Objective To evaluate the accuracy and quality of diagnostic test of Electrochemiluminescence immunoassay (ECLIA) in detecting A-fetal protein (AFP) for the diagnosis of liver cancer in Chinese patients. Methods We searched Chinese Biological Medicine Database (CBM, 1978 to 2005) and China National Knowledge Infrastructure (CNKI, 1994 to 2005). Diagnostic tests of ECLIA in detecting AFP for the diagnosis of liver cancer were included. Data were extracted, and the quality of included studies was evaluated according to the six criteria of diagnostic tests. Results Forty-eight studies were identified, but only 6 were included and none mentioned the indices about the accuracy. Conclusion The number of studies of ECLIA in detecting AFP for the diagnosis of liver caner is few and the quality is poor. We cannot draw the conclusion that ECLIA is better for sensitivity and specificity.
Objective To investigate the development and appl ication of the computer aided surgery systems in the joint surgery field. Methods The l iteratures were extensively reviewed to analysis the usefulness of current active, semi-active and passive computer aided surgery systems in solving the cl inical problems of joint surgery. Results Several computer aided surgery systems have met the high technique demands, such as the precision of anatomical position and orientation, the accuracy of normal l imb al ignment restoration, the optimum of instrumentation control in arthroplasty, peri-articular osteotomy and minimally invasive procedure. Conclusion Computer aided joint surgery systems facil itate precise surgical techniques to achieve ideal operative outcome.
The sensitivity and accuracy of the retrieval results directly affect the results in the systematic review of biomedical researchers. However, different retrieval methods and retrieval tools lead to different retrieval results. In this paper, we first evaluate the effects of Boolean logic retrieval, hierarchical retrieval, topic retrieval and full-text retrieval on the retrieval results of systematic reviews. We then introduce the application of one-stop search tool (Google Scholar and resource discovery system) in systematic review, and compare the effects of different one-stop search tools.
The Standards for reporting diagnostic accuracy studies (STARD) 2015 is a revision of the STARD 2003 on the checklist and flow chart, on the basis of the new evidences of potential bias and applicability, to better guide the application of diagnostic test in clinical practices. Currently, the interpretation and application in China is still based on STARD 2003. This review will describe the application status of the original version and introduce the updated standards for reporting diagnostic accuracy studies.
Objective To evaluate the accuracy of the related parameters measured by spinal virtual surgery system (SVSS) three-dimensional (3D) techniques by comparing with the parameters measured by multi-spiral CT (MSCT) workstation. Methods Seven vertebrae specimens of adult men were scanned with MSCT, and the messages were sent toMSCT workstation and SVSS. The 3D image of spine was reconstructed by using volume rendering and multi-planar reformation; based on the parameter requirement of lower cervical pedicle fixation, 10 related parameters were measured. Then SPSS11.0 analyzer software was used to analyze the parameters measured by 2 systems. Between June 2009 and March 2010, 6 patients who received screw insertion in lower cervical spines were given MSCT scanning, then the messages were sent to SVSS 3D reconstruction to evaluate the situation and to collect the parameters of pedicle screw insertion. Results SVSS measurement showed that 1 pedicle was clausura (C3) and the diameters of 4 pedicles in coronal view were lee than 3 mm (C4 in 1, C5 in 2, C6 in 1), which did not fit for screw insertion; the results were similar to those by MSCT measurement. A total of 66 lower cervical pedicle were measured successfully. Significant differences were found in 14 parameters as follows between 2 systems (P lt; 0.05): the left pedicle height of C3, the both sides pedicle width of C4, the right pedicle spongy width of C4, the left X-direction entrance of C6, the both sides Y-direction entrance of C3, total pedicle length of sagittal view in both sides pedicle of C3 and the left pedicle of C5, total pedicle length of axial view in C3 pedicles, the left pedicle of C5, and the right pedicle of C6. There was no significantdifference in the other parameters (P gt; 0.05). In 6 cl inical cases, 34 screws were inserted, the postoperative MSCT scanning showed that 30 screws were placed successfully. The rate of accuracy was 88.24%. According to the Richter’s perforation classification, perforation at grade I and at grade II occurred in 2 cases (5.88%), respectively. Conclusion The accuracy of the parameters measured by SVSS is similar to that by MSCT.
Objective To elaborate on the statistical analysis methods for evaluating the accuracy of imaging diagnostic tests in a multiple-reader multiple-case (MRMC) design through formula derivation and real cases. Methods This study consisted of two parts: theoretical derivation and a real case study. The theoretical part discussed in detail the principles and procedures of MRMC statistical analysis methods, particularly the Obuchowski-Rockette (OR) and Dorfman-Berbaum-Metz (DBM) methods. The real case included 100 subjects, of whom 67 had disease. Four readers interpreted all the cases based on both traditional film imaging methods and digital imaging methods. OR and DBM methods were employed for data analysis. Results The real case showed that the OR and DBM methods had a high degree of consistency, with only slight differences in the confidence intervals. Conclusion It is recommended to use the OR and DBM methods for the statistical analysis of imaging diagnostic test accuracy, ensuring that the impact of reader factors on the evaluation results is fully considered. The results from the OR and DBM methods are relatively similar; when applying these methods in practice, one should consider the specific characteristics of the data and the research design to choose the appropriate analysis method. Besides, there are still challenges when applying the OR and DBM methods, such as software implementation and missing data handling, which require further exploration.
Objective To evaluate the deviation between actual and simulated screw placement after cervical pedicle screw placement assisted by 3D printed navigation template, and analyze the correlation between screw placement deviation and navigation pipe length. Methods A total of 40 patients undergoing cervical 1-7 pedicle screw insertion assisted by 3D printed navigation template in Zigong Fourth People’s Hospital between February 2018 and August 2020 were included in this prospective study. These patients were divided into 3 groups randomly, including 12 patients with a 5-mm pipe length (5 mm group), 13 patients with a 10-mm pipe length (10 mm group), and 15 patients with a 15-mm pipe length (15 mm group). Three-dimensional modeling was performed on preoperative cervical CT images of these patients and simulated pedicle screw was placed. Individualized pedicle screw navigation templates were designed according to the position and direction of simulated pedicle screws, and 3D printing was performed on the cervical model and navigation templates. Preoperative 3D printed model and navigation templates were used to simulate the surgical process to confirm the safety of screws. During the operation, pedicle screw placement was performed according to the preoperative design and simulated surgical process. The postoperative CT images were registered with the preoperative CT images in 3D model. The safety of screw placement was evaluated by the postoperative screw placement Grade, and the accuracy of screw placement was evaluated by measuring the deviation of screw placement point and the deviation of screw placement direction in horizontal plane (inclination angle) and sagittal plane (head inclination angle). The influence of different navigation pipe lengths on the safety and accuracy of screw placement was analyzed. Results A total of 164 pedicle screws were inserted with navigation template assistance, including 48 screws (38 in Grade 0 and 10 in Grade 1) in the 5 mm group, 52 screws in the 10 mm group (all in Grade 0), and 64 screws (52 in Grade 0 and 12 in Grade 1) in the 15 mm group, and the difference in the grade among the three groups was statistically significant (P<0.05). When the navigation pipe length was 5, 10, and 15 mm, respectively, the screw entry point deviation was (1.87±0.63), (1.44±0.63), and (1.66±0.54) mm, respectively, the inclination angle deviation was (2.72±0.25), (0.90±0.21), and (1.84±0.35)°, respectively, and the head inclination angle deviation was (8.63±1.83), (7.15±1.38), and (8.24±1.52)°, respectively. The deviations in the 10 mm group were all significantly less than those in the other two groups (P<0.05). Conclusions In the cervical pedicle screw placement assisted by navigation template, all the screws were Grade 0 or Grade 1, with high safety. The mean deviation of the screw entry point is within 2 mm, with high accuracy. When the length of navigation pipe is 10 mm, the safety and accuracy of screw placement can be fully guaranteed.
With the development of computer and digital technology, the application of computer-aided technology has become a new trend in the field of oral implant. Computer-guided oral implant surgery has the advantages of being safer and more accurate than traditional implant surgery, and it can truly realize the concept of restoration-oriented implant. However, computer-guided oral implant surgery has various steps which cause deviations accumulation, so that some clinicians remain sceptical about the accuracy of the technology. Currently, due to the lack of a quantitative system for evaluating the accuracy of computer-guided oral implantation, the implant deviation in each step is still inconclusively in the stage of research and debate. The purpose of this paper is to summarize the advantages and disadvantages, research progress, accuracy and influencing factors of computer-guided oral implantation, aiming to provide a reference for improving implant accuracy and guiding clinical design and surgery.
By comparing the diagnostic accuracy of two or more tests in the same study, the one with the higher diagnostic accuracy can be screened. Therefore, it is extremely important to conduct the comparative diagnostic test accuracy study. This paper introduced the concept of the comparative diagnostic test accuracy study, compared it with single diagnostic test accuracy study, and described its role, study design, statistical analysis, current status, and challenges.
Objective To evaluate the accuracy of newer-generation home blood glucose meter (Accu-Check? Integra) in patients with impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus. Methods A cross-sectional study was performed on 109 cases with newly-diagnosed type 2 diabetes or IGR who were asked to take oral glucose tolerance test (OGTT), while paired samples, that were Accu-Check? Integra in capillary blood glucose (CBG) and laboratory glucose in venous plasma glucose (VPG ), were taken simultaneously. Taking VPG as the reference value, the accuracy of the home glucose meter was assessed according to the international standardization organization (ISO), including, the accuracy was studied by means of Median absolute difference (Median AD) and Median absolute relative difference (Median RAD), the consistency of CBG and VPG was studied by Clarke Error Grid analysis, the correlation of CBG and VPG was analyzed according to liner regression analysis, and the sensitivity and specificity for hyperglycemia were also calculated. Results There were 292 VPG values paired with CBG values, among which 93.49% of CBG values met ISO home glucose meter criteria, the median AD was 7.2 mg/dL, and the median RAD was 4.76%. Paired glucose measurements from the Accu-Check Integra meter and laboratory glucose measurement demonstrated that 100% of paired points in the overall subject population fell in zones A and B of the Clarke Error Grid. The CBG value was well correlated to VPG value in the overall level, and the sensitivity and specificity were 94.6% and 95.7% respectively for hyperglycemia. Conclusion The newer-generation home blood glucose meter (Accu-Check? Integra) demonstrates a high degree of accuracy, and it can precisely report the real value of blood glucose.