Wie vergleichbar sind Ergebnisse von Rechtschreib-und Lesetests?

Eine umschriebene Lese-Rechtschreibstörung (ICD-10: F81) ist durch eine Diskrepanz zwischen den allgemeinen kognitiven Fähigkeiten eines Kindes und dessen Lese-Rechtschreibleistungen gekennzeichnet. Für die Diagnostik steht eine Vielzahl von Lese- und Rechtschreibtests zur Verfügung. In der Studie wurde untersucht, ob die Diagnosestellung von der Wahl des Testverfahrens abhängt. Es wurden Kinder mit mehreren Rechtschreib- und Lesetests untersucht. Die allgemeinen kognitiven Fähigkeiten wurden mit dem CFT beurteilt. Außerdem erfolgte eine Einschätzung der Diktat- und Leseleistungen durch die Lehrer sowie die Eltern. Die meisten Lese- und Rechtschreibtest zeigten in unseren Untersuchungen relativ gute Übereinstimmungen hinsichtlich ihrer Ergebnisse. Bei einigen Tests zeigten sich jedoch Abweichungen, die beachtet werden sollten. Wenn Kinder mit schlechten Lese- und Rechtschreibleistungen gemäß dem Eindruck der Lehrer/innen erfasst werden sollen, besitzen Lesetests eine höhere Trefferquote bezüglich der Leseleistung als die Rechtschreibtests bezüglich der Rechtschreibleistung. Lesetests sollten daher in der Praxis obligat eingesetzt werden

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Propiniminium-Salze als C2- und C3-Bausteine für die Synthese von Pyrimido[2,1-a]isochinolinen, Pyrido[2,1-a]isochinolinium-, Chinolizinium- und Benzo[c]chinolizinium-Salzen

In dieser Arbeit wurden unterschiedliche Synthesemethoden zum schnellen, einstufigen Aufbau von anellierten Sechsringheterocyclen mit Hilfe von Propiniminium-Salzen als elektronenarme Synthesebausteine entwickelt. Im ersten Teilprojekt wurden Dreikomponentenreaktionen durchgeführt, im zweiten Teil der Arbeit wurden Reaktionen zwischen 2-alkylierten Pyridin-Derivaten und Propiniminium-Salzen untersucht. Die Dreikomponentenreaktionen von Propiniminium-Salzen, Isochinolin und Arylisocyanaten führten zu Pyrimido[2,1-a]isochinolinen. Durch Hydrolyse der noch enthaltenen Iminium-Funktion konnten die Dreikomponentenprodukte in die Benzoyl-substituierten Pyrimido[2,1-a]isochinoline überführt werden. Mit Methylindol oder Indol als dritter Komponente entstanden in einer Dreikomponentenreaktion mit Isochinolin und Propiniminium-Salz substituierte Propeniminium-Salze. Dreikomponentenreaktionen von Chinolin, Propiniminium-Salz und Arylisocyanaten ergaben Pyrimido[1,2-a]chinoline, deren Iminium-Funktionen ebenfalls hydrolysiert werden konnten. Bei Reaktionen mit 1-alkylierten 3,4-Diydroisochinolinen sowie Chinaldin und den 2-methylierten Pyridin-Derivaten, 2-Picolin, 2,6-Lutidin und 2,4,6-Collidin, konnten bei der Umsetzung mit Propiniminium-Salzen als C3-Bausteine Pyrido[2,1-a]isochinolinium-, Benzo[c]chinolizinium- und Chinolizinium-Salze erhalten werden. Aufgrund der Fluoreszenz der Pyrido[2,1-a]isochinolinium-Salze wurden UV/Vis- und fluoreszenzspektroskopische Untersuchungen durchgeführt, wobei ein großer Stokes-Shift beobachtet wurde

Modelling multiple thresholds in meta-analysis of diagnostic test accuracy studies

Abstract Background In meta-analyses of diagnostic test accuracy, routinely only one pair of sensitivity and specificity per study is used. However, for tests based on a biomarker or a questionnaire often more than one threshold and the corresponding values of true positives, true negatives, false positives and false negatives are known. Methods We present a new meta-analysis approach using this additional information. It is based on the idea of estimating the distribution functions of the underlying biomarker or questionnaire within the non-diseased and diseased individuals. Assuming a normal or logistic distribution, we estimate the distribution parameters in both groups applying a linear mixed effects model to the transformed data. The model accounts for across-study heterogeneity and dependence of sensitivity and specificity. In addition, a simulation study is presented. Results We obtain a summary receiver operating characteristic (SROC) curve as well as the pooled sensitivity and specificity at every specific threshold. Furthermore, the determination of an optimal threshold across studies is possible through maximization of the Youden index. We demonstrate our approach using two meta-analyses of B type natriuretic peptide in heart failure and procalcitonin as a marker for sepsis. Conclusions Our approach uses all the available information and results in an estimation not only of the performance of the biomarker but also of the threshold at which the optimal performance can be expected

Evaluation of the Parameter Mean Impedance for Representing Eustachian tube Functions During Pressure Increase and Decrease in Pressure Chamber Measurements

Hypothesis: The hypothesis of the study is that the mean impedance (MI) during compression and decompression provides additional information of the Eustachian tube (ET) function. Background: The continuous impedance measurement in a pressure chamber can provide valuable information about the opening function of the ET. Methods: Around 55 ear-healthy volunteers were examined in a pressure chamber. These were subjected to a decompression phase and a compression phase. The pressure change was constantly 20 kPa/min. Using evaluation software, the MI could be determined for both ears in each case for the phases of compression and decompression. Results: In 49 participants, we could interpret the data successfully. On average, an output value (without pressure changes) of the impedance of 0.58 +/- 0.11 Pa on the right side and 0.43 +/- 0.1 Pa on the left side were measured. During decompression, 0.098 +/- 0.05 Pa (right) and 0.087 +/- 0.043 Pa (left) could be determined. For compression, values of 0.086 +/- 0.044 Pa on the right and 0.079 +/- 0.045 Pa on the left were detected. The retest reliability was higher with an intraclass correlation coefficient for the decompression MI of 0.833 than the 0.772 compression MI. Conclusions: It is possible to measure MI in healthy subjects during compression and decompression. This value represents a good average in terms of the pressure tolerance of the middle ear. In future, studies will be required to determine whether MI will be a useful parameter in differentiating normal and abnormal ET function

Ligularia japonica Less.

原著和名: ハンクヮイサウ科名: キク科 = Compositae採集地: 三重県 尾鷲市 (紀伊 尾鷲市)採集日: 1983/6/23採集者: 萩庭丈壽整理番号: JH007581国立科学博物館整理番号: TNS-VS-95758