Receiver operating characteristic curve analysis of arteriovenous dialysis access flow using ultrasound

Yii, Erwin; Yii, Ming Kon; Thwaites, Stephen; Zhu, John; Chong, Timothy; Tong, Lauren; Nair, Sachin

doi:10.1111/ans.17378

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…shown that the chief determinant of Qa is the TAMV and the other less predictive parameters are EDV and PSV. 21 The mean BD of the forearm and arm AVF at 5.5 and 5.6 mm are not significantly different and again confirms that differing haemodynamics account for different Qa between the two AVF configurations.…”

Section: Test Resultsmentioning

confidence: 52%

“…Even so, these levels do not differentiate between the configuration of the AVF, that is, forearm or arm AVF even though the differing haemodynamics and complications between the two configurations have been well established 6,7,20 . We have also previously shown that the chief determinant of Qa is the TAMV and the other less predictive parameters are EDV and PSV 21 . The mean BD of the forearm and arm AVF at 5.5 and 5.6 mm are not significantly different and again confirms that differing haemodynamics account for different Qa between the two AVF configurations.…”

Section: Discussionmentioning

confidence: 93%

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Optimal flow volume measurements in forearm versus arm arteriovenous fistulas

et al. 2023

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Objectives: Successful haemodialysis is dependent on optimal arteriovenous (AV) access flow. Although 600 ml/min is frequently quoted as the critical level for functional flow volume (Qa) according to the National Kidney Foundation guideline, this may not be applicable for the different configurations of AV fistulas (AVF) or AV grafts (AVG). This study evaluates ultrasound derived Qa measurement in the inflow brachial artery to autologous AVF in the forearm radiocephalic and arm brachiocephalic/basilic configurations in relation to significant flow related AV dysfunction.Methods: Five hundred and eleven duplex ultrasound (DUS) scans were analysed in 193 patients. The end points were therapeutic intervention and/or thrombosis of AVF versus no complication within 3 months of the scan. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold Qa of the brachial artery supplying the AVF.Results: Of the 511 scans, 155 scans were assigned to the intervention group, that is, AVF requiring intervention or thrombosing within 3 months of the DUS. Using ROC curve analysis, the area under the curve (AUC) for all AVF is 0.90 (CI: 0.88-0.93) with an optimal threshold Qa of 686 ml/min. In forearm AVF, the threshold Qa is 589 ml/min while in arm AVF the threshold Qa is 877 ml/min. Forearm Qa is statistically different from arm Qa. Conclusion:Forearm AVF Qa threshold at 589 ml/min is distinct from arm AVF Qa at 877 ml/min and these are predictive of the need for impending intervention or thrombosis due to flow-limiting stenosis.arteriovenous fistula, blood flow measurement, brachial diameter, dialysis vascular access, time averaged mean velocity ultrasonography Summary at a glanceDuplex ultrasound is the first line investigation for evaluating arteriovenous fistulas for haemodialysis. While a flow volume of 600 ml/min is the accepted threshold for a functioning fistula, this study demonstrates a significant difference in the optimal thresholds for arm versus forearm configurations at 877 and 589 ml/min, respectively for predicting impending dysfunction.

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Section: Test Resultsmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 93%

Optimal flow volume measurements in forearm versus arm arteriovenous fistulas

et al. 2023

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“…A study by Yii et al [18] assessed 511 AVFs and analyzed the ROC curves for TA mean, PSV, and EDV as predictive for thrombotic flow-related AVF dysfunction. They concluded that TA mean cutoffs of 45 cm/s for forearm AVFs and 49 cm/s for arm AVFs yielded the best AUC values (0.95).…”

Section: Thrombosismentioning

confidence: 99%

Arteriovenous Fistula Ultrasound Assessment

Dana Grosu,

Bob

2024

Ultrasound - The Next Step in Clinical Evaluation [Working Title]

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Arteriovenous fistula (AVF) ultrasound (US) assessment is the first-line tool in addition to the physical examination to surveil, screen, and diagnose complications of the vascular access (VA) of chronic hemodialysis (HD) patients. The VA currently recommended by all guidelines as the “gold standard” for chronic HD patients is the AVF; therefore, creating long-lasting, complication-free fistulas is one of the targets considered by all nephrologists. US assessment is a noninvasive technique that offers detail regarding vascular morphology and hemodynamics, and may be performed at the patient’s bedside. The clinical settings in which US assessment is currently performed are the presurgical screening of veins and arteries (presurgical mapping) or the diagnosis of AVF complications, usually when there are relevant clinical signs and symptoms. Moreover, AVF point-of-care US examination (POCUS) is used to assist and aid nurses in the cannulation procedure, with the scope of minimizing accidents. The current chapter aims to provide a guidebook regarding the multiple situations in which AVF US may be performed and to highlight the importance of this tool for the purpose of maintaining the long-term functionality of the VA of HD patients.

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Application of Rapid Identification and Determination of Moisture Content of Coptidis Rhizoma From Different Species Based on Data Fusion

Tian

Liang

et al. 2023

Journal of AOAC International

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Background For thousands of years, Traditional Chinese Medicine (TCM) has been clinically proven, and doctors have highly valued the differences in utility between different species. Objective This study aims to replace the complex methods traditionally used for empirical identification by compensating for the information loss of a single sensor through data fusion. The research object of the study is Coptidis Rhizome (CR). Methods Using spectral optimization and data fusion technology, Near Infrared (NIR) and Mid-Infrared (MIR) spectra were collected for CR. PLS-DA (n = 134) and PLSR (n = 63) models were established to identify the medicinal materials and determine the moisture content in the medicinal materials. Results For the identification of the three species of CR, the mid-level fusion model performed better than the single-spectrum model. The sensitivity and specificity of the prediction set coefficients for NIR, MIR, and data fusion qualitative models were all higher than 0.95, with an AUC value of 1. The NIR data model was superior to the MIR data model. The results of low-level fusion were similar to those of the NIR optimization model. The RPD of the test set of NIR and low-level fusion model was 3.6420 and 3.4216, respectively, indicating good prediction ability of the model. Conclusion Data fusion technology using NIR and MIR can be applied to identify CR species and determine the moisture content of CR. It provides technical support for the rapid determination of moisture content, with fast analysis speed and without the need for complex pretreatment methods. Highlights This study is the first to introduce spectral data fusion technology to identify CR species. Data fusion technology is feasible for multivariable calibration model performance and reduces the cost of manual identification. The moisture content of CR can be quickly evaluated, reducing the difficulty of traditional methods.

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Receiver operating characteristic curve analysis of arteriovenous dialysis access flow using ultrasound

Cited by 3 publications

References 16 publications

Optimal flow volume measurements in forearm versus arm arteriovenous fistulas

Optimal flow volume measurements in forearm versus arm arteriovenous fistulas

Arteriovenous Fistula Ultrasound Assessment

Application of Rapid Identification and Determination of Moisture Content of Coptidis Rhizoma From Different Species Based on Data Fusion

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