Diagnoses in pathology often are qualitative, such as atypical or suspicious, and consequently are thought to have limited clinical value. To investigate the utility of a qualitative diagnostic system, seven pathologists retrospectively evaluated 100 bronchial brush specimens using the following categories: definitely benign, probably benign, possibly malignant, probably malignant, and definitely malignant. The likelihood ratio (LR) and receiver operating characteristic (ROC) curve, two statistical probabilistic measurements, were used to calculate diagnostic accuracy among individuals and groups. The results show: (1) the LR for individual diagnostic categories varied among observers, resulting in different clinically malignant probabilities; (2) observer experience did not appear to play a role in overall diagnostic accuracy, except in the diagnosis of small cell carcinoma; (3) observers operate at higher levels of diagnostic accuracy with, rather than without, clinical history. The authors conclude that qualitative diagnoses contain important information and can be interpreted effectively with LR and ROC.
Bodybuilders have used different carbohydrate loading regimens in conjunction with resistance exercise prior to competition in the belief that this would result in increased muscle size. To investigate this possibility, muscle girth measurements were obtained from nine weight-trained males before and after a control (standard isocaloric diet) and an experimental trial (carbohydrate loading). The latter regimen consisted of 3 days of intense weight-lifting while the subjects ingested a diet of 10% carbohydrate (CHO), 57% fat (F), and 33% protein (P), followed by 3 days of light weight-lifting and a day of rest while ingesting a diet of 80% CHO, 5% F, and 15% P. The control trial consisted of an identical weight-lifting regimen while subjects ingested an isocaloric (45 kcal/kg BWIday) diet. Body weight and girths (forearm, upper arm, chest, thigh, waist, and calf) were obtained before and after each trial in a relaxed and flexed state. The results indicated that an exercise/carbohydrate loading regimen had no significant effect on muscle girth as compared to the control trial. It is concluded that CHO loading has no additional advantage to enhancing muscle girth in bodybuilders over weight-lifting alone.
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