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Stroke May 2021Thrombophilia testing is frequently performed after an ischemic stroke, particularly when cryptogenic. However, there is minimal evidence supporting a significant... (Review)
Review
Thrombophilia testing is frequently performed after an ischemic stroke, particularly when cryptogenic. However, there is minimal evidence supporting a significant association between most conditions assessed through thrombophilia testing and ischemic stroke, and the rationale for thrombophilia testing in many clinical situations remains uncertain. In this topical review, we review and contextualize the existing data on the risks, predictors, and outcomes of thrombophilic conditions in patients with ischemic stroke. We report that inherited thrombophilias have an uncertain relationship with ischemic stroke. Conversely, antiphospholipid syndrome, an acquired immune-mediated thrombophilia, seems to be a strong risk factor for arterial thromboembolic events, including ischemic stroke, and especially among young patients. Our findings suggest that certain circumstances may warrant targeted thrombophilia testing, such as stroke in the young, cryptogenic stroke, and high estrogen states. Future prospective studies should investigate the utility and cost effectiveness of thrombophilia testing in various stroke settings, including among patients with patent foramen ovale; as well as the optimal secondary stroke prevention regimen in patients with confirmed thrombophilia, particularly if no other potential stroke mechanism is identified.
Topics: Cost-Benefit Analysis; Diagnostic Tests, Routine; Humans; Ischemic Stroke; Thrombophilia
PubMed: 33874743
DOI: 10.1161/STROKEAHA.120.032360 -
Revue Scientifique Et Technique... Jun 2021Before tools became available to consider diagnostic test validation studies where a 'gold-standard' is not available, new diagnostic tests were compared to a reference... (Review)
Review
Before tools became available to consider diagnostic test validation studies where a 'gold-standard' is not available, new diagnostic tests were compared to a reference standard assumed to be highly accurate if not perfect. This paper reviews such 'traditional' situations with examples and methods of study design and analysis. Three situations are described, two where a perfect reference is available for either positive or negative animals, and one where the reference is perfect for both. Thus, here the authors review circumstances to be considered when validating a diagnostic test with a credible reference standard. An appropriate study design requires an unbiased selection of animals from the population to which a new test will be applied. Examples for calculating sample size and data analysis are provided. Finally, the authors discuss situations where it may be appropriate to include influential variables ('covariates') in a diagnostic test validation study..
Topics: Animals; Diagnostic Tests, Routine; Reference Standards; Sensitivity and Specificity
PubMed: 34140725
DOI: 10.20506/rst.40.1.3223 -
Laboratory Medicine Mar 2020Metabolomics is a powerful new analytical method to describe the set of metabolites within cellular tissue and bodily fluids. Metabolomics can uncover detailed... (Review)
Review
Metabolomics is a powerful new analytical method to describe the set of metabolites within cellular tissue and bodily fluids. Metabolomics can uncover detailed information about metabolic changes in organisms. The morphology of these metabolites represents the metabolic processes that occur in cells, such as anabolism, catabolism, inhomogeneous natural absorption and metabolism, detoxification, and metabolism of biomass energy. Because the metabolites of different diseases are different, the specificity of the changes can be found by metabolomics testing, which provides a new source of biomarkers for the early identification of diseases and the difference between benign and malignant states. Metabolomics has a wide application potential in pancreatic diseases, including early detection, diagnosis, and identification of pancreatic diseases. However, there are few studies on metabolomics in pancreatic diseases in the literature. This article reviews the application of metabolomics in the diagnosis, prognosis, treatment, and evaluation of pancreatic diseases.
Topics: Biomarkers; Diagnostic Tests, Routine; Disease Management; Early Diagnosis; Humans; Metabolomics; Pancreatic Diseases; Prognosis; Sensitivity and Specificity
PubMed: 31340007
DOI: 10.1093/labmed/lmz046 -
PLoS Neglected Tropical Diseases Nov 2021As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of...
As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of supporting the needs of the programs are critical for success. Known limitations of existing diagnostic tools make it challenging to have confidence that program endpoints have been achieved. In 2019, the World Health Organization (WHO) established a Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases tasked with prioritizing diagnostic needs including defining use-cases and target product profiles (TPPs) for needed tools. Subsequently, disease-specific DTAG subgroups, including one focused on LF, were established to develop TPPs and use-case analyses to be used by product developers. Here, we describe the development of two priority TPPs for LF diagnostics needed for making decisions for stopping mass drug administration (MDA) of a triple drug regimen and surveillance. Utilizing the WHO core TPP development process as the framework, the LF subgroup convened to discuss and determine attributes required for each use case. TPPs considered the following parameters: product use, design, performance, product configuration and cost, and access and equity. Version 1.0 TPPs for two use cases were published by WHO on 12 March 2021 within the WHO Global Observatory on Health Research and Development. A common TPP characteristic that emerged in both use cases was the need to identify new biomarkers that would allow for greater precision in program delivery. As LF diagnostic tests are rarely used for individual clinical diagnosis, it became apparent that reliance on population-based surveys for decision making requires consideration of test performance in the context of such surveys. In low prevalence settings, the number of false positive test results may lead to unnecessary continuation or resumption of MDA, thus wasting valuable resources and time. Therefore, highly specific diagnostic tools are paramount when used to measure low thresholds. The TPP process brought to the forefront the importance of linking use case, program platform and diagnostic performance characteristics when defining required criteria for diagnostic tools.
Topics: Diagnostic Tests, Routine; Elephantiasis, Filarial; Humans; Public Health; World Health Organization
PubMed: 34780503
DOI: 10.1371/journal.pntd.0009968 -
Revue Medicale Suisse Aug 2019
Topics: Diagnostic Tests, Routine; Female; Humans; Papillomaviridae; Papillomavirus Infections; Sequence Analysis, RNA; Uterine Cervical Neoplasms
PubMed: 31496179
DOI: No ID Found -
The Journal of Urology Nov 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 34406024
DOI: 10.1097/JU.0000000000002160 -
The Journal of Urology Sep 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 34148355
DOI: 10.1097/JU.0000000000001923 -
The Journal of Urology Jun 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 33792362
DOI: 10.1097/JU.0000000000001740 -
The Journal of Urology Apr 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 33464932
DOI: 10.1097/JU.0000000000001619 -
The Journal of Urology Aug 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 33993708
DOI: 10.1097/JU.0000000000001864