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Screening Algorithm (screening + algorithm)
Selected AbstractsImproved prenatal aneuploidy screening using the novel advanced first-trimester screening algorithm: A multicenter study of 10,017 pregnanciesJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2008Peter Schmidt MD Abstract Purpose. It has been postulated that the maternal age component should be completely excluded from first-trimester screening (FTS) for fetal aneuploidies. In this study, we tested a new algorithm known as advanced first-trimester screening (AFS), which disregards maternal age. Method. In a multicenter study, FTS findings were retrieved from 10,017 pregnancies. FTS risk assessment was performed using the Nicolaides method, and the AFS score was calculated. The results of both methods were compared. Results. Within this population, 81 fetuses had an abnormal karyotype. The sensitivity of the 2 algorithms was 86.4%. When the AFS method was used, the positive predictive value rose from 9.6% (FTS) to 12.4% (AFS). Using AFS, the test positive rate could be decreased by 161 cases (,22.2%) (p < 0.0001), due to a reduction of false positive cases. As a result, the false positive rate of AFS was 24.5% lower than that of FTS, while the same number of aneuploidies was detected. Conclusion. AFS can markedly reduce the rate of false positive test results. If these results are confirmed by larger multicenter studies, the new AFS will represent a great improvement in fetal aneuploidy screening. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source] Design of improved permeation enhancers for transdermal drug deliveryJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 11 2009Srinivas S. Godavarthy Abstract One promising way to breach the skin's natural barrier to drugs is by the application of chemicals called penetration enhancers. However, identifying potential enhancers is difficult and time consuming. We have developed a virtual screening algorithm for generating potential chemical penetration enhancers (CPEs) by integrating nonlinear, theory-based quantitative structure,property relationship models, genetic algorithms, and neural networks. Our newly developed algorithm was used to identify seven potential CPE molecular structures. These chemical enhancers were tested for their toxicity on (a) mouse embryonic fibroblasts (MEFs) with MTT assay, and (b) porcine abdominal skin by histology using H/E staining at the end of a 48-h exposure period to the chemicals. Further, melatonin permeability in the presence of the enhancers was tested using porcine skin and Franz diffusion cells. Careful toxicity tests showed that four of the seven "general" CPEs were nontoxic candidate enhancers (menthone, 1-(1-adamantyl)-2-pyrrolidinone, R(+)-3-amino-1-hydroxy-2-pyrrolidinone, and 1-(4-nitro-phenyl)-pyrrolidine-2,5-dione). Further testing of these four molecules as potential melatonin-specific CPEs revealed that only menthone and 1-dodecyl-2-pyrrolidinone provided sufficient enhancement of the melatonin permeation. The results from our permeability and toxicity measurements provide validation of the efficacy and ability of our virtual screening algorithm for generating potential chemical enhancer structures by virtual screening algorithms, in addition to providing additional experimental data to the body of knowledge. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4085,4099, 2009 [source] A Demonstration of a Presurgical Behavioral Medicine Evaluation for Categorizing Patients for Implantable Therapies: A Preliminary StudyNEUROMODULATION, Issue 4 2008Kimberly Gardner Schocket PhD ABSTRACT Objectives., The aim of the current study was to evaluate the potential efficacy of a presurgical behavioral medicine evaluation screening algorithm with patients undergoing evaluation for implantable pain management devices. Methods., Sixty patients were evaluated for prognostic recommendations regarding outcomes from surgery for spinal cord stimulators and intrathecal pumps. Diagnostic interviews, review of medical charts, and psychosocial and functional measures were used in the initial evaluation. Results., Patients were classified into one of four prognostic groups, from low to increasing risks: Green, Yellow I, Yellow II, and Red. The Green group showed the most positive biopsychosocial profile, while the Red groups showed the worst profiles. Conclusions., This preliminary study suggests that the presurgical behavioral medicine evaluation algorithm may be an effective method for categorizing patients into prognostic groups. Psychological and adverse clinical features appear to have the most power in the classification of such patients. [source] Psychosocial Differences Between High-Risk Acute vs.PAIN PRACTICE, Issue 2 2008Chronic Low Back Pain Patients ,,Abstract: The present study was designed to evaluate the relative degree and type of emotional distress in high-risk acute low back pain (ALBP) subjects (defined as less than 3 months since initial injury) vs. high-risk chronic low back pain (CLBP) subjects (defined as greater than 3 months since initial injury). It is an extension of earlier findings that demonstrated the significant role that such emotional distress may play in the development of CLBP disability if not appropriately treated in the acute phase. This work stems from a conceptual three-stage model, which characterizes the progression from acute to chronic pain. Several psychosocial measures were administered that included information allowing for the classification of subjects as high-risk based upon an earlier developed screening algorithm. The ancova procedure in SPSS was used to compare groups, controlling for gender, ethnicity, and age. Results revealed that CLBP subjects had higher rates of certain measures of emotional distress and depression relative to ALBP subjects. These findings further support the importance of effectively managing emotional distress factors early, when treating musculoskeletal disorders such as low back pain.,, [source] Auditory Brainstem Response versus Magnetic Resonance Imaging for the Evaluation of Asymmetric Sensorineural Hearing Loss,THE LARYNGOSCOPE, Issue 10 2004Roberto A. Cueva MD Abstract Objectives/Hypothesis: Auditory brainstem response (ABR) testing and magnetic resonance imaging (MRI) are compared for the evaluation of patients with asymmetric sensorineural hearing loss (SNHL). MRI with gadolinium administration is the current gold standard for identifying retrocochlear lesions causing asymmetric SNHL. The study seeks to determine the sensitivity and specificity of ABR in screening for possible retrocochlear pathology. Most important among SNHL etiologies are neoplastic lesions such as vestibular schwannomas, cerebellopontine angle (CPA) tumors, as well as multiple sclerosis, stroke, or other rare nonneoplastic causes. The study results will allow the author to recommend a screening algorithm for patients with asymmetric SNHL. Study Design: The study is a multi-institutional, institutional review board approved, prospective, nonrandomized comparison of ABR and MRI for the evaluation of patients with asymmetric SNHL. Methods: Three hundred twelve patients (between the ages of 18 and 87) with asymmetric SNHL completed the study. Asymmetric SNHL was defined as 15 dB or greater asymmetry in two or more frequencies or 15% or more asymmetry in speech discrimination scores (SDS). These patients prospectively underwent both ABR and MRI. The ABR and MRI were interpreted independently in a blinded fashion. In addition to the ABR and MRI results, a variety of clinical and demographic data were collected. Results: Thirty-one (9.94%) patients of the study population of 312 were found on MRI to have lesions causing their SNHL. Of the 31 patients with causative lesions on MRI there were 24 vestibular schwannomas, 2 glomus jugulare tumors, 2 ectatic basilar arteries with brainstem compression, 1 petrous apex cholesterol granuloma, 1 case of possible demyelinating disease, and 1 parietal lobe mass. Twenty-two of the 31 patients had abnormal ABRs, whereas 9 patients (7 with small vestibular schwannomas) had normal ABRs. This gives an overall false-negative rate for ABR of 29%. The false-positive rate was found to be 76.84%. Sensitivity of ABR as a screening test was 71%, and specificity was 74%. Conclusions: Ten percent of patients with asymmetric SNHL (by this study's criteria) are likely to have causative lesions found on MRI. Although the recently reported annual incidence of vestibular schwannoma in the general population is 0.00124%, for patients with asymmetric SNHL in this study, the incidence was 7.7% (nearly 4 orders of magnitude higher). ABR has been demonstrated to have low sensitivity and specificity in the evaluation of these patients and cannot be relied on as a screening test for patients with asymmetric SNHL. Keeping the use of MRI conditional on the results of ABR will annually result in missed or delayed diagnosis of causative lesions in 29 patients per 1,000 screened. The author recommends abandoning ABR as a screening test for asymmetric SNHL and adoption of a focused MRI protocol as the screening test of choice (within certain guidelines). [source] | ||||||||||