Psychosocial Aspects of Diabetes
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
The diagnosis of panic disorder is based on medical history, review of current medications, a complete physical examination, discussion of symptoms and concerns, and a psychiatric assessment. There is evaluation of whether panic attacks are unexpected and recurrent. The patient and physician discuss whether one or more panic attacks was followed by at least 1 month of worrying about another attack, or changing behaviors to avoid having another attack. There is evaluation of any medical disorders, such as diabetes, that may be causative, along with medications or other substances. The patient must be evaluated about the possibility of having another type of mental health disorder. Diagnostic tests include blood and urine tests, various imaging studies, and electrocardiogram.
Quantitative methodologies and research designs
John Maltby, Glenn A. Williams, Julie McGarry, Liz Day in Research Methods for Nursing and Healthcare, 2014
Diagnostic trials are research methods that surround developing tools that can be used for recognising or detecting a particular disease. When a certain disease or health problem is suspected, diagnostic tests can be used to diagnose the underlying disease or problem. For example, in detecting lung cancer, imaging technologies such as magnetic resonance imaging (MRI) or computed tomography (CT) provide researchers with information on changes in the anatomy of the individual, but recently, researchers using diagnostic trials have found that positron emission tomography (PET) imaging, which uses biochemical processes, may be able to detect lung cancer before anatomic changes occur (Ung et al., 2007). The purpose of diagnostic and screening trials are often the same, i.e. to detect the health problem or condition early. Therefore, you will often find these two terms being used together, because a screen test can also be a diagnostic test.
Screening and Diagnostic Tests
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie in Principles of Biostatistics, 2022
Diagnostic tests, on the other hand, are used to confirm the diagnosis of a condition or disease. For example, we might test individuals who show symptoms of COVID-19, the disease caused by SARC-Cov-2 – such as a high temperature and/or breathing difficulties – for infection by the virus. Sometimes diagnostic tests are employed subsequent to a positive screening test; for example, a biopsy is often performed following a mammogram that is positive for breast cancer. Usually the proportion of individuals testing positive with a screening test is smaller than the proportion testing positive with a diagnostic test, because those being subjected to the diagnostic test are more likely to have the disease to begin with. This is certainly true in the early stages of an epidemic. For both types of tests, however, those who test positive are considered to be more likely to have the disease than those who test negative.
Characteristics and economic burden of frequent attenders with medically unexplained symptoms in primary care in Israel
Published in European Journal of General Practice, 2021
Oded Hammerman, Daniel Halperin, Daniel Tsalihin, Dan Greenberg, Talma Kushnir, Yacov Ezra
Utilisation and cost data were collected based on CHS’ administrative claims data. Actual CHS costs are presented. Services paid out of pocket or by supplementary insurance were not included. Utilisation rates for PCP visits are presented without costs, as PCP are salaried employees, and their costs are not captured in CHS’ administrative database. Utilisation/cost data for secondary and tertiary care were provided by CHS and reflect internal pricing estimates when services were provided directly by CHS or price rates when care was covered by CHS but provided externally. Costs are presented in Israeli Shekels (ILS); exchange rate 1 USD = 3.5 ILS. To present a more nuanced view, utilisation/cost data were analysed by type of service: (a) specialist consultations, (b) hospitalisations (visits priced by length of stay), (c) diagnostic tests (CT, MRI, etc.), (d) emergency department care (not resulting in hospitalisation), (e) laboratory tests, (f) surgeries (procedure-related group – PRG), (g) health professions’ services (physical therapy, occupational therapy, etc.), (h) medical equipment and (j) total costs (including prescribed medications). Other health conditions (e.g. diabetes, hypertension, chronic obstructive pulmonary disease and smoking) were also analysed.
Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease
Published in Scandinavian Journal of Gastroenterology, 2018
Neil D. Parikh, Artur V. Viana, Saloni Shah, Loren Laine
Our results suggest a possible algorithm to incorporate IEE modalities, available at no additional cost on current endoscopes, when patients with heartburn not responsive to anti-secretory therapy undergo upper endoscopy. Although IEE may not be sensitive enough to rule out non-erosive GERD, its specificity appears to be very high in our study and in prior studies of non-erosive GERD in which patients were responsive to PPI or PPI therapy was not mentioned [8–10]. For example, a finding of micro-erosions in our study (present in 57% of patients) had a specificity of 93%, while a finding of micro-erosions and vascularity at the squamocolumnar junction (present in 47% of patients) had a specificity of 98%. Two prior studies reported specificities of 100% for micro-erosion (no micro-erosions in control populations) [8,9], although a third study reported micro-erosions in 23% of the controls [10]. Diagnostic tests that are highly specific are useful in ruling in a diagnosis.
Evaluation of the diagnostic performance of an immunoblot for ANCA and anti-GBM antibody detection
Published in Autoimmunity, 2021
Matthias H. Busch, Joop P. Aendekerk, Joyce J. B. C. van Beers, Pieter van Paassen, Jan G. M. C. Damoiseaux
Limitations of our study are its retrospective design and relatively small number of controls. When a diagnostic test is used in a population with a lower disease prevalence, relatively more false-positive results will be found. It is therefore important that patients to be tested should be carefully selected based upon a given pre-test probability for AAV or anti-GBM disease (i.e. suspicion of RPGN or ANCA confirmatory settings). For this reason, we used disease controls with a diagnosis of non-ANCA vasculitis, which all together is a highly representative group to be tested for the presence of ANCA or anti-GBM antibodies. Moreover, the ANCA and anti-GBM cohort in this study are mainly patients with renal involvement. Patients with pulmonary haemorrhage may be underrepresented. On the other hand, 124 patients had biopsy-proven renal AAV or anti-GBM disease, which is a highly accurate diagnostic measure for active systemic vasculitis. Finally, the control group was used as disease-free reference group for the evaluation of the diagnostic accuracy of the immunoblot in the RPGN setting as well. RPGN was not primarily seen in this cohort, which differed from our disease group. This may partially explain the remarkably high diagnostic accuracy of the immunoblot for anti-GBM in our study.
Related Knowledge Centers
- Screening
- Molecular Diagnostics
- Medical Procedure
- Medical Diagnosis
- Monitoring
- Medical Imaging
- Clinical Chemistry
- Medical Laboratory
- Retrospective Diagnosis
- Nuclear Medicine