Pruebas diagnósticas: nociones básicas para su correcta interpretación y uso

Escrig-Sos, Javier; Martínez-Ramos, David; Miralles-Tena, Juan Manuel

doi:10.1016/s0009-739x(06)70871-5

Cited by 29 publications

(9 citation statements)

References 15 publications

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“…Regarding sensitivity and specificity, it should be taken into account that these aspects are a priori intrinsic properties or probabilities of the tests that are not fully useful when applied in a clinical setting (i.e., they do not provide the certainty with which a clinician could determine whether a positive or negative result comes from an infected or healthy person) [ 34 ]. This information can be obtained using predictive values, which are the most useful clinical parameters [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis

Velasquez-Agudelo

Cardona‐Arias

2017

BMC Infect Dis

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BackgroundOnychomycosis is a highly prevalent disease worldwide. There is no standard test for its diagnosis, which remains costly, wasteful, and is sometimes delayed. The diagnostic tests for this disease are few and discordant. The objective was to evaluate the diagnostic validity, performance, and accuracy of culture, nail clipping with Periodic Acid-Schiff –PAS- staining (biopsy), and direct potassium hydroxide (KOH) examination for the study of onychomycosis.MethodsA systematic review was conducted via meta-analysis using 5 databases and 21 search strategies. An ex ante protocol was applied with inclusion and exclusion criteria. Quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool, and the sensitivity, specificity, predictive values, likelihood ratios, diagnostic odds ratios, receiver operating characteristic (ROC) curves, and proportion of correctly diagnosed patients were evaluated with the meta-analysis of studies of evaluations of diagnostic and screening tests (Meta-DiSc) and Epidat using a random effects model.ResultsThe efficiency or accuracy of the three tests is influenced by the methodological quality of the studies. These values are lower for KOH and culture and higher for biopsy in moderate quality studies.ConclusionThe diagnostic tests evaluated in this meta-analysis independently showed acceptable validity, performance, and efficiency, with nail clipping with PAS staining outperforming the other two tests.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis

Velasquez-Agudelo

Cardona‐Arias

2017

BMC Infect Dis

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“…En esos estudios la eficiencia del diagnóstico oscila entre 76 y 94 %; los valores de eficiencia superiores al 50 %, como el alcanzado en este trabajo, indican que la probabilidad de diagnosticar gestación exitosamente es significativamente mayor que el obtenido mediante el azar; entre más cercanos sean al 100 %, son más confiables [34].…”

Section: Resultados Y Discusiónunclassified

Método no invasivo de diagnóstico de gestación en venadas Odocoileus virginianus. (Non-Invasive Method for Pregnancy Diagnosis in Odocoileus Virginianus.)

et al. 2015

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ResumenObjetivo: Valorar la eficiencia del diagnóstico de gestación mediante la estimación de niveles de progestinas fecales en venadas cola blanca O. virginianus en la época no reproductiva. Materiales y métodos: Se analizaron muestras sanguíneas y heces de nueve venadas cola blanca (VCB), semanalmente, durante dos meses en la época reproductiva. Adicionalmente, las VCB fueron expuestas a macho durante un mes durante la época reproductiva, y se colectaron heces dos veces fuera de esta, para medir los niveles de metabolitos de progestinas. Se determinó el valor de corte para diagnosticar gestación a partir de los niveles de metabolitos de progestinas fecales en fase luteal y folicular. La progesterona sanguínea fue medida por radioinmunoanálisis, y se correlacionó con los niveles de progestinas fecales. Los diagnósticos de gestación fueron relacionados con los partos. Resultados: La correlación total entre niveles de progestinas sanguíneas y metabolitos de progestinas fecales fue 0,37 (p<0,01). La variación de la correlación individual fue 0,104 hasta 0,99. El valor de corte para diagnosticar gestación fue 4000 ng/g en heces. La eficiencia del diagnóstico de gestación fue 77,78 %; el valor predictivo del diagnóstico positivo fue 75 %, y el negativo fue 80 %, respectivamente. Conclusiones: Es posible diagnosticar gestación fuera de la época de reproducción mediante la estimación de los niveles de metabolitos de progestinas fecales, en VCB en cautiverio, tomando como valor de corte 4000 ng/g de heces.

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“…The results published by Carbonero [ 4 ] differ from those obtained in this study, since the authors took sensitivity and specificity values provided by the manufacturer. It is currently known that these values vary due to external factors, as well as according to the field in which they are applied [ 32 , 50 , 51 , 52 ]. This variation is mainly due to the differences between reference populations, sampling strategies that have been used for the validation procedure, technical variation of the tests (distinct laboratories), competence of the laboratory, choice of gold standard and cut-off value for interpretation and management of results, and the sanitary conditions of the populations with respect to other conditions [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…The specificity values of the tests that include unvaccinated animals are higher than in populations where animals have received vaccination as well as in the general sampling (with and without vaccination). This is due to the fact that the number of false positives decreases by doing the more specific tests [ 51 ]. However, the specificity does not reach 100%, since false positives may also be due to the probable presence of cross reactions such as Yersinia enterocolitica O: 9, Escherichia coli O: 157, Salmonella group N (O: 30), Vibrio cholerae O1 infections, Scherichia hermani , or Stenotrophomonas maltophilia [ 67 , 68 ].…”

Section: Discussionmentioning

confidence: 99%

Bayesian Estimation of the Prevalence and Test Characteristics (Sensitivity and Specificity) of Two Serological Tests (RB and SAT-EDTA) for the Diagnosis of Bovine Brucellosis in Small and Medium Cattle Holders in Ecuador

et al. 2021

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In Ecuador, a national program for bovine brucellosis control has been in implementation since 2008. Given the costs, small- and medium-sized livestock holders are not completely committed to it. The objective of this study was to determine true prevalence (TP) of bovine brucellosis in small- and medium-sized herd populations, as well as the diagnostic sensitivity and specificity of the Rose Bengal (RB) test and the sero-agglutination test (SAT)-EDTA using a Bayesian approach. Between 2011 and 2016, 2733 cattle herds were visited, and 22,592 animal blood samples were taken in nineteen provinces on mainland Ecuador. Bayes-p and deviance information criterion (DIC) statistics were used to select models. Additionally, risk-factor analysis was used for herds according to their brucellosis test status. True prevalence (TP) in herds was estimated by pool testing. National seroprevalence of farms was 7.9% (95% CI: 6.79–9.03), and TP was 12.2% (95% CI: 7.8–17.9). Apparent prevalence (AP) in animals was 2.2% (95% CI: 1.82–2.67), and TP was 1.6% (95% CrI: 1.0–2.4). Similarly, the sensitivity of the RB was estimated at 64.6% (95% CrI: 42.6–85.3) and specificity at 98.9% (95% CrI: 98.6–99.0); for the SAT-EDTA test, sensitivity was 62.3% (95% CrI: 40.0–84.8) and 98.9% (95% CrI: 98.6–99.1) for specificity. Results of the two tests were highly correlated in infected and uninfected animals. Likewise, high spatial variation was observed, with the Coastal Region being the zone with the highest TP at 2.5%. (95% CrI: 1.3–3.8%) in individual animals and 28.2% (95% CI: 15.7–39.8) in herds. Risk factors include herd size, type of production (milk, beef, and mixed), abortions recorded, and vaccination. The results of this study serve to guide authorities to make decisions based on parallel testing at the beginning of a bovine brucellosis program for small livestock holders to increase sensitivity level of the screening tests in Ecuador.

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Pruebas diagnósticas: nociones básicas para su correcta interpretación y uso

Cited by 29 publications

References 15 publications

Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis

Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis

Método no invasivo de diagnóstico de gestación en venadas Odocoileus virginianus. (Non-Invasive Method for Pregnancy Diagnosis in Odocoileus Virginianus.)

Bayesian Estimation of the Prevalence and Test Characteristics (Sensitivity and Specificity) of Two Serological Tests (RB and SAT-EDTA) for the Diagnosis of Bovine Brucellosis in Small and Medium Cattle Holders in Ecuador

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