Elégedettséget és hangulatot mérő egytételes skálák használhatósága jóllétre vonatkozó vizsgálatokban

Elméleti háttér: Számos tanulmány foglalkozott már az egytételes skálákkal, köztük a vizuális megjelenítésűekkel. Összevetve őket olyan többtételes mérőeszközökkel, amelyek ugyanazt a konstruktumot mérik, sok esetben kimutatható volt megbízhatóságuk, validitásuk. Korlátaik mellett alkalmazásuknak sok nyilvánvaló gyakorlati előnye van. Cél: Mivel hazai mintán nem született még ilyen típusú eszközökről közlemény, el kívántuk végezni egy élettel való általános elégedettségre rákérdező, 10-fokú skála, valamint egy általunk kísérleti jelleggel kifejlesztett, hét arckifejezést bemutató hangulati arcskála validitásvizsgálatát. Módszer: Három, felnőtt válaszadókkal folytatott kérdőíves vizsgálatból származó adatokat elemeztünk. Az Egytételes Elégedettségskála elemzését egy párokat vizsgáló kutatás női és férfi almintáján végeztük el (N = 2×270), a HA7 Hangulati Arcskála elemzését pedig két másik adatbázis alapján: N = 294 (41% férfi), illetve 596 (49,7% férfi). Az eszközök validálásához több jóllétkérdőívet használtunk (élettel való elégedettség: SWLS-H, élet értelmessége: MLQ-H, önértékelés: RSES-H, pozitív és negatív érzelmek gyakorisága: PANAS). Eredmények: A korrelációs elemzések során mindkét változó esetén szoros összefüggést kaptunk az SWLS-H-val (az Egytételes Elégedettségskálánál r = 0,68 és 0,71), és szintén szignifikáns összefüggést az MLQ-P-vel (az élet értelmességének megélésével), továbbá az Egytételes Elégedettségskálánál az RSES-H-val, a Hangulati Arcskálánál a PANAS-POZ és PANAS-NEG változókkal. Függő változónak az elégedettségskálánál a RSES-H-t, az arcskálánál az SWLS-H-t tekintve a hierarchikus regressziós elemzések mindkét egytételes skála inkrementális erejét kimutatták. Következtetések: Az eredmények arra utalnak, hogy az egytételes mérőeszközöket érdemes számításba venni módszertani alternatívaként akkor, amikor kutatásokban a jóllét egyes dimenzióinak gyors, globális értékelésére van szükség. | Background: Several studies have already dealt with one-item scales, among them with the visual ones. Their reliability and validity were demonstrable in many cases when comparing them with multi-item scales which measure the same construct. Besides their limitations, their application has many clear practical advantages. Aim: Because there was no publication about such measurements from a Hungarian sample we wanted to examine the validity of a 10-grade scale of general life satisfaction (the One-item Satisfaction Scale) and the HA7 Mood Faces Scale which shows seven faces and was developed on an experimental level by the authors. Method: Data from three questionnaire studies were analyzed which were based on adult samples. We performed the analysis of the One-item Satisfaction Scale based on the men and women subsample of a research of couples (N = 2×270) and the analysis of the HA7 Mood Faces Scale based on two other databases: N = 294 (41% men) and 596 (49.7% men). Several other well-being measures were used to investigate validity (satisfaction with life: SWLS, meaning in life: MLQ, self-esteem: RSES, frequency of positive and negative emotions: PANAS). Results: We found strong relationship with SWLS for both variables, and a similarly significant correlation with MLQ-P (the presence of meaning in life). Also, the One-item Satisfaction Scale associated strongly with the RSES, while the HA7 Mood Faces Scale with PANAS-POZ and PANAS-NEG scores. Using RSES and SWLS as dependent variables in the cases of the One-item Satisfaction Scale and the HA7 Mood Faces Scale, respectively, the hierarchical regression analyses proved the incremental power of both one-item scales. Conclusions: Results imply that it is worthwhile to pay respect to one-item measurement tools as a methodological alternative when one needs the quick global evaluation of certain dimensions of well-being

Adjunctive diagnostic value of targeted electrical impedance imaging to conventional methods in the evaluation of breast lesions

PURPOSE: To determine the diagnostic accuracy of targeted electrical impedance imaging in characterizing breast lesions, and to evaluate whether lesion size, depth and histopathology affect the diagnosis. MATERIAL AND METHODS: A total of 137 women with 145 lesions (79 malignant and 66 benign) found by palpation or mammography were prospectively enrolled in this study. The patients were examined by means of clinical breast examination, mammography, ultrasonography, and electrical impedance imaging with TransScan TS2000. A level of suspicion (LOS) post-processing algorithm (v2.67) was used for TS2000 lesion assessment. Imaging findings were correlated with cytologic (n=54) and histologic diagnoses (n=91). Patients with benign lesions were followed up for a mean of 36 months. RESULTS: TS2000 showed a high sensitivity (86%) which did not differ significantly from that of mammography (87%) and ultrasonography (US) (75%). The specificity of TS2000 (49%) was significantly lower compared to mammography (97%, P<0.0001) and US (100%, P<0.0001). The additive use of TS2000 to mammography and US yielded no significant increase in sensitivity (97%), but the decrease in specificity was significant (46%, P<0.0001). Diagnostic effectiveness of TS2000 (Az=0.68), as measured by the area under the ROC curve, was significantly lower than for mammography (Az=0.93, P<0.0001) and for US (Az=0.91, P<0.0001). When using TS2000 in addition to mammography and US (Az=0.86), a significant impairment was found (P=0.0003). CONCLUSION: The role of targeted electrical impedance imaging as an adjunct to mammography and ultrasonography in the diagnosis of breast lesions is not justified by the result of this study

Can contrast-enhanced MR imaging predict survival in breast cancer?

PURPOSE: To investigate the value of pre-operative contrast-enhanced MR imaging (CE-MRI) in predicting the disease-free and overall survival in breast cancer. MATERIAL AND METHODS: The study population consisted of 50 consecutive patients with histopathologically verified primary breast cancer who pre-operatively underwent CE-MRI examination between 1992 and 1993. A three-time point MR examination was performed where the enhancement rates (C1 and C2), signal enhancement ratio (SER=C1/C2) and washout (W=C1-C2) were calculated. The relation of these MR parameters to disease-free and overall survival was investigated. The median follow-up for surviving patients was 95 months. Univariate and multivariate statistical analyses were performed to evaluate the impact of different factors on prediction of survival. RESULTS: Of the MR parameters examined at univariate analysis, increased C1 (p=0.029), W (p=0.0081) and SER values (p=0.0081) were significantly associated with shorter disease-free survival, and only C1 (p=0.016) was related significantly to overall survival. Multivariate analysis for disease-free survival showed that the SER (p=0.014) and tumor size (p=0.001) were significant and independent predictors. Age (p=0.003), lymph node status (p=0.014), tumor size (p=0.039) and proliferating cell nuclear antigen index (p=0.053) remained independently associated with overall survival at multivariate analysis. C1 was not confirmed as an independent predictor of overall survival. CONCLUSION: Our findings support the presumption that CE-MRI is useful in predicting the disease-free survival in patients with breast cancer

Epilepsziasebészeti beavatkozások eredményei a Pécsi Epilepszia Centrumban 2005 és 2016 között = Postoperative outcome of surgical interventions for epilepsy between 2005 and 2016 at the Epilepsy Center of Pécs

Absztrakt: Bevezetés: Az epilepszia krónikus, súlyos neurológiai betegség, mely jelentősen befolyásolja az életminőséget. A megfelelő indikációval végzett epilepsziasebészeti beavatkozás rohammentességet eredményezhet, mely önmagában vagy rehabilitációt követően jelentősen javíthatja az életminőséget. Célkitűzés: Jelen tanulmányunk célkitűzése a Pécsi Epilepszia Centrumban 2005 és 2016 között epilepsziasebészeti beavatkozáson átesett betegek posztoperatív eredményeinek felmérése. Módszer: Az adatgyűjtés a betegek klinikai anyagának áttekintésén túlmenően kérdőívek alkalmazásával történt, a rohamállapot értékelésén kívül a foglalkoztatottsági státuszra mint az életminőség egyik fontos indikátorára is fókuszálva. Eredmények: Reszektív epilepsziasebészeti beavatkozás 72 esetben történt. A betegek 76%-a tartósan rohammentessé vált. A betegek 10%-ánál műtét után csak igen ritkán lépett fel roham, 7%-uknak jelentősen csökkent a rohamszáma, míg 7%-ban nem változott érdemben a rohamállapot. A rohammentes és a nem rohammentes betegek csoportjainak foglalkoztatottsági adatait vizsgálva azt találtuk, hogy a rohammentesség befolyásolja a páciensek elhelyezkedési lehetőségeit. A rohammentes betegek 67%-a állt foglalkoztatottság alatt, míg a nem rohammenteseknek mindössze a 19%-a (p<0,01, Fisher-féle egzakt teszt). Következtetés: Eredményeink a nemzetközi adatoknak megfelelve alátámasztják az epilepszia reszektív sebészi kezelésének klinikai és szociális eredményességét. Orv Hetil. 2019; 160(7): 270–278. | Abstract: Introduction: Epilepsy as a chronic, severe neurologic disease significantly influences the quality of life of the epileptic patients. In candidates well selected for surgery, the seizure freedom is realistically achievable, and the quality of life can be further improved with complex individual rehabilitation. Aim: We aimed to evaluate the postoperative outcome of patients who underwent epilepsy surgery between 2005 and 2016 at the Epilepsy Center at Pécs. Method: We evaluated seizure status at regular follow-up visits after surgery and the quality of life using questionnaires focusing on employment and social status. Results: 76% of the 72 patients who underwent surgical resection for epilepsy were free from disabling seizures , and 10% had rare disabling seizures (almost seizure-free), 7% experienced worthwhile improvement and 7% had no worthwhile improvement. Comparing the employment status of patients free from disabling seizures to patients not free from disabling seizures, we found that the employment status is significantly influenced by seizure freedom (p<0.01, Fisher’s exact test). While 67% of seizure-free patients were employed, only 19% of patients not free from disabling seizures were hired. Conclusion: Our results resemble the international tendencies and success rate, proving epilepsy surgery as an available, valid and effective treatment in well selected patients. Orv Hetil. 2019; 160(7): 270–278

Application of artificial neural networks to the analysis of dynamic MR imaging features of the breast

The discriminative ability of established diagnostic criteria for MRI of the breast is assessed, and their relative relevance using artificial neural networks (ANNs) is determined. A total of 89 women with 105 histopathologically verified breast lesions (73 invasive cancers, 2 in situ cancers, and 30 benign lesions) were included in this study. A T1-weighted 3D FLASH sequence was acquired before and seven times after the intravenous administration of gadopentetate dimeglumine at a dose of 0.2 mmol/kg body weight. ANN models were built to test the discriminative ability of kinetic, morphologic, and combined MR features. The subjects were randomly divided into two parts: a training set of 59 lesions and a verification set of 46 lesions. The training set was used for learning, and the performance of each model was evaluated on the verification set by measuring the area under the ROC curve (Az). An optimally minimized model was constructed using the most relevant input variables that were determined by the automatic relevance determination (ARD) method. ANN models were compared with the performance of a human reader. Margin type, time-to-peak enhancement, and washout ratio showed the highest discriminative ability among diagnostic criteria and comprised the minimized model. Compared with the expert radiologist (Az = 0.799), using the same prediction scale, the minimized ANN model performed best (Az = 0.771), followed by the best kinetic (Az = 0.743), the maximized (Az = 0.727), and the morphologic model (Az = 0.678). The performance of a neural network prediction model is comparable to that of an expert radiologist. A neurostatistical approach is preferred for the analysis of diagnostic criteria when many parameters are involved and complex nonlinear relationships exist in the data set