The Diagnostic Value of Serum miRNA-221-3p, miRNA-382-5p, and miRNA-4271 in Ischemic Stroke: Methodological Issue to Avoid Misinterpretation

Sabour, Siamak

doi:10.1016/j.jstrokecerebrovasdis.2017.02.008

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…For example, circulating aberrantly expressed miR-132, miR-146a, miR-155, and miR-223 in septic neonates were documented to be related with immune-related genes, and might be candidate biomarkers for neonatal sepsis diagnosis ( 25 ). Sabour ( 26 ) found that miRNA-221-3p and miRNA-382-5p might be used as potential noninvasive biomarkers for the diagnosis of ischemic stroke. In sepsis, there were multiple abnormally expressed miRNAs, such as miR-29a, miR-96, and miR-101, which were also related with disease diagnosis ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

miR-141 is negatively correlated with TLR4 in neonatal sepsis and regulates LPS-induced inflammatory responses in monocytes

Lin

Wang

2021

Braz J Med Biol Res

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Neonatal sepsis is an inflammatory system syndrome and a main cause of neonatal mortality. However, there is a lack of ideal biomarkers for early neonatal sepsis diagnosis. The aim of this study was to evaluate the clinical significance of miR-141 in sepsis in neonates, and explore the regulatory effects of miR-141 on inflammation in monocytes. This study used qRT-PCR to calculate the expression of miR-141 in the serum of septic neonates. The diagnostic values of procalcitonin (PCT) and serum miR-141 were evaluated by receiver operating characteristic (ROC) curves. The relationship between miR-141 and TLR4 was determined using luciferase reporter assay. An inflammation model was established using monocytes with lipopolysaccharide (LPS) treatment. ELISA assay was used to analyze the levels of pro-inflammatory cytokines. The expression of miR-141 in neonatal sepsis was significantly lower than healthy controls. ROC curves showed that miR-141 had diagnostic accuracy. LPS stimulation in monocytes led to a decrease in the expression of miR-141. A luciferase reporter assay proved that miR-141 targeted TLR4, and a negative correlation of miR-141 with TLR4 was found in septic neonates. ELISA results demonstrated that the overexpression of miR-141 inhibited LPS-induced inflammation in monocytes. In conclusion, serum decreased miR-141 expression served as a candidate diagnostic biomarker of neonatal sepsis. TLR4 is a target gene of miR-141, which may mediate the inhibitory effects of miR-141 overexpression on LPS-induced inflammation in monocytes. Therefore, miR-141 is expected to be a potential diagnostic biomarker and a therapeutic target in neonatal sepsis.

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Section: Discussionmentioning

confidence: 99%

miR-141 is negatively correlated with TLR4 in neonatal sepsis and regulates LPS-induced inflammatory responses in monocytes

Lin

Wang

2021

Braz J Med Biol Res

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“…Moreover, sensitivity and specificity reported in their results are more important for public health purposes, but PPV and NPV are more useful for clinical purposes. Furthermore, it is very important to know that for clinical purposes, reporting diagnostic added value should be considered using receiver operating characteristic (ROC) because all the above validity estimates can be acceptable while diagnostic added value may be clinically negligible …”

Section: Comparison Of Two Observers’ Diagnoses With Different Prevalmentioning

confidence: 99%

Bedside Ultrasound in Acute Appendicitis in the Emergency Department: Methodologic and Statistical Issues on Diagnostic Value

Koohi

Sabour

2017

Academic Emergency Medicine

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published in the May issue of the Academic Emergency Medicine. The aim of the authors was to evaluate diagnostic value of pointof-care ultrasound (POCUS) in clinical decision making of emergency physicians (EPs) for acute appendicitis (AA) in the emergency department (ED). 1 A total of 264 patients were included into a prospective observational clinical study and based on their results 169 (64%) had a diagnosis of AA. All patients were examined initially with POCUS by EPs and then with radiology-performed US (RADUS) by radiologists. The sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR--) of US examinations were 92.3%, 95.8%, 21.9, and 0.08 for POCUS and 76.9%, 97.8%, 36.4, and 0.24 for RADUS, respectively. The inter-rater agreement between EPs and radiologists was depicted by Cohen's kappa value. There was a moderate consistency between POCUS and RADUS results (j = 0.67; 95% confidence interval [CI] = 0.57-0.75).However, these results are not the most appropriate estimates to evaluate diagnostic value. Diagnostic value should be considered as diagnostic accuracy (validity) and diagnostic precision (reliability or agreement). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), LR+ (ranging from 1 to infinity; the higher the LR+, the more accurate the test), LR-(ranging from 0 to 1; the lower the LR-, the more accurate the test) as well as odds ratio (ratio of true to false results) are the most appropriate estimates to evaluate validity of a test compared to a criterion standard. Therefore, it is better to report all these validity estimates together. Otherwise, final interpretation will be confusing because considering sensitivity and LR-, POCUS is more accurate than RADUS. However, by considering specificity and LR+, RADUS is more accurate than POCUS! Moreover, sensitivity and specificity reported in their results are more important for public health purposes, but PPV and NPV are more useful for clinical purposes. Furthermore, it is very important to know that for clinical purposes, reporting diagnostic added value should be considered using receiver operating characteristic (ROC) because all the above validity estimates can be acceptable while diagnostic added value may be clinically negligible. [2][3][4][5][6][7][8] Reliability (precision or agreement) as a different methodologic issue of the diagnostic value should also be assessed using appropriate estimate. For qualitative variables, weighted kappa should be used with caution. Two important weaknesses of Cohen's kappa to assess agreement of a qualitative variable are as follows. First, it depends on the prevalence in each category, which means it can be possible to have different j values having the same percentage for both concordant and discordant cells. Table 1 shows that in both (a) and (b) situations, the prevalences of concordant cells are 90%, and of discordant cells, 10%; however, we get different kappa values (0.44 as moderate and 0.80 as very good, respectively). K...

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“…Reliability (precision or agreement) as a different methodological issue of diagnostic value should be assessed using an appropriate test. For qualitative variables, weighted kappa should be applied (Szklo & Nieto, 2007;Sabour, 2016Sabour, , 2017aSabour, , 2017bSabour & Ghassemi, 2016). It is crucial to know that, using Cohen's kappa is not the most appropriate test to assess agreement.…”

mentioning

confidence: 99%

“…In both situations given in Table I (A and B), the prevalence of concordant cells is 90% and that of discordant cells is 10%; however, these result in different kappa values (0Á44 as moderate and 0Á80 as very good, respectively). The kappa value also depends upon the number of categories (Szklo & Nieto, 2007;Sabour, 2016Sabour, , 2017aSabour, , 2017bSabour & Ghassemi, 2016). Therefore, using weighted kappa in such situations can be suggested as an appropriate statistical test.…”

mentioning

confidence: 99%

Whole‐body ultra‐low dose computed tomography in comparison with spinal magnetic resonance imaging in the assessment of disease in multiple myeloma; Methodological issues on Diagnostic value

The Diagnostic Value of Serum miRNA-221-3p, miRNA-382-5p, and miRNA-4271 in Ischemic Stroke: Methodological Issue to Avoid Misinterpretation

Cited by 7 publications

References 7 publications

miR-141 is negatively correlated with TLR4 in neonatal sepsis and regulates LPS-induced inflammatory responses in monocytes

miR-141 is negatively correlated with TLR4 in neonatal sepsis and regulates LPS-induced inflammatory responses in monocytes

Bedside Ultrasound in Acute Appendicitis in the Emergency Department: Methodologic and Statistical Issues on Diagnostic Value

Whole‐body ultra‐low dose computed tomography in comparison with spinal magnetic resonance imaging in the assessment of disease in multiple myeloma; Methodological issues on Diagnostic value

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