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1.
Rev. bras. med. esporte ; 27(4): 414-418, Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1288594

ABSTRACT

ABSTRACT Introduction: The Functional Movement Test (FMS) is an evaluation method for the basic movement patterns of the human body that is designed by Gray Cook. Objective: This paper explores the application value of functional action test (FMS) biological image data in the risk assessment of sports injuries of Chinese rugby players. Methods: Taking the active national football team and provincial football players as the object, the standard FMS test is used to collect the data to determine the best deadline for the total FMS score. Results: The area under the ROC curve (AUC) of the overall athletes, men and women was significantly different from the assumption of AUC=0.5, which were 0.780 (P=0.000), 0.877 (P=0.001), 0.7130 (P=0.013); The best cutoff points corresponding to the total score of FMS are 13.5 points, 15.5 points, and 13.5 points, respectively. The chi-square test showed that the prevalence of the positive group (the total FMS score was less than the corresponding cutoff point) was significantly higher than the negative group (the total FMS score was greater than the corresponding cutoff point) (P<0.01). The OR values of the total athlete, male and female FMS total score positive groups were 25.85 (95%CI: 3.34∼200.23), 25.00 (95%CI: 2.36∼264.80), 14.22 (95%CI: 1.76∼114.92). Conclusions: Among Chinese rugby players, the total score of FMS has a strong correlation with non-contact sports injuries. The score is 13.5 for women and 15.5 for men. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: O Teste de Movimento Funcional (FMS) é um método de avaliação dos padrões básicos de movimento do corpo humano, projetado por Gray Cook. Objetivo: Este artigo explora o valor da aplicação de dados de imagem biológica do teste de ação funcional (FMS) na avaliação do risco de lesões esportivas em jogadores de rúgbi chineses. Métodos: visando a seleção nacional de futebol e jogadores de futebol da província, o teste FMS padrão foi usado para coletar os dados e determinar o melhor limite para o escore total do FMS. Resultados: A área sob a curva ROC (AUC) dos atletas em geral, homens e mulheres, foi significativamente diferente da suposição de AUC = 0,5, que foi 0,780 (P = 0,000), 0,877 (P = 0,001), 0,7130 (P = 0,013); Os melhores pontos de corte para o escore total da FMS são 13,5 pontos, 15,5 pontos e 13,5 pontos, respectivamente. O teste do qui-quadrado mostrou que a prevalência do grupo positivo (a pontuação total da FMS foi menor do que o ponto de corte correspondente) foi significativamente maior do que a do grupo negativo (a pontuação total da FMS foi maior do que o ponto de corte correspondente) (P <0,01). Os valores de OR do total de atletas, homens e mulheres, grupos positivos de pontuação total de FMS foram 25,85 (IC 95%: 3,34 ∼ 200,23), 25,00 (IC 95%: 2,36 ∼ 264,80), 14,22 (IC 95%: 1,76 ∼ 114,92). Conclusões: Entre os jogadores de rúgbi chineses, a pontuação total da FMS tem uma forte correlação com lesões esportivas sem contato. A pontuação é de 13,5 para mulheres e 15,5 para homens. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.


RESUMEN Introducción: La prueba de movimiento funcional (FMS) es un método de evaluación de los patrones de movimiento básicos del cuerpo humano diseñado por Gray Cook. Objetivo: Este artículo explora el valor de la aplicación de los datos de imágenes biológicas de la prueba de acción funcional (FMS) en la evaluación del riesgo de lesiones deportivas de los jugadores de rugby chinos. Métodos: Tomando como objeto el equipo nacional de fútbol y los jugadores de fútbol provinciales, se utilizó la prueba estándar de FMS para recopilar los datos y determinar el mejor límite para la puntuación total de FMS. Resultados: El área bajo la curva ROC (AUC) de los atletas en general, hombres y mujeres fue significativamente diferente del supuesto de AUC = 0.5, que fue 0.780 (P = 0.000), 0.877 (P = 0.001), 0.7130 (P = 0,013); Los mejores puntos de corte correspondientes a la puntuación total de FMS son 13,5 puntos, 15,5 puntos y 13,5 puntos, respectivamente. La prueba de chi-cuadrado mostró que la prevalencia del grupo positivo (la puntuación total de FMS fue menor que el punto de corte correspondiente) fue significativamente más alta que la del grupo negativo (la puntuación total de FMS fue mayor que el punto de corte correspondiente) (P <0.01). Los valores de OR del total de atletas, hombres y mujeres, grupos positivos de puntuación total de FMS fueron 25,85 (95% CI: 3,34 ∼ 200,23), 25,00 (95% CI: 2,36 ∼ 264,80), 14,22 (95% CI: 1,76 ∼ 114,92). Conclusiones: Entre los jugadores de rugby chinos, la puntuación total de FMS tiene una fuerte correlación con las lesiones de deportes sin contacto. La puntuación es de 13,5 para las mujeres y 15,5 para los hombres. Nivel de evidencia II; Estudios terapéuticos-investigación de los resultados del tratamiento.


Subject(s)
Humans , Male , Female , Athletic Injuries/prevention & control , Athletic Injuries/diagnostic imaging , Football , ROC Curve , Risk Assessment , Asian Continental Ancestry Group , Exercise Test , Models, Theoretical , Movement
2.
Int. braz. j. urol ; 47(3): 525-532, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154515

ABSTRACT

ABSTRACT Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p <0.0001). The Bland-Altman analyzes demonstrate good agreement between the two questionnaires (bias=5.6%). LUTS-V demonstrated excellent diagnostic accuracy in detecting the most serious cases with an area under the ROC curve of 83% [78-87%] 95% CI. p <0.001). LUTS-V >4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostatic Hyperplasia/diagnosis , Lower Urinary Tract Symptoms/diagnosis , Surveys and Questionnaires , ROC Curve , Middle Aged
3.
Medicina (B.Aires) ; 81(3): 329-336, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346467

ABSTRACT

Resumen El índice PROFUND se desarrolló y validó para predecir mortalidad a 12 meses en pacientes pluripatológicos. Sin embargo, su valor potencial para predecir mortalidad intrahospitalaria no ha sido suficientemente estudiado. Se evaluó la capacidad del índice PROFUND en comparación con la proteína C re activa (PCR), la albúmina, y el ancho de distribución eritrocitaria (ADE) para predecir mortalidad intrahospitalaria, mediante el análisis posterior de una cohorte prospectiva de 111 pacientes pluripatológicos internados en clínica médica. La edad promedio fue 75.8 ± 9.3 años. La mortalidad intrahospitalaria fue de 17% (19 pacientes). La mediana (RIQ) del índice PROFUND, albúmina, PCR y ADE en los fallecidos y sobrevivientes fue 12 (4) y 6 (7) p< 0.0001, 2.5 (0.4) y 2.6 (0.8) p 0.295, 58 (64) y 40 (60) p 0.176, 14.5 (2) y 14.6 (3) p 0.523, respectivamente. El análisis logístico multivariado mostró que el índice PROFUND se asocia con mortalidad intrahospitalaria (p 0.0003). El riesgo de fallecer durante la internación es 20% mayor por cada punto que se incrementa el índice PROFUND (OR 1.2, IC95% 1.1-1.4). El área bajo la curva de las características operativas del receptor (AUC-ROC) del índice PROFUND para predecir mortalidad durante la internación (0.760, IC95% 0.628-0.891) fue mayor a la del ADE, PCR y albúmina (0.494 IC95% 0.364-0.624 p 0.012; 0.583 IC95% 0.437-0.728 p 0.028; 0.621 0.494-0.748 p 0.109, respectivamente). El índice PROFUND se asocia a mortalidad intrahospitalaria, con una mayor capacidad predictiva que los biomarcadores estudiados, lo cual se sumaría a su valor pronóstico a largo plazo en pacientes pluripatológicos.


Abstract The PROFUND index was developed and valid to predict mortality at 12 months in polypathological patients (PP). However, its potential value for predicting in-hospital mortality has not been sufficiently studied. The ability of the PROFUND index in comparison with C-reactive protein (CRP), albumin, and red blood cell distribu tion width (RDW) to predict in-hospital mortality was evaluated through the subsequent analysis of a prospective cohort of 111 multiple pathological patients admitted to the clinic medical. The mean age was 75.8 ± 9.3 years. In-hospital mortality was 17% (19 patients). The median (IQR) of the PROFUND index, albumin, CRP and ADE in the deceased and survivors was 12 (4) and 6 (7) p < 0.0001, 2.5 (0.4) and 2.6 (0.8) p 0.295, 58 (64) and 40 (60) p 0.176, 14.5 (2) and 14.6 (3) p 0.523, respectively. The multivariate logistic analysis showed that the PROFUND index is associated with in-hospital mortality (p 0.0003). The risk of dying during hospitalization is 20% higher for each point that the PROFUND index increases (OR 1.2, 95% CI 1.1-1.4). The area under the curve the receiver operating characteristic (AUC-ROC) of the PROFUND index to predict mortality during hospitalization (0.760, 95% CI 0.628-0.891) was higher than that of the RDW, CRP and albumin (0.494 95% CI 0.364-0.624 p 0.012; 0.583 95% CI 0.437-0.728 p 0.028; 0.621 0.494-0.748 p 0.109, respectively). The PROFUND index is associated with in-hospital mortality, with a greater predictive capacity than the biomarkers studied, which would add to its long-term prognostic value in multiple pathological patients.


Subject(s)
Humans , Aged , Aged, 80 and over , Erythrocyte Indices , Hospitalization , Prognosis , Prospective Studies , Retrospective Studies , ROC Curve , Cohort Studies , Hospital Mortality
4.
Rev. colomb. psiquiatr ; 50(1): 11-21, Jan.-Mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1251627

ABSTRACT

RESUMEN El Cuestionario de salud del paciente-9 (PHQ-9) es uno de los instrumentos de autoinforme más utilizado en Atención Primaria (AP). No existe validez de criterio del PHQ-9 en Colombia. El objetivo fue realizar la validez de criterio del PHQ-9 como instrumento de cribado en AP. Se realizó un estudio trasversal de validez de criterio de una escala usando como criterio de referencia la minientrevista neuropsiquiátrica (MINI) en usuarios adultos de centros de AP de ambos sexos. Se calcularon la consistencia interna y la validez convergente y de criterio del PHQ-9 mediante el análisis de las características operativas del receptor (COR) y el área bajo la curva (ABC). Participaron 243 pacientes, 184 (75,7%) fueron de sexo femenino. El promedio de edad fue 34,05 (mediana 31 y DE = 12,47). El α de Cronbach fue 0,80 y ω de McDonald, 0,81. La rho de Spearman fue 0,64 para HADS-D (p < 0,010) y 0,70 para PHQ-2 (p < 0,010). El ABC fue 0,92 (IC del 95%, 0,880-0,963). El punto de corte óptimo del PHQ-9 fue ≥ 7: sensibilidad de 90,38 (IC del 95%: 81,41-99,36); especificidad de 81,68 (IC del 95%: 75,93-87,42); el VPP 57,32 (IC del 95%: 46,00-68,63); el VPN 96,89 (IC del 95%: 93,90-99,88); índice de Youden 0,72 (IC del 95%: 0,62-0,82; LR+ 4,93 (IC del 95%: 3,61-6,74); LR- 0,12 (IC del 95%: 0,005-0,270). En conclusión, la versión colombiana del PHQ-9 es un instrumento válido y confiable para el cribado de depresión en AP de Bucaramanga, con un punto de corte ≥ 7.


ABSTRACT The patient health questionnaire-9 (PHQ-9) is one of the most widely used self-report instruments in primary care. There is no criterion validity of the PHQ-9 in Colombia. The objective was to validate the PHQ-9 as a screening tool in primary care. A cross-sectional, scale criterion validity study was performed using as reference criterion the mini neuropsychiatric interview (MINI) in male and female adult users of primary care centres. We calculated the internal consistency and convergent and criterion validity of the PHQ-9 by analysing the receiver operating characteristics (ROC) and the area under the curve (AUC). We analysed 243 participants; 184 (75.7%) were female. The average age was 34.05 (median of 31 and SD = 12.47). Cronbach's α was 0.80 and McDonald's ω was 0.81. Spearman's Rho was 0.64 for HADS-D (P <0.010) and 0.70 for PHQ-2 (P <0.010). The AUC was 0.92 (95% CI 0.880-0.963). The optimal cut-off point of PHQ-9 was ≥7: sensitivity of 90.38 (95% CI: 81.41-99.36); specificity of 81.68 (95% CI: 75.93-87.42); PPV 57.32 (95% CI: 46.00-68.63); NPV 96.89 (95% CI: 93.90-99.88); Youden index 0.72 (95% CI: 0.62-0.82); LR+ 4.93 (95% CI: 3.61-6.74); LR- 0.12 (95% CI: 0.005-0.270). In sum, the Colombian version of PHQ-9 is a valid and reliable instrument for depression screening in primary care in Bucaramanga, with a cut-off point ≥ 7.


Subject(s)
Humans , Male , Female , Adult , Patient Health Questionnaire , Mass Screening , ROC Curve , Depression , Self Report
5.
Arq. bras. med. vet. zootec. (Online) ; 73(1): 1-10, Jan.-Feb. 2021. tab, graf
Article in English | ID: biblio-1153061

ABSTRACT

The objective of this study was to investigate the influence of plasma pathological changes before timed artificial insemination (TAI) on pregnancy of cows. The contents of estrogen (E2), progesterone (P4), glucose (Glu), selenium (Se), brain-derived neurotrophic factor (BDNF), and histamine (HIS) in plasma of 48 Holstein cows were measured before TAI. According to the estrus detection, the cows were divided into estrus (E) and anestrus (A) groups. After pregnancy testing at 28 d after TAI, two groups of E and A were divided into positive pregnancy of E group (EP+), negative pregnancy of E group (EP-), positive pregnancy of A group (AP+), and negative pregnancy of A group (AP-). The contents of E2, P4, Glu, Se, BDNF and hIS significantly differed among the four groups (P<0.01). The ROC analysis was used to determine the risk of negative pregnancy test (-) after TAI was increased when plasma E2 was less than 46.45 pmol/L in cows before TAI. The changes in E2, P4,hIS, Glu, and BDNF in the blood of natural estrus and natural anestrus cows affected the pregnancy after TAI. the level of E2 in plasma may be used to assess the risk of negative pregnancy after TAI.(AU)


O objetivo do presente estudo foi investigar a influência de mudanças patológicas de plasma antes de inseminação artificial (TAI) na gestação de vacas. O conteúdo de estrogênio (E2), progesterona (P4), glucose (Glu), selênio (Se), fator neurotrófico derivado do cérebro (BDNF), e histamina (HIS) no plasma de 48 vacas Holstein foi medido antes de TAI. De acordo com a detecção de estro, as vacas foram divididas em dois grupos: estro (E) e anestro (A). Após teste de gestação 28 d após TAI, dois grupos de E e A foram formados em gestação positiva do grupo E (EP+), gestação negativa do grupo E (EP-), gestação positiva do grupo A (AP+), e gestação negativa do grupo A (AP-). Os valores de E2, P4, Glu, Se, BDNF e hIS foram significativamente diferentes entre os quatro grupos (P<0,01). A análise ROC foi utilizada para determinar o risco de teste de gestação negativo (-) após aumento de TAI quando plasma E2 estava abaixo de 46,45 pmol/L em vacas antes de TAI. Alterações em E2, P4,hIS, Glu e BDNF no sangue de estro natural e anestro natural em vacas afetou a gestação após TAI. O nível de E2 no plasma pode ser usado para avaliar o risco de gestação negativa após TAI.(AU)


Subject(s)
Animals , Female , Pregnancy , Cattle , Plasma , Anestrus/blood , Estrus/blood , Insemination, Artificial/veterinary , ROC Curve
6.
Braz. j. med. biol. res ; 54(2): e10271, 2021. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142584

ABSTRACT

This study aimed to investigate the value of sirtuin 1 (SIRT1) in differentiating sepsis patients from healthy controls (HCs), and its correlation with inflammation, disease severity, as well as prognosis in sepsis patients. Serum samples were collected from 180 sepsis patients and 180 age- and gender-matched HCs. The SIRT1 level in the serum samples was detected by enzyme-linked immunoassay. The clinical data of the sepsis patients were documented, and their disease severity scores and 28-day mortality rate were assessed. SIRT1 was decreased in sepsis patients compared with HCs, and the receiver operating characteristic curve (ROC) showed that SIRT1 distinguished sepsis patients from HCs (area under the curve (AUC): 0.901; 95% confidence interval (CI): 0.868-0.934). In sepsis patients, SIRT1 negatively correlated with serum creatinine (Scr), white blood cells (WBC), C-reactive protein (CRP), acute physiology, and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score, while it positively correlated with albumin. No correlation of SIRT1 with primary infection site or primary organism was observed. Furthermore, SIRT1 was reduced in 28-day non-survivors compared with 28-day survivors, and subsequent ROC showed that SIRT1 predicted 28-day mortality of sepsis patients (AUC: 0.725; 95% CI: 0.651-0.800), and its prognostic value was not inferior to Scr, albumin, WBC, and CRP, but was less than SOFA score and APACHE II score. In conclusion, measurement of serum SIRT1 might assist with the optimization of disease assessment, management strategies, and survival surveillance in sepsis patients.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Sepsis/diagnosis , Sirtuin 1/blood , Retrospective Studies , ROC Curve , APACHE , Organ Dysfunction Scores
7.
Article in English | WPRIM | ID: wpr-880671

ABSTRACT

OBJECTIVES@#Glioma is the most common intracranial primary tumor in central nervous system. Glioma grading possesses important guiding significance for the selection of clinical treatment and follow-up plan, and the assessment of prognosis. This study aims to explore the feasibility of logistic regression model based on radiomics to predict glioma grading.@*METHODS@#Retrospective analysis was performed on 146 glioma patients with confirmed pathological diagnosis from January, 2012 to December, 2018. A total of 41 radiomics features were extracted from contrast-enhanced T@*RESULTS@#A total of 5 imaging features selected by LASSO were used to establish a logistic regression model for predicting glioma grading. The model showed good discrimination with AUC value of 0.919. Hosmer-Lemeshow test showed no significant difference between the calibration curve and the ideal curve (@*CONCLUSIONS@#The logistic regression model using radiomics exhibits a relatively high accuracy for predicting glioma grading, which may serve as a complementary tool for preoperative prediction of giloma grading.


Subject(s)
Brain Neoplasms/diagnostic imaging , Glioma/diagnostic imaging , Humans , Logistic Models , Magnetic Resonance Imaging , ROC Curve , Retrospective Studies
8.
Article in English | WPRIM | ID: wpr-880635

ABSTRACT

OBJECTIVES@#To screen the risk factors for predicting venous thromboembolism (VTE) risk after hip fracture in the elderly, to establish a prediction model based on these factors, and to analyze its prediction efficacy.@*METHODS@#A total of 52 hip fracture patients over 60 years old with VTE admitted to the Department of Orthopaedic Trauma, Xiangya Hospital, Central South University from March 2017 to April 2019 were selected as a thrombus group, and another 52 hip fracture patients over 60 years old without VTE were selected as a control group. The differences of hospitalization data and examination results between the 2 groups were compared. Logistic regression model was used to explore the influence of risk factors on VTE risk after hip fracture in the elderly and construct the prediction model based on these factors. The receiver operating characteristic curve was used to analyze the predictive effectiveness of model, Hosmer-lemeshow goodness of fit test was used to evaluate the fitting degree of prediction model.@*RESULTS@#Univariate analysis showed that injury-admission interval, Caprini score, WBC count, platelet count, neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammatory index (SII), and fibrinogen in the thrombus group were higher than those in the control group (all @*CONCLUSIONS@#SII, Caprini score, and injury-admission interval are independent predictors of VTE after hip fracture in the elderly. The prediction model based on these 3 factors has a good efficacy on the prediction of VTE risk, and could provide important reference for the prevention, management, and treatment of VTE after hip fracture in the elderly.


Subject(s)
Aged , Hip Fractures/surgery , Humans , Middle Aged , ROC Curve , Retrospective Studies , Risk Assessment , Risk Factors , Venous Thromboembolism/etiology
9.
Article in Chinese | WPRIM | ID: wpr-880095

ABSTRACT

OBJECTIVE@#To investigate the expression of microRNA-370 (miR-370) and microRNA-203 (miR-203) in the serum of patients with acute myeloid leukemia(AML), and to analyze its clinical diagnosis and prognostic significance.@*METHODS@#57 patients with acute myeloid leukemia were enrolled as experimental group, and 21 healthy people were enrolled as control group. The fasting venous blood of the personal in the two groups were collected. The expression of miR-370 and miR-203 of the personal in each groups were detected by real-time fluorescent quantitative PCR. The receiver operating characteristic (ROC) curve was plotted to detected the diagnostic values of serum miR-370, miR-203, and the Kaplan-Meier method was used to estimate the relationship between expression and overall survival of the patients.@*RESULTS@#Compared with healthy controls, serum miR-370 expression was significantly decreased in AML patients(P<0.05), and serum miR-203 expression was also significantly decreased (P<0.05). ROC curve analysis showed that the expression of serum miR-370 and miR-203 could be used to distinguish acute myeloid leukemia and healthy people. The area under the ROC curve of miR-370 was 0.909, and the sensitivity and specificity were 91.46% and 100.00%, respectively. The area under the ROC curve of miR-203 was 0.895, and the sensitivity and specificity were 83.45% and 89.71%, respectively. Serum levels of miR-370 and miR-203 were closely related to overall survival in AML patients.@*CONCLUSION@#The expression of miR-370 and miR-203 is decreased in the serum of patients with AML and may be a new markers for the diagnosis and prognosis of AML.


Subject(s)
Biomarkers, Tumor , Humans , Kaplan-Meier Estimate , Leukemia, Myeloid, Acute/genetics , MicroRNAs , Prognosis , ROC Curve
10.
Article in Chinese | WPRIM | ID: wpr-880054

ABSTRACT

OBJECTIVE@#To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.@*METHODS@#145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.@*RESULTS@#Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×10@*CONCLUSION@#Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.


Subject(s)
Anemia, Iron-Deficiency , Erythrocyte Indices , Humans , Proto-Oncogene Proteins c-ret , ROC Curve , alpha-Thalassemia , beta-Thalassemia/diagnosis
11.
Article in Chinese | WPRIM | ID: wpr-879864

ABSTRACT

OBJECTIVE@#To study the value of fecal calprotectin (FC) in the diagnosis of neonatal necrotizing enterocolitis (NEC) through a Meta analysis.@*METHODS@#Web of Science, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, Weipu Periodical Database, Wanfang Data, Chinese Biomedical Literature Database were searched for related studies published up to May 2020, with manual search as supplementation. The QUADAS criteria were used to evaluate the quality of the articles included. Meta-DiSc 1.4 and Stata 15.0 software were used to perform the Meta analysis, including the evaluation of specificity, sensitivity, likelihood ratio, and diagnostic odds ratio. The sensitivity analysis and heterogeneity testing were performed, and the summary receiver operating characteristic (SROC) curve and Fagan diagram were plotted.@*RESULTS@#A total of 15 articles were enrolled, involving 1 719 neonates. Among these articles, 4 had low quality, 2 had high quality, and the rest had medium quality. There was high heterogeneity between studies, and there was no threshold effect or publication bias. The random effects model analysis showed that FC had a pooled specificity of 0.80 (95%@*CONCLUSIONS@#FC has high potential and efficiency in the early diagnosis of NEC. FC measurement can be used for the diagnosis of NEC, but it should be combined with clinical manifestations and other related laboratory examinations.


Subject(s)
China , Enterocolitis, Necrotizing/diagnosis , Feces , Humans , Infant, Newborn , Leukocyte L1 Antigen Complex , ROC Curve , Sensitivity and Specificity
12.
Article in Chinese | WPRIM | ID: wpr-879858

ABSTRACT

OBJECTIVE@#To evaluate the value of autism screening checklists in the early identification of autism spectrum disorder (ASD).@*METHODS@#A total of 2 571 children who attended the Children's Hospital of Chongqing Medical University and completed autism screening and diagnostic test were enrolled as subjects, among whom 2 074 were diagnosed with ASD, 261 were diagnosed with global developmental delay (GDD), 206 were diagnosed with developmental language disorder (DLD), and 30 had normal development. The sensitivity, specificity, and optimal threshold value of the Modified Checklist for Autism in Toddlers (M-CHAT) and the Autism Behavior Checklist (ABC) for the early identification of ASD were evaluated by the receiver operating characteristic (ROC) curve.@*RESULTS@#The M-CHAT had a high sensitivity of 88.3% but a low specificity of 36.0% for the identification of ASD. Its sensitivity decreased with age, and was maintained above 80% for children aged 16 to < 48 months. The ABC had a high specificity of 87.3% but a low sensitivity of 27.2%, with an optimal cut-off value of 47.5 based on the ROC curve analysis. The multivariate linear regression model based on a combination of the M-CHAT and ABC for screening of ASD showed a specificity of 85.8% and a sensitivity of 56.6%.@*CONCLUSIONS@#The M-CHAT has a high sensitivity and a low specificity in the identification of ASD, with a better effect in children aged 16 to < 48 months. The ABC has a high specificity and a low sensitivity. The multiple linear regression model method based on the combined M-CHAT and ABC to screen ASD appears to be effective.


Subject(s)
Adolescent , Autism Spectrum Disorder/diagnosis , Autistic Disorder , Checklist , Humans , Infant , Mass Screening , ROC Curve
13.
Article in Chinese | WPRIM | ID: wpr-878700

ABSTRACT

Objective To explore the value of elastography strain ratio(SR)combined with breast ultrasound imaging reporting and data system(BI-RADS-US)in the differential diagnosis of breast nodules.Methods A total of 471 breast nodules(from 471 patients)were reclassified by SR combined with BI-RADS-US.With the pathology results as gold standard,the area under the receiver operating characteristic(ROC)curve(AUC)was employed to evaluate the diagnostic performance,and the sensitivity,specificity,and accuracy were compared between the combined method and BI-RADS-US.Results Among the 471 breast nodules,180 nodules were benign and 291 were malignant.The AUC of the combined method was statistically significantly higher than that of BI-RADS-US(0.798 vs. 0.730;Z= 2.583, P= 0.010).SR,BI-RADS-US,and the combined method for diagnosing breast nodules had the sensitivity of 86.6%,99.0%,and 96.6%,the specificity of 67.2%,47.2%,and 63.3%,and the accuracy of 79.2%,79.2%,and 83.9%,respectively.The combined method increased the specificity from 47.2%(BI-RADS-US)to 63.3%(χ


Subject(s)
Breast/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Diagnosis, Differential , Elasticity Imaging Techniques , Female , Humans , ROC Curve , Sensitivity and Specificity , Ultrasonography, Mammary
14.
Chinese Medical Journal ; (24): 415-424, 2021.
Article in English | WPRIM | ID: wpr-878071

ABSTRACT

BACKGROUND@#The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.@*METHODS@#Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.@*RESULTS@#The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).@*CONCLUSIONS@#The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.


Subject(s)
Area Under Curve , Breast/diagnostic imaging , Breast Neoplasms/diagnostic imaging , China , Deep Learning , Humans , ROC Curve , Sensitivity and Specificity
15.
Rev. saúde pública (Online) ; 55: 23, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1280613

ABSTRACT

ABSTRACT OBJECTIVE To predict the risk of absence from work due to morbidities of teachers working in early childhood education in the municipal public schools, using machine learning algorithms. METHODS This is a cross-sectional study using secondary, public and anonymous data from the Relação Anual de Informações Sociais, selecting early childhood education teachers who worked in the municipal public schools of the state of São Paulo between 2014 and 2018 (n = 174,294). Data on the average number of students per class and number of inhabitants in the municipality were also linked. The data were separated into training and testing, using records from 2014 to 2016 (n = 103,357) to train five predictive models, and data from 2017 to 2018 (n = 70,937) to test their performance in new data. The predictive performance of the algorithms was evaluated using the value of the area under the ROC curve (AUROC). RESULTS All five algorithms tested showed an area under the curve above 0.76. The algorithm with the best predictive performance (artificial neural networks) achieved 0.79 of area under the curve, with accuracy of 71.52%, sensitivity of 72.86%, specificity of 70.52%, and kappa of 0.427 in the test data. CONCLUSION It is possible to predict cases of sickness absence in teachers of public schools with machine learning using public data. The best algorithm showed a better result of the area under the curve when compared with the reference model (logistic regression). The algorithms can contribute to more assertive predictions in the public health and worker health areas, allowing to monitor and help prevent the absence of these workers due to morbidity.


RESUMO OBJETIVO Predizer o risco de ausência laboral decorrente de morbidades dos docentes que atuam na educação infantil na rede pública municipal, com o uso de algoritmos de machine learning. MÉTODOS Trata-se de um estudo transversal utilizando dados secundários, públicos e anônimos da Relação Anual de Informações Sociais, selecionando professores da educação infantil que atuaram na rede pública municipal do estado de São Paulo entre 2014 e 2018 (n = 174.294). Foram também vinculados dados da média de alunos por turma e número de habitantes no município. Os dados foram separados em treinamento e teste, utilizando os registros de 2014 a 2016 (n = 103.357) para treinar cinco modelos preditivos e os dados de 2017 a 2018 (n = 70.937) para testar seus desempenhos em dados novos. A performance preditiva dos algoritmos foi avaliada por meio do valor da área abaixo da curva ROC (AUROC). RESULTADOS Todos os cinco algoritmos testados apresentaram área abaixo da curva acima de 0,76. O algoritmo com melhor performance preditiva (redes neurais artificiais) obteve 0,79 de área abaixo da curva, com acurácia de 71,52%, sensibilidade de 72,86%, especificidade de 70,52% e kappa de 0,427 nos dados de teste. CONCLUSÃO É possível predizer casos de afastamentos por morbidade em docentes da rede pública com machine learning usando dados públicos. O melhor algoritmo apresentou melhor resultado da área abaixo da curva quando comparado ao modelo de referência (regressão logística). Os algoritmos podem contribuir para predições mais assertivas na área da saúde pública e da saúde do trabalhador, permitindo acompanhar e ajudar a prevenir afastamentos por morbidade desses trabalhadores.


Subject(s)
Humans , Child, Preschool , Absenteeism , Machine Learning , Schools , Brazil , Cross-Sectional Studies , ROC Curve
16.
Clinics ; 76: e2610, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278930

ABSTRACT

OBJECTIVES: To compare the early and late predictive values of several critical illness scores (CISs) and biomarkers in sepsis-3 patients with bloodstream infections (BSIs) and to identify the prognostic value of procalcitonin (PCT) for different gram-stain bacteria infections. METHODS: Patients with at least one positive blood culture within 24h of emergency department admission and with a final diagnosis of sepsis/septic shock were enrolled. CISs were calculated based on the first parameters on the day of admission. The receiver operating characteristics curve was used to analyze the predictive value of CISs and biomarkers for early and late mortality. RESULTS: Of 834 enrolled patients with sepsis-3, death occurred in 214 patients within 28 days and in 273 patients within 60 days. Compared with biomarkers, CISs showed a significantly higher area under the curve (AUC) in the prediction of early and late mortality (p<0.01), especially for patients with GNB infection. The Sequential Organ Failure Assessment score showed a higher AUC for predicting early mortality than the Mortality in Emergency Department Sepsis score (p=0.036). Compared with GNB infections, the AUC values of the PCT for gram-positive bacteria (GPB) infections were higher for predicting early or late mortality; PCT showed higher AUC than high-sensitivity C-reactive protein and white blood cells for predicting early mortality (p<0.05). CONCLUSIONS: CISs were more advantageous in the assessment of early and late prognosis, especially for patients with GNB infections; however, for sepsis with GPB infection, PCT can be used for the prediction of early mortality.


Subject(s)
Humans , Sepsis/diagnosis , Procalcitonin , Prognosis , Bacteria , Biomarkers , ROC Curve , Critical Illness
17.
Clinics ; 76: e2921, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278928

ABSTRACT

OBJECTIVES: Acute variceal bleeding (AVB) results from rupture of esophageal or gastric varices. It is a life-threatening complication of portal hypertension. Nevertheless, it remains unclear how to predict adverse outcomes and identify high-risk patients. In variceal hemorrhage, high Child-Turcotte-Pugh (Child) and Model for End-stage Liver Disease (MELD) scores are associated with a worse prognosis. The Rockall system (Rockall), Glasgow-Blatchford (Blatchford), and AIMS65 scores have been validated for risk stratification for nonvariceal upper gastrointestinal bleeding; however, their use is controversial in AVB. The aim of this study was to compare the performance of Child, MELD, Rockall, Blatchford, and AIMS65 scores in risk stratification for rebleeding and/or mortality associated with AVB. METHODS: This retrospective study was conducted at a tertiary care hospital over 42 months. The outcomes were 6-week rebleeding and mortality. The AUROC was calculated for each score (1-0.9, 0.9-0.8, and 0.8-0.7, indicating excellent, good, and acceptable predictive power, respectively). RESULTS: In total, 222 patients were included. Six-week rebleeding and mortality rates were 14% and 18.5%, respectively. No score was useful for discriminating patients at a higher risk of rebleeding. The AUROCs were 0.59, 0.57, 0.61, 0.63, and 0.56 for Rockall, Blatchford, AIMS65, Child, and MELD scores, respectively. Prediction of 6-week mortality based on Rockall (AUROC 0.65), Blatchford (AUROC=0.60), and AIMS65 (AUROC=0.67) scores were also not considered acceptable. The AUROCs for predicting mortality were acceptable for Child and MELD scores (0.72 and 0.74, respectively). CONCLUSION: Rockall, Blatchford, and AIMS65 scores are not useful for predicting 6-week rebleeding or mortality in patients with AVB. Child and MELD scores can identify patients at higher risk for 6-week mortality but not for 6-week rebleeding.


Subject(s)
Humans , Esophageal and Gastric Varices/diagnosis , Esophageal and Gastric Varices/etiology , End Stage Liver Disease , Prognosis , Severity of Illness Index , Retrospective Studies , ROC Curve , Hospital Mortality , Risk Assessment , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy
18.
Clinics ; 76: e1816, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153936

ABSTRACT

OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.


Subject(s)
Humans , Infant, Newborn , Infant , Enterocolitis, Necrotizing/diagnostic imaging , Infant, Newborn, Diseases , Prognosis , ROC Curve , Ultrasonography
19.
Rev. méd. Minas Gerais ; 31: 31102, 2021.
Article in Portuguese | LILACS | ID: biblio-1291246

ABSTRACT

INTRODUÇÃO: A consulta pré-anestésica é de extrema importância para o médico anestesiologista no planejamento do manejo das vias aéreas de pacientes sob o efeito de anestesia geral com intubação orotraqueal (IOT). OBJETIVO: Avaliar a sensibilidade, especificidade, valor preditivo positivo/negativo (VPP/VPN) de testes de predição de IOT difícil (Escore de Wilson - EW, e Teste de Mallampati modificado - TMM), em pacientes submetidos à anestesia geral, em hospital filantrópico do interior de Minas Gerais. MATERIAIS E MÉTODOS: Estudo descritivo transversal, por meio de fichas pré-anestésicas e transoperatórias, de pacientes submetidos à anestesia geral com IOT, entre os meses de janeiro (2019) e março (2020). RESULTADOS: Dos 440 pacientes, 56,1% necessitaram de IOT: média de idade de 49,9 anos (desvio padrão 18,6). A maioria foi classificada: TMM classe I e II; pontuação 0 a 2 no EW; distância esternomentoniana >12,5 cm, sugerindo IOT fácil. Apenas o TMM apresentou correlação com IOT difícil (p=0,045). Sensibilidade e especificidade dos testes respectivamente: TMM (54,6%;75,9%); EW (36,4% e 79,7%); baixo VPP (TMM: 9,5%; EW: 7,7%) e alto VPN (TMM: 97,3%; EW: 96,4%). Curva ROC: área sob a curva foi de TMM = 0,68; EW = 0,60. CONCLUSÃO: Apesar do TMM apresentar correlação significativa com a IOT difícil, não foi possível definir o melhor teste preditor. Ressaltamos que a sensibilidade e o VPP, de ambas as avaliações, ficaram abaixo daquilo que seria considerado adequado para um teste de rastreio e predição.


Introduction: A pre-anesthetic appointment is extremely important for the anesthesiologist when planning the management of the airways of patients under the effect of general anesthesia with orotracheal intubation (OTI). Objective: To evaluate the sensitivity, specificity, positive/ negative predictive value (PPV/NPV) of difficult OTI prediction tests (Wilson risk-sum ­ WRS, and Modified Mallampati Test - MMT) in patients undergoing general anesthesia in a philanthropic hospital in the countryside of the state of Minas Gerais. Materials and methods: Descriptive cross-sectional study using pre-anesthetic and transoperative records of patients submitted to general anesthesia with OTI between the months of January (2019) and March (2020). Results: Of the 440 patients, 56.1% required OTI: average age of 49.9 years (standard deviation 18.6). Most classified: MMT class I and II; score 0 to 2 on the WRS; sternomental distance greater than 12.5 cm, suggesting easy OTI. Only MMT showed statistical significance with difficult OTI (p=0.045). Sensitivity and specificity of the tests respectively: MMT (54.6%; 75.9%) WRS (36.4% and 79.7%) low PPV (MMT: 9.5%; WRS: 7.7%) and high NPV (MMT: 97.3%; WRS: 96.4%). ROC Curve: area under the curve was MMT = 0,68; WRS = 0,60. Conclusion: Although the MMT has a significant correlation with the difficult OTI, it was not possible to define the best predictor test. We emphasize that the sensitivity and PPV of both evaluations were below what would be considered adequate for a screening and prediction test.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sensitivity and Specificity , Intubation, Intratracheal , Laryngoscopy/methods , Surgical Procedures, Operative , Predictive Value of Tests , ROC Curve , Anesthesia, General/methods
20.
ABC., imagem cardiovasc ; 34(3)2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1292025

ABSTRACT

Fundamento: A identificação precoce do dano miocárdico parece ser importante na abordagem do paciente com doença de Chagas. A ecocardiografia com strain obtida por speckle tracking e a avaliação da fibrose miocárdica por meio da ressonância magnética cardíaca podem ser métodos diagnósticos promissores nesse sentido. Objetivo: Avaliar o acometimento miocárdico especificamente na forma crônica cardíaca leve da doença de Chagas por meio do strain por speckle tracking e da fibrose miocárdica pela ressonância magnética cardíaca, além de suas correlações. Método: Estudo de corte transversal que analisou portadores da forma cardíaca crônica leve da doença de Chagas (fração de ejeção preservada) submetidos à ecocardiografia com strain por speckle tracking e à ressonância magnética cardíaca. Resultados: Foram incluídos 21 participantes (mulheres: 62%; idade: 54 ± 5 anos). A prevalência de fibrose miocárdica por meio do realce tardio miocárdico foi de 50%. O strain longitudinal global encontrava-se diminuído em 17 pacientes (81%), com mediana de 14,1% (intervalo interquartil de 12,1 a 16,3). Os valores do mapa T1 encontravam-se, em média, elevados nos portadores de doença de Chagas (993 ± 163 ms). O mapa T1 foi significativamente correlacionado com o strain longitudinal global (r= 0,634; p = 0,015). Além disso, o índice de dispersão mecânica, obtido por strain, estava aumentado (> 55 ms) em 84%, com a maior área sob a curva Característica de Operação do Receptor (área sob a curva de 0,696; intervalo de confiança de 95% de 0,412-0,981) para discriminação de fibrose pelo realce tardio miocárdico. Conclusão: O strain miocárdico e o mapa T1 se comportam como marcadores precoces do dano miocárdico na cardiopatia chagásica crônica leve. O índice de dispersão mecânica estava elevado e foi o parâmetro que melhor se correlacionou com o realce tardio miocárdico. (AU)


Background: The early identification of myocardial damage seems important in the management of patients with Chagas disease. However, it is unknown whether speckle tracking echocardiography strain and cardiac magnetic resonance imaging are promising methods for assessing myocardial involvement and fibrosis, respectively. Objective: To evaluate myocardial involvement in the mild chronic cardiac form of Chagas disease using speckle tracking strain and myocardial fibrosis by cardiac magnetic resonance and assess their correlations. Method: This cross-sectional study analyzed patients with the mild chronic cardiac form of Chagas disease (preserved ejection fraction) using speckle tracking echocardiography and cardiac magnetic resonance. Results: The study included 21 participants (women: 62%; age: 54 ± 5 years). The prevalence of myocardial fibrosis was 50% on delayed myocardial enhancement. The median global longitudinal strain was decreased (14.1%; interquartile range, 12.1­16.3%) in 17 patients (81%). The mean T1 mapping value was high in patients with Chagas disease (993 ± 163 ms). The T1 map was significantly correlated with the global longitudinal strain (r = 0.634; p = 0.015). In addition, the mechanical dispersion index obtained by strain was increased (>55 ms) by 84%, with the largest area under the receiver operating characteristic curve (area under the curve, 0.696; 95% confidence interval, 0.412­0.981) for fibrosis discrimination by delayed myocardial enhancement. Conclusion: Myocardial strain and T1 mapping are early markers of myocardial damage in mild chronic Chagas heart disease. The mechanical dispersion index was high and the most closely correlated with delayed myocardial enhancement. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Chagas Cardiomyopathy/physiopathology , Chagas Cardiomyopathy/diagnostic imaging , Heart/diagnostic imaging , Myocardium/pathology , Prognosis , Stroke Volume , Fibrosis , Magnetic Resonance Imaging , Echocardiography/methods , Linear Models , Chronic Disease , Cross-Sectional Studies , ROC Curve
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