Mathematical partitioning of the receiver operating curve: A diagnostic tool for medical decision making

Schniederjans, Marc J.; Kotlyarov, Eduard V.

doi:10.1016/0038-0121(85)90007-2

Cited by 7 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A larger area under the ROC curve represents more reliability and good discrimination of the scoring system. Differences between the AUC values of all predictive tests were calculated, and a P value of 0.05 was defined as statistically significant amongst predictors [21] Differences between the AUC values of six predictor tests were analyzed using MedCalc statistical software 9.3.6.0. The data were analyzed using SPSS version 20 (SPSS, Chicago, IL).…”

Section: Methodsmentioning

confidence: 99%

Acromio-Axillo-Suprasternal Notch Index: A New Screening Test to Predict Difficult Laryngoscopy in General Population

Safavi¹

2016

JAS

View full text Add to dashboard Cite

Background: Airway management expertness is essential in every medical specialty. Inability to manage Difficult Visualization of Larynx (DVL) can be life threatening. This trail was performed to assess the ability of a new index-Acromio-axillo-suprasternal notch index-to predict difficult laryngoscopy in normal population in comparison with the other common predictors. Materials and Methods: 728 consecutive patients with ASA class I & II candidate for general anesthesia with endotracheal intubation were enrolled to this study. The four usual tests MMT, ULBT, RHTMD, NC/TMD were assessed before induction of anesthesia. The new AASI test is calculated as follow: 1) Using a ruler a line is drawn vertically from the top of the acromion process to the superior border of the axilla at the pectoralis major muscle named as line A. 2) A second line is drawn perpendicular to line A from the suprasternal notch (line B); and 3)That portion of line A that lies above where line B bisects line A is line C. AASI is calculated from the length of line C divided by line A(AASI = C/A). By a skilled anesthesiologist who blinded to the assessment, the laryngoscopy was done and based on Cormack-Lehane classification, garding of laryngoscopy was recorded. Sensitivity, specificity, positive predictive value and AUC or ROC for each airway predictor in isolation and comparison with each other was established. Results: The sensitivity of AASI was 66.67% with AUC = 0.790(P = 0.000). But MMT as an old predictive test with NC/TMD and RHTMD with AUC or ROC curve 0.626, 0.531, 0.537 respectively, are not good predictors in this study (P > 0.05). But ULBT with sensitivity 52.38% can be a good predictor (P = 0.003). There are stepwise increases in the incidence of Cormack-Lehane grade III and IV as AASI was greater than 0.6. Conclusion: We considered the value of preoperative assessment of AASI ≥ 0.6 to be a good and reliable predictor for difficult visualization of larynx

show abstract

Section: Methodsmentioning

confidence: 99%

Acromio-Axillo-Suprasternal Notch Index: A New Screening Test to Predict Difficult Laryngoscopy in General Population

Safavi¹

2016

JAS

View full text Add to dashboard Cite

show abstract

“…A value of 0.5 under the ROC curve indicated that the variable performs no better than chance and a value of 1.0 indicates perfect discrimination. A larger area under the ROC curve represents more reliability[ 31 32 ] and good discrimination of the scoring system. Differences between the AUC values of all predictive tests were calculated, and a P value of 0.05 was defined as statistically significant.…”

Section: Methodsmentioning

confidence: 99%

The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

et al. 2014

View full text Add to dashboard Cite

Background:Preoperative assessment of anatomical landmarks andclinical factors help detect potentially difficult laryngoscopies. The aim of the present study was to compare the ability to predict difficult visualization of the larynx from thefollowing preoperative airway predictive indices, in isolation and combination: Neck circumference to thyromental distance (NC/TMD), neck circumference (NC), modified Mallampatitest (MMT), the ratio of height to thyromental distance (RHTMD), and the upper-lip-bite test (ULBT).Materials and Methods:We collected data on657 consecutive patients scheduled for elective caesarean delivery under general anesthesia requiring endotracheal intubation and then evaluated all five factors before caesarean. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive values for each airway predictor in isolation and in combination were determined.Results:Difficult laryngoscopy (Grade 3 or 4) occurred in 53 (8.06%) patients. There were significant differences in thyromental distance (TMD), RHTMD, NC, and NC/TMD between difficult visualization of larynx and easy visualization of larynx patients (P < 0.05). The main end-point area under curve (AUC) of the receiver-operating characteristic (ROC) was lower for MMT (AUC = 0.497; 95% Confidence Interval = CI,0.045-0.536) and ULBT (AUC = 0.500, 95% CI, 0.461-0.539) compared to RHTMD, NC, TMD, and NC/TMD score ([AUC = 0.627, 95% CI, 0.589-0.664], [AUC = 0.691; 95% CI, 0.654-0.726], [AUC = 0.606; 95% CI, 0.567-0.643], [AUC = 0.689;95% CI, 0.625-0.724], respectively), and the differences of six ROC curves were statistically significant (P < 0.05).Conclusion:The NC/TM Discomparable with NC, RHTMD, and ULBT for the prediction of difficult laryngoscopy in caes are an delivery.

show abstract

“…A larger area under the ROC curve denotes more reliability[21] and good discrimination of the scoring system. Additionally, the ROC curves were used to recognize the optimal predictive cutoff points for each test.…”

Section: Methodsmentioning

confidence: 99%

“…A value of 0.5 under the ROC curve indicates that the variable performs no better than chance and a value of 1.0 implies perfect discrimination. A larger area under the ROC curve denotes more reliability[ 21 ] and good discrimination of the scoring system. Additionally, the ROC curves were used to recognize the optimal predictive cutoff points for each test.…”

Section: Methodsmentioning

confidence: 99%

A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy

Safavi

Honarmand

Zare

2011

Saudi Journal of Anaesthesia

View full text Add to dashboard Cite

Background:The aim of the present study was to compare the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT).Methods:We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic (ROC) Curve and the area under ROC curve (AUC) for each airway predictor in isolation and in combination were determined.Results:Difficult laryngoscopy (Grade 3 or 4) occurred in 41 (6.8%) patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT (AUC, 0.511; 95% CI, 0.470–0.552) than the ULBT (AUC, 0.709; 95% CI, 0.671–0.745, P=0.002) and the RHTMD score (AUC, 0.711; 95% CI, 0.673–0.747, P=0.001). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 (sensitivity, 75.6%; specificity, 58.5%).Conclusion:The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population.

show abstract

Mathematical partitioning of the receiver operating curve: A diagnostic tool for medical decision making

Cited by 7 publications

References 4 publications

Acromio-Axillo-Suprasternal Notch Index: A New Screening Test to Predict Difficult Laryngoscopy in General Population

Acromio-Axillo-Suprasternal Notch Index: A New Screening Test to Predict Difficult Laryngoscopy in General Population

The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy

Contact Info

Product

Resources

About