Diagnostic capability of a linear discriminant function applied to a novel Spectralis OCT glaucoma-detection protocol

Background Bruch membrane opening–minimum rim width (BMO–MRW) assessment offers a new diagnostic use in glaucoma patients of the Glaucoma Module Premium Edition (GMPE) available for the Spectralis optical coherence tomography (OCT) system. The objective of our research was to evaluate the diagnostic benefits of examining BMO–MRW and peripapillary retinal nerve fibre layer (pRNFL) readings acquired with Spectralis OCT to distinguish between healthy and mild glaucoma patients, comparing those readings with the standard pRNFL application. Moreover, we investigated whether using a particular combination of BMO–MRW and pRNFL parameters with a linear discriminant function (LDF) could further enhance glaucoma diagnosis. Methods One hundred thirty-six eyes from 136 individuals were incorporated into this observational, prospective cross-sectional study: 68 mild primary open-angle glaucoma (POAG) patients according to the Hodapp-Parrish-Anderson criteria (mean deviation between 0 and?-?6?dB) and 68 healthy control subjects selected by Propensity Score Matching. MRW and pRNFL thickness around the disc (diameters: 3.5?mm, 4.1?mm, and 4.7?mm) were obtained using the BMO–MRW protocol, and pRNFL thickness at 3.5?mm was obtained with the standard glaucoma application. The group data were contrasted. One sample was chosen at random to develop the LDF (teaching set: 34 healthy subjects and 34 POAG patients) using a combination of MRW and pRNFL parameters (acquired with the BMO–MRW protocol); the other sample provided a test of how the LDF performed on an independent group (validating set: 34 healthy subjects and 34 POAG patients). The receiver operating curves (ROCs) were plotted for every measurement and contrasted with the proposed LDF. The OCT parameters with the best area under the receiver operating characteristic curve (AUC) were determined. Results Global MRW and pRNFL thicknesses were significantly thinner in the POAG group (p?<? 0.001). The BMO–MRW parameters showed good diagnostic accuracy; the largest AUCs reached 0.875 for the LDF and 0.879 for global RNFL thickness using the standard glaucoma application. There were no statistical differences between the AUCs calculated. Conclusions BMO–MRW parameters show a strong capability to differentiate between mild glaucoma and control eyes. Our LDF based on the new BMO–MRW OCT protocol did not perform better than isolated parameters

Evaluation of Contrast Sensitivity, Chromatic Vision, and Reading Ability in Patients with Primary Open Angle Glaucoma

Purpose. To compare contrast sensitivity, acquired color vision deficiency, and reading ability in patients with glaucoma at different stages of the disease and to establish correlations between visual field parameters and visual function scores. Methods. This prospective cross-sectional study included 121 glaucoma patients. Subjects with a diagnosis of chronic open angle glaucoma were recruited and classified according to Hodapp-Parrish-Anderson criteria. Patients with severe visual field defects were excluded because they were older, which could bias the interpretation of visual function tests. Contrast sensitivity was measured using the Pelli-Robson Chart and the CSV1000E test. Chromatic vision was evaluated using the Farnsworth-panel D15 and the L''Anthony D15 tests of Vision Color Recorder software. Reading ability was measured using Radner-Vissum test. Results. Contrast sensitivity (with photopic and mesopic luminance with glare) differed significantly between patients with early and moderate visual field defects (p < 0.05). Reading ability scores and results of the chromatic vision tests did not differ significantly between the two groups. Significant and moderate Spearman correlations between visual field indexes and contrast sensitivity tests were detected. Conclusions. Contrast sensitivity was significantly worse in patients with moderate glaucoma compared to those with early-stage glaucoma. Evaluation of visual function in clinical practice provides important information to address a glaucoma patient''s vision complaints

Genetic susceptibility in the development of colorectal adenomas according to family history of colorectal cancer

Our study aimed to evaluate the relevance of genetic susceptibility in the development of colorectal adenomas (CRA) and its relationship with the presence of family history of colorectal cancer (CRC). Genomic DNA from 750 cases (first degree relatives of patients with CRC) and 750 controls (subjects with no family history of CRC) was genotyped for 99 single nucleotide polymorphisms (SNPs) previously associated with CRC/CRA risk by GWAS and candidate gene studies by using the MassArray™ (Sequenom) platform. Cases and controls were matched by gender, age and histological lesion. Eight hundred and fifty-eight patients showed no neoplastic lesions, whereas 288 patients showed low-risk adenomas, and 354 patients presented high-risk adenomas. Two SNPs (rs10505477, rs6983267) in the CASC8 gene were associated with a reduced risk of CRA in controls (log-additive models, OR: 0.67, 95%CI:0.54–0.83, and OR:0.66, 95%CI:0.54–0.84, respectively). Stratified analysis by histological lesion revealed the association of rs10505477 and rs6983267 variants with reduced risk of low- and high-risk adenomas in controls, being this effect stronger in low-risk adenomas (log-additive models, OR:0.63, 95%CI:0.47–0.84 and OR:0.64, 95%CI:0.47–0.86, respectively). Moreover, 2 SNPs (rs10795668, rs11255841) in the noncoding LINC00709 gene were significantly associated with a reduced risk of low-risk adenomas in cases (recessive models, OR:0.22, 95%CI:0.06–0.72, and OR:0.08, 95%CI:0.03–0.61) and controls (dominant models, OR:0.50, 95%CI:0.34–0.75, and OR:0.52, 95%CI:0.35–0.78, respectively). In conclusion, some variants associated with CRC risk (rs10505477, rs6983267, rs10795668 and rs11255841) are also involved in the susceptibility to CRA and specific subtypes. These associations are influenced by the presence of family history of CRC

Utilidad del nuevo software MultiColor de SPECTRALIS® en la identificación de defectos de la capa de fibras nerviosas de la retina

La fotografía de fibras clásica, usada tradicionalmente para identificar defectos en la capa de fibras nerviosas de la retina (CFNR), tiene un uso limitado debido a la necesidad de un equipo fotográfico específico y un técnico experto en la adquisición de esta clase de imágenes. El nuevo módulo MultiColor de la tomografía de coherencia óptica (OCT) SPECTRALIS®, utilizando 3 longitudes de onda diferentes simultáneamente, es capaz de proporcionar imágenes en las que se identifican las estructuras de la retina en diferente color según su profundidad. Nos propusimos realizar un pequeño estudio de concordancia para determinar la utilidad del nuevo software MultiColor frente a la fotografía de fibras tradicional en la identificación de defectos en la CFNR. La concordancia interobservador en la interpretación de imágenes MultiColor fue buena (¿ = 0, 746; p < 0, 001); y se consiguieron identificar con MultiColor en torno al 70% de pacientes con glaucoma leve. Consideramos que el nuevo software MultiColor resulta útil en la evaluación de defectos de la CFNR, y es sencillo de realizar. The classical fibre photography traditionally used to identify defects in the retinal nerve fibre layer (RNFL), has been partially discontinued due to poor availability. The new MultiColour module of SPECTRALIS® Optical Coherence Tomography (OCT), using three different laser wavelengths simultaneously, can provide images that identify the structures of the retina in different colours according to their depth. A small concordance study was conducted to determine the usefulness of the new MultiColour software versus traditional fibre photography in identifying RNFL defects. The inter-observer agreement in the interpretation of MultiColour images was good (¿=.746; P<.001), as by using Multicolour they were able to identify around 70% of patients with mild glaucoma. It is believed that the new Multicolour software is useful in evaluating RNFL defects, and is easy to perform

Effect of aspirin on the diagnostic accuracy of the faecal immunochemical test for colorectal advanced neoplasia

Background: Aspirin (ASA) is a drug that can cause gastrointestinal lesions and symptoms. Colorectal cancer (CRC) is the most prevalent type of cancer in Western countries. We assessed the effect of aspirin on the diagnostic accuracy of the faecal immunochemical test (FIT) for CRC and/or advanced neoplasia (AN) in patients undergoing colonoscopy for gastrointestinal symptoms. Methods: We conducted a prospective multicentre observational study of diagnostic tests that included patients with gastrointestinal symptoms undergoing colonoscopy between March 2012 and 2014 (the COLONPREDICT study). Symptoms were assessed and a FIT and blood tests assessing haemoglobin and carcinoembryonic antigen (CEA) levels were performed. Results: The study included 3052 patients: A total of 2567 did not take aspirin (non-user group) and 485 (16%) took aspirin (user group). Continuous treatment with ASA did not change the AUC (0.88, 0.82; p = 0.06), sensitivity (92%, 88%; p = 0.5) or specificity (71%, 67%; p = 0.2) of the FIT for CRC detection. Similarly, we found no differences in the AUC (0.81, 0.79; p = 0.6), sensitivity (74%, 75.5%; p = 0.3) or specificity (76%, 73.6%; p = 0.3) for AN detection. Patients with an aspirin use of = 300 mg/day had a lower prevalence of AN and the sensitivity, specificity and AUC for AN for these patients were 54%, 68% and 0.66, significantly lower than for the non-user group (p = 0.03). Conclusions: Aspirin does not modify the diagnostic accuracy of FIT for CRC and/or AN in patients with gastrointestinal symptoms. Aspirin use of = 300 mg/day decreases the accuracy of the test

Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort

We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 +/- 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3-3.1), CRC (HR 4.4, 95% CI 1.1-17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0-2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3-5.8), rectal bleeding (OR 0.3, 95% CI 0.1-0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7-7.1). However, CEA was increased only in 31.8% (95% CI, 16.4-52.7%) and 50% (95% CI, 25.4-74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC

Stress detection using wearable physiological and sociometric sensors

Stress remains a significant social problem for individuals in modern societies. This paper presents a machine learning approach for the automatic detection of stress of people in a social situation by combining two sensor systems that capture physiological and social responses. We compare the performance using different classifiers including support vector machine, AdaBoost, and k-nearest neighbour. Our experimental results show that by combining the measurements from both sensor systems, we could accurately discriminate between stressful and neutral situations during a controlled Trier social stress test (TSST). Moreover, this paper assesses the discriminative ability of each sensor modality individually and considers their suitability for real time stress detection. Finally, we present an study of the most discriminative features for stress detection

An artificial intelligence method using FDG PET to predict treatment outcome in diffuse large B cell lymphoma patients

Convolutional neural networks (CNNs) may improve response prediction in diffuse large B-cell lymphoma (DLBCL). The aim of this study was to investigate the feasibility of a CNN using maximum intensity projection (MIP) images from 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) baseline scans to predict the probability of time-to-progression (TTP) within 2&nbsp;years and compare it with the International Prognostic Index (IPI), i.e. a clinically used score. 296 DLBCL 18F-FDG PET/CT baseline scans collected from a prospective clinical trial (HOVON-84) were analysed. Cross-validation was performed using coronal and sagittal MIPs. An external dataset (340 DLBCL patients) was used to validate the model. Association between the probabilities, metabolic tumour volume and Dmaxbulk was assessed. Probabilities for PET scans with synthetically removed tumors were also assessed. The CNN provided a 2-year TTP prediction with an&nbsp;area under the curve (AUC) of 0.74, outperforming the IPI-based model (AUC = 0.68). Furthermore, high probabilities (&gt; 0.6) of the original MIPs were considerably decreased after removing the tumours (&lt; 0.4, generally). These findings suggest that MIP-based CNNs are able to predict treatment outcome in DLBCL

A comparative study of legitimation strategies in hybrid regimes

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