Influence diagnostics and outlier detection for meta ‐analysis of diagnostic test accuracy

SummaryMeta ‐analyses of diagnostic test accuracy (DTA) studies have been gaining prominence in research in clinical epidemiology and health technology development. In these DTA meta‐analyses, some studies may have markedly different characteristics from the others, and potentially be inappropriate to inclu de. The inclusion of these “outlying” studies might lead to biases, yielding misleading results. In addition, there might be influential studies that have notable impacts on the results. In this article, we propose Bayesian methods for detecting outlying studies and their influence diagnostics i n DTA meta‐analyses. Synthetic influence measures based on the bivariate hierarchical Bayesian random effects models are developed because the overall influences of individual studies should be simultaneously assessed by the two outcome variables and their correlation information. We propose four synthetic measures for influence analyses: (1) relative distance, (2) standardized residual, (3) Bayesian p‐value, and (4) influence statistic on the area under the summary receiver operating characteristic curve. We also show conventional univariate Bayesian influential measures can be applied to the bivariate random effects models, which can be used as marginal influential measures. Most of these methods can be similarly applied to the frequentist framework. We illustrate the effectiveness of the proposed methods by applying them to a DTA meta‐analysis of ultrasound...
Source: Research Synthesis Methods - Category: Chemistry Authors: Tags: RESEARCH ARTICLE Source Type: research

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This article highlights its key features to promote better awareness and recognition, by reviewing clinical findings and imaging of patients across various modalities including plain radiographs, ultrasound and computed tomography. The management of neurogenic heterotopic ossification is limited by late identification and consequently clinicians should always be aware of this potentially significant diagnosis. Recognition in the acute hospital setting before transfer to rehabilitation services may prevent further clinical sequelae including urinary tract infection and pressure ulcers. PMID: 31822168 [PubMed - in process]
Source: British Journal of Hospital Medicine - Category: Internal Medicine Authors: Tags: Br J Hosp Med (Lond) Source Type: research
The objective of this study is to evaluate UTI diagnostic criteria along with RBUS and VCUG in neonates admitted to the NICU in the first 3 months of life.
Source: Pediatrics and Neonatology - Category: Perinatology & Neonatology Authors: Tags: Original Article Source Type: research
We report a case of a 27-day-old male neonate admitted in our clinic for fever, foul-smelling urine, and diarrhea. A previous abdominal ultrasound at the age of 2 weeks revealed enlarged, hyperechoic kidneys, no abnormalities of the urinary exam. Clinical examination revealed poor general status, ill-looking face, diminished cutaneous turgor, distended abdomen, and palpable kidneys. Laboratory tests pointed out leukopenia, anemia, border-line platelet count, elevated inflammatory biomarker level, hyponatremia, hypoalbuminemia, proteinuria, leukocyturia, and hematuria. Both urine and blood cultures were positive for E. coli...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report a case of a 25-year-old female patient with congenital genitourinary malformation and urethrovaginal fistula. A urogenital tract malformation repair operation was performed before she was 21 years old. Frequency of urination occurred before and after menstruation for 9 years, and dyspareunia occurred for 1 year. Diagnoses: B ultrasound examination showed a 59 × 55 × 23 mm fusiform region of increased signal intensity in the vagina followed by a sound shadow. We performed a gynecologic examination and found that the long diameter of the vaginal opening was 20 mm. A brown substance observ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusions: With the aid of a regular follow-up programme, SCI patients can achieve a relatively stable situation regarding urinary tract function. UTI is the most common complication. Indicators of renal complications are frequent but not clearly related to the number of UTIs, nor to intravesical filling pressures. Main risk factors for complications are cervical levels and more complete neurological lesions. PMID: 31630596 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Urology - Category: Urology & Nephrology Tags: Scand J Urol Source Type: research
CONCLUSIONS: Focal therapy of CaP lesions with a robotic HIFU-probe is safe and renders an acceptable rate of minor early AEs. The inclusion of the urethra in the ablation zone leads to an increase in early complications and should be avoided whenever possible. PMID: 31628038 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
We present a case of a 19-year-old male with recurrent episodes of urinary tract infection (UTI) and poor urinary stream. On ultrasound examination, the patient was found to have absent right kidney with a cystic swelling noted to be arising from prostate or seminal vesicle region which was further confirmed on MRI examination. Cystoscopy reveals a bulge on the right side of the verumontanum abutting the neck of the bladder. An ultrasound-guided aspiration of the cyst was performed which relieved the symptoms of the patient. Cystic abnormalities of the seminal vesicle are very uncommon. Symptomatic cases may present as rec...
Source: Urology Annals - Category: Urology & Nephrology Authors: Source Type: research
Publication date: Available online 2 October 2019Source: Seminars in Ultrasound, CT and MRIAuthor(s): A Patiño, EL Martinez-Salazar, J Tran, A Sureshkumar, T CatanzanoABSTRACTAcute urinary tract infection diagnosis is primarily performed on clinical grounds. Diagnostic imaging is, however, often necessary as part of the workup for poor response to treatment, to evaluate causative or contributory factors, complicated infections and chronic presentations. Appropriate knowledge of the most relevant radiological findings in urinary tract infections provides pertinent differential diagnosis and guides clinical management...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research
Ş Abstract Gültekin ND, Benzer M, Tekin-Neijmann Ş. Is there any relation between connective tissue growth factor and scar tissue in vesicoureteral reflux. Turk J Pediatr 2019; 61: 71-78. Vesicoureteral reflux (VUR) is the most common uropathy in childhood which leads to increased frequency of urinary tract infection (UTI) and renal scarring. Connective tissue growth factor (CTGF) plays an important role in the development of glomerular and tubulointerstitial fibrosis in progressive kidney diseases. The aim of this study was to investigate the relation between urinary CTGF and renal damage resulted from VU...
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
Abstract INTRODUCTION: We aimed to evaluate the impact of non-refluxing hydroureter on the initial management of high-grade hydronephrosis (HGH) management. Moreover, we evaluated the occurrence of febrile urinary tract infection (FUTI) and surgical intervention for conservatively managed units. METHODS: Patients' charts with postnatal hydronephrosis from 2008‒2014 were retrospectively reviewed. We included patients who presented in the first year of life. All included patients had HGH (Society of Fetal Ultrasound [SFU] grades3 and 4) and all were non-refluxing using voiding cystourethrogram (VCUG). We cate...
Source: Canadian Urological Association Journal - Category: Urology & Nephrology Authors: Tags: Can Urol Assoc J Source Type: research
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