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1.
行列资料诊断试验预告值和准确度的一次性标化研究   总被引:1,自引:0,他引:1  
本文建立了行列资料诊断试验预告值和准确度的一次性标化方法,省去了标化过程理论样本Nt的设定和求有关理论值的计算过程,导出行列资料中标准化Ⅰ级阳性预告值和标准化Ⅱ级阳性预告值、标准化Ⅰ级阴性预告值和标准化Ⅱ级阴性预告值、标准化可疑预告值和标准化准确度的一次性标化公式。分析了标化与非标化预告值的关系及转化规律。  相似文献   

2.
行列资料诊断试验评价方法   总被引:3,自引:0,他引:3  
本文分析了行列式诊断试验资料特点,提出了适于评价该类资料的方法,同时提出了可疑度、可疑预告值概念及计算方法,并进一步将灵敏度、特异度、漏诊率、误诊率、阳性和阴性预告值划分为Ⅰ、Ⅱ两级。  相似文献   

3.
习题 1、筛检的目的是: A对可疑者用特异性高的方法确诊 B可使患者得到确诊 C为了发现早期病人 D为了节省普查时浪费的人力和物力 E为了发现有某种缺陷的人 2、评价诊断试验真实性的主要指标是: A敏感度和假阴性率 B特异度和精密度 C敏感度和特异度 D阳性预告值和假阳性率 E阴性预告值和患病率 3、如何提高筛检试验的阳性预告值: A减少筛检频率 B增加筛检频率 C筛检高危性人群 D对筛检阳性者进行更仔细的诊断 E、以上都不是 4、有人认为,用脱落细胞巴氏染色法检查子宫内膜癌和子宫颈癌,查出的阳性者中巧%是正确的、即该法查出的阳性者…  相似文献   

4.
目的评价临床诊断方法对基础训练期间新兵应力性骨折的诊断效能。方法以同位素骨扫描为金标准,对288例可疑应力性骨折患者临床诊断方法的真实性和可靠性指标进行评价。结果按病例计算时,敏感度、特异度、准确度、阳性预告值、阴性预告值、阳性似然比、阴性似然比和Youden指数分别为97.5%、61.7%、91.7%、92.9%、82.9%、2.55、0.04和0.59。两名医师临床诊断的符合率为81.7%,kappa值0.64;当以受伤部位数计算时,上述真实性指标分别为97.2%、84.1%、89.7%、82.0%、97.6%、6.12、0.03和0.81,两名医师临床诊断的符合率为94.4%,kappa值0.88。结论临床诊断方法用于诊断新兵基础训练期间应力性骨折具有较高的诊断效能和良好的符合率。  相似文献   

5.
目的研究蛋白芯片对幽门螺杆菌(Helicobacter pylori,Hp)的诊断价值,为其是否可作为群体Hp感染的筛查工具提供依据。方法120例因消化不良行胃镜检查的患者,至少在胃窦和胃体各取2块组织用于病理诊断、Hp的Gemsia染色和快速尿素酶检测(Rapid urease test,RUT)。另取静脉血2mL,分离血清用于Hp的ELISA检测和蛋白芯片检测。Gemsia染色、RUT和ELISA检测有2项阳性者做为诊断Hp感染的金标准。结果蛋白芯片检测诊断Hp感染的灵敏度和特异度分别为92.3%和95.2%,阳性预告值和阴性预告值分别为97.3%和87.0%,准确度为93.3%,并可以同时检测Hp的3个毒力因子。结论蛋白芯片是诊断Hp感染的一个良好方法,有较高的临床应用价值,是开展群体和部队官兵Hp普查的有力工具。  相似文献   

6.
新兵基础训练期间应力性骨折的临床诊断评价   总被引:1,自引:0,他引:1  
目的 评价临床诊断方法对基础训练期间新兵应力性骨折的诊断效能。方法 以同位素骨扫描为金标准,对288例可疑应力性骨折患者临床诊断方法的真实性和可靠性指标进行评价。结果 按病例计算时,敏感度、特异度、准确度、阳性预告值、阴性预告值、阳性似然比、阴性似然比和Youden指数分别为97.5%、61.7%、91.7%、92.9%、82.9%、2.55、004和0.59。两名医师临床诊断和符合率为81.7%,kappa值0.64;当以受伤部位数计算时,上述真实性指标分别为97.2%、84.1%、89.7%、82.0%、97.6%、6.12、0.03和0.81,两名医师临床诊断的符合率为94.4%,kappa值0.88。结论 临床诊断方法用于诊断新兵基础训练期间应力性骨折具有较高的诊断效能和良好的符合率。  相似文献   

7.
目的研究多因素判别分析评分在子宫内膜异位症诊断中的应用价值,提高其临床诊断率。方法对1997年1月~2000年2月在我院行妇科手术的268例患者行回顾性分析,用SAS软件包中的DISCRIM、FREQ过程处理临床数据。结果子宫内膜异位症的Bayes判别评分及临床术前诊断的灵敏度分别为89.50%、78.95%;特异度为82.4%、82.35%;阳性预告值96.22%、93.00%;阴性预告值为71.45%、45.20%。Bayes判别诊断效果优于临床诊断,两者比较差异有显著性(χ2=4.05,P<0.05)。结论多因素判别评分对提高子宫内膜异位症的术前诊断率有重要的应用价值。  相似文献   

8.
挖空细胞在病理诊断尖锐湿疣中的诊断价值   总被引:13,自引:0,他引:13  
目的 评价挖空细胞在组织学上诊断尖锐湿疣的诊断价值。方法 以挖空细胞作为诊断标准,对2063份活检标本进行组织学诊断,其诊断结果与病理学上诊断尖湿疣的“金标准”进行比较分析。结果 以挖空细胞作为尖锐湿疣的组织学诊断标准,其诊断的灵敏度为77.93%,特异度95.26%,阳性预告值97.25%,阴性预告值66.70%,阳性似然比81.81,阴性似然比23.17,漏诊率22.07%,误诊率4.74%。结论 挖空细胞是细胞感染人乳头瘤病毒(HPV)或其他病毒后,在形态学上发生特异性改变,是诊断尖锐湿疣的重要组织学依据,但不是组织学上诊断的唯一标准。  相似文献   

9.
脑血管血液动力学检测预警卒中的筛检试验评价   总被引:45,自引:4,他引:41       下载免费PDF全文
目的 评价脑血管血液动力学检测预警卒中的真实性和可靠性指标及最佳截断点。方法 以整群抽样的方法抽取东北等地区35岁及以上的人群20333例,在脑血管病危险因素基线调查时全部接受脑血管血液动力学检测,并对诸指标的检测结果进行总积分。检测随访目标人群卒中发病,随访4年共发生确诊卒中患者168例,以随访中临床卒中发生为金标准,用筛检试验方法评价脑血管血液动力学检测积分的预警效能及最佳截断点。结果 经过绘制受试者工作特征(ROC)曲线,血液动力学检测预警卒中的最佳积分值截断点应为75分以下。以75分为截断点,脑血液动力学检测后4年内预警卒中的敏感度、特异度、准确度、阳性预告值、阴性预告值、阳性似然比、阴性似然比和Youden指数分别为87.50%,67.70%,67.86%,2.21%,99.85%,2.71,0.18和0.55,其中预警脑血栓的敏感度和阳性预告值高于预警脑出血,在具有危险因素暴露的卒中高危人群中,阳性预告值是普通人群的2-3倍。脑血管血液动力学临床检测积分值的变异系数为4.03%,两名医师临床检测积分值判定的符合率为97.62%,Kappa值为0.94。结论 血液动力学检测对卒中具有良好的预警效果,其中脑血栓的预警效果优于脑出血。最佳分值截断点为75分。  相似文献   

10.
TCT诊断HPV感染在宫颈病变筛查中的诊断价值   总被引:1,自引:0,他引:1  
目的 评价薄层液基细胞学技术诊断人乳头瘤病毒感染在宫颈病变筛查中的诊断价值.方法 薄层液基细胞学技术结合TBS系统对762例标本进行细胞学分析,并将人乳头瘤病毒感染的诊断结果 与杂交二代捕获技术诊断结果 进行比较分析.结果 薄层液基细胞学技术结合TBS系统,其诊断的灵敏度为64.38%,特异度为94.85%;阳性预告值93.00%,阴性预告值71.40%;阳性似然比12.50,阴性似然比0.3750;漏诊率35.62%,误诊率5.15%;尤登指数0.5923.结论 薄层液基细胞学技术结合TBS系统对宫颈感染人乳头瘤病毒有一定的诊断率,但不够可靠.  相似文献   

11.
目的探讨血清1,3-β-D葡聚糖检测(G试验)及半乳甘露聚糖抗原检测(GM试验)联合痰真菌培养在重症监护病房(ICU)患者侵袭性真菌感染(IFI)早期诊断中的价值。方法选取徐州医科大学附属医院2015年1月—2016年12月重症监护病房(ICU)有高危IFI因素的住院患者,根据IFI的诊断标准将患者分成3组:IFI组(包括确诊及临床诊断)、拟诊IFI组、非IFI组。分析三组患者血清G试验、GM试验和痰真菌培养的结果,评价三者联合检测对IFI的早期诊断价值。结果共调查ICU住院患者264例,其中IFI组56例,拟诊IFI组43例,非IFI组165例。56例诊断IFI患者中,血清G试验阳性46例,GM试验阳性39例,真菌培养阳性34例;三者联合检测的敏感性98.2%、特异性82.4%、阳性预测值65.5%、阴性预测值99.3%、阳性似然比5.58、阴性似然比0.02、Youden指数0.98。三者联合检测的敏感性、阴性预测值均高于G试验、GM试验和痰真菌培养的单独检测,差异均有统计学意义(均P0.05);但是,三者联合检测的特异性、阳性预测值与单独检测G试验、GM试验和痰真菌培养比较,差异均无统计学意义(均P0.05)。结论 G试验、GM试验和痰真菌培养三者联合检测能提高ICU患者IFI早期诊断的敏感性,从而指导临床医生早期治疗IFI。  相似文献   

12.
HLA-B27 3种检测方法的比较   总被引:2,自引:0,他引:2  
目的:比较3种HLA-B27检测方法的敏感度、特异性、适用性。方法:采用微量淋巴细胞毒试验、PCR-SSP和流式细胞仪方法同时检测128份待检标本HLA-B27。结果:淋巴细胞毒试验、PCR-SSP和流式细胞仪方法敏感度、特异性、阳性预测价值、阴性预测价值分别为0.468、0.975、0.917、0.759;1.000、0.988、0.979、1.000;0.978、1.000、1.000、0.988。PCR-SSP和流式细胞仪方法敏感度显著性高于淋巴细胞毒试验,两两比较P〈0.01;阴性预测价值优于淋巴细胞毒试验,两两比较P〈0.05。结论:PCR-SSP和流式细胞仪方法均优于淋巴细胞毒试验,具有较好的临床适用性。  相似文献   

13.
The evaluation of diagnostic tests attempts to obtain one or more statistical parameters which can indicate the intrinsic diagnostic utility of a test. Sensitivity, specificity and predictive value are not appropriate for this use. The likelihood ratio has been proposed as a useful measure when using a test to diagnose one of two disease states (e.g. disease present or absent). In this paper, we generalize the likelihood ratio concept to a situation in which the goal is to diagnose one of several non-overlapping disease states. A formula is derived to determine the post-test probability of a specific disease state. The post-test odds are shown to be related to the pre-test odds of a disease and to the usual likelihood ratios derived from considering the diagnosis between the target diagnosis and each alternate in turn. Hence, likelihood ratios derived from comparing pairs of diseases can be used to determine test utility in a multiple disease diagnostic situation.  相似文献   

14.
This study assessed the sensitivity, specificity and predictive value of hearing complaints in outpatients attending an university ear, nose and throat clinic. A cross-sectional study was carried out in Canoas, Southern Brazil, from 1999 to 2002. Seven-hundred and ninety-five subjects who underwent the audiometric test were analyzed. The results showed that the complaint of hearing loss presented 80.9% sensitivity, 69.6% specificity and 86.5% positive predictive value and 60.4% negative predictive value. Despite its subjective character, the audiometric test can be considered a reliable diagnostic tool and should be used due to its low cost compared to the new technologies.  相似文献   

15.
Clinical studies of predictive diagnostic tests consider the evaluation of a single test and comparison of two tests regarding their predictive accuracy of disease status. The positive predictive value (PPV) curve is used for assessing the probability of predicting the disease given a positive test result. The sequential property of one PPV curve had been studied. However, in later stages of diagnostic test development, it is more interesting to compare predictive accuracy of two tests. In this article, we propose a group sequential test for the comparison of PPV curves for paired designs when both diagnostic tests are applied to the same subject. We first derive asymptotic properties of the sequential differences of two correlated empirical PPV curves under the common case-control sampling. We then apply these results to develop a group sequential test procedure. The asymptotic results are also critical for deriving both the optimal sample size ratio and minimal required sample sizes for the proposed procedure. Our simulation studies show that the proposed sequential testing maintains the nominal type I error rate in finite samples. The proposed design is illustrated in a hypothetical lung cancer predictive trial and in a cancer diagnostic trial.  相似文献   

16.
The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of immunofluorescence (IF) and enzyme-linked immunoassays (ELISA) for IgG, IgM and IgA antibodies were assessed on sera from mucocutaneous leishmaniasis patients and controls. The sensitivity of the IgG-ELISA test was 93.3% with 95% confidence interval higher than what could be due to a random test not associated with the disease. The specificity of all tests, except the IgM-ELISA, gave indices that could not have been due to chance. The IgG-ELISA and IgG-IF had the highest positive predictive value and the kappa statistic showed that the strength of agreement between the disease and the test was strongest for IgG-ELISA. The IgG-ELISA had a negative predictive value with 95% confidence limits that were not due to chance alone. Efficiency was highest for IgG-ELISA and IgG-IF. These results were obtained using sera from patients with severe or long-standing disease and from controls in whom the disease was ruled out by a negative Montenegro skin test. In field surveys where the differences between cases and controls are less easy to define the diagnostic indices of these tests may vary with the disease prevalence.  相似文献   

17.
目的探讨超声、 CT和MRI诊断肾上腺占位病变的临床价值。方法选取2017年12月至2019年12月我院收治的疑似肾上腺占位病变患者98例,术前予以超声、 CT和MRI检查。以病理检查结果为金标准,比较三种检查方式的诊断效能。结果超声阳性检出率为76.53%(75例),CT阳性检出率为78.57%(77例),MRI阳性检出率为89.80%(88例),病理检查阳性检出率为91.84%(90例)。超声和CT阳性检出率比较差异无统计学意义(P>0.05)。MRI和病理检查阳性检出率均明显高于超声和CT (P <0.05)。MRI的敏感性、阳性预测值、阴性预测值均明显高于超声(P <0.05)。CT与超声的特异性、敏感性、阳性预测值和阴性预测值比较差异无统计学意义(P>0.05)。CT与MRI的特异性和阳性预测值比较差异无统计学意义(P>0.05)。MRI的敏感性和阴性预测值均明显高于CT (P <0.05)。结论超声、 CT、 MRI在肾上腺占位病变中均有较高的诊断价值,其中MRI的特异性和敏感性最高,应用价值最显著,但在临床检验过程中仍需参考其他的检查方式,综合考虑检查结果以此提高诊断的准确率。  相似文献   

18.
OBJECTIVE: We aimed to examine sensitivity and positive predictive value of MEDLINE searching for diagnostic studies, relevant for the primary health care setting. METHOD: Results of MEDLINE searches were compared with a reference standard collection of studies on two subjects, the diagnostic value of ESR in discriminating between 'pathology' and 'no pathology', and the dipstick method in diagnosing urinary tract infections. The main outcome measures were sensitivity (proportion of the total number of reference standard diagnostic studies that could be identified by the search) and positive predictive value (proportion of the total number of publications retrieved by MEDLINE that were incorporated in the reference standard). RESULTS: The combined MeSH and freetext search was more sensitive than MeSH term searching only, for both the ESR and the dipstick search. With this combined search sensitivities of 0.91 and 0.98 and predictive values of 0.10 and 0.68 were found for ESR and dipstick respectively. By restricting the search with keywords describing the primary health care setting the predictive values increased to 0.72 and 1.00 but sensitivity dropped to 0.10 and 0.07 (ESR and dipstick respectively). CONCLUSION: Combining freetext and MeSH term searching, without restriction to the primary health care setting, is a valuable strategy in systematically searching for available evidence on the value of a diagnostic test in the scope of a specific disease. The predictive value seems to depend on the breadth of the disease area. MEDLINE should provide a term such as 'diagnostic evaluation study' to be used in the limit field Publication Type to specify diagnostic studies.   相似文献   

19.
薄层液基细胞学技术对宫颈疾病诊断价值评价   总被引:3,自引:0,他引:3  
目的评价薄层液基细胞学检测方法(TCT)对宫颈疾病的诊断价值。方法收集2006年1-12月在山西医科大学第二医院妇科住院病人的资料,选择做过TCT检查并追踪到有确切组织病理学诊断结果的462例病例为研究对象,以病理学诊断结果为金标准,评价TCT检测的诊断价值。结果462例住院病人中,经TCT检出宫颈鳞状细胞癌(SCC)和腺癌(AC)19例、鳞状上皮内高度病变(HSIL)28例、鳞状上皮内低度病变(LSIL)15例、意义不明的不典型鳞状细胞(ASC-US)和腺细胞(AGUS)35例、正常(WNL)365例。以病理学诊断结果为金标准,TCT检测的灵敏度为94.7%,特异度93.8%,约登指数为0.885,阳性似然比15.27,阴性似然比0.06,总符合率为93.7%,Kappa值0.79,阳性预测值74.2%,阴性预测值98.5%。TCT与组织病理学诊断结果的阳性符合率在宫颈癌中为95.0%,在HSIL、LSIL中分别为82.4%和68.2%。TCT检测对宫颈癌和HSIL的阳性符合率高于LSIL(P<0.05)。结论TCT检测对宫颈病变的诊断价值较高,特别是对宫颈癌和HSIL。  相似文献   

20.
运动心电图与电子束CT联合评价对冠心病的诊断价值   总被引:10,自引:0,他引:10  
目的 探讨运动心电图 (EET)与电子束 (EBCT)检测的冠状动脉钙化 (CAC)联合评价对冠心病的诊断价值。方法 经选择性冠状动脉造影并于同期行EBCT和EET检查的患者 13 5例 ,记算冠状动脉钙化积分 (CS) ,结合CS和EET评价对冠心病的诊断价值。结果 CS阈值预测冠心病的敏感性、特异性、阳性预测值和阴性预测值分别为 77%、81%、74%和 83 % ;EET阳性预测冠心病的敏感性、特异性、阳性预测值和阴性预测值分别为 73 %、76%、68%和 80 % ;CS阈值和EET综合评价 ,平行试验的敏感性和阴性预测值分别达 93 %和 92 % ,系列试验的特异性和阳性预测值分别达 96%和 91% ,均显著高于单项试验的相应指标 ( P <0 0 5和0 0 1)。结论 电子束CT冠状动脉钙化检测与运动心电图联合评价能显著提高冠心病的诊断价值。  相似文献   

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