Two-sided confidence intervals for the single proportion: comparison of seven methods by Robert G. Newcombe,Statistics in Medicine 1998;17:857–872

Julious, Steven A.

doi:10.1002/sim.2164

Cited by 88 publications

(61 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Confidence intervals for sensitivity and specificity were produced with the Wilson score method. 21 Accuracy of the sequences was also calculated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sagittal FSE T2, STIR, and T1-Weighted Phase-Sensitive Inversion Recovery in the Detection of Spinal Cord Lesions in MS at 3T

Alcaide‐Leon¹,

Pauranik²,

Alshafai

et al. 2016

American Journal of Neuroradiology

View full text Add to dashboard Cite

show abstract

“…Confidence intervals for sensitivity and specificity were produced with the Wilson score method. 21 Accuracy of the sequences was also calculated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sagittal FSE T2, STIR, and T1-Weighted Phase-Sensitive Inversion Recovery in the Detection of Spinal Cord Lesions in MS at 3T

Alcaide‐Leon¹,

Pauranik²,

Alshafai

et al. 2016

American Journal of Neuroradiology

View full text Add to dashboard Cite

show abstract

“…The kappa value based on presence or absence of scaphoid fracture of the 5 observers was 0.44 (p,0.001), which is considered moderate interobserver agreement [10].…”

Section: Healthy Volunteersmentioning

confidence: 92%

“…To get a robust estimate of specificity with 95% confidence interval, we used repeated-measures terms in the logistic regression model using generalised linear models. Here we accounted for multiple wrists from the same patient as a repeated measure, and different MRI scans read by the same radiologist as another repeatedmeasures parameter [10].…”

Section: Methodsmentioning

confidence: 99%

MRI as a reference standard for suspected scaphoid fractures

Zwart

Beeres

Ring

et al. 2012

The British Journal of Radiology

View full text Add to dashboard Cite

Objectives: Some have suggested that MRI might be the best reference standard for a true fracture among patients with suspected scaphoid fractures. The primary aim of this study was to determine the rate of false-positive diagnosis of an acute scaphoid fracture in a cohort of healthy volunteers. Methods: In a prospective study, 33 healthy volunteers were recruited and both wrists of each were scanned, except for 2 volunteers for whom only one wrist was scanned. To simulate the usual clinical context the 64 scans of healthy volunteers were mixed with 60 MRI scans of clinically suspected scaphoid fractures but normal scaphoid radiographs. These 124 MRI scans were blinded and randomly ordered. Five radiologists evaluated the MRI scans independently for the presence or absence of a scaphoid fracture and other injuries according to a standard protocol. Results: To answer the primary question, only the diagnoses from the 64 scans of healthy volunteers were used. The radiologists diagnosed a total of 13 scaphoid fractures; therefore, specificity for diagnosis of scaphoid fracture was 96% (95% confidence interval: range 94-98%). The 5 observers had a moderate interobserver agreement regarding diagnosis of scaphoid fracture in healthy volunteers (multirater k50.44; p,0.001). Conclusions: The specificity of MRI for scaphoid fractures is high (96%), but falsepositives do occur. Radiologists have only moderate agreement when interpreting MRI scans from healthy volunteers. MRI is not an adequate reference standard for true fractures among patients with suspected scaphoid fractures. The American College of Radiologists recommends MRI for diagnosis of true fractures among suspected scaphoid fractures [1]. A number of published studies cite sensitivities and specificities approaching 99% [2-9], but other studies have reported a lower sensitivity (80%) and substantial interobserver variation (k50.67) for diagnosis of a scaphoid fracture [2,8]. It has been difficult to agree upon a reliable reference standard for true fractures among suspected scaphoid fractures, and these studies often use only repeated radiographs 6 weeks after trauma as reference standard. However, it is also known that not all occult scaphoid fractures become apparent on repeated radiographs.It is not clear how to distinguish true fracture from other changes in bone signal that are detected with MRI. We propose that MRI of the wrists of healthy volunteers with no history of wrist or hand injury represents a reliable reference standard for the absence of an acute fracture of the scaphoid waist. By evaluating MRI scans of healthy volunteers, we may learn more about the diagnostic performance characteristics of MRI for suspected scaphoid fracture. A set of MRI scans with a reliable reference standard would also provide useful information about the reproducibility of the interpretation of MRI for suspected scaphoid fracture.The primary study question was to investigate the occurrence of false-positive diagnosis of an acute scaphoid fracture on MRI using a reliabl...

show abstract

“…The results of the manual read were compared to those obtained from the automated image analysis. Sensitivity and specificity data were calculated using standard methods and McNemar's test (14). Ninety-five-percent confidence intervals (CI) were calculated by using the efficiency score method (15).…”

Section: Methodsmentioning

confidence: 99%

Automatic Digital Analysis of Chromogenic Media for Vancomycin-Resistant-Enterococcus Screens Using Copan WASPLab

et al. 2016

View full text Add to dashboard Cite

Vancomycin-resistant enterococci (VRE) are an important cause of health care-acquired infections (HAIs). Studies have shown that active surveillance of high-risk patients for VRE colonization can aid in reducing HAIs; however, these screens generate a significant cost to the laboratory and health care system. Digital imaging capable of differentiating negative and "nonnegative" chromogenic agar can reduce the labor cost of these screens and potentially improve patient care. In this study, we evaluated the performance of the WASPLab Chromogenic Detection Module (CDM) (Copan, Brescia, Italy) software to analyze VRE chromogenic agar and compared the results to technologist plate reading. Specimens collected at 3 laboratories were cultured using the WASPLab CDM and plated to each site's standard-of-care chromogenic media, which included Colorex VRE (BioMed Diagnostics, White City, OR) or Oxoid VRE (Oxoid, Basingstoke, United Kingdom). Digital images were scored using the CDM software after 24 or 40 h of growth, and all manual reading was performed using digital images on a high-definition (HD) monitor. In total, 104,730 specimens were enrolled and automation agreed with manual analysis for 90.1% of all specimens tested, with sensitivity and specificity of 100% and 89.5%, respectively. Automation results were discordant for 10,348 specimens, and all discordant images were reviewed by a laboratory supervisor or director. After a second review, 499 specimens were identified as representing missed positive cultures falsely called negative by the technologist, 1,616 were identified as containing borderline color results (negative result but with no package insert color visible), and 8,234 specimens were identified as containing colorimetric pigmentation due to residual matrix from the specimen or yeast (Candida). Overall, the CDM was accurate at identifying negative VRE plates, which comprised 84% (87,973) of the specimens in this study. Members of the genus Enterococcus are commensal colonizers of the gastrointestinal tract but can cause a variety of serious nosocomial infections, including bacteremia, endocarditis, intraabdominal and pelvic infections, urinary tract infections, and, in rare cases, central nervous system infections (1-4). Treatment can be difficult, as E. faecalis has been observed to be 10 to 100 times more resistant to ␤-lactams than other streptococcal species and E. faecium is 4 to 16 times more resistant than E. faecalis (5). Vancomycin had been used for years to successfully treat enterococcal infections; however, in 1988, the first case of a vancomycinresistant-enterococcus (VRE) infection was reported (6). Resistance is conferred by the van operon, carried in either the chromosome or a plasmid, and is inducible in response to membrane disruption caused by vancomycin (7,8). Currently, resistance is widespread, with prevalence rates ranging from 1.0% to 35.5% of all Enterococcus specimens isolated, depending on the geographical location, and is more commonly found in E. faecium (4).The success of ...

show abstract

Two-sided confidence intervals for the single proportion: comparison of seven methods by Robert G. Newcombe,Statistics in Medicine 1998;17:857–872

Cited by 88 publications

References 6 publications

Comparison of Sagittal FSE T2, STIR, and T1-Weighted Phase-Sensitive Inversion Recovery in the Detection of Spinal Cord Lesions in MS at 3T

Comparison of Sagittal FSE T2, STIR, and T1-Weighted Phase-Sensitive Inversion Recovery in the Detection of Spinal Cord Lesions in MS at 3T

MRI as a reference standard for suspected scaphoid fractures

Automatic Digital Analysis of Chromogenic Media for Vancomycin-Resistant-Enterococcus Screens Using Copan WASPLab

Contact Info

Product

Resources

About