Redundancy of Single Diagnostic Test Evaluation

Moons, Kgm; És, Gorovits; Michel, B; Büller, HR; Habbema, J. Dik F.; Grobbee, Diederick E.

doi:10.1097/00001648-199905000-00015

Cited by 72 publications

(64 citation statements)

References 33 publications

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“…If biomarkers are considered separately from the Clinical model, haptoglobin and MMP-2 are associated with advanced fibrosis. These tests, however, have no additional value beyond the routine clinical data and thus can be omitted from the diagnostic process [15]. These findings suggest that the limitation of odds ratio in assessing potential new markers, highlighting the necessity for examining ROC to form a more comprehensive picture of clinical relevance for any candidate marker [16].…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Model to Predict Advanced Fibrosis in Chronic Hepatitis B Virus-Infected Patients with High Viral Load and Normal or Minimally Raised ALT

Park

Kim

et al. 2010

Dig Dis Sci

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Background/Aims Treating a group of chronic hepatitis B virus (HBV)-infected patients with high viral load and advanced fibrosis or cirrhosis, regardless of their serum alanine aminotransferase (ALT) levels, is recommended. The aim of this study was to derive and validate a model to predict advanced fibrosis in a cohort of patients with viral replication and normal or minimally raised ALT [ALT \ 2 9 upper normal limit (UNL)]. Methods Information was collected from 124 patients who underwent liver biopsy. The diagnostic value of predictors was judged using multivariate logistic modeling and area under the receiver operating characteristic curves (ROC area). Results Advanced fibrosis (F3 or F4 on METAVIR scoring schema) was diagnosed in 45.7% (95% CI, 34-57.4%) of the patients of the derivation set (70 patients) and in 37% (95% CI, 24.2-49.9%) of the validation set (54 patients). In the derivation set, age and aspartate aminotransferase (AST) were independent clinical predictors of advanced fibrosis. The ROC areas of this Age-AST model were 0.8 (95% CI, 0.7-0.9) in the derivation set and 0.82 (95% CI, 0.71-0.93) in the validation set, respectively. Without missing a single case, this model identified 11 patients (20%) without advanced fibrosis in the validation set. Conclusions A substantial proportion of patients with high viral load and ALT \ 2 9 UNL have advanced fibrosis. A simple model including age and AST is an easily applicable tool for physicians to guide their decisions on whether or not to perform liver biopsy in individual patients.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Model to Predict Advanced Fibrosis in Chronic Hepatitis B Virus-Infected Patients with High Viral Load and Normal or Minimally Raised ALT

Park

Kim

et al. 2010

Dig Dis Sci

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“…To ascertain or rule out a diagnosis, the physician decides upon additional tests based on findings in previous steps, to increase or decrease the probability of a target condition. We believe that diagnostic research should follow the sequential process of making a diagnosis in practice, and also aim to quantify the added value of a new test in relation to clinical information available from existing methods [19,20].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of multiple biomarker panel for prediction of significant fibrosis in chronic hepatitis C

Park

Kim

et al. 2011

Clinical Biochemistry

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“…A value exceeding 0.7 is interpreted as reasonable, and a value in excess of 0.8 is considered to be good. 11 A 5% level of significance was used throughout, and all statistical tests were two sided. The statistical analyses were performed using a commercially available program, SPSS 10.0 (SPSS Inc., Chicago, IL, USA).…”

Section: Discussionmentioning

confidence: 99%

Sleep-related nocturnal erections and erections during midazolam-induced sedation in healthy young men

Song¹,

Song

Lee³

et al. 2006

Int J Impot Res

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This study was performed to evaluate the characteristics of penile erection during midazolaminduced sedation after nocturnal sleep deprivation (NSD) and to determine the effect of NSD on erectile episodes in healthy, sexually functional young men. This procedure might possibly prove to be a brief office-based method of assessing whether erectile dsyfunction is psychogenic or biogenic. Nineteen volunteers between the ages of 20 and 29 years participated in this study. We measured the morning penile erection after midazolam (3-5 mg) administration intravenously and all subjects completed 42 tests. Of 42 test, 28 tests revealed erectile episodes, wereas no erectile episodes were observed in 14 tests. Nocturnal sleep deprivation rate was significantly higher in tests with erectile episodes than in tests without erectile episode (P ¼ 0.030). Test order or duration of test was not different between two test results. Number of erectile episodes (r ¼ 0.374, P ¼ 0.015), tip radial rigidity (r ¼ 0.412, P ¼ 0.007), base radial rigidity (r ¼ 0.366, P ¼ 0.017) and tip tumescence (r ¼ 0.447, P ¼ 0.003) correlated with the degree of NSD. When we determined whether NSD was discriminative with regard to erectile episodes, the area under the receiver operating characteristic curve was calculated at 0.705 (95% confidence interval, 0.527-0.883; P ¼ 0.032) for the possibility of erectile episodes. Nocturnal sleep deprivation might recover the inhibited rapid eye movement sleep during midazolam-induced sedation. Our findings suggest that erection monitoring during midazolam-induced sedation after NSD may be convenient. However, validation of midazolaminduced morning penile tumescence monitoring with a large population is mandatory.

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Redundancy of Single Diagnostic Test Evaluation

Cited by 72 publications

References 33 publications

Development and Validation of a Model to Predict Advanced Fibrosis in Chronic Hepatitis B Virus-Infected Patients with High Viral Load and Normal or Minimally Raised ALT

Development and Validation of a Model to Predict Advanced Fibrosis in Chronic Hepatitis B Virus-Infected Patients with High Viral Load and Normal or Minimally Raised ALT

Diagnostic value of multiple biomarker panel for prediction of significant fibrosis in chronic hepatitis C

Sleep-related nocturnal erections and erections during midazolam-induced sedation in healthy young men

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