cancer cohort, complete concordance with previous diagnostic data was achieved across 793 variant genotypes. A high yield (42%) was also achieved for exome-based PCD diagnosis, underscoring the scalability of our method. Simple adjustments to the variant filtering parameters further allowed the identification of a homozygous truncating mutation in a presumptive new PCD gene, DNAH8. These tools should allow diagnostic laboratories to expand their testing portfolios flexibly, using a standard set of reagents and techniques.

  15. 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

  16. 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

  17. 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…

  18. Diagnostic accuracy of nitroglycerine as a 'test of treatment' for cardiac chest pain: a systematic review.

    PubMed

    Grailey, Katherine; Glasziou, Paul P

    2012-03-01

    To determine the accuracy of using nitroglycerine as a 'test of treatment' in the diagnosis of cardiac chest pain we undertook a systematic review of studies of diagnostic accuracy. Databases searched included PubMed, Cochrane Database, Google Scholar, Science Citation Index, EMBASE and manual searching of bibliographies of known primary and review articles. Studies were included if sublingual nitroglycerine was the index test, its effect on the patient's pain score was recorded and the reference test was performed on at least 80% of patients. The data from the five papers were used to form 2×2 contingency tables. Five eligible studies were found, all in the acute setting (although one paper collected its data in the follow-up setting, all patients had acute presentations). The sensitivity ranged from 35% to 92% and the specificity from 12% to 63%. However, in all but one paper the Youden indices were close to zero suggesting that the response to nitroglycerine is not useful as a diagnostic test. The combined sensitivity was 0.52 (95% CI 0.48 to 0.56) and combined specificity was 0.49 (95% CI 0.46 to 0.52). The diagnostic OR from the combined studies was 1.2 (95% CI 0.97 to 1.5), which is not significantly different from 1. In the acute setting, nitroglycerine is not a reliable test of treatment for use in the diagnosis of coronary artery disease. However, further studies are needed to determine the diagnostic accuracy of nitroglycerine for recurrent exertional chest pain.

  19. Evaluation of a Density-Based Rapid Diagnostic Test for Sickle Cell Disease in a Clinical Setting in Zambia

    PubMed Central

    Hennek, Jonathan W.; Mantina, Hamakwa; Lee, S. Y. Ryan; Patton, Matthew R.; Sambo, Pauline; Sinyangwe, Silvester; Kankasa, Chipepo; Chintu, Chifumbe; Brugnara, Carlo; Stossel, Thomas P.; Whitesides, George M.

    2014-01-01

    Although simple and low-cost interventions for sickle cell disease (SCD) exist in many developing countries, child mortality associated with SCD remains high, in part, because of the lack of access to diagnostic tests for SCD. A density-based test using aqueous multiphase systems (SCD-AMPS) is a candidate for a low-cost, point-of-care diagnostic for SCD. In this paper, the field evaluation of SCD-AMPS in a large (n = 505) case-control study in Zambia is described. Of the two variations of the SCD-AMPS used, the best system (SCD-AMPS-2) demonstrated a sensitivity of 86% (82–90%) and a specificity of 60% (53–67%). Subsequent analysis identified potential sources of false positives that include clotting, variation between batches of SCD-AMPS, and shipping conditions. Importantly, SCD-AMPS-2 was 84% (62–94%) sensitive in detecting SCD in children between 6 months and 1 year old. In addition to an evaluation of performance, an assessment of end-user operability was done with health workers in rural clinics in Zambia. These health workers rated the SCD-AMPS tests to be as simple to use as lateral flow tests for malaria and HIV. PMID:25490722

  20. 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

  1. Diagnostic dose of synergized d-phenothrin for insecticide susceptibility testing by bottle bioassay.

    PubMed

    Petersen, John L; Floore, Thomas G; Brogdon, William G

    2004-06-01

    The diagnostic dose of d-phenothrin synergized 1:1 with piperonyl butoxide for testing insecticide susceptibility of mosquitoes by bottle bioassay is reported for 2 mosquito species, Culex quinquefasciatus and Ochlerotatus taeniorhynchus. The diagnostic dose was defined as 2 times the 95% lethal concentration (LC95). LC50, LC90, and LC95 were estimated by probit analysis of dose response data. Procedures for diluting the commercial-grade off-the-shelf pesticide in acetone, treating the bottles, and calculating baseline data for insecticide-susceptible mosquito populations are described. The advantages and disadvantages of testing off-the-shelf commercial-grade pesticides that are maintained on premises by mosquito control programs, in contrast to using reagent-grade chemicals purchased from a chemical supply house, are also discussed. Data obtained by this method can be invaluable in making timely management decisions about the choice of pesticides in a control program.

  2. LPT. Shield test facility (TAN646) interior. Addition of third steam ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    LPT. Shield test facility (TAN-646) interior. Addition of third steam generator. Burner end. Camera facing southwest. Photographer: Comiskey. Date: January 20, 1965. INEEL negative no. 65-242 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  3. 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

  4. Field Evaluation of Diagnostic Accuracy of an Oral Fluid Rapid Test for HIV, Tested at Point-of-Service Sites in Rural Zimbabwe

    PubMed Central

    Langhaug, Lisa F.; Mudzori, James; Burke, Eileen; Hayes, Richard; Cowan, Frances M.

    2009-01-01

    Abstract The objective of this study was to validate the use of OraQuick® ADVANCE Rapid HIV-1/2 Antibody test (OraSure Technologies Inc., Bethlehem, PA) on oral fluid for a population-based HIV prevalence survey of rural youth in southeast Zimbabwe. The evaluation was conducted in patients presenting for voluntary counseling and testing at rural clinics. Each participant provided an oral fluid sample tested using OraQuick® ADVANCE. In addition, dried blood specimens were collected and tested blind at the National Microbiology Reference Laboratory in Harare using two enzyme-linked immunosorbent assays (ELISA; Vironostika®, Biomérieux BV, Boxtel, The Netherlands and Ani Labsystems, Ltd., Vantaa, Finland) with confirmatory Western blot (MP Diagnostics [formerly Genelabs Diagnostics], Medical Technology Promedt Consulting GMBH, St. Ingbert, Germany) for samples with discrepant results. Diagnostic accuracy of the oral fluid assay was determined against the ELISA/Western blot algorithm as gold standard. Five hundred and ninety-one participants took part in the study between February and July 2006. Sensitivity of the test on oral fluid was 100% (95% confidence interval [CI]: 97.9–100), and specificity was 100% (95% CI: 99.1–100). HIV prevalence based on the reference standard was 29.8% (95% CI: 26.1–33.5). This is one of the first validations of this rapid assay on oral fluid conducted in a general population to be reported in Africa. While there are some limitations with the assay (e.g., unlikely to detect those in early stages of HIV infection or with reduced viral load; altered accuracy in pregnancy) these limitations also apply to other rapid assays. The results showed the assay to be 100% accurate in determining HIV status, performed well in field settings, and can be considered suitable for use in epidemiologic surveys aiming to estimate HIV prevalence in general populations. PMID:19530953

  5. Field evaluation of diagnostic accuracy of an oral fluid rapid test for HIV, tested at point-of-service sites in rural Zimbabwe.

    PubMed

    Pascoe, Sophie J S; Langhaug, Lisa F; Mudzori, James; Burke, Eileen; Hayes, Richard; Cowan, Frances M

    2009-07-01

    The objective of this study was to validate the use of OraQuick ADVANCE Rapid HIV-1/2 Antibody test (OraSure Technologies Inc., Bethlehem, PA) on oral fluid for a population-based HIV prevalence survey of rural youth in southeast Zimbabwe. The evaluation was conducted in patients presenting for voluntary counseling and testing at rural clinics. Each participant provided an oral fluid sample tested using OraQuick ADVANCE. In addition, dried blood specimens were collected and tested blind at the National Microbiology Reference Laboratory in Harare using two enzyme-linked immunosorbent assays (ELISA; Vironostika, Biomérieux BV, Boxtel, The Netherlands and Ani Labsystems, Ltd., Vantaa, Finland) with confirmatory Western blot (MP Diagnostics [formerly Genelabs Diagnostics], Medical Technology Promedt Consulting GMBH, St. Ingbert, Germany) for samples with discrepant results. Diagnostic accuracy of the oral fluid assay was determined against the ELISA/Western blot algorithm as gold standard. Five hundred and ninety-one participants took part in the study between February and July 2006. Sensitivity of the test on oral fluid was 100% (95% confidence interval [CI]: 97.9-100), and specificity was 100% (95% CI: 99.1-100). HIV prevalence based on the reference standard was 29.8% (95% CI: 26.1-33.5). This is one of the first validations of this rapid assay on oral fluid conducted in a general population to be reported in Africa. While there are some limitations with the assay (e.g., unlikely to detect those in early stages of HIV infection or with reduced viral load; altered accuracy in pregnancy) these limitations also apply to other rapid assays. The results showed the assay to be 100% accurate in determining HIV status, performed well in field settings, and can be considered suitable for use in epidemiologic surveys aiming to estimate HIV prevalence in general populations.

  6. 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.

  7. 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.

  8. 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.

  9. Sweat testing for cystic fibrosis. Diagnostic screening with a combination chloride ion-selective electrode.

    PubMed Central

    Bray, P T; Clark, G C; Moody, G J; Thomas, G; Thomas, J D

    1978-01-01

    Screening of sweat chloride in newborn infants with the Orion Skin Chloride Measuring System and incorporating some procedural innovations is described. The results indicate that while diagnostic screening for cystic fibrosis can be readily undertaken, the test with the chloride ion-selective electrode is best left at least to the second day of life or later because of insufficient sweating in very young babies. Measurements on 2 babies with cystic fibrosis are also discussed. PMID:686774

  10. 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.

  11. 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

  12. 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

  13. 34 CFR 668.148 - Additional criteria for the approval of certain tests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... validity as promulgated in the Standards for Educational and Psychological Testing; (ii) Provide test... 34 Education 3 2013-07-01 2013-07-01 false Additional criteria for the approval of certain tests... of Independently Administered Tests; Specification of Passing Score; Approval of State Process §...

  14. 34 CFR 668.148 - Additional criteria for the approval of certain tests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... validity as promulgated in the Standards for Educational and Psychological Testing; (ii) Provide test... 34 Education 3 2014-07-01 2014-07-01 false Additional criteria for the approval of certain tests... of Independently Administered Tests; Specification of Passing Score; Approval of State Process §...

  15. 34 CFR 668.148 - Additional criteria for the approval of certain tests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... validity as promulgated in the Standards for Educational and Psychological Testing; (ii) Provide test... 34 Education 3 2012-07-01 2012-07-01 false Additional criteria for the approval of certain tests... of Independently Administered Tests; Specification of Passing Score; Approval of State Process §...

  16. 34 CFR 668.148 - Additional criteria for the approval of certain tests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... validity as promulgated in the Standards for Educational and Psychological Testing; (ii) Provide test... 34 Education 3 2011-07-01 2011-07-01 false Additional criteria for the approval of certain tests... of Independently Administered Tests; Specification of Passing Score; Approval of State Process §...

  17. Ophthalmic Diagnostic Tests and Ocular Findings in a Flock of Captive American Flamingos ( Phoenicopterus ruber ruber).

    PubMed

    Meekins, Jessica M; Stuckey, Jane Ashley; Carpenter, James W; Armbrust, Laura; Higbie, Christine; Rankin, Amy J

    2015-06-01

    Seventeen adult captive American flamingos ( Phoenicopterus ruber ruber) (34 eyes) underwent a complete ocular examination, including assessment of menace response, pupillary light reflexes, dazzle reflex, palpebral and corneal reflexes, fluorescein staining, slit-lamp biomicroscopy, and direct ophthalmoscopy. Birds were randomly assigned to one of 2 groups for tear production and intraocular pressure measurements. Tear production was measured by modified Schirmer tear test I (n = 9 birds) or phenol red thread test (n = 8 birds), and intraocular pressure was measured indirectly by applanation (Tonopen-XL) (n = 9 birds) or rebound (TonoVet) (n = 8 birds) tonometry. Conjunctival swab samples were taken from one randomly selected eye of all 17 birds to identify surface ocular microbial flora via aerobic bacterial culture. Additionally, 3 of the 17 birds were anesthetized for bilateral B-mode ocular ultrasonography examination to obtain axial globe measurements. Results showed that the menace response and dazzle reflex were absent in all birds. Sixteen of the 17 birds were free of significant ocular disease; a small cataract and pigment on the anterior lens capsule were noted in one eye of one bird. Mean ± SD tear production was 12.3 ± 4.5 mm/min (range, 4-20 mm/min) for modified Schirmer tear test I and 24.2 ± 4.4 mm/15 s (range, 14-30 mm/15 s) for phenol red thread test. Modified Schirmer tear test I measurements were significantly lower than phenol red thread measurements (P < .001). Mean intraocular pressure was 16.1 ± 4.2 mm Hg (range, 7-22 mm Hg) for Tonopen and 9.5 ± 1.7 mm Hg (range, 7-13 mm Hg) for TonoVet. Tonopen measurements were significantly higher than TonoVet measurements (P < .001). An Enterococcus species (9/17 eyes; 53%) and a gram-positive coccus (7/17 eyes; 41%) were the bacteria most commonly isolated from conjunctival swab samples. Mean B-mode ultrasonographic globe measurements of 6 eyes (3 birds) were axial globe length, 13.8 ± 0.16 mm

  18. 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

  19. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Task 3 Full-scale Test Results

    SciTech Connect

    Gary Blythe

    2007-05-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project is to demonstrate the use of a flue gas desulfurization (FGD) additive, Degussa Corporation's TMT-15, to prevent the reemission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate whether the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine TMT salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project is conducting pilot- and full-scale tests of the TMT-15 additive in wet FGD absorbers. The tests are intended to determine required additive dosages to prevent Hg{sup 0} reemissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Power River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, TXU Generation Company LP, Southern Company, and Degussa Corporation. TXU Generation has provided the Texas lignite/PRB cofired test site for pilot FGD tests, Monticello Steam Electric Station Unit 3. Southern Company is providing the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot- and full-scale jet bubbling reactor (JBR) FGD systems to be tested. IPL, an AES company, provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Degussa Corporation is providing the TMT-15 additive and technical support to the test program as cost sharing. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves management and reporting. The other four tasks involve field testing on FGD systems, either at pilot or full scale. The four tasks include: Task 2 - Pilot Additive Testing

  20. Personality Assessment in the Diagnostic Manuals: On Mindfulness, Multiple Methods, and Test Score Discontinuities.

    PubMed

    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 the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), 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, multimethod 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 can 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, a multimethod assessment compels the assessor 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.

  1. 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

  2. Diagnostic Accuracy of Molecular Amplification Tests for Human African Trypanosomiasis—Systematic Review

    PubMed Central

    Boer, Kimberly R.; Dyserinck, Heleen C.; Büscher, Philippe; Schallig, Henk D. H. F.; Leeflang, Mariska M. G.

    2012-01-01

    Background A range of molecular amplification techniques have been developed for the diagnosis of Human African Trypanosomiasis (HAT); however, careful evaluation of these tests must precede implementation to ensure their high clinical accuracy. Here, we investigated the diagnostic accuracy of molecular amplification tests for HAT, the quality of articles and reasons for variation in accuracy. Methodology Data from studies assessing diagnostic molecular amplification tests were extracted and pooled to calculate accuracy. Articles were included if they reported sensitivity and specificity or data whereby values could be calculated. Study quality was assessed using QUADAS and selected studies were analysed using the bivariate random effects model. Results 16 articles evaluating molecular amplification tests fulfilled the inclusion criteria: PCR (n = 12), NASBA (n = 2), LAMP (n = 1) and a study comparing PCR and NASBA (n = 1). Fourteen articles, including 19 different studies were included in the meta-analysis. Summary sensitivity for PCR on blood was 99.0% (95% CI 92.8 to 99.9) and the specificity was 97.7% (95% CI 93.0 to 99.3). Differences in study design and readout method did not significantly change estimates although use of satellite DNA as a target significantly lowers specificity. Sensitivity and specificity of PCR on CSF for staging varied from 87.6% to 100%, and 55.6% to 82.9% respectively. Conclusion Here, PCR seems to have sufficient accuracy to replace microscopy where facilities allow, although this conclusion is based on multiple reference standards and a patient population that was not always representative. Future studies should, therefore, include patients for which PCR may become the test of choice and consider well designed diagnostic accuracy studies to provide extra evidence on the value of PCR in practice. Another use of PCR for control of disease could be to screen samples collected from rural areas and test in reference

  3. Acceptance test report: Field test of mixer pump for 241-AN-107 caustic addition project

    SciTech Connect

    Leshikar, G.A.

    1997-05-16

    The field acceptance test of a 75 HP mixer pump (Hazleton serial number N-20801) installed in Tank 241-AN-107 was conducted from October 1995 thru February 1996. The objectives defined in the acceptance test were successfully met, with two exceptions recorded. The acceptance test encompassed field verification of mixer pump turntable rotation set-up and operation, verification that the pump instrumentation functions within established limits, facilitation of baseline data collection from the mixer pump mounted ultrasonic instrumentation, verification of mixer pump water flush system operation and validation of a procedure for its operation, and several brief test runs (bump) of the mixer pump.

  4. 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

  5. 30 CFR 75.151 - Tests for methane; qualified person; additional requirement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tests for methane; qualified person; additional... Certified Persons § 75.151 Tests for methane; qualified person; additional requirement. Notwithstanding the... methane unless he demonstrates to the satisfaction of an authorized representative of the Secretary...

  6. 30 CFR 75.151 - Tests for methane; qualified person; additional requirement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tests for methane; qualified person; additional... Certified Persons § 75.151 Tests for methane; qualified person; additional requirement. Notwithstanding the... methane unless he demonstrates to the satisfaction of an authorized representative of the Secretary...

  7. 30 CFR 75.151 - Tests for methane; qualified person; additional requirement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tests for methane; qualified person; additional... Certified Persons § 75.151 Tests for methane; qualified person; additional requirement. Notwithstanding the... methane unless he demonstrates to the satisfaction of an authorized representative of the Secretary...

  8. 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.

  9. Testing 1...2...3...: Additional Files Available for Test Information Online.

    ERIC Educational Resources Information Center

    Fabiano, Emily

    1984-01-01

    Reviews databases providing information on published, standardized and unpublished, non-standardized test instruments: Educational Testing Service File, Mental Measurements Yearbook Database, Dissertation Abstracts Online, ERIC, and Psychological Abstracts. Search strategies, search examples, and a summary chart of searchable fields for test…

  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. 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.

  12. Calibration and Test of the Tangential Phase Contrast Imaging Diagnostic on CDX-U

    NASA Astrophysics Data System (ADS)

    Lo, E.; Nazikian, R.; Stutman, D.; Breslau, J.; Wright, J.; Choe, W.; Cdx-U Group

    1996-11-01

    The novel CO2 laser based tangential imaging diagnostic has been completely calibrated and the system has been tested on CDX-U plasmas. It can be shown that localized, two-dimensional images of the plasma electron density fluctuations in the tokamak core can be obtained from a tangential imaging beam. A variation of the Zernike phase mirror is used. Test measurements made on sound waves verify that the system will image phase variations placed at the object plane. An absolute sensitivity of ≈ 1 × 10^7 cm-3/√Hz has been determined. A series of plasma measurements made on CDX-U are described. Results show that the plasma fluctuations are 2-3 orders of magnitude above the noise floor of the diagnostic. It is also verified that a high-pass cut-off wavenumber (from ≈ 1-8 cm-1) for the fluctuations can be selected by translating the phase mirror. The density fluctuation k-spectrum is measured and found to peak at ≈ 1-3 cm-1. Preliminary correlation with other fluctuation diagnostics, including observation of sawteeth in the plasma core, indicate that localization of imaging to the core of the CDX-U plasma is occurring.

  13. 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

  14. 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

  15. Diagnostic tests for the detection of human papillomavirus-associated cervical lesions.

    PubMed

    Reuschenbach, Miriam; von Knebel Doeberitz, Magnus

    2013-01-01

    Current diagnostic approaches for primary cervical cancer screening, work-up of equivocal or positive screening results or follow- up after treatment of precancerous lesions primarily rely on the morphologic interpretation of squamous epithelial cells (Pap cytology), in some setting accompanied by the detection of human papillomavirus DNA and have largely contributed to remarkable reduction of disease incidence in countries with implemented screening programs. However, these approaches are limited by a poor sensitivity and reproducibility of Pap cytology and low specificity for high grade cervical intraepithelial neoplasia of HPV DNA detection assays. Early detection might be improved by complementing or even replacing these tests by markers which are more directly related to molecular events triggering HPV-induced carcinogenesis and thereby might deliver more accurate diagnostic performance. The delineation of molecular changes which occur during different stages of HPV infections and the identification of changes which induce neoplastic alterations allow for the detection of markers that specifically highlight the transforming stage of the infection where viral oncogenes are overexpressed and therefore allow for a more specific diagnosis of lesions that require treatment. The evaluation of such markers in clinical studies revealed that some indeed show an improved diagnostic performance compared to Pap cytology or HPV DNA tests only.

  16. A four-step approach for developing diagnostic tests in psychiatry.

    PubMed

    Boutros, N N; Arfken, C L

    2007-04-01

    A four-step approach for developing diagnostic tests in psychiatry is proposed. Step 1, a biological variable is observed to be deviant from healthy controls in a particular patient population. The demonstration of test retest reliability of the finding using blinding procedures is an essential component of this early step. Step 2, is the demonstration of potential clinical usefulness of the specific finding. The two most important objectives at this step are demonstration of difference between the target patient population and appropriate control groups (these should be groups of patients with diagnoses that commonly appear on the differential diagnostic lists of the target disorder). Estimation of the effect size of the finding could be a reasonable guide to which findings should be considered good candidates for Step 3 studies. During Step 3 the performance characteristics of the test should be established. Specifically, the sensitivity, specificity, positive and negative predictive values of the biological marker should be examined. Step 4 defines the clinical application of the test and helps standardize the technique used in large and multicenter clinical trials. Multicenter trials should pave the road towards standardization of laboratory procedures used to conduct the test, as well as providing data regarding cost effectiveness and impact on both short-term and long-term clinical outcomes.

  17. Diagnostic Accuracy of Tests for Polyuria in Lithium-Treated Patients.

    PubMed

    Kinahan, James Conor; NiChorcorain, Aoife; Cunningham, Sean; Freyne, Aideen; Cooney, Colm; Barry, Siobhan; Kelly, Brendan D

    2015-08-01

    In lithium-treated patients, polyuria increases the risk of dehydration and lithium toxicity. If detected early, it is reversible. Despite its prevalence and associated morbidity in clinical practice, it remains underrecognized and therefore undertreated. The 24-hour urine collection is limited by its convenience and practicality. This study explores the diagnostic accuracy of alternative tests such as questionnaires on subjective polyuria, polydipsia, nocturia (dichotomous and ordinal responses), early morning urine sample osmolality (EMUO), and fluid intake record (FIR). This is a cross-sectional study of 179 lithium-treated patients attending a general adult and an old age psychiatry service. Participants completed the tests after completing an accurate 24-hour urine collection. The diagnostic accuracy of the individual tests was explored using the appropriate statistical techniques. Seventy-nine participants completed all of the tests. Polydipsia severity, EMUO, and FIR significantly differentiated the participants with polyuria (area under the receiver operating characteristic curve of 0.646, 0.760, and 0.846, respectively). Of the tests investigated, the FIR made the largest significant change in the probability that a patient experiences polyuria (<2000 mL/24 hours; interval likelihood ratio, 0.18 and >3500 mL/24 hours; interval likelihood ratio, 14). Symptomatic questioning, EMUO, and an FIR could be used in clinical practice to inform the prescriber of the probability that a lithium-treated patient is experiencing polyuria.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. The importance of diagnostic test parameters in the interpretation of clinical test findings: The Prone Hip Extension Test as an example

    PubMed Central

    Bruno, Paul

    2011-01-01

    The use of diagnostic tests is a crucial aspect of clinical practice since they assist clinicians in establishing whether a patient has or does not have a particular condition. In order for any clinical test to be used most appropriately, it is essential that several parameters be established regarding the test and that these are made known to clinicians to inform their clinical decision making. These include the test’s sensitivity, specificity, predictive values, and likelihood ratios. This article reviews their importance as well as provides an illustrative example that highlights how knowledge of the parameters for a given test allows clinicians to better interpret their test findings in practice. PMID:21629460

  3. The modified ultrasound pattern sum score mUPSS as additional diagnostic tool for genetically distinct hereditary neuropathies.

    PubMed

    Grimm, Alexander; Rasenack, Maria; Athanasopoulou, Ioanna M; Dammeier, Nele Maria; Lipski, Christina; Wolking, Stefan; Vittore, Debora; Décard, Bernhard F; Axer, Hubertus

    2016-02-01

    The objective of this study is to evaluate the nerve ultrasound characteristics in genetically distinct inherited neuropathies, the value of the modified ultrasound pattern sum score (mUPSS) to differentiate between the subtypes and the correlation of ultrasound with nerve conduction studies (NCS), disease duration and severity. All patients underwent a standardized neurological examination, ultrasound, and NCS. In addition, genetic testing was performed. Consequently, mUPSS was applied, which is a sum-score of cross-sectional areas (CSA) at predefined anatomical points in different nerves. 31 patients were included (10xCharcot-Marie-Tooth (CMT)1a, 3xCMT1b, 3xCMTX, 9xCMT2, 6xHNPP [Hereditary neuropathy with liability to pressure palsies]). Generalized, homogeneous nerve enlargement and significantly increased UPS scores emphasized the diagnosis of demyelinating neuropathy, particularly CMT1a and CMT1b. The amount of enlargement did not depend on disease duration, symptom severity, height and weight. In CMTX the nerves were enlarged, as well, however, only in the roots and lower limbs, most prominent in men. In CMT2 no significant enlargement was detectable. In HNPP the CSA values were increased at entrapped sites, and not elsewhere. However, a distinction from CMT1, which also showed enlarged CSA values at entrapment sites, was only possible by calculating the entrapment ratios and entrapment score. The mUPSS allowed distinction between CMT1a (increased UPS scores, entrapment ratios <1.0) and HNPP (low UPS scores, entrapment ratios >1.4), while CMT1b and CMTX showed intermediate UPS types and entrapment ratios <1.0. Although based on few cases, ultrasound revealed consistent and homogeneous nerve alteration in certain inherited neuropathies. The modified UPSS is a quantitative tool, which may provide useful information for diagnosis, differentiation and follow-up evaluation in addition to NCS and molecular testing.

  4. 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

  5. Assessment of desiccants and their instructions for use in rapid diagnostic tests

    PubMed Central

    2012-01-01

    Background Malaria rapid diagnostic tests (RDTs) are protected from humidity-caused degradation by a desiccant added to the device packaging. The present study assessed malaria RDT products for the availability, type and design of desiccants and their information supplied in the instructions for use (IFU). Methods Criteria were based on recommendations of the World Health Organization (WHO), the European Community (CE) and own observations. Silica gel sachets were defined as self-indicating (all beads coated with a humidity indicator that changes colour upon saturation), partial-indicating (part of beads coated) and non-indicating (none of the beads coated). Indicating silica gel sachets were individually assessed for humidity saturation and (in case of partial-indicating silica gels) for the presence of indicating beads. Results Fifty malaria RDT products from 25 manufacturers were assessed, 14 (28%) products were listed by the “Global Fund Quality Assurance Policy” and 31 (62%) were CE-marked. All but one product contained a desiccant, mostly (47/50, 94%) silica gel. Twenty (40%) RDT products (one with no desiccant and 19 with non-indicating desiccant) did not meet the WHO guidelines recommending indicating desiccant. All RDT products with self- or partial-indicating silica gel (n = 22 and 8 respectively) contained the toxic cobalt dichloride as humidity indicator. Colour change indicating humidity saturation was observed for 8/16 RDT products, at a median incidence of 0.8% (range 0.05%-4.6%) of sachets inspected. In all RDTs with partial-indicating silica gel, sachets with no colour indicating beads were found (median proportion 13.5% (0.6% - 17.8%) per product) and additional light was needed to assess the humidity colour. Less than half (14/30, 47%) IFUs of RDT products with indicating desiccants mentioned to check the humidity saturation before using the test. Information on properties, safety hazards and disposal of the desiccant was not included in

  6. Rapid antigen-based testing for respiratory syncytial virus: moving diagnostics from bench to bedside?

    PubMed

    Prendergast, Caitlin; Papenburg, Jesse

    2013-04-01

    Respiratory syncytial virus (RSV) is the most important cause of infantile bronchiolitis and pneumonia. It is ubiquitous, with most children acquiring their primary infection within the first year of life and with subsequent reinfection occurring in all age groups. Clinically, RSV is virtually indistinguishable from other viral respiratory infections. Traditionally, the microbiologic diagnosis of RSV has been based on moderate to complex techniques performed in a laboratory (cell culture, nucleic acid amplification and immunofluorescence assays); however, rapid antigen-detection tests offer potential advantages associated with point-of-care testing. This review seeks to familiarize the readers with RSV rapid antigen-detection tests, describe their performance characteristics and comment on their strengths and weaknesses. The authors will discuss the impact of rapid RSV testing on clinical practice, with a look to the future of what the field ultimately requires of a point-of-care diagnostic technique.

  7. The status of diagnostic testing following referral from universal newborn hearing screening.

    PubMed

    Windmill, Sue; Windmill, Ian M

    2006-05-01

    The Joint Committee on Infant Hearing 2000 position statement includes guidelines for the development of Early Hearing Detection and Intervention programs. These guidelines provide specific recommendations for the audiologic test battery for infants who fail a newborn infant hearing screening. The recommended test battery includes electrophysiologic measures such as the ABR, frequency specific electrophysiologic tests, bone-conducted ABR, OAEs, tympanometry using high frequency probe stimuli, and acoustic reflexes. In the Commonwealth of Kentucky, 42 centers are listed as providing follow-up diagnostic testing services for infants failing the newborn hearing screening. The purpose of this investigation was to determine how many of these centers were abiding by the Joint Committee guidelines. Results show that only three of 42 centers listed are providing services that meet the guidelines. Less than 50% of infants identified with hearing loss are referred for genetic evaluations by the audiologist. Only 19 of the 42 sites listed provide amplification services for infants identified with hearing loss.

  8. Effect of Culture-Independent Diagnostic Tests on Future Emerging Infections Program Surveillance.

    PubMed

    Langley, Gayle; Besser, John; Iwamoto, Martha; Lessa, Fernanda C; Cronquist, Alicia; Skoff, Tami H; Chaves, Sandra; Boxrud, Dave; Pinner, Robert W; Harrison, Lee H

    2015-09-01

    The Centers for Disease Control and Prevention Emerging Infections Program (EIP) network conducts population-based surveillance for pathogens of public health importance. Central to obtaining estimates of disease burden and tracking microbiological characteristics of these infections is accurate laboratory detection of pathogens. The use of culture-independent diagnostic tests (CIDTs) in clinical settings presents both opportunities and challenges to EIP surveillance. Because CIDTs offer better sensitivity than culture and are relatively easy to perform, their use could potentially improve estimates of disease burden. However, changes in clinical testing practices, use of tests with different sensitivities and specificities, and changes to case definitions make it challenging to monitor trends. Isolates are still needed for performing strain typing, antimicrobial resistance testing, and identifying other molecular characteristics of organisms. In this article, we outline current and future EIP activities to address issues associated with adoption of CIDTs, which may apply to other public health surveillance. PMID:26291736

  9. Recommendations for reporting results of diagnostic genetic testing (biochemical, cytogenetic and molecular genetic).

    PubMed

    Claustres, Mireille; Kožich, Viktor; Dequeker, Els; Fowler, Brain; Hehir-Kwa, Jayne Y; Miller, Konstantin; Oosterwijk, Cor; Peterlin, Borut; van Ravenswaaij-Arts, Conny; Zimmermann, Uwe; Zuffardi, Orsetta; Hastings, Ros J; Barton, David E

    2014-02-01

    Genetic test results can have considerable importance for patients, their parents and more remote family members. Clinical therapy and surveillance, reproductive decisions and genetic diagnostics in family members, including prenatal diagnosis, are based on these results. The genetic test report should therefore provide a clear, concise, accurate, fully interpretative and authoritative answer to the clinical question. The need for harmonizing reporting practice of genetic tests has been recognised by the External Quality Assessment (EQA), providers and laboratories. The ESHG Genetic Services Quality Committee has produced reporting guidelines for the genetic disciplines (biochemical, cytogenetic and molecular genetic). These guidelines give assistance on report content, including the interpretation of results. Selected examples of genetic test reports for all three disciplines are provided in an annexe.

  10. 49 CFR 199.111 - Retention of samples and additional testing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.111 Retention of samples and additional testing. (a) Samples that yield positive results on confirmation must be retained by the laboratory in properly...

  11. 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…

  12. A Multi-Expert Approach for Developing Testing and Diagnostic Systems Based on the Concept-Effect Model

    ERIC Educational Resources Information Center

    Panjaburee, Patcharin; Hwang, Gwo-Jen; Triampo, Wannapong; Shih, Bo-Ying

    2010-01-01

    With the popularization of computer and communication technologies, researchers have attempted to develop computer-assisted testing and diagnostic systems to help students improve their learning performance on the Internet. In developing a diagnostic system for detecting students' learning problems, it is difficult for individual teachers to…

  13. The Relationship between Students' Reading Performance on Diagnostic Assessments and the Third Grade Reading Achievement Test in Ohio

    ERIC Educational Resources Information Center

    Hollinger, Jamie L.

    2009-01-01

    The purpose of this correlational study was twofold: to examine the relationship of students' reading performance on six different diagnostic reading assessments and the third grade Ohio Reading Achievement Test; and to assist educators in choosing the diagnostic assessments that best identify students at risk of failing the third grade Ohio…

  14. 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 MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory...

  15. 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 MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory...

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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.…

  2. A Refined QSO Selection Method Using Diagnostics Tests: 663 QSO Candidates in the Large Magellanic Cloud

    NASA Astrophysics Data System (ADS)

    Kim, Dae-Won; Protopapas, Pavlos; Trichas, Markos; Rowan-Robinson, Michael; Khardon, Roni; Alcock, Charles; Byun, Yong-Ik

    2012-03-01

    We present 663 QSO candidates in the Large Magellanic Cloud (LMC) selected using multiple diagnostics. We started with a set of 2566 QSO candidates selected using the methodology presented in our previous work based on time variability of the MACHO LMC light curves. We then obtained additional information for the candidates by crossmatching them with the Spitzer SAGE, the Two Micron All Sky Survey, the Chandra, the XMM, and an LMC UBVI catalog. Using this information, we specified six diagnostic features based on mid-IR colors, photometric redshifts using spectral energy distribution template fitting, and X-ray luminosities in order to further discriminate high-confidence QSO candidates in the absence of spectra information. We then trained a one-class Support Vector Machine model using the diagnostics features of the confirmed 58 MACHO QSOs. We applied the trained model to the original candidates and finally selected 663 high-confidence QSO candidates. Furthermore, we crossmatched these 663 QSO candidates with the newly confirmed 151 QSOs and 275 non-QSOs in the LMC fields. On the basis of the counterpart analysis, we found that the false positive rate is less than 1%.

  3. A REFINED QSO SELECTION METHOD USING DIAGNOSTICS TESTS: 663 QSO CANDIDATES IN THE LARGE MAGELLANIC CLOUD

    SciTech Connect

    Kim, Dae-Won; Protopapas, Pavlos; Trichas, Markos; Alcock, Charles; Rowan-Robinson, Michael; Khardon, Roni; Byun, Yong-Ik

    2012-03-10

    We present 663 QSO candidates in the Large Magellanic Cloud (LMC) selected using multiple diagnostics. We started with a set of 2566 QSO candidates selected using the methodology presented in our previous work based on time variability of the MACHO LMC light curves. We then obtained additional information for the candidates by crossmatching them with the Spitzer SAGE, the Two Micron All Sky Survey, the Chandra, the XMM, and an LMC UBVI catalog. Using this information, we specified six diagnostic features based on mid-IR colors, photometric redshifts using spectral energy distribution template fitting, and X-ray luminosities in order to further discriminate high-confidence QSO candidates in the absence of spectra information. We then trained a one-class Support Vector Machine model using the diagnostics features of the confirmed 58 MACHO QSOs. We applied the trained model to the original candidates and finally selected 663 high-confidence QSO candidates. Furthermore, we crossmatched these 663 QSO candidates with the newly confirmed 151 QSOs and 275 non-QSOs in the LMC fields. On the basis of the counterpart analysis, we found that the false positive rate is less than 1%.

  4. 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.

  5. Considerations for the planning and conduct of reproducibility studies of in vitro diagnostic tests for infectious agents.

    PubMed

    Derion, Toniann

    2003-01-01

    The US Food and Drug Administration (FDA) requires reproducibility studies for premarket approval of in vitro diagnostic (IVD) tests. Results of reproducibility studies provide an estimate of the variability of the IVD test among study sites, reagent lots, site operators, within a single test run, and over multiple test days. In planning the study, discuss the product registration strategy, including the intended use of the product and desired label claims, and define the study team. Design the sample panel according to the limit of detection or quantitation of the test, dynamic range of the test, FDA guidelines, sample matrix, and genotype. Consider legal and ethical issues for obtaining the panel parent specimen, such as minimizing the privacy risk and keeping promises to donors. During the study, review data promptly to determine invalid runs, discover trends in the data that may require additional operator training, ensure correct completion of case report forms, and resolve queries quickly. At the end of the study, gather the study team to review and improve processes. Use the outcome to set expectations of other functional areas and to provide product feedback.

  6. 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…

  7. 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

  8. A new generation of companion diagnostics: cobas BRAF, KRAS and EGFR mutation detection tests.

    PubMed

    Angulo, Barbara; Lopez-Rios, Fernando; Gonzalez, David

    2014-06-01

    The cobas(®) (Roche) portfolio of companion diagnostics in oncology currently has three assays CE-marked for in vitro diagnostics. Two of these (EGFR and BRAF) are also US FDA-approved. These assays detect clinically relevant mutations that are correlated with response (BRAF, EGFR) or lack of response (KRAS) to targeted therapies such as selective mutant BRAF inhibitors in malignant melanoma, tyrosine kinases inhibitor in non-small cell lung cancer and anti-EGFR monoclonal antibodies in colorectal cancer, respectively. All these assays are run on a single platform using DNA extracted from a single 5 µm section of a formalin-fixed paraffin-embedded tissue block. The assays provide an 'end-to-end' solution from extraction of DNA to automated analysis and report on the cobas z 480. The cobas tests have shown robust and reproducible performance, with high sensitivity and specificity and low limit of detection, making them suitable as companion diagnostics for clinical use. PMID:24844134

  9. Application of diagnostic tests for mycoplasmal infections of desert and gopher tortoises with management recommendations

    USGS Publications Warehouse

    Brown, D.R.; Schumacher, Isabella 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

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Task 5 Full-Scale Test Results

    SciTech Connect

    Gary Blythe; MariJon Owens

    2007-12-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project is to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate whether the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project is conducting pilot- and full-scale tests of the additives in wet FGD absorbers. The tests are intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power has provided the Texas lignite/PRB co-fired test site for pilot FGD tests and cost sharing. Southern Company has provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation is providing the TMT-15 additive, and the Nalco Company is providing the Nalco 8034 additive. Both companies are also supplying technical support to the test program as in-kind cost sharing. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves management

  17. HER2 diagnostics in gastric cancer-guideline validation and development of standardized immunohistochemical testing.

    PubMed

    Rüschoff, Josef; Dietel, Manfred; Baretton, Gustavo; Arbogast, Susanne; Walch, Axel; Monges, Geneviéve; Chenard, Marie-Pierre; Penault-Llorca, Frédérique; Nagelmeier, Iris; Schlake, Werner; Höfler, H; Kreipe, H H

    2010-09-01

    Trastuzumab-based therapy has been shown to confer overall survival benefit in HER2-positive patients with advanced gastric cancer in a large multicentric trial (ToGA study). Subgroup analysis identified adenocarcinomas of the stomach and gastroesophageal (GE) junction with overexpression of HER2 according to immunohistochemistry (IHC) as potential responders. Due to recent approval of trastuzumab for HER2 positive metastatic gastric and GE-junction cancer in Europe (EMEA) HER2 diagnostics is now mandatory with IHC being the primary test followed by fluorescence in situ hybridization (FISH) in IHC2+ cases. However, in order to not miss patients potentially responding to targeted therapy determination of a HER2-positive status for gastric cancer required modification of scoring as had been proposed in a pre-ToGA study. To validate this new HER2 status testing procedure in terms of inter-laboratory and inter-observer consensus for IHC scoring a series of 547 gastric cancer tissue samples on a tissue microarray (TMA) was used. In the first step, 30 representative cores were used to identify specific IHC HER2 scoring issues among eight French and German laboratories, while in the second step the full set of 547 cores was used to determine IHC HER2 intensity and area score concordance between six German pathologists. Specific issues relating to discordance were identified and recommendations formulated which proved to be effective to reliably determine HER2 status in a prospective test series of 447 diagnostic gastric cancer specimens.

  18. [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

  19. Fermilab PXIE Beam Diagnostics Development and Testing at the HINS Beam Facility

    SciTech Connect

    Lebedev, V.A.; Shemyakin, A.V.; Steimel, J.; Wendt, M.; Hanna, B.M.; Prost, L.R.; Scarpine, V.E.; /Fermilab

    2012-05-01

    Fermilab is planning the construction of a prototype front end of the Project X linac. The Project X Injector Experiment (PXIE) is expected to accelerate 1 mA CW H- beam up to 30 MeV. Some of the major goals of the project are to test a CW RFQ and H- source, a broadband bunch-by-bunch beam chopper and a low-energy superconducting linac. The successful characterization and operation of such an accelerator place stringent requirements on beamline diagnostics. These crucial beam measurements include bunch currents, beam orbit, beam phase, bunch length, transverse profile and emittance and beam halo and tails, as well as the extinction performance of the broadband chopper. This paper presents PXIE beam measurement requirements and instrumentation development plans. Presented are plans to test key instruments at the Fermilab High Intensity Neutrino Source (HINS) beam facility. Since HINS is already an operational accelerator, utilizing HINS for instrumentation testing will allow for quicker development of the required PXIE diagnostics.

  20. 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.

  1. Hierarchical diagnostic classification models: a family of models for estimating and testing attribute hierarchies.

    PubMed

    Templin, Jonathan; Bradshaw, Laine

    2014-04-01

    Although latent attributes that follow a hierarchical structure are anticipated in many areas of educational and psychological assessment, current psychometric models are limited in their capacity to objectively evaluate the presence of such attribute hierarchies. This paper introduces the Hierarchical Diagnostic Classification Model (HDCM), which adapts the Log-linear Cognitive Diagnosis Model to cases where attribute hierarchies are present. The utility of the HDCM is demonstrated through simulation and by an empirical example. Simulation study results show the HDCM is efficiently estimated and can accurately test for the presence of an attribute hierarchy statistically, a feature not possible when using more commonly used DCMs. Empirically, the HDCM is used to test for the presence of a suspected attribute hierarchy in a test of English grammar, confirming the data is more adequately represented by hierarchical attribute structure when compared to a crossed, or nonhierarchical structure.

  2. Results of prototype particle-beam diagnostics tests for the Advanced Photon Source (APS)

    SciTech Connect

    Lumpkin, A.H.; Chung, Y.; Kahana, E.; Patterson, D.; Sellyey, W.; Votaw, A.; Wang, X.

    1993-07-01

    The Advanced Photon Source (APS) will be a third-generation synchrotron radiation source (hard x-rays) based on 7-GeV positrons circulating in a 1,104-m circumference storage ring. In the past year a number of the diagnostic prototypes for the measurement of the charged-particle beam parameters throughout the subsystems of the facility (ranging from 450-MeV to 7-GeV positrons and with different pulse formats) have been built and tested. Results are summarized for the beam position monitor (BPM), current monitor (CM), loss monitor (LM), and imaging systems (ISYS). The test facilities ranged from the 40-MeV APS linac test stand to the existing storage rings at SSRL and NSLS.

  3. Disentangling screening and diagnostic Chlamydia test positivity among females testing at title x-funded and adolescent health clinics, san francisco 2009.

    PubMed

    Stephens, Sally C; Snell, Ameera; Liska, Sally; Rauch, Leah; Philip, Susan S; Bernstein, Kyle T

    2011-07-01

    By using a reason-for-test code, we compared positivity for female chlamydia and gonorrhea. At family planning clinics, there were no statistically significant differences in screening versus diagnostic positivity for either chlamydia or gonorrhea among women. However, at adolescent health clinics, diagnostic positivity was higher than screening positivity for chlamydia and gonorrhea.

  4. 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).

  5. Field Testing of a Wet FGD Additive for Enhanced Mercury Control

    SciTech Connect

    Gary Blythe; MariJon Owens

    2007-12-31

    This document is the final report for DOE-NETL Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project has been to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project was intended to demonstrate whether such additives can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal. The project involved pilot- and full-scale tests of the additives in wet FGD absorbers. The tests were intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power provided the Texas lignite/PRB co-fired test site for pilot FGD tests and project cost sharing. Southern Company provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested, and project cost sharing. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation provided the TMT-15 additive, and the Nalco Company provided the Nalco 8034 additive. Both companies also supplied technical support to the test program as in-kind cost sharing. The project was conducted in six tasks. Of the six tasks, Task 1 involved project planning and Task 6 involved

  6. Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India.

    PubMed

    Vyas, S; Puwar, B; Patel, V; Bhatt, G; Kulkarni, S; Fancy, M

    2014-04-01

    Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis. This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria (SD Bioline Malaria Ag P.f/Pan) versus blood smear examination as the gold standard. All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears. A total of 677 cases with fever were examined; 135 (20.0%) tested positive by rapid diagnostic test and 86 (12.7%) by blood smear. The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%. For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%. The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting.

  7. 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

  8. Diagnostic Value of Electrocardiogram in Predicting Exaggerated Blood Pressure Response to Exercise Stress Testing

    PubMed Central

    Eshraghi, Ali; Ebdali, Reyhaneh Takalloo; Sajjadi, Seyed Sajed; Golnezhad, Reza

    2016-01-01

    Introduction It is believed that an exaggerated blood pressure response (EBPR) to exercise stress test is associated with a higher risk of cardiovascular events. It is also assumed that QT dispersion (QT-d), which was originally proposed to measure the spatial dispersion of ventricular recovery times, may have a relationship to cardiovascular events. The objective of this study was to examine the difference of changes in QT-d, Maxi-QT, Mini-QT, and QT-c (corrected QT interval) of the electrocardiogram in two groups of patients with exaggerated blood pressure responses (EBPR group) and normal responses (control group) to exercise testing. Also, the diagnostic value of each of these criteria in the prediction of EBPR was studied. Methods This cross-sectional study was conducted from May 2015 to February 2016 on patients suspected of coronary artery disease (CAD) undergoing exercise testing who had been referred to Ghaem and Imam Reza hospitals in Mashhad (Iran). All patients underwent a treadmill exercise test with the 12-lead ECG, which was optically scanned and digitized for analysis of QT-d, QT max, and QT min. Patients were divided into two groups of normal and EBPR to exercise testing. QT changes of ECG were compared between the two groups, and the diagnostic accuracy of QT variables for prediction of EBPR to exercise testing was studied. A multiple linear regression analysis (MLR), Pearson Chi-qquare, independent samples t-test, and receiver operating characteristic (ROC) curve were used as statistical methods in IBM SPSS version 19. Results Sixty patients (55% male) with a mean age of 50.48 ± 10.89 years were studied in two groups of normal (n=30) and exaggerated blood pressure response (n=30) to exercise testing. Maximum QT and QT dispersion were statistically different in individuals’ exaggerated blood pressure response to exercise stress test (p < 0.05). The logistic regression analysis revealed that none of our parameters predicted the EBPR. The ROC

  9. Hypersensitivity reactions to metallic implants - diagnostic algorithm and suggested patch test series for clinical use.

    PubMed

    Schalock, Peter C; Menné, Torkil; Johansen, Jeanne D; Taylor, James S; Maibach, Howard I; Lidén, Carola; Bruze, Magnus; Thyssen, Jacob P

    2012-01-01

    Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch testing. Those without a history of dermatitis should not be tested unless considerable concern exists. Regarding post-implant testing, a subset of patients with metal hypersensitivity may develop cutaneous or systemic reactions to implanted metals following implant. For symptomatic patients, a diagnostic algorithm to guide the selection of screening allergen series for patch testing is provided. At a minimum, an extended baseline screening series and metal screening is necessary. Static and dynamic orthopaedic implants, intravascular stent devices, implanted defibrillators and dental and gynaecological devices are considered. Basic management suggestions are provided. Our goal is to provide a comprehensive reference for use by those evaluating suspected cutaneous and systemic metal hypersensitivity reactions.

  10. A test strategy for the assessment of additive attributed toxicity of tobacco products.

    PubMed

    Kienhuis, Anne S; Staal, Yvonne C M; Soeteman-Hernández, Lya G; van de Nobelen, Suzanne; Talhout, Reinskje

    2016-08-01

    The new EU Tobacco Product Directive (TPD) prohibits tobacco products containing additives that are toxic in unburnt form or that increase overall toxicity of the product. This paper proposes a strategy to assess additive attributed toxicity in the context of the TPD. Literature was searched on toxicity testing strategies for regulatory purposes from tobacco industry and governmental institutes. Although mainly traditional in vivo testing strategies have been applied to assess toxicity of unburnt additives and increases in overall toxicity of tobacco products due to additives, in vitro tests combined with toxicogenomics and validated using biomarkers of exposure and disease are most promising in this respect. As such, tests are needed that are sensitive enough to assess additive attributed toxicity above the overall toxicity of tobacco products, which can associate assay outcomes to human risk and exposure. In conclusion, new, sensitive in vitro assays are needed to conclude whether comparable testing allows for assessment of small changes in overall toxicity attributed to additives. A more pragmatic approach for implementation on a short-term is mandated lowering of toxic emission components. Combined with risk assessment, this approach allows assessment of effectiveness of harm reduction strategies, including banning or reducing of additives.

  11. Epidemiology of meningitis with a negative CSF Gram stain: under-utilization of available diagnostic tests.

    PubMed

    Nesher, L; Hadi, C M; Salazar, L; Wootton, S H; Garey, K W; Lasco, T; Luce, A M; Hasbun, R

    2016-01-01

    Meningitis with a negative cerebrospinal fluid Gram stain (CSF-GS) poses a diagnostic challenge as more than 50% of patients remain without an aetiology. The introduction of polymerase chain reaction (PCR) and arboviral serologies have increased diagnostic capabilities, yet large scale epidemiological studies evaluating their use in clinical practice are lacking. We conducted a prospective observational study in New Orleans between November 1999 and September 2008 (early era) when PCR was not widely available, and in Houston between November 2008 and June 2013 (modern era), when PCR was commonly used. Patients presenting with meningitis and negative CSF-GS were followed for 4 weeks. All investigations, PCR used, and results were recorded as they became available. In 323 patients enrolled, PCR provided the highest diagnostic yield (24·2%) but was ordered for 128 (39·6%) patients; followed by serology for arboviruses (15%) that was ordered for 100 (31%) of all patients. The yield of blood cultures was (10·3%) and that of CSF cultures was 4%; the yield for all other tests was <10%. Overall, 65% of the patients remained without a diagnosis at 4 weeks: 72·1% in early era vs. 53·4% (P < 0·01) in modern era; this change was attributed to diagnosing more viral pathogens, 8·3% and 26·3% (P < 0·01), respectively. The introduction of PCR and arboviral serologies has improved the yield of diagnosing patients with meningitis and a negative CSF-GS, but both tests are being under-utilized.

  12. An italian multicenter study for application of a diagnostic algorithm in autoantibody testing.

    PubMed

    Bonaguri, Chiara; Melegari, Alessandra; Dall'Aglio, PierPaolo; Ballabio, Andrea; Terenziani, Paolo; Russo, Annalisa; Battistelli, Luisita; Aloe, Rosalia; Camisa, Roberta; Campaniello, Giovanna; Sartori, Elisabetta; Monica, Cesare

    2009-09-01

    The presence in the serum of specific autoantibodies, such as antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA), and antiextractable nuclear antigens (anti-ENA), is one of the diagnostic criteria for autoimmune rheumatic disease, and the requests for these tests in the last few years have grown remarkably. A guideline for reducing clinically inappropriate requests in autoantibody testing (ANA, anti-dsDNA, anti-ENA) has been applied in the Parma Hospital since 2007. The results for the period January-December 2007 were compared to those of the previous period January-December 2006, and a significant reduction in the number of anti-dsDNA (23.9%) and anti-ENA (20.7%) was found. The aim of this study was to assess the applicability of a similar guideline in a wide area (Parma, Modena, Piacenza, Reggio-Emilia) with reference to the diagnosis of autoimmune rheumatic disease. This project, supported by a regional grant for innovative research projects, was started in January 2008 and consists of three different steps: (1) a study group of clinicians and laboratory physicians to evaluate the diagnostic criteria, the analytical procedures, and the number of tests performed in different hospitals; (2) developing common guidelines for autoantibody testing that takes into account the different clinical needs with the aim of improving efficiency and clinical effectiveness of diagnosis and monitoring; and (3) assessing compliance with the guidelines in the different hospitals that are evaluating the second-level test (anti-dsDNA, anti-ENA) decrease. We think that the validation of guidelines for the laboratory diagnosis of autoimmune rheumatic disease can represent a tool for improving patients' outcomes and economic efficiency.

  13. Diagnostic Algorithm for Glycogenoses and Myoadenylate Deaminase Deficiency Based on Exercise Testing Parameters: A Prospective Study

    PubMed Central

    Rannou, Fabrice; Uguen, Arnaud; Scotet, Virginie; Le Maréchal, Cédric; Rigal, Odile; Marcorelles, Pascale; Gobin, Eric; Carré, Jean-Luc; Zagnoli, Fabien; Giroux-Metges, Marie-Agnès

    2015-01-01

    Aim Our aim was to evaluate the accuracy of aerobic exercise testing to diagnose metabolic myopathies. Methods From December 2008 to September 2012, all the consecutive patients that underwent both metabolic exercise testing and a muscle biopsy were prospectively enrolled. Subjects performed an incremental and maximal exercise testing on a cycle ergometer. Lactate, pyruvate, and ammonia concentrations were determined from venous blood samples drawn at rest, during exercise (50% predicted maximal power, peak exercise), and recovery (2, 5, 10, and 15 min). Biopsies from vastus lateralis or deltoid muscles were analysed using standard techniques (reference test). Myoadenylate deaminase (MAD) activity was determined using p-nitro blue tetrazolium staining in muscle cryostat sections. Glycogen storage was assessed using periodic acid-Schiff staining. The diagnostic accuracy of plasma metabolite levels to identify absent and decreased MAD activity was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results The study involved 51 patients. Omitting patients with glycogenoses (n = 3), MAD staining was absent in 5, decreased in 6, and normal in 37 subjects. Lactate/pyruvate at the 10th minute of recovery provided the greatest area under the ROC curves (AUC, 0.893 ± 0.067) to differentiate Abnormal from Normal MAD activity. The lactate/rest ratio at the 10th minute of recovery from exercise displayed the best AUC (1.0) for discriminating between Decreased and Absent MAD activities. The resulting decision tree achieved a diagnostic accuracy of 86.3%. Conclusion The present algorithm provides a non-invasive test to accurately predict absent and decreased MAD activity, facilitating the selection of patients for muscle biopsy and target appropriate histochemical analysis. PMID:26207760

  14. 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.

  15. 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

    2016-07-15

    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.

  16. 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

  17. Calibration and test of the tangential phase contrast imaging diagnostic on CDX-U (abstract)

    SciTech Connect

    Lo, E.; Nazikian, R.; Stutman, D.; Choe, W.; Kaita, R.

    1997-01-01

    The novel CO{sub 2} laser based tangential imaging diagnostic has been completely calibrated and the system has been tested on CDX-U plasmas. It has been shown that localized, two-dimensional images of the plasma electron density fluctuations in the tokamak core can be obtained from a tangential imaging beam.1 A variation of the Zernike phase mirror is used. Test measurements made on soundwaves verify that the system will image phase variations placed at the object plane. An absolute sensitivity of {approx}1{times}10{sup 7} cm{sup {minus}3}/{radical}(Hz) has been determined. A series of plasma measurements made on CDX-U are described. Results show that the plasma fluctuations are 2{endash}3 orders of magnitude above the noise floor of the diagnostic. It is also verified that a high-pass cutoff wave number (from {approx}1{endash}8 cm{sup {minus}1}) for the fluctuations can be selected by translating the phase mirror. The density fluctuation {ital k} spectrum is measured and found to peak at {approx}1{endash}3 cm{sup {minus}1}.{copyright} {ital 1997 American Institute of Physics.}

  18. Calibration and test of the tangential phase contrast imaging diagnostic on CDX-U (abstract)

    NASA Astrophysics Data System (ADS)

    Lo, E.; Nazikian, R.; Stutman, D.; Choe, W.; Kaita, R.

    1997-01-01

    The novel CO2 laser based tangential imaging diagnostic has been completely calibrated and the system has been tested on CDX-U plasmas. It has been shown that localized, two-dimensional images of the plasma electron density fluctuations in the tokamak core can be obtained from a tangential imaging beam.1 A variation of the Zernike phase mirror is used. Test measurements made on soundwaves verify that the system will image phase variations placed at the object plane. An absolute sensitivity of ≈1×107 cm-3/√Hz has been determined. A series of plasma measurements made on CDX-U are described. Results show that the plasma fluctuations are 2-3 orders of magnitude above the noise floor of the diagnostic. It is also verified that a high-pass cutoff wave number (from ≈1-8 cm-1) for the fluctuations can be selected by translating the phase mirror. The density fluctuation k spectrum is measured and found to peak at ≈1-3 cm-1.

  19. Calibration and test of the tangential phase contrast imaging diagnostic on CDX-U

    SciTech Connect

    Lo, E.; Nazikian, R.; Stutman, D.; Choe, W.; Kaita, R.

    1997-02-01

    A novel CO{sub 2} laser-based tangential imaging diagnostic was completely calibrated and the system was tested on CDX-U plasmas. It was shown that localized, two-dimensional images of the plasma electron density fluctuations in the tokamak core can be obtained from a tangential imaging beam [E. Lo, J. Wright, and R. Nazikian, Rev. Sci. Instrum. {bold 66}, 1180 (1995)]. A variation of the Zernike phase mirror is used. Test measurements made on sound waves verify that the system will image phase variations placed at the object plane. An absolute sensitivity of {approx}1{times}10{sup 7} cm{sup {minus}3}/{radical}(Hz) was determined. A series of plasma measurements made on CDX-U is described. Results show that the plasma fluctuations are two to three orders of magnitude above the noise floor of the diagnostic. It is also verified that a high-pass cut-off wave number (from {approx}1 to 8 cm{sup {minus}1}) for the fluctuations can be selected by translating the phase mirror. The density fluctuation {ital k} spectrum is measured and found to peak at {approx}1{endash}3 cm{sup {minus}1}. {copyright} {ital 1997 American Institute of Physics.}

  20. Calibration and test of the tangential phase contrast imaging diagnostic on CDX-U

    NASA Astrophysics Data System (ADS)

    Lo, E.; Nazikian, R.; Stutman, D.; Choe, W.; Kaita, R.

    1997-02-01

    A novel CO2 laser-based tangential imaging diagnostic was completely calibrated and the system was tested on CDX-U plasmas. It was shown that localized, two-dimensional images of the plasma electron density fluctuations in the tokamak core can be obtained from a tangential imaging beam [E. Lo, J. Wright, and R. Nazikian, Rev. Sci. Instrum. 66, 1180 (1995)]. A variation of the Zernike phase mirror is used. Test measurements made on sound waves verify that the system will image phase variations placed at the object plane. An absolute sensitivity of ≈1×107 cm-3/√Hz was determined. A series of plasma measurements made on CDX-U is described. Results show that the plasma fluctuations are two to three orders of magnitude above the noise floor of the diagnostic. It is also verified that a high-pass cut-off wave number (from ≈1 to 8 cm-1) for the fluctuations can be selected by translating the phase mirror. The density fluctuation k spectrum is measured and found to peak at ≈1-3 cm-1.

  1. Interleukin (IL)-1A and IL-6: Applications to the predictive diagnostic testing of radiation pneumonitis

    SciTech Connect

    Chen Yuhchyau . E-mail: yuhchyau_chen@urmc.rochester.edu; Hyrien, Ollivier; Williams, Jacqueline; Okunieff, Paul; Smudzin, Therese; Rubin, Philip

    2005-05-01

    Purpose: To explore the application of interleukin (IL)-1{alpha} and IL-6 measurements in the predictive diagnostic testing for symptomatic radiation pneumonitis (RP). Methods and materials: In a prospective protocol investigating RP and cytokines, IL-1{alpha} and IL-6 values were analyzed by enzyme-linked immunosorbent assay from serial weekly blood samples of patients receiving chest radiation. We analyzed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) over selected threshold values for both cytokines in the application to diagnostic testing. Results: The average coefficient of variation was 51% of the weekly mean IL-1{alpha} level and 39% of the weekly mean IL-6 value. Interleukin 1{alpha} and IL-6 became positively correlated with time. Specificity for both cytokines was better than sensitivity. IL-6 globally outperformed IL-1{alpha} in predicting RP, with higher PPV and NPV. Conclusions: Our data demonstrate the feasibility of applying IL-1{alpha} and IL-6 measurements of blood specimens to predict RP. Interleukin-6 measurements offer stronger positive predictive value than IL-1{alpha}. This application might be further explored in a larger sample of patients.

  2. Rapid diagnostic tests for non-malarial febrile illness in the tropics.

    PubMed

    Chappuis, F; Alirol, E; d'Acremont, V; Bottieau, E; Yansouni, C P

    2013-05-01

    The recent roll-out of rapid diagnostic tests (RDTs) for malaria has highlighted the decreasing proportion of malaria-attributable illness in endemic areas. Unfortunately, once malaria is excluded, there are few accessible diagnostic tools to guide the management of severe febrile illnesses in low resource settings. This review summarizes the current state of RDT development for several key infections, including dengue fever, enteric fever, leptospirosis, brucellosis, visceral leishmaniasis and human African trypanosomiasis, and highlights many remaining gaps. Most RDTs for non-malarial tropical infections currently rely on the detection of host antibodies against a single infectious agent. The sensitivity and specificity of host-antibody detection tests are both inherently limited. Moreover, prolonged antibody responses to many infections preclude the use of most serological RDTs for monitoring response to treatment and/or for diagnosing relapse. Considering these limitations, there is a pressing need for sensitive pathogen-detection-based RDTs, as have been successfully developed for malaria and dengue. Ultimately, integration of RDTs into a validated syndromic approach to tropical fevers is urgently needed. Related research priorities are to define the evolving epidemiology of fever in the tropics, and to determine how combinations of RDTs could be best used to improve the management of severe and treatable infections requiring specific therapy.

  3. 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

  4. Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome.

    PubMed

    Borg, K; Lindblom, U

    1988-12-01

    The initial sensory symptoms of carpal tunnel syndrome (CTS) are usually intermittent and the clinical neurological examination is often normal. The aim of the present study was to determine the rate of impairment of different somatosensory modalities in CTS by means of the following tests: vibrametry, tactile pulses, von Frey hairs, two-point discrimination (2-PD), graphesthesia and warm and cold perception thresholds. The material consisted of 33 hands with CTS from 22 patients. Each of the first 3 tests was abnormal with elevated thresholds in 17 CTS hands (52%), 2-PD was abnormal in 10 hands (30%), graphesthesia in 8 hands (24%), and warm and cold thresholds in only 5 hands (15%). There was an overlap so that at least one test was abnormal in 27 of the 33 CTS hands (82%). Thus, impairment of sensibility can be demonstrated in a majority of patients with CTS if more than one test is applied. Vibrametry and von Frey hairs are recommended instead of the commonly used 2-PD, since abnormality was more often revealed and since they are equally easy to apply. No individual test was sensitive enough to qualify as a diagnostic criterion when it was applied with the hand in resting position. A significant increase in both sensitivity and specificity can be expected for any test if it is combined with provocation, such as wrist flexion, as has been demonstrated for vibrametry.

  5. How diagnostic tests help to disentangle the mechanisms underlying neuropathic pain symptoms in painful neuropathies.

    PubMed

    Truini, Andrea; Cruccu, Giorgio

    2016-02-01

    Neuropathic pain, ie, pain arising directly from a lesion or disease affecting the somatosensory afferent pathway, manifests with various symptoms, the commonest being ongoing burning pain, electrical shock-like sensations, and dynamic mechanical allodynia. Reliable insights into the mechanisms underlying neuropathic pain symptoms come from diagnostic tests documenting and quantifying somatosensory afferent pathway damage in patients with painful neuropathies. Neurophysiological investigation and skin biopsy studies suggest that ongoing burning pain primarily reflects spontaneous activity in nociceptive-fiber pathways. Electrical shock-like sensations presumably arise from high-frequency ectopic bursts generated in demyelinated, nonnociceptive, Aβ fibers. Although the mechanisms underlying dynamic mechanical allodynia remain debatable, normally innocuous stimuli might cause pain by activating spared and sensitized nociceptive afferents. Extending the mechanistic approach to neuropathic pain symptoms might advance targeted therapy for the individual patient and improve testing for new drugs.

  6. Technical tips: the eyes and ears of artifacts in diagnostic testing.

    PubMed

    Linenbroker, Cara

    2013-03-01

    Recognizing and eliminating artifacts are a daily part of my job as a neurodiagnostic technologist. Distinguishing between EEG and artifact is essential since it can impact the patient's diagnosis and treatment. I recently experienced an interesting situation that I had never previously encountered. My patient had a cochlear implant. This small device presented a challenge, but gave me the opportunity to put my troubleshooting skills to the test, and use some quick thinking to remove the artifact it created from the recording. It turns out this small device not only affected the EEG recording, but also another diagnostic test. I decided to do some research on the cochlear implant to find out how this tiny instrument affected the EEG recording as well as my patient's life, by allowing my patient to hear the world around him. PMID:23682542

  7. Acceptance test report for the 241-AN-107 caustic addition mixer pump data logger

    SciTech Connect

    Dowell, J.L.

    1996-04-05

    The Acceptance Test Procedure for the 241-AN-107 Caustic Addition Mixer Pump Data logger, WHC-SD-WM-ATP-149, was started on September 25, 1995, and completed November 13, 1995. K.G. Carothers of Tank Waste Remediation Engineering requested the test procedure and ICF Kaiser Control Systems Engineering group wrote the test procedure and executed it at the 305 building in 300 area and at the 241-AN Tank Farm in 200 East area. The purpose of this report is to document that the Caustic addition Mixer Pump Data logger, functioned as intended as installed at 241-AN-107 tank farm.

  8. Comparison of the Minnesota Percepto-Diagnostic Test-Revised and Bender-Gestalt in Predicting Achievement.

    ERIC Educational Resources Information Center

    Fuller, Gerald B.; Vance, Booney

    1993-01-01

    Investigated whether Minnesota Percepto-Diagnostic Test-Revised (MPD-R) or Bender-Gestalt Test (BG) would more accurately predict achievement at first-, third-, and fifth-grade levels. Administered both tests to 84 children in counterbalanced order. Results indicated that MPD-R was better predictor of achievement than BG, especially at first- and…

  9. 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…

  10. Leach testing of in situ stabilization grouts containing additives to sequester contaminants

    SciTech Connect

    Serne, R.J.; Ames, L.L.; Martin, P.F.C.; LeGore, V.L.; Lindenmeier, C.W. ); Phillips, S.J. )

    1993-04-01

    This document discusses laboratory testing performed by Pacific Northwest Laboratory (PNL) for Westinghouse Hanford Company (WHC) of special grout formulations that incorporate specific sequestering agents to help improve the ability of the cement to resist contaminant leaching. To enhance the sequestering of contaminants we chose five additives to introduce (singly) to the control cement. The additives were Florida pebble phosphate, clinoptilolite (a natural zeolite), ferrous sulfide (a reductant), a mixed bed organic ion exchange resin and a proprietary anion-adsorbing mixed metal oxide. These additives were added one per test to the standard formulation and used to encapsulate a diluted high-salt alkaline liquid waste that is produced after various processes to remove uranium and plutonium from spent nuclear fuel. This report documents the testing of these additives.

  11. 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

    Background In settings where both Plasmodium vivax and Plasmodium falciparum infection cause malaria, rapid diagnostic tests (RDTs) need to distinguish which species is causing the patients' symptoms, as different treatments are required. Older RDTs incorporated two test lines to distinguish malaria due to P. falciparum, from malaria due to any other Plasmodium species (non-falciparum). These RDTs can be classified according to which antibodies they use: Type 2 RDTs use HRP-2 (for P. falciparum) and aldolase (all species); Type 3 RDTs use HRP-2 (for P. falciparum) and pLDH (all species); Type 4 use pLDH (fromP. falciparum) and pLDH (all species). More recently, RDTs have been developed to distinguish P. vivax parasitaemia by utilizing a pLDH antibody specific to P. vivax. Objectives To assess the diagnostic accuracy of RDTs for detecting non-falciparum or P. vivax parasitaemia in people living in malaria-endemic areas who present to ambulatory healthcare facilities with symptoms suggestive of malaria, and to identify which types and brands of commercial test best detect non-falciparum and P. vivax malaria. Search methods We undertook a comprehensive search of the following databases up to 31 December 2013: Cochrane Infectious Diseases Group Specialized Register; MEDLINE; EMBASE; MEDION; Science Citation Index; Web of Knowledge; African Index Medicus; LILACS; and IndMED. Selection criteria Studies comparing RDTs with a reference standard (microscopy or polymerase chain reaction) in blood samples from a random or consecutive series of patients attending ambulatory health facilities with symptoms suggestive of malaria in non-falciparum endemic areas. Data collection and analysis For each study, two review authors independently extracted a standard set of data using a tailored data extraction form. We grouped comparisons by type of RDT (defined by the combinations of antibodies used), and combined in meta-analysis where appropriate. Average sensitivities and

  12. Hybrid Residual Flexibility/Mass-Additive Method for Structural Dynamic Testing

    NASA Technical Reports Server (NTRS)

    Tinker, M. L.

    2003-01-01

    A large fixture was designed and constructed for modal vibration testing of International Space Station elements. This fixed-base test fixture, which weighs thousands of pounds and is anchored to a massive concrete floor, initially utilized spherical bearings and pendulum mechanisms to simulate Shuttle orbiter boundary constraints for launch of the hardware. Many difficulties were encountered during a checkout test of the common module prototype structure, mainly due to undesirable friction and excessive clearances in the test-article-to-fixture interface bearings. Measured mode shapes and frequencies were not representative of orbiter-constrained modes due to the friction and clearance effects in the bearings. As a result, a major redesign effort for the interface mechanisms was undertaken. The total cost of the fixture design, construction and checkout, and redesign was over $2 million. Because of the problems experienced with fixed-base testing, alternative free-suspension methods were studied, including the residual flexibility and mass-additive approaches. Free-suspension structural dynamics test methods utilize soft elastic bungee cords and overhead frame suspension systems that are less complex and much less expensive than fixed-base systems. The cost of free-suspension fixturing is on the order of tens of thousands of dollars as opposed to millions, for large fixed-base fixturing. In addition, free-suspension test configurations are portable, allowing modal tests to be done at sites without modal test facilities. For example, a mass-additive modal test of the ASTRO-1 Shuttle payload was done at the Kennedy Space Center launch site. In this Technical Memorandum, the mass-additive and residual flexibility test methods are described in detail. A discussion of a hybrid approach that combines the best characteristics of each method follows and is the focus of the study.

  13. 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

  14. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia.

    PubMed

    Osorio, Lyda; Uribe, Marcela; Ardila, Gloria Ines; Orejuela, Yaneth; Velasco, Margarita; Bonelo, Anilza; Parra, Beatriz

    2015-06-01

    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.

  15. Thiopurine S-methyltransferase testing for averting drug toxicity: a meta-analysis of diagnostic test accuracy

    PubMed Central

    Zur, RM; Roy, LM; Ito, S; Beyene, J; Carew, C; Ungar, WJ

    2016-01-01

    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. PMID:27217052

  16. 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

  17. 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.

  18. 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.

  19. Appropriateness of Diagnostic Coronary Angiography as a Measure of Cardiac Ischemia Testing in Non-Emergency Patients – A Retrospective Cross-Sectional Analysis

    PubMed Central

    Chmiel, Corinne; Reich, Oliver; Signorell, Andri; Tandjung, Ryan; Rosemann, Thomas; Senn, Oliver

    2015-01-01

    Background Adequate application of guidelines concerning non-invasive ischemia testing (NIIT) could avoid inappropriate invasive testing in non-emergency situations. Hardly any data exists regarding frequency and appropriateness of diagnostic coronary angiography (CA). The aim of this study was to evaluate the proportion and predictors of patients without NIIT prior to elective purely diagnostic CA without therapeutic intervention. Methods Retrospective cross-sectional analysis of insurance claims data from 2012 and 2013. Patients <18 years, acute cardiac ischemia and emergency procedures and patients insured in a managed care model were excluded from analysis. The proportion of patients with NIIT procedures (stress-ECG, transthoracic echocardiography, stress echocardiography, scintigraphy, computer tomography, heart MRI) undertaken within two months before diagnostic CA was assessed. Multiple logistic regression analysis was applied to investigate independent determinants for receiving NIIT. Findings 2714 patients were included for analysis. 37.5% (1018) did not receive any NIIT before CA. When high risk patients (patients having received therapeutic cardiac intervention within one month after or 18 months prior to diagnostic CA, n = 766) were excluded 34.3% (669) did not receive NIIT before CA. High risk status as well as >6 chronic comorbidities were independently associated with a lower proportion of NIIT (p<0.0001, OR 0.607 and p = 0.0041, OR 0.648), when additionally controlled for age, sex, language area, insurance coverage, inpatient treatment, cardiovascular medication and lower number of chronic comorbidities. Age (p<0.05, OR 1.009) and intake of oral antiplatelet therapy (p<0.0001, OR 1.914) were independently associated with a higher proportion of NIIT when controlled for the mentioned cofactors. Conclusions Our data show that despite the existence of guidelines a substantial overuse of a potentially harmful and inappropriate diagnostic intervention is

  20. A Global Comparative Evaluation of Commercial Immunochromatographic Rapid Diagnostic Tests for Visceral Leishmaniasis

    PubMed Central

    Cunningham, Jane; Hasker, Epco; Das, Pradeep; El Safi, Sayda; Goto, Hiro; Mondal, Dinesh; Mbuchi, Margaret; Mukhtar, Maowia; Rabello, Ana; Rijal, Suman; Sundar, Shyam; Wasunna, Monique; Adams, Emily; Menten, Joris; Peeling, Rosanna; Boelaert, Marleen

    2012-01-01

    Background. Poor access to diagnosis stymies control of visceral leishmaniasis (VL). Antibody-detecting rapid diagnostic tests (RDTs) can be performed in peripheral health settings. However, there are many brands available and published reports of variable accuracy. Methods. Commercial VL RDTs containing bound rK39 or rKE16 antigen were evaluated using archived human sera from confirmed VL cases (n = 750) and endemic non-VL controls (n = 754) in the Indian subcontinent (ISC), Brazil, and East Africa to assess sensitivity and specificity with 95% confidence intervals. A subset of RDTs were also evaluated after 60 days’ heat incubation (37°C, 45°C). Interlot and interobserver variability was assessed. Results. All test brands performed well against ISC panels (sensitivity range, 92.8%–100%; specificity range, 96%–100%); however, sensitivity was lower against Brazil and East African panels (61.5%–91% and 36.8%–87.2%, respectively). Specificity was consistently > 95% in Brazil and ranged between 90.8% and 98% in East Africa. Performance of some products was adversely affected by high temperatures. Agreement between lots and readers was good to excellent (κ > 0.73–0.99). Conclusions. Diagnostic accuracy of VL RDTs varies between the major endemic regions. Many tests performed well and showed good heat stability in the ISC; however, reduced sensitivity against Brazilian and East African panels suggests that in these regions, used alone, several RDTs are inadequate for excluding a VL diagnosis. More research is needed to assess ease of use and to compare performance using whole blood instead of serum and in patients coinfected with human immunodeficiency virus. PMID:22942208