Evaluation of simple International ovarian tumor analysis ultra sound rules in differentiating between benign and malignant ovarian tumors and their histopathological correlation

Background: IOTA (International ovarian tumor analysis) study is considered one of the largest studies on ultrasound diagnosis of ovarian pathology conducted in literature till date. It was started in 1999 and included nine European countries. It is a standardized technique for preoperative classification of ovarian pathology defined by IOTA group.Methods: A retrospective study was analyzed from a period of January 2016 to December 2017 (2-year period). The records of all the patients operated for benign and malignant ovarian pathology in the gynae department of hospital were retrieved from medical record sections. USG findings were redefined as per IOTA simple rules by sonologist and its histopathological correlation was done using kappa statistical method.Results: In the present study, out of 61 patients IOTA was applicable to 57 patients. The sensitivity where IOTA simple rules were applicable was 92.8% and the specificity was 93%. The accuracy turned out to be 92.9%. If inconclusive results were taken as malignant then sensitivity increased to 94% and specificity decreased to 87%. Good level of agreement was found between sonological and histopathological findings with Kappa statistics application (K = 0.59).Conclusions: The IOTA simple rules can be considered as an important diagnostic modality in differentiation of benign and malignant ovarian tumors, it has an added advantage of abolishing the subjectivity of routine ultrasound. However inconclusive results demand further expertise in the field and need to be taken care of before interpretation of ovarian pathologies.

Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data / 예방의학회지

OBJECTIVES: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. METHODS: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. RESULTS: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. CONCLUSIONS: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

Reliability studies of diagnostic methods in Indian traditional Ayurveda medicine: An overview.

Recently, a need to develop supportive new scientific evidence for contemporary Ayurveda has emerged. One of the research objectives is an assessment of the reliability of diagnoses and treatment. Reliability is a quantitative measure of consistency. It is a crucial issue in classification (such as prakriti classification), method development (pulse diagnosis), quality assurance for diagnosis and treatment and in the conduct of clinical studies. Several reliability studies are conducted in western medicine. The investigation of the reliability of traditional Chinese, Japanese and Sasang medicine diagnoses is in the formative stage. However, reliability studies in Ayurveda are in the preliminary stage. In this paper, examples are provided to illustrate relevant concepts of reliability studies of diagnostic methods and their implication in practice, education, and training. An introduction to reliability estimates and different study designs and statistical analysis is given for future studies in Ayurveda.

Evaluation of the Singh index for Measurement of Osteoporosis / 대한정형외과학회잡지

PURPOSE: The Singh index which is based on a plain radiograph has commonly used in assessing the grade of osteoporosis. We studied value of the Singh index in assessing the grade of osteoporosis by obtaining reliability of the Singh index and correlation between the Singh index and bone mineral density. MATERIALS AND METHODS: Six observers assessed radiographs of 60 patients suspected osteoporosis. The interobserver and intraobserver agreement of the Singh index were obtained by using kappa statistics. The bone mineral density of proximal femur was measured by dual energy X-ray absorptiometry in all patients, and then the results of bone mineral density were compared with those of Singh index by using percentage of variance. RESULTS: The kappa values of interobserver agreement ranged from 0.28 to 0.76 (mean value: 0.45) and the strength of the agreement was moderate. The percentage of variance of BMD which was explained by Singh index was 7.1%. CONCLUSIONS: The results of this study suggest that the Singh index has low clinical value in assessing the grade of osteoporosis

The predictive value of frozen section in the diagnosis of parotid tumors

A total of 38 patients with frozen section slides who underwent parotidectomy from January 1980 to December 1993 were retrieved from the Department of Pathology. The permanent section slides of the resected specimens were used as the gold standard. The frozen section and permanent section slides were reviewed by two independent pathologists and were labeled either as benign or malignant. If malignant, the tumor grade was determined as either high grade or low grade. Kappas correlation of agreement was used to determine inter-observer variability. Of the 38 slides, 16 were correctly labeled as malignant and 20 as benign. One slide was incorrectly labeled as malignant and 1 as benign. Sensitivity was 94.1 and specificity was 95.2 percent. The prevalence of malignant parotid tumors was 44.7 per cent, with a positive predictive value of 94.1 per cent and a negative predictive value of 95.2 per cent. Kappa statistic for the permanent section was 100 per cent, and 85 per cent for the frozen section. Tumor grading revealed that only 35.2 per cent were labeled correctly as high grade or low grade. This study showed that frozen section could reliably diagnose a malignant parotid tumor but could not reliably determine tumor grade. (Author)