PPV, positive predictive value

PPV,阳性预测值
  • 文章类型: Journal Article
    尽管埃塞俄比亚的保健设施正在靠近所有地区的社区建设,送货上门的比例仍然很高,并且没有进行研究来识别低出生体重(LBW)和早产新生儿,最好,另类,并在研究区域进行适当的人体测量。本研究的目的是找到简单的,最好,和替代人体测量,并确定了其检测LBW和早产新生儿的临界点。在德雷达瓦市政府进行了一项以卫生机构为基础的横断面研究,埃塞俄比亚东部。该研究包括385名在医疗机构分娩的妇女。为了评估人体测量的总体准确性,使用非参数接收器工作特性曲线。胸围(AUC=0·95)为29·4厘米,平均上臂围(AUC=0·93)为7·9厘米,被证明是LBW和胎龄的最佳人体测量学诊断指标,分别。此外,两种人体测量工具的LBW和胎龄的相关性最高(r=0·62)。与其他测量相比,脚长在检测LBW方面具有更高的灵敏度(94·8%),具有较高的阴性预测值(NPV)(98·4%)和较高的阳性预测值(PPV)(54·8%)。发现胸围和中上臂围是识别LBW和需要特殊护理的早产儿的更好的替代测量。需要更多的研究来确定更好的诊断干预措施,例如研究区域,资源有限,送货上门比例很高。
    Despite the fact that health facilities in Ethiopia are being built closer to communities in all regions, the proportion of home deliveries remains high, and there are no studies being conducted to identify low birth weight (LBW) and premature newborn babies using simple, best, alternative, and appropriate anthropometric measurement in the study area. The objective of the present study was to find the simple, best, and alternative anthropometric measurement and identified its cut-off points for detecting LBW and premature newborn babies. A health facility-based cross-sectional study was conducted in the Dire Dawa city administration, Eastern Ethiopia. The study included 385 women who gave birth in health facility. To evaluate the overall accuracy of the anthropometric measurements, a non-parametric receiver operating characteristic curve was used. Chest circumference (AUC = 0⋅95) with 29⋅4 cm and mean upper arm circumference (AUC = 0⋅93) with 7⋅9 cm proved to be the best anthropometric diagnostic measure for LBW and gestational age, respectively. Also, both anthropometric measuring tools are achieved the highest correlation (r = 0⋅62) for LBW and gestational age. Foot length had a higher sensitivity (94⋅8 %) in detecting LBW than other measurements, with a higher negative predictive value (NPV) (98⋅4 %) and a higher positive predictive value (PPV) (54⋅8 %). Chest circumference and mid-upper arm circumference were found to be better surrogate measurements for identifying LBW and premature babies in need of special care. More research is needed to identify better diagnostic interventions in situations like the study area, which has limited resources and a high proportion of home deliveries.
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  • 文章类型: Journal Article
    未经证实:带状疱疹(HZ)及其相关并发症对老年人造成了巨大负担。2018年4月,新西兰Aotearoa推出了HZ疫苗接种计划,为65岁的人群提供单剂量疫苗,为66-80岁的人群提供4年追赶。这项研究旨在评估带状疱疹活疫苗(ZVL)对HZ和带状疱疹后神经痛(PHN)的“真实世界”有效性。
    UNASSIGNED:我们在2018年4月1日至2021年4月1日期间,使用联系的去识别患者级别的卫生部数据平台,进行了一项全国性的回顾性配对队列研究。Cox比例风险模型用于评估ZVL疫苗对HZ和PHN的有效性(VE),以调整协变量。在主要(住院HZ和PHN-主要诊断)和次要(住院HZ和PHN:主要和次要诊断,社区HZ)分析。进行了亚组分析,成年人≥65岁,免疫力低下的成年人,毛利人,太平洋人口。
    UNASSIGNED:共有824,142名(与549,870名未接种疫苗的ZVL疫苗匹配的274,272名)新西兰居民被纳入研究。匹配人群的免疫能力为93.4%,52.2%女性,80.2%的欧洲(一级种族代码),65~74岁占64.5%(平均年龄71.1±5.0)。接种疫苗与未接种疫苗的住院HZ发生率为0.16vs.0.31/1000人年和0.03vs.PHN为0.08/1000人年。在初步分析中,针对住院HZ和住院PHN的校正总VE分别为57.8%(95%CI:41.1-69.8)和73.7%(95%CI:14.0-92.0).在≥65岁的成年人中,针对住院HZ的VE为54.4%(95%CI:36.0-67.5),针对住院PHN的VE为75·5%(95%CI:19.9-92.5)。在次要分析中,对社区HZ的VE为30.0%(95%CI:25.6-34.5)。免疫功能低下的成年人对住院HZ的ZVLVE为51.1%(95%CI:23.1-69.5),PHN住院率为67.6%(95%CI:9.3-88.4)。毛利人对HZ住院的VE为45.2%(95%CI:-23.2-75.6),太平洋人民为52.2%(95%CI:-40.6-83·7)。
    UNASSIGNED:ZVL与新西兰人群HZ和PHN住院风险降低相关。
    UNASSIGNED:惠灵顿博士奖学金授予JFM。
    UNASSIGNED: Herpes zoster (HZ) and associated complications cause significant burden to older people. A HZ vaccination programme was introduced in Aotearoa New Zealand in April 2018 with a single dose vaccine for those aged 65 years and a four-year catch up for 66-80 year-olds. This study aimed to assess the \'real-world\' effectiveness of the zoster vaccine live (ZVL) against HZ and postherpetic neuralgia (PHN).
    UNASSIGNED: We conducted a nationwide retrospective matched cohort study from 1 April 2018 to 1 April 2021 using a linked de-identified patient level Ministry of Health data platform. A Cox proportional hazards model was used to estimate ZVL vaccine effectiveness (VE) against HZ and PHN adjusting for covariates. Multiple outcomes were assessed in the primary (hospitalised HZ and PHN - primary diagnosis) and secondary (hospitalised HZ and PHN: primary and secondary diagnosis, community HZ) analyses. A sub-group analysis was carried out in, adults ≥ 65 years old, immunocompromised adults, Māori, and Pacific populations.
    UNASSIGNED: A total of 824,142 (274,272 vaccinated with ZVL matched with 549,870 unvaccinated) New Zealand residents were included in the study. The matched population was 93.4% immunocompetent, 52.2% female, 80.2% European (level 1 ethnic codes), and 64.5% were 65-74 years old (mean age = 71.1±5.0). Vaccinated versus unvaccinated incidence of hospitalised HZ was 0.16 vs. 0.31/1,000 person-years and 0.03 vs. 0.08/1000 person-years for PHN. In the primary analysis, the adjusted overall VE against hospitalised HZ and hospitalised PHN was 57.8% (95% CI: 41.1-69.8) and 73.7% (95% CI:14.0-92.0) respectively. In adults ≥ 65 years old, the VE against hospitalised HZ was 54.4% (95% CI: 36.0-67.5) and VE against hospitalised PHN was 75·5% (95% CI: 19.9-92.5). In the secondary analysis, the VE against community HZ was 30.0% (95% CI: 25.6-34.5). The ZVL VE against hospitalised HZ for immunocompromised adults was 51.1% (95% CI: 23.1-69.5), and PHN hospitalisation was 67.6% (95% CI: 9.3-88.4). The VE against HZ hospitalisation for Māori was 45.2% (95% CI: -23.2-75.6) and for Pacific Peoples was 52.2% (95% CI: -40.6 -83·7).
    UNASSIGNED: ZVL was associated with a reduction in risk of hospitalisation from HZ and PHN in the New Zealand population.
    UNASSIGNED: Wellington Doctoral Scholarship awarded to JFM.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    UNASSIGNED:建议使用高通量静态全幻灯片图像扫描仪来解决资源受限环境中有限的病理学服务的挑战。然而,高昂的设备成本和先进的技术,加上大量的空间来设置设备,使其在资源有限的环境中使用不切实际。在这里,我们旨在通过使用来自撒哈拉以南非洲的疑似淋巴瘤病例的淋巴结活检,对照载玻片显微镜(GSM)验证便携式全载玻片成像(WSI)装置,来应对这一挑战.
    UNASSIGNED:这是液体活检与常规病理的多中心前瞻性病例对照头对头比较研究的一部分。对于便携式WSI扫描仪验证,这项研究的病理学家评估了2021年2月至12月间经金标准病理学初步证实的105例手术淋巴结标本.由训练有素的组织技术人员根据苏木精和伊红(H&E)和免疫组织化学(IHC)染色的标准方案处理组织。然后将每个中心的H&E和IHC幻灯片数字化。数字图像被匿名化并由组织技术人员上传到符合HIPAA的服务器。三名研究病理学家在6周的冲洗后独立访问并审查了图像。描述并使用Cohens'kappa系数(κ)测量了病理学家在GSM和WSI上建立的诊断之间的一致性。
    未经评估:在GSM上,65.5%(n=84)的标本是淋巴瘤;25%被归类为良性,而9.5%为转移性。对GSM和WSI的形态学质量评估确定79.8%和53.6%的病例是高质量的,分别。当GSM的诊断与WSI进行比较时,各种诊断类别的总体一致性为93%,100%,淋巴瘤占86%,转移,和良性条件分别。WSI检测淋巴瘤的灵敏度和特异度分别为95.2%和85.7%,分别,观察者间的总体一致性(κ)为0.86;95%CI(0.70-0.95)。
    UNASSIGNED:我们证明,移动全载玻片成像(WSI)在淋巴结标本恶性浸润的初步诊断中并不逊色于常规玻璃载玻片显微镜(GSM)。我们的结果进一步提供了概念证明,即移动WSI可以适应原发性手术病理的资源受限设置,并将显着改善患者预后。
    UNASSIGNED: Telepathology utilizing high-throughput static whole slide image scanners is proposed to address the challenge of limited pathology services in resource-restricted settings. However, the prohibitive equipment costs and sophisticated technologies coupled with large amounts of space to set up the devices make it impractical for use in resource-limited settings. Herein, we aimed to address this challenge by validating a portable whole slide imaging (WSI) device against glass slide microscopy (GSM) using lymph node biopsies from suspected lymphoma cases from Sub-Saharan Africa.
    UNASSIGNED: This was part of a multicenter prospective case-control head-to-head comparison study of liquid biopsy against conventional pathology. For the portable WSI scanner validation, the study pathologists evaluated 105 surgical lymph node specimens initially confirmed by gold-standard pathology between February and December 2021. The tissues were processed according to standard protocols for Hematoxylin and Eosin (H&E) and Immunohistochemistry (IHC) staining by well-trained histotechnicians, then digitalized the H& E and IHC slides at each center. The digital images were anonymized and uploaded to a HIPAA-compliant server by the histotechnicians. Three study pathologists independently accessed and reviewed the images after a 6-week washout. The agreement between diagnoses established on GSM and WSI across the pathologists was described and measured using Cohens\' kappa coefficient (κ).
    UNASSIGNED: On GSM, 65.5% (n=84) of specimens were lymphoma; 25% were classified as benign, while 9.5% were metastatic. Morphological quality assessment on GSM and WSI established that 79.8% and 53.6% of cases were of high quality, respectively. When diagnoses by GSM were compared to WSI, the overall concordance for various diagnostic categories was 93%, 100%, and 86% for lymphoma, metastases, and benign conditions respectively. The sensitivity and specificity of WSI for the detection of lymphoma were 95.2% and 85.7%, respectively, with an overall inter-observer agreement (κ) of 0.86; 95% CI (0.70-0.95).
    UNASSIGNED: We demonstrate that mobile whole slide imaging (WSI) is non-inferior to conventional glass slide microscopy (GSM) for the primary diagnosis of malignant infiltration of lymph node specimens. Our results further provide proof of concept that mobile WSI can be adapted to resource-restricted settings for primary surgical pathology and would significantly improve patient outcomes.
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  • 文章类型: Journal Article
    UNASSIGNED:采用数字乳腺断层合成(DBT)图像合成的乳房X线照片(SM)来代替常规的全场数字乳房X线摄影(FFDM),以减少辐射剂量。
    UNASSIGNED:比较SM和FFDM之间癌症相关发现的显着性以及这些方法与DBT的组合。
    UNASSIGNED:该研究是在三级乳腺成像中心进行的,其中200名转诊接受筛查的女性被依次纳入研究.患者同时接受FFDM和DBT,并进行为期两年的随访。评估乳腺影像报告和数据系统(BI-RADS)评分的数据,乳腺密度,肿块病变,钙化,和两位乳腺放射科专家的局灶性不对称。通过CohenKappa检验对不同方法进行比较。
    未经证实:22例可能有恶性表现的患者进行了活检。以组织病理学发现和两年随访为参考,FFDM+DBT(分别为86.1和88.9)和SM+DBT(86.1和88.2)的总体敏感性和特异性没有显示有意义的差异.比较SM和FFDM,在SM上忽略了20名受试者的钙化,但后来与DBT结合时检测到。考虑到乳房成分和BI-RADS分类,读者之间有一个极好的协议。
    UNASSIGNED:考虑到患者的BI-RADS分类,SM+DBT筛查与FFDM+DBT的结果相当。尽管与FFDM相比,SM的灵敏度略低,DBT与SM联合后,未发现恶性钙化或肿块。
    UNASSIGNED: Synthesized Mammogram (SM) from Digital Breast Tomosynthesis (DBT) images is introduced to replace the routine Full Field Digital Mammography (FFDM) to reduce radiation dose.
    UNASSIGNED: to compare the conspicuity of cancer related findings between SM and FFDM and combination of these methods with DBT.
    UNASSIGNED: The study was conducted in a tertiary breast imaging center, where 200 women referred for screening were enrolled in the study sequentially. Patients underwent FFDM and DBT simultaneously and a two-year follow-up was done. Data was evaluated for Breast Imaging Reporting and Data System (BI-RADS) score, breast density, mass lesions, calcification, and focal asymmetry by two expert breast radiologists. Comparison between different methods was made by Cohen Kappa test.
    UNASSIGNED: 22 patients with likely malignant findings went under biopsy. Taking histopathologic findings and two-year follow up as reference, the overall sensitivity and specificity for FFDM+DBT (86.1 and 88.9 respectively) and SM+DBT (86.1 and 88.2) didn\'t show a meaningful difference. Comparing SM and FFDM, calcification in 20 subjects were overlooked on SM, but later detected when combined with DBT. Considering breast composition and BI-RADS categorization, an excellent agreement existed between the readers.
    UNASSIGNED: Screening with SM+DBT shows comparable results with FFDM+DBT considering BI-RADS categorization of the patients. Although SM showed slightly inferior sensitivity compared to FFDM, after combining DBT with SM no malignant appearing calcification or mass lesion was missed.
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  • 文章类型: Journal Article
    酒精相关性肝炎(AH)是黄疸的临床综合征,腹痛,和厌食症由于长期大量饮酒。AH与基因表达的变化有关,细胞因子,免疫反应,和肠道微生物组。在AH中诊断和预测的生物标志物有限,但是一些非侵入性生物标志物正在出现。在这次审查中,临床风险分层算法,有希望的AH生物标志物,如细胞角蛋白18片段,遗传多态性,和microRNA将被审查。
    Alcohol-associated hepatitis (AH) is a clinical syndrome of jaundice, abdominal pain, and anorexia due to prolonged heavy alcohol intake. AH is associated with changes in gene expression, cytokines, immune response, and the gut microbiome. There are limited biomarkers to diagnose and prognosticate in AH, but several non-invasive biomarkers are emerging. In this review, clinical risk-stratifying algorithms, promising AH biomarkers like cytokeratin-18 fragments, genetic polymorphisms, and microRNAs will be reviewed.
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  • 文章类型: Journal Article
    肝移植后尽量减少免疫抑制药物的策略受到同种异体移植排斥的限制。肝活检是目前诊断排斥反应的标准。然而,它增加了患者的身体和经济负担,并具有诊断局限性。在这次审查中,我们旨在强调预测和诊断急性排斥反应的不同生物标志物.我们还旨在探索分子诊断的最新进展,以提高肝活检的诊断率。
    Strategies to minimize immune-suppressive medications after liver transplantation are limited by allograft rejection. Biopsy of liver is the current standard of care in diagnosing rejection. However, it adds to physical and economic burden to the patient and has diagnostic limitations. In this review, we aim to highlight the different biomarkers to predict and diagnose acute rejection. We also aim to explore recent advances in molecular diagnostics to improve the diagnostic yield of liver biopsies.
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  • 文章类型: Journal Article
    未经证实:制定并验证诊断评分,以确定不明原因发热(FUO)中的成人起病斯蒂尔病(AOSD)。
    未经评估:单个中心,2018年1月至2021年12月FUO住院患者的回顾性病例对照研究。使用来自178例AOSD和486例FUO的临床和实验室数据,我们使用贝叶斯模型平均方法开发了AOSD/FUO(AF)评分。AF评分和Yamaguchi标准通过敏感度评估,特异性,准确度,以及在发育和验证样本中AOSD诊断的阳性/阴性预测值。
    UNASSIGNED:AOSD组皮疹患者的持续瘙痒性皮疹(PPEs)高于FUO组(52.3%vs7.4%;P<0.01)。PPEs的特异性为97.5%,灵敏度为44.9%。AF评分=PPEs×3.795+消退皮疹×2.774+血清铁蛋白×1.678+肌痛×0.958+中性粒细胞计数×0.185+血小板计数×0.004。截止值≥5.245显示,在验证组中区分AOSD和FUO的最大灵敏度为88.7%,特异性为95.8%。与山口标准相比,AF评分将准确率从82.6%提高到93.3%。
    UNASSIGNED:我们开发并验证了一种新的评分,该评分可以比Yamaguchi的标准更高的分类精度来识别FUO中的AOSD。未来需要设计多中心前瞻性研究来确认AF评分的诊断价值。
    UNASSIGNED: To develop and validate a diagnostic score to identify adult-onset Still\'s disease (AOSD) in fever of unknown origin (FUO).
    UNASSIGNED: A single center, retrospective case-control study of inpatients with FUO from January 2018 to December 2021. Using clinical and laboratory data from 178 cases with AOSD and 486 cases with FUO, we developed an AOSD/FUO (AF) score with a Bayesian Model Averaging approach. AF score and Yamaguchi\'s criteria were evaluated by sensitivity, specificity, accuracy, and positive/negative predictive value for diagnosis of AOSD in developmental and validation samples.
    UNASSIGNED: Persistent pruritic eruptions (PPEs) in patients with rashes was higher in AOSD group than FUO group (52.3% vs 7.4%; P < 0.01). PPEs yielded a specificity of 97.5% and a sensitivity of 44.9%. AF score = PPEs × 3.795+Evanescent rash × 2.774+Serum ferritin × 1.678+Myalgia × 0.958+Neutrophil count × 0.185+Platelet count × 0.004. A cut-off value ≥ 5.245 revealed the maximizing sensitivity of 88.7% and specificity of 95.8% in discriminating AOSD from FUO in the validation group. And AF score improved the accuracy from 82.6% to 93.3% compared with Yamaguchi\'s criteria.
    UNASSIGNED: We developed and validated a new score which can identify AOSD in FUO with higher classification accuracy than Yamaguchi\'s criteria. Future multi-centric prospective studies need to be designed to confirm the diagnosis value of AF score.
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  • 文章类型: Journal Article
    UNASSIGNED:由于乌克兰战争,结核病(TB)儿童诊断成像方案的最佳选择是当代挑战,这可能会导致西欧结核病病例的急剧上升。我们旨在收集所有主要研究,比较影像学模式及其对疑似或确诊肺结核(PTB)儿童肺部发现的诊断准确性。
    UNASSIGNED:我们使用预先指定的搜索词搜索数据库PubMed和Embase,从1972年到2022年的英语和非英语出版和未出版的报告。我们在排除文献综述和系统综述中通过引文检索检索报告。如果大多数研究人群年龄在0至18岁之间,确诊或疑似PTB,则研究合格。研究参与者描述了来自两种或两种以上不同成像模式的诊断图像.
    未经证实:共有15项研究调查了常规胸部X线(CXR)和计算机断层扫描(CT)对儿童PTB的诊断。九项研究调查了CT或CXR证实结核病诊断的参与者数量,所有的人,包括1244名患者,据报道,与结核病相符的发现在CT上比在CXR上更常见。只有两项研究没有将放射学结果作为其PTB诊断标准的一部分。并结合他们显示CT诊断54/54(100%)患有确诊PTB的儿童,而CXR诊断为42/54(78%)。两项研究将磁共振成像(MRI)与CXR进行了比较,表明MRI诊断的PTB儿童多于CXR。一项研究报告了更高的阳性预测值(PPV),MRI对PTB结果的敏感性和特异性优于CXR。一项研究将CXR与高千伏(高kV)CXR进行了比较,发现关于PTB确认的相容的敏感性和特异性。两项研究将超声(US)与CXR进行了比较,发现US具有更高的诊断率,并且更经常正确识别合并,纵隔LAP,和胸腔积液.
    UNASSIGNED:CT对PTB发现的诊断准确性高于CXR,核磁共振和美国,并且在可用时应该是首选的成像模式。MRI对LAP的敏感性和特异性高于CXR,胸腔积液,和空化。美国在最初的诊断工作和后续行动中表示赞赏。根据当地的可用性和专业知识,提出了儿童PTB的诊断策略。正如这份系统审查没有证据表明的那样,承认高结核病负担国家的专门知识。有疑问时可以进行CT,由于较高的诊断产量。
    UNASSIGNED: The optimal choice of protocol for diagnostic imaging in children with tuberculosis (TB) is a contemporary challenge due to the war in Ukraine, which potentially can create a steep rise in TB cases in Western Europe. We aimed to gather all primary research comparing imaging modalities and their diagnostic accuracies for pulmonary findings in children with suspected or confirmed pulmonary tuberculosis (PTB).
    UNASSIGNED: We searched the databases PubMed and Embase using pre-specified search terms, for English- and non-English published and un-published reports from the period 1972 to 2022. We retrieved reports via citation search in excluded literature reviews and systematic reviews. Studies were eligible if most of the study population was between 0 and 18 years of age with confirmed or suspected PTB, and study participants had described diagnostic images from two or more different imaging modalities.
    UNASSIGNED: A total of 15 studies investigated conventional chest X-Ray (CXR) and computed tomography (CT) in diagnosing PTB in children. Nine studies investigated the number of participants in where CT or CXR confirmed the diagnosis of TB, and all of them, including a total of 1244 patients, reported that findings compatible with TB were more frequently detected on CT than CXR. Only two studies did not include radiological findings as part of their diagnostic criteria for PTB, and combined they showed that CT diagnosed 54/54 (100 %) children with confirmed PTB, while CXR diagnosed 42/54 (78 %). Two studies compared magnetic resonance imaging (MRI) with CXR and showed that MRI diagnosed more children with PTB than CXR. One study reported a higher positive predictive value (PPV), sensitivity and specificity for PTB findings for MRI than CXR. One study compared CXR with high-kilovolt (high-kV) CXR, finding compatible sensitivity and specificity regarding confirmation of PTB. Two studies compared ultrasound (US) with CXR and found that US had a higher diagnostic yield and more often correctly identified consolidations, mediastinal LAP, and pleural effusion.
    UNASSIGNED: CT showed a higher diagnostic accuracy for PTB findings than CXR, MRI and US, and should be the imaging modality of first choice when available. MRI had a higher sensitivity and specificity than CXR for LAP, pleural effusion, and cavitation. US was complimentary in initial diagnostic work-up and follow up. A diagnostic strategy for PTB in children according to local availability and expertise is proposed, as no evidence from this systematic review shows otherwise, in acknowledgement of the expertise in high TB-burdened countries. CT can be performed when in doubt, due to the higher diagnostic yield.
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  • 文章类型: Journal Article
    UNASSIGNED:隐匿性股骨颈骨折(OFNF)的诊断和治疗延迟会对随后的生活质量产生负面影响。我们调查了通过磁共振成像(MRI)证实患有这种疾病的患者的超声检查对OFNF的诊断准确性,并将这些结果与其他临床发现进行了比较。
    UNASSIGNED:纳入94名年龄在70岁以上的急性髋部疼痛患者,但没有影像学异常发现,怀疑患有隐匿性股骨颈骨折(11名男性和83名女性,平均年龄为81.8±6.0岁)。所有病例均在24h内进行超声和MRI检查。测量股骨颈前部与前关节囊之间的超声距离(超声关节肿胀)。
    未经证实:通过MRI发现,27例患者被分配到隐匿性股骨颈骨折(OFNF)组(1例,26名女性)和非OFNF组的67名患者(10名男性,57名妇女)。两组超声关节肿胀平均为7.53±1.52mm和3.45±0.89mm,分别为(p=0.006,95%CI,3.58-4.59)。5.3mm的截断值显示0.96(0.89-0.96)的灵敏度和0.98(0.92-1.00)的特异性。
    UASSIGNED:超声检查显示隐匿性股骨颈骨折的诊断准确性非常高。因此,这种方式可以为70岁以上急性髋部疼痛患者的这种情况进行初始床边检查。
    UNASSIGNED: A delay in the diagnosis and treatment of an occult femoral neck fracture (OFNF) can negatively affect the subsequent quality of life. We investigated the diagnostic accuracy of ultrasonography for OFNF in patients confirmed with this condition by magnetic resonance imaging (MRI), and compared these results with other clinical findings.
    UNASSIGNED: Ninety-four outpatients aged above 70 years with acute hip pain but without radiographic abnormal findings who were suspected of having an occult femoral neck fracture (11 men and 83 women with a mean age of 81.8 ± 6.0 years) were enrolled. Both ultrasonography and MRI were performed in all cases within 24 h. The ultrasonographic distance between the anterior aspect of the femoral neck and the anterior joint capsule (ultrasound joint swelling) was measured.
    UNASSIGNED: By MRI findings, 27 patients were assigned to an occult femoral neck fracture (OFNF) group (1 man, 26 women) and 67 patients to a non-OFNF group (10 men, 57 women). The mean ultrasound joint swelling in both groups was 7.53 ± 1.52 mm and 3.45 ± 0.89 mm, respectively (p = 0.006, 95% CI, 3.58-4.59). A cut-off value of 5.3 mm showed a sensitivity of 0.96 (0.89-0.96) and a specificity of 0.98 (0.92-1.00).
    UNASSIGNED: Ultrasonography shows very high diagnostic accuracy for occult femoral neck fracture. This modality can thus contribute to initial bed-side examinations for this condition in patients over 70 years with acute hip pain.
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